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An active transport mode provides an opportunity for integrating physical activity into one's daily life through walking, cycling, and the use of public transportation. The purpose of this study was to compare urban adults with chronic conditions who used active and inactive transport modes and to find differences in their health outcomes. A cross‐sectional study was conducted from September 2019 to May 2020. Participants were urban adults who self‐reported being overweight or obese, or having a diagnosis of chronic disease. Anonymous structured self‐reported questionnaires were used for data collection, including the World Health Organization Quality‐of‐Life Scale, International Physical Activity Questionnaire Short‐Form, and the frequency of eight modes of transportation. According to differences between the frequency score of weekly active and inactive transportation, participants were categorized into inactive, balanced, and active transport modes. In total, 617 valid responses were obtained. Participants who engaged in an active transport mode were found to have significantly less sedentary time, and better comprehensive, social, and environmental aspects of quality of life than those with an inactive transport mode. Engaging in active transportation and avoiding inactive transportation are recommended for urban adults with chronic diseases. [ABSTRACT FROM AUTHOR]

This study investigated the combined association of TV viewing and physical activity (PA) with overweight/obesity in Taiwanese elderly adults. A telephone-based survey was conducted in 2013. Self-reported data (height, weight, TV viewing time, and PA time), were collected from a nationally representative sample of 1031 adults aged >55 years. Unadjusted and adjusted binary logistic regression models were used to calculate the odds ratios (ORs) of overweight/obesity (BMI≥25kg/m2) according to four combined TV (2h/day) and PA (150min/week) categories. In total, 60.4% of the sample was overweight/obese. After adjustment for potential confounders, significantly higher ORs of overweight/obesity were observed in the high TV/sufficient PA (OR=1.96; 95% CI=1.31-2.95) and high TV/insufficient PA (OR=1.93; 95% CI=1.34-2.78), categories compared with the low TV/sufficient PA category. Consistent with those in high-income countries, Taiwanese elderly adults, who engage in more than two hours of TV viewing per day, are at a higher risk of being overweight/obese, regardless of whether they meet PA recommendations. Additional studies are required to identify at-risk populations and the associated correlates of prolonged TV viewing to design effective interventions. [ABSTRACT FROM AUTHOR]

The fat mass and obesity-associated (FTO) gene is a significant genetic contributor to polygenic obesity. We investigated whether physical activity (PA) modulates the effect of FTO rs3751812 on body mass index (BMI) among Taiwanese adults. Analytic samples included 10,853 Taiwan biobank participants. Association of the single-nucleotide polymorphism (SNP) with BMI was assessed using linear regression models. Physical activity was defined as any kind of exercise lasting 30 min each session, at least three times a week. Participants with heterozygous (TG) and homozygous (TT) genotypes had higher BMI compared to those with wild-type (GG) genotypes. The β value was 0.381(p < 0.0001) for TG individuals and 0.684 (p = 0.0204) for TT individuals. There was a significant dose-response effect among carriers of different risk alleles (p trend <0.0001). Active individuals had lower BMI than their inactive counterparts (β = −0.389, p < 0.0001). Among the active individuals, significant associations were found only with the TG genotype (β = 0.360, p = 0.0032). Inactive individuals with TG and TT genotypes had increased levels of BMI compared to those with GG genotypes: Their β values were 0.381 (p = 0.0021) and 0.950 (p = 0.0188), respectively. There was an interaction between the three genotypes, physical inactivity, and BMI (p trend  = 0.0002). Our data indicated that increased BMI owing to genetic susceptibility by FTO rs3751812 may be reduced by physical activity. [ABSTRACT FROM AUTHOR]

Low levels of physical activity (PA) are of a health concern among high body mass index (BMI) women living a sedentary lifestyle and being overweight or obese during pregnancy is associated with increased risks of maternal and fetal health complications. Obstetricians often provide advice regarding recommended PA levels, yet this has not been easily achieved in this group to prevent adverse birth-related outcomes. The purpose of this study is to explore motivators/enablers and perceived barriers through in-depth qualitative inquiry, guided by a behavioral change model, for understanding of pregnant women's decisions to engage, or refrain from PA practice. Thirteen overweight and obese pregnant women aged 28 to 45 years with an inactive, sedentary lifestyle in urban areas of northern Taiwan were recruited to participate in six focus group sessions for their intent and readiness for PA engagement in pregnancy. A thematic content analysis was performed with a constant comparison method to categorize interview data and generate themes. The findings illustrate the extent to which obese and overweight pregnant women's readiness for PA is affected by multiple factors, including personal beliefs, perceived societal norms, peer support, and the competing priorities in the environment. PA interventions are to be effective by focusing on overcoming barriers, increasing motivations, and enhancing self-management. Strategies shared by participants shed lights for program developers to design preferable behavioral interventions for this group of women who are low self-esteem with low self-efficacy to increase PA and meet recommended levels. There is considerable potential for health care providers to provide accessible information, facilitate PA, and promote an active lifestyle during and after pregnancy.

Background: Overweight/obesity is a substantial global public health concern, which can be caused by genetic factors and energy balance-related behaviors (EBRBs). If it occurs in children with congenital heart disease (CCHD), it can yield an extra burden on their health.Most studies on CCHD have taken place inWestern societies, leaving Asian populations understudied, especially children. Objective: We sought (1) to determine body mass index distribution among school-aged CCHD in Taiwan, (2) to ascertain whether the body mass index of CCHD differs from that of the general population, (3) to describe EBRBs in CCHD, and (4) to identify factors associated with underweight and overweight/obesity among CCHD. Methods: In this cross-sectional study, 97 child-parent dyads (53.6% boys; mean age, 9.73 years; 25.8%moderate-to-severe heart conditions) were enrolled. Self-administered questionnaires were used to collect demographics, medical factors, food frequency, physical activity, and sedentary behaviors. Anthropometric measurementswere taken in the hospital. Independent predictors of EBRBs and health conditionswere calculated through logistic regression analysis. Results: Among Taiwanese CCHD, 19.6% were underweight and 14.4% were overweight/obese. Children with moderate-to-severe heart defects were more often underweight. Body mass index did not differ between CCHD and children in the general population. More complex heart defects and asthma were associated with being underweight, whereas sedentary behaviors, cardiomegaly, and the NewYork Heart Association classification II to IV were associated with being overweight/obese. Conclusions: Sedentary lifestyle is seemingly the only EBRB correlatedwith being overweight. Physical activity programs for childrenmay help prevent and treat overweight or obesity in Asian CCHD, similar to Western countries. [ABSTRACT FROM AUTHOR]

