Weight Obesity Research Articles

Obesity paradox and stroke outcomes according to stroke subtype: a propensity score-matched analysis.

Obesity has traditionally been considered a risk factor for ischemic stroke. However, some clinical observations have reported a complex relationship between patients who are overweight or obese with paradoxically better stroke outcomes. Stroke subtypes have differing distributions of risk factors, so this study aimed to explain the relationship between body mass index (BMI) and functional prognosis according to stroke subtype. A prospective institutional database on stroke was accessed between March 2014 and December 2021, and consecutive patients with ischemic stroke were retrospectively selected. BMI was categorized into five groups (underweight, normal weight, overweight, obese, and morbid obesity). The outcome of interest in this study was the modified Rankin Scale (mRS) at 90 d, which was divided into favorable (mRS = 0-2) and unfavorable (mRS ≥ 3) groups. The relationship between functional outcome and BMI was analyzed according to stroke subtype. Among 2779 patients with stroke, 913 (32.9%) had unfavorable outcomes. After a propensity score-matched analysis, obesity was inversely associated with unfavorable outcomes (adjusted odds ratio [aOR] = 0.61, 95% confidence interval [95% CI]: 0.46-0.80) in all patients with stroke. Among the stroke subtypes, overweight (aOR = 0.38, 95% CI: 0.20-0.74) and obese (aOR = 0.40, 95% CI: 0.21-0.76) groups were inversely associated with unfavorable outcomes in the cardioembolism subtype. Obesity (aOR = 0.55, 95% CI: 0.32-0.95) was inversely associated with unfavorable outcomes in the small vessel disease subtype. There was no significant relationship between stroke outcome and BMI classification in the large artery disease subtype. These findings suggest that the obesity paradox in ischemic stroke outcomes might differ according to the stroke subtype.

Overweight and Obese Indians' Attitudes Toward Obesity, Willingness to Lose Weight, and Treatment Preferences

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Temporal Changes in Energy-Balance Behaviors and Home Factors in Adolescents with Normal Weight and Those with Overweight or Obesity.

This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; ), ≤ six months before (T1; ), and ≤ three months after the COVID-19 pandemic outbreak (T2; ), to capture energy-balance behaviors (i.e., physical activity [PA], screen time, sleep) and home factors (i.e., food environment, food worry, parent support for PA). At T0 and T1 (before pandemic), participants visited our laboratory for anthropometric measurements. At T2, parent proxies also completed a survey to report the COVID-19 pandemic exposure and impact. The participating families experienced moderate levels of pandemic exposure and impact, although exposure was higher in the OWOB group . Repeated-measure multivariate analyses of covariance (RM-MACOVAs) did not show significant time by weight status interaction effects (; adjusted for race and sex). However, the models detected significant time (T0 vs. T2) by race (White vs. non-White) interaction effect , with greater increase in food worry but less increase in screen time among the non-White group. Graphical visualization depicted some favorable change patterns in adolescents with normal weight (vs. those with OWOB) for certain behaviors and home factors (e.g., number of days per week ≥ 60 mins PA, food worry). These findings suggest that the COVID-19 pandemic exerted greater adverse effects on adolescents with OWOB and specifically on screen time and food worry among non-White adolescents.

The effect of empowerment program to reduce Sugar Consumption based on the Multi-Theory Model on Body Mass Index and abdominal obesity in Iranian women

