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Nouri M, Shateri Z, Faghih S. The relationship between intake of fruits, vegetables and dairy products with overweight and obesity in a large sample in Iran: Findings of STEPS 2016. Front Nutr 2023; 9:1082976. [PMID: 36733471 PMCID: PMC9886861 DOI: 10.3389/fnut.2022.1082976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background The present study aimed to investigate the association between fruits and vegetables (FVs) and dairy product intake with body weight based on the data from the nationwide Stepwise approach to surveillance (STEPS) survey in Iran. Methods STEPS is a national-based cross-sectional study conducted on 3,0541 people selected by stratified cluster random sampling in Iran from April to November 2016. The outcome of the current study was body mass index (BMI) which was classified as normal weight, underweight, overweight, and obese. Also, as exposure variables, dietary intakes of fruits, vegetables and dairy products were extracted from the STEPS questionnaires. Multinomial logistic regression was used to evaluate the association between dairy products, FVs consumption, and BMI category in the crude and adjusted models. Results In the adjusted model, we observed 41% [odd ratio (OR) = 0.59; 95% confidence intervals (CI): 0.50, 0.68, P < 0.001], 27% (OR = 0.73; 95% CI: 0.62, 0.84, P < 0.001), and 26% (OR = 0.74; 95% CI: 0.63, 0.87, P < 0.001) lower odds of being overweight, and 46% (OR = 0.54; 95% CI: 0.46, 0.64, P < 0.001), 29% (OR = 0.71; 95% CI: 0.60, 0.84, P < 0.001), and 21% (OR = 0.79; 95% CI: 0.65, 0.95, P = 0.014) decrease in obesity odds among the participants who consumed 1, 2, and more than 2 servings of fruits per day in comparison to less than one serving, respectively. Also, we observed participants who consumed 1, 2, and more than 2 servings in comparison to less than one serving of dairy products per day had 31% (OR = 0.69; 95% CI: 0.58, 0.81, P < 0.001), 23% (OR = 0.77; 95 %CI: 0.65, 0.91, P = 0.002), and 21% (OR = 0.79; 95% CI: 0.67, 0.94, P = 0.011) lower odds of being overweight and 47% (OR = 0.53; 95% CI: 0.44, 0.64, P < 0.001), 36% (OR = 0.64; 95% CI: 0.53, 0.77, P < 0.001), and 32% (OR = 0.68; 95% CI: 0.56, 0.83, P < 0.001) lower odds of obesity, respectively. In addition, compared to participants who consumed less than 2 servings of vegetables per day, participants who consumed 2, 3, and more than 3 servings had 40% (OR = 0.60; 95% CI: 0.47, 0.76, P < 0.001), 29% (OR = 0.71; 95% CI: 0.56, 0.90, P = 0.006), and 26% (OR = 0.74; 95% CI: 0.57, 0.96, P = 0.027) lower odds of being overweight, respectively. Furthermore, we observed 36% lower odds of obesity among participants who ate 2 servings of vegetables per day compared to less than 2 serving (OR = 0.64; 95% CI: 0.49, 0.84, P = 0.002). Conclusion Our findings showed that intake of FVs and dairy products is associated with a healthier weight status in adults. Further studies are needed to confirm these findings.
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Affiliation(s)
- Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran,Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran,Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,*Correspondence: Shiva Faghih,
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Çaynak S, Boyacıoğlu NE, Temel M. Body perception and sexuality of bariatric surgery patients. Perspect Psychiatr Care 2021; 57:1266-1272. [PMID: 33184907 DOI: 10.1111/ppc.12683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to determine how body perception and sexual life are affected in obese individuals who are hospitalized to undergo bariatric surgery. DESIGN AND METHODS Descriptive research design and the cross-sectional method were used. The study was conducted with 53 individuals who consented to participate. The data were analyzed with the SPSS software package. FINDINGS Low body perception and sexual dysfunction were detected, particularly in women. PRACTICE IMPLICATIONS In obesity treatment, the psychological and social problems that individuals experience due to obesity should be handled and evaluated with a multidisciplinary approach.
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Affiliation(s)
- Sibel Çaynak
- Department of Psychiatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Nur E Boyacıoğlu
- Department of Gerontology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Münire Temel
- Department of Nursing, School of Health, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
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Graça P, Gregório MJ, de Sousa SM, Brás S, Penedo T, Carvalho T, Bandarra NM, Lima RM, Simão AP, Goiana-da-Silva F, Freitas MG, Araújo FF. A new interministerial strategy for the promotion of healthy eating in Portugal: implementation and initial results. Health Res Policy Syst 2018; 16:102. [PMID: 30376876 PMCID: PMC6208124 DOI: 10.1186/s12961-018-0380-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To describe the implementation, main intervention areas and initial results of the Integrated Strategy for the Promotion of Healthy Eating (EIPAS) in Portugal. METHODS EIPAS was published as a Law, in December of 2017, as a result of a collaboration between several ministries, including the Finance, Internal Affairs, Education, Health, Economy, Agriculture, and Sea Ministries, aiming at improving the dietary habits of the Portuguese population. The working group, led by the Ministry of Health, developed this strategy for over a year. The framework produced was based on WHO and European Commission recommendations as well as on relevant data from the last Portuguese dietary intake survey (2015/2016). EIPAS also reflects the results of a public hearing, including the food industry, among others, and the experience gathered, since 2012, through the National Programme for the Promotion of Healthy Eating. It considers the 'health in all policies' challenge set by WHO and has four different strategic areas, namely (1) creation of healthier food environments, (2) improvement of the quality and accessibility of healthy food choices for consumers, (3) promotion and development of literacy, in order to encourage healthy food choices, and (4) promotion of innovation and entrepreneurship. In order to achieve these goals, a set of 51 actions was established and assigned to the seven ministries involved. RESULTS Under the scope of this strategy, Portugal has already implemented several actions, including (1) definition of standards for food availability at all public healthcare institutions; (2) implementation of a sugar tax on sweetened beverages; (3) implementation of a voluntary agreement with the food industry sector for food reformulation (work in progress); (4) design of a proposal for an interpretative model of front-of-pack food labelling; (5) improvement of the nutritional quality of food aid programmes for low-income groups; and (6) regulation of marketing of unhealthy foods to children. CONCLUSIONS For the first time, Portugal has a nutrition policy based on the WHO concept of 'health in all policies' and on the national data on food intake. The implementing process of all 51 actions and the inherent complexities and difficulties found so far have made this process be an authentic political and social laboratory that deserves to be followed.
