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Objective: The regulation of negative emotions entails the modulation of subcortical regions, such as the amygdala, by prefrontal regions. There is preliminary evidence suggesting that individuals at higher weight may present with hypoactivity in prefrontal regulatory systems during emotional regulation, although the directionality of these pathways has not been tested. In this study, we compared fronto‐amygdalar effective connectivity during cognitive reappraisal as a function of BMI in 48 adult women with obesity and 54 control participants. Methods: Dynamic causal modeling and parametric empirical Bayes were used to map effective connectivity between the dorsomedial prefrontal cortex, orbitofrontal cortex, dorsolateral prefrontal cortex, and the amygdala. Results: Difficulty in Emotion Regulation Scale scores were higher in the obesity group compared with control participants (p < 0.001). A top‐down cortical model best explained our functional magnetic resonance imaging data (posterior probability = 86%). Participants at higher BMI were less effective at inhibiting activity in the amygdala via the orbitofrontal cortex and dorsomedial prefrontal cortex during reappraisal compared with those at lower BMI. In contrast, increased excitatory modulation of dorsolateral prefrontal cortex‐to‐amygdalar connectivity was found in participants at lower BMI. Conclusions: These findings support a framework involving alterations in fronto‐amygdalar connectivity contributing to difficulties in regulating negative affect in individuals at higher weight. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to investigate the role of dietary protein on macronutrient and energy intake, maternal adiposity during pregnancy, and infant adiposity at birth. Methods: In 41 women with obesity, early‐pregnancy (13–16 weeks) protein intake was assessed with food photography and expressed as a ratio of Estimated Average Requirements (EAR) in pregnancy for protein (0.88 g/kg/d), herein "protein balance." Energy intake was measured by the intake‐balance method, gestational weight gain as grams per week, and fat mass by a three‐compartment model. Spearman correlations and linear models were computed using R version 4.1.1 (p < 0.05 considered significant). Results: Women had a mean (SD) age of 27.5 (4.8) years and a pregravid BMI of 34.4 (2.9), kg/m2, and the majority were non‐White (n = 23, 56.1%). Protein balance in early pregnancy was not significantly associated with energy intake across mid and mid/late pregnancy (β = 328.7, p = 0.30 and β = 286.2, p = 0.26, respectively) or gestational weight gain (β = 117.0, p = 0.41). Protein balance was inversely associated with fat mass in early, mid, and late pregnancy (β = −10.6, p = 0.01, β = −10.4, p = 0.03, β = −10.3, p = 0.03, respectively). Protein balance did not predict infant adiposity at birth (p > 0.05). Conclusions: Low protein intake may have been present before pregnancy, explaining early relationships with adiposity in this cohort. The protein leverage hypothesis is likely not implicated in the intergenerational transmission of obesity. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of type 2 diabetes in African American women (AAW) is nearly twice that of White women. Lower insulin sensitivity and decreased mitochondrial function may be contributing factors. The purpose of this study was to compare fat oxidation in AAW and White women. Methods: Participants were 22 AAW and 22 White women, matched for age (18.7–38.3 years) and BMI (< 28 kg/m2). Participants completed two submaximal (50% VO2max) exercise tests with indirect calorimetry and stable isotope tracers to assess total, plasma, and intramyocellular triglyceride fat oxidation. Results: The respiratory quotient during the exercise test was nearly identical in AAW and White women (0.813 ± 0.008 vs. 0.810 ± 0.008, p = 0.83). Although absolute total and plasma fat oxidation was lower in AAW, adjusting for the lower workload in AAW eliminated these racial differences. There was no racial difference in plasma and intramyocellular triglyceride source of fat for oxidation. No racial differences were observed in rates of ex vivo fat oxidation. Exercise efficiency was lower in AAW when adjusted to leg fat free mass. Conclusions: The data suggest that fat oxidation is not lower in AAW compared with White women, but additional studies are needed across exercise intensity, body weight, and age to confirm these results. [ABSTRACT FROM AUTHOR]

Objective: The study aim was to examine the relationships between longitudinal dietary trajectories from early pregnancy to 3 years post delivery and adiposity measures in women with obesity. Methods: The diets of 1208 women with obesity in the UPBEAT (UK Pregnancy Better Eating and Activity Trial) study were assessed using a food frequency questionnaire (FFQ) at 15+0 to 18+6 weeks' gestation (baseline), 27+0 to 28+6 weeks' gestation, and 34+0 to 36+0 weeks' gestation, as well as 6 months and 3 years post delivery. Using factor analysis of the baseline FFQ data, four dietary patterns were identified: fruit & vegetable, African/Caribbean, processed, and snacking. The baseline scoring system was applied to the FFQ data at the four subsequent time points. Group‐based trajectory modeling was used to extract longitudinal dietary pattern trajectories. Using adjusted regression, associations between dietary trajectories and log‐transformed/standardized adiposity measures (BMI and waist and mid‐upper arm circumferences) at 3 years post delivery were examined. Results: Two trajectories were found to best describe the data for the four individual dietary patterns; these were characterized as high and low adherence. A high adherence to the processed pattern was associated with a higher BMI (β = 0.38 [95% CI: 0.06–0.69]) and higher waist (β = 0.35 [0.03–0.67]) and mid‐upper arm circumferences (β = 0.36 [0.04–0.67]) at 3 years post delivery. Conclusions: In women with obesity, a processed dietary pattern across pregnancy and 3 years post delivery is associated with higher adiposity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the independent effects of obesity and dynapenia on falls risk, areal bone mineral density, and fracture risk (lower extremity or all other fractures). Methods: A total of 16,147 women (aged 60‐82 years) from the UK Biobank were categorized by handgrip strength (HGS; dynapenia status: HGS ≤ 21 kg) and body weight (BMI: normal weight, overweight, or obesity). Multiple logistic regression models examined the association among dynapenia and obesity and self‐reported falls (previous 12 months), lower extremity fractures, and all other fractures (previous 5 years). Results: A total of 3793/16,147 women fell, and 1413/15,570 (9.1%) eligible women experienced fall‐related fractures. Obesity (odds ratio [OR] 1.25; 95% CI: 1.12‐1.38) and dynapenia (OR 0.87; 95% CI: 0.77‐0.98) were both independently associated with greater lower extremity fracture risk, independently of areal bone mineral density. However, considering all other fracture sites, obesity conferred protection (OR 0.77; 95% CI: 0.61‐0.96), except in those with low HGS, who had an equivalent fracture risk to those with normal weight (OR 1.06; 95% CI: 0.82‐1.38). Conclusions: Dynapenia further increases the increased risk of leg and ankle fractures in obesity and counteracts the protective effects of obesity on fracture risk at all other sites (wrist, arm, hip, spine, other bones). [ABSTRACT FROM AUTHOR]

Objective: Along with rapid economic growth, the United Arab Emirates (UAE) has undergone enormous sociocultural changes. Consequently, sociocultural and psychological factors, along with malnutrition and physical inactivity, have contributed to the high obesity rate. The objective of this study is to assess the long-term impact of these new emerging factors on obesity among women in the UAE via mathematical modeling.Methods: A differential equation model was developed considering psychological/social factors in population dynamics. It predicts the long-term prevalence of obesity among women in the UAE under these factors by 2070. Computer simulations and a sensitivity analysis of the model were conducted to measure the impact of these factors on obesity.Results: The model predicts the following: 80.07% of female UAE nationals will become overweight or have obesity and 60.19% will have obesity by 2070, and the population with abnormal eating behavior will increase to 15% by 2070. Psychological/social factors aggravate the obesity problems and can cause abnormal eating behavior to develop with little effect on weight reduction.Conclusions: The obesity rate of female UAE nationals will continue to rise by 2070. Rising abnormal eating behavior caused by psychological/social factors is an emerging issue and should be recognized as a sign of escalating obesity problems in the UAE. [ABSTRACT FROM AUTHOR]

