1
|
Hurtado MD, Saadedine M, Kapoor E, Shufelt CL, Faubion SS. Weight Gain in Midlife Women. Curr Obes Rep 2024; 13:352-363. [PMID: 38416337 PMCID: PMC11150086 DOI: 10.1007/s13679-024-00555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW To summarize the evidence and clinical implications of weight and body composition changes during midlife in women and provide an overview of weight gain prevention and management in this population. RECENT FINDINGS Aging-related changes such as decreased energy expenditure and physical activity are important culprits for weight gain in midlife women. The hormonal changes of menopause also influence body adiposity distribution and increase central adiposity. These body changes can have health consequences including the development of cardiometabolic diseases, osteoarthritis, cancer, worsening in cognition, mental health, and menopause symptoms. Midlife women experience changes related to aging, menopause, and lifestyle which favor weight gain. Clinical practice should focus on early counseling and anticipatory guidance on the importance of dietary changes and physical activity to attenuate this phenomenon. Future research should focus on the longitudinal relationship between weight trends in midlife and health consequences and mortality.
Collapse
Affiliation(s)
- Maria D Hurtado
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mariam Saadedine
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- Mayo Clinic Center for Women's Health, Rochester, MN, USA
| | - Ekta Kapoor
- Mayo Clinic Center for Women's Health, Rochester, MN, USA
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Women's Health Research Center, Mayo Clinic, Rochester, MN, USA
| | - Chrisandra L Shufelt
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- Mayo Clinic Center for Women's Health, Rochester, MN, USA
| | - Stephanie S Faubion
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA.
- Mayo Clinic Center for Women's Health, Rochester, MN, USA.
| |
Collapse
|
2
|
Pham T, Bui L, Giovannucci E, Hoang M, Tran B, Chavarro J, Willett W. Prevalence of obesity and abdominal obesity and their association with metabolic-related conditions in Vietnamese adults: an analysis of Vietnam STEPS survey 2009 and 2015. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 39:100859. [PMID: 37547595 PMCID: PMC10400857 DOI: 10.1016/j.lanwpc.2023.100859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/01/2023] [Accepted: 07/12/2023] [Indexed: 08/08/2023]
Abstract
Background The abdominal obesity trends and prevalence are important contributing factors to significant rise of many noncommunicable diseases in Vietnam but have not been well-documented in the literature. This study aimed to describe the prevalence and trends of obesity and abdominal obesity in Vietnam from 2009 to 2015 and evaluate how different definitions of obesity and abdominal obesity are associated with metabolic-related conditions. Methods We conducted a secondary analysis based on the Vietnam STEPS (STEPwise approach to Surveillance) cross-sectional Survey 2009 and 2015. Obesity and abdominal obesity were defined using the body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) cut-offs from the World Health Organization (WHO) and International Diabetes Federation (IDF). Findings Depending on the specific cut-offs, from 2009 to 2015, obesity prevalence increased from 0.8%-10% to 1.7%-16.4% in women and from 0.8%-10.3% to 1.7%-15% in men; abdominal obesity prevalence increased from 3%-31.3% to 8%-41.7% in women and from 0.3%-19.3% to 0.4%-25% in men. Abdominal obesity using WC-IDF and WHR-WHO definitions had noticeably higher sensitivity and lower specificity for metabolic-related conditions compared to the other four criteria. All anthropometric measurements were statistically correlated with biomarkers/blood pressure in 2009 and 2015 except for fasting glucose. Only WC-IDF and WHR-WHO definitions showed consistent association with all reported metabolic-related conditions regardless of sex and survey years. Interpretation The prevalence of obesity and abdominal obesity in Vietnam is increasing rapidly, especially abdominal obesity in women regardless of the criteria used. More studies are needed to investigate how using different diagnostic criteria for obesity and abdominal obesity could better identify metabolic-related conditions. Funding Authors received no funding for this study.
Collapse
Affiliation(s)
- Tung Pham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Physiology, Hanoi Medical University, Hanoi, Viet Nam
- Research Advancement Consortium in Health, Hanoi, Viet Nam
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam
| | - Linh Bui
- Research Advancement Consortium in Health, Hanoi, Viet Nam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Minh Hoang
- Hanoi University of Public Health, Hanoi, Viet Nam
| | - Bao Tran
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Viet Nam
| | - Jorge Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
Jin X, Liu J, Cao Q, Lin J, Wu G, Liu L, Jiang S, Zhou X, Li Z, Yang A. Normal-weight central obesity: implications for diabetes mellitus. Front Nutr 2023; 10:1239493. [PMID: 37810923 PMCID: PMC10556475 DOI: 10.3389/fnut.2023.1239493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background Current guidelines for obesity prevention and control focus on body mass index (BMI) and rarely address central obesity. Few studies have been conducted on the association between normal-weight central obesity and the risk of diabetes mellitus (DM). Methods 26,825 participants from the National Health and Nutrition Examination Survey (NHANES) were included in our study. A weighted multivariate logistic regression model was used to analyze the relationship between different obesity patterns and the risk of DM. Results Our results suggest that normal-weight central obesity is associated with an increased risk of DM (OR: 2.37, 95% CI: 1.75-3.23) compared with normal-weight participants without central obesity. When stratified by sex, men with normal-weight central obesity, obesity and central obesity were found to have a similar risk of DM (OR: 3.83, 95% CI: 2.10-5.97; OR: 4.20, 95% CI: 3.48-5.08, respectively) and a higher risk than all other types of obesity, including men who were overweight with no central obesity (OR: 1.21, 95% CI: 0.96-1.51) and obese with no central obesity (OR: 0.53, 95% CI: 0.30-0.91). Conclusion Our results highlight the need for more attention in people with central obesity, even if they have a normal BMI.
Collapse
Affiliation(s)
- Xueshan Jin
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Jiajun Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiuyu Cao
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Jiehua Lin
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Guangfu Wu
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Longhui Liu
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Shan Jiang
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Xin Zhou
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Zhiqiang Li
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| | - Aicheng Yang
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, China
| |
Collapse
|
4
|
The effects of Nigella sativa on anthropometric indices: A GRADE-assessed systematic review and dose–response meta-analysis of controlled trials. J Funct Foods 2023. [DOI: 10.1016/j.jff.2023.105472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
|
5
|
Association of low-carbohydrate diet score and carbohydrate quality with visceral adiposity and lipid accumulation product. Br J Nutr 2023; 129:843-853. [PMID: 35570588 DOI: 10.1017/s000711452200143x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study examined the association between low-carbohydrate diet (LCD) score, glycemic index (GI), and glycemic load (GL) with visceral fat level (VFL) and lipid accumulation product (LAP). This cross-sectional study was conducted on 270 adults (118 men and 152 women) aged between 18-45 living in Tehran, Iran, between February 2017 and December 2018. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Body composition were also assessed. We used analyses of covariance and binary logistic regression to explore associations after controlling for age, energy intake (model 1), education, smoking status, physical activity, occupation, marriage and metabolic diseases. There were no significant differences between tertiles of GI, GL and LCD for means of anthropometric measures, LAP and VFL index in men, while women in the highest tertile of GI and GL had significantly higher mean LAP in the crude model (P = 0·02) and model 1(P = 0·04), which disappeared after controlling for other confounders (P = 0·12). Moreover, the OR and CIs for having high LAP and VFL was not associated with dietary GI, GL and LCD in crude and adjusted models. However, chance of high VFL reduced by 65% and 57% among women with high adherence to LCD score (OR = 0·35, 95% CI = 0·16-0·78, P = 0·01) and model 1 (OR = 0·43, 95% CI = 0·18-1, P = 0·05), respectively. However, this significant association disappeared after controlling for other confounders (P = 0·07). Overall, we found carbohydrate quality and LCD score are not associated with LAP and VFL index. However, gender-specific relationship should not be neglect and warrants further investigation.
Collapse
|
6
|
Association of the COVID-19 pandemic with changes in objectively measured sedentary behaviour and adiposity. Int J Obes (Lond) 2023; 47:375-381. [PMID: 36792912 PMCID: PMC9931562 DOI: 10.1038/s41366-023-01274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Several studies have reported that the coronavirus disease (COVID-19) pandemic has increased sedentary behaviour and obesity; however, these analyses used self-reported data, and the association between sedentary behaviour and visceral fat and adipocytokines during the COVID-19 pandemic remains unclear. We aimed to investigate the association of the COVID-19 pandemic with objectively measured sedentary behaviour and these obesity-related factors. METHODS Longitudinal analysis was conducted on 257 Japanese participants who underwent health check-ups in 2018 before and in 2020 during the COVID-19 pandemic. For both time points, sedentary behaviour was measured using an accelerometer for at least 7 days, visceral fat area (VFA) was measured using abdominal bioelectrical impedance analysis, and blood adiponectin level was measured using latex agglutination turbidimetric immunoassay. Multiple linear regression was performed to determine the association between sedentary behaviour and these outcomes. RESULTS Compared with data in 2018, sedentary behaviour and VFA were significantly increased (P < 0.001, P = 0.006) whereas adiponectin level was significantly decreased (P < 0.001) in 2020. Increased sedentary behaviour was significantly associated with an increase in VFA (β = 3.85, 95% CI 1.22-6.49, P = 0.004) and a decrease in adiponectin level (β = -0.04, 95% CI -0.06 to -0.01, P = 0.005). However, the association of sedentary behaviour with adiponectin level was not significant after considering the effects of VFA. CONCLUSIONS The COVID-19 pandemic was associated with objectively measured sedentary behaviour and obesity-related factors in Japanese adults. Additionally, an increase in sedentary behaviour was associated with an increase in VFA, whereas the association of sedentary behaviour with adiponectin was partly mediated by VFA. These results suggest that avoiding increasing sedentary time is important to prevent visceral adiposity thereby ameliorating adiponectin, especially during behavioural limitations such as the COVID-19 pandemic.
