The Obesity Pandemic: Where Have We Been and Where Are We Going?

Laparoscopic Pancreaticoduodenectomy After Roux-en-Y Gastric Bypass: Case Report and Literature Review

This is a case report of an alternate laparoscopic reconstruction possibility in a patient that required a cephalic duodenopancreatectomy (DPC) who previously underwent a Roux-en-Y gastric bypass (RYGB). The question of what type of reconstruction is to be performed in such patients is thoroughly debated in this article.

The collaborative cross mouse for studying the effect of host genetic background on memory impairments due to obesity and diabetes

BACKGROUND

Over the past few decades, a threefold increase in obesity and type 2 diabetes (T2D) has placed a heavy burden on the health-care system and society. Previous studies have shown correlations between obesity, T2D, and neurodegenerative diseases, including dementia. It is imperative to further understand the relationship between obesity, T2D, and cognitive deficits.

METHODS

This investigation tested and evaluated the cognitive impact of obesity and T2D induced by high-fat diet (HFD) and the effect of the host genetic background on the severity of cognitive decline caused by obesity and T2D in collaborative cross (CC) mice. The CC mice are a genetically diverse panel derived from eight inbred strains.

RESULTS

Our findings demonstrated significant variations in the recorded phenotypes across different CC lines compared to the reference mouse line, C57BL/6J. CC037 line exhibited a substantial increase in body weight on HFD, whereas line CC005 exhibited differing responses based on sex. Glucose tolerance tests revealed significant variations, with some lines like CC005 showing a marked increase in area under the curve (AUC) values on HFD. Organ weights, including brain, spleen, liver, and kidney, varied significantly among the lines and sexes in response to HFD. Behavioral tests using the Morris water maze indicated that cognitive performance was differentially affected by diet and genetic background.

CONCLUSIONS

Our study establishes a foundation for future quantitative trait loci mapping using CC lines and identifying genes underlying the comorbidity of Alzheimer's disease (AD), caused by obesity and T2D. The genetic components may offer new tools for early prediction and prevention.

Comparative analysis of dietary vs. non-dietary approaches in obesity and disordered eating behaviors: a narrative review of the literature

PURPOSE

This narrative review aims to conduct a comparative analysis of dietary and non-dietary approaches in the management of weight and disordered eating behaviors (DEBs) in adults with obesity.

METHODS

Studies were identified from Medline (PubMed), including only English-language manuscripts published from 1998 to 2024. To be included in the review the studies had to be RCTs that compared the effect of dietary and non-dietary approaches on weight loss and DEBs in adults with obesity not being treated with pharmacological treatments.

RESULTS

Seven randomized controlled trials (RCTs) reported in 8 manuscripts published between 1998 and 2024 met the inclusion criteria. The sample size ranged from a minimum of 16 subjects to a maximum of 219. All studies involved adult subjects, mainly women, with first-, second-, or third-degree obesity and most subjects had cognitive restriction and/or uncontrolled eating. Dietary approaches were characterized by moderate caloric restriction (CR) and restriction of fat intake. In contrast, non-dietary approaches focused on mindful eating (ME), intuitive eating (IE) and weight neutral (WN) approaches. Of the 7 RCTs included, 5 reported greater weight loss in the diet group compared to the non-diet group; however, only one of these sustained the result at follow-up. In contrast, 4 studies demonstrated greater improvements in DEBs in the non-diet group.

CONCLUSION

CR is essential for weight loss in individuals with obesity, but long-term weight management also hinges on their relationship with food. The psychological improvements reported in non-dietary versus dietary approaches should not be overlooked and can be a starting point for the development of multidisciplinary interventions involving synergistic actions between diet, exercise, and practices to improve DEBs with the goal of reducing the obesity epidemic. Level of evidence Level I, at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.

Obesity's Unexpected Influence: Reduced Alphavirus Transmission and Altered Immune Activation in the Vector

Chikungunya virus (CHIKV) and Mayaro virus (MAYV) are emerging/re-emerging alphaviruses transmitted by Aedes spp. mosquitoes and responsible for recent disease outbreaks in the Americas. The capacity of these viruses to cause epidemics is frequently associated with increased mosquito transmission, which in turn is governed by virus-host-vector interactions. Although many studies have explored virus-vector interactions, significant gaps remain in understanding how vertebrate host factors influence alphavirus transmission by mosquitoes. We previously showed that obesity, a ubiquitous vertebrate host biological factor, reduces alphavirus transmission potential in mosquitoes. We hypothesized that alphavirus-infected obese bloodmeals altered immune genes and/or pathways in mosquitoes, thereby inhibiting virus transmission. To test this, we conducted RNA sequencing (RNA-seq) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) on midgut RNA from mosquitoes fed on alphavirus-infected lean and obese mice. This approach aimed to identify potential antiviral or proviral genes and pathways altered in mosquitoes after consuming infected obese bloodmeals. We found upregulation of the Toll pathway and downregulation of several metabolic and other genes in mosquitoes fed on alphavirus-infected obese bloodmeals. Through gene knockdown studies, we demonstrated the antiviral role of Toll pathway and proviral roles of AAEL009965 and fatty acid synthase (FASN) in the transmission of alphaviruses by mosquitoes. Therefore, this study utilized obesity to identify factors influencing alphavirus transmission by mosquitoes and this research approach may pave the way for designing broadly effective antiviral measures to combat mosquito-borne viruses, such as releasing transgenic mosquitoes deficient in the identified genes.

Postgenomic understandings of fatness and metabolism

'Obesity' has, for decades, been a subject of intense scientific and public interest, and remains a key target for postgenomic science. I examine the emergence of determinism in research into 'obesity' in the postgenomic field of metabolomics. I argue that determinism appears in metabolomics research in two ways: firstly, fragmentation and narrow construal of the environment is evident in metabolomics studies on weight loss interventions, resulting in particular features of the environment (notably, dietary intake) having outsized influence while the wider social environment is neglected. Secondly, studies aiming to characterize the metabolic signature of 'obesity' are guided by a commitment to a deterministic connection between 'obesity' and dysfunction, leading to a neglect or distortion of metabolic heterogeneity across individuals regardless of body size.

Paternal obesity induces subfertility in male offspring by modulating the oxidative stress-related transcriptional network

BACKGROUND/OBJECTIVE

The effects of fathers' high-fat diet (HFD) on the reproductive health of their male offspring (HFD- F1) remain to be elucidated. Parental obesity is known to have a negative effect on offspring fertility, but there are few relevant studies on the effects of HFD-F1 on reproductive function.

METHODS

We first succeeded in establishing the HFD model, which provides a scientific basis in the analysis of HFD-F1 reproductive health. Next, we assessed biometric indices, intratesticular cellular status, seminiferous tubules and testicular transcriptomic homeostasis in HFD-F1. Finally, we examined epididymal (sperm-containing) apoptosis, as well as antioxidant properties, motility, plasma membrane oxidation, DNA damage, and sperm-egg binding in the epididymal sperm.

RESULTS

Our initial results showed that HFD-F1 mice had characteristics similar to individuals with obesity, including higher body weight and altered organ size. Despite no major changes in the types of testicular cells, we found decreased activity of important genes and noticed the presence of abnormally shaped sperm at seminiferous tubule lumen. Further analysis of HFD-F1 testes suggests that these changes might be caused by increased vulnerability to oxidative stress. Finally, we measured several sperm parameters, these results presented HFD-F1 offspring exhibited a deficiency in antioxidant properties, resulting in damaged sperm mitochondrial membrane potential, insufficient ATP content, increased DNA fragmentation, heightened plasma membrane oxidation, apoptosis-prone and decreased capacity for sperm-oocyte binding during fertilization.

CONCLUSION

HFD- F1 subfertility arises from the susceptibility of the transcriptional network to oxidative stress, resulting in reduced antioxidant properties, motility, sperm-egg binding, and elevated DNA damage. Schematic representation of the HFD-F1 oxidative stress susceptibility to subfertility. Notably, excessive accumulation of ROS surpasses the physiological threshold, thereby damaging PUFAs within the sperm plasma membrane. This oxidative assault affects crucial components such as mitochondria and DNA. Consequently, the sperm's antioxidant defense mechanisms become compromised, leading to a decline in vitality, motility, and fertility.

