Adult Weight Status Research Articles

Using interpretable machine learning methods to identify the relative importance of lifestyle factors for overweight and obesity in adults: pooled evidence from CHNS and NHANES

BackgroundOverweight and obesity pose a huge burden on individuals and society. While the relationship between lifestyle factors and overweight and obesity is well-established, the relative contribution of specific lifestyle factors remains unclear. To address this gap in the literature, this study utilizes interpretable machine learning methods to identify the relative importance of specific lifestyle factors as predictors of overweight and obesity in adults.MethodsData were obtained from 46,057 adults in the China Health and Nutrition Survey (2004–2011) and the National Health and Nutrition Examination Survey (2007–2014). Basic demographic information, self-reported lifestyle factors, including physical activity, macronutrient intake, tobacco and alcohol consumption, and body weight status were collected. Three machine learning models, namely decision tree, random forest, and gradient-boosting decision tree, were employed to predict body weight status from lifestyle factors. The SHapley Additive exPlanation (SHAP) method was used to interpret the prediction results of the best-performing model by determining the contributions of specific lifestyle factors to the development of overweight and obesity in adults.ResultsThe performance of the gradient-boosting decision tree model outperformed the decision tree and random forest models. Analysis based on the SHAP method indicates that sedentary behavior, alcohol consumption, and protein intake were important lifestyle factors predicting the development of overweight and obesity in adults. The amount of alcohol consumption and time spent sedentary were the strongest predictors of overweight and obesity, respectively. Specifically, sedentary behavior exceeding 28–35 h/week, alcohol consumption of more than 7 cups/week, and protein intake exceeding 80 g/day increased the risk of being predicted as overweight and obese.ConclusionPooled evidence from two nationally representative studies suggests that recognizing demographic differences and emphasizing the relative importance of sedentary behavior, alcohol consumption, and protein intake are beneficial for managing body weight status in adults. The specific risk thresholds for lifestyle factors observed in this study can help inform and guide future research and public health actions.

Associations between Cognitive Impairment, Weight Status and Comorbid Conditions in Hospitalized Adults of 55 Years and Older in Guadeloupe.

Cognitive decline and comorbid conditions commonly co-occur, and these conditions can affect cognitive health. We aimed to estimate the prevalence of cognitive impairment (CI) according to weight status and to evaluate the associations between CI, weight status and comorbid conditions in adults of 55 years and older. The Abbreviated Mental Test Score (AMTS) was used. Logistic regressions were performed. Overall, 415 individuals were included. The mean age was 75.7 ± 10.1 years, and the mean BMI was 26.2 ± 6.9 kg/m2. The prevalence of CI was 20.7% in the whole study group and 31%, 24.8%, 17.7% and 10.2% in underweight, normal weight, overweight and obese individuals, respectively; p < 0.004. The low folate, vitamin D and prealbumin levels were more frequently found in individuals with CI compared with those without CI. Compared with the obese individuals, a higher odds ratio of prevalent CI was noted for underweight individuals OR 3.89 (95% CI 1.54-9.80); p = 0.004. Additionally, male gender, older age, stroke, having three or more comorbid conditions and findings of undernutrition were significantly associated with CI. Being underweight was associated with an increased risk of CI. Prevention strategies including the monitoring of nutritional status may help to prevent cognitive decline and promote healthy aging.

Is problematic use of the Internet and smartphone predictor of unhealthy eating behaviors and abnormal body weight in Turkish young adults?

With technological progress, the use of the internet and smartphones has become an inseparable part of our lives and their use is increasing. The uncontrolled use of both the internet and smartphones is defined as problematic use. This study examined the effects of problematic internet and smartphone use on dietary behaviors and abnormal body weight status in young adults. Participants were 560 university students. Participants completed measures of demographics, dietary behaviors, internet and smartphone usage habits, Young's Internet Addiction Test and Smartphone Addiction Scale. Negative associations were found between dietary behaviors and problematic internet and smartphone use. Significant inverse associations were also found between these uses and recommended consumption levels of several food groups. For a healthy future generation, it is recommended that policies be developed to prevent or manage these problematic uses, especially in young adults with negative dietary behaviors and abnormal body weight.