Background/objective: The effect of eating habits and sedentary lifestyle on obesity has been extensively examined and supported; however, few studies have examined the association of sleep duration with obesity in Taiwan. To redress this gap, this study investigated the association of sleep duration with overweight and obesity in community-dwelling Taiwanese adults., Methods: A cross-sectional study was performed using the 2005-2008 Nutrition and Health Survey in Taiwan (NAHSIT). A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the association of sleep duration with overweight and obesity. Nightly sleep duration was divided into three groups: >6 to <9h (normal), ≤6h (short), and ≥9h (long)., Results: A total of 1548 adults aged 20-64 years were examined in this study. The adjusted ORs of obesity for short and long sleep duration relative to a normal sleep duration were 1.31 (95% CI 1.01, 1.76) and 1.64 (95% CI 1.04, 2.61), respectively. No significant association of sleep duration with overweight was observed., Conclusions: The present study suggests that both short and long sleep duration are associated with obesity risk., (Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Background: Obesity is a global concern, driving the search for alternative treatments beyond lifestyle changes and medications. Laser acupuncture (LA) shows promise in obesity management, yet few studies compare it with FDA-approved medications. This study aimed to assess and compare LA's impact with liraglutide on weight reduction in obese individuals. Methods: Data from the Chang Gung Research Database (CGRD) (2013–2018) were analyzed. Primary outcomes included changes in body weight and BMI within 180 days, with secondary outcomes measuring the proportion achieving 5%, 10%, and 15% weight loss. Adverse events were also assessed. Results: Of 745 subjects (173 LA users, 572 liraglutide users), LA users lost more weight by day 180 (5.82 ± 4.39 vs. 2.38 ± 5.75 kg; p < 0.001) and had a greater BMI reduction (−2.27 ± 1.73 vs. −0.93 ± 2.25 kg/m2; p < 0.001). More LA users achieved 5% and 10% weight loss compared to liraglutide users (64.2% vs. 22.7%, 26.6% vs. 4.2%; all p < 0.001). After balancing baseline differences, LA's benefits remained significant. No adverse events were reported with LA. Conclusions: LA may offer superior weight reduction compared to liraglutide. Future studies should explore LA alone or in combination with liraglutide for obesity management. [ABSTRACT FROM AUTHOR]

The study evaluated the associations of body fatness, TV-watching time, and physical activity with the occurrences of asthma and respiratory symptoms in schoolchildren in Taipei, Taiwan. A questionnaire survey was conducted to elicit episodes of respiratory symptoms and data on lifestyle and anthropometric factors in 2290 5th-grade schoolchildren. Results show that overweight was positively associated with 5 of the 7 respiratory symptoms. The risk of having respiratory symptoms increased 47%-94% in overweight schoolchildren. Watching TV ≥ 3 hrs/day was associated with more occurrences of respiratory symptoms (aOR = 1.42-1.90). Physical activity ≥3 times/week was associated with fewer occurrences of respiratory symptoms (aOR = 0.66-0.73). Overweight was positively associated with an increased risk of suspected asthma in boys (aOR = 1.56, 95% CI = 1.07-2.29), but not in girls. In summary, overweight and greater TV-watching time increase the risk of respiratory symptoms, while habitual physical activity decreases the risk of respiratory symptoms. Weight status, sedentary life, and frequency of physical exercise are the factors that can impact on the respiratory health of schoolchildren. [ABSTRACT FROM AUTHOR]

Objective: The research aimed at examining betel nut chewing and other risk factors associated with obesity among Taiwanese male adults.Design: The research analyzed the data obtained by the 2001 National Health Interview Survey in Taiwan that covered all the administrative divisions in Taiwan. Multistage stratified systematic sampling design was adopted for survey. All members of a sampled household received the interview.Subjects: The research analyzed questionnaires answered by nonaboriginal male respondents aged between 20 and 59 years old, and the total number of samples analyzed read 6126. Since very few female subjects chewed betel nut, they were excluded from the analysis.Measurements: Criteria of obesity was defined as body mass index > or = 27 kg/m2. The variables incorporated for analysis included the respondents' status of betel nut chewing, age, educational background, presence of hypertension and diabetes mellitus, drinking and smoking status, exercise status, and demand for physical strength at job. Generalized estimating equations model was employed to estimate the odd ratios (with 95% CI) of obesity of each independent variable.Results: Approximately 16.2% of respondents were obese. The distribution of betel nut chewing was current chewers 15.9%, ex-chewers 4.3%, and nonchewers 79.8%. After controlling above-mentioned independent variables, hypertension, diabetes mellitus, betel nut chewing, never exercising, and sedentary jobs were closely associated with obesity.Conclusion: The research found that betel nut chewing closely associated with obesity. The increased appetite of betel nut chewers is speculated as the underlying cause. The prospective study is needed to clarify this issue. In addition to increasing the risk of developing oral cancer, betel nut chewing seemed to be related with another health hazard: obesity. [ABSTRACT FROM AUTHOR]

Background: The aim of present study was to compare the effects of different aerobic exercise intensities and energy expenditures on the body composition of sedentary obese college students in Taiwan.Methods: Forty-eight obese participants [body mass index (BMI) ≥ 27 kg/m2, age 18-26 years] were randomized into four equal groups (n = 12): light-intensity training group (LITG), 40%-50% heart rate reserve (HRR); middle-intensity training group (MITG), 50%-70% HRR; high-intensity training group (HITG), 70%-80% HRR; and control group (CG). The aerobic exercise training program was conducted for 60 min per day on a treadmill 3 days per week for 12 weeks. All participant anthropometric data, blood biochemical parameters, and health-related physical fitness components were measured at baseline and after 12 weeks.Results: At baseline, the anthropometric indices did not differ significantly among the four groups (p > 0.05). After 12-week exercise intervention, the HITG and MITG had significantly more changes in body weight, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) than the LITG. The changes in BMI and body fat percentage differed among all four groups (p < 0.05).Conclusions: A 12-week high-intensity exercise intervention with high energy expenditure can considerably reduce body weight, body fat, WC, WHR, and WHtR, whereas a light-intensity exercise intervention can significantly reduce body weight and body fat.Trial Registration: Current Controlled Trials TPECTR09831410900 , registered on 24th Dec 2009. [ABSTRACT FROM AUTHOR]

Background: Increased media viewing such as watching television and videos and playing on/using computers has been associated with childhood obesity. Guidelines from the American Academy of Pediatrics recommend limiting children's total media time to no more than 2 hours per day. Information about media usage and school-aged obesity in Taiwan is lacking., Purpose: The purpose of this study was to investigate whether media viewing after school is associated with the total and centralobesity in school-aged children in Taipei, Taiwan's capital and largest city., Methods: A case-control study was designed, and a control approach was used to recruit participants. Two hundred seventy-five obese and 275 normal-weight children currently in the fourth grade were enrolled from 29 elementary schools in Taipei City. Media viewing after school was measured using a 3-day self-reported physical activity log and the daily sedentary activity component of the National Health Interview Survey in Taiwan. The latter was completed by the participants' parents., Results: Participants with total obesity had significantly more television watching time (60.24 minutes vs. 43.50 minutes, p < .05) and total media watching time (73.61 minutes vs. 52.67 minutes, p < .001) than normal-weight participants. Similar results were found for participants with central obesity. Total television and total media watching durations greater than 2 hours a day correlated significantly with total and central obesity. Time spent using computers did not differ significantly between obese and normal-weight control participants on weekdays., Conclusions/implications for Practice: Childhood obesity may be multifactorial in origin. Excessive sedentary activity such as watching television may have a variety of consequences beyond the putative effect on body habitus. School nurses should promote health programs targeted to prevent excessive weight and obesity in children, recommend reducing media viewing, and encourage patient participation in extracurricular outdoor activities.

Background: Weight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies. Methods: This study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale − 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes' Process Macro was used to test a mediation model. Results: The changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup. Conclusion: Because perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions. Plain English Summary: Weight stigma is commonly studied in Western countries rather than in Asian ones. To further explore how internalized weight stigma mediates the relationship between perceived weight stigma and the changes in body mass index (BMI), the study collected data through a longitudinal online survey with two phases by applying the Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ) and Depression, Anxiety, Stress Scale − 21 (DASS-21) to assess perceived weight stigma, internalized weight stigma, and psychological distress. The changes in perceived and internalized weight stigma were significantly and positively associated with changes in BMI. There were significantly positive associations between perceived weight stigma, internalized weight stigma, and psychological distress over time. Based on the findings, treatment strategies to alleviate self-stigma may enhance the results of weight-reduction programs and should be considered for inclusion in weight-loss interventions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the difference in the prevalence of obesity and the associations between the risk of obesity and socioeconomic factors with regard to working adults in China and Taiwan., Data: The 2000 China Health and Nutrition Survey and the 2001 National Health Interview Survey in Taiwan, which contains information from 20-60-year-old working adults in China (3,067 men and 2,998 women) and Taiwan (6,475 men and 6,341 women)., Method: Variables were converted to cross-economy comparable forms, and the estimated prevalence of obesity across socioeconomic groups was compared between China and Taiwan. Probit models were used to examine the associations between socioeconomic factors and the probability of being obese., Results: In China, the prevalence of obesity was higher in the higher income, more educated, and more sedentary occupation groups, while it was higher in the lower income and less educated groups in Taiwan. Also, our results indicate that occupational types rather than income and education levels are more significantly associated with the probability of being obese in China, whereas income and education levels rather than occupational types are more significantly associated with the probability of being obese in Taiwan. These findings may indicate that, when an economy becomes more developed, the association between obesity risk and income and education levels becomes more significant and negative especially among women, while the association between obesity risk and occupational types decreases especially among men.