Metabolically Unhealthy Normal Weight: Prevalence and Associated Factors in an Adult Population from Northwest Colombia

Background and Aim

Individuals with a normal weight may have metabolic alterations at risk for chronic non-communicable diseases. The prevalence of this condition and associated factors have not been reported in Latin American populations. We aimed to estimate the presence and associated factors of Metabolically Unhealthy Normal Weight (MUNW) in adults from a public program for the control and prevention of chronic diseases in Medellín, Colombia.

Methods

Cross-sectional study. Overweight and normal weight were characterized according to the absence or presence of one or more components of the metabolic syndrome, obtaining four phenotypes: Metabolically Healthy Normal Weight (MHNW), MUNW (phenotype of interest), Metabolically Healthy Overweight (MHO), and Metabolically Unhealthy Overweight (MUO). The association of these phenotypes with sociodemographic variables of lifestyles and increased waist circumference was conducted by using logistic regression.

Results

In 37,558 individuals (72.7% women), the prevalence of MUNW was 23.3%. Among the additional phenotypes, MUO was found to be more prevalent (71.6%), while MHNW and MHO were very slightly common, 2% and 3.1%, respectively. In a multiple model, the factors associated with MUNW were age over 60 years (trend [OR 1.56 95% CI 0.97-2.52] p-value = 0.066), living in a rural area ([OR 1.58 95% CI 1.09-2.29] p-value = 0.015), and increased waist circumference ([OR 1.68 95% CI 1.45-1.95] p-value < 0.001). Male gender was inversely associated with all phenotypes (P < 0.05).

Conclusion

Almost a quarter of the analyzed population presented MUNW. People living in a rural area and over 60 years old were more likely to present MUNW. Men were less likely to present the weight phenotypes studied, although they could have been underrepresented.

Insulin reduces the transmission potential of chikungunya virus and activates the toll pathway in Aedes aegypti mosquitoes

Chikungunya virus (CHIKV) is an alphavirus that has re-emerged globally over the last two decades and has the potential to become endemic in the United States due to the presence of competent mosquito vectors, Aedes aegypti and Aedes albopictus. CHIK disease is characterised by fever, rash, and joint pain, and causes chronic debilitating joint pain and swelling in >50% of infected individuals. Given the disease severity caused by CHIKV and the global presence of vectors to facilitate its spread, strategies to reduce viral transmission are desperately needed; however, the human biological factors driving CHIKV transmission are poorly understood. Towards that end, we have previously shown that mosquitoes fed on alphavirus-infected obese mice have reduced infection and transmission rates compared to those fed on infected lean mice despite similar viremia in lean and obese mice. One of the many host factors that increase in obese hosts is insulin, which was previously shown to impact the infection of mosquitoes by several flaviviruses. However, insulin's impact on alphavirus infection of live mosquitoes is unknown and whether insulin influences mosquito-borne virus transmission has not been tested. To test this, we exposed A. aegypti mosquitoes to bloodmeals with CHIKV in the presence or absence of physiologically relevant levels of insulin and found that insulin significantly lowered both infection and transmission rates. RNA sequencing analysis on mosquito midguts isolated at 1-day-post-infectious-bloodmeal (dpbm) showed enrichment in genes in the Toll immune pathway in the presence of insulin, which was validated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). We then sought to determine if the Toll pathway plays a role in CHIKV infection of Ae. aegypti mosquitoes; therefore, we knocked down Myd88, a critical immune adaptor molecule for the Toll pathway, in live mosquitoes, and found increased CHIKV infection compared to the mock knockdown control group. Overall, these data demonstrate that insulin reduces CHIKV transmission by Ae. aegypti and activates the Toll pathway in mosquitoes, suggesting that conditions resulting in higher serum insulin concentrations may reduce alphavirus transmission. Finally, these studies suggest that strategies to activate insulin or Toll signalling in mosquitoes may be an effective control strategy against medically relevant alphaviruses.

The Effectiveness of Nutritional Strategies in the Treatment and Management of Obesity: A Systematic Review

Obesity, a condition primarily resulting from positive energy balance, has become a significant global health concern. Numerous studies have demonstrated that obesity is a major risk factor for various illnesses, including different types of cancer, coronary heart disease, sleep apnea, CV stroke, type II diabetes mellitus, etc. To effectively address this issue, prevention and treatment approaches to manage body weight are crucial. There are several evidence-based approaches available for the treatment and management of obesity, taking into account factors such as body mass index classification, individual weight history, and existing comorbidities. To facilitate successful obesity treatment and management, there are pragmatic approaches and tools available, including the reduction of energy density, portion control, and diet quality enhancement. These approaches encompass the use of medications, lifestyle interventions, bariatric surgery, and formula diets. Regardless of the specific method employed, behavior change, reduction of energy intake, and increased energy expenditure are integral components for successful treatment and management of obesity. These measures allow patients to personalize and customize their dietary patterns, leading to effective and sustainable weight reduction. Incorporating physical activities and self-monitoring of individual diets are effective techniques for promoting behavior change in obesity and weight management. The main objective of this systematic review is to evaluate the effectiveness of dietary/nutritional interventions in the treatment and management of obesity through provision of valuable insights into the effectiveness of such nutritional strategies. To attain this, a comprehensive analysis of various dietary approaches and their impacts on weight will be conducted.

Comparison of aspartame- and sugar-sweetened soft drinks on postprandial metabolism

Aim: We compared the impact of artificially- and sugar-sweetened beverages co-ingested with a mixed meal on postprandial fat and carbohydrate oxidation, blood glucose, and plasma insulin and triglyceride concentrations. Methods: Eight college-aged, healthy males completed three randomly assigned trials, which consisted of a mixed macronutrient meal test with 20oz of Diet-Coke (AS), Coca-Cola (NS), or water (CON). One week separated each trial and each participant served as his own control. Resting energy expenditure (REE) via indirect calorimetry, blood pressure, and blood samples were obtained immediately before, 5, 10, 30, 60, 120, and 180 min after meal and beverage ingestion. A two-way (treatment × time) repeated-measures ANOVA was conducted to assess REE, fat and carbohydrate oxidation rates, blood glucose, and plasma insulin and triglyceride concentrations. Results: There was a significant main effect of treatment on total fat oxidation (P = 0.006), fat oxidation was significantly higher after AS (P = 0.006) and CON (P = 0.001) compared to following NS. There was a significant main effect of treatment on total carbohydrate oxidation (P = 0.005), carbohydrate oxidation was significantly lower after AS (P = 0.014) and CON (P = 0.001) compared to following NS. Plasma insulin concentration AUC was significantly lower after AS (P = 0.019) and trended lower in CON (P = 0.054) compared to following NS. Conclusion: Ingestion of a mixed meal with an artificially-sweetened beverage does not impact postprandial metabolism, whereas a sugar-sweetened beverage suppresses fat oxidation and increases carbohydrate oxidation compared to artificially-sweetened beverage and water.

Association between obesity indicators and cardiometabolic disease in Chinese adults

BACKGROUND

Obesity is an established risk factor for cardiometabolic disease. Different measurements of obesity with cardiometabolic disease have been compared in recent studies in Western countries. However, obesity-related criteria for the Chinese population differ from the standard World Health Organization guidelines, and similar research in Chinese adults is limited.

MEASURES

Data were obtained from a comprehensive intervention project involving a community population with cardiovascular and cerebrovascular risk factors in Shenzhen in 2015. A total of 4,000 participants (1,605 men and 2,395 women) with a mean age of 56.01±9.78 years were included in this study. Categorical data are reported as percentages, and continuous data are reported as mean ± standard deviation. Logistic regression analyses were conducted to examine the associations of body mass index (BMI), waist circumference (WC), and neck circumference (NC) with hypertension, diabetes, and dyslipidemia among Chinese adults.