BackgroundConsidering the prevalence of overweight and abdominal obesity in middle-aged women, this study was conducted to determine the effect of empowerment program to reduce sugar consumption based on the Multi-Theory Model (MTM) on Body Mass Index (BMI) and abdominal obesity in women aged 30–60 in Joven.MethodsThis quasi-experimental study (include descriptive and interventional sections) was conducted on the Joven city, Khorasan Razavi province, Iran country from October 2020 to August 2021. Sampling was performed as a multi-stage cluster. First, a descriptive study was performed among 400 women, and then 128 people who were eligible to enter the interventional phase of the study were selected. In the control group, 63 people and in the intervention group, 65 people were eligible to enter the study. The educational intervention was performed in five 60-minute sessions for groups of 12 people. The instruments included the demographic questionnaire, sugar consumption checklist and researcher-made questionnaire based on MTM constructs. Before the intervention, one, three and six months after the intervention, the questionnaire was completed by both intervention and control groups also measurement of waist circumference and BMI were performed using standard instruments. The obtained data were analyzed by SPSS 17.ResultsAfter the educational intervention, there was a significant difference between the intervention and control groups in all the MTM constructs. Also, six months after the educational intervention, BMI, waist circumference and amount of consumption of sugary substances decreased significantly in the intervention group (p < 0.05).ConclusionEducational intervention based on the MTM can be effective in reducing the consumption of sugary substances and shaping behaviors related to healthy lifestyle in women.

Umbilical cord DNA methylation is associated with body mass index trajectories from birth to adolescence

DNA methylation (DNAm) in cord blood has been associated with various prenatal factors and birth outcomes. This study sought to fill an important knowledge gap: the link of cord DNAm with child postnatal growth trajectories from birth to age 18 years (y). Using data from a US predominantly urban, low-income, multi-ethnic birth cohort (N=831), we first applied non-parametric methods to identify body-mass-index percentile (BMIPCT) trajectories from birth to age 18y (the outcome); then, conducted epigenome-wide association study (EWAS) of the outcome, interrogating over 700,000 CpG sites profiled by the Illumina Infinium MethylationEPIC BeadChip. Multivariate linear regression models and likelihood ratio tests (LRT) were applied to examine the DNAm-outcome association in the overall sample and sex strata. We identified four distinct patterns of BMIPCT trajectories: normal weight (NW), Early overweight or obesity (OWO), Late OWO, and normal to very late OWO. DNAm at CpG18582997 annotated to TPGS1, CpG15241084 of TLR7, and cg24350936 of RAB31 were associated with BMIPCT at birth-to-3 y, 10y, and 14y, respectively (LRT FDR < 0.05 for all). In this prospective birth cohort study, we identified 4 distinct and robust patterns of growth trajectories from birth to 18y, which were associated with variations in cord blood DNAm at genes implicated in inflammation induction pathways. These findings, if further replicated, raise the possibility that these DNAm markers along with early assessment of BMIPCT trajectories may help identify young children at high-risk for obesity later in life. Detailed in the Acknowledgements section.

Evaluating the seroprevalence of SARS-CoV-2 IgG in five different districts of Bangladesh. A seroepidemiological study

BackgroundWe aimed to measure the seroprevalences and levels of anti-SARS-CoV-2 IgG in children, unvaccinated and vaccinated adults in five districts of Bangladesh and thus, investigate the association of seroprevalence and anti-SARS-CoV-2 IgG level with respect to different attributes of study participants. MethodsIn the present study, the seroprevalences and levels of plasma anti-SARS-CoV-2 IgG were measured in children (n = 202), unvaccinated adults (n = 112), and vaccinated adults (n = 439) using quantitative ELISA. ResultsThe overall seroprevalence in the three groups of the study participants were 58.3% (90%CrI: 52.3–64.2%), 62.2% (90%CrI: 54.4–70.0%) and 90.7% (90%CrI: 88.3–92.9%), respectively. Multivariate logistic and linear regression revealed no significant association of seropositivity and levels of anti-SARS-CoV-2 IgG with the baseline characteristics of the children. AB blood group (vs A; aOR=0.21, 95% CI: 0.04–0.92, p = 0.04), O blood group (vs A; aOR=0.09, 95% CI: 0.02–0.32, p = 0.0004), BMI (aOR=1.61, 95% CI: 1.14-2.37, p = 0.01) and overweight obesity status (vs normal, aOR=0.12, 95% CI: 0.02-0.76, p = 0.03) were significantly associated with seropositivity in unvaccinated adults after adjusting for confounders. Age (p = 0.002) was significantly associated with anti-SARS-CoV-2 level in vaccinated adults after adjusting for confounders. Most of the children and unvaccinated adults belonged to the lower antibody response class which implicates the necessity of vaccination. ConclusionThis study portrays a better way of evaluating transmission of virus and gain a better understanding of the true extent of infection as illustrated by the high rates of seroprevalences in children and unvaccinated adults. The findings of this study depicted from the antibody response also suggest the importance of vaccination.