The prevalence of obesity and associated chronic diseases has increased rapidly in Taiwan. Data from three consecutive Nutrition and Health surveys in Taiwan show that obesity prevalence has tripled for elementary school boys and doubled for girls since 1993-1996. About one-third of boys (15.5% and 14.7% for overweight and obesity, respectively) and one-quarter of girls were either overweight (14.4%) or obese (9.1%) in 2001-2002. For adults, obesity prevalence rates defined by body mass index > or = 27 kg m(-2) increased from 10.5% in men and 13.2% in women in the 1993-1996 survey, to around 17% in 2005. Prevalence of overweight was around 20% in 1993-1996 for both men or women, and increased to 30% in 2005 for men. No change was found in women. The underprivileged regions usually had higher prevalence of obesity and associated diseases. Scientific bases for Taiwan obesity definition are set out together with the screening and management plans. High-calorie intake was associated with obesity in young children (grades 1-2), but not in older children and adults. Physical inactivity and sedentary lifestyle-related variables were associated with obesity in men and older boys. In addition, good dietary quality was associated with a lower risk of obesity independent of energy intake in elderly Taiwanese. More research is needed to find effective determinants and public health measures for obesity, and concerted efforts are required to combat this rising health problem.

Background: In Taiwan, the availability of a high-fat and high-energy diet has steadily risen over the past 30 y, while people have become increasingly sedentary. This lifestyle of poor diet and little physical activity has caused the prevalence of obesity to increase among adults and children. Obesity and associated chronic disease risk factors are becoming important public health issues. The purpose of this study is to evaluate the prevalence and secular trends of being overweight and obese among school children in Taiwan., Methods: We conducted a cross-sectional survey among junior high school students in Taipei in 1994 to ascertain a representative distribution of demographic, lifestyle and biochemical characteristics, including several cardiovascular disease risk factors. After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1500 children for this survey. We defined being overweight and obese based on ideal body weight (IBW) criteria. Children are considered to be overweight if their body weight is 110-120% of IBW, and obese if their body weight is greater than 120% of IBW within age- and gender-specific strata., Results: In general, obese children have higher blood pressure, plasma glucose and triglyceride levels and lower high-density-lipoprotein cholesterol levels than normal-weight children. From 1980 to 1994, the mean value of body weight increased significantly over increases in body height (especially among boys). Although the percentage of overweight children remained steady from 1980 to 1994 in both genders, the prevalence and trends of obesity increased significantly, especially among boys and older girls., Conclusion: From this survey we find that in Taiwan from 1980 to 1994 body weight increased dramatically over body height among school children. The prevalence of obesity also increased significantly, especially among boys, while the percentage of overweight children did not vary. Overall, this study indicates that obesity and the adverse effects of being over the ideal body weight is no longer just a problem of Western countries.

This study aimed to provide up-to-date information regarding the estimated prevalence of developmental coordination disorder (DCD) in Taiwanese children. Their unhealthy weight status was also examined, as well as the roles of sex and age. This cross-sectional study recruited 825 children aged between 4 and 12 years and categorized them into either typically developing children (TD, >16th percentile) or children at risk for DCD (rDCD, ≤16th percentile) based on the result of the Movement Assessment Battery for Children—2nd edition. Body mass index was calculated to determine weight status (i.e., normal weight, underweight, overweight, and obesity). The estimated prevalence of rDCD was 9.7%. There were significantly more boys in the rDCD groups (p < 0.001). Additionally, preschool children with rDCD were at greater risk for being underweight. However, there was no significant group difference which was found for overweight/obesity. A lower prevalence of rDCD was found in this study. Nevertheless, children with rDCD may be more likely to be underweight in early childhood. Early intervention should be provided to target this population. [ABSTRACT FROM AUTHOR]

Obesity is related to increased morbidity and mortality, and prevails worldwide. It has become an important health issue and requires urgent attention. In Taiwan, overweight and obesity are defined as body mass index ≥24 and 27 kg m−2, respectively. These cut-offs differ from Caucasian standards, as Asians have higher comorbidities and fat mass at lower BMI levels than Caucasians. The prevalence of obesity and overweight in Taiwan are 19.2% and 30.5% in men, 13.4% and 21.3% in women. This implies that a more profound increase in obesity prevalence is found in men than in women. A high-fat diet, sedentary lifestyle and betel nut chewing may increase substantially this obesity epidemic. Recently, type 2 diabetes mellitus has been found to be the most common type of diabetes, and obesity is significantly related to type 2 diabetes in children. In addition, obesity is associated with cardiovascular diseases risk factors and cannot be neglected in elderly. Therefore, a comprehensive prevention and management programme of obesity is urgently warranted for controlling the growing obesity trend and its related diseases in Taiwan. [ABSTRACT FROM AUTHOR]

Introduction: Maintaining a better physical and mental health status is an important issue for older adults in their later life. Thus, the study's purpose was to evaluate the association between body mass index (BMI) and mental health status in older adults aged 65 years old or above residing in communities of Taipei City, Taiwan. Methods: We carried out secondary data analysis with data from a volunteer-based health examination project for older adults >65 years old residing in Taipei City from 2006 to 2010 with a retrospective study design. BMI, calculated by standardized measuring procedures for height and weight, and mental health status, evaluated by 5-item Brief Symptom Rating Scale (BSRS-5), were collected at their first visits of health examination. A BSRS-5 score ≥6 was considered an inferior mental health status for the outcome. In statistical analysis, univariable and multivariable logistic regressions were adopted to estimate the relative risk of inferior mental health status, treating BMI as the major exposure of interest. Results: A total of 90,576 subjects were involved, with a mean age of 73.38 years old (SD = 6.64 years) and 49.21% females. With confounders controlled, compared to normal or overweight (23 ≤ BMI <30), an adjusted OR of 1.23 (95% CI: 1.18, 1.29) on inferior mental health status was detected for the underweight group (BMI <23) significantly. Adjusted OR for those obese (BMI ≧30) was 0.87 (95% CI: 0.79, 0.96). Significantly elevated ORs of underweight were found for both genders, but the significantly protective effect of obese was only detected for females. Conclusion: Keeping an appropriate weight or even being overweighted might be beneficial for older adults dwelling in the community, especially for males. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to explore the efficacy of a commercial smartwatch with a blood pressure‐monitoring feature. Design: A randomized controlled trial. Methods: Sixty healthy young adults were recruited. Participants were randomly allocated to wear a commercial smartwatch, one with and one without a blood pressure‐monitoring feature for 12 weeks. Data were collected using Omron HEM‐907, Inbody 270S, and the International Physical Activity Questionnaire. Findings: Results revealed a significant effect and group‐by‐time interaction on diastolic blood pressure. After 12 weeks in participants who wore a smartwatch with a blood pressure‐monitoring feature, the systolic and diastolic blood pressure and resting heart rate had decreased. Conclusion: Using commercial smartwatches with a blood pressure‐monitoring feature is a feasible approach to support self‐management, increase awareness, and promote physical activity for health promotion, obesity and chronic disease prevention. Clinical relevance: Wearable technologies may be an innovative strategy for preventing high blood pressure by continuous self‐monitoring and healthy behavior modifications. [ABSTRACT FROM AUTHOR]

aimed at modification of work schedule may be useful in combating obesity. [ABSTRACT FROM AUTHOR]

