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Background: Metabolic syndrome (MetS) is reportedly a crucial risk factor for coronavirus disease 2019 (COVID-19). Since the epidemiological studies that examine this association are few and include small samples, we investigated the relationship between MetS and COVID-19 severity and death using a larger sample in the Republic of Korea.Methods: We analyzed 66,321 patients, 4,066 of whom had COVID-19. We used chi-square tests to examine patients’ characteristics. We performed logistic regression analysis to analyze differences in COVID-19 infection and clinical outcomes according to the presence of MetS.Results: Although MetS was not significantly associated with COVID-19 risk, acquiring MetS was significantly associated with the risk of severe COVID-19 outcomes (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.34 to 2.91; P=0.001). The mortality risk was significantly higher in COVID-19 patients with MetS (OR, 1.74; 95% CI, 1.17 to 2.59; P=0.006). Patients with abnormal waist circumference were approximately 2.07 times more likely to develop severe COVID-19 (PP=0.012).Conclusion: COVID-19 is likely associated with severity and death in patients with MetS or in patients with MetS risk factors. Therefore, patients with MetS or those with abnormal waist circumference and HDL-C levels need to be treated with caution.

Manual titration of positive airway pressure (PAP) is a gold standard to provide an optimal pressure for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAS). Since manual titration studies were costly and time-consuming, many statistical models for predicting effective PAPs were reported. However, the prediction accuracies of the models associated with nocturnal parameters still remain low. This study proposes a fuzzy neural prediction network (FNPN) with input candidate variables, selected among easily available measurements (e.g., body mass index (BMI), waist circumstance (WC), and body composition) and OSAS related questionnaires, to rapidly predict an optimal PAP. The FNPN comprises fuzzy rules and is characterized with the ability of automatic rule growing and pruning from training data. A total of 147 participants from April 2018 to April 2019 were enrolled in Taichung Veterans General Hospital, Taiwan. After two selection processes for feature extraction, WC and BMI were the significant variables for entering the FNPN to predict optimal PAP. Experimental results showed that the average successful prediction rate of the proposed method was 71.8%. This study also found that Epworth sleepiness scales (ESS) and body composition, such as visceral fat area and percent body fat, were excluded in the final prediction model. Compared with existing models, the proposed prediction approach provided a rapid prediction of optimal PAP with higher accuracy.

Although magnesium intake is inversely associated with the risk of metabolic abnormalities, whether magnesium intake plays a role on metabolically healthy obese (MHO) phenotype has not been explored. Therefore, the purpose of this study was to determine whether the magnesium intake is associated with the MHO phenotype. Apparently, healthy women and men aged 20–65 years with obesity were enrolled in a cross-sectional study. Subjects were allocated into MHO (n=124) and metabolically unhealthy obese (MUO) (n=123) groups. MHO phenotype was defined by abdominal obesity (waist circumference ≥90 cm in men and ≥80 cm in women) and none, or not more than one of the following risk factors: triglyceride levels ≥150 mg/dL; high-density lipoprotein cholesterol (HDL-C) levels

Study design Retrospective cohort study Objective To assess the association between obesity and the development of third, fourth, and sixth cranial nerve palsy (CNP). Methods We analyzed a cohort of 4,067,842 adults aged between 20 and 90 years who underwent health checkups within the National Health Insurance Service between January 1 and December 31, 2009. The participants were followed until December 31, 2017. Cox proportional hazards regression analysis was used to determine the adjusted hazard ratios (HRs) for CNP. Model 3 (the main analysis model) was adjusted for age, sex, smoking status, alcohol consumption, and physical activity. Model 4 was additionally adjusted for hypertension, dyslipidemia, and diabetes mellitus in the setting of model 3. Results A total of 5,835 individuals were diagnosed with CNP during the follow-up period (7.3 years). General obesity (body mass index (BMI) ≥ 25 kg/m2) was associated with an increased risk of CNP compared to individuals without general obesity (model 3, HR = 1.248 [95% confidence Interval (CI): 1.184 – 1.315]; model 4, HR = 1.162 [95% CI: 1.102 – 1.227]). Abdominal obesity (waist circumference [WC] ≥ 90 cm in men and ≥ 85 cm in women) also showed an increased HR compared to individuals without abdominal obesity (model 3, 1.239 [95%CI:1.170 – 1.313]; model 4, HR = 1.127 [95% CI: 1.062 – 1.196]). Compared to the group without either type of obesity, the group with only abdominal obesity (model 3, HR = 1.167 [95% CI: 1.035 – 1.317]), the group with only general obesity (HR = 1.19 [95% CI: 1.14 – 1.24]), and the group with both obesity types (HR = 1.317, [95% CI: 1.236 – 1.404]) showed increased HRs for CNP. Conclusion Based on our population-based cohort study, both general and abdominal obesity increased the risk of CNP. Also, the combination of general and abdominal obesity may further increase the risk of CNP.

OBJECTIVE The excess of visceral adipose tissue might hinder and delay immune response. How people with abdominal obesity (AO) will respond to mRNA vaccines against SARS-CoV-2 is yet to be established. We evaluated SARS-CoV-2 specific antibody responses after the first and second dose of the BNT162b2 mRNA vaccine comparing the response of individuals with AO to those without, discerning between individuals with or without prior infection. METHODS IgG neutralizing antibodies against the Trimeric-complex (IgG-TrimericS) were measured at four time points: at baseline, at day 21 after vaccine dose 1, at one and three months after dose 2. Nucleocapsid antibodies were assessed to detect prior SARS-CoV-2 infection. Waist circumference was measured to determine AO. RESULTS Between the first and third month after vaccine dose 2, the drop in IgG-TrimericS levels was more remarkable in individuals with AO compared to those without AO (2.44 fold [95%CI: 2.22-2.63] vs 1.82 fold [95%CI: 1.69-1.92], respectively, p

OBJECTIVES: The aims of this study are to (1) create clusters of joint temporal patterns of diet and physical activity (PA), and (2) determine the association of these clusters with health status indicators including body mass index (BMI), waist circumference (WC), fasting plasma glucose, hemoglobin A1c, triglyceride, high-density lipoprotein cholesterol, total cholesterol, blood pressure and health outcomes including obesity, Type 2 Diabetes (T2DM) and metabolic syndrome (MS) in U.S. adults 20–65 years. METHODS: A random day of PA from accelerometry data and the first day 24 hour dietary recall collected in the National Health and Nutrition Examination Survey 2003–2006 were used to determine absolute PA intensity, absolute energy intake, and the time of these activities. Dietary and PA data from 1,627 U.S. adults were Z-normalized. Dynamic time warping (DTW) coupled with kernel-k means clustering algorithm was used to develop joint temporal dietary and PA patterns that maximally partition individuals with similar temporal behaviors into mutually exclusive clusters derived from the data rather than predefined standards. Multivariate regression models adjusted for ptential confounders, multiple comparisons and survey design factors determined associations between joint temporal patterns and health status indicators along with health outcomes (P

