Waist Circumference In Participants Research Articles

Dietary approach to stop hypertension and healthy eating index 2015, modify the association between FTO polymorphisms and obesity phenotypes

This study aimed to investigate the interaction of the healthy eating index (HEI) and the dietary approach to stop hypertension (DASH) diet scores with FTO polymorphisms in relation to change in obesity traits. A total of 4480 subjects aged ≥ 18 years were selected from participants of the Tehran lipid and glucose study and followed-up 3 years. Selected polymorphisms (rs1421085, rs1121980, rs8050136) were genotyped and genetic risk score (GRS) was computed. HEI and DASH scores were computed based on dietary data. Changes in body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and visceral adiposity index (VAI) were measured. Higher adherence to both DASH and HEI scores were increased with higher ages. Individuals with high GRS had a lower change in BMI when they had higher adherence to HEI, compared to subjects with lower HEI score (P trend = 0.01). Change in WC in participants in the fourth quartile of HEI score in minor allele carriers of FTO variants was lower compared to the first quartile; conversely, higher adherence to the DASH score by this genotypic group was related to increase in WC. No significant interaction was seen between FTO polymorphisms and both diet scores regarding changes in any of obesity traits. In conclusion, in individuals with high GRS higher adherence to HEI score was associated with lower change in BMI and WC, while higher adherence to DASH diet was associated with higher change in WC, compared to individuals with lower adherence to both scores.

Waist circumference and end-stage renal disease based on glycaemic status: National Health Insurance Service data 2009-2018.

Obesity is associated with an increased risk of developing type 2 diabetes mellitus (T2DM) and end-stage renal disease (ESRD). This study aimed to examine the effect of waist circumference (WC) on the risk for ESRD based on glycaemic status in a Korean population-based sample. This cohort study with a 9.2-year follow-up period used a population-based National Health Insurance Service health checkup database with approximately 10585852 participants who were followed up from 2009 to the time of ESRD diagnosis. WC was categorized into seven levels in 5-cm increments, with Level 4 as the reference group. Glycaemic status was categorized into the following groups: normal fasting glucose (NFG), impaired fasting glucose (IFG), newly diagnosed T2DM, T2DM treated with ≤2 oral hypoglycaemic agents (OHAs) and diabetes treated with ≥3 OHAs or insulin. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for ESRD according to WC values and glycaemic status of the participants. The study finally included 10177245 patients with a mean age of 47.1 (13.8) years. The study population included 5604446 men (55.1%) and 4572799 women (45.9%). In total, 8.3% (n=877143) of the study population had diabetes. During the mean follow-up of 9.2 (1.0) years (93554951 person-years of follow-up), 23031 individuals were newly diagnosed with ESRD. The ESRD risk increased in parallel with an increase in WC in participants without T2DM, that is, the NFG and IFG groups (adjusted HRs [95% CIs] of WC Levels 4, 5 and 6: 1.17 [1.09-1.26], 1.37 [1.25-1.51] and 1.84 [1.63-2.07] in the NFG group and 1.06 [0.97-1.16], 1.23 [1.10-1.38] and 1.80 [1.57-2.06] in the IFG group, respectively). In patients with T2DM, the risk for ESRD was significantly increased in those with a low WC (adjusted HRs [95% CIs] of WC Level 1: 2.23 [1.77-2.80], 3.18 [2.70-3.74] and 10.31 [9.18-11.59] in patients with newly diagnosed diabetes, patients on ≤2 OHAs and those on ≥3 OHAs or insulin, respectively). The association between WC and ESRD thus showed a J-shaped pattern in patients with newly diagnosed T2DM and a U-shaped pattern in those on ≤2 OHAs and on ≥3 OHAs or insulin. Central obesity substantially increases the risk of developing ESRD regardless of glycaemic status. The harmful effects of low WC only become significant with the progression of T2DM.