Effects of Physical Activity, Fruit and Vegetables Intake, and Alcohol Consumption on Overweight or Obesity: Meta-Analysis

Background: Overweight or obesity is a public health problem worldwide which is increasing both in the general population and in people with chronic diseases. Overall both children and adults are vulnerable to overweight or obesity. This study aims to examine the effect of physical activity, consumption of vegetables and alcohol on overweight or obesity using a meta-analysis.Subjects and Method: Meta-analysis was carried out using the PRISMA flowchart and the PICO model. Population: age 6 to 64 years. Intervention: low physical activity, low vegetable and fruit consumption, and high alcohol. Comparison: high physical activity, high vegetable and fruit consumption, and alcohol low. Outcome: overweight or obese. The databases used are Google Scholar, PubMed, and Proquest with keywords (Overweight OR Obesity OR "BMI Status") AND (“Physical Activity” OR Exercise OR Sport OR Inactive) AND (Vegetable AND Fruit) AND Alcohol AND "Cross Sectional" AND aOR. There were 22 cross-sectional studies published in 2012-2022 that met the inclusion criteria. Analysis was performed with RevMan 5.3.Results: A meta-analysis was conducted on 22 articles with a cross-sectional study design originating from Indonesia, Ghana, Arab Emirates, Texas, Ethiopia, Uganda, Botswana, Congo, Bahir Dar, North Western, Toronto, Zambia, Cameroon and Tanzania involving 91,031 ages 6-64 years. The results of the meta-analysis showed that someone with low physical activity had a risk of being overweight or obese 1.35 times compared to high physical activity (aOR= 1.35; 95% CI= 1.09 to 1.68; p&lt;0.001), someone with high consumption of vegetables and fruit have a risk of experiencing overweight or obesity 1.40 times compared to high consumption of vegetables and fruits (aOR= 1.40; 95%CI= 0.94 to 2.08; p&lt;0.001), and someone with high alcohol has a risk of experiencing overweight or obesity 1.47 times compared low alcohol (aOR= 1.47; 95% CI= 1.31 to 1.65; p&lt;0.001).Conclusion: Low vegetable and fruit consumption, high alcohol consumption and low physical activity can increase the risk of being overweight or obese. Keywords: social support, self-efficacy, social cognitive theory, hypertension, medication adherence Correspondence: Dena Tri Solehaini. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dena35tri@gmail.com. Mobile: +6282329210977.

Subcutaneous Adipose Tissue Transcriptome Highlights Specific Expression Profiles in Severe Pediatric Obesity: A Pilot Study.

The prevalence of pediatric obesity is rising rapidly worldwide, and "omic" approaches are helpful in investigating the molecular pathophysiology of obesity. This work aims to identify transcriptional differences in the subcutaneous adipose tissue (scAT) of children with overweight (OW), obesity (OB), or severe obesity (SV) compared with those of normal weight (NW). Periumbilical scAT biopsies were collected from 20 male children aged 1-12 years. The children were stratified into the following four groups according to their BMI z-scores: SV, OB, OW, and NW. scAT RNA-Seq analyses were performed, and a differential expression analysis was conducted using the DESeq2 R package. A pathways analysis was performed to gain biological insights into gene expression. Our data highlight the significant deregulation in both coding and non-coding transcripts in the SV group when compared with the NW, OW, and OB groups. A KEGG pathway analysis showed that coding transcripts were mainly involved in lipid metabolism. A GSEA analysis revealed the upregulation of lipid degradation and metabolism in SV vs. OB and SV vs. OW. Bioenergetic processes and the catabolism of branched-chain amino acids were upregulated in SV compared with OB, OW, and NW. In conclusion, we report for the first time that a significant transcriptional deregulation occurs in the periumbilical scAT of children with severe obesity compared with those of normal weight or those with overweight or mild obesity.

