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OBJECTIVE: To assess the prevalence of obesity in pregnant women in Victoria, 2010-2019. STUDY DESIGN: Retrospective cohort study; analysis of Victorian Perinatal Data Collection data. SETTING, PARTICIPANTS: Women who gave birth in seventeen Victorian Department of Health areas (eight metropolitan, nine regional), 2010-2019. MAIN OUTCOME MEASURES: Proportions of births to women with obesity (body mass index ≥ 30 kg/m2), by Department of Health area and year. RESULTS: A total of 710 364 births with records that included the mothers' BMI were recorded in Victoria during 2010-2019. The proportion of births to women with obesity rose from 19.6% (95% confidence interval [CI], 19.3-19.9%) in 2010 to 21.5% (95% CI, 21.2-21.8%) in 2019; the proportion of births to women with normal weight declined from 49.0% (95% CI, 48.6-49.4%) to 46.8% (95% CI, 46.4-47.1%). In metropolitan areas, the proportion of births to women with obesity rose from 17.7% (95% CI, 17.7-17.8%) to 19.4% (95% CI, 19.3-19.4%); in regional areas, it increased from 25.0% (95% CI, 25.0-25.1%) to 29.1% (95% CI, 29.0-29.2%). The increase in prevalence of obesity was greater among women living in the lowest socio-economic standing (Index of Relative Socio-Economic Disadvantage) quintile than for those residing in the quintile of least disadvantage (adjusted rate ratio, 2.16; 95% CI, 2.12-2.20). CONCLUSION: The proportion of births to Victorian women with obesity rose during 2010-2019, particularly in regional areas. Ensuring that regional health services are adequately resourced to meet the needs of the increasing number of women at risk of obesity during pregnancy is vital.

This article provides information about the relationship between obesity and disorders of the reproductive system. Lifestyle factors are changeable habits and lifestyles that can greatly affect overall health and well-being, including fertility. Overweight contributes to menstrual cycle disorders, infertility, miscarriage, unfavorable pregnancy outcome, deterioration of fetal well-being and diabetes mellitus.

Background Existing evidence suggests that there has been a surge of overweight and obesity in low- and middle-income countries around the world. In this study we investigated the prevalence and factors associated with overweight and obesity among women in Mali. Methods We conducted the study among 5198 women using the 2018 Mali Demographic and Health Survey data. We used binary logistic regression for the analysis and pegged statistical significance at p<0.05. Results The prevalence of overweight and obesity was 26.9%. The likelihood of overweight and obesity was high among women 40–44 y of age (adjusted odds ratio [AOR] 5.94 [confidence interval {CI} 4.10 to 8.60]), those who were widowed/divorced/separated (AOR 1.59 [CI 1.04 to 2.43]), those with secondary education (AOR 1.41 [CI 1.13 to 1.75]), richest women (AOR 3.61 [CI 2.63 to 4.95]), those who watched television at least once a week (AOR 1.28 [CI 1.07 to 1.52]) and those who lived in the Kidal region (AOR 10.71 [CI 7.05 to 16.25]). Conversely, the likelihood of overweight and obesity was low among women who belonged to other religions compared with Muslims (AOR 0.63 [CI 0.43 to 0.92]). Conclusions This study found a predominance of overweight and obesity among women in Mali. The study showed that age, marital status, education, religion, region of residence, wealth status and frequency of watching television are associated with overweight and obesity among women in Mali. It is therefore critical for public health promotion programs in Mali to sensitize people to the negative effects associated with overweight and obesity. This implies that policies aimed at controlling overweight and obesity in Mali must take these factors into consideration.

Background: Overweight and obesity are well-recognized risk factors for various non-communicable diseases. Evidence shows an increasing burden of overweight and obesity in low and middle-income countries, especially in women. Little is known about the risk factors in Zimbabwe. The aim of this study was to determine the socioeconomic risk factors for overweight and obesity in non-pregnant adult Zimbabwean women. Methods: A cross-sectional study was conducted using the 2015 Zimbabwe Demographic Health Survey (n = 8904) data on the adult female population aged 15 to 49. Body mass index (BMI) was calculated by dividing the body weight by height squared. The socio-economic variables studied were age, marital status, residence, province, religion, education, household wealth index, household size, access to mass media and the use of contraception. Prevalence of overweight (BMI >= 25-29.9 kg/m(2)) and obesity (BMI >= 30 kg/m(2)) were determined. Simple and multivariable logistic regressions were then used to ascertain any relationships. Results: The weighted prevalence of overweight and obesity in adult females was 34.2 and 12.3% respectively. The odds for being overweight and obese were significantly higher with increasing age (Adjusted Odds Ratio (AOR 2.76, 95% CI:2.45-3.11 for overweight and AOR 3.24, 95% CI:2.69-3.90 for obesity) with marriage (AOR 1.58, 95% CI:1.38-1.79 for overweight and AOR 1.54, 95% CI:1.27-1.87 for obesity), high wealth status (AOR 4.01, 95% CI:2.93-5.50 for overweight and AOR 6.97, 95% CI:4.08-11.9 for obesity), and the use of hormonal contraception (AOR 1.24, 95% CI:1.07-1.41 for overweight and AOR 1.35, 95% CI:1.10-1.64 for obesity). Additionally, having higher education increased the odds of being obese (AOR 1.44, 95% CI:1.07-1.96) while being Christian increased the odds for being overweight (AOR 1.13, 95% CI:1.00-1.28). Conclusions: The prevalence of overweight and obesity among women in Zimbabwe was high. The key social factors associ

The incidence of overweight and obesity as well as markers of Chronic Noncommunicable Diseases (NCDs) has grown in recent decades. Obesity, in addition to being associated with non-communicable chronic diseases such as diabetes and hypertension, can be considered a risk factor for the development of disorders in the supporting structures of the abdomino-pelvic viscera, which can lead to complications such as Urinary Incontinence (UI) and genital prolapses. The association between incontinence and obesity is still poorly studied. Due to the relevance of the theme, this study was proposed, which aimed to investigate the prevalence of urinary incontinence in women enrolled in a care unit in the city of Maceió and to verify the association with obesity. This is an observational, analytical, cross-sectional study, with women between 18 and 60 years old, enrolled in a Teaching Care Unit in the City of Maceió, from July to September 2017. Women with suspected or confirmed pregnancies were excluded, or who had a neurological disease that resulted in difficulty understanding, hearing or speaking, making it impossible to respond to the questionnaire 109 women participated in the research, with a mean age of 38.1±12.3, ranging between a minimum age of 18 and a maximum of 59 years. The prevalence of self-reported UI in this population was 17.43%, with no association with obesity being found. It was possible to conclude that the prevalence of UI is within the percentage described in the literature and that even though no statistically significant association was found between UI and obesity, the number of incontinent, obese or overweight women is high. In addition, UI is increasingly present in young women, as well as obesity, as confirmed in this study.

Despite adverse pregnancy outcomes for women with overweight or obesity, preconception guidelines for achieving optimal wellness for women contemplating pregnancy regarding the risks of overweight or obesity are varied based upon national affiliation. The aim of this study was to synthesize the best evidence related to preconception counseling and care focused on overweight or obesity provided to women of reproductive age. An integrative review of original studies was conducted. PubMed, Cumulative Index in Nursing and Allied Health Literature, Ovid, Scopus, Web of Science, and Embase were included. Full-text, data-based articles were searched from 2009 to 2018, with reviews and synthesis completed in 2019 and 2020. Of 8703 initial articles, 31 articles remained in the review. Quality assessment and level of evidence were evaluated based upon criteria from the Joanna Briggs Institute and the Johns Hopkins Nursing Evidence-Based Practice Quality Guide. The level of evidence for the majority of studies was non-experimental but they were of good quality with appropriate methods, samples and relevant results. Limited attention and interest in preconception counseling regarding risks of overweight or obesity by health care professionals were noted, which may contribute to women’s unawareness of these risks on preconception health.

