Showing papers in "Obesity Facts in 2013"

Carrying the Pain of Abuse: Gender-Specific Findings on the Relationship between Childhood Physical Abuse and Obesity in Adulthood

Abstract: Background: Childhood abuse has been associated with negative adult health outcomes, including obesity. This study sought to investigate the association between c

‘Small Changes’ to Diet and Physical Activity Behaviors for Weight Management

Abstract: Obesity is associated with numerous short- and long-term health consequences. Low levels of physical activity and poor dietary habits are consistent with an increased risk of obesity in an obesogenic environment. Relatively little research has investigated associations between eating and activity behaviors by using a systems biology approach and by considering the dynamics of the energy balance concept. A significant body of research indicates that a small positive energy balance over time is sufficient to cause weight gain in many individuals. In contrast, small changes in nutrition and physical activity behaviors can prevent weight gain. In the context of weight management, it may be more feasible for most people to make small compared to large short-term changes in diet and activity. This paper presents a case for the use of small and incremental changes in diet and physical activity for improved weight management in the context of a toxic obesogenic environment.

Interdisciplinary European Guidelines on metabolic and bariatric surgery.

Abstract: In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity - European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery

Obesity: the gateway to ill health - an EASO position statement on a rising public health, clinical and scientific challenge in Europe.

Abstract: Although obesity was only introduced in the 1950s into the International Classification of Diseases (currently ICD-10 code E66, though EASO thinks that this categorization requires revision and is committed to propose novel criteria for ICD-11), it had already reached epidemic proportions by the end of the century, becoming one of the leading causes of death and disability worldwide. According to the World Health Organization (WHO) the prevalence of obesity has tripled since the 1980s in many countries of the WHO European Region, with overweight and obesity affecting 50% of the population in the majority of European countries [1]. In 2008, 1.5 billion adults, 20 years and older, were overweight with an estimated 500 million adults worldwide being obese (over 200 million men and nearly 300 million women); approximately 65% of the world's population inhabit countries where overweight and obesity kill more people than underweight [2,3]. The figures of affected individuals rage on unabated, and more than 40 million children under the age of 5 years were overweight in 2010 [3]. Noteworthy, severe obesity (i.e., a BMI > 35 kg/m2) is a rapidly growing segment of the obesity epidemic in which the detrimental effects are particularly evident and harsh. Moreover, obesity not only disproportionately affects the disadvantaged segments of the population, but these groups experience the most important increases in obesity prevalence. Thus, the WHO has declared obesity as the largest global chronic health problem in adults, which is emerging as a more serious world health problem than malnutrition. In fact, obesity has become a truly global problem that has led to coin the term ‘globesity' to describe the escalating global pandemia affecting both developed and developing countries [2]. In this sense, it has been estimated that 60% of the world's population, i.e., 3.3 billion people, could be overweight (2.2 billion) or obese (1.1 billion) by 2030 if recent trends continue [4]. In spite of these preoccupying facts, obesity is frequently not even thought of as a frequent, serious, complex and chronic disease and is often even dismissed or neglected as a clinical entity.

Effects of Weight Loss and Exercise on Apelin Serum Concentrations and Adipose Tissue Expression in Human Obesity

Abstract: Objective: Apelin is an adipokine which plays a role in the regulation of glucose homeostasis and may contribute to the link between increased adipose tissue mass and obesity related metabolic diseases. Here we investigate the role of omental and subcutaneous (SC) adipose tissue apelin and its receptor APJ mRNA expression in human obesity and test the hypothesis that changes in circulating apelin are associated with reduced fat mass in three weight loss intervention studies. Methods: Apelin serum concentration was measured in 740 individuals in a cross-sectional (n = 629) study including a subgroup (n = 161) for which omental and SC apelin mRNA expression has been analyzed and in three interventions: 12 weeks exercise (n = 60), 6 months calorie-restricted diet (n = 19), 12 months after bariatric surgery (n = 32). Results: Apelin mRNA is significantly higher expressed in adipose tissue of patients with type 2 diabetes and correlates with circulating apelin, BMI, body fat, C-reactive protein, and insulin sensitivity. Obesity surgery-induced weight loss causes a significant reduction in omental and SC apelin expression. All interventions led to significantly reduced apelin serum concentrations which significantly correlate with improved insulin sensitivity, independently of changes in BMI. Conclusions: Reduced apelin expression and serum concentration may contribute to improved insulin sensitivity beyond significant weight loss.