Dentition and weight status in community-dwelling older adults.

Tooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults. This was a cross-sectional study of data from a convenience sample of older adults (65-89 years) treated at an urban U.S. dental school clinic. Clinical and demographic data were obtained from electronic health records. Dentition status was determined based on data from odontograms. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of having a non-normal weight status for each measure of dentition status, after adjusting for covariates. Patients (n = 1765) were 54.1% female, 51.5% White, 41.6% African American and 22.5% Hispanic/Latino. The median (interquartile range [IQR]) age was 71 (67.0-75.0) years; the mean (±SD) BMI was 28.5 (±5.7) kg/m2 ; 72.5% were overweight or obese. The median (IQR) number of remaining teeth was 20.0 (13.0-24.0); the median numbers of anterior and posterior occluding pairs of teeth were 5.0 (2.0-6.0) and 2.0 (0.0-5.0), respectively; and 44.9% had a functional dentition (≥21 teeth). Having a higher number of remaining teeth and more posterior occluding pairs were associated with lower odds of obesity (OR = 0.980, 95% CI = 0.964, 0.997, p = .022 and OR = 0.931, 95% CI = 0.885, 0.980, p = .006, respectively). Lack of a functional dentition was associated with higher odds of obesity (OR = 1.400, 95% CI = 1.078, 1.818, p = .012), after controlling for covariates. Older adults with tooth loss - especially loss of posterior occlusion and lack of a functional dentition - were more likely to be obese than of normal weight.

Mudanças no consumo alimentar e na prevalência de sobrepeso e obesidade em adultos brasileiros entre 2008 e 2018

ABSTRACT Objective To assess dietary intake and weight status changes among Brazilian adults. Methods In this dietary survey, data from the food consumption modules of the 2008-2009 (n=21,003 adults) and the 2017-2018 (n=28,153 adults) Household Budget Survey were evaluated to estimate the mean consumption (g/day) of 20 food groups. The body mass index was calculated to classify the weight status of adults and estimate the prevalence of overweight and obesity. Differences between surveys were identified when the 95% confidence intervals were not interspersed. All analyses were stratified by gender and considered the sample weight and the complexity of the sample design. Results The prevalence of overweight increased both among men (38.4%; 95% CI: 36.8-40.0, in 2008-2009 vs. 42.2%; 95% CI: 40.9-43.5, in 2017-2018) and women (29.5%; 95% CI: 58.0-30.9 vs. 35.2%; 95% CI: 34.0-36.4, respectively). Mean consumption of poultry and eggs (57.6g/day vs. 77.9 g/day in men and 43.5g/day vs. 57.3g/day in women, p&lt;0.05) and fast foods (31.3g/day vs. and 48.7g/day in men and 25.3g/day in 2008-2009 vs. 34.8g/day in women, p&lt;0.05) increased between the two surveys, while the mean consumption of rice, beans, fruits, coffee and tea, fish and seafood, processed meats, milk and dairy products, sweets and desserts, sugary drinks, and soups declined. Conclusion The Brazilian food consumption pattern follows the increased prevalence of overweight and reinforces the need to encourage healthy patterns that revive our country's food culture and eating habits.

Oral Motor Impairments Contribute to Weight Status of Adults with Severe Cerebral Palsy.