RESULTS

The participants had a mean BMI of 24.25±3.33 kg/m2, mean NC of 33.59±4.16 cm, and mean WC of 82.44±9.84 cm (men: 85.46±9.10 cm, women: 80.40±9.81 cm). Blood pressure, plasma glucose, and lipid levels in the BMI, WC, and NC groups were statistically significant (p < 0.05). BMI, WC, and NC were positively correlated with systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, and triglyceride and negatively correlated with low-density lipoprotein cholesterol (p < 0.05), while the risk of hypertension, diabetes, and dyslipidemia increased with an increase in BMI, WC, and NC (p < 0.05). One SD of BMI, WC, and NC resulted in an increase of 41%, 22%, and 31% risk of hypertension; 45%, 34%, and 47% risk of diabetes; and 37%, 32%, and 23% risk of dyslipidemia, respectively.

CONCLUSIONS

Compared to BMI and NC, WC was more strongly associated with cardiometabolic diseases in Chinese adults.

Region-related patterns of the main physical development indicators observed in northerners in the ontogenetic aspect

Indicators of physical development appear to be environmentally sensitive and thus we can consider them the main characteristics of the population health.The aim. To assess the line of physical development main variables in the ontogenetic aspect (data from the North born male subjects aged from 8 to 77).Material and methods. Three thousand seven hundred and ninety-four male Caucasians from 17 age groups were examined to analyse their physical development.Results. The study showed longer body length variables as the region-related somatometric picture which is characteristic of male Caucasian northerners in comparison with those from other regions of the Russian Federation, as well as from other countries. Besides, they exhibited significantly lower body mass index and reported to have had lower body weight since the age of 17. We can see the modern northerners’ somatotype being influenced by regional extremes. That also includes the end of the body growth processes by the start of ontogenesis in the youth. The line pattern of annual growth observed in the body length and weight variables indicates a combined pronounced dynamics in the 11 to 16 age period. By the age of 60–77 years subjects tend to decrease in the body length with a significant increase in the body weight and body mass index by the age of 31–36.Conclusion. The study suggests that identifying risks for the development of noninfectious and cardiovascular diseases caused by accelerated BMI in older populations requires monitoring of the North inhabitants’ main physical development indicators as well as the body annual growth variables.

A prospective cohort study of the association between key family and individual factors and obesity status among youth

There remains a significant gap in our knowledge of the synergistic nature of family dynamics, child characteristics, and child-rearing features in the etiology of obesity from childhood through adolescence. We assessed the associations of family dynamics (poverty, family structure), child characteristics (child temperament), and child-rearing features (maternal depression, maternal sensitivity, and type of child care) with the development of childhood obesity. Children (n = 1240) whose weights and heights were measured at least once for ten time points (from 2 years through 15 years) from the NICHD Study of Early Child Care and Youth Development were included. Generalized estimating equation (GEE) was used to examine the associations of family and individual factors with the childhood obesity after adjusting for covariates. Adjusted GEE models showed that living below poverty level was associated with an increased odds of obesity (odds ratio = 1.62, 95% confidence interval 1.05, 2.53). Among these key family and individual factors, poverty status was observed to be the strongest predictor of obesity of offspring across time. Findings highlight the importance of systemic-level public health changes in obesity reduction efforts and suggest that poverty-reduction based prevention and intervention are likely more effective targets than more individual/family specific targets.

Obesity, Hypovitaminosis D, and COVID-19: the Bermuda Triangle in Public Health

PURPOSE OF REVIEW

The COVID-19 pandemic has challenged public health to a significant extent by markedly increasing morbidity and mortality. Evidence suggests that obesity and hypovitaminosis D constitute important risk factors for SARS-CoV-2 infection, severity of disease, and poor outcomes. Due to their high prevalence globally, obesity and hypovitaminosis D are considered pandemics. This review presents current epidemiologic and genetic data linking obesity, hypovitaminosis D, and COVID-19, highlighting the importance of the convergence of three pandemics and their impact on public health. We also briefly summarize potential mechanisms that could explain these links.

RECENT FINDINGS

Epidemiologic data have shown that obesity is an independent risk factor for COVID-19, severe disease and death, and genetic evidence has suggested a causal association between obesity-related traits and COVID-19 susceptibility and severity. Additionally, obesity is independently associated with hypovitaminosis D, which is highly prevalent in subjects with obesity. Hypovitaminosis D is independently associated with a higher risk for COVID-19, severity, hospitalization, infectious complications, acute respiratory distress syndrome, and poor outcomes. However, genome-wide association studies have not revealed any causal association between vitamin D levels and the risk for COVID-19, while there is no robust evidence for a beneficial role of vitamin D supplementation in the prevention and treatment of COVID-19. In the context of the ongoing COVID-19 pandemic, the epidemiologic impact of obesity and hypovitaminosis D is emphasized. Efforts to increase public awareness and reinforce preventive and therapeutic measures against obesity and hypovitaminosis D are strongly required.

Effects of saffron (Crocus sativus L.) on anthropometric and cardiometabolic indices in overweight and obese patients: A systematic review and meta-analysis of randomized controlled trials

The worldwide prevalence of obesity is approximately tripled between 1975 and 2016 according to World Health Organization; therefore, obesity is now considered a global pandemic that needs academic and clinical focus. In search of antiobesity agents, Crocus sativus, known widely as saffron, has been praised for its beneficial effects. Several randomized controlled trials (RCTs) have been conducted to investigate the weight lowering effect of saffron. Following PRISMA guidelines, several medical databases were comprehensively searched for RCTs with a population consisting of obese individuals. A random-effects meta-analysis was used to pool estimates across studies, and standardized mean difference (SMD) was used to synthesize quantitative results. Twenty-five RCTs met the inclusion criteria. Meta-analysis showed a nonsignificant decrease for weight (-0.32 kg; CI: -3.15, 2.51; p = 0.82), BMI (-0.06 kg/m² ;CI:-1.04,0.93; p = .91), waist circumference (-1.23 cm; CI: -4.14, 1.68; p = .41), and hip circumference (-0.38 cm; CI: -5.99, 5.23; p = .89) and a significant decrease of waist-to-hip ratio (SMD = -0.41; CI: -0.73, -0.09; p = .01; I²  = 0%). The mean difference in fasting blood sugar showed a significant reduction in patients with metabolic syndrome (SMD = -0.30; 95% CI: -0.63, 0.03; p = .07; I²  = 0.37%) but a nonsignificant change in the HbA1C level (WMD = 0.05; 95% CI: 0.32, 0.41; p = .79). Despite bearing several limitations, mainly as a result of heterogeneity among included studies, the available evidence indicates saffron supplementation shows promising effects on some cardiometabolic factors among overweight to obese patients; however, further investigations and high-quality evidence are required for more generalizable and comprehensive results.

BMI is important in predicting the loss of response in inflammatory bowel disease patients on tumour necrosis factor-α inhibitors

INTRODUCTION

Obesity is an emerging phenomenon among patients with inflammatory bowel disease (IBD). This study aims to evaluate whether the response to tumour necrosis factor-α (TNF-α) inhibitors (infliximab and adalimumab) could be influenced by BMI in IBD.

METHODS

We identified a cohort of 181 IBD patients attending a single-tertiary centre, naive to biologic therapy and stratified them according to their BMI. The primary outcome is the first occurrence of loss of response (LOR).