Overweight and Obesity: Its Impact on Foot Type, Flexibility, Foot Strength, Plantar Pressure and Stability in Children from 5 to 10 Years of Age: Descriptive Observational Study

Overweight (OW) and childhood obesity (OB) may cause foot problems and affect one's ability to perform physical activities. The study aimed to analyze the differences in descriptive characteristics, foot type, laxity, foot strength, and baropodometric variables by body mass status and age groups in children and, secondly, to analyze the associations of the BMI with different physical variables by age groups in children. A descriptive observational study involving 196 children aged 5-10 years was conducted. The variables used were: type of foot, flexibility, foot strength and baropodometric analysis of plantar pressures, and stability by pressure platform. Most of the foot strength variables showed significant differences between the normal weight (NW), OW and OB groups in children aged between 5 and 8. The OW and OB groups showed the highest level of foot strength. In addition, the linear regression analyses showed, in children aged 5 to 8 years, a positive association between BMI and foot strength (the higher the BMI, the greater the strength) and negative association between BMI and stability (lower BMI, greater instability). Children from 5 to 8 years of age with OW and OB show greater levels of foot strength, and OW and OB children from 7 to 8 years are more stable in terms of static stabilometrics. Furthermore, between 5 and 8 years, having OW and OB implies having more strength and static stability.

Central obesity in the adult populations of the Altai Republic and the Republic of Tuva. Anthropological and genetic aspects

In the present study, we identified the factors affected central obesity prevalence in the adult Altains, Russians and Tuvans permanently residing in the Altai and the Tuva Republics. The data was collected in 2018–2020. The examination program included anthropometrical examination and the genetic testing of females and males, aged 18–35 years. Anthropometrical examination was carried out in accordance with the guidelines accepted in the Research Institute and Museum of Anthropology. Body composition was analyzed by bioelectrical impedance analyzer. The SNPs rs1800592 UCP1, rs660339 UCP2 and rs1800849 UCP3 were assessed. The prevalence analyses of underweight, overweight and general obesity in the groups of female and males were conducted. The anthropometric indices were used to estimate the prevalence of central obesity. General obesity occurred more often in the group of Altai people, whereas in the Tuva people the central obesity is more pronounced. The Altai and Tuva people are alike in the total body measurements, whereas Russians were significantly higher. All studied groups demonstrated the sexual dimorphism of the body composition and waist to hip ratio. No significant differences in waist to height ratio between males and females were identified in the studied groups. No association between genetic variants and the obesity-related traits, which reflect the body fat and its distribution, was revealed. All factors included in the model are able to predict 8 % of the variability of the central obesity-related traits. Ethnic background contributes the most to the variability of the central obesity index.

Melatonin Prescription in Children and Adolescents in Relation to Body Weight and Age.

The prescription of melatonin to children and adolescents has increased dramatically in Sweden and internationally during the last ten years. In the present study we aimed to evaluate the prescribed melatonin dose in relation to body weight and age in children. The population-based BMI Epidemiology Study Gothenburg cohort has weight available from school health care records, and information on melatonin prescription through linkage with high-quality national registers. We included prescriptions of melatonin to individuals below 18 years of age where a weight measurement not earlier than three months before, or later than six months after the dispensing date, was available (n = 1554). Similar maximum doses were prescribed to individuals with overweight orobesity as to individuals with normal weight, and to individuals below and above 9 years of age. Age and weight only explained a marginal part of the variance in maximum dose, but were inversely associated and explained a substantial part of the variance in maximum dose per kg. As a result, individuals overweight or with obesity, or age above 9 years, received lower maximum dose per kg of body weight, compared with individuals with normal weight or below 9 years of age. Thus, the prescribed melatonin dose to individuals under 18 years of age is not primarily informed by body weight or age, resulting in substantial differences in prescribed dose per kg of body weight across BMI and age distribution.

