Showing papers on "Body mass index published in 2010"

Overweight, Obesity, and Depression A Systematic Review and Meta-analysis of Longitudinal Studies

Abstract: Context: Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. Objective: To conduct a systematic review and meta-analysis on the longitudinal relationship between depression, overweight, and obesity and to identify possible influencing factors. Data Sources: Studies were found using PubMed, PsycINFO, and EMBASE databases and selected on several criteria. Study Selection: Studies examining the longitudinal bidirectional relation between depression and overweight (body mass index 25-29.99) or obesity (body mass index >= 30) were selected. Data Extraction: Unadjusted and adjusted odds ratios (ORs) were extracted or provided by the authors. Data Synthesis: Overall, unadjusted ORs were calculated and subgroup analyses were performed for the 15 included studies (N = 58 745) to estimate the effect of possible moderators (sex, age, depression severity). Obesity at baseline increased the risk of onset of depression at follow-up (unadjusted OR, 1.55; 95% confidence interval [CI], 1.22-1.98; P = 60 years) but not among younger persons (aged < 20 years). Baseline depression (symptoms and disorder) was not predictive of overweight over time. However, depression increased the odds for developing obesity (OR, 1.58; 95% CI, 1.33-1.87; P < .001). Subgroup analyses did not reveal specific moderators of the association. Conclusions: This meta-analysis confirms a reciprocal link between depression and obesity. Obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression. In addition, depression was found to be predictive of developing obesity.

Prevalence of high body mass index in US children and adolescents, 2007-2008.

Abstract: Context The prevalence of high body mass index (BMI) among children and adolescents in the United States appeared to plateau between 1999 and 2006. Objectives To provide the most recent estimates of high BMI among children and adolescents and high weight for recumbent length among infants and toddlers and to analyze trends in prevalence between 1999 and 2008. Design, Setting, and Participants The National Health and Nutrition Examination Survey 2007-2008, a representative sample of the US population with measured heights and weights on 3281 children and adolescents (2 through 19 years of age) and 719 infants and toddlers (birth to 2 years of age). Main Outcome Measures Prevalence of high weight for recumbent length (≥95th percentile of the Centers for Disease Control and Prevention growth charts) among infants and toddlers. Prevalence of high BMI among children and adolescents defined at 3 levels: BMI for age at or above the 97th percentile, at or above the 95th percentile, and at or above the 85th percentile of the BMI-for-age growth charts. Analyses of trends by age, sex, and race/ethnicity from 1999-2000 to 2007-2008. Results In 2007-2008, 9.5% of infants and toddlers (95% confidence interval [CI], 7.3%-11.7%) were at or above the 95th percentile of the weight-for-recumbent-length growth charts. Among children and adolescents aged 2 through 19 years, 11.9% (95% CI, 9.8%-13.9%) were at or above the 97th percentile of the BMI-for-age growth charts; 16.9% (95% CI, 14.1%-19.6%) were at or above the 95th percentile; and 31.7% (95% CI, 29.2%-34.1%) were at or above the 85th percentile of BMI for age. Prevalence estimates differed by age and by race/ethnic group. Trend analyses indicate no significant trend between 1999-2000 and 2007-2008 except at the highest BMI cut point (BMI for age ≥97th percentile) among all 6- through 19-year-old boys (odds ratio [OR], 1.52; 95% CI, 1.17-2.01) and among non-Hispanic white boys of the same age (OR, 1.87; 95% CI, 1.22-2.94). Conclusion No statistically significant linear trends in high weight for recumbent length or high BMI were found over the time periods 1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008 among girls and boys except among the very heaviest 6- through 19-year-old boys.Published online January 13, 2010 (doi:10.1001/jama.2009.2012).