RESULTS

The median BMI was 26 kg/m2 (15-63 kg/m2). Approximately 68% of patients had LOR on both adalimumab (ADA) (n = 52) and infliximab (IFX) (n = 71). However, 83% on ADA with BMI ≥30 kg/m2 had LOR compared to 61% on IFX with BMI ≥30 kg/m2. For patients on ADA, Cox regression analysis revealed that after accounting for age, sex, disease type, duration of disease, fistulising disease, smoking status, haemoglobin, C-reactive protein, albumin and platelet levels, there were statistically significant associations between BMI (≥30 kg/m2 vs. <30 kg/m2) and LOR [P = 0.010; hazard ratio (HR) 3.2; confidence interval (CI), 1.3-7.6]. However, for patients on IFX, after accounting for the same factors, the only significant factor was the association of lower rate of LOR with higher albumin levels (P = 0.024; HR 0.95; CI, 0.91-0.99). There was an increased accelerated time to LOR for patients on ADA with BMI ≥30 kg/m2 compared to BMI <30 kg/m2 (P = 0.026). However, there was no difference in time to LOR for patients on IFX (P = 0.177).

CONCLUSION

BMI is important in predicting the LOR among IBD patients on TNF-α inhibitors, especially among patients receiving ADA.

The Relationship between Obesity and Pre-Eclampsia: Incidental Risks and Identification of Potential Biomarkers for Pre-Eclampsia

Obesity has been steadily increasing over the past decade in the US and worldwide. Since 1975, the prevalence of obesity has increased by 2% per decade, unabated despite new and more stringent guidelines set by WHO, CDC, and other public health organizations. Likewise, maternal obesity has also increased worldwide over the past several years. In the United States, pre-pregnancy rates have increased proportionally across all racial groups. Obesity during pregnancy has been directly linked to obstetric complications including gestational diabetes, HTN, hematomas, pre-eclampsia, and congenital defects. In the particular case of pre-eclampsia, the incidence rate across the globe is 2.16%, but the condition accounts for 30% of maternal deaths, and a robust body of evidence underscored the relationship between obesity and pre-eclampsia. More recently, attention has focused on the identification of reliable biomarkers predictive of an elevated risk for pre-eclampsia. The aim of this literature review is to elucidate the relationship between obesity and these predictive biomarkers for future prediction and prevention of pre-eclampsia condition in women at risk.

Obesity as a Condition Determined by Food Addiction: Should Brain Endocannabinoid System Alterations Be the Cause and Its Modulation the Solution?

Obesity is a complex disorder, and the number of people affected is growing every day. In recent years, research has confirmed the hypothesis that food addiction is a determining factor in obesity. Food addiction is a behavioral disorder characterized by disruptions in the reward system in response to hedonic eating. The endocannabinoid system (ECS) plays an important role in the central and peripheral control of food intake and reward-related behaviors. Moreover, both obesity and food addiction have been linked to impairments in the ECS function in various brain regions integrating peripheral metabolic signals and modulating appetite. For these reasons, targeting the ECS could be a valid pharmacological therapy for these pathologies. However, targeting the cannabinoid receptors with inverse agonists failed when used in clinical contexts as a consequence of the induction of affective disorders. In this context, new classes of drugs acting either on CB1 and/or CB2 receptors or on synthetic and degradation enzymes of endogenous cannabinoids are being studied. However, further investigation is necessary to find safe and effective treatments that can exert anti-obesity effects, normalizing reward-related behaviors without causing important adverse mood effects.

The influence of supraliminal priming on energy density of food selection: a randomised control trial

Background

Many people exercise because they know it is good for their health. Although this is true, it can make us feel deserving of a reward and lead us to eat more indulgent, less healthy food than if we had not done any exercise. Generally, lower energy-dense (LED) foods are recognised as healthier choices than higher energy-dense (HED) options. Despite our intention to make healthy choices, seeing tempting higher-calorie foods on offer often side-tracks us. Priming is a psychological tool that makes specific changes to our environment that remind us of our motivation to be healthy. This makes it easier to choose a healthier option, by nudging us towards it without us even realising. However, it is currently unclear which method of priming achieves the best results.

Aims

Our study explores whether priming people to expect they will receive LED food leads them to make this healthier choice after exercise, even when also offered tempting less healthy HED foods at the moment of selection.

Methods

Our study observed the foods selected by university athletes after their sports matches. Before the match, half of the participants were primed by asking them to choose a LED snack from the options we offered, which they would receive after the match. The remaining half of participants were not asked this same question. To distract the athletes from our observation of their food choices, participants completed a task prior to choosing their snack, which was disguised as a ‘thank you’ for taking part.

Results

Overall, we found the priming group did not choose LED foods significantly more than the control group, hence priming did not increase LED food selection.

Conclusion

Importantly, our results indicate that priming must be more noticeable to achieve its goal. Additionally, we demonstrated that priming may be less successful for young athletic individuals, compared to older and more overweight adults recruited in other studies. This highlights the importance of studying a broader demographic range of individuals from the general population. We support future research into this area, which will help us to tweak priming to achieve the best outcomes.

Trial registration

ISRCTN Registry, ISRCTN74601698. Date registered: 02/10/2020 (retrospectively registered).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00554-1.

Proteomic and Structural Manifestations of Cardiomyopathy in Rat Models of Obesity and Weight Loss

Obesity cardiomyopathy increases the risk of heart failure and death. Obesity is curable, leading to the restoration of the heart phenotype, but it is not clear if there are any after-effects of obesity present after weight loss. We characterize the proteomic landscape of obesity cardiomyopathy with an evaluation of whether the cardiac phenotype is still shaped after weight loss. Cardiomyopathy was validated by cardiac hypertrophy, fibrosis, oversized myocytes, and mTOR upregulation in a rat model of cafeteria diet-induced developmental obesity. By global proteomic techniques (LC-MS/MS) a plethora of molecular changes was observed in the heart and circulation of obese animals, suggesting abnormal utilization of metabolic substrates. This was confirmed by increased levels of cardiac ACSL-1, a key enzyme for fatty acid degradation and decreased GLUT-1, a glucose transporter in obese rats. Calorie restriction and weight loss led to the normalization of the heart's size, but fibrosis was still excessive. The proteomic compositions of cardiac tissue and plasma were different after weight loss as compared to control. In addition to morphological consequences, obesity cardiomyopathy involves many proteomic changes. Weight loss provides for a partial repair of the heart's architecture, but the trace of fibrotic deposition and proteomic alterations may occur.

The impact of gardening on nutrition and physical health outcomes: a systematic review and meta-analysis

Community gardening has been widely recognized as a multicomponent approach that has affected a broad range of health and well-being outcomes. The objective of this study was to investigate the association between community gardening and nutrition and physical health among adults. A systematic review and meta-analysis were conducted. Five electronic databases were searched systematically. Quality of included studies was appraised by several quality assessment tools related to the study design of each included article. Evidence from 19 articles was included (14 cross-sectional studies, 4 quasi-experimental studies and 1 case-control study). Although the majority of included studies appeared to have moderate quality, there existed weaknesses in the methods used, including low response rate and lack of confounder controls. Due to diversity in the measurement units, only body mass index (BMI) data could be pooled to perform meta-analysis. The results suggest that gardening had a significantly positive effect on BMI reduction. Subgroup analysis showed that quasi-experimental and case-control studies produced greater pooled effect size than those of cross-sectional design. Funnel plot and Egger's test showed no significant evidence of publication bias. As robust evidence for the effect of community gardening on BMI reduction was found, this intervention should be integrated in health promoting policy to improve population health.

NLRP3 inflammasome deficiency attenuates metabolic disturbances involving alterations in the gut microbial profile in mice exposed to high fat diet

Obesity-related diseases (e.g. type 2 diabetes mellitus and cardiovascular disorders) represent an increasing health problem worldwide. NLRP3 inflammasome activation may underlie obesity-induced inflammation and insulin resistance, and NLRP3 deficient mice exposed to high fat diet (HFD) appear to be protected from left ventricle (LV) concentric remodeling. Herein, we investigated if these beneficial effects were associated with alterations in plasma metabolites, using metabolomic and lipidomic analysis, and gut microbiota composition, using 16S rRNA sequencing of cecum content, comparing NLRP3 deficient and wild type (WT) mice on HFD and control diet. Obese NLRP3 deficient mice had lower systemic ceramide levels, potentially resulting attenuating inflammation, altered hepatic expression of fatty acids (FA) with lower mono-saturated FA and higher polyunsaturated FA levels, potentially counteracting development of liver steatosis, downregulated myocardial energy metabolism as assessed by proteomic analyses of LV heart tissue, and different levels of bile acids as compared with WT mice. These changes were accompanied by an altered composition of gut microbiota associated with decreased systemic levels of tri-methylamine-N-oxide and lipopolysaccharide, potentially inducing attenuating systemic inflammation and beneficial effects on lipid metabolism. Our findings support a role of NLRP3 inflammasome in the interface between metabolic and inflammatory stress, involving an altered gut microbiota composition.