Summary: Elevation of serum uric acid (SUA) is linked with the development of certain disease conditions such as cardiovascular diseases, chronic kidney disease, stroke, hypertension, and metabolic syndrome (MS). Although limited information exists to prove its association, a good number of studies and clinical trials support its role. This study investigate the relationship between MS and SUA of the undergraduate students of the University of Nigeria, Nsukka. Body mass index (BMI), blood pressure, fasting blood sugar (FBS), serum lipid profile, and SUA concentrations of 229 students comprising of 89 males and 140 females were determined following standard procedures with little modifications where necessary. Result reveals that body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), FBS, low density lipoprotein (LDL), total cholesterol (TC), high density lipoprotein (HDL), triacylglycerol (TAG) and serum uric acid concentration had no significant difference between the age groups while height, pulse, waist, and BMI had significant (p < 0.05) difference between the age groups. The SUA correlates positively with sex (r = 0.650, p < 0.01), SBP (r = 0.250, p < 0.01), TC (r = 0.205, p < 0.01) and triacylglycerol (r = 0.550, p < 0.01). The result of this study demonstrates that an increase in SUA concentration may lead to a concomitant increase in blood pressure, total cholesterol, and triacylglycerol which in turn may predispose the subjects to MS within the different age groups as revealed by our data.

Background Several risk factors, among others lifestyle factors, have been suggested for hand eczema (HE). Objectives To investigate a possible association between HE and life style factors, including smoking, alcohol consumption, stress, body mass index (BMI), waist circumference, physical activity, diet and amount of sleep in the Dutch general population. Methods Data from the large population-based LifeLines Cohort Study was used. Individuals with HE in the past year were identified by a cross-sectional questionnaire in 2020. At baseline, information on lifestyle factors was collected. Results In total 57 046 individuals were included in the present analysis. Smoking ≥8 cigarettes/day, and smoking ≥15 pack years showed a positive association with HE in the past year. Also, chronic stress, a BMI > 30 kg/m2, and a waist circumference of >90 cm, were positively associated with HE in the past year. Conclusions The current study indicates that lifestyle factors are associated with HE. Advice regarding lifestyle factors might contribute to enhance overall health, of which HE might possibly benefit in conjunction. Further studies should also focus on the association between lifestyle factors and the severity and prognosis of HE rather than on occurrence alone. This article is protected by copyright. All rights reserved.

To determine and compare the incidence and severity of cognitive disorders (CD) in patients of young and middle age with atrial fibrillation (AF), abdominal obesity (AO) and metabolic syndrome (MS) 196 patients were examined. CD, associated with impairment of memory, attention, impaired perception, verbal speed, and еxecutive functions, were diagnosed in 88.3 % of patients with AF and AO, and in 89.5 % of patients with MS. In patients with AF, including combination with AO, predement and severe CD occurred more frequently than in patients with AO and with sinus rhythm. In patients with sinus rhythm and normal waist circumference without cardiovascular disease, moderate and severe CD were not observed. The severity of CD in patients with AF and AO do not depend on structural changes of the carotid arteries and the heart. Risk factors for development of CD in patients of young and middle age with AF and AO were the presence of MS and elevated levels of C-reactive protein in serum. Patients of young and middle age with AF, AO and MS requires assessment of cognitive function for early diagnosis and prevention of CD progression.

Background: Obesity and diabetes are associated with a higher risk of heart failure (HF). The interrelationships between different measures of adiposity—overall obesity, central obesity, fat mass (FM)—and diabetes status for HF risk are not well-established. Methods: Participant-level data from the ARIC study (Atherosclerosis Risk in Communities; visit 5) and the CHS (Cardiovascular Health Study; visit 1) cohorts were obtained from the National Heart, Lung, and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center, harmonized, and pooled for the present analysis, excluding individuals with prevalent HF. FM was estimated in all participants using established anthropometric prediction equations additionally validated using the bioelectrical impedance-based FM in the ARIC subgroup. Incident HF events on follow-up were captured across both cohorts using similar adjudication methods. Multivariable-adjusted Fine-Gray models were created to evaluate the associations of body mass index (BMI), waist circumference (WC), and FM with risk of HF in the overall cohort as well as among those with versus without diabetes at baseline. The population attributable risk of overall obesity (BMI≥30 kg/m 2 ), abdominal obesity (WC>88 and 102 cm in women and men, respectively), and high FM (above sex-specific median) for incident HF was evaluated among participants with and without diabetes. Results: The study included 10 387 participants (52.9% ARIC; 25.1% diabetes; median age, 74 years). The correlation between predicted and bioelectrical impedance-based FM was high ( R 2 =0.90; n=5038). During a 5-year follow-up, 447 participants developed HF (4.3%). Higher levels of each adiposity measure were significantly associated with higher HF risk (hazard ratio [95% CI] per 1 SD higher BMI=1.15 [1.05, 1.27], WC=1.22 [1.10, 1.36]; FM=1.13 [1.02, 1.25]). A significant interaction was noted between diabetes status and measures of BMI ( P interaction=0.04) and WC ( P interaction=0.004) for the risk of HF. In stratified analysis, higher measures of each adiposity parameter were significantly associated with higher HF risk in individuals with diabetes (hazard ratio [95% CI] per 1 SD higher BMI=1.29 [1.14–1.47]; WC=1.48 [1.29–1.70]; FM=1.25 [1.09–1.43]) but not those without diabetes, including participants with prediabetes and euglycemia. The population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF was higher among participants with diabetes (12.8%, 29.9%, and 13.7%, respectively) versus those without diabetes (≤1% for each). Conclusions: Higher BMI, WC, and FM are strongly associated with greater risk of HF among older adults, particularly among those with prevalent diabetes.