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Affiliation(s)
- Pedro Graça
- National Programme for the Promotion of Healthy Eating, Directorate-General of Health, Lisbon, Portugal.,Faculty of Nutrition and Food Sciences of University of Porto, Porto, Portugal
| | - Maria João Gregório
- National Programme for the Promotion of Healthy Eating, Directorate-General of Health, Lisbon, Portugal. .,Faculty of Nutrition and Food Sciences of University of Porto, Porto, Portugal. .,EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisbon, Portugal.
| | - Sofia Mendes de Sousa
- National Programme for the Promotion of Healthy Eating, Directorate-General of Health, Lisbon, Portugal
| | - Sónia Brás
- Technical Experts of the Cabinet of the Secretary of State for local Administration, Lisbon, Portugal
| | - Tatiana Penedo
- Technical Experts of the Cabinet of the Secretary of State for local Administration, Lisbon, Portugal
| | - Telmo Carvalho
- Department of Sea and Marine Resources, Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 1495-006, Lisbon, Portugal.,Ministry of Sea, Lisbon, Portugal
| | - Narcisa M Bandarra
- Department of Sea and Marine Resources, Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 1495-006, Lisbon, Portugal
| | | | - Ana Paula Simão
- Legal Advisor to the Secretary of State of Industry, Lisbon, Portugal
| | - Francisco Goiana-da-Silva
- Department of Surgery and Cancer, Imperial College Medical School, London, United Kingdom.,Invited Assistant of Management and Leadership on Health, Health Sciences Faculty of Beira Interior University, Covilhã, Portugal
| | | | - Fernando Ferreira Araújo
- Secretário de Estado Adjunto e da Saúde, XXI Governo Constitucional, Lisbon, Portugal.,Invited Professor of Faculty of Medicine of University of Porto, Porto, Portugal
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Oliveira A, Araújo J, Severo M, Correia D, Ramos E, Torres D, Lopes C. Prevalence of general and abdominal obesity in Portugal: comprehensive results from the National Food, nutrition and physical activity survey 2015-2016. BMC Public Health 2018; 18:614. [PMID: 29747603 PMCID: PMC5946450 DOI: 10.1186/s12889-018-5480-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 04/19/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study includes, for the first time, estimates of general and abdominal obesity prevalence for all ages of the Portuguese population, using common standardized methodologies. Results are compared by sex, age groups, educational level and geographical regions. METHODS Participants were a representative sample of the Portuguese population aged between 3 months and 84 years of age (n = 6553), enrolled in the National Food, Nutrition and Physical Activity Survey, 2015-2016. Objective anthropometric measurements included length/height, weight and body circumferences, performed according to standard procedures. Body mass index (BMI) was classified according to the World Health Organization (WHO) growth charts for children and adolescents, and WHO criteria for adults. Abdominal obesity was defined in adults as waist-hip ratio ≥ 0.85 in women or ≥ 0.90 in men. Prevalence estimates and 95% confidence intervals (95%CI) were weighted according to a complex sampling design, considering stratification by seven geographical regions and cluster effect for the selected Primary Health Care Unit. RESULTS The national prevalence of obesity is 22.3% (95%CI: 20.5-24.0), significantly higher in women. Obesity prevalence is much higher in the elderly (39.2%, 95%CI. 34.2-44.2), while children and adolescents have the lowest prevalence around 8-9%. In a regression model, three knot points denoting an inflection of obesity prevalence across the life span were observed around 5, 15 and 75 years. The prevalence of pre-obesity at national level is 34.8% (95%CI: 32.9-36.7), higher in men, and almost 18% of children and 24% of adolescents have pre-obesity. The sex- and age-standardized prevalence of obesity ranged from 38.3% (95%CI: 34.6-42.1) to 13.1% (95%CI: 10.3-15.9) for the less and the most educated individuals, respectively. Although some geographical region disparities, obesity prevalence did not significantly differed across regions (p = 0.094). The national prevalence of abdominal obesity in adults is 50.5% (95%CI: 47.9-53.1), particularly high in the elderly (80.2%). CONCLUSION Almost 60% of the general Portuguese population is obese or pre-obese. Women, elderly and less educated individuals present the highest obesity prevalence. Abdominal obesity, in particular, seems to be a relevant public health problem among the elderly men.
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Affiliation(s)
- Andreia Oliveira
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joana Araújo
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
| | - Milton Severo
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Daniela Correia
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
| | - Elisabete Ramos
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Duarte Torres
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
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Ribeiro G, Camacho M, Santos O, Pontes C, Torres S, Oliveira-Maia AJ. Association between hedonic hunger and body-mass index versus obesity status. Sci Rep 2018; 8:5857. [PMID: 29643337 PMCID: PMC5895788 DOI: 10.1038/s41598-018-23988-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/23/2018] [Indexed: 01/25/2023] Open
Abstract
Obesity-associated differences in hedonic hunger, while consistently reported, have not been adequately quantified, with most studies failing to demonstrate strong correlations between Body Mass Index (BMI) and hedonic hunger indicators. Here, we quantified and assessed the nature of the relationship between hedonic hunger and BMI, in a cross-sectional study using the Portuguese version of the PFS (P-PFS) to measure hedonic hunger. Data were collected from 1266 participants belonging to non-clinical, clinical (candidates for weight-loss surgery) and population samples. Across samples, significant but weak positive associations were found between P-PFS scores and BMI, in adjusted linear regression models. However, in logistic regression models of data from the clinical and non-clinical samples, the P-PFS Food Available domain score was significantly and robustly associated with belonging to the clinical sample (OR = 1.8, 95%CI: 1.2–2.8; p = 0.008), while in the population sample it was associated to being obese (OR = 2.1, 95%CI: 1.6–2.7; p < 0.001). Thus, hedonic hunger levels are associated with obesity status with the odds of being obese approximately doubling for each unit increase in the P-PFS Food Available score.
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Affiliation(s)
- Gabriela Ribeiro
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Av. de Brasília, Doca de Pedrouços, 1400-038, Lisboa, Portugal.,Lisbon Academic Medical Centre PhD Program, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Marta Camacho
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Av. de Brasília, Doca de Pedrouços, 1400-038, Lisboa, Portugal.,John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, CB2, 0SP, UK
| | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Cristina Pontes
- Psychiatry and Mental Health Clinic, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Sandra Torres
- Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.,Centro de Psicologia da Universidade do Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Av. de Brasília, Doca de Pedrouços, 1400-038, Lisboa, Portugal. .,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira, 126, 1340-019, Lisboa, Portugal. .,NOVA Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056, Lisboa, Portugal. .,Champalimaud Research, Champalimaud Centre for the Unknown, Av. de Brasília, Doca de Pedrouços, 1400-038, Lisboa, Portugal.
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da Rocha MC, Marinho RT, Rodrigues T. Mortality Associated with Hepatobiliary Disease in Portugal between 2006 and 2012. GE Port J Gastroenterol 2018; 25:123-131. [PMID: 29761148 PMCID: PMC5939859 DOI: 10.1159/000484868] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/24/2017] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Hepatobiliary disease is becoming a major public health problem, and recent data suggest that the burden of liver disease is higher than previously thought. Our aim was to quantify the mortality from hepatobiliary disease in Portugal and to compare this with the mortality related o other causes over a 7-year period (2006-2012). MATERIALS AND METHODS A statistical analysis of mortality data according to cause, sex, age, and region from the National Statistics Institute in Portugal was carried out. The data related to 14 causes of death, the most frequent of which were alcoholic liver disease (ALD) (International Classification of Diseases code K70), unspecified cirrhosis of liver (UCL) (K74.6), hepatocellular carcinoma (HCC) (C22.0), unspecified malignant neoplasm of liver (C22.9), and cholangiocarcinoma (C22.1). RESULTS Between 2006 and 2012, 18,279 deaths (24.5/100,000) from hepatobiliary disease were registered in Portugal, constituting the 8th leading cause of death. The main causes of death from hepatobiliary disease were ALD (7.1/100,000), UCL (5.5/100,000), and HCC (4.3/100,000), with a male predominance (72%). ALD was the main aetiology in younger age groups (40-65 years), while primary neoplasms of the liver and the intrahepatic bile ducts were predominant in the elderly (>80 years). The mortality related to HCC increased by 66% between 2006 and 2012. CONCLUSION These data outline the burden of hepatobiliary disease in Portugal (8th cause of death) and highlight a potential impact on economic productivity.