Does Regular Breakfast Cereal Consumption Help Children and Adolescents Stay Slimmer? A Systematic Review and Meta-Analysis

Abstract: Objective: To review systematically the evidence on breakfast cereal consumption and obesity in children and adolescents and assess whether the regular consumptio

Are Anti-Stigma Films a Useful Strategy for Reducing Weight Bias Among Trainee Healthcare Professionals? Results of a Pilot Randomized Control Trial

Abstract: Background: Weight bias is an important clinical issue that the educators of tomorrow's healthcare professionals cannot afford to ignore. This study, therefore, aimed to pilot a randomized controlled trial of the effects of educational films designed to reduce weight stigmatization toward obese patients on trainee dietitians' and doctors' attitudes. Methods: A pre-post experimental design with a 6-week follow-up, which consisted of an intervention group (n = 22) and a control group (n = 21), was conducted to assess the efficacy of brief anti-stigma films in reducing weight bias, and to test whether future, larger-scale studies among trainee healthcare professionals are feasible. Results: Participants at baseline demonstrated weight bias, on both implicit and explicit attitude measures, as well as strong beliefs that obesity is under a person's control. The intervention films significantly improved explicit attitudes and beliefs toward obese people, and participant evaluation was very positive. The intervention did not significantly improve implicit anti-fat bias. Conclusion: The current study suggests both that it is possible to conduct a substantive trial of the effects of educational films designed to reduce weight stigma on a larger cohort of trainee healthcare professionals, and that brief educational interventions may be effective in reducing stigmatizing attitudes in this population.

Effect of BMI and binge eating on food reward and energy intake: further evidence for a binge eating subtype of obesity.

Abstract: Background: The psychological characteristics of binge eating have been proposed as a phenotype to further understanding of overconsumption and susceptibility to obesity. This study examined the influence of trait binge eating in lean and overweight or obese women on appetite, food reward and energy intake. Methods: 25 lean and 25 overweight or obese women were categorised as either ‘binge type' or ‘non-binge type' based on their scores on the Binge Eating Scale. Food reward and food intake were assessed in fasted and fed conditions. Results: Overweight or obese binge types (O-B) consumed more energy than overweight or obese non-binge types (O-NB) and lean binge (L-B) and non-binge types (L-NB). Both L-B and O-B exhibited greater preference for sweet foods. In O-NB, L-B and L-NB, lower liking and wanting for sweet foods was exhibited in the fed condition compared to the fasted condition. However, in O-B wanting for sweet foods was greater when they were fed compared to when they were in a fasted state. Conclusions: These findings provide further support for trait binge eating as a hedonic subtype of obesity. Binge types were characterised by greater intake of high-fat sweet foods and increased wanting for these foods when satiated. Additionally, these findings highlight the potential for separation in liking and wanting for food as a marker of susceptibility to overeat.

Predicting metabolic syndrome in obese children and adolescents: look, measure and ask.

Abstract: Objective: To verify in obese children whether or not the presence of i) high waist-to-height ratio (WHtR), ii) family history for type 2 diabetes (T2D) and iii) acanthosis nigricans (AN), singularly or together, might predict the occurrence of metabolic syndrome or prediabetes. Methods. 1,080 Italian obese children (567 females) were enrolled. Blood pressure, fasting plasma glucose, insulin, and lipids were measured, and oral glucose tolerance test (OGTT) was performed. The WHtR was calculated, family history for T2D was assessed, and the presence of AN was noticed. The odds ratios for showing metabolic syndrome and/or prediabetes according to the presence of these features were calculated. Results: The prevalence of metabolic syndrome was 29.2%. AN (OR1.81; p = 0.002) and WHtR higher than 0.60 (OR 2.24; p Conclusions: Three simple actions, i.e., looking at the patient, asking about T2D family history, and measuring WHtR, may represent a powerful tool in the hands of pediatricians to identify obese children with high cardiovascular and metabolic risk.

Association between sleeping hours and siesta and the risk of obesity: the SUN Mediterranean Cohort.