Interactive effect of prepregnancy overweight/obesity and GDM history on prevalence of GDM in biparous women.

Prepregnancy overweight/obesity (OWO) and gestational diabetes mellitus (GDM) history may increase the prevalence of GDM in parous women, but little is known about their potential combined effect on the prevalence of GDM in biparous women. This study aims to explore the interactive effect of prepregnancy overweight/obesity (OWO) and GDM history on the prevalence of GDM in biparous women. A retrospective study was conducted on 16,282 second-birth women who delivered a single neonate at ≧28 weeks of gestation twice. Logistic regression was used to assess the independent and multiplicative interactions of prepregnancy overweight/obesity (OWO) and GDM history on the risk of GDM in biparous women. Additive interactions were calculated using an Excel sheet that was made by Anderson to calculate relative excess risk. A total of 14,998 participants were included in this study. Both prepregnancy OWO and GDM history were independently associated with an increased risk of GDM in biparous women (odds ratio (OR) = 19.225, 95% confidence interval (CI) = 17.106, 21.607 and OR = 6.826, 95% CI = 6.085, 7.656, respectively). The coexistence of prepregnancy OWO and GDM history was associated with GDM, with an adjusted OR of 1.754 (95% CI, 1.625, 1.909) compared to pregnant women without either condition. The additive interaction between prepregnancy OWO and GDM history was found to be not significant with regard to GDM in biparous women. Prepregnancy OWO and GDM history both increase the risk of GDM in biparous women and have multiplicative interactions but not additive interactions.

Body mass index and death by cognitive impairment.

Epidemiological studies have reported that among participants with impaired cognitive, overweight and mild obesity are associated with substantially improved survival, this finding has been termed the "obesity paradox" and has led to uncertainty about secondary prevention. To explore whether the association of BMI with mortality differed in different MMSE score, and whether the obesity paradox in patient with cognitive impairment (CI) is real. The study used data from CLHLS, a representative prospective population-based cohort study in China, which included 8348 participants aged ≥ 60years between 2011 and 2018. The independent association between BMI and mortality in differed MMSE score by calculating hazard ratios (HRs) in multivariate Cox regression analysis. During a median (IQR) follow-up of 41.18months, a total of 4216 participants died. In the total population, underweight increased the risk of all-cause mortality (HRs, 1.33; 95% CI 1.23-1.44), compared with normal weight, and overweight was associated with a decreased risk of all-cause mortality (HR 0.83; 95% CI 0.74-0.93). However, compared to normal weight, only underweight was associated with increased mortality risk among participants with MMSE scores of 0-23, 24-26, 27-29, and 30, and the fully-adjusted HRs (95% CIs) for mortality were 1.30 (1.18, 1.43), 1.31 (1.07, 1.59), 1.55 (1.34, 1.80) and 1.66 (1.26, 2.20), respectively. The obesity paradox was not found in individuals with CI. Sensitivity analyses carried out had hardly any impact on this result. We found no evidence of an obesity paradox in patients with CI, compared with patients of normal weight. But underweight individuals may have increased mortality risk whether in the population with CI or not. And overweight/obese people with CI should continue to aim for normal weight.

High Fat-to-Muscle Ratio Was Associated with Increased Clinical Severity in Patients with Abdominal Trauma

Overweight and moderate obesity confer a survival benefit in chronic diseases such as coronary artery disease and chronic kidney disease, which has been termed the "obesity paradox". However, whether this phenomenon exists in trauma patients remains controversial. We performed a retrospective cohort study in abdominal trauma patients admitted to a Level I trauma center in Nanjing, China between 2010 and 2020. In addition to the traditional body mass index (BMI) based measures, we further examined the association between body composition-based indices with clinical severity in trauma populations. Body composition indices including skeletal muscle index (SMI), fat tissue index (FTI), and total fat-to-muscle ratio (FTI/SMI) were measured using computed tomography. Our study found that overweight was associated with a four-fold risk of mortality (OR, 4.47 [95% CI, 1.40-14.97], p = 0.012) and obesity was associated with a seven-fold risk of mortality (OR, 6.56 [95% CI, 1.07-36.57], p = 0.032) compared to normal weight. Patients with high FTI/SMI had a three-fold risk of mortality (OR, 3.06 [95% CI, 1.08-10.16], p = 0.046) and double the risk of an intensive care unit length of stay ≥ 5 d (OR, 1.75 [95% CI, 1.06-2.91], p = 0.031) compared to patients with low FTI/SMI. The obesity paradox was not observed in abdominal trauma patients, and high FTI/SMI ratio was independently associated with increased clinical severity.