693-P: Significant Changes in Dietary Behaviour, Glycemic Control, and Weight after Participation in Personalized Glycemic Response–Based Diabefly Program

Background: Retrospective evaluation of glycemic responses correlated with lifestyle habits can help in mapping personalized glycemic responses (PGR) for individuals. PGR can aid in more specific nutritional interventions in individuals with diabetes ultimately aiding in better glycemic control and weight management. Methods: Participants (n=108, mean age 47.24± 12.28 years, 55.5% females) were enrolled in PGR based Diabefly program and were provided with support for lifestyle modification through a combination of expert led care and mobile application. The outcomes were analyzed at the beginning and end of the program. Paired t-test was used for analysis with P<0.considered as statistically significant. Results: After the program, the daily mean calorie intake significantly reduced by 9.34 ± 30.3 % from a baseline of 1466.93 ± 408.16 cal (P<0.001) . Similarly, the daily mean carbohydrate and fat intake significantly reduced by 10.44 ± 31.99 % and 7.95 ± 39.90 % respectively (P<0.0for both) . The daily mean fiber intake improved by 4.74 ± 44.9 % from the baseline (P=0.26) . Further, the mean energy attributed from protein showed a significant increase by 10.36 ± 25.31 % (P<0.001) . Among participants (n=66) who provided complete data of body weight, BMI, and HbA1c a significant reduction was observed by 3.41 ± 3.33 kg, 1.16± 1.kg/m2, and 2.02 ± 1.73% from a baseline of 76.42 ± 16.61 kg, 27.34 ± 4.40 kg/m2, and 8.78 ± 1.90 % respectively (P<0.0for all) . Waist circumference in participants with complete data (n=53) showed a mean reduction by 4.85 ± 4.45 % from the baseline of 100.3 ± 14.1 cm (P<0.001) . Conclusion: Significant change in dietary behavior was observed after the completion of the program. Effective weight reduction, waist circumference reduction, and improved glycemic control was also observed suggesting the potential of understanding PGR in an effective manner through the Diabefly program for improved outcomes. Disclosure R.Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. A.K.Singal: Other Relationship; Fitterfly Healthtech Pvt Ltd. M.A.Khader: Employee; Fitterfly HealthTech Pvt Ltd. R.M.Ranadive: Employee; Fitterfly Healthtech Pvt Ltd. S.Budyal: None. A.A.Saraf: None. V.Raskar: None. A.Sarwate: None. M.V.Joshi: None. S.Joshi: Consultant; Fitterfly Health Tech Pvt Ltd, Wellthy Therapeutics Pvt Ltd.

Macronutrient composition of the diet and long-term changes in weight and waist circumference in the EPIC–Italy cohort

Background and aimsThe overall macronutrient composition of diet, rather than just calorie intake, may influence long-term changes of anthropometry. We investigated relationships between dietary macronutrient composition and long-term changes in weight and waist circumference in participants of the EPIC–Italy – the Italian section of the European Prospective Investigation into Cancer and Nutrition – study. Methods and resultsA total of 32,119 participants provided anthropometric measures at recruitment and 12 years later (mean). Diet at recruitment was assessed using validated semi-quantitative food frequency questionnaires. Weight and waist changes associated with replacing 10% of energy from one macronutrient with 10% of energy from another macronutrient were assessed by multivariable linear regression.Increased energy from total protein at the expense of any other macronutrient was significantly associated with increased weight and waist circumference. Increased starch at the expense of sugar and total protein was associated with significantly decreased weight and waist circumference; when starch replaced total fat, weight significantly decreased. Increased sugar at the expense of starch and total fat was significantly associated with increased weight and waist circumference; but increase at the expense of total protein was significantly associated with decreased weight and waist circumference. ConclusionOur results suggest that increasing protein at the expense of fat or carbohydrates, and reducing starch by increasing other macronutrients, might be associated with increased weight and waist gain.

The Most Important Predictors of Metabolic Syndrome Persistence after 10-year Follow-Up: YHHP Study.