Prevalence of overweight in adolescents from a Southern Brazilian city according to different anthropometric indexes

Objective:

To identify the prevalence of overweight in adolescents according to different classification criteria for obesity and somatic maturation stages.

Methods:

Cross-sectional study in 10 schools in a city from Southern Brazil, with 1715 adolescents. Height, weight, waist circumference, and neck circumference (NC) data were collected. Body Mass Index was classified according to World Health Organization (WHO) and Centers for Disease Control and Prevention criteria, and the waist-to-height ratio (WHtR) was classified according to Brazilian and European cut-off points. Somatic maturation was obtained through the Peak Height Velocity. The prevalence data were compared between sex and stages of somatic maturation; the concordance between different criteria was verified.

Results:

The prevalence of overweight was high in both sexes; WHO criteria showed that 34.5% of boys and 29.3% of girls were overweight. For the WHtR, the prevalence was 28.4% in boys and 23.7% in girls. NC classified 13.8% of boys and 15.8% of girls as being overweight. The prevalence of overweight was higher in adolescents before complete somatic maturation.

Conclusions:

The prevalence of overweight was high among adolescents. The boys presented higher frequency of overweight, except if NC was used to classify them. Adolescents before somatic maturation had a higher prevalence of overweight. NC showed a lower ability to track obese adolescents.

Facing obesity in pain rehabilitation clinics: Profiles of physical activity in patients with chronic pain and obesity-A study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

Background

The obesity epidemic has influenced pain rehabilitation clinics. To date, little is known about baseline level of physical activity (PA) in patients referred to pain rehabilitation clinics. We aimed to investigate the PA levels of patients referred to pain rehabilitation clinics and to evaluate the effect of excess weight on PA level.

Methods and findings

Data were obtained from the Swedish Quality Registry for Pain Rehabilitation between 2016 and 2017. These data included PA time (everyday PA and physical exercise per week), Body Mass Index (BMI), sociodemographic factors, chronic pain and psychological aspects (e.g., pain intensity, depressive and anxiety symptoms and insomnia problems). Insufficient PA was defined as less than 150 minutes per week. We performed logistic regressions as well as orthogonal partial least square regression to estimate the effects of excess weight on PA. Over one-fourth of the patients were classified as obese (BMI ≥30 kg/m², 871/3110, 25.3%) and nearly one-third of these patients were classified as severely obese (BMI ≥35 kg/m², 242/871, 27.8%). Time estimations for physical exercise varied among the BMI groups, but patients in the higher BMI category were more likely to spend less time on everyday PA. Compared to normal weight, mild obesity [odds ratio (OR) 0.65, 95% confidence interval (CI) 0.53–0.81] and severe obesity (OR 0.56, 95% CI 0.42–0.74) were associated with less PA. Mild obese patients had an elevated risk of 65% and severe obese patients had an elevated risk of 96% for insufficient PA. Increased pain intensity was positively related to insufficient PA (OR 1.17, 95% CI 1.06–1.29) among the obese patients.

Conclusion

Having low PA is very common for patients referred to pain rehabilitation clinics, especially for those with comorbid obesity. As a first step to increase PA, obese patients need to be encouraged to increase the intensity and amount of less painful daily PA.

Validation of Obesity Status Based on Self-Reported Data among Filipina and Indonesian Female Migrant Domestic Workers in Macao (SAR), China

BACKGROUND

Migrant domestic workers are at high risk of overweight and obesity. It is crucial to assess the prevalence of obesity among this migrant population, for surveillance and intervention. Self-reported height and weight are commonly used to derive body mass index (BMI) and assess the prevalence of obesity. The accuracy of BMI from self-reported height and weight in migrant populations remains unknown. The aim of this study was to assess the accuracy of BMI from self-reported measures and identify the optimal adjustment to be made to overweight and obesity cut-off points when using self-reported body mass index among migrant workers.

METHODS

Self-reported and objectively measured height and weight were obtained from 1388 female Filipina domestic workers and 369 female Indonesian domestic workers recruited using respondent-driven sampling between November 2016 and August 2017. Self-reported BMI (based on self-reported height and weight) and measured BMI (based on objectively measured height and weight) were calculated as weight in kilograms divided by the square of height in meters for all participants (kg/m2).

RESULTS

BMI derived from self-reported height and weight was underestimated for both Filipina (z = -27.5, p < 0.001) and Indonesian (z = -9.9, p < 0.001) participants. Applying the gold standard of Asian BMI cut-off points to self-reported BMI, the sensitivity in identifying overweight or obesity was 64.4% for Filipina participants and 78.6% for Indonesian participants and the specificity was 97.9% for Filipina participants and 93.8% for Indonesian participants for overweight or obesity. When self-reported measures were used, the receiver operator characteristic (ROC) curves and the corresponding area under the curve (AUC) indicated optimal cut-off points of 22.0 kg/m2 and 22.3 kg/m2 for Filipina and female Indonesian participants for overweight or obesity.

CONCLUSIONS

Although BMI derived from self-reported height and weight allows for quick and low-cost obesity screening, a considerable underestimation of overweight or obesity prevalence was observed in Filipina and female Indonesian migrant domestic workers in Macao (Special Administrative Region, SAR), China. With the best compromise between sensitivity and specificity, the new cut-off points can be used in future studies to identify overweight or obesity in these two populations using self-reported height and weight.

An Atypical Case of Morbid Obesity, Presenting With Deep Vein Thrombosis and Pulmonary Embolism

Extreme obesity or Class III obesity is defined as a body mass index (BMI) greater than 40 kg/m² and is invariably associated with a marked increase in morbidity and mortality. Our patient is a 36-year-old male wrestler, with a BMI of 63.53 kg/m², and has been suffering from recurrent deep vein thrombosis (DVT), pulmonary embolism, osteoarthritis of both knees, obstructive sleep apnea, insulin-dependent type ll diabetes mellitus, fungal infections, pulmonary hypertension, neuropathy, and foot ulcers. He has been subjected to multiple surgeries and interventions, primarily because of his profession. He presents to us with pain in his chest and in his left leg for the past two days. Extreme obesity is a global health problem and has acquired the level of a pandemic. This case emphasizes the role of early detection and management of extreme obesity and its complications.

Abdominal Obesity Phenotypes and Incidence of Thyroid Autoimmunity: A 9-Year Follow-up

PURPOSE

The association between obesity and autoimmune diseases has been suggested by several previous studies. The objective of our study was to assess the association of abdominal obesity phenotypes with thyroid autoimmunity.

MATERIALS AND METHODS

This study was conducted within the framework of a population-based cohort study, Tehran Thyroid Study (TTS) on 4708 subjects without thyroid autoimmunity at baseline. Participants were categorized into four abdominal obesity phenotypes according to waist circumference (WC) and other metabolic syndrome components. Serum concentrations of thyroid peroxidase antibody (TPOAb), free T4 (FT4), thyrotropin (TSH), glucose, and lipid profiles were measured after 3, 6 and 9 years of follow-up. Cox proportional hazard models were used to evaluate associations of different phenotypes with the incidence of thyroid autoimmunity, adjusted for age, sex, FT4, and TSH.