Abstract: Objectives: Our aim was to investigate the association between sleeping hours at night and during the siesta and the incidence of obesity in a Mediterranean cohort. Methods: After a median of 6.5 years of follow-up, we included 10,532 or 9,470 participants without chronic disease or obesity at baseline for analyzing the association between the incidence of obesity and nocturnal sleep duration or having siesta. Sleeping hours and siesta were assessed at baseline. Weight was recorded at baseline and every 2 years during the follow-up. The outcome was the incidence of obesity during follow-up among participants with initial BMI <30 kg/m 2 . Results: During follow-up we observed 446 new cases of obesity in the analysis of nocturnal sleep duration. Sleeping less than 5 h at night was associated with a higher risk of becoming obese compared to sleeping between 7 and <8 h (HR 1.94; 95% CI 1.19–3.18; p for quadratic trend = 0.06) after adjusting for potential confounders. During follow-up, we observed 396 incident cases of obesity in the analysis of siesta. Those who took a siesta for 30 min/day had a 33% lower risk of becoming obese (HR 0.67; 95% CI 0.46–0.96; p for quadratic trend = 0.13) compared to those who did not take siesta. Conclusion: Our results suggest that short nocturnal sleep duration could be a modifiable risk factor for obesity. It is possible that this association may be stronger among men and subjects who experienced previous weight gain. Additionally, siesta might be a novel and independent protective factor for obesity; however, confirmatory studies are needed.

Attitudes of health care professionals towards female obese patients.

Abstract: Objective: The health care setting has been reported to be one main source of weight stigma repeatedly; however, studies comparing different professions have been lacking Methods: 682 health care professionals (HCP) of a large German university hospital were asked to fill out a questionnaire on stigmatizing attitudes, perceived causes of obesity, and work-related impact of obesity Stigmatizing attitudes were assessed on the Fat Phobia Scale (FPS) based on a vignette describing a female obese patient Results: Only 25% graded current health care of obese patients to be ‘good' or ‘very good' 63% of all HCPs ‘somewhat' or ‘strongly' agreed that it was often difficult to get the resources needed in order to care for obese patients The mean FPS score was comparable to that in the general public (M = 359), while nursing staff showed slightly more positive attitudes compared to physicians and therapists Higher age, higher BMI, and ascribing personal responsibility for obesity to the individual were associated with a higher level of stigmatizing attitudes The nursing staff agreed on obesity as an illness to a greater extent while physicians attributed obesity to the individual Conclusions: In summary, by making complex models on the causes of obesity known among health care professionals, stigmatizing attitudes might be reduced Ongoing further education for health care professionals ought to be part of anti-stigma campaigns in the medical field

Prevalence, trends and associated socio-economic factors of obesity in South Asia.

Abstract: Aim: Worldwide obesity levels have increased unprecedentedly over the past couple of decades. Although the prevalence, trends and associated socio-economic factors of the condition have been extensively reported in Western populations, less is known regarding South Asian populations. Methods: A review of articles using Medline with combinations of the MeSH terms: ‘Obesity’, ‘Overweight’ and ‘Abdominal Obesity’ limiting to epidemiology and South Asian countries. Results: Despite methodological heterogeneity and variation according to country, area of residence and gender , the most recent nationally representative and large regional data demonstrates that without any doubt there is a epidemic of obesity, overweight and abdominal obesity in South Asian countries. Prevalence estimates of overweight and obesity (based on Asian cut-offs: overweight ≥ 23 kg/m 2 , obesity ≥ 25 kg/m 2 ) ranged from 3.5% in rural Bangladesh to over 65% in the Maldives. Abdominal obesity was more prevalent than general obesity in both sexes in this ethnic group. Countries with the lowest prevalence had the highest upward trend of obesity. Socio-economic factors associated with greater obesity in the region included female gender, middle age, urban residence, higher educational and economic status. Conclusion: South Asia is significantly affected by the obesity epidemic. Collaborative public health interventions to reverse these trends need to be mindful of many socio-economic constraints in order to provide long-term solutions.