Collapse
|
7
|
Lee J, Min S, Oh SW, Oh S, Lee YH, Kwon H, Lee CM, Choi HC, Heo NJ. Association of intraabdominal fat with the risk of incident chronic kidney disease according to body mass index among Korean adults. PLoS One 2023; 18:e0280766. [PMID: 36757992 PMCID: PMC9910748 DOI: 10.1371/journal.pone.0280766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/08/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND The association between abdominal visceral adipose tissue and the risk of incident chronic kidney disease according to body mass index in the Asian population, remains unclear. We evaluated the impact of abdominal adiposity stratified by body mass index on the risk of incident chronic kidney disease. METHODS A cohort study included 11,050 adult participants who underwent health check-ups and re-evaluated the follow-up medical examination at a single university-affiliated healthcare center. Cross-sectional abdominal adipose tissue areas were measured using computed tomography. The primary outcome was progression to chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73m2). The highest quartile of visceral adipose tissue was used for the cut-off of central obesity. RESULTS During the mean of 5.6 follow-up years, 104 incident chronic kidney disease cases were identified. The risk for chronic kidney disease incidence was significantly increased in the 3rd and 4th quartile ranges of visceral adipose tissue [hazard ratio (95% confidence interval)]: 4.59 (1.48-14.30) and 7.50 (2.33-24.20), respectively. In the analysis stratified by body mass index, the chronic kidney disease incidence risk was increased in the highest quartile range of visceral adipose tissue in the normal weight group: 7.06 (1.35-37.04). However, there was no significant relationship between visceral adipose tissue and chronic kidney disease in the obese group. Compared to the subjects with normal weight and absent central obesity, the hazard ratio for chronic kidney disease incidence was 2.32 (1.26-4.27) among subjects with normal weight and central obesity and 1.81 (1.03-3.15) among subjects with obesity and central obesity. CONCLUSION Visceral adipose tissue was a significant risk factor for subsequent chronic kidney disease progression, and the association was identified only in the normal weight group. Normal-weight central obesity was associated with excess risk of chronic kidney disease, similar to the risk in the group with obesity and central obesity.
Collapse
Affiliation(s)
- Jeonghwan Lee
- Department of Internal Medicine, Boramae Medical Center, Seoul National University Hospital, Seoul, South Korea
| | - Seran Min
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Won Oh
- Department of Family Medicine, Healthcare System Gangnam Center of Seoul National University Hospital, Seoul, South Korea
- * E-mail: (NJH); (SWO)
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Yoon-Hye Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Cheol Min Lee
- Department of Family Medicine, Healthcare System Gangnam Center of Seoul National University Hospital, Seoul, South Korea
| | - Ho-Chun Choi
- Department of Family Medicine, Healthcare System Gangnam Center of Seoul National University Hospital, Seoul, South Korea
| | - Nam Ju Heo
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
- * E-mail: (NJH); (SWO)
| |
Collapse
|
8
|
Sun Y, Li Y, Yu T, Zhang J. Causal associations of anthropometric measurements with osteoarthritis: A Mendelian randomization study. PLoS One 2023; 18:e0279198. [PMID: 36716300 PMCID: PMC9886244 DOI: 10.1371/journal.pone.0279198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/29/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE We believe that there is a causal relationship between waist circumference and knee osteoarthritis. To confirm the hypothesis, we have conducted this study. METHODS Genetic variants associated with the five anthropometric variables were obtained from previous large-scale genomewide association studies. Summary-level data on osteoarthritis were obtained from the UK Biobank. The univariable and multivariable MR framework were used to evaluate the associations. The two-sided p value was considered to be statistically significant at 0.01 (where p = 0.05/5) after Bonferroni correction for the five exposure variables. RESULTS In the univariable MR, there was evidence of a detrimental effect of height, weight, BMI, waist circumference, and hip circumference on osteoarthritis risk in the main IVW analyses (height: OR 1.115, 95% CI 1.054-1.180; weight: OR 1.765, 95% CI 1.650-1.889; BMI: OR 1.952, 95%CI 1.841-2.068; waist circumference: OR 2.140, 95% CI 1.994-2.296; hip circumference: OR 1.719, 95% CI 1.600-1.846). And the analyses on knee osteoarthritis and hip osteoarthritis yielded similar results. However, the multivariable MR showed that only waist circumference was causally associated with osteoarthritis, after adjusting for the confounding exposure effects (waist circumference: OR 1.877, 95% CI 1.286-2.739). Such association was also repeated in the analyses on knee osteoarthritis but not hip osteoarthritis. CONCLUSION Our study highlighted the causal associations between waist circumference and knee osteoarthritis risk.
Collapse
Affiliation(s)
- Yang Sun
- Department of Orthopedics, The First Hospital of Jilin University, Jilin Changchun, China
| | - Yue Li
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tiecheng Yu
- Department of Orthopedics, The First Hospital of Jilin University, Jilin Changchun, China
| | - Jiting Zhang
- Department of Orthopedics, The First Hospital of Jilin University, Jilin Changchun, China
| |
Collapse
|
9
|
Staple Food Preference and Obesity Phenotypes: The Regional Ethnic Cohort Study in Northwest China. Nutrients 2022; 14:nu14245243. [PMID: 36558402 PMCID: PMC9784345 DOI: 10.3390/nu14245243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Staple food preference vary in populations, but evidence of its associations with obesity phenotypes are limited. Using baseline data (n = 105,840) of the Regional Ethnic Cohort Study in Northwest China, staple food preference was defined according to the intake frequency of rice and wheat. Overall and specifically abdominal fat accumulation were determined by excessive body fat percentage and waist circumference. Logistic regression and equal frequency substitution methods were used to evaluate the associations. We observed rice preference (consuming rice more frequently than wheat; 7.84% for men and 8.28% for women) was associated with a lower risk of excessive body fat (OR, 0.743; 95%CI, 0.669-0.826) and central obesity (OR, 0.886; 95%CI, 0.807-0.971) in men; and with lower risk of central obesity (OR, 0.898; 95%CI, 0.836-0.964) in women, compared with their wheat preference counterparties. Furthermore, similar but stronger inverse associations were observed in participants with normal body mass index. Wheat-to-rice (5 times/week) reallocations were associated with a 36.5% lower risk of normal-weight obesity in men and a 20.5% lower risk of normal-weight central obesity in women. Our data suggest that, compared with wheat, rice preference could be associated with lower odds ratios of certain obesity phenotypes in the Northwest Chinese population.
Collapse
|
10
|
Gholami F, Rasaei N, Samadi M, Yekaninejad MS, Keshavarz SA, Javdan G, Karimi Z, Mirzaei K. The relationship of genetic risk score with cardiometabolic risk factors: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:459. [PMID: 36324080 PMCID: PMC9632045 DOI: 10.1186/s12872-022-02888-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background & aims For more than eight decades, cardiovascular disease (CVD) has remained the leading cause of death in the world. CVD risk factors are multifaceted, with genetics and lifestyle both playing a role. The aim of this study was to investigate the association between a genetic profile risk score for obesity GRS and cardio-metabolic risk factors in overweight and obese women. Methods The current cross-sectional study was conducted on 391 overweight and obese women. The genetic risk score was created by combining three single nucleotide polymorphisms [MC4R (rs17782313), CAV-1 (rs3807992), and Cry-1 (rs2287161)]. Anthropometric measurements, blood pressure, and some blood parameters were measured by standard protocols. Results A significant association between the GRS and some of cardiometabolic risk factors variables such as body mass index (β = 0. 49, 95%CI = 0.22 to 0.76, p < 0.001), waist circumference (β = 0. 86, 95%CI = 0.18 to 1.54, p = 0.01), body fat mass (β = 0. 82, 95%CI = 0.25 to 1.39, p = 0.005), %body fat (β = 0. 44, 95%CI = 0.06 to 0.82, p = 0.02), and hs-CRP (β = 0.46, 95% CI = 0.14 to 0.78, p = 0.005) was observed in crude model. After adjustment for confounding factors (age, BMI, and physical activity), a significant positive association was observed between BMI (p = 0.004), WC (p = 0.02), body fat mass (p = 0.01), %BF (p = 0.01), hs-CRP (p = 0.009), and GRS. In addition, we discovered a significant negative association between the GRS and BMC (= -0.02, 95%CI = -0.05 to -0.001, p = 0.04). But other variables did not show any significant association with GRS among obese and overweight women. Conclusion We found a significant positive association between GRS, including MC4R (rs17782313), CAV-1 (rs3807992), and Cry-1 (rs2287161) and cardiometabolic risk factors among overweight and obese Iranian women.
Collapse
Affiliation(s)
- Fatemeh Gholami
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran
| | - Niloufar Rasaei
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran
| | - Mahsa Samadi
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran
| | - Mir Saeid Yekaninejad
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Seyed Ali Keshavarz
- grid.411705.60000 0001 0166 0922Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamali Javdan
- grid.412237.10000 0004 0385 452XFood Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Karimi
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Khadijeh Mirzaei
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran ,grid.411705.60000 0001 0166 0922 Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Steiner BM, Berry DC. The Regulation of Adipose Tissue Health by Estrogens. Front Endocrinol (Lausanne) 2022; 13:889923. [PMID: 35721736 PMCID: PMC9204494 DOI: 10.3389/fendo.2022.889923] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/25/2022] [Indexed: 12/14/2022] Open
Abstract
Obesity and its' associated metabolic diseases such as type 2 diabetes and cardiometabolic disorders are significant health problems confronting many countries. A major driver for developing obesity and metabolic dysfunction is the uncontrolled expansion of white adipose tissue (WAT). Specifically, the pathophysiological expansion of visceral WAT is often associated with metabolic dysfunction due to changes in adipokine secretion profiles, reduced vascularization, increased fibrosis, and enrichment of pro-inflammatory immune cells. A critical determinate of body fat distribution and WAT health is the sex steroid estrogen. The bioavailability of estrogen appears to favor metabolically healthy subcutaneous fat over visceral fat growth while protecting against changes in metabolic dysfunction. Our review will focus on the role of estrogen on body fat partitioning, WAT homeostasis, adipogenesis, adipocyte progenitor cell (APC) function, and thermogenesis to control WAT health and systemic metabolism.
Collapse
Affiliation(s)
| | - Daniel C. Berry
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| |
Collapse
|
12
|
Prevalence of central obesity according to different definitions in normal weight adults of two cross-sectional studies in Panama. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100215. [PMID: 36777687 PMCID: PMC9904116 DOI: 10.1016/j.lana.2022.100215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Central Obesity (CO) might arise among individuals with normal body mass index (BMI). We aim to estimate the prevalence of Normal Weight CO (NWCO), using different definitions, and to compare its association with cardiometabolic risk factors in the adult population of Panama. Methods Data from two population-based studies conducted in Panama in 2010 and 2019 were used. Using standard definitions, normal weight was defined as a BMI between 18·5 and 24·9 while CO was defined as a Waist-to-Height Ratio (WHtR) ≥ 0·5 in both sexes or a Waist Circumference (WC) ≥ 90, ≥94, or ≥102 cm for men, and 80 or 88 cm for women. Unconditional logistic regression models were used to estimate the association between each CO definition and dyslipidemia, high blood pressure (HBP), diabetes, and clusters of cardiovascular risk factors. Findings Recent CO prevalence ranged between 3·9% (WC ≥ 102 cm for men and WC ≥ 88 cm for women) and 43·9% (WHtR ≥ 0·5) among individuals classify as normal weigh according to the BMI. Different cardiovascular risk factors were present in this normal weight population but among men the threshold of WC ≥ 102 cm screened less than 1·0%. Interpretation NWCO was associated with cardiovascular risk factors, particularly with elevated concentration of triglycerides. CO evaluation at the primary health care level may be a useful technique to identify normal weight people with metabolically obese characteristics. Funding Gorgas Memorial Institute for Health studies via Ministry of Economy and Finance of Panama and Inter-American Development Bank.