RESULTS

Highest and lowest incidence rates of TPOAb positivity were observed among metabolically unhealthy, non-abdominally obese (MUNAO) [8.78 (7.31-10.55) per 1000 person-years of follow-up] and metabolically unhealthy abdominally obese (MUAO) [4.98 (3.88-6.41) per 1000 person-years of follow-up] phenotypes. Considering the metabolically healthy non-abdominal obese (MHNAO) individuals as reference, none of metabolically healthy abdominally obese (MHAO), MUNAO, and MUAO phenotypes were associated with increased risk of developing TPOAb positivity. Compared to individuals with high WC, the incidence rate (95%CI) of TPOAb positivity was higher among those with normal WC: 8.44 (7.13-10.0) vs 5.11 (4.01-6.51) per 1000 person-years, respectively. Higher WC was not associated with incident TPOAb positivity.

CONCLUSION

There was no significant association between baseline abdominal obesity phenotype status and development of TPOAb positivity over 9 years of follow-up.

The Lymphatic Vasculature in the 21st Century: Novel Functional Roles in Homeostasis and Disease

Mammals have two specialized vascular circulatory systems: the blood vasculature and the lymphatic vasculature. The lymphatic vasculature is a unidirectional conduit that returns filtered interstitial arterial fluid and tissue metabolites to the blood circulation. It also plays major roles in immune cell trafficking and lipid absorption. As we discuss in this review, the molecular characterization of lymphatic vascular development and our understanding of this vasculature's role in pathophysiological conditions has greatly improved in recent years, changing conventional views about the roles of the lymphatic vasculature in health and disease. Morphological or functional defects in the lymphatic vasculature have now been uncovered in several pathological conditions. We propose that subtle asymptomatic alterations in lymphatic vascular function could underlie the variability seen in the body's response to a wide range of human diseases.

Obesity as a risk factor for COVID-19: an overview

The current coronavirus disease-2019 (COVID-19) pandemic presents a huge challenge for health-care systems worldwide. Many different risk factors are associated with disease severity, such as older age, diabetes, hypertension, and most recently obesity. The incidence of obesity has been on the rise for the past 25 years, reaching over 2 billion people throughout the world, and obesity itself could be considered a pandemic. In this review, we summarize aspects involved with obesity, such as changes in the immune response, nutritional factors, physiological factors, and the gut-lung axis, that impact the viral response and the COVID-19 prognosis.

Anthocyanins and Human Health-A Focus on Oxidative Stress, Inflammation and Disease

Consumption of anthocyanins (ACNs), due to their antioxidant, anti-inflammatory and anti-apoptotic effects, has been proposed for the prevention and treatment of several different diseases and conditions. ACNs are recognized as one of the leading nutraceuticals for prolonging health benefits through the attenuation of oxidative stress, and inflammatory or age-related diseases. Increased consumption of ACNs has the potential to attenuate the damage ensuing from oxidative stress, inflammation, enhance cardiometabolic health, and delay symptoms in predisposed neuropathology. A myriad of evidence supports ACN consumption as complementary or standalone treatment strategies for non-communicable diseases (NCDs) including obesity, diabetes, cardiovascular disease (CVD), neurodegenerative diseases, as well as, more recently, for the modulation of gut bacteria and bone metabolism. While these findings indicate the beneficial effects of ACN consumption, their food sources differ vastly in ACN composition and thus potentially in their physiological effects. Consumption of foods high in ACNs can be recommended for their potential beneficial health effects due to their relatively easy and accessible addition to the everyday diet.

MetAP2 inhibition reduces food intake and body weight in a ciliopathy mouse model of obesity

The ciliopathies Bardet-Biedl syndrome and Alström syndrome are genetically inherited pleiotropic disorders with hyperphagia and obesity as primary clinical features. Methionine aminopeptidase 2 inhibitors (MetAP2i) have been shown in preclinical and clinical studies to reduce food intake, body weight, and adiposity. Here, we investigated the effects of MetAP2i administration in a mouse model of ciliopathy produced by conditional deletion of the Thm1 gene in adulthood. Thm1 conditional knockout (cko) mice showed decreased hypothalamic proopiomelanocortin expression as well as hyperphagia, obesity, metabolic disease, and hepatic steatosis. In obese Thm1-cko mice, 2-week administration of MetAP2i reduced daily food intake and reduced body weight 17.1% from baseline (vs. 5% reduction for vehicle). This was accompanied by decreased levels of blood glucose, insulin, and leptin. Further, MetAP2i reduced gonadal adipose depots and adipocyte size and improved liver morphology. This is the first report to our knowledge of MetAP2i reducing hyperphagia and body weight and ameliorating metabolic indices in a mouse model of ciliopathy. These results support further investigation of MetAP2 inhibition as a potential therapeutic strategy for ciliary-mediated forms of obesity.

Body mass index and risk of sick leave: A systematic review and meta-analysis

Body mass index (BMI) is related to different health dimensions and can be a risk factor for diseases. Our objective was to systematically review and meta-analysis the association BMI and the risk of sick leave. Four databases were searched for articles until late December 2018 and the results of the studies were extracted and combined using random effects methods. Several sub-group analyses were conducted as well as bias of publication were measured. A total of 23 longitudinal studies entered into meta-analysis. BMI ≥ 25 was a risk factor for sick leave; the risk ratio (RR) is equal to 1.20 with confidence interval (CI): 1.14 to 1.28. In the overweight, this result was achieved: RR = 1.09 and CI = 1.04 to 1.15 (P = 0.001) and in the obesity, RR = 1.30 and CI = 1.19 to 1.42 (P < 0.001). In both men and women, overweight and obesity were both a risk factor for sick leave. A high BMI is a risk factor that threatens health in different dimensions and therefore, overweight/obesity prevention and treatment should be given increasing attention. This will reduce the burden of illness and its consequences.

A MetAP2 inhibitor blocks adipogenesis, yet improves glucose uptake in cells

Adipose tissue expansion involves angiogenesis to remodel its capillary network. The enzymemethionine aminopeptidase 2(MetAP2) promotes angiogenesis.MetAP2 inhibitors suppress angiogenesis and have potential anti-obesity effect. However, impairment in adipose tissue expansion is also linked with impaired glycemic control.This study investigated the effect of BL6, a MetAP2 inhibitor, on adipogenesis and glucose disposal.To test effect on angiogenesis, Human Umbilical Vein Endothelial Cells(HUVECs) were treated with BL6 for 24h to determine tube formation. Further, to test effect on adipogenesis and glucose disposal,3T3-L1 pre-adipocytes were treated with BL6(0 µM, 20µM, 50 µM or 100µM) during differentiation. Differentiated cells were stained with Oil Red O for determining lipid accumulation, and glucose uptake assay. Protein levels and RNA expression for key genes involved in the adipogenic cascade were determined.BL6 treatment of HUVECs dose dependently blocked angiogenesis. During differentiation of pre-adipocytes, 50μM and 100µM BL6 significantly reduced lipid accumulation. Treatment with 100µM BL6 significantly decreased expression of adipogenic genes. Interestingly, BL6 treatment dose dependently increased glucose uptake by 3T3-L1 cells.MetAP2 inhibitor blocks angiogenesis, attenuates adipogenesis, yet increases cellular glucose uptake. Collectively this proof of concept study supports a possible role for MetAP2 inhibitor BL6, as a putative anti-obesity therapeutic agent.

Bariatric Surgery Among Medicare Subgroups: Short- and Long-Term Outcomes

OBJECTIVE

This study sought to examine weight change, postoperative adverse events, and related outcomes of interest among age-qualified (AQ) and disability-qualified (DQ) Medicare recipients compared with non-Medicare (NM) patients undergoing an initial bariatric procedure.

METHODS

The Longitudinal Assessment of Bariatric Surgery (LABS-2) is an observational cohort study of 2,458 adults who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) bariatric surgery. Weight, percentage body fat, functional status, and comorbidities, as well as postoperative adverse events, were assessed at baseline and annually for 5 years. The 1,943 participants who reported insurance type were categorized into the following groups: AQ, DQ, or NM.