Correlation of Resistin with Inflammatory and Cardiometabolic Markers in Obese Adolescents with and without Metabolic Syndrome

Abstract: Objective: The link between plasma resistin and obesity-related cardiometabolic disorders in children remains debatable. This study assessed the relationships of plasma resistin with cardiovascular risk factors, pro-inflammatory markers and insulin resistance index (HOMA-IR) in obese (Ob) adolescents and obese adolescents with metabolic syndrome (Ob-MS) compared to healthy controls (CO). Methods: 114 obese adolescents (60 Ob, age 13.6 ± 0.9 years, BMI 28.0 ± 2.2 kg/m 2 , and 54 Ob-MS, age 13.8 ± 1.0 years, BMI 32.5 ± 4.8 kg/m 2 ) and 37 CO (age 13.7 ± 0.8 years, BMI 22.8 ± 0.8 kg/m 2 ) were studied. Anthropometrics, cardiac variables as well as fasting plasma concentrations of lipids, glucose, insulin, and adipocytokines (resistin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)) were measured. HOMA-IR was calculated, and the presence of MS was assessed. Results: Plasma resistin was significantly higher in Ob-MS than in both Ob and CO and was correlated with anthropometric, cardiovascular, pro-inflammatory markers and several components of MS as was HOMA-IR in Ob and Ob-MS. With increasing the number of MS components, plasma resistin, pro-inflammatory markers, and HOMA-IR were also increased. Multiple regression models highlighted significant correlation between resistin and both HOMA-IR (r = 0.40, p < 0.05) and systolic blood pressure (r = 0.63, p < 0.01) in Ob-MS. Conclusion: These results support the hypothesis that there is an association between circulating resistin and childhood obesityrelated inflammatory and cardiometabolic events.

Abdominal obesity in German adolescents defined by waist-to-height ratio and its association to elevated blood pressure: the KiGGS study.

Abstract: Objective: The aim of this study was to compare the fixed 0.5 cut-off and the age- and sexspecific 90th percentile (P90) for waist-to-height ratio (WHtR) in German adolescents with respect to the prevalence of abdominal obesity and to compare the screening ability of WHtR and BMI to identify hypertensive blood pressure (BP) values. Methods: Between 2003 and 2006, the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was carried out including 3,492 boys and 3,321 girls aged 11–17 years. Abdominal obesity was assessed by two WHtR cut-points (P90; 0.5). Hypertensive BP was defined as BP exceeding age-, sex- and height-specific 95th percentiles or the adult threshold for hypertension (140/90 mm Hg). Results: Agreement between the WHtR cut-offs was very good (Kappa 0.89 for boys; 0.81 for girls), and the prevalence of abdominal obesity was slightly higher using P90 (boys 12.0%; girls 11.3%) compared to 0.5 (boys 10.7%; girls 8.0%). WHtR and BMIfor-age had equivalent ability to discriminate hypertensive BP (ROC-AUC < 0.7; sensitivity of the 0.5 cut-off for detecting hypertensive BP < 30%). Conclusion: The fixed 0.5 WHtR cut-off can be used in German adolescents to characterize abdominal obesity. However, WHtR is not suitable as a screening tool for hypertensive BP in adolescents.

Bright Light for Weight Loss: Results of a Controlled Crossover Trial

Abstract: Objective: To investigate whether bright light treatment can reduce body mass in overweight subjects irrespective of their seasonal (= light) dependence

Altered activities of antioxidant enzymes in patients with metabolic syndrome.

Abstract: Objective: In the pathogenesis of the metabolic syndrome (MetS), an increase of oxidative stress could play an important role which is closely linked with insulin resistance, endothelial dysfunction, and chronic inflammation. The aim of our study was to assess several parameters of the antioxidant status in MetS. Methods: 40 subjects with MetS and 40 age- and sex-matched volunteers without MetS were examined for activities of superoxide dismutase (CuZnSOD), catalase (CAT), glutathione peroxidase 1 (GPX1), glutathione reductase (GR), paraoxonase1 (PON1), concentrations of reduced glutathione (GSH), and conjugated dienes in low-density lipoprotein (CD-LDL). Results: Subjects with MetS had higher activities of CuZnSOD (p Conclusions: Our results implicated an increased oxidative stress in MetS and a decreased antioxidative defense that correlated with some laboratory (triglycerides, high-density lipoprotein cholesterol (HDL-C)) and clinical (waist circumference, blood pressure) components of MetS.