Adults with severe cerebral palsy (CP) are susceptible to malnutrition and metabolic disorders due to limited daily physical activity and challenges related to eating. We hypothesized that the condition of being underweight arises from inadequate energy intake due to difficulties in eating, rather than heightened total energy expenditure or an elevated resting metabolic rate. The present study encompassed 17 adults with severe CP (classified as GMFSC III-V). Energy intake, utilization, and expenditure were gauged via thorough dietary recordings and double-labeled water (DLW) analyses. Resting metabolic rates were assessed through indirect calorimetry, and metabolic health was investigated via blood samples. Oral motor function, eating assessment during meals, and weight fluctuations throughout the experimental period were also evaluated. We found significant correlations between weight, oral impairments (p < 0.01), and eating difficulties (p < 0.05). While total energy expenditure and daily consumption were similar between underweight (UW) and overweight (OW) individuals, significant variability in both expenditure and intake was evident within the UW group. Particularly, those with lower BMIs experienced heightened mealtime impairments and complications. Our present findings indicate that eating difficulties are the central concern for UW status in this population.

Accuracy of Assessing Weight Status in Adults by Structured Observation

The assessment of weight status is important in many epidemiological studies, but its direct measurement is not always possible. Self-reported weight and height are often used, although previous research reported low accuracy. This study aimed to test the ability of trained observers to accurately estimate weight status in adults using structured observation. A cross-sectional study was conducted. For each participant, height and weight were estimated in categories, and weight status was recorded using Stunkard’s body figures, by two trained observers. Height and weight were also measured, using standardized procedures. Subjects were classified according to World Health Organization body mass index (BMI) cut-offs from objective measurements and from the BMI assigned to each body figure. Sensitivity, specificity, and likelihood ratios were calculated to assess the accuracy of estimating weight status by observation. Kappa was used to test inter-observer reliability. A total of 127 participants were assessed, 70 women and 57 men, aged between 19 and 89 years (mean ± standard deviation: 50.3 ± 16.3 years). Most participants were overweight or obese (64.3% women; 78.9% men). The sensitivity and specificity of overweight/obesity status identification were 72.8% and 78.4%, respectively. Observers’ gender, participants’ gender, and participants’ age were significantly associated with the estimation of overweight/obesity. The agreement between observers was moderate for BMI estimates (κ = 0.52) but substantial when distinguishing normal weight from overweight/obesity (κ = 0.67). Trained observers were able to distinguish normal weight from overweight/obesity with high sensitivity and specificity, and substantial interrater reliability. This innovative methodology showed potential for improvement through enhanced training techniques. The use of structured observation may be a useful and accurate alternative to self-reported weight status assessment, whenever anthropometric measurement is not achievable.

Socio-Demographic, Lifestyle, and Clinical Characteristics of Early and Later Weight Status in Older Adults: Secondary Analysis of the ASPREE Trial and ALSOP Sub-Study.

To identify the socio-demographic, lifestyle, and clinical characteristics associated with self-reported weight status in early (age 18 years) and late (age ≥ 70 years) adulthood. The number of participants was 11,288, who were relatively healthy community-dwelling Australian adults aged ≥70 years (mean age 75.1 ± 4.2 years) in the Aspirin in Reducing Events in the Elderly (ASPREE) Longitudinal Study of Older Persons (ALSOP) sub-study. Self-reported weight at the study baseline (age ≥ 70 years) and recalled weight at age 18 years were collected. Height measured at baseline was used to calculate the BMI at both time points. Individuals were categorised into one of five 'lifetime' weight status groups: healthy weight (at both age 18 year and ≥70 years), overweight (at either or both times), non-obese (age 18 year) to obesity (age ≥70 years), obesity (age 18 years) to non-obese (age ≥ 70 years), and early and later life obesity (at age 18 years and ≥70 years). Participants who experienced obesity in early and/or late adulthood were at a higher risk of adverse clinical characteristics. Obesity in late adulthood (regardless of early adulthood weight status) was associated with high proportions of hypertension, diabetes, and dyslipidaemia, whereas obesity in early adulthood (regardless of late adulthood weight status) was associated with lower cognitive scores (on all four measures). Healthy or overweight weight status in early and later adulthood was associated with more favourable socioeconomic, lifestyle, and clinical measures. Obesity in early adulthood was associated with lower cognitive function in later adulthood, whereas obesity in later adulthood was associated with hypertension, diabetes, and dyslipidaemia.