Background: High meat consumption might play a role in promoting low-grade systemic inflammation, but evidence is limited. Objectives: We examined cross-sectional associations of habitual meat consumption with serum C-reactive protein (CRP) and total white blood cell count (WBCC) in British adults. Methods: We included 403,886 men and women (aged 38–73 y) participating in the UK Biobank who provided information on meat intake (via touchscreen questionnaire) and a nonfasting blood sample at recruitment (2006–2010). For a subset of participants (∼5%), an additional blood sample was collected (median 4.4 y later). We used multivariable linear regression models to estimate associations of meat intake (total meat, unprocessed red meat, processed meat, and poultry) with logCRP and logWBCC. Results: The difference in the serum CRP (mg/L) for each 50-g/d higher intake for total meat was 11.6% (95% CI: 11.1, 12.0%), for processed meat was 38.3% (95% CI: 36.0, 40.7%), for unprocessed red meat was 14.4% (95% CI: 13.6, 15.1%), and for poultry was 12.8% (95% CI: 12.0, 13.5%). The difference in the WBCC (×10–9L) for each 50 g/d higher intake of total meat was 1.5% (95% CI: 1.4, 1.6%), for processed meat was 6.5% (95% CI: 6.1, 6.9%), for unprocessed red meat was 1.6% (95% CI: 1.4, 1.7%), and for poultry was 1.6% (95% CI: 1.4, 1.7%). All associations were attenuated after adjustment for adiposity; by 67% with BMI (in kg/m2) and by 58% with waist circumference for total meat and CRP, and by 53% and 47%, respectively, for WBCC, although associations remained statistically significant. Findings of sensitivity analyses in 15,420 participants were similar prospectively, except there were no associations between unprocessed red meat and WBCC. Conclusions: Higher meat consumption, particularly of processed meat, was positively associated with inflammatory markers in these British adults; however, the magnitudes of associations are small and predominantly due to higher adiposity.

Objective To examine the combined association of central obesity and depressive symptoms with risk of heart disease in a national prospective cohort study of the Chinese population. Methods Data came from 10,722 community-dwelling adults aged over 45 years, from the China Health and Retirement Longitudinal Study during 2011-2018. Central obesity was assessed with waist circumference (WC) in physical examinations (men with a WC of ≥ 90 cm and women with a WC of ≥ 80 cm). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (score ≥ 10). Participants were assigned to four groups according to central obesity (yes/no) and depressive symptoms (yes/no). Cox proportional hazard regression was used after adjusting for covariates. Results During 7 years of follow-up, we identified 1080 heart disease cases. Compared with people without central obesity and depressive symptoms, the multivariable-adjusted hazard ratios (95% confidence intervals) were 1.39 (1.18, 1.64) for those who had central obesity alone, 1.44 (1.18, 1.77) for those who had depressive symptoms alone, and 1.88 (1.55, 2.30) for those who had both central obesity and depressive symptoms. The combined association in men was more evident than that in women. Conclusions Our study provided evidence that the coexistence of central obesity and depressive symptoms were associated with a substantially increased risk of heart disease compared to those without these two conditions.

Ergonomics is a broad area in which the assessment of the workers is conducted for their comfort in the workplace. Theses study includes motion study, time study, and postures, etc. This paper presents the anthropometric assessment of the person involved in the education system to know the impact of the human factors on their strength. A health survey (ergonomic assessment) was done to track the problem they were suffering. The majority of the participants were suffered from back pain and shoulder/muscle pain. Therefore, concentrating on the back pain, the flexibility of the back was set as the target. The human body parts were measured with the help of various tools and the output response was measured through a customized reach tool-box. Further the statistical tool was utilized for finding the significance of the anthropometric measures on body flexibility. Statistically, the inputs such as weight (wtg) (P = 0.03), waist (wg) (P = 0.001), and age (ag) (P = 0.002) were found significant. Also, it is recommended the staff engage in the office activity must take a break for refreshment, as well as the management, should conduct the motivation session to encourage the people to involve in physical activity like yoga, gym, sports, etc to release their stress and the musculoskeletal disorder.

Obesity and its associated comorbidities are a major public health concern worldwide. Reduced energy intake and increased physical activity interventions have limited success in the long term. Nutraceuticals might be an alternative means to help lose weight and reduce obesity-associated cardiometabolic risk factors without changes in the habitual diet. The objective of the present study was to comparatively evaluate the efficiency of nutraceuticals based on the combination of a decaffeinated green coffee bean extract (GCBE) and two types of oat beta-glucans (BG) with different physiochemical properties on obesity related biomarkers in overweight/obese subjects. A randomized, dose–response, parallel, blind study was carried out in four groups of subjects (n = 15 each) who consumed for 6 weeks, twice a day, a nutraceutical containing 3 g d−1 or 5 g d−1 doses of 35% or 70% BG and a fixed amount of GCBE providing 600 mg d−1 of phenols. 35% BG showed a 10 and 100 times higher molecular weight and viscosity, respectively, compared to 70% BG. Food intake, anthropometry and different cardiometabolic markers were assessed at the beginning and end of the intervention. According to the general model of variance with repeated measure analysis, the intervention caused positive changes in the levels of total cholesterol, LDL cholesterol, VLDL cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, haemoglobin A1c, insulin, systolic blood pressure (SBP), total body fat percentage (TBF%), visceral fat percentage, and waist and hip circumferences without differences among the treatments, except for SBP and TBF%. Looking into the rates of change [(end value − beginning value)/beginning value] of these parameters, 5 g – 70% BG was the treatment that lowered TBF% the most. In conclusion, 5 g – 70% BG may be more effective in helping to lose weight and additionally, it produced the least bloating according to participants’ subjective perception., This research was funded by project AGL2015-69986-R from the Ministerio de Economía y Competitividad. JGC had a predoctoral grant funded by Comunidad de Madrid (PEJD-2018-PRE/SAL-9104).

Background: This article assessed the relationship between waist circumference (WC) and cardiorespiratory fitness (CRF) of children and adolescents aged 7–18 years. Methods: Using a stratified cluster random sampling method, 92,574 children and adolescents (47,364 males and 45,210 females) were extracted. CRF was measured by performance in the 20 m shuttle run test (20mSRT) and the subsequent estimation of maximal oxygen consumption (V˙O2max) using the Léger equations. Participants were divided into five groups of WC percentiles and three groups of CRF percentiles by the Lambda Mu Sigma (LMS). The correlation between WC and CRF was examined by one-way ANOVA and curvilinear regression analysis. Results: WC increased with age, while V˙O2max showed an age-related decline. Controlling for gender, urban, and rural factors, for children and adolescents aged 10–12, 13–15, and 16–18 years, the V˙O2max Z-score of the normal WC group was significantly higher than the very low WC group (P