Mona Bustami,1 Khalid Z Matalka,2 Eyad Mallah,3 Luay Abu-Qatouseh,1 Wael Abu Dayyih,3 Nour Hussein,4 Nayef Abu Safieh,4 Yousef Elyyan,5 Nagham Hussein,6 Tawfiq Arafat7 1Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, 11196, Jordan; 2Faculty of Health Sciences, American University of Madaba, Madaba, Jordan; 3Department of Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, 11196, Jordan; 4School of Medicine, University of Jordan, Amman, Jordan; 5Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan; 6Istishari Hospital, Amman, Jordan; 7Jordan Center for Pharmaceutical Research, Amman, JordanCorrespondence: Mona Bustami Email mbustami@uop.edu.joObjective: The study aimed to investigate the prevalence of obesity among Jordanian women and its association with a wide range of chronic diseases.Methods: Subjects were enrolled in the present cross-sectional study based on a random drop-off technique at the Obstetrics and Gynecology clinics at Jordan University Hospital. Initially, any female 18 years of age and older was asked to enroll in the study. Relevant data were gathered using a questionnaire composed of 30 questions, and body mass index (BMI) was determined from each participant’s weight and height. The following variables were collected: socio-demographic, chronic diseases, and health status. Each variable’s frequencies were reported, and the 95% confidence interval (95% CI) for each variable was calculated. For association analysis, Chi-square analysis was performed with an odds ratio (OR) and 95% CI. Multinomial logistic regression analysis was applied to a combination of independent variables and a dependent condition with covariate factors.Results: The age-standardized prevalence of overweight/obese Jordanian women was 70.6% (95% CI 66.0– 74.8%). On the other hand, the age-standardized prevalence of only obes

Supa Pengpid,1,2 Karl Peltzer21ASEAN Institute for Health Development, Mahidol University, Salaya, Nakhonpathom, Thailand; 2Deputy Vice Chancellor Research and Innovation Office, North West University, Potchefstroom, South AfricaObjective: The study aimed to assess the prevalence and correlates of underweight and overweight or obesity among women in India.Subjects and methods: In a population-based cross-sectional 2015–2016 National Family Health Survey, ever married non-pregnant women (18–49 years) were interviewed and assessed with anthropometric, blood pressure and biochemical measures.Results: The total sample included 5,82,320 non-pregnant women 18–49 years, median age 31 years, interquartile range =16 years, from India. Overall, 20.1% of the women were underweight [body mass index (BMI) m2,] and 36.3% were overweight, or had class I or class II obesity (BMI ≥23.0 kg/m2,). In adjusted multinomial logistic regression, younger age, lower education, lower wealth status, not eating daily fruits, vegetables, fried food, belonging to the scheduled tribe and tobacco use were associated with underweight, while older age, higher education, higher wealth, belonging to other backward class or other, urban residence, daily fruit consumption, daily fried food consumption, having hypertension, heart disease and high or very high blood glucose levels were associated with overweight or obesity. Belonging to the scheduled caste and tobacco use were negatively associated with overweight or obesity.Conclusions: A high dual burden of both underweight and overweight or obesity was observed among women in India. Sociodemographic and health variables were identified as risk factors for both underweight and overweight or obesity, which can be utilized in informing intervention strategies.Keywords: women, underweight, overweight, obesity, health variables, India &nbsp

Contains fulltext : 229383.pdf (publisher's version ) (Open Access), Obesity leads to an amplified risk of disease and contributes to the occurrence of type 2 diabetes, fatty liver disease, coronary heart disease, stroke, chronic kidney disease and various types of cancer. MicroRNAs (miRNAs), small non-coding RNA molecules of 20-25 nucleotides, can remain stable in plasma and have been studied as potential (predictive) biomarkers for obesity and related metabolic disorders. The aim of this study was to identify circulating miRNAs as biomarkers for obesity status and metabolic alterations in women. Circulating miR-216a and miR-155-5p were selected by miRNA expression profiling and validated by real time quantitative PCR in a validation cohort of 60 obese women and 60 normal weight-age-matched control women. This was supplemented by correlation analysis of the candidate miRNA and anthropometric variables, blood biochemistry and lipid profile markers. Circulating miR-216a was validated as a biomarker of obesity status with significantly reduced levels in obese women. Interestingly, this was associated with a negative correlation between the plasma miR-216a content and body mass index (BMI), waist circumference, mean arterial pressure (MAP), triglycerides, ratio of total cholesterol/high density lipoprotein (HDL)-cholesterol and high sensitivity-C reactive protein (hs-CRP).Taken together, we provide evidence for an abnormally expressed circulating miRNA, miR-216a, with additive value as a predictive marker for obesity that correlates with metabolic alterations presented by lipid profile and inflammatory markers.

Aim To determine the levels of circulating soluble receptor for advanced glycation end products (sRAGE), as a biomarker of risk of metabolic syndrome and cardiovascular disease development in centrally obese (CO) women considered metabolically healthy (COH) in comparison with those metabolically unhealthy (COU). Methods 47 lean healthy, 17 COH (presenting waist-toheight ratio ≥0.5 but not elevated blood pressure, atherogenic lipid profile, and insulin resistance), and 50 COU (CO presenting ≥2 risk factors) women aged 40-45 years were included. Anthropometric characteristics, blood chemistry and hematology data, adipokines, markers of inflammation, sRAGE, soluble vascular adhesion protein-1 (sVAP-1), and the activity of semicarbazide sensitive amine oxidase (SSAO) were determined. Results Central obesity associated with low sRAGE levels (lean healthy: 1503 ± 633 pg/mL; COH: 1103 ± 339 pg/mL, P < 0.05; COU: 1106 ± 367 ng/mL, P < 0.0.1), hyperleptinemia, and elevated markers of inflammation irrespective of the presence or absence of cardiometabolic risk factors. COU women presented high adiponectin levels. SVAP-1 concentrations and the activity of SSAO were similar in all 3 groups. Conclusion COH women present abnormalities in nonstandard markers of cardiometabolic risk (sRAGE, leptin, high sensitive C-reactive protein), supporting the view that there is no healthy pattern of obesity. The clinical impact of our findings for future prognosis of metabolically healthy obese subjects remains to be elucidated in longitudinal studies.

Pegah JafariNasabian,1 Julia E Inglis,1 Owen J Kelly,2 Jasminka Z Ilich1 1Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 2Abbott Nutrition, Columbus, OH, USA Abstract: Osteosarcopenic obesity syndrome (OSO) has recently been identified as a condition encompassing osteopenia/osteoporosis, sarcopenia and obesity. OSO is especially deleterious in older adults (even if they are not obese by conventional measures), due to age-related redistribution of fat and its infiltration into bone and muscle. Osteoporosis and bone fractures in elderly increase the risk of sarcopenia, which, through decreased mobility, increases the risk of more falls and fractures, creating a vicious cycle. Obesity plays a dual role: to a certain extent, it promotes bone and muscle gains through mechanical loading; in contrast, increased adiposity is also a source of pro-inflammatory cytokines and other endocrine factors that impair bone and muscle. As the elderly population increases, changes in lifestyle to delay the onset of OSO, or prevent OSO, are warranted. Among these changes, dietary patterns and physical activity modifications are the first ones to be implemented. The typical Western diet (and lifestyle) promotes several chronic diseases including OSO, by facilitating a pro-inflammatory state, largely via the imbalance in omega-6/omega-3 fatty acid ratio and low-fiber and high-processed food consumption. Nutritional modifications to prevent and/or alleviate the OSO syndrome include adequate intake of protein, calcium, magnesium and vitamin D and increasing consumptions of foods containing omega-3 polyunsaturated fatty acids and fiber. Certain types of physical activity, often decreased in overweight/obese women and in elderly, might preserve bone and muscle, as well as help in reducing body fat accrual and fat infiltration. Habitual daily activities and some alternative modes of exercise may be more appropriate for older adults and play a cru

Introduction –Des études relèvent un risque particulièrement élevé d’obésité chez les femmes ayant recours à l’aide alimentaire. Après une description des niveaux de corpulence, l’objectif de cette étude était d’analyser les facteurs socioéconomiques associés à l’obésité dans cette population.Méthodes –Les facteurs socioéconomiques ont été recueillis lors d’un entretien en face-à-face tandis que les mesures anthropométriques l’ont été dans les structures d’aide alimentaire, à l’issue de l’entretien, ou à l’occasion d’un examen clinique et biologique en centre de santé. Les facteurs associés au risque d’obésité ont été analysés par des régressions logistiques univariées et multivariées.Résultats –Les analyses ont porté sur 668 femmes pesées et mesurées (65,4% dans les structures, 34,6% en centre de santé). La prévalence du surpoids, obésité incluse, était de 71,9% (IC95% :[65,9-77,1]) et celle de l’obésité de 35,5% [30,1-41,1]. Le risque d’obésité était associé de manière indépendante à l’âge (pour un an :ORa=1,02 [1,00-1,05], p<0,02), au niveau scolaire (<2e cycle universitaire vs ≥2e cycle universitaire :ORa=7,1 [1,8-28,2], p=0,006), au type d’aide alimentaire (repas vs paniers/libre-service :ORa=0,06 [0,01-0,26], p<10-3) et de couverture complémentaire d’assurance maladie (pas d’assurance maladie complémentaire vs mutuelle :ORa=3,12 [1,5-6,6], p=0,003). Le type de logement et la situation familiale étaient également associés à l’obésité.Conclusion –Compte tenu des prévalences élevées de surpoids et d’obésité chez les femmes ayant recours à l’aide alimentaire, il apparaît indispensable de poursuivre les efforts de diversification des aliments distribués par l’aide alimentaire et de cibler les actions de prévention, de dépistage et de prise en charge de l’obésité dans ce cadre, selon l’âge et la situation socioéconomique des femmes., Introduction –After assessing the prevalence of overweight and obesity, the main objective was to investigate correlated socioeconomic factors with obesity among women using food assistance programs.Methods –Socioeconomic factors were collected through a face-to-face interview in food aid structure and a health examination at health centres, including anthropometric measurements. Obesity-associated socioeconomic factors were identified through univariate and multivariable logistic regression analyses.Results –Analyses were conducted on 668 women with measured anthropometric data (65.4% in food aid structures, 34.6% at health examination centres). The prevalence of overweight, including obesity, was 71.9% [95%IC: 65.9-77.1] and the prevalence of obesity was 35.5% [30.1-41.1]. The risk of obesity was independently associated with age (for one year :ORa=1.02, [1.00-1.05], p<0.02), education level (