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Affiliation(s)
- Manuel Coelho da Rocha
- Department of Gastroenterology and Hepatology, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal
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Abstract
AIM To determine the relationship of visceral fat (VF) with the surgical outcome of the patients with colorectal cancer (CRC) submitted to curative surgery. METHODS Retrospective analysis of all patients submitted to CRC surgery during 3 years with a minimum of 5 years of follow-up. We assessed the length of hospital stay, complications, pathologic reports, surgical re-interventions and hospital re-admissions, relapses, survival time and disease-free time. VF was calculated based on patients' pre-operative CT-scan. The patients were divided into quartiles according to the VF area. Linear regression models and logistic regression models were used to establish a relationship between VF and all data collected. RESULTS The study included 199 patients (129 with colon cancer [CC] and 70 with rectal cancer). The average area of VF was 115.7 cm2. Patients with CRC revealed a direct relationship between VF and postoperative complications (p = 0.043), anastomotic leakage (p = 0.009) and re-operation (p = 0.005). The subgroup of patients with CC had an inverse association between VF and lymph nodes harvested (p = 0.027). Survival analyses did not reveal significant differences. CONCLUSION VF has an influence on postoperative complications, anastomotic leakage and re-operation. A negative influence of VF on lymph nodes harvested was observed on CC patients.
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Affiliation(s)
- André Goulart
- Department of General Surgery, Hospital de Braga, Braga, .,Life and Health Sciences Research Institute (ICVS), University of Minho, Braga,
| | - Nuno Malheiro
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
| | - Hugo Rios
- Department of General Surgery, Hospital de Braga, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
| | - Pedro Leão
- Department of General Surgery, Hospital de Braga, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
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Silva B, Camões M, Simões M, Bezerra P. Obesity, Physical Fitness and Inflammation in the Elderly. Geriatrics (Basel) 2017; 2:E30. [PMID: 31011040 DOI: 10.3390/geriatrics2040030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/14/2017] [Accepted: 09/20/2017] [Indexed: 11/17/2022] Open
Abstract
Among the elderly, obesity is paradoxically associated with a lower mortality risk. Thus, this study describes fitness levels by Body Mass Index (BMI) category and the associations of high-sensitivity C-reactive protein (hs-CRP) and Vitamin D levels with muscle strength, in community-dwelling older adults. A cross-sectional study, with 1338 subjects having mean age of 78.3 years, were assessed in anthropometrics, muscle strength, and cardiorespiratory fitness. In a sub-sample, blood samples were collected and objective markers of inflammation were provided: high-sensitivity C-reactive protein (hs-CRP) and Vitamin D (25(OH) D). Obese women (BMI ≥ 30.0 kg/m2) showed significantly better results for grip strength than normal weight group (BMI between 18.5–24.9 kg/m2): 22.3 (7.0) vs. 20.0 (6.8); p = 0.002. After adjustment, higher levels of hs-CRP were an independent predictor of lower levels of grip strength (β = −0.213, 95% CI: −0.424; −0.002) and Vitamin D levels were positively associated with higher levels of muscle strength (β = 0.098, 95% CI: 0.008–0.189). The multivariate analysis found a significant and positive association between 25(OH) D and grip strength: (β = 0.098, 95% CI: 0.008–0.189). A positive pattern of higher levels of absolute strength among obese older subjects could have an important impact on morbidity and mortality risk, through the inverse association with acute inflammation and an increase in Vitamin D profile.
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de Morais Macieira LM, Tavares Lopes de Andrade Saraiva JM, da Conceição Santos L. Overweight and obesity and their associated factors among early adolescence school children in urban and rural Portugal. BMC Nutr 2017; 3:17. [PMID: 32153799 PMCID: PMC7050717 DOI: 10.1186/s40795-017-0134-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 02/11/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Obesity is defined as an abnormal or excessive accumulation of body fat and it is currently one of the most concerning public health issues, as it is related to a wide range of serious diseases and disorders. The study of the causes of obesity is multifactorial, and its diagnosis requires specific methods. Its management is complex, and it is crucial that it is handled appropriately, and its primary focus should be on prevention through lifestyle changes.The objectives of this study are to determine the prevalence of overweight/obesity in adolescents of both genders, aged 10 to 12 years, from different geographical environments (rural and urban), as well as to identify the underlying risk factors related to the respective obesity rates, namely: family environment, eating habits, and physical exercise. METHODS An observational, cross-sectional study in a sample of 129 adolescents aged 10 to 12 years was conducted. Participants of both genders from rural and urban environments were included in this study. A questionnaire was completed on eating habits and physical activity, focusing on the number of daily meals, meal composition, and sedentary lifestyle habits. An anthropometric assessment was also performed, including weight, height, skinfolds, waist circumference, arm circumference, and percentage of lean mass and body fat, using bioelectrical impedance analysis. RESULTS In the rural environment, the obesity rate was 16.9%, with 26.8% being either overweight or obese; whereas in the urban environment, these rates were respectively 16.7% and 33.4%. Living in a rural environment was not an independent predictor of being overweight or obesity, p = 0.581, or for increased percentage of body fat, p = 0.790. In contrast, being 12 years old, eating high-calorie foods four times a week or less, and having at least one obese parent were predictors of being overweight or obesity. Being 12 years old was also a predictor of gaining moderate to high body fat. CONCLUSIONS Adolescents' residence in a rural or urban environment does not affect the occurrence of being overweight, obesity or high body fat. Paternal obesity was an important predictor of obesity in children. Obese fathers tended to serve higher calorie meals to their children.
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Affiliation(s)
- Luísa Maria de Morais Macieira
- University Paediatric Clinic, Faculty of Medicine, University of Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
- Dietetics and Nutrition at the College of Health Technology, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Jorge Manuel Tavares Lopes de Andrade Saraiva
- University Paediatric Clinic, Faculty of Medicine, University of Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
- Medical Genetics Unit, Paediatric Hospital, Centro Hospitalar e Universitário de Coimbra, Rua Afrânio Peixoto n° 28, 3000-013 Coimbra, Portugal
| | - Lélita da Conceição Santos
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Rua Afrânio Peixoto n° 28, 3000-013 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
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10
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Abstract
BACKGROUND AND PURPOSE This study tests the psychometric properties of the Adherence to Weight Control Questionnaire, a new screening tool to measure treatment adherence (TAWC) and the risk of nonadherence to weight control (RNAWC) in adolescents. METHODS Participants are 92 adolescents (12-18 years old) from a pediatric obesity clinic. Construct validity were evaluated using a principal axis factoring method with varimax rotation. Reliability and criterion-related validity of both scales were also checked. RESULTS Both scales presented good reliability values (.770 and .908). Statistical analyses yielded a 1-factor solution for the RNAWC and a 4-factor solution for the TAWC. Criterion-related validity of scales was also checked. CONCLUSIONS Results showed that this theory-driven measure of adherence to weight control has adequate psychometric properties to support both research and the clinical practice.
