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BACKGROUND Minimally invasive heart valve surgery has previously been shown to be safe and feasible in obese patients. Within this population, we investigated the effect of obesity class on the patient outcomes of minimally invasive aortic valve replacement (mini-AVR). METHODS A single-center retrospective cohort study of consecutive patients with obese body mass indices (BMIs) who underwent mini-AVR between 2012 and 2020. Patients were stratified into three groups according to Centers for Disease Control and Prevention adult obesity classifications: Class I (BMI: 30.0

In 2020, updated versions of the clinical practice guidelines of the European Association for Endoscopic Surgery, the Canadian Adult Obesity Clinical Practice Guidelines and the Dutch Federation for Medical Specialist clinical practice guidelines on bariatric surgery were published. We systematically reviewed and compared them on recommendations and references. Although the authors would have had access to the same literature, only 5 out of 655 unique references were used by all 3 guidelines and just 49 references by any combination of 2 guidelines. These findings attest to the subjectivity involved in clinical practice guidelines development and could be the cause for the observed differences in recommendations. International cooperation in guideline development might be a conceivable solution.

Purpose Obesity that occurs in adulthood is influenced by various factors, not only energy balance, especially concerning the amount of energy consumed, but also heredity. The hereditary factors of obese parents on childhood obesity have been studied, but what about adulthood? This study examines the relationship between a history of obesity in adolescence, and maternal and paternal incidences of adult obesity. Patients and Methods This study was a cross-sectional study that included adult men and women aged 20–60 years old. The subjects had no chronic or metabolic disease. This research was conducted from April to November, 2020, in North Sumatra Province, Indonesia. The parameters studied were demographics, daily food intake, anthropometry and a history of obesity in adolescence, and for the participants’ fathers and mothers. The statistical test used was the chi-squared test/Fisher test. Results This study included 136 research subjects, 60 male and 76 female; based on the results of the study, 47.8% were found to be obese, but food intake showed a low intake (96.2%). There was a significant relationship between a history of obesity in adolescence and incidences of obesity (≥30 kg/m2) in the mother and father, with significance values of p=0.01, p=0.004, and p=0.001, respectively. Conclusion This study found that there was a significant relationship between a history of obesity in adolescence and incidences of adult obesity (≥ 30kg/m2) in parents, but not with the level of food intake per day. The risk of obesity will increase further with a history of obesity in parents and obesity in adolescence, and this can be used to understand and prevent obesity., Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/xQs0Dh_2jKE

Background: Childhood obesity is associated with an increased risk of adult obesity and related chronic disease. Our aim was to identify modifiable exposures that are independently associated with obesity in the preschool age group. Methods: A prospective cohort study of 5734 children in New Zealand with anthropometric measurements was completed at age 4.5 years. The modifiable exposures of interest, measured at age 9 months and 2 years, were: food security during infancy; and, at age 2 years, screen time; sleep duration; and takeaway food and soft drink intake. The risk of obesity independently associated with each exposure was determined using Binomial and Poisson regression and described using adjusted risk ratios (RRs) and 95% confidence intervals (CIs), after controlling for confounding variables including gender, ethnicity, birth weight, and mother's age. The probability of obesity given cumulative exposures to the four risk factors and the population attributable fraction (PAF) were estimated. Results: Lower food security during infancy (1 hour/day; RR = 1.22; 95% CI : 1.01–1.48), shorter sleep duration (≤11.5 hours/day; RR = 1.30; 95% CI : 1.05–1.61), and weekly to daily consumption of takeaway/soft drink (RR = 1.25, 95% CI : 1.00–1.57) were independently associated with an increased risk of obesity at age 4.5 years. The cumulative PAF for childhood obesity was 42.9%, under an ideal scenario where all risk factors were eliminated. Conclusion: Exposure to modifiable factors by age 2 years is associated with obesity at age 4.5 years. Interventions to prevent childhood obesity need to be effective during infancy. Refereed/Peer-reviewed

Background: Among adults, weight stigma is associated with markers of poor cardiometabolic health. Although weight-based teasing (WBT) is common among youth with high body weight, few studies have examined its associations with cardiometabolic markers. Owing to unique stressors (e.g., parental deployment and frequent moves), military-dependent youth may be at particularly high risk for obesity, WBT, and poor cardiometabolic health. We, therefore, assessed associations between WBT and cardiometabolic health markers among adolescent military dependents presenting for a weight gain prevention trial. Methods: Participants underwent fasting phlebotomy; had fasting weight, height, and waist circumference measured; and completed assessments of WBT, anxiety, and loss-of-control eating. Multivariate analysis of covariance, adjusting for relevant covariates including demographics and body composition, was used to examine differences in metabolic syndrome (MetS) components (waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose) between youth reporting WBT and youth reporting no WBT. Bootstrapped models examined whether WBT mediated the relationship between BMIz and MetS components. Results: Data from 142 youth (57.7% female; 14.4 ± 1.6 years; 51.2% non-Hispanic White, 20.9% non-Hispanic Black; BMIz: 1.9 ± 0.4) were analyzed. WBT was not significantly associated with any MetS component. Relationships were observed between BMIz and all MetS components (except systolic blood pressure and glucose), although WBT did not significantly mediate these relationships (p's > 0.05). Conclusions: This study did not find support for a relationship between WBT and MetS components in adolescent military dependents at risk for adult obesity. Prospective research is needed to determine whether associations between WBT and adverse cardiometabolic outcomes emerge primarily in adulthood.

Obesity affects 2 of 5 Americans, and nearly 1 of 10 is considered severely obese, with the greatest risk of morbidity and mortality. A reduction in body weight of 2% to 5% can lead to improvements in cardiovascular health, with weight loss maintenance associated with the best health outcomes. Lifestyle interventions that focus on changes in diet and physical activity behaviors are best to maintain weight loss. This article provides a review of the treatment of adult obesity with a focus on dietary interventions.