Gender and Socioeconomic Status in Relation to Weight Perception and Weight Control Behavior in Korean Adults

Abstract: Aim: In Korea, obesity is more prevalent among men and lower socioeconomic groups. To explain this obesity disparity, we compared weight perception and weight control behavior across gender and socioeconomic status (SES). Methods: We analyzed data from 16,260 participants aged 20 years or older in a nationally representative cross-sectional survey. SES indicators included education and income levels. Weight under-perception was defined when participants considered themselves lighter than their measured BMI status. Either no active or inappropriate weight control (i.e., trying to gain weight in obese individuals) was considered to be unhealthy patterns. Multivariate prevalence ratios were calculated using log-binomial regressions. Results: Men had a higher prevalence of weight under-perception (24.5 vs. 11.9%) and unhealthy patterns of weight control behavior (57 vs. 40%) than women. Low education level was associated with weight under-perception (p trend = 0.022 in men, p trend < 0.001 in women). Both education and income levels were significantly associated with patterns of weight control behavior (for education: p trend < 0.001 in men and women; for income: p trend = 0.047 in men, p trend < 0.001 in women). Conclusion: Weight perception and weight control behavior significantly varied by gender and SES. Public actions should be directed toward improving perception and behavior of high-risk populations.

Anxiety and Depressed Mood in Obese Pregnant Women: A Prospective Controlled Cohort Study

Abstract: Background: The psychological health in obese women during pregnancy has been poorly studied. Objective: To compare levels of anxiety and depressed mood during pregnancy in obese versus normal-weight women. Methods: 63 obese pregnant women and 156 normal-weight controls were included prospectively before 15 weeks of gestation. Levels of state and trait anxiety and depressed mood were measured during the first, second and third trimester of pregnancy. A linear mixed-effect model with repeated measures was used to evaluate group differences. Results: The levels of state anxiety significantly increased from trimester 1 to trimester 3 in obese pregnant women (beta = 3.70; p = 0.007), while this parameter remained constant throughout pregnancy in normal-weight women. Levels of trait anxiety and depressed mood significantly decreased from trimester 1 to trimester 2 in controls, but not in obese pregnant women. Variables such as maternal education, ethnicity, marital state, psychological history and miscarriages, parity and smoking behaviour had significant effects on anxiety and/or depressed moods during pregnancy. Obese pregnant women show higher levels of anxiety and depressive symptomatology compared to normal-weight pregnant women. Conclusion: Interventional programmes aiming at preventing the deleterious influence of maternal obesity on perinatal outcomes should include a psycho-educational program specifically tailored to this high-risk group.

Effect of weight reduction following bariatric surgery on serum visfatin and adiponectin levels in morbidly obese subjects.

Abstract: Objective: Adipokines are signaling and mediator proteins secreted from adipose tissue. A novel adipokine, visfatin, was reported as a protein which was mainly expressed in visceral adipose tissue. Controversial results have been shown regarding the changes of adipokines following weight reduction. So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects. Methods: 35 severely obese patients (26 females and 9 males), aged 15-58 years, were studied. Anthropometric parameters and biochemical parameters as well as adiponectin and visfatin were analyzed before and 6 weeks after weight reduction. Results: Anthropometric indices decreased significantly. Blood levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride were reduced significantly. The reduction of visfatin and the elevation of adiponectin were significant as well. However, other parameters like fasting glucose and insulin did not change. Moreover, we could not find any significant correlation between the change of serum visfatin and that of adiponectin. Conclusions: 6-week weight reduction after bariatric surgery resulted in decreased serum visfatin and increased adiponectin levels. However, we cannot find any significant correlation between changes of adiponectin, visfatin, BMI, waist circumference, and insulin resistance. Further studies with different design are suggested to clarify these associations.

Role of Peripheral Blood Mononuclear Cells in the Predisposition of Obese Individuals to Inflammation and Infection

Abstract: Objective : To compare the production of pro- and anti-inflammatory cytokines by peripheral blood mononuclear cells (PBMC) from obese but otherwise healthy individ

Trends in obesity and abdominal obesity in the older adult population of Spain (2000-2010)

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.