IntroductionTo train and prepare cadets for a career as firefighters in Rio de Janeiro, the second-year students of the Officers Training Course are submitted to a Search, Rescue, and Survival Training (SRST) course, which is characterized by long periods of high physical exertion and sleep restriction during a 9-day instruction module, and food restriction during a 7-day survival module. The present study investigated changes in the body composition of 39 male cadets submitted to SRST during training and 4 weeks of recovery with no restrictions in food consumption.Materials and MethodsEach cadet was evaluated by anthropometric measurements at six time points: pre-SRST; after the first module; after the second module; and after 1, 2, and 4 weeks of recovery. Measurements included body girths and skinfolds, to estimate trunk (chest and waist) and limbs (arm and thigh) dimensions, as well as body composition. Repeated measures ANOVA and Friedman test were applied (depending on each data distribution).ResultsStatistically significant decreases in body weight (76.2; 69.8-87.2 to 63.9; 58.9-73.5 kg) and fat free mass (FFM, 69.2; 63.7-77.2 to 60.1; 56.2-68.0 kg) were observed following the second module of SRST. Following a single week of recovery, the FFM returned to pre-SRST values. Body weight returned to pre-training levels in 2 weeks. Body fat percentage and mass also significantly decreased during SRST (9.0; 7.7-12.3 to 6.5; 5.1-9.3% and 6.9; 5.6-10.0 to 6.9; 5.6-10.0 kg, respectively), which showed a slower and more gradual recovery that reached pre-SRST values after 4 weeks. The girths of arm, thigh, chest and waist significantly decreased due to SRST. The girths of the limbs (arm and thigh) returned to pre-training values after one month of recovery, while the girths of the trunk (chest and waist) did not return to pre-SRST values during the study period.ConclusionsThe findings suggest that men who experience periods of high energy demands and sleep restriction followed by a period of food restriction will endure unavoidable physical consequences that can be mostly reversed by a 1-month recovery.

BACKGROUND Recent studies showed that eating behaviors such as disinhibition, emotional and external eating, and snacking mediate genetic susceptibility to obesity. It remains unknown if diet quality and intake of specific food groups also mediate the genetic susceptibility to obesity. OBJECTIVE This study aimed to assess if diet quality and intakes of specific food groups mediate the association between a polygenic risk score (PRS) for body mass index (BMI) and BMI and waist circumference (WC). We hypothesized that poor diet quality, high intakes of energy-dense food groups and low intakes of nutrient-dense food groups mediate the genetic susceptibility to obesity. METHODS This cross-sectional study included 750 participants (56.3% women, age 41.5 ± 14.9 years, BMI 27.8 ± 7.5 kg/m2) from the Quebec Family Study. A PRSBMI based on > 500,000 genetic variants was calculated using LDpred2. Dietary intakes were assessed with a 3-day food record from which a diet quality score (i.e., Nutrient Rich Food Index 6.3) and food groups were derived. Mediation analyses were conducted using a regression-based and bootstrapping approach. RESULTS : The PRSBMI explained 25.7% and 19.8% of the variance in BMI and WC, respectively. The association between PRSBMI and BMI was partly mediated by poor diet quality (β = 0.33 ± 0.12; 95% CI: 0.13, 0.60), high intakes of fat and high-fat foods (β = 0.46 ± 0.16; 95% CI: 0.19, 0.79) and sugar-sweetened beverages (β = 0.25 ± 0.14; 95% CI: 0.05, 0.60), and low intakes of vegetables (β = 0.15 ± 0.08; 95% CI: 0.03, 0.32), fruits (β = 0.37 ± 0.12; 95% CI: 0.17, 0.64) and dairy products (β = 0.17 ± 0.09; 95% CI: 0.02, 0.37). The same trends were observed for WC. CONCLUSIONS The genetic susceptibility to obesity was partly mediated by poor diet quality and intakes of specific food groups. These results suggest that improvement in diet quality may reduce obesity risk among individuals with high genetic susceptibility and emphasize the need to intervene on diet quality among these individuals.

Purpose Glaucoma leads to pathological loss of axons in the retinal nerve fibre layer at the optic nerve head (ONH). This study aimed to develop a strategy for the estimation of the cross-sectional area of the axons in the ONH. Furthermore, improving the estimation of the thickness of the nerve fibre layer, as compared to a method previously published by us. Methods In the 3D-OCT image of the ONH, the central limit of the pigment epithelium and the inner limit of the retina, respectively, were identified with deep learning algorithms. The minimal distance was estimated at equidistant angles around the circumference of the ONH. The cross-sectional area was estimated by the computational algorithm. The computational algorithm was applied on 16 non-glaucomatous subjects. Results The mean cross-sectional area of the waist of the nerve fibre layer in the ONH was 1.97 ± 0.19 mm2. The mean difference in minimal thickness of the waist of the nerve fibre layer between our previous and the current strategies was estimated as CIμ (0.95) 0 ± 1 μm (d.f. = 15). Conclusions The developed algorithm demonstrated an undulating cross-sectional area of the nerve fibre layer at the ONH. Compared to studies using radial scans, our algorithm resulted in slightly higher values for cross-sectional area, taking the undulations of the nerve fibre layer at the ONH into account. The new algorithm for estimation of the thickness of the waist of the nerve fibre layer in the ONH yielded estimates of the same order as our previous algorithm.

Objective: Rheumatoid cachexia (RC) is prevalent among patients with established rheumatoid arthritis (RA). Although changes in muscle mass and fat mass have been reported in early RA, these findings have not been classified according to existing RC definitions. This study aimed to describe the prevalence of RC and associated variables in patients with early RA. Method: This cross-sectional study included 87 patients. Body composition was evaluated with dual-energy X-ray absorptiometry after a median disease duration of 15 months. RC was defined as a fat-free mass index < 10th percentile and fat mass index > 25th percentile. We also assessed the erythrocyte sedimentation rate (ESR), C-reactive protein, Disease Activity Score in 28 joints, aerobic capacity, physical activity, traditional cardiovascular disease risk factors, functional disability, and sociodemographic data. Associations between RC and the independent variables were determined with logistic regression analyses. Results: The prevalence of RC was 24%. RC was significantly associated [odds ratio (95% confidence interval)] with aerobic capacity [0.28 (0.09–0.89), p = 0.030], low-intensity physical activity [0.77 (0.60–0.99), p = 0.048], body mass index [0.78 (0.70–0.92), p = 0.002], waist circumference [0.96 (0.92–0.99), p = 0.023], body weight [0.94 (0.90–0.98), p = 0.004], and ESR at the time of diagnosis [1.02 (1.00–1.05), p = 0.033]. All of these associations remained significant after adjusting for age and gender. Conclusion: RC was highly prevalent in early RA. Patient outcome may be improved by detecting this condition early and applying treatments for improving inflammation, aerobic capacity, physical activity, and body composition.