Introduction: The aim of this study was to assess the efficacy of choline and DHA or exposure to environmental enrichment in obese adult and aging rats on alterations in body mass index, serum lipid profile and arterial wall changes, despite stopping high fat diet consumption and interventions during adulthood. Methods: 21 day old male Sprague Dawley rats were assigned as Experiment-1 & 2 - PND rats were divided into 4 groups with interventions for 7 months (n = 8/group). NC– Normal control fed normal chow diet; OB- Obese group, fed high fat diet; OB + CHO + DHA- fed high fat diet and oral supplementation of choline, DHA. OB + EE- fed high fat diet along with exposure to enriched environment . Experiment-2 had similar groups and interventions as experiment 1 but for next 5 months were fed normal chow diet without any interventions. Body mass index was assessed and blood was analyzed for serum lipid profile. Common Carotid Artery (CCA) was processed for Haematoxylin and eosin, Verhoff Vangeison stains. Images of tissue sections were analyzed and quantified using image J and tissue quant software. Results: In experiment.1, mean body mass index (p < 0.001), serum lipid profile (p < 0.01), thickness of tunica intima (p < 0.05), tunica media (p < 0.01) and percentage of collagen fibers (p < 0.01) of CCA were significantly increased in OB compared to NC. These were significantly attenuated in OB + CHO + DHA and OB + EE compared to OB. In experiment.2, mean body mass index (p < 0.01), serum lipid profile (p < 0.05) and thickness of tunica media of CCA (p < 0.01) were significantly increased in OB compared to NC. In OB + CHO + DHA and OB + EE, significant attenuation was observed in mean body mass index and mean thickness of tunica media compared to same in OB. Conclusion: Adult obesity has negative impact on body mass index, serum lipid profile and arterial wall structure that persists through aging. Supplementation of choline and DHA or exposure to enriched environment during obesity attenuates these negative impacts through aging.

Objective: The objective is to evaluate data sets for children aged 24 to 59 months that identified the risk factors of being obese and overweight and compare it between two U.S. states (Alabama and Delaware). Methods: An analysis of survey data sets published between 2013 and 2017, comparing the factors of obesity and its prevalence amongst different races of 50,760 children aged 24 to 59 months in the U.S., was conducted using Microsoft Excel 2016 and IBM SPSS version 1.0.0. Results: Hispanic children have the highest rate of obesity in the U.S compared to all other races. Children aged 2 - 4 years old from Alabama were more at risk for being overweight and obese compared to those from Delaware. Those between the ages of 48 - 59 months of age were more at risk than the other age groups. Conclusions: Childhood obesity is a predisposing factor for adult obesity. There is a need to identify the risk factors of obesity early in a person’s life and address them appropriately.

Purpose of the ReviewPathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges.Recent FindingsEvidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care.SummaryMore emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it.

Background/objectives Childhood rapid growth and earlier puberty onset have been associated with adult obesity. However, the association between childhood stunting, pubertal timing and adult obesity is unclear. We examined whether the relationship between stunting at age 2 years (y) and body composition at 23 years is mediated by adolescent body mass index, and pubertal development, using the Birth-to-Twenty Plus cohort (South Africa). Subjects/methods For 1036 participants, data on anthropometrics between birth and 23 years, maternal factors, and pubertal development (Tanner scale at 9–16 years) were collected. Stunting at 2 years (height-for-age z-score Results Stunting was directly associated with slower pubertal development and with shorter adult stature, but was not associated with adolescent BMI trajectories, adult FM or FFM. However, stunting was indirectly associated with adult FM and FFM through the direct associations between slower pubertal development and lower FM and between shorter height and lower FFM. BMI trajectories were independently associated with FM and FFM. Conclusions Being stunted in this population predicted adult body composition through slower pubertal development and shorter adult stature.

Both medication and surgical interventions can be used to treat obesity, yet their use and effectiveness in routine clinical practice are not clear. This study sought to characterize the prevalence and management of patients with obesity within a large U.S. academic medical center.All patients aged ≥18 years who were seen in a primary care clinic within the Duke Health System between 2013 and 2016 were included. Patients were categorized according to baseline BMI as underweight or normal weight (25 kg/mOf the 173,462 included patients, most were overweight (32%) or obese (40%). Overall,1% (n=295) of obese patients were prescribed medication for weight loss or underwent bariatric surgery within the 3-year study period. Most patients had no change in BMI class (70%) at 3 years.Despite a high prevalence of obesity within primary care clinics of a large, U.S. academic health center, the use of pharmacologic and surgical therapies was low, and most patients had no weight change over 3 years. This highlights the significant need for improvement in obesity care at a health system level.

Purpose: This study aims to investigate the impact of disadvantaged neighborhoods and lifestyle factors on obesity among Australian adults. Design: Quantitative, longitudinal research design. Setting: Cohort. Sample: Data for this study came from a cohort of 10 734 adults (21 468 observations) who participated in the Household, Income and Labour Dynamics in Australia survey. The participants were interviewed at baseline in 2013 and were followed up in 2017. Measures: Generalized Estimating Equation model with logistic link function was employed to examine within-person changes in obesity due to disadvantaged neighborhoods and lifestyle factors at 2-time points over a 4-year follow-up period. Results: Adults living in the most disadvantaged area were 1.22 (odds ratio [OR]: 1.22, 95% CI: 1.08-1.38) and 1.30 (OR: 1.30, 95% CI: 1.20-1.42) times, respectively, more prone to be overweight and obese compared with peers living at least disadvantaged area. Study results also revealed that adults who consume fruits regularly and perform high levels of physical activity were 6% (OR: 0.94, 95% CI: 0.91-0.98) and 12% (OR: 0.88, 95% CI: 0.85-0.92) less likely to be obese, respectively, compared to their counterparts. Current alcohol drinkers were 1.07 (OR: 1.07, 95% CI: 1.01-1.13) times more likely to be obese compared to peers not consuming alcohol. Highly psychologically distressed adults were 1.08 times (OR: 1.08, 95% CI: 1.02-1.13) more likely to be obese than their peers. Conclusion: This study contributes to the literature regarding disadvantaged neighborhoods and lifestyle factors, which have an influence on adult obesity rates and thus help health decision-makers to formulate effective obesity prevention strategies.

Objective:To evaluate the impact of a multi-level, multi-component (MLMC) adult obesity intervention on beverage intake in Native American adults living in five geographically and culturally diverse tribal communities.Design:A 14-month, community-randomised, MLMC design was utilised, with three communities randomised to Intervention and two communities randomised to Comparison. FFQ were administered pre- and post-interventions, and difference-in-differences (DiD) analysis was used to assess intervention impact on beverage intake.Setting:The intervention took place within food stores, worksites, schools and selected media outlets located in the five communities. Key activities included working with store owners to stock healthy beverages, display and dispersal of educational materials, support of policies that discouraged unhealthy beverage consumption at worksites and schools and taste tests.Participants:Data were collected from 422 respondents between the ages of 18 and 75 living in the five communities pre-intervention; of those, 299 completed post-intervention surveys. Only respondents completing both pre- and post-intervention surveys were included in the current analysis.Results:The DiD for daily servings of regular, sugar-sweetened soda from pre- to post-intervention was significant, indicating a significant decrease in Intervention communities (P < 0·05). No other changes to beverage intake were observed.Conclusions:Large, MLMC obesity interventions can successfully reduce the intake of regular, sugar-sweetened soda in Native American adults. This is important within modern food environments where sugar-sweetened beverages are a primary source of added sugars in Native American diets.