Background:Metabolic syndrome (MetS) is one of the world's largest health epidemics, and its management is a major challenge worldwide. The aim of this 10-year follow-up study was to assess the most important predictors of MetS persistence among an Iranian adult population.Methods:In this cohort study, 887 out of 2000 participants with MetS aged 20–74 years in the central part of Iran were followed-up for about 10 years from 2005–2006 to 2015–2016. MetS was defined based on the criteria of NCEP-ATP III adopted for the Iranian population. Cox proportional hazards regression was conducted to evaluate the predictors of MetS persistence in crude- and multivariate-adjusted models.Results:Our analyses showed that 648 out of 887 participants (73%) completed the follow-up and 565 (87.2%) of them had persistence of MetS after 10-year follow-up. There was a significant association between age, weight, body mass index, triglyceride, and waist circumference in participants who had MetS compared to those without MetS after 10-year follow-up (P < 0.05). There was a direct association between increases in the mean changes of systolic/diastolic blood pressure, waist circumference, and low HDL-C and risk of MetS persistence after adjusting the model for sex and age in the total population (Ptrend < 0.05). The trends were the same for women except in diastolic blood pressure. After adjustment for potential confounders, the risk of MetS persistence in men was significantly higher than women (HR = 1.98, 95% CI: 1.38–2.85, Ptrend = 0.001).Conclusions:Most of the risk factors of MetS were positively associated with persistence of MetS. Therefore, modification of lifestyle is recommended to reduce MetS.

Secondhand smoke, obesity, and risk of type II diabetes among California teachers

PurposeTo examine if secondhand smoke (SHS) is associated with elevated risk of type II diabetes among California teachers. We also aim to determine if overall and central obesity are mediators or effect modifiers of this association. MethodsUsing data from the California Teachers Study, conducted in 1995–2013 in California public schools, we obtained information on SHS exposure among 39,887 lifetime nonsmokers. The association between SHS and incident diabetes after 17 years of follow-up was assessed using Cox regression models. The mediation and modification effects of BMI and waist circumference on this association were tested. ResultsAt baseline, 70.2% of the nonsmokers reported exposure to SHS. Higher intensity, duration, and intensity-years of exposure to SHS were associated with higher multivariate adjusted risk of incident diabetes in a dose-response manner (hazard ratio = 1.28; 95% confidence interval, 1.11–1.48 for highest quartile vs. lowest quartile of exposure; P = .001 for trend). Participant's waist circumference (measured 2 years after baseline) could explain greater than 50% of the association between SHS and diabetes. ConclusionsSHS exposure is associated with increased risk of type II diabetes among nonsmokers of California teachers with obesity being a potentially important mediator but not an effect modifier for this association.

Is obesity associated with impaired reaction time in youth?

Recent research demonstrates a significant relationship between weight status and impaired reaction time in young, adult, and elderly individuals. However, most such studies were performed on small samples, used only body mass index as the body obesity index, used simple reaction time, and oftentimes did not consider some potential confounders such as age, socioeconomic status, or physical activity in their studies. The present study explored the relationship between various reaction time tasks and various obesity indices in a sample of youth. Two hundred and thirty-four young males (19-24years) underwent standard anthropometry, various information processing tasks (e.g., clinical reaction time, simple audio and visual reaction time, and choice reaction time), as well as an inhibitory control task (congruent and incongruent Simon reaction time). Results revealed no significant relationship between any of the information processing tests and body mass index, nor for fat percentage, waist circumference, and waist-to-height ratio after adjustment for potential confounders. A weak positive association was observed only between congruent Simon reaction time (but not incongruent Simon reaction time) and waist circumference in participants (t value = 0.199; Std error = 0.0014; p = 0.047; Cohen's f2 = 0.09). Inhibitory control, but not information processing speed, was associated only with waist circumference in apparently healthy young men. LevelI, experimental study.