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Cunha FM, Oliveira J, Preto J, Saavedra A, Costa MM, Magalhães D, Lau E, Bettencourt-Silva R, Freitas P, Varela A, Carvalho D. The Effect of Bariatric Surgery Type on Lipid Profile: An Age, Sex, Body Mass Index and Excess Weight Loss Matched Study. Obes Surg 2016; 26:1041-7. [PMID: 26220239 DOI: 10.1007/s11695-015-1825-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bariatric surgery improves lipid profile. A still unanswered question is whether this improvement is merely weight-dependent or also results from factors inherent to specificities of the bariatric procedure. We aimed to study lipid profile 1 year after bariatric surgery and compare its changes between the different procedures in patients matched for initial weight and weight loss. METHODS We retrospectively analysed patients submitted to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) or sleeve gastrectomy (SG) between 2010 and 2013. Patients were matched for age (±5 years), sex, pre-surgery body mass index (BMI) (±2 Kg/m(2)) and excess weight loss (EWL) (±5%). Baseline and 1-year lipid profile, its variation and percentage of variation was compared between surgeries. RESULTS We analysed 229 patients: 72 pairs RYGB-AGB, 47 pairs RYGB-SG and 33 pairs AGB-SG. The median age was 41 (35-52) years and 11.8% were male. Pre-operative BMI was 44.0 ± 4.6 and 32.1 ± 4.4 Kg/m(2) at 1 year. EWL at 1 year was 64.2 ± 18.9%. There were no differences in baseline lipid profile between patients submitted to different types of bariatric surgery. At 1 year, high-density lipoprotein cholesterol (HDL) and triglycerides (TG) improved similarly with all surgeries. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) at 1 year decreased significantly more in patients submitted to RYGB than in weight-matched patients undergoing AGB or SG. CONCLUSIONS RYGB is the only bariatric surgery that reduces TC and LDL in age-, sex-, BMI- and EWL-matched patients. All three procedures improved TG and HDL similarly when the confounding effect of weight loss is eliminated.
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Santos I, Vieira PN, Silva MN, Sardinha LB, Teixeira PJ. Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry. J Behav Med 2016; 40:366-371. [PMID: 27586133 DOI: 10.1007/s10865-016-9786-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/13/2016] [Indexed: 01/23/2023]
Abstract
To describe key behaviors reported by participants in the Portuguese Weight Control Registry and to determine associations between these behaviors and weight loss maintenance. A total of 388 adults participated in this cross-sectional study. Assessments included demographic information, weight history, weight loss and weight maintenance strategies, dietary intake, and physical activity. Participants lost on average 18 kg, which they had maintained for ~28 months. Their average dietary intake was 2199 kcal/day, with 33 % of energy coming from fat. About 78 % of participants engaged in levels of moderate-plus-vigorous physical activity exceeding 150 min/week (51 % above 250 min/week), with men accumulating 82 more minutes than women (p < 0.05). The most frequently reported strategies for both weight loss and maintenance were keeping healthy foods at home, consuming vegetables regularly, and having daily breakfast. Greater weight loss maintenance was associated with higher levels of physical activity, walking, weight self-monitoring, establishing specific goals, and with reduced portion size use, reduced consumption of carbohydrates, and increased consumption of protein, (p < 0.05). Results indicate that weight loss maintenance is possible through the adoption of a nutritionally-balanced diet and regular participation in physical activity, but also suggest that adopting different (and, to a degree, individualized) set of behavioral strategies is key for achieving success.
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Affiliation(s)
- Inês Santos
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Paulo N Vieira
- Universidade Europeia, Quinta do Bom Nome, Estrada da Correia 53, 1500-210, Lisbon, Portugal
| | - Marlene N Silva
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Luís B Sardinha
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Pedro J Teixeira
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal.
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López-Sobaler AM, Aparicio A, Aranceta-Bartrina J, Gil Á, González-Gross M, Serra-Majem L, Varela-Moreiras G, Ortega RM. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study. Biomed Res Int 2016; 2016:8341487. [PMID: 27382572 DOI: 10.1155/2016/8341487] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/22/2016] [Accepted: 05/18/2016] [Indexed: 02/02/2023]
Abstract
Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18–64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415–2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045–1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m2, WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m2, WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future.
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Camolas J, Ferreira A, Mannucci E, Mascarenhas M, Carvalho M, Moreira P, do Carmo I, Santos O. Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-R. Eat Weight Disord 2016; 21:277-88. [PMID: 26429794 DOI: 10.1007/s40519-015-0222-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/05/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the "individual experience of overweightness". METHODS This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation. RESULTS Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test-retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness. CONCLUSIONS ORWELL-R shows good internal consistency and adequate test-retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.
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Affiliation(s)
- José Camolas
- Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal.
| | | | | | - Mário Mascarenhas
- Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | | | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Isabel do Carmo
- Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | - Osvaldo Santos
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina da Universidade de Lisboa/DECO PROTESTE, Edf. Egas Moniz, Av. Prof. Egas Moniz, 1649-029, Lisbon, Portugal
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15
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Abstract
OBJECTIVES To determine the prevalence of multimorbidity in the adult population attending primary care in Portugal, to identify associated sociodemographic factors, and to reveal combinations of chronic health problems. DESIGN Cross-sectional, analytical study. SETTING Primary Care Centres in mainland Portugal across the five Portuguese Healthcare Administrative Regions. PARTICIPANTS 1279 women and 714 men agreed to participate. The mean age was 56.3 years (59.0 years for men; 54.8 years for women). The most frequent marital status was married/cohabiting (69.5%). The most predominant living arrangement was living as a couple (57.2%). A considerable proportion consisted of pensioners/retirees (41.5%) and adults with a low educational level (48.7%). Sufficient monthly income was reported in 54.4% of the cases. PRIMARY OUTCOME MEASURES For each patient, multimorbidity was measured either by the presence of ≥2 or ≥3 chronic health problems, from a list of 147 chronic health problems. Clinical data were collected using the general practitioner's knowledge of the patient's history, patient's self-report and medical records. Cluster analyses were performed to reveal distinct patterns of multimorbidity. SECONDARY OUTCOME MEASURES Patient social and demographic data (sex, age, residence area, current marital status, number of years of formal education, living arrangements, professional status and self-perceived economic status). Logistic regression analyses were performed to determine the association between sociodemographic factors and multimorbidity. RESULTS Multimorbidity (2 or more chronic health problems) was present in 72.7%. When a cut-off of three or more was used, an expressive percentage of multimorbidity (57.2%) remained present. The likelihood of having multimorbidity increased significantly with age. Pensioners/retirees and adults with low levels of education were significantly more likely to suffer from multimorbidity. Cardiometabolic and mental disorders were the most common chronic health problems. Six multimorbidity clusters have been identified. CONCLUSIONS Multimorbidity was found to be a common occurrence in the Portuguese primary care users. Future primary healthcare policies should take multimorbidity into consideration.