Association Between Weight Status and Rate of Cognitive Decline: China Health and Nutrition Survey 1997-2018.

There is a close relationship between weight status and cognitive impairment in older adults. This study examined the association between weight status and the trajectory of cognitive decline over time in a population-based cohort of older adults in China. We used data from adults aged ≥55 years participating in the China health and nutrition survey (1997-2018). Underweight (body mass index [BMI] ≤ 18.5 kg/m2), normal weight (18.5-23 kg/m2), overweight (23-27.5 kg/m2), and obesity (BMI ≥ 27.5 kg/m2) were defined using the World Health Organization Asian cutpoints. Global cognition was estimated every 2-4years through a face-to-face interview using a modified telephone interview for cognitive status (scores 0-27). The association between BMI and the rate of global cognitive decline, using a restricted cubic spline for age and age category, was examined with linear mixed-effects models accounting for correlation within communities and individuals. We included 5 992 adults (53% female participants, mean age of 62 at baseline). We found differences in the adjusted rate of global cognitive decline by weight status (p = .01 in the cubic spline model). Models were adjusted for sex, marital status, current employment status, income, region, urbanization, education status, birth cohort, leisure activity, smoking status, and self-reported diagnosis of hypertension, diabetes, or Myocardial Infarction (MI)/stroke. In addition, significant declines by age in global cognitive function were found for all weight status categories except individuals with obesity. In a cohort of adults in China, cognitive decline trajectory differed by weight status. Aslower rate of change was observed in participants classified as having obesity.

The relationship between intake of fruits, vegetables and dairy products with overweight and obesity in a large sample in Iran: Findings of STEPS 2016.

The present study aimed to investigate the association between fruits and vegetables (FVs) and dairy product intake with body weight based on the data from the nationwide Stepwise approach to surveillance (STEPS) survey in Iran. STEPS is a national-based cross-sectional study conducted on 3,0541 people selected by stratified cluster random sampling in Iran from April to November 2016. The outcome of the current study was body mass index (BMI) which was classified as normal weight, underweight, overweight, and obese. Also, as exposure variables, dietary intakes of fruits, vegetables and dairy products were extracted from the STEPS questionnaires. Multinomial logistic regression was used to evaluate the association between dairy products, FVs consumption, and BMI category in the crude and adjusted models. In the adjusted model, we observed 41% [odd ratio (OR) = 0.59; 95% confidence intervals (CI): 0.50, 0.68, P < 0.001], 27% (OR = 0.73; 95% CI: 0.62, 0.84, P < 0.001), and 26% (OR = 0.74; 95% CI: 0.63, 0.87, P < 0.001) lower odds of being overweight, and 46% (OR = 0.54; 95% CI: 0.46, 0.64, P < 0.001), 29% (OR = 0.71; 95% CI: 0.60, 0.84, P < 0.001), and 21% (OR = 0.79; 95% CI: 0.65, 0.95, P = 0.014) decrease in obesity odds among the participants who consumed 1, 2, and more than 2 servings of fruits per day in comparison to less than one serving, respectively. Also, we observed participants who consumed 1, 2, and more than 2 servings in comparison to less than one serving of dairy products per day had 31% (OR = 0.69; 95% CI: 0.58, 0.81, P < 0.001), 23% (OR = 0.77; 95 %CI: 0.65, 0.91, P = 0.002), and 21% (OR = 0.79; 95% CI: 0.67, 0.94, P = 0.011) lower odds of being overweight and 47% (OR = 0.53; 95% CI: 0.44, 0.64, P < 0.001), 36% (OR = 0.64; 95% CI: 0.53, 0.77, P < 0.001), and 32% (OR = 0.68; 95% CI: 0.56, 0.83, P < 0.001) lower odds of obesity, respectively. In addition, compared to participants who consumed less than 2 servings of vegetables per day, participants who consumed 2, 3, and more than 3 servings had 40% (OR = 0.60; 95% CI: 0.47, 0.76, P < 0.001), 29% (OR = 0.71; 95% CI: 0.56, 0.90, P = 0.006), and 26% (OR = 0.74; 95% CI: 0.57, 0.96, P = 0.027) lower odds of being overweight, respectively. Furthermore, we observed 36% lower odds of obesity among participants who ate 2 servings of vegetables per day compared to less than 2 serving (OR = 0.64; 95% CI: 0.49, 0.84, P = 0.002). Our findings showed that intake of FVs and dairy products is associated with a healthier weight status in adults. Further studies are needed to confirm these findings.