Introduction –Un temps de sommeil court est un facteur de risque potentiel d’obésité aujourd’hui largement documenté, susceptible de toucher particulièrement les populations précaires. L’objectif principal de ce travail était d’étudier l’association entre un temps de sommeil court et le risque d’obésité chez les femmes recourant à l’aide alimentaire en France.Méthodes –Le temps de sommeil total (TST) a été mesuré au moyen d’un agenda de sommeil permettant de différencier précisément le temps passé au lit (TPL) et le TST. L’association entre un TST très court et le risque d’obésité a été analysée par des régressions logistiques multivariées.Résultats –Plus d’une femme sur 10 (11,6%) avait un temps de sommeil particulièrement court (TST<5 heures). La prévalence de l’obésité était très élevée parmi les femmes ayant un TST<5 heures :55,6% contre 32,6% (p<0,05) pour celles avec un TST≥5 heures. Après ajustement sur les facteurs sociodémographiques, dormir moins de 5 heures était significativement associé au risque d’obésité (données de corpulence mesurées) parmi les femmes.Conclusion –L’association entre un temps de sommeil court et l’obésité mesurée mise en évidence dans notre analyse montre l’importance d’une prévention globale de l’obésité dans les populations précaires intégrant la prise en compte du sommeil. Ces résultats sont à confirmer par d’autres études menées sur des populations similaires., Introduction –Short sleep duration is a well-documented obesity risk factor that may affect particularly socioeconomic disadvantaged populations. Our main objective was to assess the association between short sleep duration and obesity in women who resort to food aid in France.Methods –Total sleep time (TST) was measured through sleep logs allowing to differentiate TST from time in bed (TIB). Association between short sleep duration and the risk of obesity was identified through multivariable logistic regressions.Results –More than 1 out of 10 women (11.6%) had a particularly short sleep duration (TST<5 hours). Obesity frequency was very high among women that slept less than 5 hours: 55.6% vs. 32.6% (p<0.05) in those who slept 5 hours or more. After adjustment for socioeconomic factors, sleeping less than five hours was significantly associated with the risk of obesity (measured corpulence data).Conclusion –The association between short sleep duration and the risk of obesity identified in our analysis shows the importance of a global obesity prevention including sleeping, in socioeconomic disadvantaged populations. These results must be confirmed in other studies carried on similar populations., http://www.invs.sante.fr/beh/2014/18-19/2014_18-19_5.html, info:eu-repo/semantics/published

BACKGROUND Polycystic ovary syndrome (PCOS) is closely associated with obesity but the prevalence of obesity varies between published studies. The objective of this research was to describe the prevalence of overweight, obesity and central obesity in women with and without PCOS and to assess the confounding effect of ethnicity, geographic regions and the diagnostic criteria of PCOS on the prevalence. METHODS MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL) and PSYCINFO were searched for studies reporting the prevalence of overweight, obesity or central obesity in women with and without PCOS. Data were presented as prevalence (%) and risk ratio (RR) [95% confidence interval (CI)]. Random-effect models were used to calculate pooled RR. RESULTS This systematic review included 106 studies while the meta-analysis included 35 studies (15129 women). Women with PCOS had increased prevalence of overweight [RR (95% CI): 1.95 (1.52, 2.50)], obesity [2.77 (1.88, 4.10)] and central obesity [1.73 (1.31, 2.30)] compared with women without PCOS. The Caucasian women with PCOS had a greater increase in obesity prevalence than the Asian women with PCOS compared with women without PCOS [10.79 (5.36, 21.70) versus 2.31 (1.33, 4.00), P < 0.001 between subgroups). CONCLUSIONS Women with PCOS had a greater risk of overweight, obesity and central obesity. Although our findings support a positive association between obesity and PCOS, our conclusions are limited by the significant heterogeneity between studies and further studies are now required to determine the source of this heterogeneity. Clinical management of PCOS should include the prevention and management of overweight and obesity.

Background: Central obesity is closely related to morbidity. Finding potentially modifiable risk factors is important. The aim was to assess associations between sleep duration and central obesity in women. Methods: A population-based, cross-sectional sample of 400 women (range 20-70 years) in Uppsala, Sweden was investigated by full-night polysomnography and measurement of anthropometric variables. Results: Sleep duration was inversely related to both waist circumference and sagittal abdominal diameter. A mean difference of 9 cm in waist circumference (p<0.0001) and 3 cm in sagittal abdominal diameter (p<0.0001) was observed between women sleeping <5 hours and women sleeping ≥8 hours. Sleep duration remained inversely related to waist circumference (adj. β= -1.22 cm/h; p=0.0023) and sagittal abdominal diameter (adj. β= -0.46 cm/h; p=0.001) after adjusting for potential confounders. Duration of slow-wave sleep (SWS, adj. β= -0.58 cm/min; p=0.025) and rapid eye movement (REM) sleep (adj. β= -0.62 cm/min; p=0.002) were both inversely related to waist circumference. Moreover, duration of REM sleep was inversely related to sagittal abdominal diameter (adj. β= -0.021 cm/min; p<0.0001). These associations were stronger in young women (age <50 years). Conclusion: An inverse relationship between short sleep duration and central obesity was found in women after adjusting for confounders. Loss of SWS and REM sleep may be contributing factors to the development of central obesity. By increasing the duration and quality of sleep, central obesity in women may be reduced.

The program of physical rehabilitation for the main and control groups in the initial degree of exogenous obesity in women first mature age. The methods of the study, were used during the research on the effectiveness of the proposed program. The results obtained during the initial and follow-up survey of women. Based on the analysis of the results justified the use of the proposed program for the initial degrees of exogenous obesity in first mature age women with complex use of traditional and non-traditional means of physical rehabilitation., Представлена программафизической реабилитации для основной и контрольной групп при начальных степенях экзогенного ожирения у женщин первого зрелого возраста. Рассмотрены методы исследования, которые использовались во время исследования эффективности предложенной программы. Проанализированы результаты, полученные при проведении первичного и повторного обследования женщин. На основе анализа полученных результатов обосновано использование предложенной программы при начальных степенях экзогенного ожирения у женщин первого зрелого возраста с комплексным использованием традиционных и нетрадиционных средств физической реабилитации., Представлено програми фізичної реабілітації для основної та контрольної груп при початкових ступенях екзогенного ожиріння в жінок першого зрілого віку. Розглянуто методи дослідження, які використовувалися під час дослідження ефективності запропонованої програми. Проаналізовано результати, що були одержані при проведенні первинного та повторного обстеження жінок. На підставі аналізу одержаних результатів обґрунтовано використання запропонованої програми при початкових ступенях екзогенного ожиріння у жінок першого зрілого віку з комплексним використанням традиційних і нетрадиційних засобів фізичної реабілітації.

BACKGROUND: Obesity is a growing problem in lower income countries particularly among women. There are few studies exploring individual socioeconomic status indicators in depth. This study examines the interaction of education and wealth in relation to obesity, hypothesising that education protects against the obesogenic effect of wealth. METHODS: Four datasets of women of reproductive age from the Egyptian Demographic and Health Surveys spanning the period 1992–2008 are used to examine two distinct time periods: 1992/95 (N = 11097) and 2005/08 (N = 23178). The association in the two time periods between education level and household wealth in relation to the odds of being obese is examined, and the interaction between the two socioeconomic indicators investigated. Estimates are adjusted for age group and area of residence. RESULTS: An interaction was found between the association of education and wealth with obesity in both time periods (P-value for interaction, <0.001). For women with the lowest education level, moving up one wealth quintile was associated with a 78% increase in the odds of obesity in 1992/95 (OR; 95% CI: 1.78; 1.65,1.91) and a 33% increase in 2005/08 (OR; 95%CI: 1.33; 1.26,1.39). For women with the highest level of education, there was little evidence of an association between wealth and obesity (OR; 95%CI: 0.82; 0.57,1.16 in 1992/95 and 0.95; 0.84,1.08 in 2005/08). Obesity levels increased most in women who were in the no/primary education, poorest wealth quintile and rural groups (absolute difference in prevalence percentage points between the two time periods: 20.2, 20.1, and 21.3 respectively). CONCLUSION: In the present study, wealth appears to be a risk factor for obesity in women with lower education levels, while women with higher education are protected. The findings also suggest that a reversal in the social distribution of obesity risk is occurring which can be explained by the large increase in obesity levels in lower socioeconomic gr

This paper analyses the current burden of obesity in the female population of Jordan on a national scale and examines the factors associated with it. Demographics and Health Surveys (DHS) were used for the years 2002, 2007 and 2009 covering a total of 23,197 women, 15-49 years of age, and variables including body mass index, age, governorate, educational level, marital status and wealth index, among others were investigated. The overall prevalence of obesity (body mass index, BMI ? 30) in Jordanian women was found to be 26.3 percent in 2002, 19.7 percent in 2007 and 28.2 percent in 2009. Multivariate analysis demonstrated that being obese was significantly associated with increasing age, being married and having only primary education. Apart from age, the strength of these associations decreased from 2002 to 2009 which could point to a generalisation obesity epidemic, for all population groups. This paper contributes to the increasing research on obesity in Jordan, and confirms many findings of smaller studies, by including a larger sample size and greater geographic coverage, on a national scale. The contextual policy analysis reveals that the public health efforts of the Jordanian government are relatively limited in this area, and concludes by trying to make a case for a more comprehensive approach in order to moderate the health impact of obesity in Jordan.