Collapse
|
13
|
Wall JJS, Boag KF, Waduud MA, Pabale K, Wood B, Bailey M, Scott JA. New Measures, Old Conclusions: Obesity Does Not Worsen Outcomes after Elective Abdominal Aortic Aneurysm Repair. AORTA (STAMFORD, CONN.) 2022; 10:20-25. [PMID: 35640583 PMCID: PMC9179208 DOI: 10.1055/s-0042-1742699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background
The “obesity paradox,” whereby the body mass index (BMI) mortality curve is “U-shaped,” is a well-studied phenomenon in vascular surgery. However, there has been an overreliance on BMI as the measure of obesity, which has shown to poorly correlate with clinical outcomes. Robust measures such as waist-hip ratio (WHR) have been suggested as a more accurate marker reflecting central obesity.
Objectives
The objectives of this study were to evaluate the correlation between BMI and WHR on postoperative morbidity and mortality after elective abdominal aortic aneurysm (AAA) repair.
Methods
Data were collected from the Leeds Vascular Institute between January 2006 and December 2016. The primary outcome was mortality and secondary outcomes included length of stay (LOS) and all-cause readmission. Binary logistic regression, linear regression, and correlation analysis were used to identify associations between BMI and WHR in relation to outcome measures.
Results
After exclusions, 432 elective AAA repairs (281 open surgical repair [OSR] and 151 endovascular aneurysm repairs [EVARs]) were identified to be eligible for the study. The combined 30-day and 4-year mortality was 1.2 and 20.1%, respectively. The 30-day readmission rate was 3.9% and the average LOS was 7.33 (standard deviation 18.5) days. BMI data was recorded for 275 patients (63.7%) and WHR for 355 patients (82.2%). Logistic regression analysis highlighted no association between BMI and WHR with mortality, readmission, or LOS following OSR or EVAR.
Conclusion
The results of this study suggest patients should not be denied treatment for AAA based on obesity alone.
Collapse
Affiliation(s)
- Joshua John Sommerville Wall
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, West Yorkshire, United Kingdom.,Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Leeds, West Yorkshire, United Kingdom
| | - Katie F Boag
- Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Leeds, West Yorkshire, United Kingdom
| | - Mohammed A Waduud
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, West Yorkshire, United Kingdom
| | - Keleabetswe Pabale
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, West Yorkshire, United Kingdom
| | - Benjamin Wood
- Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Leeds, West Yorkshire, United Kingdom
| | - Marc Bailey
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, West Yorkshire, United Kingdom.,Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Julian A Scott
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, West Yorkshire, United Kingdom.,Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Leeds, West Yorkshire, United Kingdom
| |
Collapse
|
14
|
Frank LD, Bigazzi A, Hong A, Minaker L, Fisher P, Raine KD. Built environment influences on healthy eating and active living: The NEWPATH study. Obesity (Silver Spring) 2022; 30:424-434. [PMID: 35080350 DOI: 10.1002/oby.23352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/25/2021] [Accepted: 11/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The Neighbourhood Environments in Waterloo: Patterns of Active Transportation and Health (NEWPATH) study examined built environment influences on travel, physical activity, food consumption, and health. This collaboration between researchers and practitioners in health and transportation planning is the first, to our knowledge, to integrate food purchasing, diet, travel, and objectively measured physical activity into a trip-destination protocol. This study simultaneously examines diet and physical activity relationships with BMI and waist circumference (WC). METHODS Individual diet and travel diary data were linked to objective built-environment measures of walkability and retail food environments. BMI and WC were self-reported (n = 1,160). Some respondents wore accelerometers to objectively measure physical activity (n = 549). Pathways from the built environment through behavior (walking and eating) to BMI and WC were assessed using path analysis. RESULTS Walkability was associated with lower BMI and WC through physical activity and active travel. Healthy retail food environments were associated with healthy eating and lower BMI and WC, whereas walkability and healthy retail food environments were insignificant (p < 0.05). Walkable neighborhoods had less healthy food environments, but active travel was not associated with healthy eating or caloric intake. CONCLUSIONS Findings highlight the importance of neighborhood walkability and food environments in shaping physical activity, diet, and obesity.
Collapse
Affiliation(s)
- Lawrence D Frank
- Department of Urban Studies and Planning, University of California at San Diego, San Diego, California, USA
| | - Alexander Bigazzi
- Department of Civil Engineering, School of Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andy Hong
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Hayes House, Oxford, UK
| | - Leia Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada
| | - Pat Fisher
- Region of Waterloo, Kitchener, Ontario, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
15
|
Robson E, Norris T, Costa S, Kivimäki M, Hamer M, Johnson W. Contribution of 20-year body mass index and waist circumference history to poor cardiometabolic health in overweight/obese and normal weight adults: A cohort study. Nutr Metab Cardiovasc Dis 2021; 31:2851-2859. [PMID: 34340899 DOI: 10.1016/j.numecd.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS We investigated the associations of 20-year body mass index (BMI) and waist circumference (WC) histories with risk of being 1) metabolically unhealthy overweight/obese (MUOO) vs metabolically healthy overweight/obese (MHOO) and 2) metabolically unhealthy normal weight (MUNW) vs metabolically healthy normal weight (MHNW). METHODS AND RESULTS Participants comprised 3018 adults (2280 males; 738 females) with BMI and WC measured, every ~5 years, in 1991-1994, 1997-1999, 2002-2004, 2007-2009, and 2012-2013. Mean age in 2012-2013 was 69.3 years, with a range of 59.7-82.2 years. Duration was defined as the number of times a person was overweight/obese (or centrally obese) across the 5 visits, severity as each person's mean BMI (or WC), and variability as the within-person standard deviation of BMI (or WC). At the 2013-2013 visit, participants were categorised based on their weight (overweight/obese or normal weight; body mass index (BMI) ≥25 kg/m2) and health status (healthy or unhealthy; two or more of hypertension, low high-density lipoprotein cholesterol, high triglycerides, high glucose, and high homeostatic model assessment of insulin resistance). Logistic regression was used to estimate associations with the risk of being MUNW (reference MHNW) and MUOO (reference MHOO) at the last visit. BMI and WC severity were each related to increased risk of being unhealthy, with estimates being stronger among normal weight than overweight/obese adults. The estimates for variability exposures became null upon adjustment for severity. Individuals who were overweight/obese at all 5 time points had a 1.60 (0.96-2.67) times higher risk of being MUOO than MHOO compared to those who were only overweight/obese at one (i.e., the last) time point. The corresponding estimate for central obesity was 4.20 (2.88-6.12). Greater duration was also related to higher risk of MUNW than MHNW. CONCLUSION Being overweight/obese yet healthy seems to be partially attributable to lower exposure to adiposity across 20 years of adulthood. The results highlight the importance of maintaining optimum and stable BMI and WC, both in adults who become and do not become overweight/obese.
Collapse
Affiliation(s)
- Ellie Robson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tom Norris
- Leicester Real World Evidence Unit, University of Leicester, Leicester, UK
| | - Silvia Costa
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mark Hamer
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, University College London, London, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| |
Collapse
|
16
|
Li L, Yan Q, Ma N, Chen X, Li G, Liu M. Analysis of intestinal flora and inflammatory cytokine levels in children with non-infectious diarrhea. Transl Pediatr 2021; 10:1340-1345. [PMID: 34189092 PMCID: PMC8193003 DOI: 10.21037/tp-21-168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Non-infectious diarrhea is a common symptom in infants and young children. We aimed to analyze the intestinal flora and serum inflammatory cytokine levels of children with non-infectious diarrhea. METHODS Eighty-nine children with non-infectious diarrhea and 76 healthy children were enrolled from the First Affiliated Hospital of Hainan Medical University between February 2017 and June 2020. Fecal bacterial samples were collected in sterile containers. Following serial dilution, the bacterial samples were cultured in an aerobic medium to cultivate Escherichia coli (E. coli), Enterococci, Lactobacilli, and Bifidobacteria. The levels of inflammatory cytokines in the serum, including interleukin (IL)-2, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α), were determined by enzyme-linked immunosorbent assay. Results between the groups were compared using the paired t-test. The chi-square test was employed to analyze categorical data, with analysis of variance used for multiple-group comparisons. RESULTS No significant differences were observed between the diarrhea and control groups in terms of sex, age, or body mass index distribution. Compared to the control group, the diarrhea group had significantly elevated levels of E. coli and Enterococci but significantly decreased levels of Bifidobacteria and Lactobacilli. In terms of inflammatory cytokines, the levels of IL-2, IL-8, IL-10, and TNF-α were significantly higher in the diarrhea group than in the control group (all P<0.05). In children with non-infectious diarrhea, the levels of IL-2, IL-8, IL-10, and TNF-α were positively correlated with the amount of E. coli (r values of 0.412, 0.381, 0.479, and 0.216, respectively) and Enterococci (r values of 0.257, 0.336, 0.357, and 0.328). Further, the amount of Lactobacilli was positively correlated with IL-2 and IL-10 levels (r values of 0.342 and 0.438, respectively), and that of Bifidobacteria was negatively correlated with IL-2, IL-8, IL-10, and TNF-α levels (r values of -0.252, -0.336, -0.328, and -0.293, respectively). Finally, the level of Lactobacilli was also negatively correlated with IL-8 and TNF-α levels (r values -0.301 and -0.464, respectively; both P<0.05). CONCLUSIONS The abundance and abnormality of E. coli, Enterococci, Lactobacilli, and Bifidobacteria in the intestinal flora of children with non-infectious diarrhea are associated with increased levels of IL-2, IL-8, IL-10, and TNF-α.