Association between Sleep Quality and Body Weight Status in Adults during the COVID-19 Pandemic

Introduction: The COVID-19 pandemic is a new emerging situation that has dramatically impacted sleep quality and body weight status. This study aimed to determine the association between sleep quality and body weight status in Malaysian adults during the COVID-19 pandemic. Methods: An online cross-sectional study involved 427 Malaysian adults aged 18 to 59. The convenience sampling method was used. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Self-administered socio-demographic, height, and weight for BMI were obtained. Pearson correlation test was conducted to measure the association between sleep quality and body weight status using IBM SPSS Statistics for Windows version 22.0. Results: A total of 78.5% of them were females, and 84.8% of Malaysian adults reported poor sleep quality. The participants’ mean global PSQI score and body mass index were 8.1 (±2.7) and 24.6 (±6.1) kg/m2, respectively. 8.0% were underweight, followed by 55.5% of normal BMI, 17.5% overweight, and 19.0% obese. The study showed a significant and positive correlation between global PSQI score and body mass index (r=0.137, p=0.005). Conclusion: Sleep quality is significantly associated with body weight status. Adults with poorer sleep quality should be targeted when promoting healthy body weight. Future research on the interventions to improve adults’ sleep quality is essential, particularly during the pandemic.

Bariatric surgery in the management of childhood and adolescence obesity.

Nowadays, childhood obesity is literally a global pandemic health problem. According to current data, pediatric obesity is strongly associated with adult excess weight status as well as the development of certain co morbidities, already present in childhood, including cardiovascular disorders (dyslipidemia, hypertension), endocrine/metabolic (Type 2 diabetes, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal, and musculoskeletal problems. Additionally, children with obesity frequently experience psychosocial issues, such as mood disorders, anxiety, prejudice and low self-esteem. The aim of this article was to evaluate whether or not bariatric surgery is an effective and safe treatment option for childhood obesity. This paper is based on a literature search in Pub Med for articles referring to the medical co morbidities and the results of different types of bariatric surgery for the treatment of childhood obesity (up to 18 years) until December 2021. The following keywords were used as MESH terms: childhood obesity, adolescence obesity, co morbidities and bariatric surgery. The bibliographic references of the studies found in these databases were also reviewed. Although some researchers demonstrate that surgical interventions in adolescents might be a reliable intervention to lose weight in a maintainable way and reverse many of the co morbidities associated with severe obesity, their safety and long-term efficacy are still not clarified. Thus, large long-term prospective studies, with detailed recording of complications and co morbidity resolution are obviously needed in order to determine the role of surgical treatment in childhood obesity.

Persistent, High Levels of Social Jetlag Predict Poor Weight Outcomes in a Weight Gain Prevention Study for Young adults.

Social jetlag (SJL), the discrepancy in sleep timing between weekdays and weekends, is associated with higher BMI and cardiometabolic risk and is common in young adults. We examined whether chronic SJL impacts weight gain in young adults participating in a weight gain prevention trial. Young adults (n = 599, age 18-35; BMI: 21.0-30.9kg/m2) completed assessments at 0, 4, 12, and 24 months. Multilevel mixed growth models were used to examine (1) associations between demographics and longitudinal SJL and (2) longitudinal SJL as a predictor of weight change and cardiometabolic outcomes. SJL was assessed as a continuous and clinically-significant dichotomous (< vs. ≥2h) variable. 38% of participants had clinically-significant SJL at ≥ 1 timepoints (Baseline M ± SD = 1.3±0.89). Younger (b=-0.05, p < 0.001), female (b = 0.18, p = 0.037) and Black (compared to White, b = 0.23, p = 0.045) participants were more likely to have greater SJL. Individuals with high SJL (≥ 2h; between-person effect) were more likely to have greater weight gain over 2 years (b = 0.05, p = 0.028). High SJL did not affect the rate of change in waist circumference or cardiometabolic markers over time. High SJL is associated with greater weight gain over time. Reducing SJL may positively impact weight status in young adults.