Background: Obesity, a known risk factor for cardiovascular disease and heart failure (HF), is associated with adverse cardiac remodeling in the general population. Little is known about how nutritional status modifies the relationship between obesity and outcomes. We aimed to investigate the association of obesity and nutritional status with clinical characteristics, echocardiographic changes, and clinical outcomes in the general community.Methods and Findings: We examined 5,300 consecutive asymptomatic Asian participants who were prospectively recruited in a cardiovascular health screening program (mean age 49.6 ± 11.4 years, 64.8% male) between June 2009 to December 2012. Clinical and echocardiographic characteristics were described in participants, stratified by combined subgroups of obesity and nutritional status. Obesity was indexed by body mass index (BMI) (low, ≤25 kg/m2 [lean]; high, >25 kg/m2 [obese]) (WHO-recommended Asian cutoffs). Nutritional status was defined primarily by serum albumin (SA) concentration (low, <45 g/L [malnourished]; high, ≥45 g/L [well-nourished]), and secondarily by the prognostic nutritional index (PNI) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Cox proportional hazard models were used to examine a 1-year composite outcome of hospitalization for HF or all-cause mortality while adjusting for age, sex, and other clinical confounders. Our community-based cohort consisted of 2,096 (39.0%) lean-well-nourished (low BMI, high SA), 1,369 (25.8%) obese-well-nourished (high BMI, high SA), 1,154 (21.8%) lean-malnourished (low BMI, low SA), and 681 (12.8%) obese-malnourished (high BMI, low SA) individuals. Obese-malnourished participants were on average older (54.5 ± 11.4 years) and more often women (41%), with a higher mean waist circumference (91.7 ± 8.8 cm), the highest percentage of body fat (32%), and the highest prevalence of hypertension (32%), diabetes (12%), and history of cardiovascular disease (11%), compared to all other subgroups (all p < 0.001). N-terminal pro B-type natriuretic peptide (NT-proBNP) levels were substantially increased in the malnourished (versus well-nourished) groups, to a similar extent in lean (70.7 ± 177.3 versus 36.8 ± 40.4 pg/mL) and obese (73.1 ± 216.8 versus 33.2 ± 40.8 pg/mL) (p < 0.001 in both) participants. The obese-malnourished (high BMI, low SA) group also had greater left ventricular remodeling (left ventricular mass index, 44.2 ± 1.52 versus 33.8 ± 8.28 gm/m2; relative wall thickness 0.39 ± 0.05 versus 0.38 ± 0.06) and worse diastolic function (TDI-e' 7.97 ± 2.16 versus 9.87 ± 2.47 cm/s; E/e' 9.19 ± 3.01 versus 7.36 ± 2.31; left atrial volume index 19.5 ± 7.66 versus 14.9 ± 5.49 mL/m2) compared to the lean-well-nourished (low BMI, high SA) group, as well as all other subgroups (p < 0.001 for all). Over a median 3.6 years (interquartile range 2.5 to 4.8 years) of follow-up, the obese-malnourished group had the highest multivariable-adjusted risk of the composite outcome (hazard ratio [HR] 2.49, 95% CI 1.43 to 4.34, p = 0.001), followed by the lean-malnourished (HR 1.78, 95% CI 1.04 to 3.04, p = 0.034) and obese-well-nourished (HR 1.41, 95% CI 0.77 to 2.58, p = 0.27) groups (with lean-well-nourished group as reference). Results were similar when indexed by other anthropometric indices (waist circumference and body fat) and other measures of nutritional status (PNI and GLIM criteria). Potential selection bias and residual confounding were the main limitations of the study.Conclusions: In our cohort study among asymptomatic community-based adults in Taiwan, we found that obese individuals with poor nutritional status have the highest comorbidity burden, the most adverse cardiac remodeling, and the least favorable composite outcome. [ABSTRACT FROM AUTHOR]

Background: The relationship between sleep duration and physical fitness is one aspect of sleep health. Potential factors associated with sleep duration interfere with physical fitness performance, but the impact trends on physical fitness indicators remain unclear.Methods: This study examined associations between sleep duration and physical fitness among young to middle-aged adults in Taiwan. A total of 42,781 Taiwanese adults aged 23-45 participated in the National Physical Fitness Examination Survey 2013 (NPFES-2013) in Taiwan between October 2013 and March 2014. A standardized structural questionnaire was used to record participants' sleep duration, which was stratified as short (< 6 h/day (h/d)), moderate (6-7 h/d; 7-8 h/d; 8-9 h), and long (≥ 9 h/d) sleep duration groups. Physical fitness was assessed based on four components: body composition (body mass index [BMI], waist-to-height ratio [WHtR], and waist-to-hip ratio [WHR]), muscle strength and endurance (1-min bent-leg sit-up test [BS]), flexibility (sit-and-reach test [SR]), and cardiorespiratory endurance index (3-min step test [CEI]).Results: By using analysis of covariance (ANCOVA), after sex grouping and age adjustment, we observed that sleep duration was significantly associated with obesity, functional fitness, and self-perception of health. The sleep duration for low obesity-related values (BMI, WHtR, and WHR) for men was 7-9 h/d, and that for women was 7-8 h/d. Sleeping more than 8 h/d showed poor functional fitness performances (BS and SR). For both sexes, sleep duration of 8-9 h/d was the optimal sleep duration for self-perceptions of health.Conclusions: Our research found that there were wide and different associations of sleep duration with physical fitness and self-perception of health among Taiwanese adults aged 23-45, and there were differences in these associated manifestations between men and women. This study could be of great importance in regional public health management in Taiwan, and provide inspirations for clinical research on physical fitness. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the relationship between metabolically healthy obesity and cardiovascular disease risk in Taiwanese individuals. Methods: Taiwanese individuals were recruited from a nationwide, representative community-based prospective cohort study and classified according to body mass index as follows: normal weight (18.5–23.9 kilogram (kg)/meter(m)2) and obesity/overweight (≥24 kg/m2). Participants without diabetes, hypertension, and hyperlipidemia and who did not meet the metabolic syndrome without waist circumference criteria were considered metabolically healthy. The study end points were cardiovascular disease morbidity and mortality. Multivariable adjusted hazard ratios and 95% confidence intervals were obtained from a Cox regression analysis. Results: Among 5 358 subjects (mean [standard deviation] age, 44.5 [15.3] years; women, 48.2%), 1 479 were metabolically healthy with normal weight and 491 were metabolically healthy with obesity. The prevalence of metabolically healthy obesity/overweight was 8.6% in the Taiwanese general population, which included individuals who were >20 years old, not pregnant, and did not have CVD (n = 5,719). In the median follow-up period of 13.7 years, 439 cardiovascular disease events occurred overall and 24 in the metabolically healthy obesity group. Compared with the reference group, the metabolically healthy obesity group had a significantly higher cardiovascular disease risk (adjusted hazard ratio: 1.74, 95% confidence interval: 1.02, 2.99). Conclusions: Individuals with metabolically healthy obesity have a higher risk of cardiovascular disease and require aggressive body weight control for cardiovascular disease control. [ABSTRACT FROM AUTHOR]