Objective: Leukocyte cell‐derived chemotaxin 2 (LECT2) is an obesity‐upregulated hepatokine inducing skeletal muscle insulin resistance. The study's aim was to explore whether LECT2 is expressed in human adipose tissue and whether the expression is dysregulated during obesity and associated with obesity‐related metabolic disorders. Methods: This study measured metabolic parameters, serum LECT2, and expression of LECT2 and CD209, a gene encoding a putative receptor for LECT2, in abdominal subcutaneous and visceral adipose tissues in women with obesity (with or without type 2 diabetes) and women with normal weight. The expression/secretion of LECT2 and its putative effects were assessed in human adipocytes. Results: Adipose tissue LECT2 mRNA and serum LECT2 were higher in women with obesity and were significantly correlated with parameters related to insulin resistance. LECT2 was mainly expressed by adipocytes. Both LECT2 and CD209 expression was higher in adipocytes from women with obesity. Incubating adipocytes with substances mimicking the microenvironment of obesity adipose tissue increased LECT2 expression/secretion. LECT2 treatment of adipocytes suppressed insulin‐stimulated Akt phosphorylation; it reduced adiponectin (ADIPOQ) and increased leptin (LEP) expression in a CD209‐dependent manner. Conclusions: This study demonstrates that LECT2 expression in adipose tissue is high in patients with obesity and associated with insulin resistance and suggests that adipocyte‐derived LECT2 may contribute to adipose tissue dysfunction. [ABSTRACT FROM AUTHOR]

Objective: The effectiveness of a pregnancy and postpartum behavioral lifestyle intervention on postpartum weight retention was examined. Methods: Pregnant women with overweight and obesity in South Carolina were recruited into a theory‐based randomized controlled trial (n = 112 intervention, n = 107 standard care), which was designed to reduce gestational weight gain and postpartum weight retention. Results: Participants (44% African American, 56% White) had a mean prepregnancy BMI of 32.3 kg/m2 and were at 12.6 weeks' gestation at baseline. From prepregnancy to 6 months post partum, intervention participants retained less weight than standard care women (mean difference: −3.6 kg, 95% CI: −5.5 to −1.8). The intervention effect was maintained at 12 months post partum (mean difference: −2.4 kg, 95% CI: −4.3 to −0.5). Intervention women had 2.3 times higher odds of having no weight retention at 6 months post partum versus standard care women (95% CI: 1.2 to 4.4). Intervention participants also had lower odds of retaining ≥5% of their prepregnancy weight after delivery (adjusted odds ratio: 0.3, 95% CI: 0.1 to 0.5 at 6 months; adjusted odds ratio: 0.3, 95% CI: 0.2 to 0.6 at 12 months). Conclusion: This theory‐based lifestyle intervention resulted in significantly less weight retention at 6 and 12 months after delivery among pregnant women with overweight and obesity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the effectiveness of different exercise modalities and determine the optimal exercise prescription for improving cardiorespiratory fitness, body composition, and metabolic health of women with obesity.Methods: A systematic review of randomized controlled trials (RCTs) published between January 1988 and October 2020 was conducted. The RCTs were screened using the following inclusion criteria: 1) participants: women aged 18 to 65 years with BMI > 30 kg/m2 and without comorbidities; 2) intervention: exercise; 3) comparison: non-intervention control; and 4) outcomes measures: cardiorespiratory fitness (maximal oxygen consumption), body composition (i.e., body weight, percentage body fat), and/or metabolic measures (i.e., blood pressure, cholesterol).Results: A total of 20 RCTs with a total of 2,062 participants were included. Although the results showed that any form of exercise was more effective than control, improvements in fitness and body composition were modest. Aerobic exercise (vigorous and moderate intensity) appeared most promising for improving fitness and body weight, whereas low-load resistance training resulted in the largest improvements in body fatness.Conclusions: In women living with obesity, aerobic exercise was consistently effective in improving fitness and body composition. Although both resistance training and combined exercise interventions appear promising, more research is needed to evaluate their efficacy and determine an optimal exercise prescription for this population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the differences between the vaginal microbiome of reproductive‐aged women with overweight and obesity (Ow/Ob) compared with healthy weight (HW). Methods: In this case‐control study, a cohort of 367 nonpregnant women (18 to 40 years) with Ow/Ob (BMI ≥25 kg/m2) was case‐matched with 367 women with HW (BMI 18.0 to 24.9 kg/m2). The study was a secondary analysis of 16S rRNA vaginal microbiome surveys through the Vaginal Human Microbiome Study (VaHMP). Groups were matched on age, race/ethnicity, income, and nulliparity status. Results: Mean age and BMI of Ow/Ob and HW groups were 26.8 versus 26.7 years and 37.0 versus 22.1 kg/m2, respectively. The overall vaginal microbiome composition differed between groups (PERMANOVA, p = 0.035). Women with Ow/Ob had higher alpha diversity compared with women with HW (Wilcoxon test, Shannon index p = 0.025; inverse Simpson index p = 0.026). Lactobacillus dominance (≥30% proportional abundance) was observed in a greater proportion of women with HW (48.7%) compared with Ow/Ob (40.1%; p = 0.026). Conclusions: The vaginal microbiome differs in reproductive‐aged women with Ow/Ob compared with women with HW, with increased alpha diversity and decreased predominance of Lactobacillus. Observed differences in the vaginal microbiome may partially explain differences in preterm birth and bacterial vaginosis risk between these populations. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to estimate long-term impacts of health education interventions on cardiometabolic health disparities.Methods: The model simulates how health education implemented in the United States throughout 2019 to 2049 would lead to changes in adult BMI and consequent hypertension and type 2 diabetes. Health outcome changes by sex, racial/ethnic (non-Hispanic White, non-Hispanic Black, and Hispanic), and weight status (normal: 18.5 ≤ BMI < 25; overweight: 25 ≤ BMI < 30; and obesity: 30 ≤ BMI) subpopulations were compared under a scenario with and one without health education.Results: By 2049, the intervention would reduce average BMI of women with obesity to 27.7 kg/m2 (CI: 27.4-27.9), which would be 2.9 kg/m2 lower than the expected average BMI without an intervention. Education campaigns would reduce type 2 diabetes prevalence, but it would remain highest among women with obesity at 27.7% (CI: 26.2%-29.2%). The intervention would reduce hypertension prevalence among White women by 4.7 percentage points to 38.0% (CI: 36.4%-39.7%). For Black women in the intervention, the 2049 hypertension prevalence would be 52.6% (CI: 50.7%-54.5%). Results for men and women were similar.Conclusions: Long-term health education campaigns can reduce obesity-related disease. All population groups benefit, but they would not substantially narrow cardiometabolic health disparities. [ABSTRACT FROM AUTHOR]