Eating alone and weight change in community-dwelling older adults during the coronavirus pandemic: A longitudinal study

ObjectivesIt is likely that the number of older adults who eat alone has increased during the COVID-19 pandemic. Older adults who eat alone tend to experience weight fluctuations. Weight loss and underweight in older adults cause health problems. The study objective was to longitudinally investigate the association between changes in eating alone or with others and body weight status in older adults. MethodsThis longitudinal cohort study was conducted in March and October 2020 in Minokamo City, Gifu Prefecture, Japan. Questionnaire data for 1071 community-dwelling older adults were analyzed. Multinomial logistic regression analysis was performed using changes in eating alone or with others as the independent variable and body weight status as the dependent variable. The analysis was adjusted for age, sex, living arrangements, educational level, diseases receiving medical treatment, cognitive status, depression, and instrumental activities of daily living. Missing data were imputed using multiple imputation. ResultsThe average age of participants was 81.1 y (SD, 4.9 y). Individuals who reported eating alone in both surveys were more likely to report weight loss than those who reported eating with others in both surveys (adjusted model: odds ratio, 2.25; 95% confidence interval, 1.06–4.78; P = 0.04). ConclusionsThese findings suggest that measures to prevent weight loss in older adults who eat alone are particularly important during the COVID-19 pandemic.

Food Sales and Adult Weight Status: Results of a Cross-Sectional Study in England

Ecological studies often use supermarket location as a proxy measure of the food environment. In this study, we used data on sales at a leading mainstream supermarket chain to explore how area-level supermarket use is associated with overweight and obesity in English adults. Sales data were aggregated to local authority level and joined to a national dataset describing self-reported height and weight and fruit and vegetable consumption. Regression models showed a modest association between higher levels of unhealthy food sales relative to health food sales and increased odds of being overweight and obese. Although effect sizes were small, they persisted after adjustment for area-level deprivation. Supermarket sales data provide additional understanding in the study of food environments and their impact on increasing weight status. Future health policies should consider using ‘big data’ combined with other research methods to address the increasing consumption of unhealthy and highly processed foods.

Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia.

Introduction: The coronavirus disease 2019 (COVID-19) isolation has altered individuals’ food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown. Methods: This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported. Results: Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (β = 0.084, p = 0.015, 95% CI = 0.017–0.160), as well as oils and fats (β = 0.123, p = 0.001, 95% CI = 0.059–0.241), was positively associated with weight gain during the pandemic. On the contrary, an increased plain water intake was negatively associated with weight gain during the lockdown (β = −0.100, p = 0.003, 95% CI = −0.171–−0.034). Findings in the current study also suggested that cutting back cereals and grains (β = 0.156, p < 0.001, 95% CI = 0.122–0.288), as well as oils and fats (β = 0.091, p = 0.012, 95% CI = 0.022–0.183), contributed significantly to weight loss during the pandemic confinement. Conclusion: In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.

Self-esteem and weight status of young adults: Findings from a pilot study.