Collapse
Affiliation(s)
- Lijia Li
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Qingqing Yan
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Na Ma
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Xiuling Chen
- Department of Pediatrics, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Guiling Li
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Min Liu
- Department of Pediatrics, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| |
Collapse
|
17
|
Rauf A, Khalil AA, Rahman UU, Khalid A, Naz S, Shariati MA, Rebezov M, Urtecho EZ, de Albuquerque RDDG, Anwar S, Alamri A, Saini RK, Rengasamy KRR. Recent advances in the therapeutic application of short-chain fatty acids (SCFAs): An updated review. Crit Rev Food Sci Nutr 2021; 62:6034-6054. [PMID: 33703960 DOI: 10.1080/10408398.2021.1895064] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Over the past decade, the gut microbiota has emerged as an important frontier in understanding the human body's homeostasis and the development of diseases. Gut flora in human beings regulates various metabolic functionalities, including enzymes, amino acid synthesis, bio-transformation of bile acid, fermentation of non-digestible carbohydrates (NDCs), generation of indoles and polyamines (PAs), and production of short-chain fatty acids (SCFAs). Among all the metabolites produced by gut microbiota, SCFAs, the final product of fermentation of dietary fibers by gut microbiota, receive lots of attention from scientists due to their pharmacological and physiological characteristics. However, the molecular mechanisms underlying the role of SCFAs in the interaction between diet, gut microbiota, and host energy metabolism is still needed in-depth research. This review highlights the recent biotechnological advances in applying SCFAs as important metabolites to treat various diseases and maintain colonic health.
Collapse
Affiliation(s)
- Abdur Rauf
- Department of Chemistry, University of Swabi, Swabi, Anbar, Khyber Pakhtunkhwa (KP), Pakistan
| | - Anees Ahmed Khalil
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Pakistan
| | - Ubaid-Ur- Rahman
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ahood Khalid
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Pakistan
| | - Saima Naz
- Deaprtment of Biotechnology, Woman University Mardan, Mardan, Khyber Pakhtunkhwa (KP), Pakistan
| | - Mohammad Ali Shariati
- K.G. Razumovsky, Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian
| | - Maksim Rebezov
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian.,Prokhorov General Physics Institute of the, Russian Academy of Science, Moscow, Russian
| | | | | | - Sirajudheen Anwar
- Department of Pharmacology & Toxicology, College of Pharmacy, University of Hail, Hail, KSA
| | - Abdulwahab Alamri
- Department of Pharmacology & Toxicology, College of Pharmacy, University of Hail, Hail, KSA
| | | | - Kannan R R Rengasamy
- Indigenous Knowledge Systems Centre, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, North West Province, South Africa
| |
Collapse
|
18
|
Interaction between the genetic risk score and dietary protein intake on cardiometabolic traits in Southeast Asian. GENES AND NUTRITION 2020; 15:19. [PMID: 33045981 PMCID: PMC7552350 DOI: 10.1186/s12263-020-00678-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
Background Cardiometabolic diseases are complex traits which are influenced by several single nucleotide polymorphisms (SNPs). Thus, analysing the combined effects of multiple gene variants might provide a better understanding of disease risk than using a single gene variant approach. Furthermore, studies have found that the effect of SNPs on cardiometabolic traits can be influenced by lifestyle factors, highlighting the importance of analysing gene-lifestyle interactions. Aims In the present study, we investigated the association of 15 gene variants with cardiometabolic traits and examined whether these associations were modified by lifestyle factors such as dietary intake and physical activity. Methods The study included 110 Minangkabau women [aged 25–60 years and body mass index (BMI) 25.13 ± 4.2 kg/m2] from Padang, Indonesia. All participants underwent a physical examination followed by anthropometric, biochemical and dietary assessments and genetic tests. A genetic risk score (GRS) was developed based on 15 cardiometabolic disease-related SNPs. The effect of GRS on cardiometabolic traits was analysed using general linear models. GRS-lifestyle interactions on continuous outcomes were tested by including the interaction term (e.g. lifestyle factor*GRS) in the regression model. Models were adjusted for age, BMI and location (rural or urban), wherever appropriate. Results There was a significant association between GRS and BMI, where individuals carrying 6 or more risk alleles had higher BMI compared to those carrying 5 or less risk alleles (P = 0.018). Furthermore, there were significant interactions of GRS with protein intake on waist circumference (WC) and triglyceride concentrations (Pinteraction = 0.002 and 0.003, respectively). Among women who had a lower protein intake (13.51 ± 1.18% of the total daily energy intake), carriers of six or more risk alleles had significantly lower WC and triglyceride concentrations compared with carriers of five or less risk alleles (P = 0.0118 and 0.002, respectively). Conclusions Our study confirmed the association of GRS with higher BMI and further showed a significant effect of the GRS on WC and triglyceride levels through the influence of a low-protein diet. These findings suggest that following a lower protein diet, particularly in genetically predisposed individuals, might be an effective approach for addressing cardiometabolic diseases among Southeast Asian women.
Collapse
|
19
|
Secular changes in mid-adulthood body mass index, waist circumference, and low HDL cholesterol between 1990, 2003, and 2018 in Great Britain. Eur J Clin Nutr 2020; 75:539-545. [PMID: 32939041 PMCID: PMC7610415 DOI: 10.1038/s41430-020-00758-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/25/2020] [Accepted: 09/05/2020] [Indexed: 12/25/2022]
Abstract
Objective To investigate the extent to which 1) secular changes in mid-adulthood WC are independent of BMI and 2) secular changes in low HDL-C are dependent on WC in each sex. Methods The sample comprised 19,406 adults (aged 43-47 years) from three birth cohort studies with BMI and WC measured in 1990, 2003, or 2018; 13,239 participants additionally had HDL-C measured in 2003 or 2018. Quantile regression was used to model differences between 1990-2003 and 2003-2018 in 1) BMI and WC internal Z-scores and 2) WC in cm before and after adjustment for BMI. Binary logistic regression was used to model differences between 2003-2018 in low HDL-C, before and after adjustment for BMI or WC. Results Secular increases in BMI and WC were larger between 1990-2003 than 2003-2018 and at the upper ends of the distributions. At the 85th quantile, effect sizes were larger for WC than BMI Z-scores in females but not males. Adjustment for BMI attenuated estimates of secular increases in WC in cm more in males than females. Odds ratios for low HDL-C in 2018 compared to 2003 were 1.73 (95% CI 1.32, 2.28) in males and 1.34 (1.01, 1.78) in females. Adjustment for WC did not substantially change the estimate in males but attenuated the estimate for females to 1.09 (0.81, 1.47). Conclusions In women much more so than in men, secular increases in mid-adulthood WC appear to have occurred independently of BMI and largely explain the observed rise in low HDL-C prevalence between 2003-2018.
Collapse
|
20
|
Tian Q, Wang A, Zuo Y, Chen S, Hou H, Wang W, Wu S, Wang Y. All-cause mortality in metabolically healthy individuals was not predicted by overweight and obesity. JCI Insight 2020; 5:136982. [PMID: 32663197 PMCID: PMC7455121 DOI: 10.1172/jci.insight.136982] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Metabolically healthy obesity (MHO) and metabolically healthy overweight (MH-OW) have been suggested to be important and emerging phenotypes with an increased risk of cardiovascular disease (CVD). However, whether MHO and MH-OW are associated with all-cause mortality remains inconsistent. METHODS The association of MHO and MH-OW and all-cause mortality was determined in a Chinese community-based prospective cohort study (the Kailuan study), including 93,272 adults at baseline. Data were analyzed from 2006 to 2017. Participants were categorized into 6 mutually exclusive groups, according to BMI and metabolic syndrome (MetS) status. The primary outcome was all-cause death, and accidental deaths were excluded. RESULTS During a median follow-up of 11.04 years (interquartile range, 10.74–11.22 years), 8977 deaths occurred. Compared with healthy participants with normal BMI (MH-NW), MH-OW participants had the lowest risk of all-cause mortality (multivariate-adjusted HR [aHR], 0.926; 95% CI, 0.861–0.997), whereas there was no increased or decreased risk for MHO (aHR, 1.009; 95% CI, 0.886–1.148). Stratified analyses and sensitivity analyses further validated that there was a nonsignificant association between MHO and all-cause mortality. CONCLUSIONS Overweight and obesity do not predict increased risk of all-cause mortality in metabolic healthy Chinese individuals. FUNDING National Natural Science Foundation of China (NSFC; 81673247, 81872682 and 81773527), the NSFC Joint Project, and the Australian National Health and Medical Research Council (NHMRC; NSFC 81561128020-NHMRC APP1112767). Obesity does not predict increased risk of all-cause mortality in metabolic healthy Chinese individuals.
Collapse
Affiliation(s)
- Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, and.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yingting Zuo
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Wei Wang
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health
| |
Collapse
|
21
|
Haregu TN, Nanayakkara S, Carrington M, Kaye D. Prevalence and correlates of normal body mass index central obesity among people with cardiovascular diseases in Australia. Public Health 2020; 183:126-131. [PMID: 32497780 DOI: 10.1016/j.puhe.2020.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/13/2020] [Accepted: 03/19/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Obesity is one of the most common risk factors for cardiometabolic diseases in Australia and worldwide. Recent studies show that people with normal body mass index (BMI) but with central obesity are at increased risk of morbidity and mortality from cardiometabolic diseases. This risk has not been explained well. The aim of this study was to examine the magnitude, correlates and effects of normal BMI central obesity in the Australian adult population. STUDY DESIGN Longitudinal study with data linkage. METHODS We used the Baker Biobank, which contains sociodemographic, behavioural, clinical and mortality data. Data were collected between 2000 and 2011 from 6530 adults who were between 18 and 69 years of age. Biobank data were linked to the National Death Index. A matrix of BMI and waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were used to create adiposity categories. For analysis, we used descriptive statistics, logistic regression and cox regression models. RESULTS The overall prevalence of normal BMI central obesity was 13.4% by WHtR and 14.4% by WHR. Gender, age, BMI and physical activity were associated with normal BMI central obesity. Higher odds of multimorbidity and increased hazards of all-cause and cardiovascular mortality were associated with WHR. CONCLUSION WHtR and WHR, when each used with BMI, provided similar estimates of prevalence of normal BMI central obesity. However, WHR is a better predictor of all-cause and cardiovascular mortality.