Body-Mass Index and Mortality among 1.46 Million White Adults

Abstract: BACKGROUND A high body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) is associated with increased mortality from cardiovascular disease and certain cancers, but the precise relationship between BMI and all-cause mortality remains uncertain. METHODS We used Cox regression to estimate hazard ratios and 95% confidence intervals for an association between BMI and all-cause mortality, adjusting for age, study, physical activity, alcohol consumption, education, and marital status in pooled data from 19 prospective studies encompassing 1.46 million white adults, 19 to 84 years of age (median, 58). RESULTS The median baseline BMI was 26.2. During a median follow-up period of 10 years (range, 5 to 28), 160,087 deaths were identified. Among healthy participants who never smoked, there was a J-shaped relationship between BMI and all-cause mortality. With a BMI of 22.5 to 24.9 as the reference category, hazard ratios among women were 1.47 (95 percent confidence interval [CI], 1.33 to 1.62) for a BMI of 15.0 to 18.4; 1.14 (95% CI, 1.07 to 1.22) for a BMI of 18.5 to 19.9; 1.00 (95% CI, 0.96 to 1.04) for a BMI of 20.0 to 22.4; 1.13 (95% CI, 1.09 to 1.17) for a BMI of 25.0 to 29.9; 1.44 (95% CI, 1.38 to 1.50) for a BMI of 30.0 to 34.9; 1.88 (95% CI, 1.77 to 2.00) for a BMI of 35.0 to 39.9; and 2.51 (95% CI, 2.30 to 2.73) for a BMI of 40.0 to 49.9. In general, the hazard ratios for the men were similar. Hazard ratios for a BMI below 20.0 were attenuated with longer-term follow-up. CONCLUSIONS In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9.

Sugar-Sweetened Beverages, Obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk

Abstract: Obesity has recently emerged as a major global health problem. According to World Health Organization estimates, ≈1.6 billion adults worldwide were overweight (body mass index [BMI] ≥25 kg/m2) and at least 400 million were obese (BMI ≥30 kg/m2) in 2005, numbers that are expected to reach 2.3 billion and 700 million, respectively, by 2015. In the United States, the percentage of overweight and obese adults increased markedly from 47% and 15% in 1976 to 1980 to >66% and 33% in 2005 to 2006, with the greatest proportion of increase seen among non-Hispanic black and Mexican American women.1,2 The implications of excess body weight are far-reaching. Epidemiological studies indicate that overweight and obesity are important risk factors for type 2 diabetes mellitus (T2DM), cardiovascular disease, cancer, and premature death.3 In the United States, healthcare expenditures attributable to overweight and obesity are estimated to be $147 billion or 9.1% of total healthcare costs per year.4 Such excess costs could have serious repercussions for resource-poor countries, which must manage the dual burdens of chronic and infectious disease. In the setting of a pandemic of obesity and related chronic diseases, the American Heart Association recently released a scientific statement recommending reductions in added-sugar intake to no more than 100 to 150 kcal/d for most Americans.5 The statement identified sugar-sweetened beverages (SSBs) as the primary source of added sugars in the American diet.6 Although it has long been suspected that SSBs contribute at least in part to the obesity epidemic, only in recent years have large epidemiological studies been able to substantiate the relationship between SSB consumption and long-term weight gain, T2DM, and cardiovascular risk. It is thought that SSBs contribute to weight gain because of their high added-sugar content, low satiety, and potential incomplete compensation for total …

Visceral Adiposity Index: A reliable indicator of visceral fat function associated with cardiometabolic risk

Abstract: Objective To individuate a novel sex-specific index, based on waist circumference, BMI, triglycerides, and HDL cholesterol, indirectly expressing visceral fat function. Research design and methods Visceral adiposity index (VAI) was first modeled on 315 nonobese healthy subjects. Using two multiple logistic regression models, VAI was retrospectively validated in 1,498 primary care patients in comparison to classical cardio- and cerebrovascular risk factors. Results All components of metabolic syndrome increased significantly across VAI quintiles. VAI was independently associated with both cardiovascular (odd ratio [OR] 2.45; 95% CI 1.52-3.95; P Conclusions Our study suggests VAI is a valuable indicator of "visceral adipose function" and insulin sensitivity, and its increase is strongly associated with cardiometabolic risk.

