A shift in the epidemiology of low body mass index in Brazilian adults

The future of human malnutrition: rebalancing agency for better nutritional health

The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global ‘double burden’ of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this ‘competition of agency’, and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health.

Effects of eating behaviors on being overweight in japanese university students: a cross-sectional survey at the Okayama University

Being overweight is an important risk factor for lifestyle-related diseases. The objective of the present study was to examine whether eating until full, eating quickly, or both eating behaviors were associated with being overweight, defined as a body mass index (BMI) ≥ 25, in young adults. This cross-sectional survey comprised 1918 students (1139 male and 779 female students) at the Okayama University in Japan. In logistic regression analysis, eating until full was not associated with being overweight in either sex. The adjusted odds ratio of being overweight among those who reported eating quickly was 3.93 (2.45-6.31; P < .0001) for male and 1.59 (0.79-3.21; P = .193) for female students. Moreover, the adjusted odds ratio of being overweight was 2.72 (1.72-4.30; P < .001) in male students who frequently reported eating a fatty diet. The combination of eating quickly and frequently eating a fatty diet had a supra-additive effect on being overweight in the male students.

MACI - a new era?

Full thickness articular cartilage defects have limited regenerative potential and are a significant source of pain and loss of knee function. Numerous treatment options exist, each with their own advantages and drawbacks. The goal of this review is to provide an overview of the problem of cartilage injury, a brief description of current treatment options and outcomes, and a discussion of the current principles and technique of Matrix-induced Autologous Chondrocyte Implantation (MACI). While early results of MACI have been promising, there is currently insufficient comparative and long-term outcome data to demonstrate superiority of this technique over other methods for cartilage repair.

How did you get so thin? The effect of attribution on perceptions of underweight females

This study applied attribution theory to determine how responsible women are viewed as being for their weight and to gain a better understanding of how underweight females are perceived. Additionally, the impact of having been teased for being underweight on perceptions and responsibility ratings was explored. Participants (515 undergraduates: 285 women and 230 men) were shown a photograph of an objectively underweight woman in one of three randomly assigned conditions: thinness attributed to an eating disorder, illness, or heredity. An underweight female was perceived as most responsible for her weight and ascribed more negative characteristics when she was described as having an eating disorder than when her weight was attributed to heredity or illness. Weight-related teasing histories were unrelated to perceptions of underweight women. However, underweight women may be at risk for being stereotyped (e.g., depressed, undereating) even when it is known that their weight is related to heredity.

Sexual dimorphism of body composition

Sexual dimorphism in human body composition is evident from fetal life, but emerges primarily during puberty. At birth, males have a similar fat mass to females but are longer and have greater lean mass. Such differences remain detectable during childhood; however, females enter puberty earlier and undergo a more rapid pubertal transition, whereas boys have a substantially longer growth period. After adjusting for dimorphism in size (height), adult males have greater total lean mass and mineral mass, and a lower fat mass than females. These whole-body differences are complemented by major differences in tissue distribution. Adult males have greater arm muscle mass, larger and stronger bones, and reduced limb fat, but a similar degree of central abdominal fat. Females have a more peripheral distribution of fat in early adulthood; however, greater parity and the menopause both induce a more android fat distribution with increasing age. Sex differences in body composition are primarily attributable to the action of sex steroid hormones, which drive the dimorphisms during pubertal development. Oestrogen is important not only in body fat distribution but also in the female pattern of bone development that predisposes to a greater female risk of osteoporosis in old age. Disorders of sex development are associated with significant abnormalities of body composition, attributable largely to their impact on mechanisms of hormonal regulation.

Validity of overweight and obesity in a nation based on self-report versus measurement device data

OBJECTIVE

To analyze overweight and obesity in a nation by self-report (SR) data and by data about the target person provided via other household members compared to measurement devices (MD). The magnitude of hypothesized under-reporting by the SR data should be estimated with adjustment for age, gender, and education.

DESIGN

Two cross-sectional studies, nationally representative health examination surveys (response rates: 61.4 and 73.2%, respectively).

SETTING

Adult general population of Germany aged 20-79 years.

SUBJECTS

Sample 1 included 6806 residents. Samples 2 (n=98 673) and 3 (n=34 960) included residents in the second survey.

MEASUREMENTS

In sample 1 MD data were collected, in sample 2 SR data were collected, and in sample 3 body weight and height information was provided from another household member living together with the target person.

RESULTS

MD data revealed higher proportions of overweight and obesity compared to SR. Among women with body mass index (BMI) 35.00 or higher, the odds ratio (OR) was 3.9 (95% confidence interval, CI, 3.2-4.7), and among men 2.8 (CI, 2.2-3.6) for MD versus SR. Data from other household members also revealed higher proportions of overweight and obesity than SR (OR for BMI 35.00 or higher 2.1, CI, 1.7-2.5, for data from other household members versus SR in women and OR 1.3, CI, 1.1-1.5, in men).

CONCLUSIONS

MD data should be used when providing proportions of overweight and obesity in a nation such as Germany.