Dose Response Association between Physical Activity and Biological, Demographic, and Perceptions of Health Variables

Abstract: Background: Few population-based studies have examined the association between physical activity (PA) and cardiovascular disease risk factors, demographic variables, and perceptions of health status, and we do not have a clear understanding of the dose-response relationship among these variables. Methods: Data from the 2003-2006 National Health and Nutrition Examination Survey was used to examine the dose-response relationship between objectively measured PA and metabolic syndrome (and its individual cardiovascular disease risk factors), demographic variables, and perceptions of health. After exclusions, 5,538 participants 18 years or older were included in the present study, with 2,538 participants providing fasting glucose and 2,527 providing fasting triglyceride data. PA was categorized into deciles. Results: Overall, the health benefits showed a general pattern of increase with each increasing levels of PA. Of the ten PA classifications examined, participants in the highest moderate-to-vigorous physical activity (MVPA) category (at least 71 min/day) had the lowest odds of developing metabolic syndrome. Conclusion: At a minimum, sedentary adults should strive to meet current PA guidelines (i.e., 150 min/week of MVPA), with additional positive benefits associated with engaging in three times this level of PA.

Obesity-related adipokines predict patient-reported shoulder pain.

Abstract: Background/Aims: Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links. Methods: 50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire) and pain (Short Form McGill Pain Questionnaire) measures. Synovial fluid (SF) samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity. Results: 54% of the cohort was female (n = 27). The mean age (SD) of the sample was 62.9 (9.9) years and the mean BMI (SD) was 28.1 (5.4) kg/m2. From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p Conclusions: The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets.

An observational study of the association between adenovirus 36 antibody status and weight loss among youth.

Abstract: Objective: Although the human adenovirus 36 (Ad-36) is associated with obesity and relative hypolipidemia, its role in pediatric weight loss treatment response is uncertain. Therefore, the primary study objective was to determine whether Ad-36 antibody (AB) status was associated with response to a pediatric weight loss program. The secondary objective was to assess the association between Ad-36 AB status and baseline lipid values. Methods: Participants included 73 youth aged 10-17 years in a residential camp-based weight loss program. The study examined differences in baseline lipid values between Ad-36 AB+ and AB- youth as well as differences in response to treatment, including indices of body size and fitness. Results: At baseline, results showed that Ad-36 AB+ youth evidenced significantly lower levels of total cholesterol and triglycerides than Ad-36 AB- youth (all p Conclusion: Ad-36 AB status showed a weak association with treatment response, but was associated with a better lipid profile. Ad-36 AB status should be assessed in studies of pediatric obesity treatment and prevention.

Higher BMI is associated with reduced cognitive performance in division I athletes.

Abstract: Objective: Poor cardiovascular fitness has been implicated as a possible mechanism for obesity-related cognitive decline, though no study has examined whether BMI

BMI and BAI as Markers of Obesity in a Caucasian Population

Abstract: Background: BMI is known to have limited accuracy, which is different for males and females with similar body fat content. That is why Bergman et al. (Obesity 2011;19:1083-1089) introduced an alternative variable of obesity, called the body adiposity index (BAI). Their primary research was conducted in samples of Mexican-American and African-American populations. The objective of our research was to investigate the sex-specific relationship between both BMI and BAI and body fat content in a healthy Caucasian population. The accuracy of both indexes was compared. Methods: 684 women and 528 men aged 20-22 years with Caucasian origin only participated in the study. Participants were students of universities in southern Poland. They had no indication of cardiometabolic problems, as evaluated by interview. Results: The study revealed that BAI is a more sensitive method in assessing obesity in Caucasian males rather than BMI. In the population of Caucasian women BAI results indicate a significant underestimation of obesity. Conclusion: The fact that there is a high statistical correlation between BAI and % fat mass among obese and overweight men and women suggests that BAI could be highly specific provided that the BAI cutoffs will be adapted to the European population.

Longer weekly sleep duration predicts greater 3-month BMI reduction among obese adolescents attending a clinical multidisciplinary weight management program.