Objective Increased glucocorticoid metabolite excretion and enhanced expression and activity of 11-hydroxysteroid dehydrogenase type 1 in adipose tissue are closely correlated with obesity and its detrimental consequences. Weight loss ameliorates the latter. The aim of this study was to explore whether increased glucocorticoid exposure in obesity is improved with substantial weight loss and thus is a consequence rather than a cause of obesity. Design and patients A prospective cohort study in 31 women. Measurements 11-HSD type 1 expression and activity, urinary glucocorticoid metabolite excretion, body composition including regional adipose tissue depots and insulin resistance by HOMA-IR before and 2years after gastric bypass surgery. Results After weight loss, excretion of cortisol and cortisone metabolites decreased. Both cortisol and cortisone metabolite excretion correlated with central obesity, where the intraabdominal fat depot showed the strongest association. Cortisol metabolites correlated with 11-HSD type 1 activity in abdominal subcutaneous adipose tissue. The ratio of cortisol to cortisone metabolites [(5-tetrahydrocortisol (5THF)+tetrahydrocortisol (THF)+-cortol)/(tetrahydrocortisone (THE)+-cortolone)] and the ratio of 5-THF/THF both decreased after stable weight loss, reflecting a downregulation of the net activities of 11-HSD type 1 and 5-reductase. Conclusion Long-term weight loss in women is not only followed by reduced glucocorticoid production, but also favourably decreases the global and tissue-specific activity of the cortisol-activating enzyme 11 -HSD type 1, possibly contributing to the health benefits of bariatric surgery.

Background: In South Africa, poverty and the dual epidemics of HIV and tuberculosis underscore the need for prevention efforts for obesity. The aim of this study was to describe the prevalence of obesity in a cohort of South African women and discuss the implications for public health practices. Methods. A total of 5,495 HIV-negative women from KwaZulu-Natal, South Africa enrolled in three microbicide trials during the period of 2002-2008 were categorised as normal weight (body mass index (BMI: 18.6-<25), overweight (BMI: 25-<30) or obese (BMI: 30+). Incidence of HIV and other sexually transmitted infections such as Chlamydia and gonorrhoea were also estimated and compared by BMI groups. Combined data was analysed using STATA 10.0. Results: Approximately 70% of the sample population was classified as being overweight or obese. Older age and lack of education were determined to be significant predictors of obesity. Women who were 35years or older were more than three times as likely to be overweight and more than 12 times as likely to be obese compared to the youngest group. The highest HIV and STI incidence rates were observed among those with BMI <25kg/m2 (normal weight) compared to women with BMI more than 25kg/m2 (8.1 and 19.8 per 100 person-year respectively, P<0.001, both). Conclusion: Effective obesity prevention strategies are needed to re-formulate HIV prevention programmes by incorporating healthy diet and life style messages to target those who are at highest risk not just for HIV infection but also for non-communicable diseases. © 2013 Wand and Ramjee; licensee BioMed Central Ltd.

Background The obesity epidemic is generally monitored by the proportion of the population whose body mass index (BMI) exceeds 30 kg/m2 but this masks the growing proportion of those who are morbidly obese. This issue is important as the adverse health risks amplify as the level of obesity increases. The aim of this study was to determine how the prevalence of morbid obesity (BMI >= 40.0 kg/m2) has changed over a decade among women living in south-eastern Australia. Methods BMI was determined for women in the Geelong Osteoporosis study (GOS) during two time periods, a decade apart. Height and weight were measured for 1,494 women (aged 20--94 years) during 1993--7 and for 1,076 women (aged 20--93 years), 2004--8, and the BMI calculated as weight in kilograms divided by the square of the height in metres (kg/m2). Prevalence estimates were age-standardised to enable direct comparisons. Results Mean BMI increased from 26.0 kg/m2 (95%CI 25.7-26.3) in 1993--7, to 27.1 kg/m2 (95%CI 26.8-27.4) in 2004--8. During this period, the prevalence of morbid obesity increased from 2.5% to 4.2% and the standardised morbidity ratio for morbid obesity was 1.69 (95%CI 1.26-2.27). Increases in mean BMI and prevalence of morbid obesity were observed for all ages and across the socioeconomic spectrum. Conclusions These findings reveal that over a decade, there has been an increase in mean BMI among women residing in south-eastern Australia, resulting in a measurable increase in the prevalence of morbid obesity.

BACKGROUND: The obesity epidemic is generally monitored by the proportion of the population whose body mass index (BMI) exceeds 30 kg/m2 but this masks the growing proportion of those who are morbidly obese. This issue is important as the adverse health risks amplify as the level of obesity increases. The aim of this study was to determine how the prevalence of morbid obesity (BMI ≥ 40.0 kg/m2) has changed over a decade among women living in south-eastern Australia. METHODS: BMI was determined for women in the Geelong Osteoporosis study (GOS) during two time periods, a decade apart. Height and weight were measured for 1,494 women (aged 20-94 years) during 1993-7 and for 1,076 women (aged 20-93 years), 2004-8, and the BMI calculated as weight in kilograms divided by the square of the height in metres (kg/m2). Prevalence estimates were age-standardised to enable direct comparisons. RESULTS: Mean BMI increased from 26.0 kg/m2 (95%CI 25.7-26.3) in 1993-7, to 27.1 kg/m2 (95%CI 26.8-27.4) in 2004-8. During this period, the prevalence of morbid obesity increased from 2.5% to 4.2% and the standardised morbidity ratio for morbid obesity was 1.69 (95%CI 1.26-2.27). Increases in mean BMI and prevalence of morbid obesity were observed for all ages and across the socioeconomic spectrum. CONCLUSIONS: These findings reveal that over a decade, there has been an increase in mean BMI among women residing in south-eastern Australia, resulting in a measurable increase in the prevalence of morbid obesity.

Objective: To assess characteristics of short sleepers and long sleepers and to assess association between sleep duration and central obesity in a population-based sample of women. Method: Non-pregnant women >= 20 years that were randomly selected from the population-registry of Uppsala, Sweden, answered a questionnaire (n =6461) including questions on sleeping habits and somatic disorders. Results: There was a U-shaped association between sleep duration and waist circumference. Short sleeping women (<5 h) had a waist circumference of 89.2 +/- 14.9 cm (mean +/- SD) decreasing to 82.9 +/- 11.9 cm for women sleeping 7-<8 h and increasing to 89.0 +/- 16.7 cm for women sleeping >= 10 h. Both short sleepers and long sleepers were more often physically inactive, smokers, ill or taking medication, and psychologically distressed than normal sleepers (6-<9 h). In women <50 years both short and long sleep duration were risk factors for central obesity. Short sleep duration remained a risk factor for central obesity, whereas the association with long sleep duration did not reach statistical significance after adjustments. Conclusions: Short sleepers and long sleepers showed differences in characteristics compared to normal sleepers. Furthermore, we showed an independent association between short sleep duration and central obesity, which was strongest in younger women. It is important to identify short sleepers, especially in younger women.

Silvia Migliaccio1,2, Emanuela A Greco1, Rachele Fornari1, Lorenzo M Donini1, Andrea Lenzi11Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma, 2Dipartimento di Scienze della Salute, Università Foro Italico di Roma, ItaliaAbstract: The belief that obesity is protective against osteoporosis has recently come into question. The latest epidemiologic and clinical studies have shown that a high level of fat mass might be a risk factor for osteoporosis and fragility fractures. Further, increasing evidence seems to indicate that different components of the metabolic syndrome, ie, hypertension, increased triglycerides, reduced high-density lipoprotein cholesterol, are also potential risk factors for the development of low bone mineral density and osteoporosis. This review considers both the older and more recent data in the literature in order to evaluate further the relationship between fat tissue and bone tissue.Keywords: bone mineral density, fat mass, body mass index, fractures, adipocytes

Background: Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. Methods: Obesity was defined as body mass index (BMI) ≥30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age ≥18. Data were analyzed using chi-square tests and logistic regression models. Results: Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. Conclusions: Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA-regardless of sexual orientation-may play a role in the development of obesity. © 2010, Mary Ann Liebert, Inc.

