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Maternal PCOS status may negatively influence offspring infant and childhood growth, cardiometabolic health, reproductive health, and neurodevelopment. Current findings across studies are divergent, often because of small numbers of subjects, as well as heterogeneous selection criteria, ethnicities, and definitions of control groups. Coexisting maternal obesity, pregnancy complications, and comorbidity make it difficult to identify the contribution of maternal PCOS. Large, prospective, international, multiethnic studies with standardized investigation protocols and questionnaires on PCOS offspring health and development are needed.

Background Overweight and obesity are associated with musculoskeletal pain, particularly in the female population. However, regular resistance training may positively affect these complaints. Objective The present study aimed to investigate between group differences in musculoskeletal pain in previously inactive women, allocated to three different resistance-training modalities available in health- and fitness clubs. Methods This is secondary analysis from a single-blinded randomized controlled trial, including healthy women (aged 18–65) with a BMI (kg/m2) ≥25. The participants were allocated to 12 weeks (3 times/weekly) of either BodyPump (high-repetition low-load group session) (n = 24), heavy load resistance training with a personal trainer (n = 28), non-supervised heavy load resistance training (n = 19) or non-exercising controls (n = 21). Primary outcome was self-reported musculoskeletal pain in ten different body parts, measured with the Standardized Nordic Pain Questionnaire, at baseline and post-test. In addition, the study included sub-analyses of the participants when they were divided into high (≥28 of 36 sessions, n = 38) and low (≤27 of 36 sessions, n = 22) exercise adherence. Results The analysis revealed no between group differences in musculoskeletal pain in any of the ten body parts. The results did not change when the participants were divided into high versus low adherence. Conclusions Twelve weeks of BodyPump, heavy load resistance training with a personal trainer and non-supervised heavy load resistance training did not show any effect on self-reported musculoskeletal pain in overweight women. Clinical Trial registration number: NCT01993953 . ( https://clinicaltrials.gov/ct2/show/NCT01993953 ).

Abstract The health effects of acute exposure to temperature extremes are established; those of long-term exposure only recently received attention. We performed a systematic review to assess the associations of long-term (>3 months) exposure to higher or lower temperature on total and cardiopulmonary mortality and morbidity, screening 3455 studies and selecting 34. The studies were classified in those observing associations within a population over years with changing annual temperature indices and those comparing areas with a different climate. We also assessed the risk of bias, adapting appropriately an instrument developed by the World Health Organization for air pollution. Studies reported that annual temperature indices for extremes and variability were associated with annual increases in mortality, indicating that effects of temperature extremes cannot be attributed only to short-term mortality displacement. Studies on cardiovascular mortality indicated stronger associations with cold rather than hot temperature, whilst those on respiratory outcomes reported effects of both heat and cold but were few and used diverse health outcomes. Interactions with air pollution were not generally assessed. The few studies investigating effect modification showed stronger effects among the elderly and those socially deprived. Comparisons of health outcome prevalence between areas reported lower blood pressure and a tendency for higher obesity in populations living in warmer climates. Our review indicated interesting associations between long-term exposure to unusual temperature levels in specific areas and differences in health outcomes and cardiovascular risk factors between geographical locations with different climate, but the number of studies by design and health outcome was small. Risk of bias was identified because of the use of crude exposure assessment and inadequate adjustment for confounding. More and better designed studies, including the investigation of effect modifiers, are needed.

The aim of the present study was to investigate the relationship between green areas and adolescents' body mass index (BMI). This is based on the notion that nature environment is known to have beneficial effects on human health, and that some of the explanation for this is that green areas are especially motivating or suitable as arenas for physical activity. We included 10,527 participants from the Norwegian Youth Study, which was conducted between 2001 and 2004. The participants reported body weight, height, and important potential confounding variables about lifestyle, family situation, and neighbourhood characteristics. Green area was assessed from land cover maps and we calculated the percentage of green areas within 1 km and 5 km buffers around the adolescents' schools. We found that the percentage of overweight and obese adolescents increased significantly when the percentage of green areas in the participants' surrounding increased (p, Highlights • Prevalence of overweight among Norwegian adolescents varies dependent on greenness. • The prevalence is highest in most green areas and lowest in less green areas. • Physical activity and active transportation are independent explanatory factors. • Health promoting activities should be understood better in rural areas in Norway.