Abstract: Aims: To determine whether baseline levels of self-reported sleep and sleep problems among obese adolescents referred to an outpatient multidisciplinary family-based weight management program predict reduction in BMI 3 months later. Methods: A retrospective medical chart review was conducted for 83 obese adolescents. The following baseline variables were extracted: self-reported sleep duration (weekdays and weekends), and presence of snoring, daytime fatigue, suspected sleep apnea, and physician-diagnosed sleep apnea. Anthropometric data at baseline and 3 months were also collected. Results: On average, adolescents reported significantly less sleeping on weeknights (7.7 ± 1.3 h) compared to weekend nights (10.0 ± 1.8 h), t(82) = 10.5, p = 0.0001. Reduction in BMI after 3 months of treatment was predicted by more weekly sleep at baseline (R 2 = 0.113, F(1, 80) = 10.2, p = 0.002). Adolescents who reduced their BMI by ≥ 1 kg/m 2 reported greater weekly sleep at baseline compared to adolescents who experienced <1 kg/m 2 reduction (60.7 ± 7.5 h vs. 56.4 ± 8.6 h; F(1, 80) = 5.7, p = 0.02). Conclusion: Findings from this study, though correlational, raise the possibility that increased duration of sleep may be associated with weight loss among obese adolescents enrolled in a weight management program. Evidence-based behavioral techniques to improve sleep hygiene and increase sleep duration should be explored in pediatric weight management settings.

N-3 polyunsaturated fatty acids, body fat and inflammation.

Abstract: Background: Based on animal studies, n-3 polyunsaturated fatty acids (PUFAs) have been suggested to lower the risk of obesity and inflammation. We aimed to investigate if, among humans, intake of n-3 PUFAs was associated with i) total body fat, ii) body fat distribution and iii) obesity-related inflammatory markers. Methods: The study population consisted of 1,212 healthy individuals with information on habitual food intake from food frequency questionnaires, six different measures of body fat, and levels of six circulating inflammatory markers. Multiple linear regression analysis of intakes of PUFAs in relation to outcomes were performed and adjusted for potential confounders. Results: Absolute n-3 PUFA intake, but not n-3/n-6, was inversely associated with the different measures of body fat. Among n-3 PUFA derivatives, only α-linolenic acid (ALA) was inversely associated with body fat measures. No significant interactions with the dietary macronutrient composition were observed. Pro-inflammatory cytokines were not associated with absolute PUFA intake, but the macrophage inflammatory protein-1α (MIP-1α) was associated with the n-3/n-6 ratio. Conclusion: In humans, intake of n-3 PUFAs, in particular ALA, is beneficially associated with body fatness. The favourable association is, however, not reflected in systemic levels of pro-inflammatory cytokines, nor is it influenced by macronutrients in the diet.

Maternal obesity and pre-pregnancy folic acid supplementation.

Abstract: Objective: The purpose of this nested cohort study was to compare the rate of pre-pregnancy supplementation in obese women with that of women with a normal BMI. Methods: Pregnant women were enrolled at their convenience in a large university hospital. Weight and height were measured in the first trimester and BMI categorised. Results: Of the 288 women, 35.1% were in the normal, 29.5% in the overweight and 35.4% in the obese BMI categories. Only 45.1% (n = 46) of the obese women took pre-pregnancy folic acid compared with 60.4% (n = 61) of women with a normal BMI (p Conclusions: Obese women should take folate supplements whether they are planning to conceive or not.

Association of anthropometric measures with cardiovascular risk factors and metabolic syndrome in normal-weight children and adolescents: the CASPIAN III study.

Abstract: Objective: This nationwide study was conducted to determine the association of anthropometric measures with cardiovascular risk factors and metabolic syndrome (MetS) in Iranian normal-weight children and adolescents. Methods: We analyzed the data of 3,565 children and adolescents (50.3% boys), aged 10-18 years, with a normal BMI (5th-84th percentile) obtained from the third survey of ‘Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN III) study. The diagnostic criteria for MetS were defined by the International Diabetes Federation consensus. Results: The prevalence of MetS for 10- to 13.9-year-old boys, 14- to 18-year-old boys, 10- to 13.9-year-old girls, and 14- to 18-year-old girls were 1.4, 2.8, 2.3, and 3.3%, respectively. After adjustment for age and sex, each unit increase in BMI (within normal range) and waist circumference increased the odds of MetS from 6 to 72% and from 1 to 20%, respectively. The dominant pattern of dyslipidemia among the participants was high triglycerides and low high-density lipoprotein cholesterol. Conclusion: This study complements recent research about the high frequency of metabolic risk factors among normal-weight individuals in the pediatric age group.