Funder: Sue and Bob O'Donnell, Summary: Biases introduced in early���stage studies can lead to inflated early discoveries. The risk of generalizability biases (RGBs) identifies key features of feasibility studies that, when present, lead to reduced impact in a larger trial. This meta���study examined the influence of RGBs in adult obesity interventions. Behavioral interventions with a published feasibility study and a larger scale trial of the same intervention (e.g., pairs) were identified. Each pair was coded for the presence of RGBs. Quantitative outcomes were extracted. Multilevel meta���regression models were used to examine the impact of RGBs on the difference in the effect size (ES, standardized mean difference) from pilot to larger scale trial. A total of 114 pairs, representing 230 studies, were identified. Overall, 75% of the pairs had at least one RGB present. The four most prevalent RGBs were duration (33%), delivery agent (30%), implementation support (23%), and target audience (22%) bias. The largest reductions in the ES were observed in pairs where an RGB was present in the pilot and removed in the larger scale trial (average reduction ES ���0.41, range ���1.06 to 0.01), compared with pairs without an RGB (average reduction ES ���0.15, range ���0.18 to ���0.14). Eliminating RGBs during early���stage testing may result in improved evidence.

이 연구는 2017년도 국민건강영양조사 자료를 통해 우리나라 성인 비만의 성별의 차이에 따른 운동습관, 주관적 건강상태 및 영양섭취상태의 차이를 규명함으로써 성인 남녀 비만의 치료전략의 기초자료를 제공하기 위해 실시되었다. 체질량지수(BMI)가 25kg/m2 이상으로 비만에 해당하는 19세 이상 65세 미만의 성인 남녀를 대상으로 선정하였는데, 남성은 772명, 여성은 595명으로 총 1,367명이 선정되었다. 주요 연구결과를 살펴보면 운동습관의 경우 여가 관련 고강도 활동량, 여가 관련 중강도 활동량, 총 활동량에서 여성이 남성보다 유의하게 낮은 것으로 나타났고, 평소 하루 앉아서 보내는 시간은 남성이 여성보다 유의하게 높은 것으로 나타났다. 성별에 따른 주관적 건강상태는 유의한 차이가 나타났으며(χ² =28.902, p

Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity.We developed methods to correct for self-reporting bias and to estimate state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI). BMI data reported by 6,264,226 adults (18 years of age or older) who participated in the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias with the use of measured data from 57,131 adults who participated in the National Health and Nutrition Examination Survey. We fitted multinomial regressions for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI [the weight in kilograms divided by the square of the height in meters],25), overweight (25 to30), moderate obesity (30 to35), and severe obesity (≥35). We evaluated the accuracy of our approach using data from 1990 through 2010 to predict 2016 outcomes.The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low-income adults (31.7%; 95% CI, 30.2 to 33.2).Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with large disparities across states and demographic subgroups. (Funded by the JPB Foundation.).

Despite the rising incidence of childhood obesity, international data from Eurostat show that the prevalence of obesity among those aged 15-19 years remains under 5%, which offers an important opportunity for preventing subsequent adult obesity. Young people engage poorly, even obstructively, with conventional health initiatives and are often considered 'hard to reach'. However, when approached in the language of youth, via IT, they express great concern, and unwanted weight gain in young people can be prevented by age-appropriate, independent, online guidance. Additionally, when shown online how 'added value' by industry can generate consumer harms as free market 'externalities', and how obesogenic 'Big Food' production and distribution incur environmental and ethical costs, young people make lasting behavioural changes that attenuate weight gain. This evidence offers a novel approach to obesity prevention, handing the initiative to young people themselves and supporting them with evidence-based methods to develop, propagate and 'own' social movements that can simultaneously address the geopolitical concerns of youth and obesity prevention.

In this study, we evaluated the relationship between circulating betatrophin levels and obesity. Obesity is a common public health problem that is increasing globally. Betatrophin, a newly identified protein, is predominantly expressed in white and brown fat tissues and in the liver. Growing evidence suggests that betatrophin plays a pivotal role in metabolism, including the synthesis and degradation of lipids in cells, and adipocyte differentiation. Previous studies have assessed the association between circulating betatrophin levels and obesity; however, this relationship remains unclear. Therefore, our study is aimed at examining the impact of betatrophin on obesity using a meta-analysis of the current evidence. We performed a meta-analysis to quantify the relationship between betatrophin levels and obesity. A literature search was conducted through the EMBASE, Web of Science, and MEDLINE databases. Retrieved studies were screened, without any language restrictions to identify relevant literature published up to December 2018. Observational studies, in which the association between circulating concentrations of betatrophin and obesity was evaluated, were considered suitable for the systematic review. Of the 65 manuscripts retrieved, 9 datasets from 6 studies, involving 681 participants, detected an association between circulating betatrophin and obesity. Circulating betatrophin levels of obese subjects were higher than those of nonobese subjects (random−effects weighted mean difference WMD=0.250 μg/mL, 95% CI: 0.048–0.451, I2=94.8%, p=0.015), yet with significant between-study heterogeneity. This heterogeneity appeared to be modified by glycemic status but not by age, the ELISA kits used, sample source, or body mass index. The high circulating betatrophin concentration may directly increase the risk of obesity in adults. Betatrophin may serve as a therapeutic target for obesity in adults.

Mexico ranks 2nd in adult obesity and 4th in milk intake worldwide. Low levels of IGF-1 have been related to obesity and can be reverted by milk intake. The rs6214 polymorphism has been associated with an increase in the expression of IGF-1. Therefore, the aim of the study was to evaluate the association between both, rs6214 polymorphism and milk intake, and obesity. We analysed 99 adult volunteers, with and without a history of milk intake, for the presence of this polymorphism through qPCR and body composition by electro-bioimpedance. Univariate logistic regression analyses showed that TT genotype is inversely associated with obesity and body fat mass. Besides, milk intake is also related to low obesity, body fat mass and visceral fat, and high percentage of lean mass. Multivariate logistic regression analyses confirm the univariate relationships, showing a clear inverted association between TT genotype, milk intake and obesity.

Objective The aim of this work is to develop a practical, tangible, measurable, and simple standard of care for the treatment of adult obesity that provides guidance for both clinical providers and community settings. Methods Three roundtables with relevant stakeholder groups were convened by the STOP Obesity Alliance at The George Washington University to develop the proposed standard of care. Results The proposed standard of care for adult obesity treatment proposes practices for the spectrum of clinical, community, and digitally based entities and for clinical providers. Coverage and payment policy standards are also provided. Conclusions These standards are intended to augment published guidelines developed for obesity care providers and can also be viewed as the first step to define an optimal benefit package.