The Women's Health Study of Accra, Ghana measured the burden of obesity and obesity-linked illnesses in urban women. This is a Cross-sectional community based study. 1328 adult women, age 18 years and older, were selected as a representative sampling of the women of Accra. A comprehensive medical history, physical examination and laboratory tests were performed. Overweight and obesity status was determined by calculating the body mass index (BMI) (kg/m2). BMI measurements are available for 1237 non-pregnant women. A total of 430 women (34.8%) were obese; 340 (27.4%) were overweight; 369 (29.8%) were normal weight; and 98 (8.0%) were underweight. Risk factors for obesity include age 50 to 70 years, OR 2.12 [1.72 -2.62], p<0.001; total pregnancies > 5 (p<0.001); mean age of last delivery > 34 years (p<0.001); ownership of a television OR 1.57 [1.20-2.07], p=0.001; telephone OR 1.55 [1.22-1.98], p=0.001; or a refrigerator OR 1.55 [1.20-2.00], p=0.001. There was no significant association with socioeconomic status. Significant medical conditions associated with obesity include hypertension OR 2.97 CI [2.17-4.05], p<0.001; elevated fasting blood glucose OR 1.94 [CI 1.04 – 3.62], p=0.037. This study identifies an unexpected high prevalence of obesity and obesity-linked illnesses in this population. Public and professional awareness of the prevalence of obesity and the associated health risks are critical for programs designed to improve women's health.

This study investigates the associations between obesity and migraine. A neurologist clinically assessed 684 women aged 40-74 years attending a population-based mammography screening programme. Body height and weight were measured and body mass index (BMI) calculated. Obesity was defined as a BMI ≥ 30 kg/m2. The proportion of obesity did not differ between women with active migraine, women with inactive migraine or women who had never experienced migraine (P = 0.96). The distribution of frequency, intensity, duration or severity of attacks did not differ between obese and non-obese women with migraine. In this study there were no significant associations between migraine or migraine characteristics on the one hand and obesity on the other.

The current study examined environmental and socio-cultural factors postulated to predict adherence to a standard weight management program in Mexican-American women. In addition, the study gathered preliminary data on the effectiveness of the program with the study sample. One-hundred overweight or obese Mexican-American women in the Albuquerque area completed a pre-treatment intake and were enrolled in the group-based treatment. Of the 100 women who enrolled, 82 attended at least one treatment session. In terms of the predictors of treatment adherence, income was found to positively predict attendance in multivariate analyses. In addition, neighborhood satisfaction positively predicted reported walking goals completed, and familism (attention to the needs of the family above those of the self) negatively predicted reported calorie goals completed in multivariate analyses. In addition, exploratory analyses revealed that intake depression symptoms and body image varied by level of attendance, such that treatment completers reported lower baseline levels of body dissatisfaction and depression symptoms. In terms of treatment effectiveness, women who completed the program demonstrated significant pre- to post-treatment weight losses, reductions in waist-to-hip ratios, and reduced symptoms of depression, binge eating and body dissatisfaction. The results of the current study support the idea that economic, environmental, socio-cultural, and psychological factors predict adherence to a standard obesity treatment in Mexican-American women. In addition, there is preliminary evidence that such a program may be beneficial for weight loss. The results of the current study indicate that weight management programs should attempt to address the multi-level barriers to adherence that Mexican-American women may face.

Introduction Previous studies on the association between abdominal and general obesity and respiratory disease have provided conflicting results. Aims and objectives We aimed to explore the associations of abdominal obesity with respiratory symptoms, asthma, and chronic obstructive pulmonary disease independently from general obesity in women and men. Methods This cross-sectional study was based on the Respiratory Health in Northern Europe (RHINE) III questionnaire (n = 12 290) conducted in 2010–2012. Abdominal obesity was self-measured waist circumference using a sex-specific standard cut-off point: ≥102 cm in males and ≥88 cm in females. General obesity was defined as self-reported BMI ≥30.0 kg/m2. Results There were 4261 subjects (63% women) with abdominal obesity and 1837 subjects (50% women) with general obesity. Both abdominal and general obesity was independent of each other and associated with respiratory symptoms (odds ratio (OR) from 1.25 to 2.00)). Asthma was significantly associated with abdominal and general obesity in women, OR (95% CI) 1.56 (1.30–1.87) and 1.95 (1.56–2.43), respectively, but not in men, OR 1.22 (0.97–3.17) and 1.28 (0.97–1.68) respectively. A similar sex difference was found for self-reported chronic obstructive pulmonary disease. Conclusions General and abdominal obesity were independent factors associated with respiratory symptoms in adults. Asthma and chronic obstructive pulmonary disease were independently linked to abdominal and general obesity in women but not men.

Obesity has been associated with dyslipidaemia (increased levels of triglycerides, total cholesterol and low levels of HDL-C together with small dense lipoprotein particles) in the absence of metabolic disorders such as, type 2 diabetes mellitus and inflammation. Since community based studies in South Africa reported that obesity is more common in women, and rural Africans have a more favourable lipid profile compared to their White counterparts, the current study investigated the association of obesity in women without metabolic disorders with lipid levels and changes in proportions of small and large LDL and HDL particles. Methods The present study was part of the project “Prevention, Control and Integrated Management of Chronic Disease in a rural area, South Africa”. A total of 521 women participated in the above project. After excluding people with diabetes mellitus, insulin resistance and inflammation, 308 women were left and of these 67 were obese. Sixty seven ages matched, randomly selected non-obese women served as controls. Anthropometry variables as well as systolic and diastolic blood pressures were measured and the WHO steps questionnaire was administered to collect information on medication, lifestyle and diseases. Fasting blood levels of total cholesterol, HDL C, triglyceride, adiponectin, CRP, glucose and insulin were measured. Proportions of small and large HDL and LDL particles were determined. Results There was no significant difference in TC, TG and LDL-C levels (p=0.558, 0.087 and 0.948) between obese and non-obese women or between women with increased waist circumference (WC) and those with normal WC. The HDL-C concentration was significantly lower in obese women compared to women with non- obese (p=0.001). The lipid ratios TC/HDL-C and Apo B-100/Apo A-I were significantly higher in obese women than those with non- obese (p=0.013 and p=0.006) respectively. The same phenomenon was observed in women with xv increased waist circumference (p=0.001**, VLIR

PURPOSE: To determine the relationship between abdominal hernia and obesity. Although obesity is frequently cited as a risk factor for abdominal hernia, few studies have confirmed this association (Menzo et al. Surg Obes Relat Dis 14:1221-1232. 10.1016/j.soard.2018.07.005, 2018). METHODS: A cross-sectional study of primary care ambulatory patients aged older than 16 years treated at UCLA Health from 01/01/2018 to 06/06/2023. Abdominal hernia was identified by clinic encounter ICD-10 codes (K40-K46). RESULTS: There were 41,703 hernias identified among 1,362,440 patients (306.1 per10,000) with a mean age of 62.5 ± 16.1 years, and 57.6% were men. Nearly half (44.7%) of all abdominal hernias were diaphragmatic. There was an approximately equal distribution of the ventral (28.7%) and inguinal (24.3%) hernia. Each hernia type had a different relationship with obesity: The odds of having a ventral hernia increased with BMI in both sexes: BMI 25-29.9 kg/m2 odds ratio (OR) = 1.65, (CI 1.56-1.74); BMI 30-39.9 kg/m2 OR = 2.42 (CI 2.29-2.56), BMI 40-49.9 kg/m2 OR = 2.28 (CI 2.05-2.54) and BMI > = 50 kg/m2 OR = 2.54 (CI 2.03-3.17) all relative to normal BMI. In contrast, the odds of having an inguinal hernia decreased with obesity relative to normal weight [obesity (BMI 30-39.9 kg/m2): OR = 0.60 (CI 0.56-0.65)], morbid obesity (BMI 40-49.9 kg/m2): OR = 0.29 (CI 0.23-0.37). The OR for diaphragmatic hernia peaks with obesity in women and overweight status in men but was found to decrease with morbid obesity [OR = 1.18 (CI 1.07-1.30)]. There was no significant difference between men and women in the prevalence of femoral hernia (men: 0.7/per10,000, women: 0.9/per10,000, p = 0.19). CONCLUSIONS: The relationship between hernia and obesity is complex with some hernias decreasing in prevalence as obesity increases. Further research is needed to better understand this paradoxical relationship.

Obesity in women of reproductive age is common. Emerging evidence suggests that maternal obesity not only increases the risk of adverse pregnancy outcomes but also has an enduring impact on the metabolic health of the offspring. Given this, management of obesity prior to pregnancy is critically important. Almost all international guidelines suggest that women with obesity should aim to achieve weight loss prior to pregnancy. However, current pre-conception weight loss therapies are sub-optimal. Lifestyle modification typically results in modest weight loss. This may assist fertility but does not alter pregnancy outcomes. Bariatric surgery results in substantial weight loss, which improves pregnancy outcomes for the mother but may be harmful to the offspring. Alternative approaches to the management of obesity in women planning pregnancy are needed. Very low energy diets (VLEDs) have been proposed as a possible tool to assist women with obesity achieve weight loss prior to conception. While VLEDs can induce substantial and rapid weight loss, there are concerns about the impact of rapid weight loss on maternal nutrition prior to pregnancy and about inadvertent exposure of the early fetus to ketosis. The purpose of this review is to examine the existing literature regarding the safety and efficacy of a preconception VLED program as a tool to achieve substantial weight loss in women with obesity.