Eating frequency and weight loss: results of 6 months follow up of a public health campaign at Aurangabad

Background: Obesity is a major health problem in developed as well as developing countries. The “carbo-insulin connection” theory was popularized by late Dr. Shrikant Jichkar from 1997 to 2004. He advocated the idea of eating only twice a day to lose weight and prevent obesity. The author tried this theory on himself from January to March 2013 and lost 8kg of weight and 2 inches from his belly! Since then the author is conducting lectures for lay people educating them about eating twice and losing weight. Author has addressed audiences in many cities and towns of Maharashtra. The present study provides the encouraging results of this public health campaign. Methods: This study was a self-controlled community trial. The tenure of the study was from 1 st July 2013 to 30 th June 2014. The subjects were enrolled in the study after taking their informed consent during the author’s lectures on weight loss arranged in various cities and towns of Maharashtra. The author got pretested questionnaires filled from the audience who attended his lectures on weight loss. The follow up was done on phone every fortnightly. Total 446 individuals participated in this campaign. Results: The weight loss and decrease in waist circumference in participants was as below: weight loss: average 1.5 kg in first month, 4.2 kg in 3 months and 6.8 kg in 6 months; inches loss: average 0.5 cm in 1 st month, 1.5 cm in 3 months and 3.5 cm in 6 months. No side effects were observed. Conclusions: The weight loss activities have taken a form of exploitative business for many. Poor and ignorant people are being looted. This simple method of weight loss costs nothing, there is no requirement of a doctor and contrary to many other successful methods of weight loss, can be followed for a life time. Hence such a simple method should be advocated for all. There is a need to spread this message in the form of a public health campaign.

Physical Environment May Modify the Association Between Depressive Symptoms and Change in Waist Circumference: The Multi-Ethnic Study of Atherosclerosis

Although the bidirectional association between depressive symptoms and adiposity has been recognized, the contribution of neighborhood factors to this relationship has not been assessed. This study evaluates whether physical and social neighborhood environments modify the bidirectional relationship between depressive symptoms and adiposity (measured by waist circumference and body mass index). Using data on 5,122 men and women (ages 45 to 84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) we investigated whether neighborhood physical (i.e., walking environment and availability of healthy food) and social (i.e., safety, aesthetics, and social coherence) environments modified the association between the following: (1) baseline elevated depressive symptoms (Center for Epidemiologic Study Depression Scale score ≥ 16) and change in adiposity (as measured by waist circumference and body mass index) and (2) baseline overweight/obesity (waist circumference > 102 cm for men and >88 cm for women, or body mass index ≥ 25 kg/m(2)) and change in depressive symptoms using multilevel models. Neighborhood-level factors were obtained from the MESA Neighborhood Study. A greater increase in waist circumference in participants with vs without elevated depressive symptoms was observed in those living in poorly-rated physical environments but not in those living in better-rated environments (interaction p = 0.045). No associations were observed with body mass index. Baseline overweight/obesity was not associated with change in depressive symptoms and there was no modification by neighborhood-level factors. Elevated depressive symptoms were associated with greater increase in waist circumference among individuals living in poorly-rated physical environments than in those in better-rated physical environments. No association was found between overweight/obesity and change in depressive symptoms.

Combined Impact of Lifestyle Factors on Prospective Change in Body Weight and Waist Circumference in Participants of the EPIC-PANACEA Study

BackgroundThe evidence that individual dietary and lifestyle factors influence a person’s weight and waist circumference is well established; however their combined impact is less well documented. Therefore, we investigated the combined effect of physical activity, nutrition and smoking status on prospective gain in body weight and waist circumference.MethodsWe used data of the prospective EPIC-PANACEA study. Between 1992 and 2000, 325,537 participants (94,445 men and 231,092 women, aged between 25–70) were recruited from nine European countries. Participants were categorised into two groups (positive or negative health behaviours) for each of the following being physically active, adherent to a healthy (Mediterranean not including alcohol) diet, and never-smoking for a total score ranging from zero to three. Anthropometric measures were taken at baseline and were mainly self-reported after a medium follow-up time of 5 years.ResultsMixed-effects linear regression models adjusted for age, educational level, alcohol consumption, baseline body mass index and follow-up time showed that men and women who reported to be physically active, never-smoking and adherent to the Mediterranean diet gained over a 5-year period 537 (95% CI −706, −368) and 200 (−478, −87) gram less weight and 0.95 (−1.27, −0.639) and 0.99 (−1.29, −0.69) cm less waist circumference, respectively, compared to participants with zero healthy behaviours.ConclusionThe combination of positive health behaviours was associated with significantly lower weight and waist circumference gain.