This study aims to assess the prevalence of different modes of commuting to school and work for 10–12 year-olds and their parents; to assess the associations with demographic variables (country, sex, parental education and ethnicity) and with weight status in eight European countries. As part of the ENERGY project a cross-sectional survey was conducted in 2010 in which modes of commuting and socio-demographic variables for children (N = 7903) and one of their parents (n = 6455) were measured by questionnaires. Children's weight and height were objectively measured; parents self-reported their weight and height. Logistic multilevel regression analyses assessed the associations between mode of commuting and overweight. Differences between countries and differences in mode of commuting according to demographic variables were tested using χ2-test and Marascuilo's Post-hoc analysis. There were marked differences between countries, especially regarding cycling to school, which was common in The Netherlands and Norway and rare in Greece and Spain. Demographic variables were associated with mode of commuting in children and parents. Mode of commuting was not associated with being overweight in children, after adjustment for demographic variables. Bicycling to work, but not other modes of commuting, was significantly inversely associated with being overweight among parents (OR = 0.74 (95%CI 0.57–0.97)). Interventions targeting active commuting may promote cycling, and should take into account the differences regarding demographic variables.

Author´s accepted manuscript Impaired health-related quality of life (HRQoL) is common in bariatric surgery candidates and is often one of the motivating factors for seeking bariatric surgery. Although many studies have reported changes in HRQoL after bariatric surgery, few are long-term prospective studies and no systematic review has been conducted. A systematic database search identified studies reporting HRQoL preoperatively and ≥ 5 years after bariatric surgery. Change in HRQoL over time was the outcome variable, divided into primary and secondary outcomes. Seven prospective cohort studies met the inclusion criteria. Eight HRQoL measures and six surgical methods were identified. Longterm follow-up time ranged from 5-10 years, sample sizes from 44 to 655 patients, and follow-up rates from 61 to 92%. None of the seven studies were randomized controlled trails and only two studies used control groups. Six out of seven studies showed statistically significant improvements in all of the primary outcomes, while one study showed statistically significant improvements in one of two primary outcomes. Of the statistically significant HRQoL improvements, 92 percent were clinically meaningful. Peak improvements in primary HRQoL outcomes were typically observed during the first years of follow-up, followed by a gradual decline that seemed to stabilize five years postoperatively. Long-term HRQoL scores typically remained improved relative to preoperative scores but were somewhat below population norm scores. In conclusion, while bariatric surgery candidates reported impaired HRQoL pre-surgically, their HRQoL improved considerably after bariatric surgery and much of the initial HRQoL improvements were maintained over the long term.

This article is designed as ”Open Access”. This is the journal's PDF originally published in Journal of Diabetes and its Complications, http://dx.doi.org/10.1016/j.jdiacomp.2013.07.006 To review the most important moral challenges following from the widespread use of bariatric surgery for type 2 diabetes for patients with BMI < 35 kg/m2, although high quality evidence for its short and long term effectiveness and safety is limited. Methods Extensive literature search to identify and analyze morally relevant issues. A question based method in ethics was applied to facilitate assessment and decision making. Results Several important moral issues were identified: assessing and informing about safety, patient outcomes, and stakeholder interests; acquiring valid informed consent; defining and selecting outcome measures; stigmatization and discrimination of the patient group, as well as providing just distribution of health care. The main sources of these challenges are lack of high quality evidence, disagreement on clinical indications and endpoints, and the disciplining of human behavior by surgical interventions. Conclusion A lack of high quality evidence on the effect of bariatric surgery for the treatment of T2DM in patients with BMI < 35/kg/m2 poses a wide variety of moral challenges, which are important for decisions on the individual patient level, on the management level, and on the health policy making level. Strong preferences among surgeons and patients may hamper high quality research.