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has rapidly increased worldwide. The aim of this study was to investigate whether there is an independent relationship between regional fat distribution, especially leg fat mass, and the presence of NAFLD using nationally representative data in Korea.Methods: This cross-sectional study analyzed data from 14,502 participants in the Korea National Health and Nutrition Examination Survey 2008 to 2011. Total fat mass, leg fat mass, and appendicular skeletal muscle mass were measured by dual-energy X-ray absorptiometry. Validated NAFLD prediction models and scoring systems for hepatic fibrosis were used.Results: The leg fat to total fat (LF/TF) ratio showed a negative relationship with many factors, including body mass index, waist circumference, blood pressure, fasting blood glucose, and liver enzyme levels. When the LF/TF ratio and indices of hepatic steatosis were stratified by quartiles, the LF/TF ratio showed a negative correlation with the scoring systems that were used. The LF/TF ratio showed better accuracy in predicting NAFLD than total fat mass or leg fat mass alone. After adjusting for various traditional and lifestyle factors, a low LF/TF ratio remained a risk factor for NAFLD. Among NAFLD subjects, the LF/TF ratio showed a negative relationship with hepatic fibrosis.Conclusion: A lower LF/TF ratio was markedly associated with a higher risk of hepatic steatosis and advanced hepatic fibrosis using various predictive models in a Korean population. Therefore, the LF/TF ratio could be a useful anthropometric parameter to predict NAFLD or advanced hepatic fibrosis.

Background: Cardiometabolic Index (CMI) was associated with several risk factors for stroke; however, few studies assessed the role of CMI in stroke risk. Objective: This study aimed to assess the association between CMI and stroke in a population- based cross-sectional study. Methods: This study included 4445 general residents aged ≥40 years selected by multistage stratified random cluster sampling. CMI was calculated as the product of the ratio of waist circumference to height (WHtR) and the ratio of triglyceride levels to high-density lipoprotein cholesterol levels (TG/HDL-C). Participants were categorized according to CMI quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to assess the association between CMI and stroke. Results: A total of 4052 participants were included in the study, with an overall stroke prevalence of 7.2%. The prevalence of stroke increased with CMI quartiles, ranging from 4.4% to 9.2% (p for trend Conclusion: Although there was a strong and independent association between CMI and stroke in the general population, CMI had limited discriminating ability for stroke. Thus, new parameters should be developed.

Context Nondigestible fermentable carbohydrates (NDFCs) can be fermented by microbiota, thereby yielding metabolites that have a beneficial role in the prevention and treatment of obesity and its complications. However, to our knowledge, no meta-analysis has been conducted to evaluate the effects of NDFCs on obesity. Objective To conduct a meta-analysis of randomized controlled trials (RCTs) to summarize existing evidence on the effects of numerous NDFCs on adiposity and cardiovascular risk factors in adults with overweight or obesity with ≥2 weeks of follow-up. Data Sources The following databases were searched: MEDLINE, Embase, and CINAHL. Data Extraction Seventy-seven RCTs with 4535 participants were identified for meta-analysis from the 3 databases. Data Analysis The findings suggest that increased intake of NDFCs is significantly effective in reducing body mass index by 0.280 kg/m2, weight by 0.501 kg, hip circumference by 0.554 cm, waist circumference by 0.649 cm, systolic blood pressure by 1.725 mmHg, total cholesterol by 0.36 mmol/L, and low-density lipoprotein by 0.385 mmol/L, with evidence of moderate-to-high quality. Conclusion Convincing evidence from meta-analyses of RCTs indicates that increased NDFC intake improves adiposity, blood lipid levels, and systolic blood pressure in people with overweight and obesity.

The effects of diet quality (DQ), physical activity (PA), and socioeconomic status (SES) on the risk of NAFLD are unclear. We examined the association among DQ, PA, SES, and NAFLD risk.This is a cross-sectional analysis of the National Health and Nutrition Examination Surveys, 2017-2018, which included 3589 participants with reliable information on vibration-controlled transient elastography (VCTE) measurements, 24-h dietary recalls, PA, and SES. DQ was assessed by the Healthy Eating Index (HEI)-2015. PA was determined by the Global Physical Activity Questionnaire. SES was assessed by the educational attainment and family poverty income ratio (PIR). Risk of NAFLD was considered by means of a composite outcome using VCTE measurements: non-NAFLD versus NAFLD without clinically significant fibrosis (CSF) versus NAFLD with CSF. The NAFLD risk was lower in physically active (≥600 metabolic equivalent of task [MET] min/week) versus inactive participants (600 MET min/week) (OR: 0.71, p = 0.043). A high-quality diet (HQD) (HEI56.64) was associated with a lower risk of NAFLD (OR: 0.58, p 0.01) compared with a non-HQD. The lowest NAFLD risk was observed in those physically active with HQD (OR: 0.43, p 0.01). Body mass index and waist circumference significantly mediated the effect of DQ and PA on NAFLD risk. Education (college or above) (OR: 0.65, p = 0.034), but not PIR, was associated with a reduced NAFLD risk. HQD and increased PA partially mediated the effect of education on NAFLD risk. The total effect of education on NAFLD risk mediated by DQ was 29% and by PA was 8%.HQD, increased physical activity, and college education were associated with lower NAFLD risk in the US population.

Background Peanut consumption has little effect on body weight, despite its high energy density and is associated with reduced cardiovascular disease risk. Based on previous research, we hypothesized that the consumption of whole peanut would be associated with greater improvements in body composition, lipid profile, and biomarkers of inflammation and oxidative stress. Methodology Twenty-four women with obesity (BMI > 30 kg/m2 ), 33.1 ± 8.7 years old, were assigned to 3 groups and consumed 56 g of whole peanut (WP), skinned peanut (SP), and no peanut (NP) and consumed energy-restricted diets (250 kcal/d less than their customary diet) for eight weeks. Results WP lost an average of 3.2 kg, while SP group lost 2.6 kg and the NP group 1.8 kg. However, only the groups that consumed peanuts showed a significant reduction in body mass index (BMI). WP group presented lower body weight, BMI, waist circumference, total lean mass, and total body fat than the SP group in the 8th week. There was a significant reduction in total cholesterol and LDL after four weeks of intervention, which was maintained in week-8 for the WP and SP groups. In addition, there was an improvement in platelets and plasma homocysteine with WP. Conclusion Our results suggest that the regular intake of the whole peanut as part of an energy-restricted diet showed health benefits since it enhanced body weight loss, besides improving body composition and reducing cholesterol, platelets, and homocysteine concentrations. This article is protected by copyright. All rights reserved.