RESULTS

The median preoperative BMI ranged from 45 to 48 kg/m² across groups. For RYGB, 5-year BMI loss was approximately 30% for all groups, and for LAGB, BMI loss was 12% to 15%. Diabetes remission after 5 years was also similar across groups within procedure types (RYGB: 33%-40%; LAGB: 13%-19%). The frequency of adverse events after RYGB ranged from 4.1% for NM participants to 6.7% for DQ participants. After LAGB, there were no adverse events for the AQ group, whereas 3% of DQ participants and 1.8% of NM participants had at least one adverse event.

CONCLUSIONS

Medicare participants experienced substantial BMI loss and diabetes remission, with a frequency of adverse events similar to that of NM participants.

Obesity Paradox in Ischemic Stroke: Clinical and Molecular Insights

It has recently emerged the concept of "obesity paradox," a term used to describe the unexpected improved prognosis and lower mortality rates found in several diseases in patients with higher body weight. Concerning stroke, few clinical studies have assessed this obesity paradox showing contradictory results. Therefore, our aim was to compare clinical evolution and inflammatory balance of obese and non-obese patients after ischemic stroke. We designed a prospective case-control study in patients with acute ischemic stroke categorized into obese (body mass index, BMI ≥ 30 kg/m²) and non-obese (BMI < 30 kg/m²). We compared clinical, anthropometric, radiological, and laboratory variables. The main outcome variable was the functional outcome at 3 months. We included 98 patients (48 non-obese and 50 obese). No differences in functional outcome at 3 months were found (p = 0.882) although a tendency of a greater recovery on neurological impairments was seen in obese subjects. Importantly, obese patients (p = 0.007) and patients who experienced poor outcome (p = 0.006) exhibited a higher reduction in body weight at 3 months after stroke. Moreover, pro-inflammatory IL-6 levels (p = 0.002) were higher in the obese group. However, IL-6 levels decreased over the first week in obese while increased in non-obese. On the contrary, levels of the anti-inflammatory IL-10 rose over the first week in obese patients, whereas remained stable in non-obese. In summary, despite exhibiting several factors associated with poor outcome, obese patients do not evolve worse than non-obese after ischemic stroke. Obesity may counterbalance the inflammatory reaction through an anti-inflammatory stream enhanced in the first moments of stroke.

Increased concentration of serum MDA, decreased antioxidants and altered trace elements and macro-minerals are linked to obesity among Bangladeshi population

BACKGROUND AND OBJECTIVE

Obesity is an emerging public health concern in Bangladesh. This study aimed to find the levels of the serum malondialdehyde (MDA), non-enzymatic antioxidants (vitamin A, C and E), trace elements (zinc and iron) and macro-minerals (calcium, potassium and sodium) in obesity and its action in disease advancement.

METHODS

Level of lipid peroxidation was estimated by measurement of the serum concentrations of malondialdehyde (MDA). Vitamin A and E concentration was found by RP-HPLC method and vitamin C was assessed for serum ascorbic acid by UV spectrophotometric method. Serum trace elements (Zn and Fe) and macro-minerals (Na, K and Ca) were estimated by Atomic Absorption Spectroscopy (AAS).

RESULTS

Our study observed significantly elevated concentrations of MDA (p < 0.001) and depleted concentrations of antioxidants (vitamin A, E and C) (p < 0.05) in the patient than control group. Analysis of serum trace elements (Zn and Fe) and macro-minerals (Na, K and Ca) and found that the mean values of Zn, Fe, Na, K and Ca were 0.39 ± 0.02 and 0.43 ± 0.03, 3284.81 ± 34.51, 162.18 ± 3.72, 44.62 ± 2.13 mg/L for the patient and 0.91 ± 0.13, 0.88 ± 0.06, 2562.74 ± 95.92, 243.58 ± 8.97, 87.66 ± 2.10 mg/L for the controls, consequently. There was a substantial difference in trace elements and macro-minerals between the patients and controls (p < 0.001).

CONCLUSION

Our study proposes that increased serum concentrations of MDA and decreased non-enzymatic antioxidant and altered trace elements and macro-minerals are powerfully related with obesity.

Rosmarinic acid and its ester derivatives for enhancing antibacterial, α-glucosidase inhibitory, and lipid accumulation suppression activities

Rosmarinic acid (RA), commonly found in Nepetoidae subfamily of Lamiaceae family, possesses various biological activities. To expand its application, RA was modified by esterification with methyl (me), propyl (pro), and hexyl (hex) alcohols and then tested antibacterial, α-glucosidase inhibitory, and lipid accumulation suppression activities. Consequently, RA derivatives enhanced antibacterial activity, especially the RA-pro and RA-hex, which effectively inhibited the growth of Bacillus cereus rather than tannic acid, a natural antibacterial agent. RA-hex also inhibited α-glucosidase inhibitory activity greater than luteolin. By computational molecular docking, dihydroxyphenyl group and hexyl group were selected as essential groups for interaction with the active site of α-glucosidase through hydrogen bonding and hydrophobic interaction, contributing to the great inhibitory activity. Furthermore, RA-pro and RA-hex effectively suppressed lipid accumulation of 3T3-L1 cells, superior to EGCG, a well-known anti-obesity phytochemical. These biological effects of RA derivatives commonly attributed to hydrophobicity, hydrogen bonding, and steric bulkiness of the side chain. PRACTICAL APPLICATIONS: Rosmarinic acid (RA), a fundamental compound in the family Lamiaceae, is one of powerful naturally occurring antioxidants as well as other biological activities. Furthermore, its abundance in nature was also high in amount in the plant kingdom. So, natural RA can be one of possible natural resources for creating potent natural drugs and biologically useful substances after chemical modification. Studies on various biological activities may intensively expand usage and application of RA. In this study, RA was derivatized to corresponding ester such as methyl, propyl, and hexyl alcohols with higher hydrophobicity, and found great antibacterial, α-glucosidase inhibitory, and lipid accumulation suppression activities. RA-pro and RA-hex significantly suppressed lipid accumulation and cell differentiation. Therefore, RA derivatives with multiple biological activities have the potential to be applied in the food and pharmaceutical industries as food ingredients and supplements.

Frequency of insulin resistance in nondiabetic adult Bangladeshi individuals of different obesity phenotypes

Insulin resistance (IR) is the corner stone of metabolic obesity. This cross-sectional analytical study was aimed to find out the frequency of IR in non-diabetic adult individuals of different obesity phenotypes that would help to implement preventive measures to avoid the cardiometabolic catastrophes.

METHODS

Total 955 nondiabetic adult individuals were selected and categorized into six metabolic phenotypes by metabolic syndrome criteria in each BMI group (18.5-24.9-normal weight, 25-29.9-overweight, ≥30-obese). From them, metabolically obese normal weight, metabolically obese overweight, metabolically healthy obese and metabolically unhealthy obese were selected as Obesity phenotypes (N = 616).

RESULTS

The frequency of IR was found to be very high (60.2%) in total nondiabetic adult obese individuals (N = 616). Highest frequency of IR was found in MUO phenotype (76.3%), lowest frequency of IR was found in MONW phenotype (37.1%) and frequency of IR in MOOW and MHO phenotypes found to be identical but significantly (p < 0.0001) less than MUO and significantly (p < 0.0001) more than MONW phenotype. Among the obesity phenotypes, females were more insulin resistant than males (67.5% vs 48.1% respectively, p < 0.05). Frequency of IR found significantly (p < 0.05) more in female than male in all obesity phenotypes except in MUO phenotype where males found to show significantly (p < 0.05) higher frequency than females. Frequency of IR was significantly higher in younger (20-39 yrs) age group than 40-60 yrs age group (63.2% vs 53.5% respectively, p < 0.05).

CONCLUSION

IR is alarmingly high (60.2%) in nondiabetic adult obese individuals. Among different obesity phenotypes, it is highest (76.3%) in MUO and lowest (37.1%) in MONW.