Objective: This study examined the effectiveness of a nonsurgical, preconception weight loss intervention on pregnancy outcomes in women with obesity.Methods: This was a two-arm, parallel-group randomized controlled trial. A total of 164 women with BMI 30 to 55 kg/m2 who were aged 18 to 38 years and planning pregnancy were randomized to a 12-week standard dietary intervention (SDI; n = 79) or a modified very low-energy diet (VLED; n = 85). Participants were observed for ≤48 weeks while trying for pregnancy and then during pregnancy. The primary outcome was maternal fasting plasma glucose at 26 to 28 weeks' gestation. Exploratory outcomes were individual and composite obesity-related adverse pregnancy outcomes.Results: Weight loss was greater in the VLED group (SDI 3.2 [0.6] kg vs. VLED 13.0 [0.5] kg, p < 0.01). In completers who had a singleton live birth (SDI 22/79 vs. VLED 35/85, p = 0.10), there was no difference in fasting glucose at 26 to 28 weeks' gestation (SDI 4.8[0.2] mmol/L vs. VLED 4.6 [0.1] mmol/L, p = 0.42). However, the composite of adverse pregnancy outcomes was significantly lower in the VLED group (p < 0.001).Conclusions: Substantial prepregnancy weight loss in women with obesity does not alter fasting glucose at 26 to 28 weeks' gestation but does reduce a composite of adverse pregnancy outcomes. A better understanding of metabolic changes in pregnancy after preconception weight loss may assist in improving maternal and neonatal health outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to estimate trends in cardiovascular disease risk factors by BMI category among adults in England (n = 115,860). Methods: Risk factors included cigarette smoking, hypertension, total diabetes, and raised total cholesterol. Risk factor prevalence was computed in the following four 4‐year time periods: 2003‐2006; 2007‐2010; 2011‐2014; and 2015‐2018. Change was computed as the difference between the first and last time periods, expressed in percentage points (PP). Results: Hypertension remained at a stable level among men with normal weight but decreased among men with obesity (−4.1 PP; 95% CI: −7.1 to −1.0). Total diabetes remained at a stable level among adults with normal weight but increased among adults with obesity (men: 3.5 PP, 95% CI: 1.2 to 5.7; women: 3.6 PP, 95% CI: 1.8 to 5.4). Raised total cholesterol decreased in all BMI groups but fell more sharply among women with obesity (−21 PP; 95% CI: −25 to −17) versus their counterparts with normal weight (−16 PP; 95% CI: −18 to −14). Conclusions: Greater reductions in hypertension and raised total cholesterol among adults with overweight and obesity partially reflect improvements in screening, treatment, and control among those at highest cardiovascular risk. Higher levels of risk factor prevalence among adults with overweight and obesity, in parallel with rising diabetes, highlight the importance of national prevention efforts to combat the public health impact of excess adiposity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effects of an antenatal behavioral lifestyle intervention on total gestational weight gain (GWG) and perinatal outcomes.Methods: Pregnant women with overweight and obesity in South Carolina were recruited into a theory-based randomized controlled trial (n = 112 intervention, n = 105 standard care), which was designed to target weight self-monitoring, increased physical activity, and improved dietary practices.Results: Participants were racially/ethnically diverse (44% African American). Intervention and standard care participants had similar total GWG at delivery (12.9 ± 6.9 vs. 12.4 ± 8.3 kg, respectively), but intervention participants had a smaller standard deviation (P = 0.04) in total GWG. The treatment effects were moderated by race/ethnicity and prepregnancy BMI. Among African American participants with overweight, intervention participants gained 4.5 kg less, whereas, among African American women with obesity, intervention participants gained 4.1 kg more than standard care participants. Total GWG among White participants was similar regardless of weight status and group assignment. Fewer intervention participants than standard care participants had adverse pregnancy outcomes (P ≤ 0.01).Conclusions: The behavioral lifestyle intervention favorably impacted GWG in African American participants with overweight but not African American participants with obesity. The intervention's overall favorable impact on perinatal outcomes suggests that the mechanisms beyond total GWG may drive these outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aryl hydrocarbon receptor (AHR) plays a key role in obesity. In vitro studies revealed that the tryptophan metabolite kynurenine (Kyn) activates AHR signaling in cultured hepatocytes. The objective of this study was to determine whether Kyn activated the AHR in mice to induce obesity.Methods: Mice were fed a low-fat diet and the same diet supplemented with Kyn. Body mass, liver status, and the expression of identified relevant genes were determined.Results: Kyn caused mice to gain significant body mass, develop fatty liver and hyperglycemia, and increase expression levels of cytochrome P450 1B1 and stearoyl-CoA desaturase 1. The hyperglycemia was accompanied with decreased insulin levels, which may have been due to the repression of genes involved in insulin secretion. Kyn plasma concentrations and BMI were measured in female patients, and a significant association was observed between Kyn and age in patients with obesity but not in patients who were lean.Conclusions: Results show that (1) Kyn or a metabolite thereof is a ligand responsible for inducing AHR-based obesity, fatty liver, and hyperglycemia in mice; (2) plasma Kyn levels increase with age in women with obesity but not in lean women; and (3) an activated AHR is necessary but not sufficient to attain obesity, a status that also requires fat in the diet. [ABSTRACT FROM AUTHOR]

Figurines of women with obesity or who are pregnant ("Venus figurines") from Upper Paleolithic Europe rank among the earliest art and endured from 38,000 to 14,000 BP (before present), one of the most arduous climatic periods in human history. We propose that the Venus representation relates to human adaptation to climate change. During this period, humans faced advancing glaciers and falling temperatures that led to nutritional stress, regional extinctions, and a reduction in the population. We analyzed Paleolithic figurines of women with obesity to test whether the more obese figurines are from sites during the height of the glacial advance and closer to the glacial fronts. Figurines are less obese as distance from the glaciers increases. Because survival required sufficient nutrition for child‐bearing women, we hypothesize that the overnourished woman became an ideal symbol of survival and beauty during episodes of starvation and climate change in Paleolithic Europe. [ABSTRACT FROM AUTHOR]

Objective: Whether the presence of gestational diabetes (GDM) and its treatment mode influence the serum metabolic profile in women with overweight or obesity was studied.Methods: The serum metabolic profiles of 352 women with overweight or obesity participating in a mother-infant clinical study were analyzed with a targeted NMR approach (at 35.1 median gestational weeks). GDM was diagnosed with a 2-hour 75-g oral glucose tolerance test.Results: The metabolomic profile of the women with GDM (n = 100) deviated from that of women without GDM (n = 252). Differences were seen in 70 lipid variables, particularly higher concentrations of very low-density lipoprotein particles and serum triglycerides were related to GDM. Furthermore, levels of branched-chain amino acids and glycoprotein acetylation, a marker of low-grade inflammation, were higher in women with GDM. Compared with women with GDM treated with diet only, the women treated with medication (n = 19) had higher concentrations of severalizes of VLDL particles and their components, leucine, and isoleucine, as well as glycoprotein acetylation.Conclusions: A clearly distinct metabolic profile was detected in GDM, which deviated even more if the patient was receiving medical treatment. This suggests a need for more intense follow-up and therapy for women with GDM during pregnancy and postpartum to reduce their long-term adverse health risks. [ABSTRACT FROM AUTHOR]