Effect of Adolescent Body Mass Index Trajectories on Working Memory: A Prospective Birth Cohort in Brazil

Most research on the association between high body mass index (BMI) and working memory (WM) has been cross-sectional in design, limiting conclusions about long-term effects of overweight and obesity on WM. The aim of this study was to examine the association of BMI trajectory from 11 to 22 years with WM at 22 years of age. Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N = 3,010). Information on BMI was collected at ages 11, 15, 18, and 22 years. Group-based trajectory modeling was used separately for each sex to identify BMI trajectories. Working Memory performance (Digit Span backward score) was examined at age 22. Multiple linear regression was used to assess the association between BMI trajectory from 11 to 22 years and WM at age 22. In both sexes, the trajectory groups were: stable normal weight, stable overweight, and stable obesity. In the adjusted analyses, women in the stable-obesity group had lower WM at 22 years (β = −.49; 95% CI: −0.75, −0.23; p < .001) than those in the stable-normal weight group. No associations were found between BMI trajectories and WM in men. This study may contribute to future investigations of possible explanatory avenues for the association between high BMI and WM.

Association of general and abdominal obesity with lung function, FeNO, and blood eosinophils in adult asthmatics: Findings from NHANES 2007-2012.

Purpose: Obesity is considered a risk factor for asthma exacerbation. However, limited studies have focused on the association of different levels of weight clusters with asthma. As such, we study the associations between different weight clusters with FeNO, blood eosinophils, and lung function among adult asthmatics. Methods: Data from 789 participants aged 20years or older in the National Health and Nutrition Examination Survey 2007-2012 were analyzed. Body mass index (BMI) and waist circumference (WC) were used to determine the weight status. The study population was divided into five groups, including normal weight and low WC (153), normal weight and high WC (43), overweight and high WC (67), overweight and abdominal obesity (128), and general and abdominal obesity (398). A Multivariate linear regression model was used to evaluate the abovementioned associations after adjusting for potential confounding factors. Results: The adjusted models showed that general and abdominal obesity cluster (adjusted β = -0.63, 95% confidence interval (CI): -1.08, -0.17p < 0.01), and the normal weight with high WC cluster (adjusted β = -0.96, 95% CI: -1.74, -0.19p < 0.05) were associated with lower levels of blood eosinophils percentage than normal weight and low WC cluster. A similar tendency was shown in the levels of FeNO, but the differences were not significant (p > 0.05). Furthermore, abdominal obesity clusters were significantly associated with lower FVC, FVC% predicted, and FEV1 measures than normal weight and low WC cluster, especially those individuals with general and abdominal obesity cluster. No association was found between different weight clusters and FEV1/FVCF ratio. The two other weight clusters did not show the association with any of the lung function measures. Conclusion: General and abdominal obesity were associated with lung function impairment and a significant reduction of FeNO and blood eosinophil percentage. This study emphasized the importance of concurrent determination of BMI and WC in asthma clinical practice.

Maternal tobacco smoking and childhood obesity in South Africa: A cohort study.