Collapse
Affiliation(s)
- T N Haregu
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
| | - S Nanayakkara
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
| | - M Carrington
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
| | - D Kaye
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
| |
Collapse
|
22
|
Zhu Y, Lin Q, Zhang Y, Deng H, Hu X, Yang X, Yao B. Mid-upper arm circumference as a simple tool for identifying central obesity and insulin resistance in type 2 diabetes. PLoS One 2020; 15:e0231308. [PMID: 32437358 PMCID: PMC7241705 DOI: 10.1371/journal.pone.0231308] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Our research aimed to explore the correlation between mid-upper arm circumference (MUAC) and central obesity and insulin resistance (IR) in Chinese subjects with type 2 diabetes. MATERIALS A total of 103 participants (60 men) were recruited in our study. MUAC was measured around the mid-arm between the shoulder and elbow. Waist circumference (WC) was obtained as central obesity parameter, and the IR parameter of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) was calculated. The subjects were divided into three groups according to the tertiles cut-points of MUAC level. RESULTS Body mass index (BMI), WC, the percentages of central obesity and HOMA-IR were significantly higher in the groups with higher MUAC than those in the group with lower MUAC (all P < 0.05). Pearson analysis showed that MUAC was correlated with BMI, WC, waist-to-hip ratio (WHR), logHOMA-IR, low density lipoprotein cholesterol (LDL-C), uric acid (UA) and high density lipoprotein cholesterol (HDL-C) in all subjects. Multivariate linear regression analysis revealed that MUAC was independently associated with logHOMA-IR (β = 0.036, P<0.001) after adjusting for age, gender, WHR, UA, TG, LDL-C and HDL-C. Binary logistic regression analysis revealed that MUAC was an independent predictor of central obesity (OR: 2.129, 95%CI: 1.311-3.457, P = 0.002). Furthermore, MUAC≥30.9cm for male and ≥30.0cm for female were the optimal cutoff values for identifying central obesity. CONCLUSIONS Our study indicated that among Chinese subjects with type 2 diabetes, MUAC is a simple and effective tool for the determination of central obesity and IR. Additionally, the larger MUAC is proved to be more associated with metabolic risk factors of higher UA and LDL-C and lowever HDL-C.
Collapse
Affiliation(s)
- Yanhua Zhu
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiongyan Lin
- Department of Endocrinology, Jieyang People’s Hospital (Jieyang Affiliated Hospital, Sun Yat-sen University), Jieyang, Guangdong, China
| | - Yao Zhang
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hongrong Deng
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiling Hu
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xubin Yang
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail: (BY); (XY)
| | - Bin Yao
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail: (BY); (XY)
| |
Collapse
|
23
|
Vimaleswaran KS. A nutrigenetics approach to study the impact of genetic and lifestyle factors on cardiometabolic traits in various ethnic groups: findings from the GeNuIne Collaboration. Proc Nutr Soc 2020; 79:194-204. [PMID: 32000867 DOI: 10.1017/s0029665119001186] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Several studies on gene-diet interactions (nutrigenetics) have been performed in western populations; however, there are only a few studies to date in lower middle-income countries (LMIC). A large-scale collaborative project called gene-nutrient interactions (GeNuIne) Collaboration, the main objective of which is to investigate the effect of GeNuIne on cardiometabolic traits using population-based studies from various ethnic groups, has been initiated at the University of Reading, UK. While South Asians with higher genetic risk score (GRS) showed a higher risk of obesity in response to a high-carbohydrate diet, South East and Western Asian populations with higher GRS showed an increased risk of central obesity in response to a high-protein diet. The paper also provides a summary of other gene-diet interaction analyses that were performed in LMIC as part of this collaborative project and gives an overview of how these nutrigenetic findings can be translated to personalised and public health approaches for the prevention of cardiometabolic diseases such as obesity, type 2 diabetes and CVD.
Collapse
Affiliation(s)
- Karani S Vimaleswaran
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| |
Collapse
|
24
|
Kim CS, Han KD, Choi HS, Bae EH, Ma SK, Kim SW. Association of Body Mass Index and Waist Circumference with All-Cause Mortality in Hemodialysis Patients. J Clin Med 2020; 9:jcm9051289. [PMID: 32365666 PMCID: PMC7288310 DOI: 10.3390/jcm9051289] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
In this study based on a large nationally representative sample of Korean adults, we investigated the potential associations of the body mass index (BMI) and waist circumference (WC) with mortality in patients undergoing hemodialysis. We obtained the data of 18,699 participants >20 years of age who were followed up with for 4 years and for whom BMI and WC information were available, using a nationally representative dataset from the Korean National Health Insurance System. Patients were stratified into five levels by their baseline BMI and into six levels by their WC (5-cm increments). A total of 4975 deaths occurred during a median follow-up period of 48.2 months. Participants with a higher BMI had a lower mortality rate than those with a lower BMI. In a fully adjusted Cox regression analysis, being overweight and obese was associated with a significantly lower relative risk of all-cause mortality relative to the reference group. Conversely, the mortality rate was higher among participants with a high WC than among those with a low WC. Participants with the highest WC had a higher risk of mortality, while those with the lowest WC level had a significantly lower risk of mortality. In conclusion, all-cause mortality was positively associated with WC, a measure of abdominal obesity, and inversely associated with BMI, a measure of body volume, in patients undergoing hemodialysis.
Collapse
Affiliation(s)
- Chang Seong Kim
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea; (C.S.K.); (H.S.C.); (E.H.B.); (S.K.M.)
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea;
| | - Hong Sang Choi
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea; (C.S.K.); (H.S.C.); (E.H.B.); (S.K.M.)
| | - Eun Hui Bae
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea; (C.S.K.); (H.S.C.); (E.H.B.); (S.K.M.)
| | - Seong Kwon Ma
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea; (C.S.K.); (H.S.C.); (E.H.B.); (S.K.M.)
| | - Soo Wan Kim
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Korea; (C.S.K.); (H.S.C.); (E.H.B.); (S.K.M.)
- Correspondence: ; Tel.: +82-62-220-6271; Fax: +82-62-220-8578
| |
Collapse
|
25
|
Bracht JR, Vieira‐Potter VJ, De Souza Santos R, Öz OK, Palmer BF, Clegg DJ. The role of estrogens in the adipose tissue milieu. Ann N Y Acad Sci 2019; 1461:127-143. [DOI: 10.1111/nyas.14281] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/24/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | - Orhan K. Öz
- Department of RadiologyUniversity of Texas Southwestern Medical Center Dallas Texas
| | - Biff F. Palmer
- Department of MedicineUniversity of Texas Southwestern Medical Center Dallas Texas
| | - Deborah J. Clegg
- College of Nursing and Health ProfessionsDrexel University Philadelphia Pennsylvania
| |
Collapse
|
26
|
A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England. Br J Nutr 2019; 123:681-690. [DOI: 10.1017/s0007114519003301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractThe National Institute for Health and Care Excellence (NICE) has acknowledged the value of waist-to-height ratio (WHtR) as an indicator for ‘early health risk’. We used recent UK data to explore whether classification based on WHtR identifies more adults at cardiometabolic risk than the ‘matrix’ based on BMI and waist circumference, currently used for screening. Data from the Health Survey for England (4112 adults aged 18+ years) were used to identify cardiometabolic risk, indicated by raised glycated Hb, dyslipidaemia and hypertension. HbA1c, total/HDL-cholesterol and systolic blood pressure (BP) were more strongly associated with WHtR than the ‘matrix’. In logistic regression models for HbA1c ≥ 48 mmol/mol, total/HDL-cholesterol > 4 and hypertension (BP > 140/90 mmHg or on medication), WHtR had a higher predictive value than the ‘matrix’. AUC was significantly greater for WHtR than the ‘matrix’ for raised HbA1c and hypertension. Of adults with raised HbA1c, 15 % would be judged as ‘no increased risk’ using the ‘matrix’ in contrast to 3 % using WHtR < 0·5. For hypertension, comparative values were 23 and 9 %, and for total/HDL-cholesterol > 4, 26 and 13 %. Nearly one-third of the ‘no increased risk’ group in the ‘matrix’ had WHtR ≥ 0·5 and hence could be underdiagnosed for cardiometabolic risk. WHtR has the potential to be a better indicator of cardiometabolic risks associated with central obesity than the current NICE ‘matrix’. The cut-off WHtR 0·5 in early screening translates to a simple message, ‘your waist should be less than half your height’, that allows individuals to be aware of their health risks.
Collapse
|
27
|
Dual-energy X-ray absorptiometry-assessed adipose tissues in metabolically unhealthy normal weight Asians. Sci Rep 2019; 9:17698. [PMID: 31776349 PMCID: PMC6881341 DOI: 10.1038/s41598-019-53557-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 10/14/2019] [Indexed: 12/23/2022] Open
Abstract
Normal body mass index (BMI) is associated with lower risk for cardiometabolic diseases. However, there is a subset of individuals with BMI in this range who present with this metabolic abnormality (called metabolically unhealthy normal weight, MUHNW). Here we aimed to assess the adipose characteristics of people with MUHNW using dual-energy X-ray absorptiometry (DXA). This study included 3259 people with normal BMI who underwent health examinations from January 1, 2007 through December 31, 2016. Body fat percentage (%BF), android-gynoid percent fat ratio (AG ratio), and visceral adipose tissue (VAT) were measured simultaneously using DXA CoreScan software. Those with MUHNW comprised 12.67% of the sample. Among those with MUHNW, 71.6% of the women and 56.5% of the men showed high VAT amounts, but less than 40% of either showed high %BFs. Furthermore, considering the combined effects of fat amount and distribution, a normal BMI accompanied by high AG ratio and/or high VAT mass but low %BF presents a much higher risk for metabolic syndrome than when %BF is high, most predominantly in women. In conclusion, using DXA-measured abdominal fat, particularly VAT accumulation, is clinically more important than using %BF when assessing metabolic syndrome in those with normal BMI.
Collapse
|
28
|
Dybala MP, Brady MJ, Hara M. Disparity in Adiposity among Adults with Normal Body Mass Index and Waist-to-Height Ratio. iScience 2019; 21:612-623. [PMID: 31731199 PMCID: PMC6889773 DOI: 10.1016/j.isci.2019.10.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/10/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022] Open
Abstract
Body mass index (BMI) is commonly used to define obesity. However, concerns about its accuracy in predicting adiposity have been raised. The feasibility of using BMI as well as waist-height ratio (WHtR) in assessing adiposity was examined in relation to a more direct measurement of percent body fat (%BF). We analyzed the relation between dual-energy X-ray absorptiometry (DXA)-measured fat mass and BMI and WHtR using the US 1999-2004 National Health and Nutrition Examination Survey (NHANES) data. A considerable proportion of subjects in the healthy BMI range 20-25 were found to have excess adiposity, including 33.1% of males and 51.9% of females. The use of WHtR also supports the notion of normal-weight central obesity (NWCO), which increases with age. These findings have important implications not only for clinical practice but also for many comparative studies where control subjects are usually selected based on age, sex, and BMI.