Objective: This cohort study aimed to explore the relationship between the Notch signaling pathway and the degree of nonalcoholic fatty liver disease (NAFLD). Moreover, this study intended to investigate whether this pathway is related to hepatic lipid metabolism and Toll-like receptors (TLRs).Methods: This study used real-time polymerase chain reaction analysis to evaluate the hepatic expression level of all genes studied (Notch receptors NOTCH1, NOTCH2, NOTCH3, and NOTCH4, transcription factors HES1 and HES5, and Hes-related repressor proteins HEY1 and HEY2) in hepatic tissue from two cohorts: women with severe obesity (n = 57) and normal liver structure (n = 20) or NAFLD (n = 37).Results: In women with severe obesity and NAFLD, this study found downregulation of hepatic HES5 expression. This expression correlated positively with the hepatic expression of HES1, HEY1, and NOTCH3. This study also found a positive correlation between HES5 expression and sterol regulatory element-binding protein 1c (SREBP1c) and between NOTCH3 and several genes related to hepatic lipid metabolism (encoding liver X nuclear receptor α variant 1, farnesoid X nuclear receptor, SREBP1c, acetyl-CoA carboxylase 1, fatty acid synthase, peroxisome proliferator-activated receptor α, carnitine palmitoyltransferase 1, carnitine O-octanoyltransferase, ATP-binding cassette subfamily A member 1, and ATP-binding cassette subfamily G member 1). Finally, this study found a positive correlation between NOTCH2 and TLR2, TLR4, and TLR9 and a positive relationship between NOTCH1 and TLR9.Conclusions: Taken together, these findings suggest that hepatic expression of Notch proteins and ligands in relation to lipid metabolism pathways in the liver could have a role in NAFLD pathogenesis. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the changes in red blood cell total phospholipid (RBC-TPL) and subcutaneous adipose tissue (SAT) fatty acid (FA) composition in response to 12 weeks of exercise training in South African women with obesity and the associations with changes in cardiometabolic risk factors.Methods: Previously sedentary women were randomized into control (n = 15) or exercise (n = 20) groups. RBC-TPL and SAT FA profiles, SAT gene expression, systemic inflammatory markers, liver fat, and insulin sensitivity (SI ) were measured before and after the intervention.Results: Compared with control, exercise training induced decreases in RBC-TPL dihomo-γ-linolenic acid content and stearoyl-CoA desaturase-1 and increased delta-5 desaturase-estimated activity (P < 0.05). In the combined group, these changes correlated with changes in circulating leptin and TNFα (P < 0.05), as well as lower liver fat (P < 0.01). Exercise training decreased saturated FA (lauric and myristic acids) and increased polyunsaturated FA (eicosadienoic and adrenic acids) (P < 0.05) in abdominal SAT, whereas γ-linolenic acid decreased (P < 0.01) in gluteal SAT. These changes in RBC-TPL and SAT FA compositions were not associated with changes in SAT gene expression and SI .Conclusions: Exercise training alters RBC-TPL desaturase activities, which correlate with lower liver fat and systemic inflammation but not with the improvement of SI . [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the effects of intermittent fasting (IF) on mRNA levels of peripheral clock genes in skeletal muscle and subcutaneous adipose tissue (SAT) in women with obesity.Methods: Women were randomized to one of two IF protocols and provided with all foods at 100% or 70% of calculated weekly energy requirements for 8 weeks. Breakfast was consumed before a 24-hour fast, which was initiated on three nonconsecutive days per week. Muscle and SAT biopsies were performed at 8 am after an overnight fast at baseline and at week 8 on a refed day and again following a 24-hour fast at week 8 for analysis of the mRNA levels of key genes involved in circadian regulation.Results: A group-by-time interaction was observed in Per2 in muscle (F = 3.497, P = 0.044) and SAT (F = 6.686, P = 0.008), but significance was lost upon post hoc adjustment. A time effect was observed in Rorα in muscle, which was decreased by refeeding in both groups (F = 7.225, P = 0.003).Conclusions: There was no universal effect of IF to alter peripheral clocks, which may be partly because of the alignment of the fasting/feeding cycle with the biological clock. Optimizing intermittent fasting protocols could be important to prevent circadian misalignment in humans. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare two energy-restricted, nutrient-dense diets at the upper or lower ends of the dietary fat recommendation range (lower fat [20% energy from fat] versus moderate fat [35%]) on weight loss using behavioral theory-based nutrition education.Methods: A total of 101 premenopausal women with overweight or obesity were randomized to an energy-restricted lower-fat or moderate-fat diet for 1 year. Interventions included 28 behavioral theory-based nutrition education sessions plus weekly exercise sessions.Results: Both treatment groups experienced weight loss (-5.0 kg for lower fat and -4.3 kg for moderate fat; P < 0.0001), but there was no difference in weight loss or fat intake between groups. Total and low-density lipoprotein cholesterol decreased (-3. 4 mg/dL and -3.8 mg/dL; P < 0.05), and high-density lipoprotein cholesterol increased (1.9 mg/dL; P < 0.05) in both groups at 12 months. Diet quality, assessed by the Healthy Eating Index, increased significantly at 4 months versus baseline (70.8 [0.9] vs. 77.8 [1.0]) and was maintained through 12 months. Higher Healthy Eating Index scores were associated with greater weight loss at 4 months (r = -0.2; P < 0.05).Conclusions: In the context of a well-resourced, free-living weight-loss intervention, total fat intake did not change; however, theory-based nutrition education underpinned by food-based recommendations resulted in caloric deficits, improvements in diet quality, and weight loss that was sustained for 1 year. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to characterize changes in body composition during pregnancy in women with obesity.Methods: Fifty-four healthy women with obesity (class 1, 30-34.9 kg/m2 : n = 25; class 2, 35-39.9 kg/m2 : n = 21; class 3, ≥ 40.0 kg/m2 : n = 8) expecting a singleton pregnancy were studied. Body composition was measured in early pregnancy (13-16 weeks), midpregnancy (24-27 weeks), and late pregnancy (35-37 weeks) using air displacement plethysmography, stable isotopes, and skinfold thickness measurements. Fasting glucose, insulin, and leptin were measured.Results: The gain in fat-free mass was lower in the second trimester compared with the third (2.7 ± 0.2 to 5.3 ± 0.2 kg; P < 0.001), whereas fat mass accumulation declined over time (0.6 ± 0.3 to -0.7 ± 0.4 kg; P = 0.005). Women with class 1 and 2 obesity gained 1.1 ± 0.7 kg of fat mass during pregnancy, while women with class 3 obesity lost 4.1 ± 0.6 kg (both P < 0.001). The difference in fat accumulation between obesity classes was observed only in the second trimester (P = 0.02). Gestational weight gain was associated positively with changes in plasma concentrations of insulin, leptin, and insulin resistance (all P < 0.01).Conclusions: Gestational weight gain in pregnancy differs by obesity class and trimester. Women with class 3 obesity gain less body weight and fat mass. Fat mass gain is most likely preventable in the second trimester. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the relationship between weight history during adulthood and frailty in late life in men and women participating in the GAZEL (GAZ and ELectricité) cohort.Methods: This cohort study included 8,751 men and 3,033 women (aged 61 to 76 years) followed up since 1989. Modified Fried's frailty criteria (weakness, fatigue, unintentional weight loss, low physical activity, and impaired mobility) were assessed in 2015. Reported BMI was determined each year to characterize: obesity status in 2015, obesity duration over the 1990 to 2015 period, and trajectories of BMI. Associations between frailty and weight history were assessed using multinomial regression.Results: In 2015, 12% of men had obesity, 1.8% severe obesity, and 0.4% morbid obesity; for women, these percentages were 11%, 2.2%, and 0.8%, respectively. Individuals with obesity were more likely to be frail than those with normal BMI and the risk of frailty increased with each additional year of obesity (adjusted odds ratio 1.04 [1.00-1.08] for men and 1.07 [1.02-1.13] for women). Trajectories of BMI revealed that both long-term obesity and onset of obesity in late adulthood were associated with frailty.Conclusions: Current and past obesity appear to be important determinants of frailty. Early weight management may be beneficial in old age. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether a positive association exists between waist circumference (WC) and dementia among older persons.Methods: The study population comprised 872,082 participants aged 65 years and older who participated in a Korean national health screening examination between January 1, 2009, and December 31, 2009. Adjusted hazard ratios and 95% CIs for dementia during follow-up from 2009 to 2015 were calculated according to baseline BMI and WC categories.Results: After a multivariate adjustment that included BMI, the hazard ratios for dementia showed a stepwise increase according to the increase in WC categories by 5 cm from 85 to 90 cm in men and from 80 to 85 cm in women until ≥ 110 cm (from 1.06 [95% CI: 1.03-1.09] to 1.64 [95% CI: 1.37-1.94] in men and from 1.04 [95% CI: 1.02-1.07] to 1.58 [95% CI: 1.36-1.84] in women). The influence of the current WC category for abdominal obesity on the risk of dementia was different according to BMI; especially, the normal weight men and women with abdominal obesity had a prominent increased risk of dementia compared with those without abdominal obesity.Conclusions: Abdominal obesity, as measured by WC, was associated with significantly increased risk of dementia after adjustment for general obesity. [ABSTRACT FROM AUTHOR]