Meta-analysis identifies 13 new loci associated with waist-hip ratio and reveals sexual dimorphism in the genetic basis of fat distribution

Abstract: Waist-hip ratio (WHR) is a measure of body fat distribution and a predictor of metabolic consequences independent of overall adiposity. WHR is heritable, but few genetic variants influencing this trait have been identified. We conducted a meta-analysis of 32 genome-wide association studies for WHR adjusted for body mass index (comprising up to 77,167 participants), following up 16 loci in an additional 29 studies (comprising up to 113,636 subjects). We identified 13 new loci in or near RSPO3, VEGFA, TBX15-WARS2, NFE2L3, GRB14, DNM3-PIGC, ITPR2-SSPN, LY86, HOXC13, ADAMTS9, ZNRF3-KREMEN1, NISCH-STAB1 and CPEB4 (P = 1.9 × 10⁻⁹ to P = 1.8 × 10⁻⁴⁰) and the known signal at LYPLAL1. Seven of these loci exhibited marked sexual dimorphism, all with a stronger effect on WHR in women than men (P for sex difference = 1.9 × 10⁻³ to P = 1.2 × 10⁻¹³). These findings provide evidence for multiple loci that modulate body fat distribution independent of overall adiposity and reveal strong gene-by-sex interactions.

Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis.

Abstract: We performed a systematic review and meta-analysis of studies that assessed the performance of body mass index (BMI) to detect body adiposity. Data sources were MEDLINE, EMBASE, Cochrane, Database of Systematic Reviews, Cochrane CENTRAL, Web of Science, and SCOPUS. To be included, studies must have assessed the performance of BMI to measure body adiposity, provided standard values of diagnostic performance, and used a body composition technique as the reference standard for body fat percent (BF%) measurement. We obtained pooled summary statistics for sensitivity, specificity, positive and negative likelihood ratios (LRs), and diagnostic odds ratio (DOR). The inconsistency statistic (I2) assessed potential heterogeneity. The search strategy yielded 3341 potentially relevant abstracts, and 25 articles met our predefined inclusion criteria. These studies evaluated 32 different samples totaling 31 968 patients. Commonly used BMI cutoffs to diagnose obesity showed a pooled sensitivity to detect high adiposity of 0.50 (95% confidence interval (CI): 0.43–0.57) and a pooled specificity of 0.90 (CI: 0.86–0.94). Positive LR was 5.88 (CI: 4.24–8.15), I2=97.8%; the negative LR was 0.43 (CI: 0.37–0.50), I2=98.5%; and the DOR was 17.91 (CI: 12.56–25.53), I2=91.7%. Analysis of studies that used BMI cutoffs ⩾30 had a pooled sensitivity of 0.42 (CI: 0.31–0.43) and a pooled specificity of 0.97 (CI: 0.96–0.97). Cutoff values and regional origin of the studies can only partially explain the heterogeneity seen in pooled DOR estimates. Commonly used BMI cutoff values to diagnose obesity have high specificity, but low sensitivity to identify adiposity, as they fail to identify half of the people with excess BF%.

Assessment of Cardiovascular Risk and Prevention of Cardiovascular Disease in Women with the Polycystic Ovary Syndrome: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society

Abstract: Objective: Women with polycystic ovary syndrome (PCOS) often have cardiovascular disease (CVD) risk factors. The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD. Participants: An expert panel in PCOS and CVD reviewed literature and presented recommendations. Evidence: Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts, and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described, or methodology precluded evaluation. Inclusion/exclusion criteria were confirmed by at least two reviewers and arbitrated by a third. Consensus Process: Systematic reviews of CVD risk factors were compiled and submitted for approval to the AE-PCOS Society B...

Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance

Abstract: Background Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power. Methods We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3.3-MJ (800-kcal) low-calorie diet. Participants were randomly assigned, in a two-by-two factorial design, to one of five ad libitum diets to prevent weight regain over a 26-week period: a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. Results A total of 1209 adults were screened (mean age, 41 years; body-mass index [the weight in kilograms divided by the square of the height in meters], 34), of whom 938 entered the low-calorie-diet phase of the study. A total of 773 participants who completed that phase were randomly assigned to one of the five...

Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk—a review of the literature

Abstract: Overweight and obesity have become a major public health problem in both developing and developed countries as they are causally related to a wide spectrum of chronic diseases including type II diabetes, cardiovascular diseases and cancer. However, uncertainty regarding the most appropriate means by which to define excess body weight remains. Traditionally, body mass index (BMI) has been the most widely used method by which to determine the prevalence of overweight in, and across, populations as well as an individual's level of risk. However, in recent years, measures of central obesity, principally waist circumference and the waist:hip ratio and to a lesser extent the waist:height ratio, which more accurately describe the distribution of body fat compared with BMI, have been suggested to be more closely associated with subsequent morbidity and mortality. There is also uncertainty about how these measures perform across diverse ethnic groups; earlier, most of the evidence regarding the relationships between excess weight and risk has been derived chiefly from Caucasian populations, and hence, it remains unclear whether the relationships are consistent in non-Caucasian populations. The purpose of this review, therefore, is to provide an overview of the current evidence-base focusing predominantly on three main questions: (1) Which, if any, of the commonly used anthropometric measures to define excess weight is more strongly associated with cardiovascular risk? (2) Which of the anthropometric measures is a better discriminator of risk? and (3) Are there any notable differences in the strength and nature of these associations across diverse ethnic groups?

Regulation of Abdominal Adiposity by Probiotics (Lactobacillus Gasseri SBT2055) in Adults With Obese Tendencies in a Randomized Controlled Trial

Abstract: In spite of the much evidence for the beneficial effects of probiotics, their anti-obesity effects have not been well examined. We evaluated the effects of the probiotic Lactobacillus gasseri SBT2055 (LG2055) on abdominal adiposity, body weight and other body measures in adults with obese tendencies. We conducted a multicenter, double-blind, randomized, placebo-controlled intervention trial. Subjects (n=87) with higher body mass index (BMI) (24.2–30.7 kg/m2) and abdominal visceral fat area (81.2–178.5 cm2) were randomly assigned to receive either fermented milk (FM) containing LG2055 (active FM; n=43) or FM without LG2055 (control FM; n=44), and were asked to consume 200 g/day of FM for 12 weeks. Abdominal fat area was determined by computed tomography. In the active FM group, abdominal visceral and subcutaneous fat areas significantly (P<0.01) decreased from baseline by an average of 4.6% (mean (confidence interval): −5.8 (−10.0, −1.7) cm2) and 3.3% (−7.4 (−11.6, −3.1) cm2), respectively. Body weight and other measures also decreased significantly (P<0.001) as follows: body weight, 1.4% (−1.1 (−1.5, −0.7) kg); BMI, 1.5% (−0.4 (−0.5, −0.2) kg/m2); waist, 1.8% (−1.7 (−2.1, −1.4) cm); hip, 1.5% (−1.5 (−1.8, −1.1) cm). In the control group, by contrast, none of these parameters decreased significantly. High-molecular weight adiponectin in serum increased significantly (P<0.01) in the active and control groups by 12.7% (0.17 (0.07, 0.26) μg/ml) and 13.6% (0.23 (0.07, 0.38) μg/ml), respectively. The probiotic LG2055 showed lowering effects on abdominal adiposity, body weight and other measures, suggesting its beneficial influence on metabolic disorders.

The Attractive Female Body Weight and Female Body Dissatisfaction in 26 Countries Across 10 World Regions: Results of the International Body Project I

Abstract: This study reports results from the first International Body Project (IBP-I), which surveyed 7,434 individuals in 10 major world regions about body weight ideals and body dissatisfaction. Participants completed the female Contour Drawing Figure Rating Scale (CDFRS) and self-reported their exposure to Western and local media. Results indicated there were significant cross-regional differences in the ideal female figure and body dissatisfaction, but effect sizes were small across high-socioeconomic-status (SES) sites. Within cultures, heavier bodies were preferred in low-SES sites compared to high-SES sites in Malaysia and South Africa (ds = 1.94-2.49) but not in Austria. Participant age, body mass index (BMI), and Western media exposure predicted body weight ideals. BMI and Western media exposure predicted body dissatisfaction among women. Our results show that body dissatisfaction and desire for thinness is commonplace in high-SES settings across world regions, highlighting the need for international attention to this problem.

Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963-1965 Through 2007-2008

Abstract: Healthy People 2010 identified overweight and obesity as 1 of 10 leading health indicators and called for a reduction in the proportion of children and adolescents who are overweight or obese, but the United States has made little progress toward the target goal. Progress toward reducing the national prevalence of overweight and obesity is monitored using data from the National Health and Nutrition Examination Survey (NHANES). Results from the 2007–2008 NHANES, using measured heights and weights, indicate that an estimated 16.9% of children and adolescents aged 2–19 years are obese. Between 1976–1980 and 1999–2000, the prevalence of obesity increased. Between 1999–2000 and 2007–2008, there was no significant trend in obesity prevalence for any age group. Table 1 shows the increase in obesity that has occurred since 1976–1980. Among preschool children aged 2–5, obesity increased from 5.0% to 10.4% between 1976–1980 and 2007–2008 and from 6.5% to 19.6% among those aged 6–11. Among adolescents aged 12–19, obesity increased from 5.0% to 18.1% during the same period. Figure 1 shows the trends since the 1960s by age group. Body mass index (BMI), expressed as weight in kilograms divided by height in meters squared (kg/m 2 ), is commonly used to classify obesity among adults, and is also recommended in children. Cutoff criteria are based on the 2000 CDC BMI-for-age-growth charts for the United States. Based on current recommendations of expert committees, children with BMI values at or above the 95th percentile of the sex-specific BMI growth charts are categorized as obese. This is different from previous years where children above this cutoff were labeled overweight. This change in terminology reflects the labels used by organizations such as the Institute of Medicine and the American Academy of Pediatrics. For more information see Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics 120:S193–228. 2007. Although this cutpoint is not diagnostic, elevated BMI among children indicates increased risk for future adverse health outcomes or development of disease. Racial and ethnic disparities in adolescent obesity

Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults

Abstract: The obesity epidemic is attributed in part to reduced physical activity. Evidence supports that reducing time spent sitting, regardless of activity, may improve the metabolic consequences of obesity. Analyses were conducted in a large prospective study of US adults enrolled by the American Cancer Society to examine leisure time spent sitting and physical activity in relation to mortality. Time spent sitting and physical activity were queried by questionnaire on 53,440 men and 69,776 women who were disease free at enrollment. The authors identified 11,307 deaths in men and 7,923 deaths in women during the 14-year follow-up. After adjustment for smoking, body mass index, and other factors, time spent sitting (≥6 vs. <3 hours/day) was associated with mortality in both women (relative risk = 1.34, 95% confidence interval (CI): 1.25, 1.44) and men (relative risk = 1.17, 95% CI: 1.11, 1.24). Relative risks for sitting (≥6 hours/day) and physical activity (<24.5 metabolic equivalent (MET)-hours/week) combined were 1.94 (95% CI: 1.70, 2.20) for women and 1.48 (95% CI: 1.33, 1.65) for men, compared with those with the least time sitting and most activity. Associations were strongest for cardiovascular disease mortality. The time spent sitting was independently associated with total mortality, regardless of physical activity level. Public health messages should include both being physically active and reducing time spent sitting.

Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality

Abstract: Aims We hypothesized that subjects with a normal body mass index (BMI), but high body fat (BF) content [normal weight obesity (NWO)], have a higher prevalence of cardiometabolic dysregulation and are at higher risk for cardiovascular (CV) mortality. Methods and results We analysed 6171 subjects >20 years of age from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES III mortality study, whose BMI was within the normal range (18.5–24.9 kg/m2), and who underwent a complete evaluation that included body composition assessment, blood measurements, and assessment of CV risk factors. Survival information was available for >99% of the subjects after a median follow-up of 8.8 years. We divided our sample using sex-specific tertiles of BF%. The highest tertile of BF (>23.1% in men and >33.3% in women) was labelled as NWO. When compared with the low BF group, the prevalence of metabolic syndrome in subjects with NWO was four-fold higher (16.6 vs. 4.8%, P < 0.0001). Subjects with NWO also had higher prevalence of dyslipidaemia, hypertension (men), and CV disease (women). After adjustment, women with NWO showed a significant 2.2-fold increased risk for CV mortality (HR = 2.2; 95% CI, 1.03–4.67) in comparison to the low BF group. Conclusion Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality.

Impact of Body Mass Index and the Metabolic Syndrome on the Risk of Cardiovascular Disease and Death in Middle-Aged Men

Abstract: BACKGROUND: The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories and metabolic syndrome (MetS) and the risk of cardiovascular disease a ...

The influence of exercise and BMI on injuries and illnesses in overweight and obese individuals: a randomized control trial

Abstract: Medically treated injuries have been shown to increase with increasing body mass index (BMI). Information is lacking on the frequency and type of injuries and illnesses among overweight and obese adults who engage in regular physical activities as part of weight loss or weight gain prevention programs. Sedentary adults with BMIs between 25 and 40 kg/m2 (n = 397) enrolled in one of two randomized clinical trials that emphasized exercise as part of a weight loss or weight gain prevention program. Interventions differed by duration of the exercise goal (150, 200, or 300 minutes/week or control group). Walking was prescribed as the primary mode of exercise. At six month intervals, participants were asked, "During the past six months, did you have any injury or illness that affected your ability to exercise?" Longitudinal models were used to assess the effects of exercise and BMI on the pattern of injuries/illnesses attributed to exercise over time; censored linear regression was used to identify predictors of time to first injury/illness attributed to exercise. During the 18-month study, 46% reported at least one injury/illness, and 32% reported at least one injury that was attributed to exercise. Lower-body musculoskeletal injuries (21%) were the most commonly reported injury followed by cold/flu/respiratory infections (18%) and back pain/injury (10%). Knee injuries comprised one-third of the lower-body musculoskeletal injuries. Only 7% of the injuries were attributed to exercise alone, and 59% of the injuries did not involve exercise. BMI (p ≤ 0.01) but not exercise (p ≥ 0.41) was significantly associated with time to first injury and injuries over time. Participants with higher BMIs were injured earlier or had increased odds of injury over time than participants with lower BMIs. Due to the linear dose-response relationship between BMI and injury/illness, any weight loss and reduction in BMI was associated with a decrease risk of injury/illness and delay in time to injury/illness. Overweight and obese adults who were prescribed exercise as part of weight loss or weight gain prevention intervention were not at increased risk of injury compared to overweight adults randomized not to participate in prescribed exercise. Since onset of injury/illness and pattern of injuries over time in overweight and obese individuals were attributed to BMI, weight reduction may be an avenue to reduce the risk of injury/illness in sedentary and previously sedentary overweight and obese adults. Clinicaltrials.gov NCT00177502 and NCT00177476

Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review.

Abstract: The purpose of this systematic review was to study the relative health risks of poor cardio-respiratory fitness (or physical inactivity) in normal-weight people vs. obesity in individuals with good cardio-respiratory fitness (or high physical activity). The core inclusion criteria were: publication year 1990 or later; adult participants; design prospective follow-up, case-control or cross-sectional; data on cardio-respiratory fitness and/or physical activity; data on BMI (body mass index), waist circumference or body composition; outcome data on all-cause mortality, cardiovascular disease mortality, cardiovascular disease incidence, type 2 diabetes or cardiovascular and type 2 diabetes risk factors. Thirty-six publications filled the criteria for inclusion. The data indicate that the risk for all-cause and cardiovascular mortality was lower in individuals with high BMI and good aerobic fitness, compared with individuals with normal BMI and poor fitness. In contrast, having high BMI even with high physical activity was a greater risk for the incidence of type 2 diabetes and the prevalence of cardiovascular and diabetes risk factors, compared with normal BMI with low physical activity. The conclusions of the present review may not be applicable to individuals with BMI > 35.