BackgroundChildhood obesity has been associated with increased odds of adult obesity and co-morbidities in later life. Finding the key determinants may help in designing the most appropriate and effective interventions to prevent obesity. This study aimed to identify the determinants of obesity among school adolescents in a sub-urban state of Malaysia.MethodsThis cross-sectional study involved 1,404 school adolescents aged 12 years (46% boys and 54% girls). Socio-demographic, dietary and physical activity data were collected using questionnaires whilst body weight and height were measured and body mass index was classified based on WHO BMI-for-age Z-scores cut-off.ResultsA multivariable linear regression model showed that BMI z-score was positively associated with parents’ BMI (PP=0.003), and serving size of milk and dairy products (P=0.036) whilst inversely associated with household size (P=0.022). Overall, 13.1% of the variances in BMI Z-scores were explained by parents’ BMI, birth weight, servings of milk and dairy products and household size.ConclusionThis study found important determinants of body weight status among adolescents mainly associated with family and home environmental factor. This evidence could help to form the effective and tailored strategies at the earliest stage to prevent obesity in this population.

The purpose of the proposed study is to classify the thermal images of abdomen, forearm, and shank regions in obesity and normal subjects using the Speeded Up Robust Feature (SURF)-based machine learning classifiers compared to the convolutional neural network. Total populations of 60 subjects, among which 30 normal and 30 obese subjects, were recruited for the proposed study. The thermal images were acquired in abdomen, forearm, and shank regions using FLIR thermal camera (FLIR A300). SURF-based feature extraction method is used along with SVM classifiers for binary classification of adult obesity and normal subjects. After data augmentation process, convolution neural network VGG19 is used for the classification of obesity and normal subjects, and its performance is compared with SVM classifiers. The SURF-based SVM classifier provides an accuracy of 93% compared to VGG19 net. The machine learning classifier provided better results compared to the pre-trained models in CNN in the thermal image obesity analysis.

There have been increasing concerns about adverse effects and drug interactions with meperidine. The goal of this study was to characterize meperidine use in the United States. Meperidine distribution data were obtained from the Drug Enforcement Administration's Automated of Reports and Consolidated Orders System. The Medicare Part D Prescriber Public Use File was utilized to capture overall trends in national prescriptions in this observational report. Nationally, meperidine distribution decreased by 94.6% from 2001 to 2019. In 2019, Arkansas, Alabama, Oklahoma, and Mississippi saw significantly greater distribution when compared with the US state average of 9.27 mg per 10 persons (SD = 6.82). Meperidine distribution showed an 18‐fold difference between the highest state (Arkansas = 36.8 mg) and lowest state (Minnesota = 2.1 mg). Five of the six states with the lowest distribution were in the Northeast. Meperidine distribution per state was correlated with the prevalence of adult obesity (r(48) = +0.48, p, Meperidine distribution per 10 persons by state in 2019 as reported by the US Drug Enforcement Administration's Automated Reports and Consolidated Orders System. There was an 18‐fold difference between the highest and lowest states. *p

This study aimed to explore the relationship between obesity-related glomerulopathy (ORG) and Helicobacter pylori (HP) infection in adults. Therefore, an artificial intelligence health data monitoring system was established based on the partial differential network mathematical model. The 13C breath test method was applied to detect HP infection in the research objects. A total of 130 patients were included in this study, and rolled into an experimental group (test results were negative) and a control group (test results were positive) according to the results of the 13C breath test. The results showed that there were 83 patients (63.85%) with HP-positive infection and 47 patients (36.15%) with HP-negative infection. The serum creatinine (SCr), 24-hour urine protein level, and the proportions of patients with damaged renal tubules, abnormal retinol-binding protein (RBP), and abnormal N-aceltyl-D-glucosaminidase (NAG) of the patients in the experimental group were markedly higher than those of the control group (P

We performed this systematic review and meta-analysis to evaluate observational studies assessing the association between ultra-processed food (UPF) consumption and the risk of overweight, obesity, and abdominal obesity in the general population. We searched the databases PubMed/MEDLINE, Scopus, Embase, and ISI Web of Science from inception until December 2020. Data were extracted from 12 studies (nine cross-sectional and three cohort studies). Odds ratio (OR) were pooled using a random-effects model. UPF consumption was associated with an increased risk of obesity (OR = 1.55; 95% CI: 1.36, 1.77; I2 = 55%), overweight (OR = 1.36; 95% CI: 1.14, 1.63; I2 = 73%), and abdominal obesity (OR = 1.41; 95% CI: 1.18, 1.68; I2 = 62%). Furthermore, every 10% increase of UPF consumption in daily calorie intake was associated with a 7%, a 6%, and a 5% higher risk of overweight, obesity, and abdominal obesity, respectively. Dose-response meta-analysis of cross-sectional studies showed a positive linear association between UPF consumption and abdominal obesity. There was also a positive linear association between UPF consumption and risk of overweight/obesity in the analysis of cross-sectional studies and a positive monotonic association in the analysis of cohort studies. Our study suggests that UPF consumption is associated with an increased risk of excess weight or abdominal obesity.

Adult obesity may be positively associated with risks of rheumatoid arthritis (RA), but associations with early life body size are unknown. We examined whether birthweight, childhood body mass index (BMI), height, and changes in BMI and height were associated with risks of adult RA. A cohort of 346 602 children (171 127 girls) from the Copenhagen School Health Records Register, born in 1930–1996, with measured weights and heights from 7 to 13 years of age, were included. Information on RA, including serological status, came from national registers from 1977 to 2017. Cox regressions were performed. During a median of 35.1 years of observation time per person, 4991 individuals (3565 women) were registered with RA. Among girls, per BMI z-score, risks of RA and seropositive RA increased by 4–9% and 6–10%, respectively. Girls with overweight had higher risks of RA than girls without overweight. Girls who became overweight by 13 years of age had increased risks of RA compared to girls without overweight at 7 or 13 years (hazard ratio = 1.40, 95% confidence interval 1.19–1.66). For boys, associations between BMI and RA (including seropositive RA) were not statistically significant. Height was not associated with RA (any type) in girls. Taller boys had higher risks of RA, especially seropositive RA. Birthweight was not associated with RA. Among women, childhood adiposity was associated with increased risks of RA. Among men, childhood height was positively associated with risks of RA. These findings support the hypothesis that early life factors may be important in the aetiology of RA.