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Affiliation(s)
- Filipe Prazeres
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
- Centro de Saúde de Aveiro, Aveiro, Portugal
| | - Luiz Santiago
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
- USF Topázio, Coimbra, Portugal
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Lamy E, Simões C, Rodrigues L, Costa AR, Vitorino R, Amado F, Antunes C, do Carmo I. Changes in the salivary protein profile of morbidly obese women either previously subjected to bariatric surgery or not. J Physiol Biochem 2015; 71:691-702. [PMID: 26399515 DOI: 10.1007/s13105-015-0434-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/13/2015] [Indexed: 01/31/2023]
Abstract
Saliva is a non-invasive source of biomarkers useful in the study of physiological mechanisms. Moreover, this fluid has diverse functions, among which food perception and ingestion, making it particularly suitable for the study of obesity. The aims of this study were to assess changes in salivary proteome among morbidly obese women, with a view to provide information about mechanisms potentially related to the development of obesity, and to evaluate whether these changes persist after weight loss. Mixed saliva samples from morbidly obese women (N = 18) who had been either subjected (group O-BS) or not (group O) to bariatric surgery and women with normal weight (N = 14; group C) were compared for protein profiles, alpha-amylase abundance and enzymatic activity, and carbonic anhydrase (CA) VI abundance. Differences in salivary obese profiles were observed for 23 different spots. Zinc-alpha-2 glycoprotein-containing spots showed higher abundance in group O only, whereas cystatin S-containing spots presented higher abundance in the two groups of obese subjects. Most of the spots identified as salivary amylase were present at lower levels in group O-BS. With regard to the amylase enzymatic activity, increases were observed for group O and decreases for group O-BS. One interesting finding was the high correlation between levels of CA VI and body mass index in group O, which was not observed for groups O-BS or C. The differences between groups, mainly regarding salivary proteins involved in taste sensitivity and metabolism, point to the potential of using saliva in the study of obesity development.
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Affiliation(s)
- Elsa Lamy
- ICAAM (Instituto de Ciências Agrárias e Ambientais Mediterrânicas), Universidade de Évora, Apartado 94, 7002-554, Évora, Portugal.
| | - Carla Simões
- Departamento de Química, Universidade de Évora, Évora, Portugal
| | - Lénia Rodrigues
- ICAAM (Instituto de Ciências Agrárias e Ambientais Mediterrânicas), Universidade de Évora, Apartado 94, 7002-554, Évora, Portugal
| | - Ana Rodrigues Costa
- ICAAM (Instituto de Ciências Agrárias e Ambientais Mediterrânicas), Universidade de Évora, Apartado 94, 7002-554, Évora, Portugal.,Departamento de Química, Universidade de Évora, Évora, Portugal
| | - Rui Vitorino
- QOPNA (Química Orgânica Produtos Naturais e Agroalimentares), Universidade de Aveiro, Aveiro, Portugal.,iBiMED, Institute for Biomedical Research, University of Aveiro, Aveiro, Portugal
| | - Francisco Amado
- QOPNA (Química Orgânica Produtos Naturais e Agroalimentares), Universidade de Aveiro, Aveiro, Portugal
| | - Célia Antunes
- ICAAM (Instituto de Ciências Agrárias e Ambientais Mediterrânicas), Universidade de Évora, Apartado 94, 7002-554, Évora, Portugal.,Departamento de Química, Universidade de Évora, Évora, Portugal.,CNC (Centro de Neurociências e Biologia Celular), Universidade de Coimbra, Coimbra, Portugal
| | - Isabel do Carmo
- Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
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Abstract
Obesity is one of the largest and fastest growing public health problems in the world. Last century social changes have set an obesogenic milieu that calls for micro and macro environment interventions for disease prevention, while treatment is mandatory for individuals already obese. The cornerstone of overweight and obesity treatment is diet and physical exercise. However, many patients find lifestyle modifications difficult to comply and prone to failure in the long-term; therefore many patients consider anti-obesity drugs an important adjuvant if not a better alternative to behavioral approach or obesity surgery. Since the pharmacological options for obesity treatment remain quite limited, this is an exciting research area, with new treatment targets and strategies on the horizon. This review discusses the development of innovative therapeutic agents, focusing in energy homeostasis regulation and the use of molecular vaccines, targeting hormones such as somatostatin, GIP and ghrelin, to reduce body weight.
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Affiliation(s)
- Mariana P Monteiro
- Department of Anatomy; Unit for Multidisciplinary Biomedical Research (UMIB); Institute for Biomedical Sciences Abel Salazar (ICBAS); University of Porto; Porto, Portugal
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18
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Cohen AK, Rai M, Rehkopf DH, Abrams B. Educational attainment and obesity: a systematic review. Obes Rev 2013; 14:989-1005. [PMID: 23889851 PMCID: PMC3902051 DOI: 10.1111/obr.12062] [Citation(s) in RCA: 243] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/14/2013] [Accepted: 05/28/2013] [Indexed: 01/17/2023]
Abstract
Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.
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Affiliation(s)
- A K Cohen
- Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
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Henriques A, Alves E, Barros H, Azevedo A. Women's satisfaction with body image before pregnancy and body mass index 4 years after delivery in the mothers of generation XXI. PLoS One 2013; 8:e70230. [PMID: 23936169 PMCID: PMC3729558 DOI: 10.1371/journal.pone.0070230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/17/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Body image satisfaction (BIS) influences body weight regulation and may contribute to long-term healthier lifestyle after pregnancy. Thus, we aimed to assess the association between BIS before pregnancy and body mass index (BMI) 4 years after the index pregnancy. METHODS As part of the follow-up of a birth cohort, 3612 women with prepregnancy BMI >18.5 kg/m(2) were reevaluated 4 years after the birth of a child. BIS was defined as the difference between perceived and ideal body size before pregnancy, assessed by Stunkard Silhouettes after birth. The associations of BIS with BMI change (continuous) and BMI classes at 4 years, based on measured weight and height, were estimated using linear and multinomial regression, respectively. RESULTS Among women with normal prepregnancy BMI, those who felt too small, regarding their ideal, had a 0.25 kg/m(2) smaller increase in BMI within 4 years and a lower likelihood of becoming overweight or obese [multivariate-adjusted odds ratio (OR) = 0.63; 95% confidence interval (95%CI): 0.44-0.91 and OR = 0.21; 95%CI: 0.05-0.91, respectively) than those satisfied with body image. Feeling too large was associated with a 0.41 kg/m(2) larger increase in BMI and a higher risk of becoming overweight or obese (OR = 2.12; 95%CI:1.73-2.59 and OR = 3.42; 95%CI:2.02-5.79, respectively). A similar, non-significant, trend was observed for overweight women. Obese women who felt too large had a non-significant decrease in BMI. CONCLUSIONS BIS plays a role in maternal body weight after delivery. Realistic body size goals may promote the motivation to lose weight and contribute to higher success in attaining them.
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Affiliation(s)
- Ana Henriques
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
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20
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Gutiérrez-Fisac JL, León-Muñoz LM, Regidor E, Banegas J, Rodríguez-Artalejo F. Trends in obesity and abdominal obesity in the older adult population of Spain (2000-2010). Obes Facts 2013; 6:1-8. [PMID: 23428930 PMCID: PMC5644783 DOI: 10.1159/000348493] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/17/2012] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE This work examines the trend in obesity and abdominal obesity in the Spanish population aged 60 years and over during the first decade of the 21st century. METHODS We analyze data from a representative study of the Spanish population aged 60 years and older conducted in 2000-2001 and from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) conducted in 2008-2010. RESULTS In men, the distribution of BMI did not vary in the period 2000-2010. In contrast, in women there was a reduction in both mean BMI--from 29.3 to 28.8 kg/m2--and the prevalence of obesity--from 40.8 to 36.3%. This decline was greatest in women aged 60-69 years. In men, no significant changes were observed in mean waist circumference (WC) or in the prevalence of abdominal obesity. In contrast, WC decreased by 3.6 cm and abdominal obesity prevalence by 12.7% in women. The decline was greatest in women aged 60-69 years, in whom mean WC decreased by 5.1 cm and abdominal obesity prevalence by 18.6%. CONCLUSION These findings show that the frequency of obesity has begun to decline in Spanish women aged 60 and over. The causes of this decline are unclear.