Objective: Obesity has been related to later-life dementia. Serum glucose levels and insulin resistance are known to influence cognition in individuals with diabetes. This study aimed to evaluate memory function in middle-aged individuals with obesity in association with glucose metabolism and brain iron content.Methods: This was a cross-sectional case-control study including 121 participants aged 27.2 to 66.6 years (56 without obesity, 65 with obesity) stratified according to sex and menopausal status. Insulin sensitivity, body composition, brain iron content, and memory function were evaluated by euglycemic hyperinsulinemic clamp, dual-energy x-ray absorptiometry, magnetic resonance relaxometry (R2*), and California Verbal Learning Test, respectively.Results: Women with obesity, but not men, had lower scores in some California Verbal Learning Tests in association with metabolic parameters and increased brain iron content compared with controls. Fasting plasma glucose, glycated hemoglobin (HbA1c; within normal range), and R2* were negatively associated with memory scores, whereas insulin sensitivity showed positive associations. Remarkably, only HbA1c levels and R2* in the right inferior fronto-orbital region remained significant after controlling for age, sex, education, and BMI.Conclusions: Impairments in memory function in middle-aged women with obesity are associated with HbA1c levels and brain iron content independently of insulin sensitivity. These results may have implications in the design of therapeutic strategies in women with obesity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the efficacy of a home-based lifestyle intervention delivered through Parents as Teachers (PAT), a national home-visiting organization, designed to minimize excessive weight gain through 12 months post partum in socioeconomically disadvantaged (SED) African American women with overweight or obesity.Methods: This randomized controlled trial was conducted at a single center as part of the Lifestyle Interventions for Expectant Moms (LIFE-Moms) consortium. Analysis was conducted with 185 SED African American women (BMI 25.0-45.0 kg/m2 at pregnancy onset) retained from an original sample of 267 randomized to standard PAT or PAT+Lifestyle, which embedded lifestyle therapy within standard PAT delivered prenatally and for 12 months post partum.Results: Compared with standard PAT, the PAT+Lifestyle group gained less weight (2.5 kg vs. 5.7 kg; P = 0.01) and were more likely to return to their baseline weight (38.0% vs. 21.5%; P = 0.01) from baseline to 12 months post partum. There were no differences between groups in cardiometabolic outcomes, indices of glycemic control and insulin sensitivity, and plasma lipid profile. The estimated cost of PAT+Lifestyle was $81 more to deliver per family than standard PAT.Conclusions: PAT+Lifestyle decreases weight gain during pregnancy through 12 months post partum in SED African American women with overweight or obesity at the start of pregnancy with minimal additional cost. [ABSTRACT FROM AUTHOR]

Objective: High BMI predicts adverse cardiovascular outcomes and positively correlates with increased levels of adipokines. The relationship among BMI, IL-6, TNFα, adiponectin, and oxidized high-density lipoprotein (Ox-HDL) with circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) has not been well studied. Elevated CEC levels have been described in both humans and mice with obesity and diabetes. Ox-HDL has been shown to be a potent driver of adipogenesis in vivo and in vitro. In this study, elevated BMI was examined in 2 groups of women studied in Brooklyn, New York, and Huntington, West Virginia, respectively.Methods: Twenty-six females with obesity and five lean controls without overt cardiovascular disease were enrolled, 13 from Huntington and 13 from Brooklyn. Cytokine levels, EPCs, and CECs were determined.Results: Females with obesity had elevated levels of leptin, IL-6, and Ox-HDL, increased CEC levels, and decreased EPC and adiponectin levels (all P < 0.01). The Ox-HDL levels were higher in women from Brooklyn versus Huntington (P < 0.01), possibly from higher TNFα levels in Brooklyn or higher adiponectin levels in Huntington. Seventy-five percent of the variance in Ox-HDL levels could be predicted in this population (P < 0.01).Conclusions: This study reveals a unique inflammatory biomarker profile in females with obesity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare intermittent fasting (IF) versus continuous energy intakes at 100% or 70% of calculated energy requirements on insulin sensitivity, cardiometabolic risk, body weight, and composition.Methods: Women with overweight (n = 88; 50 ± 1 years, BMI 32.3 ± 0.5 kg/m2 ) were randomized to one of four diets (IF70, IF100, dietary restriction [DR70], or control) in a 2:2:2:1 ratio for 8 weeks. IF groups fasted for 24 hours after breakfast on three nonconsecutive days per week. All foods were provided and diets matched for macronutrient composition (35% fat, 15% protein, 50% carbohydrate). Insulin sensitivity by hyperinsulinemic-euglycemic clamp, weight, body composition, and plasma markers were assessed following a "fed" day (12-hour fast) and a 24-hour fast (IF only).Results: IF70 displayed greater reductions in weight, fat mass, total- and low-density lipoprotein cholesterol, and nonesterified fatty acids compared with DR70 and IF100 (all P ≤ 0.05). IF100 lost more weight and fat than control. However, fasting insulin was increased. There were no group differences in insulin sensitivity by clamp; however, a 24-hour fast transiently reduced insulin sensitivity.Conclusions: When prescribed at matched energy restriction, IF reduced weight and fat mass and improved total and low-density lipoprotein cholesterol more than DR. IF prescribed in energy balance did not improve health compared with other groups, despite modest weight loss. [ABSTRACT FROM AUTHOR]

Objective: Maternal obesity (OB) accounts for the majority of large-for-gestational-age infants, and newborn percent fat (NB%fat) correlates strongest with childhood OB. In addition to maternal glucose, fasting triglycerides (TGs) may contribute, but postprandial triglycerides (PPTGs) are unstudied. It was hypothesized that fasting TGs and PPTGs are higher in women with OB compared with women with normal weight (NW) throughout pregnancy, correlate more strongly with NB%fat than glucose, and may relate to dietary chylomicron TGs.Methods: Fasting TGs and PPTGs, free fatty acids, glucose, and insulin were prospectively measured 10 times over 4 hours after a controlled liquid breakfast early (14-16 weeks) and later (26-28 weeks) in pregnancy in 27 mothers with NW and 27 with OB. NB%fat was measured by dual x-ray absorptometry.Results: Fasting TGs and PPTGs were already ≥ 30% higher in mothers with OB at 14 to 16 weeks (P < 0.001) versus mothers with NW. In mothers with OB, a simple 1-hour (r = 0.71; P < 0.01) or 2-hour (r = 0.69; P < 0.01) PPTG at 14 to 16 weeks correlated strongest with NB%fat. In mothers with NW, the increase in TGs from early to later pregnancy correlated strongest with NB%fat (r = 0.57; P < 0.01). Maternal glucose did not statistically add to prediction models.Conclusions: These novel data suggest that 1- or 2-hour PPTGs might be a new target for early intervention in pregnancies with OB to prevent excess newborn adiposity and attenuate child OB risk. [ABSTRACT FROM AUTHOR]

Objective: Epidemiologic analyses indicate a lack of association between BMI (kg/m2 ) and mortality among Hispanic adults. Because BMI provides only a surrogate for the real variable of interest, adiposity, this study evaluated associations between measures of body composition and mortality.Methods: Using data from US-residing Mexican Americans in the National Health and Nutrition Examination Survey (NHANES) III (n = 4,480) and NHANES 1999-2010 (n = 5,849), the association between seven measures of body composition measured via anthropometry and bio-electrical impedance analysis (i.e., waist circumference, waist-to-height ratios [WHtR], skinfolds, lean mass, fat mass, percent body fat, and BMI) and all-cause and cardiovascular and diabetes mortality were examined. Additional analyses were stratified by gender.Results: Waist circumference (hazard ratio [HR]: 1.04, 95% CI: 1.01-1.07) and WHtR (HR: 1.08, 95% CI: 1.03-1.14) were weakly associated with an increased all-cause mortality, while WHtR was associated with an increased risk of diabetes-related death (HR: 1.26, 95% CI: 1.07-1.49). In gender-stratified analyses, there was an increased risk of mortality in females who had increases in WHtR and waist circumference for all-cause mortality and cardiovascular deaths.Conclusions: Waist circumference and WHtR were associated with increased risk of all-cause and diabetes-related mortality in US-residing Mexican American adults. [ABSTRACT FROM AUTHOR]