The use of stimulants, an improperly composed diet, lack of exercise, metabolic and mental stress, as well as overweight increase the risk of periodontitis. These lifestyle choices have an (in)direct influence on the immune system and can initiate inflammatory reactions at the level of the periodontium. Ultimately, this increases the susceptibility to gingivitis and periodontitis. A complete diet in terms of macro- (proteins, omega-3 fatty acids) and micro-nutrients (vitamins), as well as physical activity and sufficient relaxation appear to be essential for a healthy periodontium. A healthy weight, but especially a waist circumference within the normal range, also contribute to a reduction in the risk of periodontitis: directly, through the release of pro-inflammatory cytokines via the adipocytes, and indirectly, through obesity-related disorders. An unhealthy lifestyle thus increases the susceptibility to periodontal disease. Lifestyle advice should therefore be part of periodontal care.Het gebruik van genotsmiddelen, een onjuist samengestelde voeding, bewegingsarmoede, metabole en mentale stress evenals overgewicht verhogen het risico op parodontitis. De genoemde leefstijlkeuzes zijn (in)direct van invloed op het immuunsysteem en kunnen ontstekingsreacties ter hoogte van het parodontium initiëren. Dit verhoogt uiteindelijk de vatbaar­heid voor gingivitis en parodontitis. Een volwaardige voeding in termen van macro- (eiwitten, omega 3-vetzuren) en micronutriënten (vitamines) evenals fysieke activiteit en voldoende ontspanning blijken essentieel voor een gezond parodontium. Een gezond gewicht maar vooral een buikomvang binnen de normale range, dragen eveneens bij aan risicoreductie op parodontitis. Direct door het vrijmaken van pro-inflammatoire cytokines via de adipocyten en indirect door met overgewicht samenhangende aandoeningen. Een ongezonde leefstijl leidt dus tot een grotere vatbaarheid voor parodontale aandoeningen. Adviezen ten aanzien van leefstijl vormen derhalve een onderdeel van de parodontale zorg.

OBJECTIVE The role of the gut in diabetes remission after Roux-en-Y gastric bypass (RYGB) is incompletely understood. We assessed the temporal change in insulin secretory capacity after RYGB, using oral and intravenous (IV) glucose, in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Longitudinal, prospective measures of β-cell function were assessed after oral glucose intake and graded glucose infusion in individuals with severe obesity and diabetes studied at 0, 3 (n = 29), 12 (n = 24), and 24 (n = 20) months after RYGB. Data were collected between 2015 and 2019 in an academic clinical research center. RESULTS The decreases in body weight, fat mass, waist circumference, and insulin resistance after surgery (all P < 0.001 at 12 and 24 months) did not differ according to diabetes remission status. In contrast, both the magnitude and temporal changes in β-cell glucose sensitivity after oral glucose intake differed by remission status (P = 0.04): greater (6.5-fold; P < 0.01) and sustained in those in full remission, moderate and not sustained past 12 months in those with partial remission (3.3-fold; P < 0.001), and minimal in those not experiencing remission (2.7-fold; P = not significant). The improvement in β-cell function after IV glucose administration was not apparent until 12 months, significant only in those in full remission, and only ∼33% of that observed after oral glucose intake. Preintervention β-cell function and its change after surgery predicted remission; weight loss and insulin sensitivity did not. CONCLUSIONS Our data show the time course of changes in β-cell function after RYGB. The improvement in β-cell function after RYGB, but not changes in weight loss or insulin sensitivity, drives diabetes remission.

Метою даного дослідження був субаналіз поширеності та виявлення артеріальної гіпертензії (АГ) серед когорти респондентів із надлишковою масою тіла та ожирінням залежно від ступеня та типу ожиріння в рамках великого популяційного визначення факторів ризику, проведеного нами в Україні на міській популяції у 2009–2013 рр. Визначено, що в проаналізованій міській популяції населення України нормальну масу тіла мали лише 29,3 %, а 70,7 % — сумарно надлишкову масу тіла та ожиріння I–III ступеня. Відзначалася тенденція до збільшення поширеності надлишкової маси тіла та ожиріння з віком обстежуваних, як серед чоловіків, так і жінок. Встановлено, що із збільшенням маси тіла та віком зростає виявлення АГ в популяції. Відсоток виявлення АГ в популяції збільшився з 29,8 % при нормальній масі тіла до 75,0 % при ожирінні II–III ступенів. Виявлено, що незалежно від статі поява та прогресування абдомінального типу ожиріння асоціюється зі збільшенням виявлення артеріальної гіпертензії. Так, відповідно до рекомендацій ESC (2012), у жінок з окружністю талії (ОТ) ≥ 80 см АГ виявлена у 57,2 %, у чоловіків з ОТ ≥ 94 см — у 44,1 %. За критеріями АHA (2013), у жінок з ОТ ≥ 88 см АГ виявлена у 63,6 %, у чоловіків з ОТ ≥ 102 см — у 47,3 %.

Background Few studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design. Objective This study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment. Methods We included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals. Results A total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey. Conclusions Underweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.

Background Vitamin D deficiency is now very common globally. Although ultraviolet B (UVB) light dermal exposure is an important endogenous source of vitamin D, dietary supplementation and routine food fortification are of benefit for increasing serum 25-hydroxyvitamin D [25(OH)D]. However, there remains a high prevalence of vitamin D deficiency (~40 in Europe and 62% in Iran). We have designed a two-phase study including the production of nano-encapsulated vitamin D3, an assessment of its stability after fortifying dairy products, and a human trial evaluating the effects of fortified dairy products on the physical and mental health of participants. Methods and design: We established the optimal nanocapsule structure for vitamin D fortification of the various dairy products. The second phase of the study was performed as a ten-week, quadruple-blind randomized controlled trial, where milk and yogurt were fortified with vitamin D-containing nano-capsules, with active and control products being distributed to adult participants living in the City of Mashhad. Preliminary results Among 346 subjects who intended to participate in our study, 306 participants were selected according to inclusion criteria. At the end of the trial, seventeen subjects were excluded (with a dropout rate of 5.5%). The mean age of the eligible participants was 41.82 ± 7.81 (51.8% being women). Waist circumferences were 102.59 ± 7.74 and 89.39 ± 7.0 for men and women, respectively. There were no significant differences for weight, waist circumference, BMI, energy intake, and physical activity between the four groups at baseline assessments. Discussion This study will be the first RCT determining the efficacy of vitamin D fortification in dairy products using nano encapsulation technology on several aspects of physical and mental health. The sample size and high quality of methodology of this study demonstrate the feasibility and benefits of nanotechnology in the food fortification industry and general health in the population. The trial registration details registry name: The National Institute for Medical Research Development (NIMAD), registration number: IRCT20101130005280N27, date of registration: 3.9.2018 and the trial was prospectively registered.