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Affiliation(s)
- Juan Luis Gutiérrez-Fisac
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid ⁄ IdiPAZ-CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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21
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Abstract
PURPOSE We evaluated the association between risk of obesity in the Portuguese population and two obesity-related single-nucleotide gene polymorphisms: fat-mass and obesity-associated (FTO) rs9939609 and peroxisome proliferator-activated receptor gamma (PPARG) rs1801282. PATIENTS AND METHODS A total of 194 Portuguese premenopausal female Caucasians aged between 18 and 50 years (95 with body mass index [BMI] ≥30 g/m(2), 99 controls with BMI 18.5-24.9 kg/m(2)) participated in this study. The association of the single-nucleotide polymorphisms with obesity was determined by odds ratio calculation with 95% confidence intervals. RESULTS Significant differences in allelic expression of FTO rs9939609 (P<0.05) were found between control and case groups, indicating a 2.5-higher risk for obesity in the presence of both risk alleles when comparing the control group with the entire obese group. A fourfold-higher risk was found for subjects with class III obesity compared to those with classes I and II. No significant differences in BMI were found between the control and case groups for PPARG rs1801282 (P>0.05). CONCLUSION For the first time, a study involving an adult Portuguese population shows that individuals harboring both risk alleles in the FTO gene locus are at higher risk for obesity, which is in agreement to what has been reported for other European populations.
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Affiliation(s)
- Fábio Ferreira Carlos
- Centro de Investigação em Genética Molecular Humana, Universidade Nova de Lisboa, Caparica, Portugal
- Investigação e Serviços em Ciências Biológicas, Stab Vida, Caparica, Portugal
| | - José Silva-Nunes
- Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal
- Endocrinology Department, Curry Cabral Hospital, Lisbon, Portugal
| | - Orfeu Flores
- Centro de Investigação em Genética Molecular Humana, Universidade Nova de Lisboa, Caparica, Portugal
| | - Miguel Brito
- Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal
| | - Gonçalo Doria
- Centro de Investigação em Genética Molecular Humana, Universidade Nova de Lisboa, Caparica, Portugal
| | - Luísa Veiga
- Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal
| | - Pedro Viana Baptista
- Centro de Investigação em Genética Molecular Humana, Universidade Nova de Lisboa, Caparica, Portugal
- Correspondence: Pedro Viana Baptista, Centro de Investigação em Genética Molecular Humana, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, Caparica 2829-516, Portugal, Tel/Fax +351 21 294 8530, Email
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Carraça EV, Silva MN, Coutinho SR, Vieira PN, Minderico CS, Sardinha LB, Teixeira PJ. The association between physical activity and eating self-regulation in overweight and obese women. Obes Facts 2013; 6:493-506. [PMID: 24217426 PMCID: PMC5644742 DOI: 10.1159/000356449] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 05/26/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Successful weight management relies heavily on eating and exercise behaviors. However, little is known about the association between both on a psychosocial level. This study examined the relationship between exercise and eating regulation by exploring the mediating effects of negative body image investment and depressive mood, and their stability through time. METHODS Analyses were conducted at two different moments (12 and 36 months), involving a sample of 221 overweight/obese women (age: 37.6 ± 7 years; BMI: 31.6 ± 4.1 kg/m(2)) that participated in a behavioral weight control intervention. Bivariate correlations and mediation analyses using Preacher & Hayes resampling procedures were conducted. RESULTS At 12 months, negative body image investment was the only significant mediator of the exercise-eating relationship. This variable explained larger portions of the indirect effects of structured rather than lifestyle exercise on eating. At 36 months, negative investment and to a lesser extent depressive mood partially explained the exercise-eating association. CONCLUSIONS Our findings suggest that, besides physiological effects of exercise, psychological mechanisms related to body image and mood also explain the role of physical activity as a 'gateway behavior' for improved eating regulation in overweight women. These effects appear to be stable and may help understand the key role of exercise in long-term weight management.
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Affiliation(s)
| | | | | | | | | | | | - Pedro J. Teixeira
- *Pedro J. Teixeira, PhD, Faculdade de Motricidade Humana, Estrada da Costa, Cruz Quebrada, 1495—688 Lisbon (Portugal),
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Freitas P, Carvalho D, Santos AC, Matos MJ, Madureira AJ, Marques R, Martinez E, Sarmento A, Medina JL. Prevalence of obesity and its relationship to clinical lipodystrophy in HIV-infected adults on anti-retroviral therapy. J Endocrinol Invest 2012; 35:964-70. [PMID: 22186163 DOI: 10.3275/8187] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Combination antiretroviral therapy (cART) is associated with lipodystrophy (lipoatrophy and lipoaccumulation) and several metabolic abnormalities that together can contribute to an increased cardiovascular risk. The aim of this study was to evaluate the prevalence of obesity in patients on cART according to the presence of clinical lipodystrophy (CL) and to analyze factors associated with obesity. METHODS We evaluated 368 HIV-infected adults on cART. RESULTS CL was present in 59.0%. Independently of gender, patients with CL were more frequently underweight [5.7% (21/368)] and of normal weight [47.3% (174/368)], and less frequently overweight [33.2% (122/368)] or obese [13.9% (51/368)]. Mean body mass index was higher in patients with abdominal prominence regardless of the presence of clinical lipoatrophy. Patients with CL had lower waist circumference, higher waist/hip and fat mass ratio and lower total and subcutaneous fat, without significant difference in visceral fat but with a higher visceral/subcutaneous fat ratio, as evaluated by CT at abdominal level. CL was significantly less frequent in overweight [odds ratio (OR)=0.21, 95% confidence interval (CI): 0.05-0.92] and obese (OR=0.05, 95%CI: 0.01-0.26) patients, when compared to underweight ones, independent of age, gender, duration of infection, cART regimen, virological suppression, and HIV-infection risk factor. CONCLUSIONS Being overweight or obese is highly prevalent in HIV-infected patients on cART. Patients with CL were more frequently under- or normal weight, and less frequently overweight or obese. Obesity is a condition that should be considered in HIV patients on cART.
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Affiliation(s)
- P Freitas
- Department of Endocrinology, Hospital de São João and University of Porto Medical School, Alameda Hernâni Monteiro, Porto, Portugal.
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Sardinha LB, Santos DA, Silva AM, Coelho-e-Silva MJ, Raimundo AM, Moreira H, Santos R, Vale S, Baptista F, Mota J. Prevalence of overweight, obesity, and abdominal obesity in a representative sample of Portuguese adults. PLoS One 2012; 7:e47883. [PMID: 23118905 PMCID: PMC3485315 DOI: 10.1371/journal.pone.0047883] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 09/18/2012] [Indexed: 01/18/2023] Open
Abstract
This study determined the prevalence of overweight, obesity, and abdominal obesity in the Portuguese adults and examined the relationship between above mentioned prevalences and educational level. Body mass, stature, and waist circumference were measured in a representative sample of the Portuguese population aged 18–103 years (n = 9,447; 18–64 years: n = 6,908; ≥65 years: n = 2,539). Overweight and obesity corresponded to a body mass index ranging between 25–29.9 kg/m2 and ≥30 kg/m2, respectively. Abdominal obesity was assessed as >102 cm for males and >88 cm for females. After adjusting for educational level, the combined prevalences of overweight and obesity were 66.6% in males and 57.9% in females (18–64 years). Respective values in older adults (≥65 years) were 70.4% for males and 74.7% for females. About 19.3% of adult males and 37.9% of adult females presented abdominal obesity. Correspondent values in older adults were 32.1%, for males, and 69.7%, for females. In adults, low educational level was related to an increased risk for overweight (OR = 2.54; 95% CI: 2.08–3.09), obesity (OR = 2.76; 95% CI: 2.20–3.45), and abdominal obesity (OR = 5.48; 95% CI: 4.60–6.52). This reinforces the importance of adjusting public health strategies for educational level.