Collapse
Affiliation(s)
- Michael P Dybala
- Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC1027, Chicago, IL 60637, USA
| | - Matthew J Brady
- Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC1027, Chicago, IL 60637, USA
| | - Manami Hara
- Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC1027, Chicago, IL 60637, USA.
| |
Collapse
|
29
|
Gut Microbiome: Profound Implications for Diet and Disease. Nutrients 2019; 11:nu11071613. [PMID: 31315227 PMCID: PMC6682904 DOI: 10.3390/nu11071613] [Citation(s) in RCA: 509] [Impact Index Per Article: 101.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/05/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023] Open
Abstract
The gut microbiome plays an important role in human health and influences the development of chronic diseases ranging from metabolic disease to gastrointestinal disorders and colorectal cancer. Of increasing prevalence in Western societies, these conditions carry a high burden of care. Dietary patterns and environmental factors have a profound effect on shaping gut microbiota in real time. Diverse populations of intestinal bacteria mediate their beneficial effects through the fermentation of dietary fiber to produce short-chain fatty acids, endogenous signals with important roles in lipid homeostasis and reducing inflammation. Recent progress shows that an individual’s starting microbial profile is a key determinant in predicting their response to intervention with live probiotics. The gut microbiota is complex and challenging to characterize. Enterotypes have been proposed using metrics such as alpha species diversity, the ratio of Firmicutes to Bacteroidetes phyla, and the relative abundance of beneficial genera (e.g., Bifidobacterium, Akkermansia) versus facultative anaerobes (E. coli), pro-inflammatory Ruminococcus, or nonbacterial microbes. Microbiota composition and relative populations of bacterial species are linked to physiologic health along different axes. We review the role of diet quality, carbohydrate intake, fermentable FODMAPs, and prebiotic fiber in maintaining healthy gut flora. The implications are discussed for various conditions including obesity, diabetes, irritable bowel syndrome, inflammatory bowel disease, depression, and cardiovascular disease.
Collapse
|
30
|
Sun Y, Liu B, Snetselaar LG, Wallace RB, Caan BJ, Rohan TE, Neuhouser ML, Shadyab AH, Chlebowski RT, Manson JE, Bao W. Association of Normal-Weight Central Obesity With All-Cause and Cause-Specific Mortality Among Postmenopausal Women. JAMA Netw Open 2019; 2:e197337. [PMID: 31339542 PMCID: PMC6659146 DOI: 10.1001/jamanetworkopen.2019.7337] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE Current public health guidelines for obesity prevention and control focus on promoting a normal body mass index (BMI), rarely addressing central obesity, which is reflected by high waist circumference (WC) and common in the general population. Studies of the association of normal-weight central obesity with long-term health outcomes are sparse. OBJECTIVE To examine associations of normal-weight central obesity with all-cause and cause-specific mortality in postmenopausal women in the United States. DESIGN, SETTING, AND PARTICIPANTS A nationwide prospective cohort study of 156 624 postmenopausal women enrolled in the Women's Health Initiative at 40 clinical centers in the United States between 1993 and 1998. These women were observed through February 2017. Data analysis was performed from September 15, 2017, to March 13, 2019. EXPOSURES Different combinations of BMI (calculated as weight in kilograms divided by height in meters squared; normal weight: BMI, 18.5-24.9; overweight: BMI, 25.0-29.9; and obesity: BMI, ≥30) and WC (normal: WC, ≤88 cm and high: WC, >88 cm). MAIN OUTCOMES AND MEASURES Mortality from all causes, cardiovascular disease, and cancer. RESULTS Of the 156 624 women (mean [SD] age, 63.2 [7.2] years), during 2 811 187 person-years of follow-up, 43 838 deaths occurred, including 12 965 deaths from cardiovascular disease (29.6%) and 11 828 deaths from cancer (27.0%). Compared with women with normal weight and no central obesity and adjusted for demographic characteristics, socioeconomic status, lifestyle factors, and hormone use, the hazard ratio for all-cause mortality was 1.31 (95% CI, 1.20-1.42) among women with normal weight and central obesity, 0.91 (95% CI, 0.89-0.94) among women with overweight and no central obesity, 1.16 (95% CI, 1.13-1.20) for women with overweight and central obesity, 0.93 (95% CI, 0.89-0.94) for women with obesity and no central obesity, and 1.30 (95% CI, 1.27-1.34) for women with obesity and central obesity. Compared with normal weight without central obesity, normal-weight central obesity was associated with higher risk of cardiovascular disease mortality (hazard ratio, 1.25; 95% CI, 1.05-1.46) and cancer mortality (hazard ratio, 1.20; 95% CI, 1.01-1.43). CONCLUSIONS AND RELEVANCE Normal-weight central obesity in women was associated with excess risk of mortality, similar to that of women with BMI-defined obesity with central obesity. These findings underscore the need for future public health guidelines to include the prevention and control of central obesity, even in individuals with normal BMI.
Collapse
Affiliation(s)
- Yangbo Sun
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Linda G. Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Robert B. Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Bette J. Caan
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Thomas E. Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Marian L. Neuhouser
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Aladdin H. Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla
| | - Rowan T. Chlebowski
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center Duarte, Duarte, California
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
- Obesity Research and Education Initiative, University of Iowa, Iowa City
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City
| |
Collapse
|
31
|
Nishizawa H, Shimomura I. Population Approaches Targeting Metabolic Syndrome Focusing on Japanese Trials. Nutrients 2019; 11:nu11061430. [PMID: 31242621 PMCID: PMC6627423 DOI: 10.3390/nu11061430] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/21/2019] [Accepted: 06/23/2019] [Indexed: 12/02/2022] Open
Abstract
The clinical importance of assessment of metabolic syndrome lies in the selection of individuals with multiple risk factors based on visceral fat accumulation, and helping them to reduce visceral fat. Behavioral modification by population approach is important, which adds support to the personal approach. The complexity of visceral fat accumulation requires multicomponent and multilevel intervention. Preparation of food and physical environments could be useful strategies for city planners. Furthermore, actions on various frameworks, including organizational, community, and policy levels, have been recently reported. There are universal public health screening programs and post-screening health educational systems in Japan, and diseases management programs in Germany. Understanding one’s own health status is important for motivation for lifestyle modification. The U.S. Preventive Services Task Force recommends that primary care practitioners screen all adults for obesity and offer behavioral interventions and intensive counseling. Established evidence-based guidelines for behavioral counseling are needed within the primary care setting.
Collapse
Affiliation(s)
- Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5, Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5, Yamada-oka, Suita, Osaka 565-0871, Japan.
| |
Collapse
|
32
|
Kochetkov AI, Ostroumova OD, Starodubova AV, Оstroumova ТМ, Bondarenko DA. Association between Sympathetic Nervous System Activation, Obesity and Insulin Resistance. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2019. [DOI: 10.20996/1819-6446-2019-15-2-230-243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- A. I. Kochetkov
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University
| | - O. D. Ostroumova
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. V. Starodubova
- Federal Research Centre for Nutrition, Biotechnology and Food Safety; Pirogov Russian National Research Medical University
| | - Т. М. Оstroumova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - D. A. Bondarenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| |
Collapse
|
33
|
Mellon SH, Bersani FS, Lindqvist D, Hammamieh R, Donohue D, Dean K, Jett M, Yehuda R, Flory J, Reus VI, Bierer LM, Makotkine I, Abu Amara D, Henn Haase C, Coy M, Doyle FJ, Marmar C, Wolkowitz OM. Metabolomic analysis of male combat veterans with post traumatic stress disorder. PLoS One 2019; 14:e0213839. [PMID: 30883584 PMCID: PMC6422302 DOI: 10.1371/journal.pone.0213839] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/02/2019] [Indexed: 12/26/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is associated with impaired major domains of psychology and behavior. Individuals with PTSD also have increased co-morbidity with several serious medical conditions, including autoimmune diseases, cardiovascular disease, and diabetes, raising the possibility that systemic pathology associated with PTSD might be identified by metabolomic analysis of blood. We sought to identify metabolites that are altered in male combat veterans with PTSD. In this case-control study, we compared metabolomic profiles from age-matched male combat trauma-exposed veterans from the Iraq and Afghanistan conflicts with PTSD (n = 52) and without PTSD (n = 51) (‘Discovery group’). An additional group of 31 PTSD-positive and 31 PTSD-negative male combat-exposed veterans was used for validation of these findings (‘Test group’). Plasma metabolite profiles were measured in all subjects using ultrahigh performance liquid chromatography/tandem mass spectrometry and gas chromatography/mass spectrometry. We identified key differences between PTSD subjects and controls in pathways related to glycolysis and fatty acid uptake and metabolism in the initial ‘Discovery group’, consistent with mitochondrial alterations or dysfunction, which were also confirmed in the ‘Test group’. Other pathways related to urea cycle and amino acid metabolism were different between PTSD subjects and controls in the ‘Discovery’ but not in the smaller ‘Test’ group. These metabolic differences were not explained by comorbid major depression, body mass index, blood glucose, hemoglobin A1c, smoking, or use of analgesics, antidepressants, statins, or anti-inflammatories. These data show replicable, wide-ranging changes in the metabolic profile of combat-exposed males with PTSD, with a suggestion of mitochondrial alterations or dysfunction, that may contribute to the behavioral and somatic phenotypes associated with this disease.
Collapse
Affiliation(s)
- Synthia H. Mellon
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, United States of America
- * E-mail:
| | - F. Saverio Bersani
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Daniel Lindqvist
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Rasha Hammamieh
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Duncan Donohue
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Kelsey Dean
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Marti Jett
- Integrative Systems Biology, US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, Frederick, MD, United States of America
| | - Rachel Yehuda
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Janine Flory
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Victor I. Reus
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Linda M. Bierer
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Iouri Makotkine
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Duna Abu Amara
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
| | - Clare Henn Haase
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
| | - Michelle Coy
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Francis J. Doyle
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Charles Marmar
- Department of Psychiatry, New York University Langone Medical School, New York, NY, United States of America
- Stephen and Alexandra Cohen Veteran Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, United States of America
| | - Owen M. Wolkowitz
- Department of Psychiatry and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| |
Collapse
|
34
|
Teslow EA, Mitrea C, Bao B, Mohammad RM, Polin LA, Dyson G, Purrington KS, Bollig-Fischer A. Obesity-induced MBD2_v2 expression promotes tumor-initiating triple-negative breast cancer stem cells. Mol Oncol 2019; 13:894-908. [PMID: 30636104 PMCID: PMC6441886 DOI: 10.1002/1878-0261.12444] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/05/2018] [Accepted: 12/21/2018] [Indexed: 12/26/2022] Open
Abstract
Obesity is a risk factor for triple‐negative breast cancer (TNBC) incidence and poor outcomes, but the underlying molecular biology remains unknown. We previously identified in TNBC cell cultures that expression of epigenetic reader methyl‐CpG‐binding domain protein 2 (MBD2), specifically the alternative mRNA splicing variant MBD variant 2 (MBD2_v2), is dependent on reactive oxygen species (ROS) and is crucial for maintenance and expansion of cancer stem cell‐like cells (CSCs). Because obesity is coupled with inflammation and ROS, we hypothesized that obesity can fuel an increase in MBD2_v2 expression to promote the tumor‐initiating CSC phenotype in TNBC cells in vivo. Analysis of TNBC patient datasets revealed associations between high tumor MBD2_v2 expression and high relapse rates and high body mass index (BMI). Stable gene knockdown/overexpression methods were applied to TNBC cell lines to elucidate that MBD2_v2 expression is governed by ROS‐dependent expression of serine‐ and arginine‐rich splicing factor 2 (SRSF2). We employed a diet‐induced obesity (DIO) mouse model that mimics human obesity to investigate whether obesity causes increased MBD2_v2 expression and increased tumor initiation capacity in inoculated TNBC cell lines. MBD2_v2 and SRSF2 levels were increased in TNBC cell line‐derived tumors that formed more frequently in DIO mice relative to tumors in lean control mice. Stable MBD2_v2 overexpression increased the CSC fraction in culture and increased TNBC cell line tumor initiation capacity in vivo. SRSF2 knockdown resulted in decreased MBD2_v2 expression, decreased CSCs in TNBC cell cultures, and hindered tumor formation in vivo. This report describes evidence to support the conclusion that MBD2_v2 expression is induced by obesity and drives TNBC cell tumorigenicity, and thus provides molecular insights into support of the epidemiological evidence that obesity is a risk factor for TNBC. The majority of TNBC patients are obese and rising obesity rates threaten to further increase the burden of obesity‐linked cancers, which reinforces the relevance of this report.