Objective: Obesity in females is often associated with metabolic complications and hyperandrogenism, but the sources of androgens are not completely understood. Therefore, this study investigated whether adipose tissue could be a source of androgens promoting hyperandrogenism development in obese female rats.Methods: Gene expression of steroidogenic enzymes and testosterone levels were determined in periovarian and inguinal adipose tissue and in the supernatant of cultured preadipocytes and adipocytes. The conversion of pregnenolone to androgens was analyzed by thin-layer chromatography.Results: Substantial amounts of testosterone in adipose tissue (25-153 ng/g tissue) and in the supernatant of adipocytes (0.33-0.69 ng/ten thousand cells]) were found. StAR and steroidogenic enzymes encoded by genes including Cyp11A1, Cyp17A1, Cyp19, Hsd3b2, Hsd17b3, and Srd5a2 were expressed in adipose tissue and cultured cells. Thin layer chromatography data revealed that preadipocytes and adipocytes were able to convert pregnenolone to testosterone. Higher levels for all steroidogenic enzymes were found in both depots of obese animals compared with lean animals, with significantly higher levels in inguinal tissue.Conclusions: The whole steroidogenic machinery and capacity for testosterone biosynthesis were found in fat depots of female rats. These findings support the hypothesis that adipose tissue may contribute substantially to the hyperandrogenism in female obesity. [ABSTRACT FROM AUTHOR]

Objective: In longitudinal studies, women gain significant amounts of weight during young adulthood, pointing to pregnancy as an important trigger for weight gain. Studies examining the effect of parity vary in their findings and are complicated by multiple potential confounders. This study examines the association between parity and long-term weight gain in a cohort of young women participating in the Australian Longitudinal Study on Women's Health (ALSWH).Methods: A sample of 8,009 parous and nulliparous women was drawn from this cohort and allocated to one of six parity groups (0-5+). Weight gain and factors associated with BMI ≥ 25 over a 16-year period were identified by using generalized linear equations.Results: Median BMI increased by between 2.95 and 4.9 units over 16 years, with women of parity 5 + showing the biggest gain. Associations between several variables and a BMI ≥ 25 (controlling for multiple demographic and behavioral factors) demonstrated no effect for parity but significant effects for survey year, no paid job, and depression. University education and high levels of physical activity were protective.Conclusions: In this sample, parity was not associated with a BMI ≥ 25 over a 16-year period. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to quantify the impact of crime on physical activity location accessibility, leisure-time physical activity (LTPA), and obesity among African American women.Methods: An agent-based model was developed in 2016 to represent resource-limited Washington, DC, communities and their populations to simulate the impact of crime on LTPA and obesity among African American women under different circumstances.Results: Data analysis conducted between 2016 and 2017 found that in the baseline scenario, African American women had a 25% probability of exercising. Reducing crime so more physical activity locations were accessible (increasing from 10% to 50%) decreased the annual rise in obesity prevalence by 2.69%. Increasing the probability of African American women to exercise to 37.5% further increased the impact of reducing crime on obesity (2.91% annual decrease in obesity prevalence).Conclusions: These simulations showed that crime may serve as a barrier to LTPA. Reducing crime and increasing propensity to exercise through multilevel interventions (i.e., economic development initiatives to increase time available for physical activity and subsidized health care) may promote greater than linear declines in obesity prevalence. Crime prevention strategies alone can help prevent obesity, but combining such efforts with other ways to encourage physical activity can yield even greater benefits. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the feasibility and cardiometabolic effects of mindfulness-based stress reduction (MBSR) in women with overweight or obesity.Methods: Eighty-six women with BMI ≥ 25 kg/m2 were randomized to 8 weeks of MBSR or health education and followed for 16 weeks. The primary outcome was the Toronto Mindfulness Scale. Secondary outcomes included the Perceived Stress Scale-10, fasting glucose, and blood pressure.Results: Compared to health education, the MBSR group demonstrated significantly improved mindfulness at 8 weeks (mean change from baseline, 4.5 vs. -1.0; P = 0.03) and significantly decreased perceived stress at 16 weeks (-3.6 vs. -1.3, P = 0.01). In the MBSR group, there were significant reductions in fasting glucose at 8 weeks (-8.9 mg/dL, P = 0.02) and at 16 weeks (-9.3 mg/dL, P = 0.02) compared to baseline. Fasting glucose did not significantly improve in the health education group. There were no significant changes in blood pressure, weight, or insulin resistance in the MBSR group.Conclusions: In women with overweight or obesity, MBSR significantly reduces stress and may have beneficial effects on glucose. Future studies demonstrating long-term cardiometabolic benefits of MBSR will be key for establishing MBSR as an effective tool in the management of obesity. [ABSTRACT FROM AUTHOR]

Objective: There is growing evidence that circulating microRNAs (miRNAs) play an important role in obesity. However, whether they can contribute to adult weight gain is still unclear.Methods: In the training set with 40 nonsmoking, healthy women identified from the Mano-A-Mano Mexican American Cohort study, global circulating miRNA profiles in plasma samples were assessed. Cox proportional hazard regression was used to assess the effects of plasma miRNAs on significant weight gain during a 5-year follow-up. Plasma miRNAs associated with significant weight gain were further validated in two testing sets (N = 160 and 100, respectively).Results: A total of 23 significant plasma miRNAs were identified in the training set. Among them, eight were validated in two testing sets. They were miR-142, miR-122, miR-125b, miR-15b, miR-130b, miR222, miR-519d, and miR-31. Using those eight miRNAs, a risk score for significant weight gain was created. Study participants with a high risk score had 3.01-fold increased risk of having significant weight gain in the whole study population (hazard ratio: 3.01, 95% confidence interval: 1.70-5.47).Conclusions: The findings provide evidence that circulating miRNAs play important roles in obesity and weight gain and suggest new targets for understanding the mechanisms of weight gain and developing weight loss intervention strategies. [ABSTRACT FROM AUTHOR]

Objective: Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation.Methods: Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed. BMI categorization followed the National Institutes of Health BMI classification that subdivides obesity into three ascending BMI groups.Results: Records were obtained on 1,224 women, of whom 31.6% were classified with obesity. Despite similar mean gestational age (31 to 31.6 weeks, P = 0.57) and birth weight (1,488 to 1,569 g, P = 0.51) of the infants in the BMI categories, delivery room (DR) resuscitation was more common for infants of women with level III obesity (63.2%, P = 0.04) with a trend toward the continued need for assisted ventilation (54.7%, P = 0.06).Conclusions: Preterm infants of women with level III obesity were more likely to require DR resuscitation with a trend to continued need for ventilatory support beyond 6 hours of age. This could impact utilization of DR resources at delivering hospitals. [ABSTRACT FROM AUTHOR]

Objective: Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore needed.Methods: Seventy healthy postmenopausal women (age 60 ± 5.6 years) with BMI 32.5 ± 5.5 were randomized to a Paleolithic-type diet (PD) or a prudent control diet (CD) for 24 months. Blood samples and fat biopsies were collected at baseline, 6 months, and 24 months to analyze inflammation-related parameters.Results: Android fat decreased significantly more in the PD group (P = 0.009) during the first 6 months with weight maintenance at 24 months in both groups. Long-term significant effects (P < 0.001) on adipose gene expression were found for toll-like receptor 4 (decreased at 24 months) and macrophage migration inhibitory factor (increased at 24 months) in both groups. Serum interleukin 6 (IL-6) and tumor necrosis factor α levels were decreased at 24 months in both groups (P < 0.001) with a significant diet-by-time interaction for serum IL-6 (P = 0.022). High-sensitivity C-reactive protein was decreased in the PD group at 24 months (P = 0.001).Conclusions: A reduction of abdominal obesity in postmenopausal women is linked to specific changes in inflammation-related adipose gene expression. [ABSTRACT FROM AUTHOR]