Researchers have examined the association between self-esteem and obesity in past studies. However, most studies have focused on pediatric or adolescent populations. In this pilot study, we aim to explore the association of self-esteem with weight status in young adults, a group of individuals in a significant and pivotal period of their lives whose needs and challenges have received little attention in previous studies. Exactly 127 college juniors and seniors in the Midwest participated in late 2017. For our survey, we collected the following information: body weight, height, self-esteem score from the state self-esteem scale, grade point average, risk of eating disorders, sleep quality, nutritional behavior, lifestyle (smoking, frequency of exercise, alcohol drinking, average daily time watching television, playing video games, and social media use), and demographic and socioeconomic background. We used logistic regression for our analysis. The logistic regression indicates that a one-point increase in the self-esteem score was negatively associated with a young adult's odds of having an unhealthy weight (being overweight or obese) by approximately 3%. Furthermore, soda drinking is a statistically significant factor associated with weight status. This finding suggests self-esteem is positively associated with a healthy weight in young adults. A larger-scale study should be conducted in the future to validate this relationship and better understand young adults' needs.

Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries.

Adolescent overweight and obesity are well documented in high-income countries (HICs). They are also emerging as a global public health concern in low-and middle-income countries (LMICs), yet there is a lack of reliable, national-level data to inform policies and interventions. This study aimed to estimate the prevalence of overweight and obesity and assess associated lifestyle risk factors amongst school-going adolescents in LMICs as well as HICs. A total of 282,213 samples were drawn from 89 LMICs and HICs in the 'latest Global School-based Student Health Survey' of school children, aged 11-17 years, during 2003 to 2015, in the six World Health Organisation (WHO) regions. The prevalence of adolescent overweight and obesity were estimated using the WHO BMI-for-age growth standards. A multinomial logistic regression model was employed to estimate the adjusted (age and sex) association of food patterns, physical activity, and sedentary behaviours with adolescent overweight and obesity. The pooled prevalence of overweight and obesity amongst adolescents was 10.12%, and 4.96%, respectively, ranging from 2.40% in Sri Lanka to 29.08% in Niue for overweight and 0.40% in Sri Lanka to 34.66% in the Cook Islands for obesity. Overweight and obesity were associated with unhealthy dietary intake and lifestyles including respectively fast-food intake (adjusted relative risk ratio, RRR = 1.09; 95% CI: 1.05-1.12 and RRR = 1.32; 95% CI: 1.26-1.38), a high level of carbonated soft drinks consumption (RRR = 1.19; 1.12-1.24 and RRR = 1.28; 1.18-1.38), a low level of physical activity (RRR = 1.11; 1.06-1.17 and 1.20; 1.12-1.28), and high level of sedentary behaviours (RRR = 1.33; 1.27-1.39 and RRR = 1.73; 1.63-1.84). Adolescents who consumed vegetables at least two times per day had a lower risk of overweight (22%) and obesity (17%) than those who did not consume vegetables per day. Adolescent overweight and obesity represent a global public health problem and can possibly track into adult weight status and morbidity. School-based obesity prevention that promotes environmental and policy changes related to healthy dietary practices and active living are urgently needed to curb the trend.

Transition Patterns of Weight Status and Their Predictive Lipid Markers Among Chinese Adults: A Longitudinal Cohort Study Using the Multistate Markov Model.