Collapse
Affiliation(s)
- Emily A Teslow
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Cristina Mitrea
- Department of Computer Science, Wayne State University, Detroit, MI, USA
| | - Bin Bao
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ramzi M Mohammad
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lisa A Polin
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Greg Dyson
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kristen S Purrington
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Aliccia Bollig-Fischer
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
35
|
Hamer M, Batty GD. Association of body mass index and waist-to-hip ratio with brain structure: UK Biobank study. Neurology 2019; 92:e594-e600. [PMID: 30626649 DOI: 10.1212/wnl.0000000000006879] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 12/06/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To examine the association of body mass index (BMI) and waist-to-hip ratio (WHR) with brain volume. METHODS We used cross-sectional data from the UK Biobank study (n = 9,652, age 55.4 ± 7.5 years, 47.9% men). Measures included BMI, WHR, and total fat mass as ascertained from bioimpedance. Brain images were produced with structural MRI. RESULTS After adjustment for a range of covariates, higher levels of all obesity measures were related to lower gray matter volume: BMI per 1 SD (β coefficient -4,113, 95% confidence interval [CI] -4,862 to -3,364), WHR (β coefficient -4,272, 95% CI -5,280 to -3,264), and fat mass (β coefficient -4,590, 95% CI -5,386 to -3,793). The combination of overall obesity (BMI ≥30 kg/m2) and central obesity (WHR >0.85 for women, >0.90 for men) was associated with the lowest gray matter compared with that in lean adults. In hypothesis-free testing with a Bonferroni correction, obesity was also related to various regional brain volumes, including caudate, putamen, pallidum, and nucleus accumbens. No associations between obesity and white matter were apparent. CONCLUSION The combination of heightened BMI and WHR may be an important risk factor for gray matter atrophy.
Collapse
Affiliation(s)
- Mark Hamer
- From School Sport (M.H.), Exercise & Health Sciences, Loughborough University; and Department of Epidemiology and Public Health (M.H., G.D.B.), University College London, UK.
| | - G David Batty
- From School Sport (M.H.), Exercise & Health Sciences, Loughborough University; and Department of Epidemiology and Public Health (M.H., G.D.B.), University College London, UK
| |
Collapse
|
36
|
Liu D, Li Q, Dong J, Li D, Xu X, Xing W, Zhang X, Cao W, Hou H, Wang H, Song M, Tao L, Kang X, Meng Q, Wang W, Guo X, Wang Y. The Association Between Normal BMI With Central Adiposity And Proinflammatory Potential Immunoglobulin G N-Glycosylation. Diabetes Metab Syndr Obes 2019; 12:2373-2385. [PMID: 31814749 PMCID: PMC6861528 DOI: 10.2147/dmso.s216318] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The mechanism by which normal body mass index (BMI) with central adiposity (NWCA) increases the risk of the diseases has not been completely elucidated. The inflammatory role of immunoglobulin G (IgG) N-glycosylation in obesity defined by BMI or central adiposity defined by waist-to-hip ratio (WHR) was reported, respectively. We undertook this three-center cross-sectional study to determine the association between the IgG N-glycans and NWCA. METHODS The participants were categorized into four different phenotypes: normal BMI with normal WHR (NW), normal BMI with central adiposity (NWCA), obesity with normal WHR (ONCA) and obesity with central adiposity (OCA). The IgG N-glycans were analyzed using ultra-performance liquid chromatography analysis of released glycans, and differences among groups were compared. RESULTS In total, 17 out of 24 initial IgG N-glycans were significantly different among the four groups (NW, ONCA, NWCA and OCA) (P<0.05/6*78=0.0001). The changes of IgG glycans in central obesity (12 GPs) were more than those in obesity (3 GPs). In addition, lower galactosylation and bisecting GlcNAc and higher fucosylation were associated with increased risk of NWCA. CONCLUSION Central obesity was involved in more changes of IgG N-glycosylation representing stronger inflammation than obesity, which might make a greater contribution to the risk of related disorders. NWCA was associated with an increased pro-inflammatory of IgG N-glycosylation, which was accompanied by the development of central obesity and other related disorders.
Collapse
Affiliation(s)
- Di Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
| | - Qihuan Li
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
- Meinian Institute of Health, Beijing100191, People’s Republic of China
| | - Jing Dong
- Center for Physical Examination, Xuanwu Hospital, Capital Medical University, Beijing100050, People’s Republic of China
| | - Dong Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian271016, Shandong Province, People’s Republic of China
| | - Xizhu Xu
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian271016, Shandong Province, People’s Republic of China
| | - Weijia Xing
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian271016, Shandong Province, People’s Republic of China
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian271016, Shandong Province, People’s Republic of China
| | - Hao Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
- School of Medical and Health Sciences, Edith Cowan University, Perth6027, Australia
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
| | - Lixin Tao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
| | - Xiaoping Kang
- The Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing102211, People’s Republic of China
| | - Qun Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian271016, Shandong Province, People’s Republic of China
- School of Medical and Health Sciences, Edith Cowan University, Perth6027, Australia
| | - Xiuhua Guo
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
- Xiuhua Guo School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing100069, People’s Republic of ChinaTel +86 10 83911504 Email
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing100069, People’s Republic of China
- Correspondence: Youxin Wang School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing100069, People’s Republic of ChinaTel +86 10 83911779 Email
| |
Collapse
|
37
|
Benites-Zapata VA, Toro-Huamanchumo CJ, Urrunaga-Pastor D, Guarnizo-Poma M, Lazaro-Alcantara H, Paico-Palacios S, Pantoja-Torres B, Ranilla-Seguin VDC. High waist-to-hip ratio levels are associated with insulin resistance markers in normal-weight women. Diabetes Metab Syndr 2019; 13:636-642. [PMID: 30641781 DOI: 10.1016/j.dsx.2018.11.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/13/2018] [Indexed: 02/07/2023]
Abstract
AIM To assess the association between high waist-to-hip ratio (WHR) levels and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in a sample of normal-weight women. METHODS We conducted an analytical cross-sectional study in euthyroid non-diabetic women, who attended the outpatient service of a private clinic in Lima-Peru from 2012 to 2016. Participants were divided in two groups according to the presence or absence of high WHR levels, IR or hyperinsulinemia after OGTT. We considered WHR values > 0.85 as high levels. IR was defined as a Homeostasis Model Assessment (HOMA-IR) value > 2.39 and hyperinsulinemia after OGTT as a serum insulin value ≥ 80μU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson generalized linear models to evaluate the association between high WHR levels and IR or hyperinsulinemia after OGTT and reported the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed the data of 248 euthyroid, non-diabetic and normal-weight women. The prevalence of high WHR levels was 68.9% (n = 171) while the prevalence of IR and hyperinsulinemia after OGTT was 25% (n = 62) and 15.3% (n = 38), respectively. WHR values were positively correlated with HOMA-IR (r = 0.307; p < 0.001) and serum insulin after OGTT (r = 0.260; p < 0.001). In the adjusted model, high WHR levels were associated with both IR (aPR = 2.63; 95%CI: 1.39-5.01) and hyperinsulinemia after OGTT (aPR = 2.35; 95%CI: 1.03-5.38). CONCLUSION High WHR levels were associated with both IR markers used in our study, appearing to be a useful anthropometric indicator to assess IR in euthyroid normal-weight women without type 2 diabetes mellitus.
Collapse
Affiliation(s)
| | - Carlos J Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | | | | | | | | | | |
Collapse
|
38
|
Dearborn JL, Viscoli CM, Inzucchi SE, Young LH, Kernan WN. Metabolic syndrome identifies normal weight insulin-resistant stroke patients at risk for recurrent vascular disease. Int J Stroke 2018; 14:639-645. [PMID: 30507360 DOI: 10.1177/1747493018816425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The obesity paradox refers to the finding in observational studies that patients with obesity have a better prognosis after stroke than normal weight patients. AIM To test the hypothesis that there might be important heterogeneity within the obese stroke population, such that those with metabolic syndrome would be at higher risk for stroke or myocardial infarction and all-cause mortality compared to patients without metabolic syndrome. METHODS The Insulin Resistance Intervention after Stroke trial enrolled non-diabetic patients with a recent ischemic stroke or transient ischemic attack and insulin resistance. We examined the association between metabolic syndrome and outcome risk in patients with normal weight at entry (body mass index (BMI) = 18.5-24.9 kg/m2), overweight (BMI = 25-29.9 kg/m2), or obesity (BMI ≥ 30 kg/m2). Analyses were adjusted for demographic features, treatment assignment, smoking, and major comorbid conditions. RESULTS Metabolic syndrome was not associated with greater risk for stroke or myocardial infarction among 1536 patients who were overweight (adjusted hazard ratio (HR), 0.95; 95% confidence interval (CI): 0.69-1.31) or 1626 obese patients (adjusted HR, 1.00; 95% CI: 0.70-1.41). However, among 567 patients with a normal BMI, metabolic syndrome was associated with increased risk for stroke or myocardial infarction (adjusted HR, 2.05; 95% CI: 1.25-3.37), and all-cause mortality (adjusted HR, 1.70; 95% CI: 1.03-2.81) compared to patients without metabolic syndrome. CONCLUSIONS The presence of metabolic syndrome identified normal weight patients with insulin resistance but no diabetes who have a higher risk of adverse cardiovascular outcomes, compared with patients without metabolic syndrome.