Objectives: This study was carried out in order to determine the prevalence of obesity among the students of the Faculty of Health Sciences and to evaluate the anthropometric measurements of the students. Materials and methods: The population of the study was in total 984 volunteering undergraduate students from Ankara University Faculty of Health Sciences, Child Development, Midwifery, Nursing, Health Management and Social Work departments. The sociodemographic characteristics of the students were obtained with the help of the questionnaire and the anthropometric measurements by the researchers. SPSS package program was used for descriptive statistics, chi-square test and multiple logistic regression analysis for assessment of data. Results: 16.5% of the students participating in the study were overweight and 4.5% were obese. Approximately half of the students who are overweight and obese reported staying in the dormitory. Average BMI value in males is 23.1 kg/m2 and 22.3 kg/m2 in females. 29.1% of females are at risk in terms of abdominal obesity and 30.6% of males in terms of waist/height ratio. Male gender and presence of an obese person in the family increases the risk of being overweight or obese. Conclusions: Risky health behaviors are observed among university students and in order to avoid such behaviors, it is necessary to provide training especially on subjects such as nutrition and physical activity. Adopting the right nutritional habits and healthy lifestyle is important in individuals who will be the future healthcare professionals, for both their and future generations' health. © 2021 European Society for Clinical Nutrition and Metabolism WOS:000757020900062

Aims: We describe a 22-year prospective observational population-based study that determined the prevalence and incidence of type 2 diabetes (T2D) and intermediate hyperglycaemia (IH), obesity, hypertension, and disorders of lipid metabolism in a middle-age population in the Finnish municipality of Savitaipale. Methods: 1151 people participated in the baseline survey in 1996–1999, following two follow-up examinations, in 2007–2008 and 2018−2019. Follow-up studies comprised clinical measurements, 2-h oral glucose tolerance test and other biochemistry, questionnaires, and registry data. Results: The prevalence of T2D quadrupled to 27% and the proportion of normoglycemic people decreased from 73% to 44% while IH increased only slightly during the 22-year follow-up. A large proportion of people who died between the surveys were diabetic. The mean body mass index (BMI) did not, whereas mean waist circumference increased significantly, by 5−6 cm (P = 0.001) during the 22 years. Systolic blood pressure increased by 13−15 mmHg from baseline (P = 0.0001) but diastolic blood pressure did not. The mean plasma levels of total and LDL-cholesterol decreased 10.8% and 8.9% in women (P = 0.001), 21.5% and 22.2% in men (P = 0.001), respectively, while HDL-cholesterol and triglycerides remained stable. The proportion of those achieving targets in the treatment of dyslipidaemia increased significantly (P

Introduction: Unhealthy lifestyle habits, including sedentary behaviour and improper diet are major risk factors for obesity. Overweight is very frequent in hypertensive and type 2 diabetic patients. Psychosocial factors are associated with multiple health behaviors related to overweight/obesity. The aim of the study was to evaluate the relationship between obesity and psychosocial risk factors in hypertensive patients having different levels of education. Material and methods: 623 hypertensive patients, admitted to the Cardiovascular Rehabilitation Clinic in Tîrgu Mureș were evaluated by weight, height, waist circumference, laboratory analyses and psychosocial risk based on a validated questionnaire on nine topics. Non-paired Student t test was used for statistical evaluation of the obtained data. Results: Obesity or overweight affected 86.9% of the studied hypertensive patients. Obesity was more frequent in subjects having type 2 diabetes as comorbidity. Mean BMI was significantly higher in the lower education group (p=0.007) compared to those with higher level of education. Average triglyceride and uric acid levels were significantly higher in obese subjects compared to those having lower BMI (p Conclusions: Weight excess in very frequent in the studied hypertensive patients, especially in those with type 2 diabetes as comorbidity and having lower educational level. Hypertriglyceridemia and hyperuricemia occurred more frequently in obese subjects compared to non-obese ones. Overweight is less frequent in patients living alone.

Introduction: To determine whether dietary carbohydrates quality index (CQI), glycemic index, and glycemic load is associated with general and abdominal obesity. Methods: 850 participants, 20 to 59 years old, were enrolled in a cross-sectional study from five Tehran districts through health houses. The 168 items in the semi--quantitative food frequency questionnaire were used to assess dietary intake. The CQI was calculated by using the following four components: glycemic index, total fiber, solid carbohydrate to total carbohydrate ratio, and whole grains: total grains ratio. Results: After adjusting for confounding factors, the chance of obesity in men (OR=0.38, 95% CI 0.15to 0.95; P=0.04) measured by waist circumference (WC) was significantly lower in the fourth quintile of CQI in comparison with the first quintile. In addition, OR for obesity in men (OR=2.53, 95% CI0.52 to 1.37; P=0.04) was significantly 2.5 times higher among those in the fourth quintile of glycemic index compared with those in the lowest quintile. There was no significant association between dietary carbohydrates with general obesity in men and women. Conclusion: In summary, dietary CQI is significantly inversely related to central obesity in men,according to this study. Additionally, adherence to a diet with a higher glycemic index in men is positively associated with central obesity.

Obesity and overweight conditions have become major health challenges worldwide. The exploration of effective weight loss strategies is essential. Nudges are currently advancing approaches that represent a new and better method for changing the behaviors of people. However, the effectiveness of nudge interventions on weight loss in overweight people who may be obese has not been synthesized in a systematic manner. In this study, a systematic literature search was performed. Only randomized controlled trials (RCTs) were considered. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated as summary statistics. In total, 25 RCTs involving a population of 5,929 individuals were included. Significant effects of the nudge strategy on weight loss (WMD: -0.96 kg, 95% CI: -1.49 to -0.43), body mass index (WMD: -0.3 kg/m2, 95% CI: -0.41 to -0.19) and waist circumference (WMD: -0.75 cm, 95% CI: -1.23 to -0.27) were observed. The subgroup analysis showed that the reduction in body weight associated with nudge interventions was significant in younger and more obese people. Moreover, the effect of nudge intervention on weight loss weakened over time. Overall, the nudge strategy can promote changes in weight loss, body mass index and waist circumference of adults, albeit at a mild magnitude and in particular types of individuals. Nudge strategies can be recommended to clinical practitioners and policy-makers to promote obesity management.

Summary Background Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women, and is associated with cardiovascular diseases as well as non-alcoholic fatty liver disease. The recent evidence suggested the beneficial effects of l -carnitine in women with PCOS. Objective The present study aimed to investigate the effect of l -carnitine supplementation on liver fat content and cardiometabolic outcomes in overweight/obese women with PCOS. Methods The present study was designed as a 12-week double-blind, randomized controlled clinical trial. Sixty-two overweight/obese women with PCOS were assigned into the treatment (received 1000 mg/d l -carnitine capsule) and the control (received placebo capsule) groups. The outcomes included lipid accumulation product (LAP), atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli II indices. Results At the end of the trial, there was no significant difference between the treatment and the control groups in terms of LAP (−1.1 vs. −4.0; P = 0.45), AIP (0.0 vs. −0.09; P = 0.14), AC (−0.2 vs. −0.8; P = 0.06) and Castelli II index (−0.2 vs. −0.6; P = 0.07) after controlling the mean change of waist circumference. Conclusion l -carnitine supplementation for 12 weeks has no beneficial effect on liver fat content and cardiometabolic outcomes in overweight or obese women with PCOS. Trial registration: Registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1.