Tobacco use and obesity are major public health problems and part of the leading causes of preventable disease and death worldwide. The prevalence of overweight children has escalated over the years; making the weight gain in children a critical issue for health professionals and academics alike. This study examines the association between maternal tobacco use and body weight abnormalities among South African children. The study uses data from the National Income Dynamics Study (NIDS), conducted from 2008 to 2017. The survey is available in five waves which have been merged into a panel dataset of 211,718 children aged between 0 to 5 years old, drawn from a nationally representative sample of households followed across time. Thus, the subgroup of children aged between 6 and 15 years old was excluded from the analysis. The empirical investigation employs a logistic regression model to estimate the marginal effect of maternal smoking on childhood overweight prevalence measured by three anthropometric based proxies, namely risk of child overweight, child overweight and child obesity. This framework assumes unobserved child characteristics to be uncorrelated with independent variables (random effect assumption); hence allowing to control for time-invariant sociodemographic factors which are likely to affect child nutritional health. In addition to sociodemographic and health characteristics of mothers, empirical findings suggest that maternal smoking exhibits a significant odds and/ or probability of weight abnormalities in children. Notably, children of smoking mothers are likely to be obese, overweight, or at risk of becoming overweight with a possible coexistence of mother-child overweight. Similarly, weight irregularities in children are likely to increase with mother's age. Conversely, married mothers although associated with increased odds of children having high BMI, display a reduced probability of children being abnormally weighted. Finally, child support grant has the potential to improve children nutritional health as children whose mothers are recipient of such grant have a negative probability of having high BMI. Overall, maternal smoking contributes to child overweight and/or obesity in south Africa; suggesting that maternal healthy lifestyle could be an alternative strategic tool to fight against overweight in children. However, mothers' inability to remain and/or follow a healthy life style is plausible as age increases, with spillover effect on child care. Thus, policymakers should prioritize programs to reduce smoking, especially amongst pregnant women and caregivers, to minimise the risk of overweight in children. Promoting the consumption of healthy foods accompanied by physical activity may reduce mothers' stress levels and their incentive to self-medicate using tobacco substances. In addition, comprehensive action programs including child support grant and recommendations for treatment plans that address the problems of children who are already suffering from overweight, remain essential.

Gallbladder disease is associated with the risk of cardiovascular disease among Uyghurs in Xinjiang: a prospective cohort study

BackgroundGallbladder disease (GBD) can increase the risk of cardiovascular disease (CVD). However, GBD has rarely been reported in the less developed, rural areas of Xinjiang. This study aimed to determine the prevalence of GBD and incidence of CVD in a prospective cohort study in rural Xinjiang. Moreover, the study aimed to explore the association between GBD and CVD within this cohort.MethodsThe study cohort included 11,444 Uyghur adults in Xinjiang, 3rd division, from the 51st Mission. Study groups were classified according to whether GBD was present or absent at baseline. The occurrence of CVD was the end event. Demographic, anthropometric, and biochemical data were recorded, and the incidence of CVD in the GBD and non-GBD groups analysed. Cox proportional hazards regression models were used to assess the association between GBD and CVD and factors associated with their incidence. Several subgroup analyses were performed to assess CVD incidence in different subgroups. The interaction between GBD and cardiometabolic risk factors, and subsequent risk of developing CVD, was evaluated.ResultsPrevalence of GBD in the study cohort was 10.29%. After a median follow-up of 4.92 years, the cumulative incidence of CVD in the study cohort was 10.49%, 8.43% in males and 12.65% in females. CVD incidence was higher in the GBD group (34.04% vs. 7.78%, HR = 4.96, 95% CI: 4.40–5.59). After multivariate adjustment, the risk of CVD remained higher in the GBD group (HR = 2.89, 95% CI: 2.54–3.29). Subgroup analyses showed male sex, smoking, alcohol consumption, lack of exercise, and abnormal renal function were all associated with increased risk of CVD. Moreover, the risk of CVD was markedly higher in GBD combined with cardiometabolic risk factors (hypertension, T2DM, dyslipidaemia, overweight, and abdominal obesity), than in cardiometabolic risk factors alone and this was higher in the GBD group than in the non-GBD group regardless of whether cardiometabolic risk factors were combined.ConclusionGBD is an important independent risk factor for CVD development. Awareness of these associations will raise concerns among clinicians about the risk of cardiovascular disease in patients with GBD.