Aims and objectives: To measure the effect of chair resistance training (RT) on the quality of life (QoL) of older long‐term care residents with sarcopenic obesity (SO). Background: Sarcopenia combined with obesity, commonly called SO, is considered to be related to health‐related QoL. Despite concerns regarding SO‐related long‐term healthcare issues, intervention studies on SO residents in nursing homes are scant in Taiwan. Design: This research was a quasi‐experiment conducted according to the TREND Checklist. A total of 123 older persons were enrolled from six nursing facilities. The RT was implemented between October 2015–March 2016. Method: The intervention group received progressive RT with sandbags/dumbbells twice a week for 3 months, whereas the comparison group received the usual care. QoL was the major outcome variable. Data were analysed using chi‐square test, Student's t test and generalised estimating equation (GEE). Results: The various definition criteria for SO can influence the results of QoL in the older persons. From the body composition perspective, in the GEE analysis, the SO cut‐off points for neither skeletal muscle mass percentage (SMMp) nor appendicular skeletal muscle mass index demonstrated significant between‐group differences in the QoL variable after the 3‐month RT intervention. Between‐group analysis revealed a significant effect of time on anxiety/depression [Exp(B): 0.41, 95% confidence interval: 0.18–0.93, p‐value <.05] in participants who met all three criteria of the definition of SO (low SMMp, low handgrip strength, and obesity). RT was one of the protective factors. Conclusion: In the SO group, the effect of muscle strength on QoL is greater than the effect of changes in body composition after RT. Relevance to clinical practice: This study analysed the influence of RT on QoL in subjects with different categories of SO. RT is one of the ways to promote QoL among the SO population. ClinicalTrials.gov Identifier: NCT02912338. [ABSTRACT FROM AUTHOR]

Aims and objectives: The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. Background: As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health‐related quality of life. Design: This study adopted a cross‐sectional correlational research design. The STROBE checklist for cross‐sectional studies was used as a reference for reporting the study. Methods: A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. Results: Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = −0.38), comorbidity index (ß = −0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. Conclusions: Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. Relevance to clinical practice: The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of obesity has become a pandemic problem, and dietary patterns are one of the important factors causing obesity. Although the correlation between dietary patterns and obesity has been well explored, the gender difference on the association between dietary patterns and obesity remains unclear. The objective of this study examined whether gender difference existed in the relationship of dietary patterns with metabolic parameters and specific indices of adiposity among young and middle-aged adults with dyslipidemia and abnormal fasting plasma glucose (FPG) in Taiwan.Methods: A total of 14,087 subjects aged between 20 and 50 years with dyslipidemia and abnormal FPG were recruited in Taiwan between 2001 and 2010 for a cross-sectional study. Dyslipidemia was defined primarily according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with minor modification. Abnormal FPG level was defined by the American Diabetes Association. Principal component analysis was conducted to identify dietary patterns. Multivariate logistic regression analysis was performed to evaluate the association of dietary patterns and metabolic parameters with different indices of adiposity including general obesity, central obesity, and high body fat, stratified by gender.Results: Two dietary patterns derived from principal component analysis were the prudent dietary pattern and the western dietary pattern. Both men and women in the highest quartile of the western dietary pattern had a significantly increased odds ratio of general obesity, central obesity, and high body fat. However, only male subjects in the higher quartiles of the prudent dietary pattern had a significantly decreased odds ratio of all indices of obesity. Both men and women with higher high-density lipoprotein cholesterol and total cholesterol levels had a significantly reduced odds ratio of general and central obesity, while those with higher triglycerides and FPG levels had a significantly increased odds ratio of general and central obesity. Higher low-density lipoprotein cholesterol level was significantly associated with an elevated odds ratio of high body fat, while higher total cholesterol level was significantly correlated with a reduced odds ratio of high body fat only in women.Conclusions: Gender difference exists in the association of dietary patterns and metabolic parameters with obesity and body fat in young and middle-aged adults with dyslipidemia and abnormal FPG in Taiwan. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the gender‐specific lifestyles of adults with metabolic syndrome in the Taiwanese community. Background: Many studies show different prevalence of metabolic syndrome in males and females; however, few studies have investigated gender‐specific lifestyle risk factors, which are important for effectively reducing prevalence. Design: A cross‐sectional study design was used. Methods: Between 2012 and 2015, a total of 1,066 individuals were recruited in northern Taiwan. Data were collected by questionnaires and analysed by descriptive statistics, chi‐square tests and logistic regression. This study followed the STROBE guidelines. Results: The prevalence of metabolic syndrome was 40.8% in men and 36.0% in women. Women had healthier dietary habits, a higher rate of moderate–vigorous physical activity, and a lower rate of smoking and obesity than men. Men, who were overweight or obese, lacked vigorous physical activity, often consumed excess amounts of salt and fat, and seldom consumed appropriate amounts of protein tended to have metabolic syndrome. Women with an unhealthy metabolism tended to be overweight or obese and seldom consumed dairy products. Conclusions: Men, who had normal body weight, performed vigorous physical activity, seldom consumed excess amounts of salt and fat, and often consumed appropriate amounts of protein tended not to have metabolic syndrome. Women with a healthy metabolism were of normal body weight and often consumed dairy products. There exist gender differences in health habits with metabolic syndrome. Relevance to clinical practice: Although the associated risk factors differed between men and women, controlling body weight and maintaining a healthy lifestyle may reduce the risk of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity among children can cause metabolic syndrome in adulthood and are a significant public health issue. Some studies suggest that maternal pre-pregnancy body mass index (BMI) and excessive gestational weight gain during pregnancy are associated with overweight and obesity in offspring. However, it is difficult to collect information on accurate pre-pregnancy BMI and pregnancy weight gain for women living in areas where medical resources are scarce. Maternal pre-delivery BMI might be predictive of the risk of overweight and obesity among offspring of pregnant mothers living in suburban areas. Methods: We retrospectively collected data on term neonates with appropriate weights for their gestational age born between April 2013 and October 2015. We excluded neonates with major congenital anomalies or diseases and incomplete data. Mothers with systemic diseases or drug abuse were also excluded. Offspring body weights and heights at 1- and 2-years-old were recorded. Maternal pre-delivery BMI was divided into following groups: <25, 25-29.9, and S30 kg/m2. Results: We included 261 mother-child pairs in this study. The BMIs of the offspring differed significantly among the three maternal pre-delivery BMI groups at the age of 2 years (15.18 ± 1.04, 15.83 ± 1.28, and 16.29 ± 1.61 kg/m2, p < 0.001, respectively). After adjusting for potential cofounders possibly affecting weight using multivariate linear regression, the children's BMIs (adjusted 95% CI: 0.71 [0.31-1.11]; p = 0.001) and BMI percentiles (adjusted 95% CI 15.80 [7.32-24.28]; p < 0.001) at the age of 2 years were significantly higher in those born to mothers with pre-delivery BMIs of 25-29.9 kg/m2 compared to mothers with pre-delivery BMIs <25 kg/m2. Maternal pre-delivery BMI S30 kg/m2 was significantly associated with increased BMIs (adjusted 95% CI: 1.17 [0.72-1.63]; p < 0.001) and BMI percentiles (adjusted 95% CI: 23.48 [13.87-33.09]; p < 0.001) in their children. A maternal pre-delivery BMI of 27.16 kg/m2 was the optimal cut-off for predicting offspring overweight/obesity at the age of 2 years. Discussion: Our results indicate that the maternal pre-delivery BMI was significantly associated with offspring BMI and weight gain at the age of 2 years. A maternal pre-delivery BMI of 27.16 kg/m2 might be a useful predictor for estimating the risk of overweight or obesity in offspring at the age of 2 years. [ABSTRACT FROM AUTHOR]