Purpose: Early growth patterns have been associated with subsequent obesity risk. However, findings from middle-income populations suggest that early infant growth may benefit lean mass and height rather than adiposity. We tested the hypothesis that rapid weight or length gain in different growth periods would be associated with size and body composition in adolescence, in a prospective birth cohort from southern Brazil. Methods: Body composition was assessed in 425 adolescents (52.2% male) at 14 years. Exposures were birth weight z-score and conditional growth in weight or length for the periods 0–6, 6–12 and 12–48 months. Differences in anthropometric and body composition outcomes between tertiles of growth in each period were tested by one-way analysis of variance. Results: Size at birth and conditional weight and length at 6 months were associated with later height. The effect of infant weight gain on lean mass was greater for males than females, and effect on fat mass greater for females than males. By early childhood, rapid weight gain generated relatively similar effects on both tissue masses in both sexes. Rapid length gain had stronger effects on outcomes in males than females at each time point, and benefited lean mass more than adiposity. All effects were substantially attenuated after adjusting for current height. Early weight gain was more important than length gain at influencing body composition outcomes in adolescence. Conclusions: Rapid infant weight and length gains were primarily associated with larger size in adolescence rather than increased adiposity. From one year onwards, associations between rapid weight gain and fat and lean masses remained after adjustment for height.

To examine the strength and direction of the relationship between physical activity level, screen use and BMI in a cohort at ages 6, 8, 10 and 14 yrs as part of a prospective longitudinal cohort study. The sample comprised 1403 males and females who participated in the followup survey at 14 yrs of age between 2003 and 2005. Exploratory structural equation modelling was used to examine the interrelationships between physical activity level, BMI and screen time at 6, 8, 10 and 14 yrs. Predictors of BMI at 6, 8, 10 and 14 yrs explained 1.3, 76.1, 80.1 and 73.1 percent of the variances, respectively, with previous BMI the largest predictor [χ 2 = 43.082, df = 36, p = 194]. Increased screen time predicted higher BMI and lower physical activity at 8 and 10 yrs but not 14 yrs. At 14 yrs, physical activity predicted BMI. Sedentary patterns of behaviour in early childhood were predictive of later and concurrent obesity, whereas physical activity was predictive of obesity in adolescence. Different intervention targets are required for children and adolescents. © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Dette er en post-print forfatterversjon. For forlagsversjon, se Surgery for obesity and related diseases, tilgjengelig online at http://www.soard.org/article/S1550-7289%2808%2900835-6 Background The relationship among musculoskeletal pain, depression, and health-related quality of life in patients with severe obesity who are accepted for bariatric surgery should be explored further. Methods In this cross-sectional study, we measured the health-related quality of life using the generic questionnaire “Short-Form 36 Health Status Survey.” Multiple regression analysis was used to explore associations between the predictors (musculoskeletal pain and depression) and the physical cumulative summary (PCS) and mental cumulative summary (MCS). Age, gender, body mass index, and the number of co-morbidities were entered as covariates. Results The study subjects included 28 women and 23 men, with a mean age of 37.7 years and a mean body mass index of 51.9 kg/m2. The PCS and MCS scores were very poor compared with the age- and gender-adjusted population norm (P

We thank Dr. Galland for very correctly pointing out that our list of potential explanations for why there may be increases in obesity beyond diet and exercise is incomplete. In addition to organic pollutants [1], chemicals in our environment [1], weight cycling [2], pharmaceutical prescriptions [3], higher maternal age [4], reduction in variability of ambient temperature [5], decreased prevalence of smoking [6], inadequate sleep [7], low calcium [8] and intestinal bacteriome [9] cited in the manuscript, Dr. Galland has eloquently explained how allergic disorders may also contribute to obesity and vice versa. However, there are many more factors that have also been reported to be associated with obesity. In fact, the recent Downey Report in 2015 [10] lists 104 putative causes of obesity cited in scientific peer reviewed papers. Clearly, this highlights how there may be numerous factors that may potentially alter our physiology and contribute to rise in obesity beyond diet and exercise. In view of all this evidence it is surprising to us that the public, and many researchers, health professionals and individuals with obesity still consider obesity to be a simple matter of will power and that eating less and exercising more is the solution. Given that even bariatric surgery, our most effective obesity treatment, rarely returns an individual to a normal weight status work is needed to undo these misconceptions and develop more novel and comprehensive obesity interventions.