BackgroundObesity is well recognized as a risk factor for cardiometabolic diseases. The development of obesity is a dynamic process that can be described as a multistate process with an emphasis on transitions between weight states. However, it is still unclear what convenient biomarkers predict transitions between weight states. The aim of this study was to show the dynamic nature of weight status in adults stratified by age and sex and to explore blood markers of metabolic syndrome (MetS) that predict transitions between weight states.MethodsThis study involved 9795 individuals aged 18 to 56 at study entry who underwent at least two health check-ups in the eight-year period of study in the health check-up centre of our institution. Weight, height and biochemical indices were measured at each check-up. The participants were divided into four groups based on age and sex (young male, middle-aged male, young female and middle-aged female groups). A multistate Markov model containing 3 states (healthy weight, overweight and obesity) was adopted to study the longitudinal weight data.ResultsYoung people were more likely to transit between weight states than middle-aged people, and middle-aged people were more resistant to recover from worse states. The mean sojourn time in obesity was greatest in the middle-aged male group (6.23 years), and the predicted rate of obesity beginning with healthy weight was greatest in the young male group (13.7%). In multivariate models, age group and triglyceride (TG) and high-density lipoprotein cholesterol (HDL) levels were significant for specific transitions in females, whereas age group and HDL levels were significant in males. In females, if HDL levels increased 1 mmol/L, the probability of progression from healthy weight to overweight decreased by 37.0% (HR= 0.63), and the probabilities of recovery (overweight to healthy weight and obesity to overweight) increased by 62.0% (HR= 1.62) and 1.23-fold (HR= 2.23), respectively. In males, if TG levels increased 1 mmol/L, the risk of progression from healthy weight to overweight increased by 24.0% (HR= 1.24). Each unit increase in HDL levels was associated with a 0.99-fold (HR= 1.99) increase in the chance of recovery from overweight to healthy weight and with a 0.37-fold (HR= 0.63) decrease in the risk of progression from healthy weight to overweight.ConclusionThe weight status of young people was less stable than that of middle-aged people. Males were more likely to become overweight and more resistant to recover from worse states than females. Young males with healthy weight were more likely to develop obesity than other healthy weight groups. Blood lipid levels, especially HDL, were predictors of weight transitions in adults. Prevention and intervention measures should be applied early.

Relationship Among the Presence of Metabolic Syndrome, Weight Status and Plasma miRNA Expression in Older Adults From the Healthy Survey of São Paulo: A Population-Based Study

Abstract Objectives To evaluate the plasma expression of miR-30a, miR-130b, miR-376a and miR-let7c according to the presence of metabolic syndrome (MetS) and body mass index (BMI) in older adults and assess their association with metabolic biomarkers. Methods Data from 193 older adults (68.0 ± 11.0 years; 52.3% female) of the 2015 Health Survey of São Paulo with focus on Nutrition were used for this cross-sectional study. Participants with acute inflammatory diseases and in use of medication that can influence in this outcome were excluded from analysis. The presence of MetS was defined according to American Heart Association/National Heart, Lung, and Blood Institute criteria (2005). Overweight and obese individuals were grouped. The miRNAs were quantified by qRT-PCR, using a Fluidigm chip. The miRNA expression according to the BMI was assessed using the Kruskal-Wallis test followed by the Dunn test, while the miRNA expression according to the presence of MetS was determined by the Mann-Whitney test. Spearman correlation between miRNA and metabolic biomarkers was performed. Results A total of 44.6% of the participants were overweight/obese and 61% of them had MetS. Plasma expression of miR-130b and miR-376a was lower in overweight individuals compared to non-overweight individuals. MiR-let7c, miR-122 and miR-30a showed greater expression in individuals with MetS compared to those without MetS. MiR-30a showed positive correlations with fasting blood glucose (r = 0.100; P = 0.016), total cholesterol (CT) (r = 0.091; P = 0.028), LDL-c (r = 0.083; P = 0.047), no HDL-c (r = 0.101; P = 0.015) and triacylglycerols (TG) (r = 0.133; P = 0.001). The expression of miR-let7c showed positive correlations with fasting glucose (r = 0.0113; P = 0.006), CT (r = 0.100; P = 0.016), LDL-c (r = 0.102; P = 0.002), not HDL-c (r = 0.143; P &amp;lt; 0.001), TG (r = 0.201; P &amp;lt; 0.001) and negative correlation with HDL-c (r = −0.124; P = 0.002). The expression of miR-130b correlated with TG (r = 0.099; P = 0.018) and miR-376a with CT (r = 0.085; P = 0.042) and TG (r = 0.116; P = 0.005). Conclusions Plasma expression of miRNA in older adults varied according to the presence of MetS and weight status, presenting correlations with metabolic biomarkers. Funding Sources Grant 2017/05125-7 | 2020/03104-5;2019/22934-1, São Paulo Research Foundation (FAPESP) | 150834/2020-9, National Council for Scientific and Technological Development (CNPq).