[Abstract] Obesity is one of the great challenges in healthcare nowadays with important implications for health so requiring comprehensive management. This document aims to establish practical and evidence-based recommendations for the diagnosis and management of in Spain, from the perspective of the clinical endocrinologist. A position statement has been made that can be consulted at www.seen.es, and that has been agreed by the Obesity Group of the Spanish Society of Endocrinology and Nutrition (GOSEEN), together with the Nutrition Area (NutriSEEN) and the Working Group of Endocrinology, Nutrition and Physical Exercise (GENEFSEEN). [Resumen] La obesidad supone uno de los grandes retos en salud en la actualidad. Las importantes repercusiones que implica obligan a un manejo integral. El presente documento tiene como objetivo establecer recomendaciones prácticas y basadas en la evidencia para el diagnóstico y el manejo de la obesidad en España, desde la perspectiva del endocrinólogo clínico. Se ha realizado un documento de posicionamiento que puede consultarse en www.seen.es, que ha sido consensuado por el Grupo de Obesidad de la Sociedad Española de Endocrinología y Nutrición (GOSEEN), junto con el Área de Nutrición (NutriSEEN) y el Grupo de trabajo de Endocrinología, Nutrición y Ejercicio Físico (GENEFSEEN).

Childhood and adolescent obesity affects nearly 20% of the US pediatric population, and this trend has been increasing. Metabolic and bariatric surgery has become a standard of care for the treatment of adult obesity, but the application of surgical therapy to the pediatric population raises multiple ethical issues. Utilizing the framework of medical ethics, we seek to define and discuss the challenges raised by the ethical constructs of autonomy, beneficence, non-maleficence, and justice. By appropriately recognizing the ethical issues involved in the surgical management of pediatric obesity, members of a child’s care team can more appropriately recognize which patients may be appropriate candidates for bariatric surgery.

Childhood maltreatment has been shown to relate to adult obesity. In this epidemiological study, we investigate the association between childhood maltreatment and waist-to-height-ratio (WHtR) in a sample of the German adult population, comprising of N = 2936 participants. WHtR, an indicator for risk of obesity, was the primary outcome. Childhood maltreatment was assessed by the Childhood Trauma Screener (CTS), which assesses emotional and physical neglect, abuse as well as sexual abuse. Cohort-data were harmonized and analyzed within DataSHIELD. We used multivariable regression models to estimate the association of childhood maltreatment and WHtR at different levels of adjustments for potential confounders. Overall childhood maltreatment was associated with a higher WHtR in both sexes (women: p = 0.004, men: p

Introduction: Obesity is associated with comorbidities that may be detrimental to single-ventricle patients who have had a Fontan procedure. We assessed the prevalence of obesity in adults with a Fontan circulation and evaluated the hypothesis that higher body mass index (BMI) in early childhood is associated with obesity in adulthood. Methods: Retrospective cohort study of patients with a Fontan circulation aged 18-32 years, seen 2011-2019. Those with an atriopulmonary Fontan or chromosomal abnormality known to affect growth were excluded. Historical height and weight measurements, results of recent cardiac testing, and body mass index (BMI) over time were recorded. Obesity was defined as BMI ≥30 kg/m 2 . The associations between childhood anthropometrics, adult BMI, and most recent cardiac testing were assessed. Results: The cohort included 113 adults with a Fontan circulation (median age 22.7 [IQR 20.2-26.4] years; 44% female). There were no significant differences in age, age at Fontan, Fontan type, or ventricular morphology between obese (n=21, 19%; 52% female) and non-obese (n=92, 81%; 41% female) patients. Compared to non-obese adults, obese patients had higher BMI percentiles at age 2 years (80 th [33-95] vs 43 rd [13-82] percentile, p=0.02), at age 4 years (90 th [73-93] vs 57 th [22-81] percentile, p=0.002), and at the time of the Fontan procedure (85 th [51-98] vs 20 th [5-57] percentile, p=0.002). Being overweight at time of Fontan (BMI percentile >85%) strongly predicted later obesity (OR=18.3, 95% CI 3.7-90.3, p2 (19.1±5.2 vs 25.5±6.6 mL/kg/min, p2 (59±13 vs 65±14% predicted, p=0.06), higher systolic blood pressure (121±17 vs 112±12 mmHg, p=0.007) and higher ventricular end-diastolic pressure (11±4 vs 9±3 mmHg, p= 0.03). Adult BMI weakly correlated with ventricular end-diastolic pressure (r=0.24, p=0.048). Conclusions: Higher BMI in early childhood is associated with obesity in adults with a Fontan circulation. Adult obesity is associated with worse exercise capacity, higher blood pressure, and higher ventricular end-diastolic pressure. Weight interventions in children with a Fontan circulation may help prevent later obesity and its adverse consequences.

Fetal/infant growth affects adult obesity and morbidities/mortality and has been associated with prenatal exposure to cortisol. Bidirectional relations between maternal stress and breastfeeding suggest that they interact to influence offspring growth. No models have tested this hypothesis, particularly regarding longer-term offspring outcomes. We used a subset of the IDAHO Mom Study (n = 19&ndash, 95) to examine associations among maternal prenatal cortisol (cortisol awakening response (CAR) and area under the curve), and standardized weight-for-length (WLZ) and length-for-age (LAZ) z-scores from birth-18 months, and main and interactive effects of prenatal cortisol and breastfeeding on infant growth from birth-6 months. CAR was negatively associated with LAZ at birth (r = &minus, 0.247, p = 0.039) but positively associated at 13&ndash, 14 months (r = 0.378, p = 0.033), suggesting infant catch-up growth with lower birth weights, likely related to elevated cortisol exposure, continues beyond early infancy. A negative correlation between breastfeeding and 10-month WLZ (r = &minus, 0.344, p = 0.037) and LAZ (r = &minus, 0.468, p = 0.005) suggests that breastfeeding assists in managing infant growth. WLZ and LAZ increased from birth to 6 months (ps &lt, 0.01), though this was unrelated to interactions between prenatal cortisol and breastfeeding (i.e., no significant moderation), suggesting that other factors played a role, which should be further investigated. Findings add to our understanding of the predictors of infant growth.