Leptin blocks the inhibitory effect of vitamin D on adipogenesis and cell proliferation in 3T3-L1 adipocytes

Recently, we demonstrated high serum leptin and 25(OH)D (calcidiol) in obese animals, with high C/EBP_β and PPAR_γ expression in adipose tissue. Since the role of vitamin D in adipogenesis remains controversial and hyperleptinemia is found in obesity, we asked if leptin could interfere in vitamin D action on adipocytes. Here, we studied the direct effect of these two hormones upon 3T3L1 preadipocytes incubated with or without 1,25(OH)2D (100 nM, 24 h) and with leptin (10^-7 M, 4 h later). RT-PCR (VDR and Cyp27b1/1α-hydroxylase), western blotting (VDR, Cyp27b1/1α-hydroxylase, ObR-b, C/EBP_β, PPAR_γ and Bax content), a cell proliferation assay and an Annexin V-FITC binding assay were performed. Incubation with 1,25(OH)2D decreased Cyp27b1/1α-hydroxylase and VDR. Co-incubation of 1,25(OH)2D and leptin did not change Cyp27b1/1α-hydroxylase and had no additive effect upon the decreased VDR mRNA. Incubation with 1,25(OH)2D decreased C/EBP_β and PPARγ. In the cell proliferation assay, 1,25(OH)2D decreased the number of 3T3L1 cells. No changes in OBR-b or apoptotic parameters (Bax and annexin-V) were observed. The 1,25(OH)2D decreased pro-adipogenic factors and proliferation of adipocytes. However, since it inhibits the conversion of 25(OH)D to 1,25(OH)2D and VDR mRNA long-term, it could decrease the vitamin D response in adipocytes, leading to greater adipogenesis. The co-incubation of both hormones, simulating what occurs in obesity, even neutralizing the effect on Cyp27b1/1α-hydroxylase, did not change the vitamin D sensitivity but decreased SOCS-3 and pSTAT-3. Thus, an excess of vitamin D and hyperleptinemia could decrease vitamin D sensitivity in adipocytes, contributing to increased adipogenesis.

Acute anti-obesity effects of intracerebroventricular 11β-HSD1 inhibitor administration in diet-induced obese mice

The hypothalamus is the regulatory centre of both appetite and energy balance and endoplasmic reticulum (ER) stress in the hypothalamus is involved in the pathogenesis of obesity. Recently, inhibition of 11 β hydroxysteroid dehydrogenase type1 (11β-HSD1) was reported to have an anti-obesity effect by reducing fat mass. However, the link between the role of 11β-HSD1 in the hypothalamus and obesity has yet to be determined. In the present study, embryonal primary hypothalamic neurones and high-fat diet (HFD) fed mice were used to investigate the anorexigenic effects of 11β-HSD1 inhibitors both in vitro and in vivo. In hypothalamic neurones, carbenoxolone (a non selecitve 11β-HSD inhibitor) alleviated ER stress and ER stress-induced neuropeptide alterations. In HFD mice, i.c.v. administration of carbenoxolone or KR67500 (nonselective and selective 11β-HSD1 inhibitors, respectively) was associated with less weight gain compared to control mice for 24 hours after treatment, presumably by reducing food intake. Furthermore, glucose regulated protein (Grp78), spliced X-box binding protein (Xbp-1s), c/EBP homologous protein (chop) and ER DnaJ homologue protein (Erdj4) expression was decreased in the hypothalami of mice administrated 11β-HSD1 inhibitors compared to controls. Conversely, the phosphorylation of protein kinase B (PKB/Akt), signal transducer and activator of transcription 3 (Stat3), mitogen-activated protein kinase (MAPK/ERK) and S6 kinase1 (S6K1) in the hypothalamus was induced more in mice treated using the same regimes. In conclusion, acute 11β-HSD1 inhibition in the hypothalamus could reduce food intake by decreasing ER stress and increasing insulin, leptin, and mammalian target of rapamycin complex 1 (mTORC1) signalling.

A systematic review of the long-term effectiveness of work-based lifestyle interventions to tackle overweight and obesity

Obesity is one of the five leading global risks for mortality, accounting for 5% of deaths worldwide. Workplace health promotion programs have the potential to deliver population-level interventions combining physical activity and exercise. However, there is no recent critical review of trials on long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity. Good quality evidence is needed to develop optimal strategies to tackle adult obesity. 1035 studies were retrieved by literature search in MEDLINE, Embase, PSYCH INFO and Cochrane library from 2005 to September 2016. 11 studies were identified, which were critiqued using 2010 CONSORT guideline. Most of the studies were not high quality. Five studies reported positive findings. Many studies included environmental interventions, but only two showed significant Body Mass Index (BMI) reduction. Studies showing significant BMI reduction were of high intensity or included a specific motivational component. Although there is some evidence demonstrating long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity, more research is needed into the best methods of conducting these interventions. This study provides evidence that could be used as the basis for implementing similar programs.

Analysis of facial soft tissue values and cranial skeletal widths in different body mass index percentile adolescent subjects

OBJECTIVE

The purpose of this study was to analyze facial soft tissue thickness and cranial skeletal transverse widths in adolescent subjects with different body mass index (BMI) percentiles.

METHODS

The 80 subjects were divided into three groups according to BMI percentile: normal-weight, overweight, and obese adolescent subjects. Facial soft tissue linear and cranial skeletal transversal width measurements were performed on lateral and postero-anterior cephalometric radiographs.

RESULTS

Glabella, nasion, pogonion, and gnathion soft tissue thicknesses were significantly different among normal-weight, overweight, and obese subjects (p < 0.05). However, other facial soft tissue thickness parameters were not statistically significantly different among the groups (p > 0.05). Moreover, there were no significant differences in cranial skeletal transversal widths among groups (p > 0.05).

CONCLUSION

Nasion soft tissue thickness was thicker in overweight subjects; whereas, glabella, pogonion and gnathion soft tissue thickness was thicker in obese subjects. All measured cranial skeletal widths were similar in normal-weight, overweight, and obese subjects.

Evidence of genetic predisposition for metabolically healthy obesity and metabolically obese normal weight

Obesity has evolved into a global pandemic that constitutes a major threat to public health. The majority of obesity-related health care costs are due to cardiometabolic complications, such as insulin resistance, dyslipidemia, and hypertension, which are risk factors for Type 2 diabetes and cardiovascular disease. However, many obese individuals, often called metabolically healthy obese (MHO), seem to be protected from these cardiometabolic complications. Conversely, there is a group of individuals who suffer from cardiometabolic complications despite being of normal weight; a condition termed metabolically obese normal weight (MONW). Recent large-scale genomic studies have provided evidence that a number of genetic variants show an association with increased adiposity but a favorable cardiometabolic profile, an indicator for the genetic basis of the MHO and MONW phenotypes. Many of these loci are located in or near genes that implicate pathways involved in adipogenesis, fat distribution, insulin signaling, and insulin resistance. It has been suggested that a threshold for subcutaneous adipose tissue expandability may be at play in the manifestation of MHO and MONW, where expiry of adipose tissue storage capacity could lead to ectopic lipid accumulation in non-adipose tissues such as liver, muscle, heart, and pancreatic beta cells. Understanding the genetic aspects of the mechanisms that underpin MHO and MONW is crucial to define appropriate public health action points and to develop effective intervention measures.

Prevalence of obesity and body size perceptions in urban and rural Senegal: new insight on the epidemiological transition in West Africa

Background:

The objectives of this study were to assess the prevalence of obesity in Dakar and in Tessekere, a rural municipality in northern Senegal, and to compare ideal body size between these populations.

Methods:

A cross-sectional survey was carried out in 2015 on a representative sample of 1 000 adults, aged 20 years and older in Dakar, and 500 adults of the same age in Tessekere.

Results:

The prevalence of obesity and overweight was higher in Dakar than in Tessekere. However, overweight and obesity rates of young women living in this rural area were close to those of young women in Dakar. At a body mass index of 27.5 kg/m², less than 40% of the men in Dakar and Tessekere found themselves too fat, compared to 50% of urban women and 30% of rural women.

Conclusion:

This study explains how and why obesity is becoming a rural health problem in Senegal.