Collapse
Affiliation(s)
- Jennifer L Dearborn
- 1 Beth Israel Deaconess Medical Center, Boston MA.,2 Yale School of Medicine, New Haven, CT, USA.,3 Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | |
Collapse
|
39
|
Elling D, Surkan PJ, Enayati S, El-Khatib Z. Sex differences and risk factors for diabetes mellitus - an international study from 193 countries. Global Health 2018; 14:118. [PMID: 30486848 PMCID: PMC6263066 DOI: 10.1186/s12992-018-0437-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023] Open
Abstract
Background Increases in overweight and obesity among youths have resulted in the diagnosis of Type 2 diabetes mellitus (T2DM) at earlier ages. The impact of lifestyle-related factors has been implicated; however, its relation to morbidity and mortality and sex differences remain unclear. We aimed to document the changes in risk factors and sex differences associated with T2DM-related morbidity and mortality during 1995–2015. Method We used mortality rates and morbidity estimates from the Global Burden of Diseases Study 2016 using Disability-Adjusted Life Years (DALY). Multiple linear regression analyses were used to determine associations between T2DM-related mortality and related risk factors. DALYs were grouped by country income level, and were stratified by sex. Results Increases in mortality were observed for both sexes, and females tended to have higher mortality rates per 100,000 persons. Body mass index (BMI) continued to be the leading risk factor for T2DM-related mortality, and increases in BMI were more common in low- and middle-income countries (LIC and MIC). Low physical activity was strongly associated with mortality rates, followed by dietary risks and smoking (2.4; 1.4; 0.8 per 100,000 persons, respectively). Similar patterns were observed after adjustments for income level, sex, and age. DALYs continued to show increasing trends across all income levels during 1995–2015 (high-income (HIC):16%; MIC: 36%; LIC: 12%). Stratification by sex showed similar results; males had fewer T2DM DALYs than females, though a greater increase was observed among males. Conclusion Overall, T2DM related mortality was higher among females. Compared to in HIC, there appeared to be a considerable increase in the burden of T2DM in MIC and LIC, where BMI is the leading risk factor for T2DM-related mortality. Prevention programs should emphasize related risk factors according to the existing standard of care.
Collapse
Affiliation(s)
- Devy Elling
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden. .,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Sahba Enayati
- Kompetenzcenter Gesundheit, St. Stephan, Wels, Austria
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Québec, Canada
| |
Collapse
|
40
|
Reed JL, Keast ML, Beanlands RA, Blais AZ, Clarke AE, Pipe AL, Tulloch HE. The effects of aerobic interval training and moderate-to-vigorous intensity continuous exercise on mental and physical health in women with heart disease. Eur J Prev Cardiol 2018; 26:211-214. [PMID: 30157673 DOI: 10.1177/2047487318795246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jennifer L Reed
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.,2 School of Human Kinetics, University of Ottawa, Canada.,3 Faculty of Medicine, University of Ottawa, Canada
| | - Marja-Leena Keast
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Rachelle A Beanlands
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Angelica Z Blais
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.,2 School of Human Kinetics, University of Ottawa, Canada
| | - Anna E Clarke
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Andrew L Pipe
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.,3 Faculty of Medicine, University of Ottawa, Canada
| | - Heather E Tulloch
- 1 Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.,3 Faculty of Medicine, University of Ottawa, Canada
| |
Collapse
|
41
|
Mathisen TF, Rosenvinge JH, Friborg O, Pettersen G, Stensrud T, Hansen BH, Underhaug KE, Teinung E, Vrabel K, Svendsen M, Bratland‐Sanda S, Sundgot‐Borgen J. Body composition and physical fitness in women with bulimia nervosa or binge-eating disorder. Int J Eat Disord 2018; 51:331-342. [PMID: 29473191 PMCID: PMC5947292 DOI: 10.1002/eat.22841] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Knowledge about physical fitness in women with bulimia nervosa (BN) or binge-eating disorder (BED) is sparse. Previous studies have measured physical activity largely through self-report, and physical fitness variables are mainly restricted to body mass index (BMI) and bone mineral density. We expanded the current knowledge in these groups by including a wider range of physical fitness indicators and objective measures of physical activity, assessed the influence of a history of anorexia nervosa (AN), and evaluated predictive variables for physical fitness. METHOD Physical activity, blood pressure, cardiorespiratory fitness (CRF), muscle strength, body composition, and bone mineral density were measured in 156 women with BN or BED, with mean (SD) age 28.4 years (5.7) and BMI 25.3 (4.8) kg m-2 . RESULTS Level of physical activity was higher than normative levels, still <50% met the official physical activity recommendation. Fitness in women with BN were on an average comparable with recommendations or normative levels, while women with BED had lower CRF and higher BMI, VAT, and body fat percentage. We found 10-12% with masked obesity. A history of AN did not predict current physical fitness, still values for current body composition were lower when comparing those with history of AN to those with no such history. DISCUSSION Overall, participants with BN or BED displayed adequate physical fitness; however, a high number had unfavorable CRF and body composition. This finding calls for inclusion of physical fitness in routine clinical examinations and guided physical activity and dietary recommendations in the treatment of BN and BED.
Collapse
Affiliation(s)
| | - Jan H. Rosenvinge
- Department of Psychology, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
| | - Gunn Pettersen
- Department of Health and Caring SciencesFaculty of Health Sciences, UiT—The Arctic University of NorwayTromsøNorway
| | - Trine Stensrud
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | - Bjørge Herman Hansen
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | - Karoline E. Underhaug
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | - Elisabeth Teinung
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | | | - Mette Svendsen
- Department of Endocrinology, Obesity and Preventive MedicineOslo University HospitalOsloNorway
| | - Solfrid Bratland‐Sanda
- Department of Outdoor Studies, Sports and Physical EducationUniversity College of Southeast NorwayNotoddenNorway
| | - Jorunn Sundgot‐Borgen
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| |
Collapse
|
42
|
Frayon S, Cavaloc Y, Wattelez G, Cherrier S, Lerrant Y, Ashwell M, Galy O. Potential for waist-to-height ratio to detect overfat adolescents from a Pacific Island, even those within the normal BMI range. Obes Res Clin Pract 2017; 12:351-357. [PMID: 29254830 DOI: 10.1016/j.orcp.2017.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/28/2017] [Accepted: 12/01/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Waist-to-height ratio (WHtR) is a simple anthropometric proxy for central body fat; it is easy to use from a health education perspective. A WHtR value >0.5 has been proposed as a first level indicator of health risk. The first aim of this study was to compare WHtR with values based on body mass index (BMI) in their prediction of the percentage of body fat (%BF) in a multi-ethnic population of adolescents from New-Caledonia (age 11-16year). Secondly, to see whether WHtR >0.5 could be used to detect overfat subjects whose BMI was in the normal range. MATERIALS AND METHODS Body fat percentage (%BF, based on skinfold measurements), BMI and WHtR were calculated for New Caledonian adolescents from different ethnic backgrounds. The relationship between %BF, BMI and WHtR was determined using quadratic models and from linear regression equations. The sensitivity and specificity of WHtR for detecting overfat adolescents (%BF >25% in boys and >30% in girls) were assessed and compared with those from the BMI-based classification. RESULTS WHtR showed better correlation with %BF than BMI-based measurements. WHtR >0.5 was also more accurate than BMI in detecting overfat adolescents. Moreover, using this boundary value, 8% of adolescents in the normal BMI range were shown to be over-fat. CONCLUSIONS WHtR is a good anthropometric proxy to detect overfat adolescents. Detecting overfat adolescents within the normal BMI range is particularly important for preventing non communicable diseases. We therefore recommend using WHtR for health education programs in the Pacific area and more generally.
Collapse
Affiliation(s)
- Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, New Caledonia.
| | - Yolande Cavaloc
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, New Caledonia
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, New Caledonia
| | - Sophie Cherrier
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, New Caledonia
| | - Yannick Lerrant
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, New Caledonia
| | - Margaret Ashwell
- Ashwell Associates, Ashwell St., Ashwell, Hertfordshire SG7 5PZ, UK; Honorary Senior Visiting Fellow, Cass Business School, City, University of London, EC1Y 8TZ, UK
| | - Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, New Caledonia
| |
Collapse
|
43
|
O'Donovan G, Stensel D, Hamer M, Stamatakis E. The association between leisure-time physical activity, low HDL-cholesterol and mortality in a pooled analysis of nine population-based cohorts. Eur J Epidemiol 2017; 32:559-566. [PMID: 28667447 PMCID: PMC5570782 DOI: 10.1007/s10654-017-0280-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 06/24/2017] [Indexed: 01/29/2023]
Abstract
The objective of this study was to investigate associations between leisure-time physical activity, low high-density lipoprotein cholesterol (HDL-C) and mortality. Self-reported leisure-time physical activity, HDL-C concentration, and mortality were assessed in 37,059 adults in Health Survey for England and Scottish Health Survey. Meeting physical activity guidelines was defined as ≥150 min wk−1 of moderate-intensity activity, ≥75 min wk−1 of vigorous-intensity activity, or equivalent combinations. Low HDL-C was defined as <1.03 mmol L−1. Cox proportional hazard models were adjusted for age, sex, smoking, total cholesterol, systolic blood pressure, body mass index, longstanding illness, and socioeconomic status. There were 2250 deaths during 326,016 person-years of follow-up. Compared with those who met physical activity guidelines and whose HDL-C was normal (reference group), all-cause mortality risk was not elevated in those who met physical activity guidelines and whose HDL-C concentration was low (hazard ratio: 1.07; 95% confidence interval: 0.75, 1.53). Compared with the reference group, all-cause mortality risk was elevated in those who did not meet physical activity guidelines and whose HDL-C was normal (1.37; 1.16, 1.61), and in those who did not meet physical activity guidelines and whose HDL-C was low (1.65; 1.37, 1.98). Cardiovascular disease mortality hazard ratios were similar, although confidence intervals were wider. There was no statistically significant evidence of biological interaction between physical inactivity and low HDL-C. This novel study supports the notion that leisure-time physical activity be recommended in those with low HDL-C concentration who may be resistant to the HDL-raising effect of exercise training.
Collapse
Affiliation(s)
- Gary O'Donovan
- School of Sport, Exercise and Health Sciences, National Centre for Sport & Exercise Medicine-East Midlands, Loughborough University, Loughborough, LE11 3TU, UK.
| | - David Stensel
- School of Sport, Exercise and Health Sciences, National Centre for Sport & Exercise Medicine-East Midlands, Loughborough University, Loughborough, LE11 3TU, UK
| | - Mark Hamer
- School of Sport, Exercise and Health Sciences, National Centre for Sport & Exercise Medicine-East Midlands, Loughborough University, Loughborough, LE11 3TU, UK
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
| | - Emmanuel Stamatakis
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
- Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia
| |
Collapse
|