Funder: Zhangjiang Lab, Funder: the Shanghai AI Platform for Diagnosis and Treatment of Brain Diseases, Funder: the Project of Zhangjiang Hi-Tech District Management Committee, Funder: Shanghai (grant 2016-17), Funder: BRIDGET (JPND: BRain Imaging, cognition Dementia and next generation GEnomics); Grant(s): MR/N027558/1, Funder: Associazione Emma e Ernesto Rulfo per la Genetica Medica (IT), Funder: the Swedish Research Council FORMAS, Funder: the Medical Research Council, Funder: the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, Funder: the Human Brain Project (HBP SGA 2), Funder: the Fondation de France, the Fondation pour la Recherche Médicale, Funder: the Assistance-Publique-Hôpitaux-de-Paris and INSERM (interface grant), Funder: Paris Sud University IDEX 2012, Funder: cross-NIH alliance that funds Big Data to Knowledge Centres of Excellence, Background: Childhood trauma increases the risk for adult obesity through multiple complex pathways, and the neural substrates are yet to be determined. Methods: Participants from three population-based neuroimaging cohorts, including the IMAGEN cohort, the UK Biobank (UKB), and the Human Connectome Project (HCP), were recruited. Voxel-based morphometry analysis of both childhood trauma and body mass index (BMI) was performed in the longitudinal IMAGEN cohort; validation of the findings was performed in the UKB. White-matter connectivity analysis was conducted to study the structural connectivity between the identified brain region and subdivisions of the hypothalamus in the HCP. Results: In IMAGEN, a smaller frontopolar cortex (FPC) was associated with both childhood abuse (CA) (β = − .568, 95%CI − .942 to − .194; p = .003) and higher BMI (β = − .086, 95%CI − .128 to − .043; p < .001) in male participants, and these findings were validated in UKB. Across seven data collection sites, a stronger negative CA-FPC association was correlated with a higher positive CA-BMI association (β = − 1.033, 95%CI − 1.762 to − .305; p = .015). Using 7-T diffusion tensor imaging data (n = 156), we found that FPC was the third most connected cortical area with the hypothalamus, especially the lateral hypothalamus. A smaller FPC at age 14 contributed to higher BMI at age 19 in those male participants with a history of CA, and the CA-FPC interaction enabled a model at age 14 to account for some future weight gain during a 5-year follow-up (variance explained 5.8%). Conclusions: The findings highlight that a malfunctioning, top-down cognitive or behavioral control system, independent of genetic predisposition, putatively contributes to excessive weight gain in a particularly vulnerable population, and may inform treatment approaches.

OBJECTIVE The purpose of this study was to determine whether having childhood depressive symptoms is a risk factor that prospectively predicts impairment in glucose homeostasis. RESEARCH DESIGN AND METHODS A non–treatment-seeking sample of 115 children (aged 5–13 years), oversampled for being at risk for adult obesity, was assessed at baseline and again ~6 years later. Children self-reported depressive symptoms using the Children’s Depression Inventory at baseline. Insulin resistance was assessed at baseline and follow-up with the homeostasis model assessment of insulin resistance index (HOMA-IR). RESULTS Children’s depressive symptoms were a significant predictor of follow-up HOMA-IR, fasting insulin, and fasting glucose in models accounting for baseline HOMA-IR, insulin, or glucose values; sex; race; baseline age; baseline BMI; change in BMI at follow-up; family history of type 2 diabetes; and time in the study (P < 0.01). CONCLUSIONS In this study, depressive symptomatology at baseline predicted the progression of insulin resistance during child and adolescent development independent of changes in BMI. Research is needed to determine whether early intervention to decrease elevated depressive symptoms in youth ameliorates later development of insulin resistance and lessens the risk of type 2 diabetes.

Background Obesity is a significant risk factor for Noncommunicable diseases, and it is related to many adverse health consequences. The risk of obesity commonly changes with age, which is called a longitudinal or aging effect. Also, individuals born or enter to the study of the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. In the current study, an advanced statistical model is used to distinguish between longitudinal and cross-sectional effects of age on the risk of obesity for men and women. Methods Participants are a group of 6504 Iranian adults over 35 years of age in 2001, who live in the central region of Iran. They were followed up for 12 years in a large community-based study. Various medical indexes, including Body Mass Index, were collected in 2001, 2007, and 2013. The Marginal Logistic Regression model, which includes linear and quadratic effects of the Baseline Age and its difference with current age, is used. Results Between 2001 and 2013, the prevalence of obesity raised from 13% to 18% in men and from 31% to 44% in women. The odds of obesity for women was approximately three times the odds of obesity for men on average adjusting for the age effects. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the prevalence of obesity for individuals with Baseline Age 35 to 55 and a decline thereafter. Also, the odds ratio of obesity across one’s life course, had about 3% increase, on average, by each year aging, regardless of the age at baseline. Conclusions The high rate of obesity and its fast growth is a serious public health issue among Iranians, especially in adults age 35-55, and women. In the present study, Baseline Age was more strongly associated with the risk of obesity than aging. Considering both cross-sectional and longitudinal effects of age, helps us to understand the effect of age on obesity better and to identify the related factors.

Reducing sugar-sweetened beverage (SSB) consumption is a leading strategy to help combat high rates of adult obesity and overweight. Regulating SSB sales in schools has reduced access among youth. However, current federal school nutrition standards are focused on student rather than staff environments (i.e. school staff lounges). This study examines the association between the availability of SSBs in school vending machines and school staff SSB consumption. The study sample included 51 public schools in California, Oregon, Washington, Maryland, and Washington DC participating in an evaluation of Kaiser Permanente’s Thriving Schools initiative in school year 2017–18. Data collection included: 1) observations of school cafeterias, staff lounges, stores and outdoor snack areas for the presence of, and content in, vending machines, and 2) an online survey of school staff about their SSB consumption. Fifty-nine percent (n = 1586) of staff responded to the survey; 1229 (77% of respondents) reported on SSB consumption. Thirty percent of schools had staff lounges with SSB vending machines and 34% of staff reported drinking ≥1 SSBs/day. On average, the probability of consuming ≥1 SSBs/day was 6.6% greater in staff in schools with SSBs available in staff lounge vending machines (95% CI: 0.11%, 13.12%). Staff in schools with SSB vending machines in staff lounges were more likely to report consuming ≥1 SSBs per day compared to staff without SSB vending in staff lounges. Examining the impact of extending SSB regulations to the entire school environment on school staff SSB consumption is an important next step.