Background: Nurses with obesity will lead to health problems as well as their high turnover rate and low retention rate. Objectives: This study explored the associations with female nurses' work stress, social support and overweight/obesity, and tried to find the predictors of the female nurses' overweight/ obesity. Methods: The study applied a cross-sectional and correlational design. Findings: The results of this study showed that "regular exercise frequency lower than or equal to 2 days a week", "rotating night shifts greater than or equal to 4 times a month", "nursing working hours higher than 44 hours a week", "high work stress", and "low social support" were the main predictors of "overweight/ obesity". Conclusions: Conducting workshops were recommended to nurse managers to motivate female nurses" exercise frequency, remind female nurses of keeping a healthy diet during night shifts, and provide female nurses with some relaxing skills to release their work stress. [ABSTRACT FROM AUTHOR]

Background: Improvements in insulin resistance and pancreatic β-cell function have been shown following exercise in adults with obesity; however, few adolescent-based studies have been conducted. This study examined the impact of exercise training on body fat and insulin sensitivity and secretion in overweight and obese adolescents.Methods: The effects of a 12-week exercise program on the parameters of adiposity and glucose homeostasis were investigated in 47 overweight and obese male adolescents.Results: After the exercise training program, body weight, body mass index, waist circumference, and body fat were significantly decreased (P < 0.001). Improvements in insulin sensitivity (HOMA-IR: 1.40 vs. 0.86, P < 0.001) and the disposition index (5.84 vs. 12.77, P < 0.001) were also observed. Compared to baseline, oral glucose tolerance tests showed reduced glucose and insulin levels at all time points following the exercise training (all P < 0.001). Subgroup analysis of overweight and obese adolescents with abnormal glucose tolerance revealed that there was no difference in plasma glucose levels as compared to the lean group.Conclusions: A 12-week exercise training is effective in reducing body fat and improving insulin sensitivity and secretion. In addition, the benefits of the exercise intervention were even experienced by those with impaired glucose tolerance. [ABSTRACT FROM AUTHOR]

Background: Diet has been associated with differences in weight and nutritional status of an individual. The prevalence of overweight and obesity increased among adults in Taiwan. Hence, we examined the relationship between dietary patterns and weight status by gender among middle-aged and older adults in Taiwan.Methods: The cross-sectional data of 62,965 participants aged ≥40 years were retrieved from the Mei Jau health screening institutions' database collected from 2001 and 2010. Diet information was evaluated using a food frequency questionnaire, while the dietary patterns were derived using principal component analysis before summing up and dividing into quintiles of consumption. The association between dietary patterns and weight status among adult men and women was explored using multinomial logistic regression models. Three models were analyzed before stratifying data by gender.Results: Two dietary patterns were derived with one reflecting a high consumption of vegetables and fruits (vegetable-fruit dietary pattern) and the other a high consumption of meat and processed foods (meat-processed dietary pattern). After adjustment, highest consumption of vegetables and fruits (Q5) reduced the likelihood of being overweight (OR = 0.91; 95% CI, 0.85-0.97) or obese (OR = 0.85; 95% CI, 0.78-0.92), while highest consumption of meat and processed foods increased the likelihood of being overweight (OR = 1.50; 95% CI, 1.40-1.59) or obese (OR = 1.94; 95% CI, 1.79-2.10). Women were less likely to be overweight or obese with the highest intake of fruits and vegetables (Q5) while both genders were more likely to be overweight or obese with high consumption of meat and processed foods.Conclusions: High intake of vegetables and fruits is associated with lower odds of being overweight or obese, especially among women. But, high intake of meat and processed foods is associated with higher odds of overweight and obesity in both genders. [ABSTRACT FROM AUTHOR]

Background/aim Participation in physical activity is an important health concern for children in most Western communities, but little is known about Asian children's participation. The purpose of this study was to extend the current knowledge on how much time preschool children in Taiwan spend on physical activity, to examine its relationship with gross motor performance and to provide information on the establishment of physical activity guidelines for preschool children in Taiwan. Methods Two hundred and sixty-four children between 36 and 71 months old were recruited from a university medical centre and from preschools in Taiwan. The primary outcomes were measured using the Movement Assessment Battery for Children-Second Edition and the modified Preschool-aged Children's Physical Activity Questionnaire. Results 89.8% of our participants did not meet the recommendations from the National Association for Sport and Physical Education for time spent in physical activities. Participants spent an average of 155 minutes/week in low intensity physical activity. Children with motor difficulties tended to spend less time on physical activity than did typically developing children. The mother's level of education and whether the child was overweight or obese correlated with how much time the children spent on physical activity. Conclusions We conclude that paediatric occupational therapists should explain to parents the relationship between physical activity and motor development and advocate for developmentally positive physical activities for preschool children. Physical activity guidelines for Taiwanese preschoolers should be established immediately. [ABSTRACT FROM AUTHOR]

Background: The Asia-Pacific region is home to nearly half of the world's population. The region has seen a recent rapid increase in the prevalence of obesity, type-2 diabetes and cardiovascular disease. The present systematic review summarizes the recent prevalence and trends of Metabolic Syndrome (MetS) among adults in countries of the Asia-Pacific Region.Methods: Data on MetS in Asia-Pacific countries were obtained using a stepwise process by searching the online Medline database using MeSH terms 'Metabolic Syndrome X' and 'Epidemiology/EP'. For the purpose of describing prevalence data for the individual countries, studies that were most recent, nationally representative or with the largest sample size were included. When evaluating secular trends in prevalence in a country we only considered studies that evaluated the temporal change in prevalence between similar populations, prospective studies based on the same population or National surveys conducted during different time periods.Results: This literature search yielded a total of 757 articles, and five additional article were identified by screening of reference lists. From this total, 18 studies were eligible to be included in the final analysis. Of the 51 Asia-Pacific countries (WHO) we only located data for 15. There was wide between country variation in prevalence of MetS. A national survey from Philippines conducted in 2003 revealed the lowest reported prevalence of 11.9% according to NCEP ATP III criteria. In contrast, the highest recorded prevalence in the region (49.0%) came from a study conducted in urban Pakistan (Karachchi, 2004). Most studies reported a higher prevalence of MetS in females and urban residents. Data on secular trends were available for China, South Korea and Taiwan. An increase in the prevalence of MetS was observed in all three countries.Conclusion: Despite differences in methodology, diagnostic criteria and age of subjects studied, the Asia-Pacific region is facing a significant epidemic of MetS. In most countries nearly 1/5th of the adult population or more were affected by MetS with a secular increase in prevalence. Strategies aimed at primary prevention are required to ameliorate a further increase in the epidemic and for the reduction of the morbidity and mortality associated with MetS. [ABSTRACT FROM AUTHOR]