Background: Obesity is a disease with a com­plex (multi-causal) cause because it involves genetic and environmental factors. Some of them are heredity, individual socio-economic factors, eating patterns (habits), food con­sump­tion, physical activity, hormonal, nutri­tional knowledge, and perception. This study aimed to analyze the effect of oral contraceptives on obesity in women of childbearing age.Subjects and Method: This was a meta ana­lysis and systematic review from several obser­vational studies. The articles were collected from PubMed, Google Scholar, and Springer­link databases, published from 2000-2020. Data collection used eligibility criteria, inclu­ding population (P): women of reproductive age, intervention (I): oral contraceptive, com­parison (C): non oral contraceptive, and out­come (O): obesity. Keywords used “pil contra­ception” OR “Pil Contraceptive” AND “Oral Contraceptive” OR “Oral Contraception” AND “Obesity” OR “Overweight” AND“ Cross sectio­nal” AND “Cohort” AND “Adjusted Odds Ratio”. Selected articles were full text of obser­vational study. These articles were selected by PRISMA flow diagram. Quantitative synthesis was conducted using Review Manager 5.3 program.Results: A total of 3 articles reviewed in a meta-analysis with subgroup analysis using an observational cohort design showed that oral contraceptives increased the risk of obesity in women of reproductive age (aOR= 1.14, 95% CI= 1.03-1.26, p<0.001). A meta-analysis of 4 articles that conducted a subgroup analysis with a cross sectional observational design also showed that oral contraceptives increased the risk of obesity in women of childbearing age (aOR= 1.52; 95% CI= 0.78-298; p <0.001). This meta-analysis combines primary research from Korea, India, Canada, Congo, and the United States of America.Conclusion: Oral contraceptives increase the risk of obesity.Keywords: oral contraception, obesityCorrespondence: Muhammad Zia Ulhaq. Masters Program in Public Health, Universitas Sebel

Objective: To conduct a geospatial analysis of the prevalence of overweight and obesity based on the "National Survey of Nutritional Situation" of 2015. Methodology: A cross-sectional spatial distribution analysis model is applied at the departmental level using data from the survey. Prevalences of overweight, obesity class I, II, and III according to body mass index and abdominal obesity in women and men according to waist circumference are calculated. Geographic information system tools, such as the Global Moran Index, the local spatial autocorrelation index (LISA), and G* Getis Ord, are used to determine patterns of high and low prevalence clusters. Results: Local clusters shown in the maps demonstrate that their residuals are normally distributed in space. Randomness is observed in the spatial autocorrelation model. LISA high-high clusters are present in ten departments with these conditions (La Guajira, Magdalena, Atlántico, Sucre, Cesar, Norte de Santander, Córdoba, Antioquia, Chocó, and Cundinamarca). According to the body mass index, 38.5 per 100 inhabitants are overweight, 20.9 per 100 inhabitants have obesity, and according to waist circumference, 53.2 per 100 inhabitants have abdominal obesity. Conclusions: The spatial distribution of overweight and obesity may be conditioned by sociodemographic variables examined in this study. The country faces the challenge of continuing to implement population health actions to reduce these conditions., Objetivo: Realizar uma análise geoespacial do comportamento de sobrepeso e obesidade baseado na “Pesquisa Nacional de Situação Nutricional” de 2015. Metodologia: Aplica-se um modelo de análise geoespacial de distribuição espacial transversal a partir da Pesquisa, em escala departamental. Para tanto, calculam-se as prevalências de sobrepeso, obesidade classe I, II e III segundo o índice de massa corporal e a obesidade abdominal em mulheres e homens, em relação com a circunferência da cintura. Utilizam-se ferramentas de sistemas de informação geográfica, como o índice de Moran Global, o índice local de autocorrelação espacial (LISA) e o G* Getis Ord, para determinar os padrões de agrupamentos de altas e baixas prevalências. Resultados: Os conglomerados locais ilustrados nos mapas demonstram que seus residuais estão distribuídos normalmente no espaço. Observa-se uma aleatoriedade no modelo da autocorrelação espacial. As agrupações de LISA alta-alta apresentam-se em dez departamentos com estas condições (La Guajira, Magdalena, Atlántico, Sucre Cesar, Norte de Santander, Córdoba, Antioquia, Chocó e Cundinamarca). Segundo o índice de massa corporal, 38,5 a cada 100 habitantes têm sobrepeso; 20,9 a cada 100 habitantes apresentam obesidade, e segundo a circunferência de cintura, 53,2 a cada 100 habitantes têm obesidade abdominal. Conclusões: A distribuição espacial do sobrepeso e a obesidade pode estar condicionada por variáveis sociodemográficas tratadas no estudo. O país tem o desafio de continuar implementando ações populacionais em saúde pública para diminuir estas condições., Objetivo: Analizar geoespacialmente el comportamiento de las personas con sobrepeso y obesidad entre 18 y 64 años en Colombia en el 2015. Métodos: Se aplica un modelo de análisis geoespacial de distribución espacial trasversal con la última versión de la Encuesta Nacional de Situación Nutricional (ENSIN) de 2015 a escala departamental. Para lograrlo, se calculan las prevalencias a escala departamental de sobrepeso, obesidad clase I, II y III según el Índice de Masa Corporal (IMC) y la obesidad abdominal en mujeres y hombres de acuerdo con la circunferencia de cintura. Luego, se utiliza el índice de Moran Global, índice de Moran Local de Anselin y el G* Getis Ord para determinar los patrones de agrupaciones altas y bajas. Resultados: Los conglomerados locales ilustrados en los mapas de Anselin y G* Getis Ord demuestran que sus residuales están distribuidos normalmente en el espacio y el modelo de la autocorrelación espacial es aleatoria confirma que los factores que influyen en estas comorbilidades es ser afrocolombiano 13%, estar no afiliado y con contributivo el 26%, no tener actividad física y no tener parques cercanos el 13%. En el 2015, en Colombia y el índice de masa corporal, el 38.46 por cada 100 habitantes tienen sobrepeso; el 20.89 por cada 100 habitantes presenta obesidad y según la circunferencia de cintura 53.17 por cada 100 habitantes con obesidad abdominal. Conclusiones: los indicadores epidemiológicos y espaciales permitieron ser útiles para el análisis y visualizar el comportamiento geoespacial del sobrepeso y la obesidad en Colombia en el 2015.

Females suffering from polycystic ovarian syndrome have marked insulin resistance, independent of obesity. These women also have multiple risk factors for cardiovascular diseases, such as dyslipidemia, insulin resistance and hypertension. Uric acid level has also been recognized recently as a risk factor for cardiovascular diseases, females with PCOS may have abnormal profile of uric acid. Objectives: To compare uric acid levels in females of polycystic ovarian syndrome with and without insulin resistance. Methods: Cross-sectional comparative study was conducted in Biochemistry Department of Islam Medical College, Sialkot. Patients were divided into 2 groups based on their insulin resistance. In group-A patients were taken with PCOS and in group-B patients were taken with PCOS without insulin resistance. A total of 108 cases (54 in each group) fulfilling the inclusion/exclusion criteria. In both groups uric acid level was measured by standard procedure. Data were entered and analyzed using SPSS version 22 accordingly. Results: The mean age for all the cases was 29.43 ± 4.08 years, while mean age in insulin resistance group was 29.33 ± 4.06 years and mean age in non-insulin resistance group was 29.52 ± 4.13 years. The mean uric acid in insulin resistance and non-insulin resistance group was 4.92 ± 0.89 mg/dl and 4.48 ± 0.95 mg/dl with significantly higher mean uric acid in insulin resistance group, p-value < 0.05. Conclusion: We conclude that females having PCOS with insulin resistance had higher mean uric acid levels. Females with insulin resistance must be prevented from hyperuricemia to minimize the further risk of insulin resistance.