Obesity and socioeconomic status in adults: United States, 2005-2008.

Abstract: Data from the National Health and Nutrition Examination Survey, 2005-2008. Among men, obesity prevalence is generally similar at all income levels, however, among non-Hispanic black and Mexican-American men those with higher income are more likely to be obese than those with low income. Higher income women are less likely to be obese than low income women, but most obese women are not low income. There is no significant trend between obesity and education among men. Among women, however, there is a trend, those with college degrees are less likely to be obese compared with less educated women. Between 1988-1994 and 2007-2008 the prevalence of obesity increased in adults at all income and education levels.

Adiposity, Cardiometabolic Risk, and Vitamin D Status: The Framingham Heart Study

Abstract: National Institutes of Health's National Heart, Lung, and Blood Institute (N01-HC-25195, R01-DK-80739): American Heart Association

Sarcopenia Exacerbates Obesity-Associated Insulin Resistance and Dysglycemia: Findings from the National Health and Nutrition Examination Survey III

Abstract: Background Sarcopenia often co-exists with obesity, and may have additive effects on insulin resistance. Sarcopenic obese individuals could be at increased risk for type 2 diabetes. We performed a study to determine whether sarcopenia is associated with impairment in insulin sensitivity and glucose homeostasis in obese and non-obese individuals. Methodology We performed a cross-sectional analysis of National Health and Nutrition Examination Survey III data utilizing subjects of 20 years or older, non-pregnant (N = 14,528). Sarcopenia was identified from bioelectrical impedance measurement of muscle mass. Obesity was identified from body mass index. Outcomes were homeostasis model assessment of insulin resistance (HOMA IR), glycosylated hemoglobin level (HbA1C), and prevalence of pre-diabetes (6.0≤ HbA1C<6.5 and not on medication) and type 2 diabetes. Covariates in multiple regression were age, educational level, ethnicity and sex. Principal Findings Sarcopenia was associated with insulin resistance in non-obese (HOMA IR ratio 1.39, 95% confidence interval (CI) 1.26 to 1.52) and obese individuals (HOMA-IR ratio 1.16, 95% CI 1.12 to 1.18). Sarcopenia was associated with dysglycemia in obese individuals (HbA1C ratio 1.021, 95% CI 1.011 to 1.043) but not in non-obese individuals. Associations were stronger in those under 60 years of age. We acknowledge that the cross-sectional study design limits our ability to draw causal inferences. Conclusions Sarcopenia, independent of obesity, is associated with adverse glucose metabolism, and the association is strongest in individuals under 60 years of age, which suggests that low muscle mass may be an early predictor of diabetes susceptibility. Given the increasing prevalence of obesity, further research is urgently needed to develop interventions to prevent sarcopenic obesity and its metabolic consequences.

Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood.

Abstract: Background— We sought to examine the association of gestational weight gain (GWG) and prepregnancy weight with offspring adiposity and cardiovascular risk factors. Methods and Results— Data from 5154 (for adiposity and blood pressure) and 3457 (for blood assays) mother-offspring pairs from a UK prospective pregnancy cohort were used. Random-effects multilevel models were used to assess incremental GWG (median and range of repeat weight measures per woman: 10 [1, 17]). Women who exceeded the 2009 Institute of Medicine–recommended GWG were more likely to have offspring with greater body mass index, waist, fat mass, leptin, systolic blood pressure, C-reactive protein, and interleukin-6 levels and lower high-density lipoprotein cholesterol and apolipoprotein A1 levels. Children of women who gained less than the recommended amounts had lower levels of adiposity, but other cardiovascular risk factors tended to be similar in this group to those of offspring of women gaining recommended amounts. When examined in ...