Adolescent obesity is a crucial public health concern, and understanding its risk factors can facilitate the establishment of prevention policies. In this study we investigated the prevalence of adolescent obesity in Taiwan, determined the influential factors, and compared the prevalence of obesity in our study population with international indices. The cross‐sectional study was an analysis of data from the 2010–2011 Nutrition and Health Survey in Taiwan, an anthropometric measurement and questionnaire survey of adolescents aged 11–18 years. Our sample was 1,826 adolescents (910 males and 916 females). Data were analyzed using logistic regression modeling. Based on body mass index standards specific to Taiwan norms, the prevalence of overweight and obesity in Taiwan adolescents was 12.4% and 16.8%, respectively. The prevalence was lower when international indices of overweight and obesity were applied. In logistic regression, obesity was linked to male gender, an obese father, overweight or obese mother, poor dietary attitudes, and perceived low dietary benefits. Monitoring and preventing adolescent obesity should focus on both adolescents and their parents. When planning behavioral change and education for adolescent obesity, health professionals and policy‐makers should view the family as a unit. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Auricular acupoint stimulation has become a popular weight loss method. However, its efficacy for obesity treatment has not been fully studied. This study aimed to investigate the effect of a 10-week intervention of auricular electrical stimulation combined with auricular acupressure on weight reduction in obese outpatients. In this single-blind randomized sham-controlled study, 134 participants were randomly assigned to an experimental group receiving stimulation at true acupoints, or a sham group receiving stimulation delivered in the same manner but at sham acupoints. Each participant received nutrition counseling by a nutritionist weekly. The results showed significant differences in body mass index, blood pressure, total cholesterol, triglyceride, and leptin or adiponectin over time within the group, but not between the groups. This study could not exclude the effect of placebo and dietary consultation. Further study that adds a control group receiving no treatment is therefore needed to confirm the effects of auricular acupressure. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop a descriptive theory for the weight loss experiences of obese perimenopausal women with metabolic syndrome. Background Obesity and metabolic syndrome both pose a threat to the health of perimenopausal women; therefore, understanding perimenopausal women's subjective feelings and experiences is beneficial to establishing effective prevention strategies. However, studies have rarely explored these relevant experiences. Design A qualitative study using the grounded theory method to establish a descriptive theory. Methods Eighteen obese perimenopausal women with metabolic syndrome aged 45-60 years participated in comprehensive interviews. Results 'Crossing the gaps to making life modifications' was the core category, and 'the awareness of weight gain and health alarm' was the antecedent condition. In the weight loss experience, the following three interaction categories were identified: (1) 'experiencing bad feelings,' (2) 'encountering obstacles' and (3) 'making efforts to transition to a new life.' Some women adhered to new life habits through perceiving social support and by using self-incentives. Finally, women enjoyed and mastered self-monitoring of their health in their new life, and practiced new changes as part of their life. However, some participants felt that making changes to their life was too time-consuming. Therefore, these women chose to live with their abnormal health without making changes. Conclusions Obese perimenopausal women with metabolic syndrome experienced various gaps in their weight loss process. Although they struggled with many obstacles, these women were able to learn from their experiences and face their health challenges. Relevance to clinical practice These findings can guide healthcare professionals to provide appropriate interventions to understand the hidden health problems of this particular group of women. Healthcare professionals should develop a set of plans by which women receive a complete weight loss program and support from professionals and family. [ABSTRACT FROM AUTHOR]

The article presents findings of a study to develop and psychometrically test the Energy Retention Behavior Scale for Children (ERB-C scale) to help health professionals comprehensively assess the energy retention behavior of children. Energy retention causes obesity, so the scale was formed that showed satisfactory validity and reliability.

Obesity has become a major health risk in industrialized countries, with disturbed sleep identified as a correlate. This study used data drawn from Taiwan’s 2005 Social Development Trend Survey on Health and Safety and the propensity-score-matching method to shed light on gender-specific associations between sleep problems and obesity among 24,113 adults aged 20–64 years. The average increase in obesity prevalence among respondents with disrupted sleep was 1.85%, as compared to those who did not report disrupted sleep, with similar psycho-social attributes. Similarly, the prevalence of obesity among those who reported restless sleep was increased by an average of 1.40% compared to those who did not report restless sleep with similar psycho-social attributes. We also found gender-specific vulnerability to different types of sleep problems. Among men who reported disrupted sleep, we found a 3.12% increase in the prevalence of obesity. Among women exposed to restless sleep, the increase in obesity prevalence was 1.84%. The observed gender difference in the prevalence of increases in obesity may be attributed to gender-specific behavioral responses to poor sleep. With poor sleep, men may respond to hunger by overeating; women may respond by physical inactivity. Both can contribute to an elevated risk of obesity. [ABSTRACT FROM AUTHOR]

This study examined associations between four health-related physical fitness measures and obesity in Taiwanese youth aged 10–18 years. Data from 13,500 school-aged youth were randomly selected from the “School Physical Fitness Database” of Taiwan by sex and age. Variables examined were height, body mass and performance on modified sit-and-reach (flexibility), bent-leg sit-up (abdominal muscular strength/endurance), standing long jump (lower body explosive strength) and distance run/walk (cardiorespiratory endurance). Adjusted logistic regression analyses were performed. Increased odds of being obese with decreased fitness levels were observed for lower body explosive strength and cardiorespiratory endurance in both sexes. The highest odds of being obese was found in the least fit quintile of cardiorespiratory endurance compared with the most fit quintile both in boys (Odds ratio, OR = 10.44; 95% confidence interval (CI), 7.94–13.73) and girls (OR = 5.40; 95% CI, 3.90–7.47). These findings suggest that in addition to cardiorespiratory fitness, lower body explosive strength is also associated with childhood and adolescent obesity. [ABSTRACT FROM PUBLISHER]

The article discusses studies on obesity, diet, and lifestyle of patients with diabetes, published in medical journals in 2012. J. B. Dixon and colleagues identified preoperative predictors of diabetes remission after gastric bypass surgery in ethnic Chinese patients with type 2 diabetes living in Taiwan. J. W. Sacre and colleagues compared heart rate recovery after exercise to assess diabetic cardiac autonomic neuropathy.

To examine the relationships between depression, coronary artery disease, type 2 diabetes, metabolic syndrome and quality of life in Taiwanese adults from a cardiovascular department of a major hospital in Taiwan. Research suggests associations between depression, metabolic syndrome and quality of life. Despite this fact, few studies have investigated these relationships among Taiwanese. A cross-sectional descriptive correlational design was used to conduct this study. A convenience sample of 140 adults participated in the study. Data were analysed with descriptive statistics, Pearson's correlations, hierarchical regression and t-tests. Almost a half of the subjects (46·5%) had metabolic syndrome. The most common combination of metabolic syndrome criteria was elevated blood glucose, central obesity and high blood pressure (23·7%). A greater number of individuals had coronary artery disease (72·9%), type 2 diabetes (35%) and/or depression (21·4%). Type 2 diabetes and depression were significant predictors of overall quality of life (β = −0·16, p < 0·01 and β = −0·63, p < 0·001, respectively). In addition, there were significant differences between individuals with and without type 2 diabetes and/or depression regarding overall quality of life scores; t (138) = 3·50, p < 0·01); and t (138) = 7·80, p < 0·001), respectively. Coronary artery disease, type 2 diabetes and depression were common among our sample of individuals with metabolic syndrome. Those with diabetes and/or depression had worse quality of life than those without those diseases. Nurses need to be prepared to assess and intervene in preventing or treating depression among patients with chronic diseases, especially those with coronary artery disease, type 2 diabetes and metabolic syndrome. When individuals are treated for depression, they are more likely to engage in self-management of their diseases, which will prevent complications and improve their quality of life. [ABSTRACT FROM AUTHOR]

In this study we explored the relationship among obesity, menopausal status, and health behavior among middle-aged women in a rural community of southern Taiwan. This was a cross-sectional study using a face-to-face interview to collect data. Sixty middle-aged women from four community centers participated in this study. The results indicated that approximately 23.3% of the women had body mass index (BMI) ≥27 kg/m2, and 38.3% of the women's waist girths were above 80 cm. Both BMI and waist circumference (WC) of the middle-aged women were significantly different between reproductive and postmenopausal status. The variable of nutrition-related health behavior was significantly and negatively associated with the BMI levels and accounted for 12% of the total variance. An understanding of the factors that contribute to obesity is provided among middle-aged women in Taiwan's rural communities. [ABSTRACT FROM AUTHOR]