Objective: To describe the determinants of 12-year weight change among middle-aged women in Sweden.Methods: In 1991/1992, 49,259 women across Sweden were recruited into a cohort. In 2003, 34,402 (73%) completed follow-up. Lifestyle and health characteristics including weight were collected, and 12-year weight change and substantial weight gain (≥+5.0 kg) were calculated; association between baseline characteristics and odds ratios (OR) with 95% confidence intervals (CI) of substantial weight gain were estimated.Results: During the 12-year follow-up, 81% of women experienced weight gain. Being above average weight (64.5 kg) at baseline (OR =1.20, 95% CI: 1.14-1.26) and smoking 1 to 9 (OR = 1.10, 95% CI: 1.01-1.20), 10 to 19 (OR = 1.30, 95% CI: 1.21-1.39), or ≥20 cigarettes daily (OR = 1.17, 95% CI: 1.04-1.32) increased a woman's odds of experiencing substantial weight gain (influenced by smoking cessation). In contrast, risk of substantial weight gain was reduced among women 45 to 50 years of age (OR = 0.79, 95% CI: 0.73-0.85), women reporting high alcohol consumption (OR = 0.90, 95% CI: 0.83-0.98), and those with medium (OR = 0.93, 95% CI: 0.87-1.00) or high (OR 0.83, 95% CI: 0.77-0.90) physical activity levels.Conclusions: The majority of women experienced weight gain during middle age. Population-specific determinants of weight gain should guide obesity prevention efforts. [ABSTRACT FROM AUTHOR]

Objective: To compare early pregnancy clinical and biomarker risk factors for later development of preeclampsia between women with obesity (body mass index, BMI ≥30 kg/m2 ) and those with a normal BMI (20-25 kg/m2 ).Methods: In 3,940 eligible nulliparous women from the Screening for Pregnancy Endpoints (SCOPE) study, a total of 53 biomarkers of glucose and lipid metabolism, placental function, and known markers of preeclampsia were measured at 14 to 16 weeks' gestation. Logistic regression was performed to identify clinical and biomarker risk factors for preeclampsia in women with and without obesity.Results: Among 834 women with obesity and 3,106 with a normal BMI, 77 (9.2%) and 105 (3.4%) developed preeclampsia, respectively. In women with obesity, risk factors included a family history of thrombotic disease, low plasma placental growth factor, and higher uterine artery resistance index at 20 weeks. In women with a normal BMI, a family history of preeclampsia or gestational hypertension, mean arterial blood pressure, plasma endoglin and cystatin C, and uterine artery resistance index were associated with preeclampsia, while high fruit intake was protective.Conclusions: Women with obesity and a normal BMI have different early pregnancy clinical and biomarker risk factors for preeclampsia. [ABSTRACT FROM AUTHOR]

Objective: Self-reports tend to differ from objective measurements of food intake, particularly in adults with obesity; however, no studies have examined how neural responses to food (an objective measure) and subjective ratings of food differ by BMI status. This study tested normal-weight women (NWW) and women with obesity (OBW) for group differences in neural indices of attention towards food pictures, subjective ratings of these pictures, and the disparity between objective and subjective measurements.Methods: Twenty-two NWW (21.8 ± 1.7 kg/m2 ) and 22 OBW (37.0 ± 5.7 kg/m2 ) viewed food and flower pictures while late positive potential amplitude, an event-related potential, was recorded. Participants rated pictures for arousal and valence.Results: Late positive potential amplitude was larger toward food than flower pictures. OBW self-reported flower pictures as more pleasant than food; NWW showed no difference for pleasantness. There were no significant main effects or interactions for arousal. Standardized scores showed that only on subjective, but not objective, measures did OBW compared with NWW disproportionately indicate food pictures as less pleasant than flowers.Conclusions: Compared with NWW, OBW showed larger discrepancies between neural and subjective reports of attention towards food. Inaccurate self-reports of attention towards food may reduce the efficiency of health interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine whether changes in diet quality predict changes in central adiposity among postmenopausal women.Methods: At baseline and 3-year follow-up, Women's Health Initiative Observational Study participants completed food frequency questionnaires, and waist circumference was measured (WC, n = 67,175). In a subset, trunk fat was measured via dual-energy X-ray absorptiometry (DXA, n = 4,254). Using multivariable linear regression, 3-year changes in dietary patterns (Healthy Eating Index-2010, Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension) were examined as predictors of concurrent changes in WC and, secondarily, DXA.Results: Mean (SD) age and 3-year changes in weight and WC were 63 (7) years, 0.52 (4.26) kg, and 0.94 (6.65) cm. A 10% increase in any dietary pattern score, representing improved diet quality, was associated with 0.07 to 0.43 cm smaller increase in WC over 3 years (all P < 0.05). After adjusting for weight change, associations attenuated to 0.02 to 0.10 cm but remained statistically significant for all patterns except Alternate Mediterranean Diet. Results were similar for DXA trunk fat.Conclusions: Three-year improvements in diet quality are modestly protective against gain in WC and partially explained by lesser weight gain. Achieving and maintaining a healthful diet after menopause may protect against gains in central adiposity. [ABSTRACT FROM AUTHOR]

Objective: This analysis was focused on 1-year maternal and infant follow-up of a randomized trial that tested a weight management intervention conducted during pregnancy.Methods: One hundred fourteen women with obesity (mean BMI 36.7 kg/m(2) ) were randomly assigned at a mean of 15 weeks gestation to a weight management intervention or usual care control condition. The intervention ended at delivery and resulted in less gestational weight gain and a lower proportion of large-for-gestational-age newborns among intervention compared with control participants. The primary outcome at 12 months postpartum was maternal weight. Secondary outcomes included infant weight-for-age and weight-for-length z-scores.Results: At 1 year, mothers in the intervention group weighed 96.3 ± 18.6 kg and those in the control group 99.7 ± 19.2 kg. There was no significant difference between groups in change in weight from randomization to 1 year postpartum (b = -0.47, 95% CI: -4.03 to 3.08). There was a significant main effect of group for infant weight-for-age z-scores (b = -0.40, 95% CI: -0.75 to -0.05) but not infant weight-for-length z-scores (b = -0.20, 95% CI: -0.59 to 0.20).Conclusions: A gestational weight management intervention did not influence maternal weight or infant weight-for-length at 1 year postpartum. Future studies may be warranted to determine whether extending prenatal interventions into the postpartum period would be beneficial for maternal and infant outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the combined effect of education and reproductive history on weight trajectory.Methods: The association of education with weight trajectory (1996-2012) in relation to reproductive history was analyzed among 9,336 women (born 1973-1978) from the Australian Longitudinal Study on Women's Health using random effects models.Results: Compared with women with a university degree/higher, lower-educated women were 2 kg heavier at baseline and gained an additional 0.24 kg/year. Giving birth was associated with an increase in weight which was more pronounced among women having their first birth <26 years of age (2.1 kg, 95% CI: 1.5-2.7), compared with 26 to 32 years or >32 years. While younger first-time mothers had a steeper weight trajectory (∼+0.16 kg/year, 95% CI: 0.1-0.3), this was less steep among lower-educated women. High-educated women with a second birth between 26 and 32 years had 0.9 kg decreased weight after this birth, while low-educated women gained 0.9 kg.Conclusions: While the effect of having children on weight in young adulthood was minimal, women having their first birth <26 years of age had increased risk of weight gain, particularly primiparous women. Educational differences in weight persisted after accounting for reproductive history, suggesting a need to explore alternative mechanisms through which social differences in weight are generated. [ABSTRACT FROM AUTHOR]