Background: Postpartum weight retention is the increase in postnatal weight compared to pre-pregnancy weight. This weight gain may persist and increase the long-term prevalence of obesity in women. The application of lifestyle interventions consisting of diet, physical activity, and behavior change interventions is believed to be able to reduce postpartum weight retention. This study aims to determine the effectiveness of lifestyle interventions carried out during pregnancy for reducing postpartum weight retention based on various types of interventions derived from studies that have been conducted.Subjects and Method: The writing of this meta-analysis was based on the PRISMA 2020 flow diagram with population: pregnant women, intervention: lifestyle intervention, comparison: without lifestyle intervention, and outcome: postpartum weight retention. The selected articles are full articles, randomized controlled trials (RCT) issued in 2013 – 2022, and are in English. Selected studies were assessed based on the JBI Critical Appraisal Checklist for RCT and then analyzed using RevMan 5.3.Results: 778 articles were identified from December 2022 to January 2023 and 14 RCT articles were obtained for meta-analysis. The diet subgroup accompanied by a behavior change intervention had the largest effect size (SMD = -0.60, 95% CI -0.86 to -0.33, p < 0.001), followed by the diet subgroup accompanied by physical activity and behavior change intervention (SMD = -0.10, CI 95 % -0.14 to -0.06, p < 0.001). Physical activity was found to reduce postpartum weight retention, but not statistically significant. The results of the type of intervention subgroup difference test showed a statistically significant effect (p = 0.001).Conclusion: Diets coupled with behavioral interventions show superior results. Variations in the types of lifestyle interventions carried out during pregnancy can influence the success of interventions for postpartum weight loss.Keywords: Postpartum weight retention

Background: The prevalence of overweight and obesity among women continues to increase every year. Overweight and obesity can lead to complications in pregnancy such as Excessive gestational weight gain (EGWG) and Gestational diabetes mellitus (GDM). Physical activity intervention is an option to prevent EGWG and GDM. The study aims to analyze the effects of physical activity interventions in reducing EGWG and GDM.Subjects and Method: The study used a meta-analysis study design by following PRISMA guidelines. The research question was formulated in PICO. The population was pregnant women with a Body Mass Index (BMI) of > 25 kg/m2. The intervention used was measured physical activity. The comparison was without measured physical activity. The outcomes were EGWG and GDM. Article search was carried out through the databases such as PubMed, Cochrane Library, Scopus Database, and PEDro which was published from 2011 to 2020. The article search used the following keywords: "pregnancy" OR "pregnant woman" AND "obese" OR "overweight" AND "excessive gestational weight gain" OR "gestational weight gain" OR "weight gain" AND "gestational diabetes mellitus" OR "gestational diabetes" AND "exercise " OR "antenatal exercise" OR "physical activity". Articles that met the criteria were full-text articles with a Randomized Control Trial (RCT) study design. The assessment of the quality of the study was conducted with Cochrane Collaboration's Tool for Assessing Risk of Bias and the articles were subsequently analyzed using the Review Manager 5.4 application.Results: A total of 10 articles analyzed in this study came from Asian, European, Australian, and American countries with a total sample of 2,086. The results of the meta-analysis showed that overweight and obese pregnant women who performed measured physical activity did not experience weight changes compared to those who did not engage in physical activity (SMD= 0.03; CI 95%= 0.17 to 0.73; p = 0.770). However, overweight and ob

Introduction: Diabetes, hypertension, high cholesterol, and obesity are increasingly prevalent in Afro-Caribbean populations. Much remains unknown about the relationship between these cardiometabolic outcomes and neighborhood socioeconomic status (SES). This study explores associations between neighborhood SES and cardiometabolic outcomes in urban Jamaica. Methods: Data from urban participants (n=833, women 577, men 282) in an ancillary study to the Jamaica Health and Lifestyle Survey 2016-2017 was analyzed to examine associations between neighborhood SES and cardiometabolic outcomes. Median property sales price was obtained from the Jamaica National Land Agency and selected as the primary neighborhood SES measure. Survey-weighted Poisson regression was used to assess prevalence ratios for measured diabetes, hypertension, high cholesterol, and obesity. Neighborhood percentages of educational attainment, dependency ratio, employment, and household state assistance were covariates in adjusted models. Results: Most participants were aged 45 to 64 (34.9%) and had at least a high school education (77.7%). Men were more likely to be adequately physically active (52.4% vs. 42.0%, p=0.003) and current smokers (29.7% vs. 10.8%, p <0.001). More women had hypertension (53.0% vs. 45.6%, p=0.047), high cholesterol (34.3% vs. 21.7%, p<0.001), and obesity (45.7% vs. 19.4%, p<0.001). Survey-weighted regression showed high neighborhood SES was associated with higher prevalence of hypertension (PR=1.33, p=0.044) and high cholesterol (PR=2.46, p<0.001) in fully adjusted models unstratified by sex when compared with low SES. Increased obesity was observed for the middle (PR=1.46, p<0.001) and high (PR=1.60, p<0.001) SES tiers. In stratified analyses, high neighborhood SES was associated with more obesity among women (P=1.32, p=0.015) and high total cholesterol among men (PR=4.70, p=0.005). Mid SES was associated with increased hypertension among men (PR=2.02, p=0.024). Conclusions: Amo

Objective: to analyze the risk of mortality from COVID-19 in people with obesity. Methods: observational, retrospective, and analytical study. Data were collected in the State System of Data Analysis. For the comparative analysis of people with and without obesity, n=168,808 was adopted. The analyses were performed using the log-binomial regression model and relative risk calculation. The comparative model was adjusted for sex, age group, heart disease and diabetes. Results: in more than 95% of COVID-19 notifications, information regarding the risk factor obesity was recorded as ignored. Obese individuals with COVID-19 had 26% higher risk of death when compared to those without obesity. Obese individuals in the 11 to 60 age groups had the highest mortality risks compared to individuals without obesity. Obese women in the age groups 31 to 50 years and elderly women over 71 years had the lowest mortality risk when compared to obese men. Conclusion: obese people, especially adults, have an increased risk of mortality from COVID-19. Contributions to practice: to help establish public health strategies to identify the profiles of individuals considered at high risk in the SARS-CoV-2 pandemic., Objetivo: analisar o risco de mortalidade por COVID-19 em pessoas com obesidade. Métodos: estudo observacional, retrospectivo e analítico. Os dados foram coletados no Sistema Estadual de Análise de Dados. Para a análise comparativa de pessoas com e sem obesidade, adotou-se n=168.808. As análises foram realizadas por meio do modelo de regressão log-binomial e cálculo de risco relativo. O modelo comparativo foi ajustado ao sexo, faixa etária, cardiopatia e diabetes. Resultados: em mais de 95% das notificações de COVID-19, a informação quanto ao fator de risco obesidade foi registrada como ignorado. Pessoas obesas com COVID-19 apresentaram 26% maior risco de óbito quando comparadas às pessoas sem obesidade. Indivíduos obesos nas faixas etárias entre 11 a 60 anos apresentaram os maiores riscos de mortalidade comparados aos indivíduos sem obesidade. As mulheres obesas nas faixas etárias de 31 a 50 anos e idosas acima de 71 anos apresentaram menor risco de mortalidade quando comparadas aos homens obesos. Conclusão: pessoas obesas, principalmente os adultos, possuem risco aumentado de mortalidade por COVID-19. Contribuições para a prática: auxiliar o estabelecimento de estratégias de saúde pública que atuem na identificação dos perfis dos indivíduos considerados de alto risco na pandemia ocasionada pelo vírus SARS-CoV-2., Objetivo: Analizar la mortalidad de Covid-19 en personas con obesidad en el estado de São Paulo. Método: Para el análisis comparativo de casos de Covid-19 en personas con y sin obesidad se adoptó N = 168.808. Resultados: Más del 95% de las notificaciones de covid-19, la información sobre el factor de riesgo de obesidad se registró como ignorada. Las personas obesas con covid-19 tenían un 26 % más de riesgo de muerte en comparación con las personas sin obesidad. Las mujeres obesas de 31 a 50 años y las ancianas mayores de 71 años tenían menor riesgo de mortalidad en comparación con los hombres obesos. Conclusión: las personas con algún grado de obesidad tienen mayor riesgo de mortalidad en comparación con las personas sin obesidad. Contribuciones a la práctica: el estudio mostró la falta de completitud de los formularios de notificación en covid-19, lo que puede influir directamente en las estrategias de enfrentamiento de la enfermedad. Por lo tanto, es necesario comprender que la obesidad es un factor de riesgo modificable y se debe invertir en la creación y el fortalecimiento de las políticas públicas de salud existentes para combatir la obesidad.

Mervat Naguib,1 Mohamed Magdy,1 Omar Ahmed Elsayed Yousef,2 Walaa Ibrahim,3 Doaa Mostafa Gharib3 1Diabetes and Endocrinology Unite, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Faculty of Medicine, University of Debrecen, Debrecen, Hungary; 3Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Mervat Naguib, Diabetes and Endocrinology Unite, Internal Medicine Department, Faculty of Medicine, Cairo University, 41 Manial Street, Cairo, 11451, Egypt, Tel +20 25729584, Fax +20 2628884, Email mervat.naguib@cu.edu.eg; mervat.naguib@kasralainy.edu.egBackground: Obesity is associated with metabolic and cardiovascular co-morbidities. It is important to determine the factors associated with metabolic derangement in obesity. Autophagy plays a major role in the pathogenesis of metabolic syndrome. MicroRNA-30a targets beclin1, the main regulator of autophagy.Purpose: We assess circulating microRNA-30a and serum beclin1 in women with metabolically unhealthy obesity (MUO), women with metabolically healthy obesity (MHO) and non-obese healthy control and determine their relationship with different clinical and metabolic variables in women with obesity.Patients and Methods: This cross-sectional study included 34 women with MHO, 34 with MUO, and 20 healthy non-obese women. Blood pressure, body mass index (BMI), and waist circumference were recorded. Glycemic and lipid indices, urinary albumin-to-creatinine ratio, ALT, AST, microRNA-30a expression in serum were measured using real-time polymerase chain reaction and beclin1 by enzyme-linked immunosorbent assay were measured.Results: The expression of microRNA-30a was significantly higher, and beclin1 level was significantly lower in women with MUO compared to those in women with MHO (P< 0.001; for both). People with MUO were significantly older (P< 0.001) and had higher TSH (P=0.006), HbA1c (P< 0.001), triglyceride (P