Laboratory changes and prognostic indicators of the adverse course of chronic heart failure with preserved left ventricular ejection fraction, excess weight and concomitant atrial fibrillation

Aim. To investigate the peculiarities of clinical and laboratory changes and to identify prognostic indicators of the adverse course of chronic heart failure with preserved left ventricular ejection fraction (CHFprEF), excess weight and concomitant atrial fibrillation (AF). Materials and methods. The open, prospective, cohort study in parallel groups included 248 patients with CHFprEF, overweight and abdominal obesity, average age 65.0 ± 11.0 years; 146 (58.9 %) women and 102 (41.1 %) men. The first group included 181 patients with CHFprEF and excess weight without concomitant AF, and the second group – 67 CHFprEF patients with excess weight and AF. The complex clinical examination was performed according to the standards, including complaints, medical and family history, clinical, laboratory and instrumental examinations. Results. It has been established that patients with CHFprEF and overweight or abdominal obesity concomitant AF have a predisposition to anemia, which was manifested by significant lower indicators of hemoglobin and erythrocytes in parallel with lower values of lymphocytes, more pronounced signs of systemic inflammation, dysfunction of the kidneys and liver with manifestations of cholestasis, which indicated deeper functional and structural disorders of organs and systems. ROC-analysis of the patients with CHFprEF, excess weight and concomitant AF demonstrated increase in the clinical endpoints rate for patients with BMI ˃32 kg/m2, the waist circumference / hips circumference ratio ˃1.1 U, leucocytes level ˃6 × 109 l, serum creatinine ˃96 mcmol/l, urea ˃7.3 mmol/l, glomerular filtration rate ≤65 ml/min/1.73 m2, LDL / HDL cholesterol ratio ˃2.05 U. The 5-years death predictors were found in patients with CHFprEF, excess weight and concomitant AF: functional class of CHF ˃ІІ, HDL cholesterol ≤0.9 mmol/l, LDL cholesterol ≤0.66 mmol/l and triglycerides ≤1.45 mmol/l; additionally, there were defined the predictors of recurrent admission to hospital with the CHFprEF decompensation: leucocytes level ˃6 × 109 l, LDL cholesterol ˃2.49 mmol/l, the LDL / HDL cholesterol ratio ˃2.05 U and the atherogenic ratio ˃2.91 U. Conclusions. In patients with CHFprEF and excess weight, concomitant AF was associated with more severe laboratory changes, which reflected deeper functional and structural disorders of organs and systems. Laboratory predictors of the adverse course of CHFprEF in this category of patients have been established.

Risk of noncommunicable diseases and associated factors in Algerian adolescents (10–19 years old)

ObjectiveNoncommunicable diseases (NCDs) are a public health problem and their prevalence is increasing worldwide at an alarming rate. The objective of this study was to assess the predictive factors for NCDs in adolescents. Material and methodsThe study included adolescents enrolled in public establishments in Constantine (east of Algeria). Demographic variables, health variables, smoking, anthropometry, diet, and physical activity were assessed by means of a questionnaire. All data were analyzed using the software R 3.2.4. The significance threshold was set at 95%. ResultsThe sample consisted of 1,222 adolescents (56.1% girls) aged 10–19 years. Overall, 8.6% had NCDs; 23.2% were overweight (obesity included). The frequency of consumption was insufficient for dairy products and fruits and vegetables (p=0.0000) and the opposite was found for fatty and sugary products (p=0.0000). A total of 82.8% had been breastfed. Physical activity recommendations were not followed. Risk factors for the development of NCDs were family history of these diseases (odds ratio [OR]=2.89), active smoking (OR=3.18), passive smoking (OR=2.03), fetal macrosomia (OR=1.40), time in front of screens ≥3 h/day (OR=1.28), and overweight (OR=1.15). The consumption of fatty and sweet products was positively correlated with weight status (r=0.258; p=0.0000). Protective factors were breastfeeding for ≥ 6 months (OR=0.69) and moderate physical activity of ≥60 min/day (OR=0.38). ConclusionAdolescents presented predictors factors for NCDs due to harmful behaviors to their health.