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Affiliation(s)
- Luís B Sardinha
- Exercise and Health Laboratory, Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics, Technical University of Lisbon, Cruz-Quebrada, Portugal.
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Nora M, Guimarães M, Almeida R, Martins P, Gonçalves G, Freire MJ, Ferreira T, Freitas C, Monteiro MP. Metabolic laparoscopic gastric bypass for obese patients with type 2 diabetes. Obes Surg 2011; 21:1643-9. [PMID: 21512818 DOI: 10.1007/s11695-011-0418-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Bariatric surgery has been proposed as the most effective treatment for patients with type 2 diabetes mellitus (T2DM) and body mass index (BMI) above 35 kg/m(2). The purpose of our study was to access remission rate and improvement of metabolic control of T2DM after gastric bypass. METHODS A prospective study was carried out on 94 diabetic patients, who underwent gastric bypass with a 200-cm biliopancreatic limb. Characteristics evaluated included weight, BMI, percentage of excess BMI lost (% EBMIL), fasting glucose, HbA1c, and lipid profile up to 36 months after surgery, as well as anti-diabetic treatment before and after surgery. RESULTS At the time of surgery, patients had a mean BMI of 44.3 ± 0.65 kg/m(2) and length of T2DM diagnosis of 6.2 ± 0.98 years and HbA1c of 6.6 ± 0.21%. After a mean time of follow-up of 2.6 ± 0.13 years, the weight loss was significant from 3 months onwards after surgery, reaching its peak at 24 months with a BMI of 32.1 ± 0.9 kg/m(2) and corresponding % EBMIL of 69.0 ± 2.84%. Remission rates of diabetes were 87.91% at 6 months, 92.68% at 12 months, 92.85% at 24 months, and 100% at 36 months of follow-up. CONCLUSIONS Gastric bypass in obese patients is associated with a high remission rate of diabetes and improvement of the metabolic control. Although confirmation with randomized controlled studies is needed, these results suggest that this type of surgery might be particularly indicated for obese diabetic patients with good pancreatic reserve.
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Marques-Vidal P, Paccaud F, Ravasco P. Ten-year trends in overweight and obesity in the adult Portuguese population, 1995 to 2005. BMC Public Health 2011; 11:772. [PMID: 21982584 DOI: 10.1186/1471-2458-11-772] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 10/07/2011] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND There is little information regarding the trends in body mass index (BMI) and obesity in the overall Portuguese population, namely if these trends are similar according to educational level. In this study, we assessed the trends in the prevalence of overweight and obesity in the Portuguese population, overall and by educational level. METHODS Cross-sectional national health interview surveys conducted in 1995-6 (n = 38,504), 1998-9 (n = 38,688) and 2005-6 (n = 25,348). Data were derived from the population and housing census of 1991 and two geographically-based strata were defined. The sampling unit was the house, and all subjects living in the sampling unit were surveyed. Height and weight were self-reported; the effects of gender, age group and educational level were also assessed by self-reported structured questionnaires. Bivariate comparisons were performed using Chi-square or analysis of variance (ANOVA). Trends in BMI levels were assessed by linear regression analysis, while trends in the prevalence of obesity were assessed by logistic regression. RESULTS Mean (±standard deviation) BMI increased from 25.2 ± 4.0 in 1995-6 to 25.7 ± 4.5 kg/m² in 2005-6. Prevalence of overweight remained stable (36.1% in 1995-6 and 36.4% in 2005) while prevalence of obesity increased (11.5% in 1995-6 and 15.1% in 2005-6). Similar findings were observed according to age group. Mean age-adjusted BMI increase (expressed in kg/m²/year and 95% confidence interval) was 0.073 (0.062, 0.084), 0.016 (0.000, 0.031) and 0.073 (0.049, 0.098) in men with primary, secondary and university levels, respectively; the corresponding values in women were 0.085 (0.073, 0.097), 0.052 (0.035, 0.069) and 0.062 (0.038, 0.084). Relative to 1995-6, obesity rates increased by 48%, 41% and 59% in men and by 40%, 75% and 177% in women with primary, secondary and university levels, respectively. The corresponding values for overweight were 6%, 1% and 23% in men and 5%, 7% and 65% in women. CONCLUSION Between 1995 and 2005, obesity increased while overweight remained stable in the adult Portuguese population. Although higher rates were found among lesser educated subjects, the strong increase in BMI and obesity levels in highly educated subjects is of concern.
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Carraça EV, Silva MN, Markland D, Vieira PN, Minderico CS, Sardinha LB, Teixeira PJ. Body image change and improved eating self-regulation in a weight management intervention in women. Int J Behav Nutr Phys Act 2011; 8:75. [PMID: 21767360 PMCID: PMC3150233 DOI: 10.1186/1479-5868-8-75] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 07/18/2011] [Indexed: 11/29/2022] Open
Abstract
Background Successful weight management involves the regulation of eating behavior. However, the specific mechanisms underlying its successful regulation remain unclear. This study examined one potential mechanism by testing a model in which improved body image mediated the effects of obesity treatment on eating self-regulation. Further, this study explored the role of different body image components. Methods Participants were 239 overweight women (age: 37.6 ± 7.1 yr; BMI: 31.5 ± 4.1 kg/m2) engaged in a 12-month behavioral weight management program, which included a body image module. Self-reported measures were used to assess evaluative and investment body image, and eating behavior. Measurements occurred at baseline and at 12 months. Baseline-residualized scores were calculated to report change in the dependent variables. The model was tested using partial least squares analysis. Results The model explained 18-44% of the variance in the dependent variables. Treatment significantly improved both body image components, particularly by decreasing its investment component (f2 = .32 vs. f2 = .22). Eating behavior was positively predicted by investment body image change (p < .001) and to a lesser extent by evaluative body image (p < .05). Treatment had significant effects on 12-month eating behavior change, which were fully mediated by investment and partially mediated by evaluative body image (effect ratios: .68 and .22, respectively). Conclusions Results suggest that improving body image, particularly by reducing its salience in one's personal life, might play a role in enhancing eating self-regulation during weight control. Accordingly, future weight loss interventions could benefit from proactively addressing body image-related issues as part of their protocols.
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Affiliation(s)
- Eliana V Carraça
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz Quebrada, Portugal
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Abstract
Metabolic syndrome (MetS) is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular atherosclerotic diseases and diabetes mellitus type 2. Currently, several different definitions of MetS exist, causing substantial confusion as to whether they identify the same individuals or represent a surrogate of risk factors. Recently, a number of other factors besides those traditionally used to define MetS that are also linked to the syndrome have been identified. In this review, we critically consider existing definitions and evolving information, and conclude that there is still a need to develop uniform criteria to define MetS, so as to enable comparisons between different studies and to better identify patients at risk. As the application of the MetS model has not been fully validated in children and adolescents as yet, and because of its alarmingly increasing prevalence in this population, we suggest that diagnosis, prevention and treatment in this age group should better focus on established risk factors rather than the diagnosis of MetS.