The worldwide prevalence and severity of childhood obesity has steadily risen over the last 50 years.1 Although there have been some indicators of recent stabilization,2 it has been suggested that we have simply reached our upper genetic limit.3 Whether this is true, the current prevalence is shockingly high; one-third of children aged 2 to 19 have a BMI >85th percentile, and 18.5% have a BMI >95th percentile,4 consequently affecting 13.7 million children in the United States and 340 million children worldwide. It makes intuitive sense that childhood obesity is a serious health problem. However, at exactly what age obesity begins to predict future disease has proven an elusive question. The evidence is clear that (1) child obesity predicts adult obesity,5 (2) adult obesity predicts cardiometabolic disease and early mortality,6 and (3) obesity in late adolescence predicts early mortality, the majority of which is related to cardiovascular disease.7 But is obesity something to be concerned about in a 3-year-old? Researchers in previous studies have demonstrated that single time-point measures … Address correspondence to Sarah Armstrong, MD, Duke Clinical Research Institute, 200 Morris St, Durham, NC 27701. E-mail: sarah.c.armstrong{at}duke.edu

PURPOSE OF REVIEW: We review the current options to manage adolescent obesity which include nutrition, physical activity, behavior modification, sleep management, pharmacotherapy and surgery. Since lifestyle interventions alone are often not effective in adolescents, a multi-disciplinary treatment approach is necessary in management. RECENT FINDINGS: Medications (often used off-label) and metabolic/bariatric surgery are effective treatment strategies to treat adolescents with severe obesity. SUMMARY: The use of pharmacotherapy and surgery is limited due to lack of pediatric obesity tertiary care centers. With more centers, the treatment of adolescent obesity will improve and aid to decrease the prevalence of adult obesity.

The complications associated with adult obesity are overwhelming national healthcare systems. No country has yet implemented a successful population-level strategy to reverse the rising trends of obesity. This article presents epidemiological data on the complications of adult obesity and discusses some of the challenges associated with managing this disease at a population and individual level.

Background The study aimed to explore the association between early life and life-course exposure to social disadvantage and later life body mass index (BMI) accounting for genetic predisposition and maternal BMI. Methods We studied participants of Helsinki Birth Cohort Study born in 1934–1944 (HBCS1934–1944, n = 1277) and Northern Finland Birth Cohorts born in 1966 and 1986 (NFBC1966, n = 5807, NFBC1986, n = 6717). Factor analysis produced scores of social disadvantage based on social and economic elements in early life and adulthood/over the life course, and was categorized as high, intermediate and low. BMI was measured at 62 years in HBCS1934–1944, at 46 years in NFBC1966 and at 16 years in NFBC1986. Multivariable linear regression analysis was used to explore associations between social disadvantages and BMI after adjustments for polygenic risk score for BMI (PRS BMI), maternal BMI and sex. Results The association between exposure to high early social disadvantage and increased later life BMI persisted after adjustments (β = 0.79, 95% CI, 0.33, 1.25, p p = 0.181), and in HBCS1934–1944 there was no association between high early social disadvantage and increased later life BMI (β 0.22, 95% CI –0.91,1.35, p = 0.700). In HBCS1934–1944 and NFBC1966, participants who had reduced their exposure to social disadvantage during the life-course had lower later life BMI than those who had increased their exposure (β − 1.34, [− 2.37,-0.31], p = 0.011; β − 0.46, [− 0.89,-0.03], p = 0.038, respectively). Conclusions High social disadvantage in early life appears to be associated with higher BMI in later life. Reducing exposure to social disadvantage during the life-course may be a potential pathway for obesity reduction.

Objective. To evaluate the impact of a faith-based diabetes risk prevention program.Design. Nine predominately African American (AA) churches were randomized to one of three groups – group 1 (inter...

Two-thirds of the US population is either overweight or obese. Obesity is one of the major drivers of preventable diseases and health care costs. In the US, current estimates for these costs range from $147 to $210 billion per year. Obesity is a multifactorial disease: genetics, lifestyle choices, metabolism, and diet. Low-fat diets have been suggested as the key to weight management. However, over the past 30 years, the calories from fat in people's diets have gone down, but obesity rates keep climbing. Evidence suggests that diets high in added sugar promote the development of obesity. However, the impact of sugar consumption on weight gain and body fat accumulation remains a controversial topic. Therefore, the aim of this review is to provide basic framework information about the prevalence of obesity and sugar consumption in the US over the last five decades. We also review the process by which sugar is converted to fat and stored in the human body. The relationship between sugar consumption and obesity was analyzed using United States Department of Agriculture (USDA) Sugar and Sweetener Outlook data, and obesity prevalence was analyzed using data from the Centers for Disease Control and Prevention (CDC). The analysis revealed a reduction in sugar consumption concurrent with a slowing down of the annual rate of increase of obesity. However, although the data show that the sugar consumption trend is going in the right direction (declining), the US population still consumes more than 300% of the recommended daily amount of added sugar.

Introduction: Obesity is treatment-resistant, and is linked with a number of serious, chronic diseases. Adult obesity rates in the United States have tripled since the early 1960s. Recent reviews show that an increased ratio of omega-6 to omega-3 fatty acids contributes to obesity rates by increasing levels of the endocannabinoid signals AEA and 2-AG, overstimulating CB1R and leading to increased caloric intake, reduced metabolic rates, and weight gain. Cannabis, or THC, also stimulates CB1R and increases caloric intake during acute exposures. Goals: To establish the relationship between Cannabis use and body mass index, and to provide a theoretical explanation for this relationship. Results: The present meta-analysis reveals significantly reduced body mass index and rates of obesity in Cannabis users, in conjunction with increased caloric intake. Theoretical explanation: We provide for the first time a causative explanation for this paradox, in which rapid and long-lasting downregulation of CB1R following acute Cannabis consumption reduces energy storage and increases metabolic rates, thus reversing the impact on body mass index of elevated dietary omega-6/omega-3 ratios.

Obesity in children and adolescents has become a severe social issue worldwide. More than 85% of obesity in children and adolescents develops into adult obesity or leads to adult diseases like high blood pressure, artery hardening, and diabetes because of unbalanced growth and development. For this reason, a long-term and systematic care system needs to be developed using wireless communications technologies. Although many of the world’s governments have tried a variety of obesity-care policies, a poor care system remains in the children- and adolescent-healthcare areas. Therefore, this study proposes the big-data-based real-time interactive growth management (RIGM) system for the integrated growth and development of children and adolescents in the wireless communications environment. In the development of the RIGM, the activity, heart rate, steps, and other kinds of bio-data that can be received from a smart device are monitored; the growth and development status is analyzed comprehensively in the platform that receives the bio-data through wireless communications, and it is interactively checked by an application in real time. After the designed child and adolescent growth-management system was tested, the possibility of its use as a systematic growth-management system was confirmed.