Objective: Independent and joint impacts of maternal race/ethnicity and obesity on adverse birth outcomes, including pre-eclampsia, low birth weight, and macrosomia, were characterized.Methods: Retrospective cohort study of all 2007 California births was conducted using vital records and claims data. Maternal race/ethnicity and maternal body mass index (BMI) were the key exposures; their independent and joint impact on outcomes using regression models was analyzed.Results: Racial/ethnic minority women of normal weight generally had higher risk as compared with white women of normal weight (e.g., African-American women, pre-eclampsia adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI]: 1.48-1.74 vs. white women). However, elevated BMI did not usually confer additional risk (e.g., pre-eclampsia aOR comparing African-American women with excess weight with white women with excess weight, 1.17, 95% CI: 0.89-1.54). Obesity was a risk factor for low birth weight only among white women (excess weight aOR, 1.24, 95% CI: 1.04-1.49 vs. white women of normal weight) and not among racial/ethnic minority women (e.g., African-American women, 0.95, 95% CI: 0.83-1.08).Conclusions: These findings add nuance to our understanding of the interplay between maternal race/ethnicity, BMI, and perinatal outcomes. While the BMI/adverse outcome gradient appears weaker in racial/ethnic minority women, this reflects the overall risk increase in racial/ethnic minority women of all body sizes. [ABSTRACT FROM AUTHOR]

Objective: It is unclear how specific periods of gestational weight gain (GWG) during pregnancy relate to childhood adiposity. The goal of this study was to assess the differential impact of GWG timing on childhood body composition.Methods: In 979 mother-child pairs from the pre-birth Project Viva cohort, trimester-specific GWG was calculated using clinically recorded weights. Outcomes included body mass index (BMI) z-score, dual X-ray absorptiometry fat mass index (kg/m(2) ), and fat-free mass index (kg/m(2) ) in mid-childhood. Linear regression models were used to assess associations of each trimester's GWG (per 0.2 kg/week) with childhood outcomes, adjusted for maternal prepregnancy BMI, sociodemographic variables, lifestyle, and GWG in prior trimester(s).Results: Mean (SD) first trimester GWG was 0.22 (0.22) kg/week, second trimester 0.49 (0.18) kg/week, and third trimester 0.47 (0.20) kg/week. Faster first trimester GWG was associated with higher BMI z-score (0.06 units [95% CI: 0.01-0.12] per 0.2 kg/week) and with higher adiposity according to all indices; associations were strongest in women with prepregnancy BMI >30 kg/m(2) . Faster second trimester GWG was associated with higher BMI z-score (0.11 [0.04-0.18]), fat mass (fat mass index = 0.16 [0.02-0.31] kg/m(2) ), and lean mass (fat-free mass index = 0.11 [0.01-0.22] kg/m(2) ). Third trimester GWG was not associated with childhood adiposity.Conclusions: These results reinforce the importance of addressing appropriate GWG in early pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To estimate the risk of preterm preeclampsia in primiparous women by pre-pregnancy obesity class.Methods: A retrospective cohort study of primiparous women with singleton gestations was performed for deliveries from January 2003 to April 2014. Cases were stratified by delivery occurring either at ≥ 37 weeks or < 37 weeks. Pre-pregnancy maternal obesity was defined as a body mass index (BMI) ≥ 30 kg/m(2) . World Health Organization criteria were used to define BMI class of obesity. Multinomial logistic regression modeling estimated the association between term and preterm preeclampsia and pre-pregnancy obesity.Results: Of 28,361 women with complete pre-pregnancy BMI data, 2,588 women (9.1%) had a diagnosis of preeclampsia. Women who developed preeclampsia prior to 37 weeks (n = 784) were more likely to be women with obesity compared to women who developed preeclampsia after 37 weeks (33.1% vs. 25.3%, P = 0.0001). Compared to normal-weight women without preeclampsia, the risk of preterm preeclampsia increased proportionally with pre-pregnancy obesity class, with women with a BMI ≥ 40 kg/m(2) having the greatest risk (RR 5.23, 95% CI: 3.86-7.09, P <0.001).Conclusions: The risk of preterm preeclampsia increased significantly as the severity of maternal pre-pregnancy obesity increased. Reduction in maternal pre-pregnancy BMI may be protective in mitigating such risk. [ABSTRACT FROM AUTHOR]

Objective: This study investigated functional brain response differences to food in women with BMI either <25 kg/m(2) (lean) or >35 kg/m(2) (severe obesity).Design and Methods: Thirty women, 18-65 years old, from academic medical centers participated. Baseline brain perfusion was measured with arterial spin labeling. Brain activity was measured via blood-oxygen-level-dependent functional magnetic resonance imaging in response to food cues, and appeal to cues was rated. Subjective hunger/fullness was reported pre- and post-imaging. After a standard meal, measures were repeated.Results: When fasting, brain perfusion did not differ significantly between groups; and both groups showed significantly increased activity in the neo- and limbic cortices and midbrain compared with baseline (P < 0.05, family-wise-error whole-brain corrected). Once fed, the lean group showed significantly decreased activation in these areas, especially the limbic cortex, whereas the group with severe obesity showed no such decreases (P < 0.05, family-wise-error whole-brain corrected). After eating, appeal ratings of food decreased only in lean women. Within groups, hunger decreased (P < 0.001) and fullness increased (P < 0.001) fasted to fed.Conclusions: While fasting, brain response to food cues in women did not differ significantly despite BMI. After eating, brain activity quickly diminished in lean women but remained elevated in women with severe obesity. These brain activation findings confirm previous studies. [ABSTRACT FROM AUTHOR]

Objective: This article examines relations between patterns of dietary exposures at 9 months and infant and maternal weight status at 1 year postpartum.Methods: Participants were part of the Infant Feeding Practices Study II and included 1807 mothers participating through the first year postpartum. All data were self-reported monthly by mothers. Latent class analysis was conducted to identify patterns of infant dietary exposures at 9 months. Factors that predicted dietary pattern class membership were examined including infant sleep and parity. Dietary pattern membership was used to predict child and maternal weight outcomes at 1 year postpartum.Results: Five patterns of dietary exposures were identified, characterized by differences in milk-feeding and solid foods at 9 months: "Breastfed Fruits and Vegetables," "Breastfed Low Variety," "Formula-Fed Fruits and Vegetables," "Formula-Fed Low Variety," and "Mixed High Energy Density." Infants in the Mixed High Energy Density dietary pattern were more likely to be overweight at 1 year.Conclusions: Dietary classes that capture different combinations of several aspects of infant feeding may be more useful than single dietary predictors, for example, breastfeeding, formula-feeding, or early introduction to solids, to describe differences in infants' early dietary experience and risk for overweight. [ABSTRACT FROM AUTHOR]

Objective: The Lifestyle Interventions for Expectant Moms (LIFE-Moms) Consortium is designed to determine, in pregnant women with overweight or obesity, whether various behavioral and lifestyle interventions reduce excessive gestational weight gain (GWG) and subsequent adverse maternal and neonatal outcomes and obesity in offspring. The design and planning process of the LIFE-Moms Consortium is described.Methods: The LIFE-Moms Consortium is a collaboration among seven clinical centers, a Research Coordinating Unit, and the NIH designed to support each clinical center's conduct of a separate trial of a unique intervention. Specific common measures, procedures, and eligibility criteria are consistent across the seven trials allowing data to be combined in exploratory analyses and/or compared readily.Results: Numerous committees and working groups were created to define common measures and outcomes during pregnancy and through 1 year postpartum, develop Consortium policies, and oversee progress of the trials. The primary outcome for the Consortium is excessive GWG. Secondary outcomes include maternal, neonatal, and infant anthropometric measures, physical activity, sleep, and complications of pregnancy and delivery.Conclusions: A multi-center consortium of independent, lifestyle interventions with common measures and outcomes may enhance the ability to identify promising interventions for improving outcomes in pregnant women and their offspring. [ABSTRACT FROM AUTHOR]