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Affiliation(s)
- Eva Kassi
- Department of Biochemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Pervanidou
- First Department of Paediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregory Kaltsas
- Department of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece
| | - George Chrousos
- First Department of Paediatrics, National and Kapodistrian University of Athens, Athens, Greece
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Vieira PN, Mata J, Silva MN, Coutinho SR, Santos TC, Minderico CS, Sardinha LB, Teixeira PJ. Predictors of Psychological Well-Being during Behavioral Obesity Treatment in Women. J Obes 2011; 2011:936153. [PMID: 21052555 PMCID: PMC2971564 DOI: 10.1155/2011/936153] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 09/12/2010] [Accepted: 09/28/2010] [Indexed: 11/17/2022] Open
Abstract
This study examined the association of autonomy-related variables, including exercise motivation, with psychological well-being and quality of life, during obesity treatment. Middle-aged overweight/obese women (n = 239) participated in a 1-year behavioral program and completed questionnaires measuring need support, general self-determination, and exercise and treatment motivation. General and obesity-specific health-related quality of life (HRQOL), self-esteem, depression, and anxiety were also assessed. Results showed positive correlations of self-determination and perceived need support with HRQOL and self-esteem, and negative associations with depression and anxiety (P < .001). Treatment autonomous motivation correlated positively with physical (P = .004) and weight-related HRQOL (P < .001), and negatively with depression (P = .025) and anxiety (P = .001). Exercise autonomous motivation was positively correlated with physical HRQOL (P < .001), mental HRQOL (P = .003), weight-related HRQOL (P < .001), and self-esteem (P = .003), and negatively with anxiety (P = .016). Findings confirm that self-determination theory's predictions apply to this population and setting, showing that self-determination, perceived need support, and autonomous self-regulation positively predict HRQOL and psychological well-being.
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Affiliation(s)
- Paulo N. Vieira
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Jutta Mata
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Marlene N. Silva
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Sílvia R. Coutinho
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Teresa C. Santos
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Cláudia S. Minderico
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Luís B. Sardinha
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
| | - Pedro J. Teixeira
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz-Quebrada, Portugal
- *Pedro J. Teixeira:
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Abstract
OBJECTIVES The aim of this study was to determine the prevalence and tracking of overweight and obesity in a representative sample of Greek youth and the relation with child and parental factors. METHODS Data were derived from 2 follow-ups of the Greek 1983 National Perinatal Survey by means of a questionnaire completed by parents in 1990 and parents/adolescents in 2001. Parent- and self-reported height and weight measurements were available for 7,219 participants aged 7, and 2,842 participants aged 18. RESULTS The overall overweight/obesity prevalence was 24.3% at age 7, and 15.1% at age 18. The overweight prevalence increased from childhood to adolescence in boys (16.1 to 19.1%) and decreased in girls (19.2 to 8.0%), while the obesity prevalence showed a decrease in both boys (6.2 to 3.6%) and girls (5.8 to 1.0%). Overall, tracking of weight status was 73.7%. More boys (49.2%) remained overweight/obese than girls (24.7%). At age 7, overweight/ obesity was positively associated with male gender, paternal education, and urban residence. Overweight/obesity also correlated with male gender at age 18, and with parental weight status. CONCLUSIONS The prevalence of overweight among Greek youth is high and showed an increase from childhood to adolescence in boys, and a decrease in girls.
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Affiliation(s)
- Alexandra Veltsista
- 1st Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.
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Santos R, Soares-Miranda L, Vale S, Moreira C, Marques AI, Mota J. Sitting time and body mass index, in a Portuguese sample of men: results from the Azorean Physical Activity and Health Study (APAHS). Int J Environ Res Public Health 2010; 7:1500-7. [PMID: 20617042 PMCID: PMC2872332 DOI: 10.3390/ijerph7041500] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 03/13/2010] [Accepted: 03/21/2010] [Indexed: 11/16/2022]
Abstract
The aim of this study was to verify the relation between body mass index (BMI) and sitting time in a sample of 4,091 Azorean men. BMI was calculated from self-reported weight and height. Total physical activity (PA) time and total sitting time were assessed with the IPAQ (short version). Linear Regression analysis showed that total sitting time (hours/day) was positively associated with BMI (B = 0.078; p < 0.001) after adjustments for age, meal frequency, alcohol and tobacco consumptions, island of residence, education level and total PA time. Although the cross sectional design precludes us from establishing causality, our findings emphasize the importance of reducing sedentary behavior to decrease the risk of obesity.
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Affiliation(s)
- Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Portugal.
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Marques-Vidal P, Bovet P, Paccaud F, Chiolero A. Changes of overweight and obesity in the adult Swiss population according to educational level, from 1992 to 2007. BMC Public Health 2010; 10:87. [PMID: 20170554 PMCID: PMC2831837 DOI: 10.1186/1471-2458-10-87] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Accepted: 02/22/2010] [Indexed: 11/11/2022] Open
Abstract
Background In many high income developed countries, obesity is inversely associated with educational level. In some countries, a widening gap of obesity between educational groups has been reported. The aim of this study was to assess trends in body mass index (BMI) and in prevalence of overweight and obesity and their association with educational level in the adult Swiss population. Methods Four cross-sectional National health interview surveys conducted in 1992/93 (n = 14,521), 1997 (n = 12,474), 2002 (n = 18,908) and 2007 (n = 17,879) using representative samples of the Swiss population (age range 18-102 years). BMI was derived from self-reported data. Overweight was defined as BMI ≥ 25 and <30 kg/m2, and obesity as BMI ≥ 30 kg/m2. Results Mean (± standard deviation) BMI increased from 24.7 ± 3.6 in 1992/3 to 25.4 ± 3.6 kg/m2 in 2007 in men and 22.8 ± 3.8 to 23.7 ± 4.3 kg/m2 in women. Between 1992/3 and 2007, the prevalence of overweight + obesity increased from 40.4% to 49.5% in men and from 22.3% to 31.3% in women, while the prevalence of obesity increased from 6.3% to 9.4% in men and from 4.9% to 8.5% in women. The rate of increase in the prevalence of obesity was greater between 1992/3 and 2002 (men: +0.26%/year; women: +0.31%/year) than between 2002 and 2007 (men: +0.10%/year; women: +0.10%/year). A sizable fraction (~25%) of the increasing mean BMI was due to increasing age of the participants over time. The increase was larger in low than high education strata of the population. BMI was strongly associated with low educational level among women and this gradient remained fairly constant over time. A weaker similar gradient by educational level was apparent in men, but it tended to increase over time. Conclusion In Switzerland, overweight and obesity increased between 1992 and 2007 and was associated with low education status in both men and women. A trend towards a stabilization of mean BMI levels was noted in most age categories since 2002. The increase in the prevalence of obesity was larger in low education strata of the population. These findings suggest that obesity preventive measures should be targeted according to educational level in Switzerland.
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Affiliation(s)
- Pedro Marques-Vidal
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Center (CHUV) and University of Lausanne, Lausanne, Switzerland.
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