Introduction With obesity rates and obesity-related healthcare costs increasing, policy makers must understand the scope of obesity across populations. Objective This study sought to characterize adult obesity using electronic health records (EHRs) available from a statewide clinical data research network, the OneFlorida Clinical Research Consortium, which contains claims and EHR data from over 12 million patients in Florida. The primary aim was to compare EHR-based Florida obesity rates with those rates obtained from the Behavioural Risk Factor Surveillance System (BRFSS). Methods Body mass index from OneFlorida patient data (2012-2016) was used to characterize obesity among adults 20-79 years old. Obesity rates from both OneFlorida and BRFSS (2013) were reported by demographics and by county. Results Among the 1,344,015 adults in OneFlorida with EHR data and who met inclusion criteria, the obesity rate was 37.1%. Women had higher obesity rates compared with men. Obesity rates varied within racial/ethnic groups, with the highest rate among African-Americans (45.7%). Obesity rates from OneFlorida were consistently higher than those found in BRFSS (overall 27.8%). Conclusions Utilizing clinical big data available through hospital system and health partner collaborations provides an important view of the extent of obesity. Although these data are available only from healthcare users, they are large in scope, directly measured and are available sooner than commonly used national data sources.

The impact of childhood obesity on the Swedish Health Care system is described. Childhood Obesity and Diabetes Type 2 is increasing for the last 10 years, but not Diabetes Type 1. Thus, prevention is needed. How to define prevention of obesity? Could treatment of childhood obesity be regarded as prevention of adult obesity? Of course it could, but we are lacking a long term follow-up from childhood to adulthood. However, we know that childhood obesity is a risk factor for adult disease. But we need long-lasting results in children to being able to state that we have prevented adult obesity. What about treatment of children with overweight, i.e. defined as the less severe level of an increased body weight as opposed to obesity? There are few if any studies restricting the treatment only to overweight children. Normally, obese children are treated, and some overweight children are added usually to increase the study sample. Then of course promotion of a healthy lifestyle could be of major interest. Finally, the traditional concept of primary prevention seems to be the only solution that is realistic according to many. However, there is no clear pattern when primary prevention works.

Background: The responses to behavioral, pharmacological, or surgical obesity treatments are highly individualized. The Accumulating Data to Optimally Predict obesity Treatment (ADOPT) project provides a framework for how obesity researchers, working collectively, can generate the evidence base needed to guide the development of tailored, and potentially more effective, strategies for obesity treatment. Objectives: The objective of the ADOPT biological domain subgroup is to create a list of high‐priority biological measures for weight‐loss studies that will advance the understanding of individual variability in response to adult obesity treatments. This list includes measures of body composition, energy homeostasis (energy intake and output), brain structure and function, and biomarkers, as well as biobanking procedures, which could feasibly be included in most, if not all, studies of obesity treatment. The recommended high‐priority measures are selected to balance needs for sensitivity, specificity, and/or comprehensiveness with feasibility to achieve a commonality of usage and increase the breadth and impact of obesity research. Significance: The accumulation of data on key biological factors, along with behavioral, psychosocial, and environmental factors, can generate a more precise description of the interplay and synergy among them and their impact on treatment responses, which can ultimately inform the design and delivery of effective, tailored obesity treatments.

Objectives: From 2000 to 2010, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) at the Centers for Disease Control and Prevention (CDC) funded 37 state health departments to address the obesity epidemic in their states through various interventions. The objective of this study was to investigate the overall impacts of CDC-DNPAO statewide intervention programs on adult obesity prevalence in the United States. Methods: We used a set of an individual-level, interrupted time-series regression and a quasi-experimental analysis to evaluate the overall effect of CDC-DNPAO intervention programs before (1998-1999) and after (2010) their implementation by using data from CDC’s Behavioral Risk Factor Surveillance System. Results: States that implemented the CDC-DNPAO program had a 2.4% to 3.8% reduction in the odds of obesity during 2000-2010 compared with states without the program. The effect of the CDC-DNPAO program varied by length of program implementation. A quasi-experimental analysis found that states with longer program implementation did not necessarily have lower odds of obesity than states with shorter program implementation. Conclusions: Statewide obesity interventions can contribute to reduced odds of obesity in the United States. Future research should evaluate the CDC-DNPAO programs in relation to their goals, objectives, and other environmental obesity risk factors to inform future interventions.

Amaç: Bu çalışmanın amacı, Mersin ilinde obezite sıklığı ve etkenlerini içerenen yeni bilgileri yansıtmaktır. Yöntem: Araştırmaya toplam 8272 kişi dahil edildi. Vücut kitle indeksi, vücutağırlığının boyun karesine metre cinsinden (ağırlık / yükseklik2, kg / m2)orantılı olarak formülünden elde edildi. 26 soru içeren anket formundakisosyodemografik özellikler, fiziksel aktivite, beslenme alışkanlıkları ileilgili sorular katılımda bulunmayı kabul eden personele uygulanmıştır. Bulgular: Araştırmaya katılanların 3872’i (%46.81) kadın, 4277'i (%52.48) erkekti.Katılımcıların yaş ortalaması 39.09, en düşük yaş 16, en yüksek 65 idi. Hem yaşhem de cinsiyet yetişkin obezite prevelansını etkiledi. Araştırmamızdakatılanların % 48.05'i aşırı kilolu ve% 12.45'i obez olarak değerlendirildi.Tüm yetişkinlerde ortalama vücut kitle indeksi 25.45 idi. Ankette sorulduğunda;2867 kişi (% 35.1) fiziksel aktivite yapmadığını ve 3343 kişi (% 40.9) aradasırada egzersiz yaptığını belirtti. Katılımcıların% 24'ü düzenli olarakegzersiz yapıyordu. Sonuç: Obezite, 21. yüzyılda hızla yayılmakta olan önemli bir halk sağlığıproblemidir. Ülkemizde insidansı da artmaktadır. Halk sağlığı girişimleri ileobeziteyi önleme önem kazanmakta ve bu da daha maliyet etkinliğigöstermektedir., Objective: The aim of this study is toreflect the latest information about obesity frequencies and involving factorsin Mersin province, Turkey. Methods: A total of 8272people were included in the study. Body mass index was obtained from the formulaby proportioning body weight to the square of the height in meters ( weight /height2, kg / m2). Socio-demographic characteristics, physical activity, nutrition habitsrelated questions have been applied under the 26-question survey to the staffwho agreed to participate. Results: 3872 of therespondents (47.52%) were women, 4277 (52.48%) were male. The mean age of theparticipants was 39.09, the lowest age of 16, the highest was 65. Both age andsex effects adult obesity prevelance. %48.05 of participants was overweight and%12.45 was obese in our study. The mean body mass index for all adults was25.45. When asked in the survey; 2867 people (35.1%), said they are not makingphysical activity, and 3343 people (40.9%) perform occasionally. 24% of therespondents exercise regularly. Conclusion:Obesity is a majorpublic health problem in the 21st century which is rapidlyspreading. The incidence is alsoincreasing in our country. Preventing obesity with public health initiatives isgaining importance, which is more cost effective.