Purpose: Obesity and pregnancy are strictly related: on the one hand, obesity—one of the most common comorbidities in women of reproductive age—contributes to infertility and obesity-related pregnancy complications, whereas pregnancy is a condition in which, physiologically, the pregnant woman undergoes weight gain. Endoscopic sleeve gastroplasty (ESG) may be used for the treatment of obesity in women of childbearing age. Materials and Methods: A retrospective analysis was conducted to evaluate weight trajectories, the evolution of obesity-related comorbidities, and lifestyle modification in women who became pregnant after ESG. A comparison was made between childbearing-age women who became pregnant after ESG and non-pregnant women. Results: A total of 150 childbearing-age women underwent ESG at a large tertiary medical center. Of these, 11 patients (33.4 ± 6.2 years) became pregnant after the procedure, following a mean time interval of 5.5 ± 3.9 months. Three women (two affected by polycystic ovary syndrome) reported difficulty getting pregnant before undergoing ESG. The mean preconception BMI was 31.9±4.0 kg/m2 (−7.24 ± 4.0 kg/m2 after ESG). Total body weight loss (TBWL, %) was 18.08 ± 8.00, 11.00 ± 11.08, and 12.08 ± 8.49, at the beginning of pregnancy, at the delivery, and at the first follow-up (19.6 ± 7.8 months after ESG). TBWL of at least 5% was achieved before pregnancy in all patients (73% reached a TBWL ≥ 10%). No significant differences in weight loss and QoL were found between the pregnancy and non-pregnancy groups up to 24 months after ESG. Conclusions: Endoscopic sleeve gastroplasty allows for adequate weight loss before and after pregnancy in patients with obesity. Graphical Abstract: [Figure not available: see fulltext.]

Background: Obesity is a multifactorial, chronic, progressive disease associated with decreased health-related quality of life, co-morbidities, and increased mortality risk. Lifestyle interventions, focusing on dietetics, physical exercise, and behavioral therapy, are a cornerstone of therapy. Despite this very multidisciplinary treatment approach, the definition of treatment success is still based only on an average weight loss of ≥ 5%. However, the heterogeneous nature of obesity may necessitate a more comprehensive approach to assessing treatment effects. Objectives: Here, we describe changes in physiological, psychological, and behavioral health after a multidisciplinary combined lifestyle intervention (CLI). Additionally, we investigated whether these changes were related to weight loss. Methods: This prospective longitudinal study comprised 96 adults with obesity (73 women, 81 Caucasian) participating in a CLI at the Obesity Center CGG, Erasmus University Medical Center, Rotterdam, The Netherlands. The 1.5-year intervention comprised mul-tidisciplinary professional guidance towards a healthy diet, increased physical activity, and included cognitive behavioral therapy. Physiological health outcomes, psychological well-being, eating behavior, and physical activity were assessed after ten weeks and 1.5 years and compared to baseline. Results: An average of 5.2% weight loss (-6.0 kg) was accompanied by a mean 9.8% decrease in fat mass (-5.9 kg; both P < 0.001) and significant improvements in metabolism, hormonal status, and immune parameters (all P < 0.05). Moreover, we observed decreased psychopathology, increased quality of life, and decreased disordered eating (all P < 0.05). Weight loss correlated with most metabolic changes (all P < 0.05) but not with most psychological/behavioral changes. Conclusions: Combined lifestyle intervention in patients with obesity was accompanied by significant improvements in body weight and body composition along w

To better understand the physiological basis of obesity in women, we investigated whether obesity or menstrual cycle phase affects laboratory test-meal size or meal-stimulated plasma cholecystokinin (CCK) concentration. Women with healthy weight (body mass index [BMI] of 18.5-24.9 kg/m(2), N = 16) or obesity (BMI 30-39.9 kg/m(2), N = 20) were tested once in the late-follicular or peri-ovulatory phase (LF/PO) and once in the mid-luteal phase (ML). Meals of ham sandwiches were offered and blood was sampled. Menstrual cycle phases were verified with participants' reports of menses and measurements of progesterone and luteinizing hormone (LH) concentrations. Women with obesity ate significantly larger meals than women with healthy weight, (mean, 711 [95% CI, 402-1013] kJ, P = 0.001, during the LF/PO and 426 [105-734] kJ, P = 0.027, larger during the ML). Women with healthy weight ate smaller meals during LF/PO than ML (decrease, 510 [192-821 kJ], P = 0.008), but women with obesity did not (decrease, 226 [-87-542] kJ, P = 0.15). CCK concentrations 18 to 30 minutes after meal onset were lower in women with obesity than in women with healthy weight during LF/PO (3.6 [3.1-4.1] vs 6.1 [4.5-7.7] pmol/L; P = 0.004), but not during ML, with a significant interaction effect (1.8 [1.2-2.4] pmol/L, P = 0.048). Women with obesity consumed larger meals than women with healthy weight but displayed reduced meal-stimulated plasma CCK concentrations. These data are consistent with the hypothesis that a defect in CCK secretion compromises satiation in obese women and contributes to the development or maintenance of obesity.

Obesity in women of child-bearing age is common. There is little evidence that modest weight loss using lifestyle modification alters pregnancy outcomes. Bariatric surgery results in substantial weight loss, which reduces the risk of adverse outcomes for the mother but may increase risks for the baby. In order to reduce obesity-related adverse pregnancy outcomes for both mother and baby, alternative approaches to the management of obesity in women planning pregnancy are needed. OBJECTIVE: This study aims to explore the health consequences of substantial pre-conception weight loss, compared with modest pre-conception weight loss, in women with obesity. OUTCOMES: Primary outcome: To determine if non-surgical substantial pre-conception weight loss (10-15% body weight) in women with obesity (BMI 30-55kg/m2) causes a 10% reduction in fasting glucose at 26-28 weeks’ gestation compared with modest pre-conception weight loss (≤ 3% body weight). Secondary outcome: To determine if non-surgical substantial (10-15% body weight) compared with modest pre-conception weight loss (≤ 3% body weight) in women with obesity (BMI 30-55kg/m2) results in a reduction in the rate of (1) a composite of gestational diabetes, gestational hypertension/pre-eclampsia, delivery <37 weeks’ gestation, primary Caesarean section, shoulder dystocia/birth injury, large-for-gestational-age offspring, intra-uterine-growth-restriction, neonatal hypoglycaemia, neonatal hyperbilirubinemia and neonatal SCN/ICU admission, (2) gestational diabetes (3) large-for-gestational-age neonates (4) intra-uterine-growth-restriction (5) gestational hypertension/preeclampsia, (6) delivery >37 weeks’ gestation, (7) primary Caesarean section, (8) neonatal hypoglycaemia, (9) neonatal SCN/ICU admission, (10) maternal and neonatal length-of-stay, (11) a decrease in time-to-conception, (12) an increase in live birth rate (13) no difference in gestational weight gain. METHODS: This is a two-arm, parallel group, randomised controll

BACKGROUND: Current guidelines for the management of obesity in women planning pregnancy suggest lifestyle modification before conception. However, there is little evidence that lifestyle modification alters pregnancy outcomes. Bariatric surgery results in significant weight loss. This appears to reduce the risk of adverse pregnancy outcomes for the mother but may increase the risk of adverse outcomes for the infant. In order to reduce the risks of obesity-related adverse pregnancy outcomes for both mother and offspring, alternative approaches to the management of obesity in women planning pregnancy are needed. METHODS/DESIGN: This study, a two-arm, parallel group, randomized control trial, will be conducted at the Metabolic Disorders Centre, University of Melbourne. This trial will recruit 164 women aged 18-38 years with a body mass index of 30-55 kg/m2 who plan to conceive in the next 6-12 months. Women will be randomized to one of two 12-week interventions (Group A and Group B). Group A will aim for modest weight loss (MWL; ≤ 3% body weight) using a hypocaloric diet. Group B will aim for substantial weight loss (SWL; 10-15% body weight) using a modified very low energy diet (VLED) program. All participants will be asked to comply with National Health and Medical Research Council (NHMRC) guidelines for exercise and will be provided with standard pre-pregnancy advice according to Royal Australian and New Zealand College of Obstetrics and Gynaecology guidelines. All participants will then be observed for the subsequent 12 months. If pregnancy occurs within the 12-month follow-up period, data on weight and metabolic status of the mother, and pregnancy outcomes of mother and offspring will be recorded. The primary outcome is maternal fasting plasma glucose at 26-28 weeks' gestation, given that this is known to correlate with pregnancy outcomes. Time to conception, live birth rate, gestational weight gain, and a composite of adverse pregnancy outcomes for mother and ba