Childhood obesity is a problem because it is an important predictor of adult obesity; furthermore, obesity in childhood appears to increase the risk of subsequent morbidity, whether or not obesity persists into adulthood. Many studies have shown that except genetic factors, environmental factors such as dietary pattern and lifestyle are related to the occurrence of obesity and its related comorbidities. Systematic approaches to provide adequately nutritional education, dietary intervention, and encouraged regular physical activity are needed to prevent the occurrence of obesity and to reduce the increase of obesity-related disorders among children. Compared with that of adults, the obesity prevention and treatment programs for children and young adolescents have a better effect such as easier modifiable behavior, greater support from family members, and increase of lean body mass with age. More important, the guideline and approaches for prevention and treatment of children and young adolescents' obesity should be monitored and updated in the future. [ABSTRACT FROM AUTHOR]

Objective: To describe recent trends in overweight and obese schoolchildren in Taiwan using international cut-off points. Design: Three independent cross-sectional surveys were used. Participants: The study enrolled 157 485 students in 1991, 130 770 students in 1997 and 72 789 students in 2003, all aged 6-18 years, from elementary schools, secondary high schools and senior vocational high schools Results: The prevalence of overweight and obese students increased significantly between 1991 and 2003. During this period, the percentage of male overweight and obese students increased from 5.7% to 14.2% and from 7.9% to 17.4%, respectively. The prevalence of female overweight and obese students increased from 11.1% to 13.4% and from 3.1% to 4.1%, respectively. Covariance analysis indicates that both sexes in 2003 had significantly higher percentages of overweight and obese subjects than those in 1991 and 1997 (p<0.001). Additionally, the prevalence of overweight and obese boys was higher than that for girls in each survey (p<0.001). Discussion: Analytical results demonstrate that prevalence and secular trends in overweight and obese Taiwanese children and adolescents increased significantly from 1991 to 2003. Taiwanese boys are more likely to become overweight and obese than their female counterparts. [ABSTRACT FROM AUTHOR]

Through this study, we aimed to determine the association of regular leisure-time physical activity (LTPA) with self-reported body mass index (BMI) and obesity risk among middle-aged and older adults in Taiwan. We conducted a cross-sectional study and reviewed the data derived from the Taiwan National Physical Activity Survey (TNPAS). Responses from 12,687 participants aged 45–108 years from the database were collected in this study. All the participants completed a standardized structured questionnaire that solicitated information regarding their demographic characteristics (age, gender, education, occupation, and self-reported health status), physical activity behaviors (regular/nonregular LTPA), and self-reported anthropometrics (height, weight, and BMI). Multiple linear and logistic regressions were used to examine the association between regular LTPA and BMI, and between regular LTPA and obesity status, respectively. Regular LTPA was associated with male gender, normal weight, excellent or good self-reported health status, and a lower rate of being underweight compared with nonregular LTPA. Regular LTPA was significant negatively associated with being underweight (OR = 0.71, p < 0.05), whereas it had no significant relationship with BMI and obesity (p > 0.05). Regular LTPA was associated with a reduced risk of being underweight among middle-aged and elderly adults in Taiwan. Further research on the relevant mechanism underlying this phenomenon is warranted. [ABSTRACT FROM AUTHOR]

The purposes of this study were to identify patterns of physical activity among white-collar men in Taiwan and to analyze the relationships between physical activity patterns and obesity indices. This cross-sectional survey included 350 subjects (between 21 and 75 years old). The Monitoring Trends and Determinants of Cardiovascular Disease Optional Study of Physical Activity Questionnaire (MOSPA-Q), developed and published by the World Health Organization (WHO) was used to measure subjects' daily energy expenditures attributed to physical activity. Obesity indices included body weight, body mass index (BMI), waist/hip ratio (WHR), body fat percentage, total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Three patterns of physical activity, namely work-oriented, active, and light-active lifestyles, were identified through cluster analysis. The work-oriented group reported spending the most amount of time on work-related activities (10.5 hours/week). The active group spent the most time (1 hour/day) of the three groups on leisure activities. The light-active group spent the most time (7 hours/day) of the three groups on light activities. Referencing the 150 minutes/week of moderate-intensity physical activity recommended by the US Centers for Disease Control and prevention (CDC) for health gain as a cut-off point, 1.1%, 15.2%, and 29.1% of subjects in the active, light-active and work-oriented groups, respectively, failed to achieve this minimal level. Those in the work-oriented group categorized in high work-overload and prevalent inactivity situations returned the worst obesity indices (Body weight, BMI, WHR, and body fat percentages) adjusted by age. [ABSTRACT FROM AUTHOR]

Objective:To examine the prevalence of childhood and adolescent obesity in Taiwan and investigate the association between excess weight and physical fitness and blood pressure.Design:Cross-sectional study.Subjects:A total of 13 935 children and adolescents aged 6–18 years (boys: 7031, girls: 6904) were involved in the 1999 survey and 24 586 (boys: 12 367, girls: 12 219) were available in the 2001 survey.Measurements:Weight, height, systolic and diastolic blood pressures, and health-related fitness tests (bent-leg curl-ups, sit-and-reach test and step test) were measured.Results:The overall prevalence of obesity (including overweight) in boys was 19.8% in 1999 and 26.8% in 2001. It was lower in girls with 15.2% in 1999 and 16.5% in 2001. The normal weight group performed better (P<0.05) than the overweight/obese group in all fitness tests except in the 2001 sit-and-reach test where there were no differences between the two groups. The risk of hypertension increased nearly two times for the overweight/obese-fit group and nearly three times for the overweight/obese-unfit group compared to the normal weight-fit group (adjusted odds ratio (AOR)=1.93, 95%CI=1.514–2.451 and AOR=2.93, 95%CI=2.493–3.454, respectively).Conclusion:Overall, the findings demonstrated that there is an increasing trend in overweight/obesity prevalence for Taiwanese youth even in a 2-year period. The overweight/obese youngsters tend to have poorer muscular strength and cardiovascular endurance than the normal weight group. The overweight/obese and unfit group had a greater risk of hypertension than other groups. However, this risk was significantly lower if obese/overweight children had a higher than average level of cardiovascular fitness.European Journal of Clinical Nutrition (2006) 60, 1367–1375. doi:10.1038/sj.ejcn.1602466; published online 14 June 2006 [ABSTRACT FROM AUTHOR]

Obesity contributes to multiple systemic disorders; however, extensive discussion regarding obesity and open-angle glaucoma (OAG) remains limited, and conclusions in the existing literature diverge. This study aims to analyze the risk of OAG among obese adults in Taiwan. In this study, adults (aged ≥18 years) with a diagnostic code of obesity or morbid obesity registered in the Longitudinal Health Insurance Database (LHID) 2000 and LHID2005 from 1 January 2001 to 31 December 2010 were included. All adults were traced until the diagnosis of OAG, the occurrence of death, or 31 December 2013. Risk of OAG was significantly higher in obese adults than in non-obese adults after multivariable adjustment (adjusted hazard ratio (aHR): 1.43 (95% confidence interval (CI) 1.11–1.84)/aHR: 1.54 (95% CI 1.23–1.94) in the LHID2000/LHID2005). Both databases demonstrated that young obese adults (aged ≤40 years) had a remarkably increased risk of OAG compared with young non-obese adults (aHR 3.08 (95% CI 1.82–5.21)/aHR 3.81 (95% CI 2.26–6.42) in the LHID2000/LHID2005). This two-database matched-cohort study suggests that obese adults have an increased risk of OAG. In young adults, in particular, obesity could be a potential risk factor of OAG. [ABSTRACT FROM AUTHOR]