Objective: Turner syndrome (TS) patients are at high risk of cardiometabolic disorders. Cardiometabolic risk factors are more commonly related to visceral rather than total body adiposity. Adipocytokines have been explored as a potential link between obesity and obesity-related cardiometabolic dysfunction. This study explored the validity of epicardial fat-thickness (EFT) and perihepatic fat-thickness (PHFT) measurement as cardiometabolic-risk predictors in TS-girls in relation to standard obesity-indices and metabolic syndrome (MetS) components. Methods: Forty-six TS girls and twenty-five controls (10-16 years) were subdivided into two age-groups (10 to less than 13 and 13-16). Participants were assessed for body mass index (BMI) Z-scores, waist circumference (WC), total-fat mass (FM) and trunk-FM by bioimpedance-technique, EFT and PHFT by cardiovascular magnetic resonance, lipid-profile, homeostasis model assessment of insulin resistance (HOMA-IR), and serum chemerin. MetS was defined according to International Diabetes Federation criteria. Results: Overweight/obesity and MetS were detected in 45.7% and 37% of TS-girls respectively. BMI Z-score, WC, total-FM, trunk-FM, EFT and PHFT values were significantly higher in TS-age groups compared to age-matched control groups, being more pronounced in the older group when TS-girls had been exposed to estrogen. Dyslipidemia, higher HOMA-IR, chemerin, EFT and PHFT values were observed in lean-Turner compared to BMI-Z-matched controls. EFT and PHFT were significantly correlated with chemerin and several components of MetS. EFT at a cut-off-value of 6.20 mm (area under the curve=0.814) can predict MetS in TS-girls. Conclusion: TS-girls displayed an adverse cardiometabolic profile during late childhood and adolescence. EFT and PHFT are emerging cardiometabolic risk predictors in TS-patients. Excess EFT rather than total body adiposity may contribute to altered metabolic profile among lean-Turner patients.

Summary Background A body shape index (ABSI) is a novel anthropometric measure calculated using waist circumference (WC), body mass index (BMI), and body height. This study investigated the usefulness of ABSI to identify individuals with metabolic syndrome (MetS) and increased arterial stiffness in the middle-aged population. Methods Middle-aged workers who underwent periodic health check-ups and who were without previous cardiovascular events were enrolled (n = 10,182). In addition to ABSI, visceral fat area (VFA) was evaluated using computed tomography. Obesity and MetS were diagnosed on the basis of WC, VFA, and ABSI. Arterial stiffness was examined by measuring the cardio-ankle vascular index (CAVI). Results ABSI was significantly associated with CAVI in multivariable regression analysis. Logistic regression analysis revealed that ABSI was independently associated with the presence of MetS diagnosed on the basis of WC or VFA after adjustment for potential confounders, including BMI. Subjects with MetS diagnosed on the basis of each obesity index showed higher CAVI values than those without. Among subjects with MetS diagnosed on the basis of WC or VFA, those with MetS who met the definition of ABSI obesity showed significantly higher CAVI than those who did not. The other logistic regression analysis demonstrated that CAVI was independently associated with MetS defined on the basis of ABSI. Conclusions ABSI was significantly associated with CAVI and the presence of MetS in the middle-aged population and helped to discriminate individuals with MetS and increased CAVI. ABSI could serve to identify individuals with MetS and increased arterial stiffness.

Introduction: Sport is very important in the lives of children and adolescents, as it brings countless benefits at the physical, psychological and social levels. Objective: The aim of the study was to investigate the effects on physical fitness of an exercise program for overweight and obese female adolescents, with an emphasis on teaching volleyball. Methods: Twenty-five volunteers participated, aged between 13 and 14 years, of which 11 were overweight or obese for statistical analysis. Anthropometric and physical capacity assessments were performed, before and after 12 weeks, through activities related to volleyball. Results: There was an increase in height and span and a reduction in waist circumference, with no significant differences in body weight, BMI, arm circumference and triceps skinfold thickness; there was an increase in the sit-and-reach test, in the number of sit-ups and in the distance of the horizontal jump. There was a decrease in the time in the square test and the 20-meter run, with no significant differences in the medicine ball throw and in the 6-minute run test. Conclusion: It is concluded that the volleyball teaching program provided benefits for the physical fitness of overweight and obese adolescents. Level of evidence II; Lower quality RCT (example

Background and objectives: In patients with type 2 diabetes mellitus (DM2), the presence of increased waist circumference and triglycerides is a reflection of increased visceral fat and insulin resistance. However, information about the prevalence and clinical characteristics of the hypertriglyceridemic waist (HTGW) phenotype in patients with DM2 is scarce. The aim of the present study was to analyze the prevalence and characteristics of DM2 patients with HTGW. Methods: We analyzed 4214 patients with DM2 in this epidemiological, cross-sectional study conducted in primary care centers across Spain between 2011 and 2012. The HTGW phenotype was defined as increased waist circumference according to the International Diabetes Federation criteria for Europids (>= 94 cm for men and >= 80 cm for women) with the presence of triglyceride levels >= 150 mg/dL. We compared the demographic, clinical and analytical variables according to the presence or absence of the HTGW phenotype. Results: Thirty-five percent of patients presented the HTGW phenotype. Patients with the HTGW phenotype had a higher body mass index (31.14 +/- 4.88 vs. 29.2 +/- 4.82 kg/m2; p < .001) and glycated hemoglobin levels (7.38 +/- 1.2% vs. 7 +/- 1.07%; p < .001). The presence of hypertension, peripheral arterial disease, cardiac insufficiency and microvascular complications were higher when compared with patients without the HTGW phenotype. Patients with the HTGW phenotype were less adherent to prescribed diet (69.8 vs. 81%; p < .001), exercise (44.6 vs. 58.2%; p < .001) and presented greater weight increase within the year prior to the study visit (29.4 vs. 22.5%; p < .001). Conclusions: The HTGW phenotype is prevalent in the Spanish DM2 population and identifies a subgroup of patients with higher cardiometabolic risk and prevalence of diabetic complications. (C) 2020 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.

Background: Physical activity (PA) and discretionary screen time (DST; television and computer use during leisure) are both associated with obesity risk, but little longitudinal evidence exists on their combined influence. This study examined the independent and joint associations of changes in PA and DST with incident obesity, body mass index (BMI) and waist circumference (WC). Methods: We analysed the data of individuals aged 40–69 years from the UK Biobank, a large-scale, population-based prospective cohort study. PA was measured using the International Physical Activity Questionnaire and DST was defined as the total of daily TV viewing and non-occupational computer use. Changes in PA and DST over time were defined using departure from sex-specific baseline tertiles and categorised as worsened (PA decreased/DST increased), maintained, and improved (PA increased/DST decreased). We then used each exposure change to define a joint PA-DST change variable with nine mutually exclusive groups. We used multivariable adjusted mixed-effects linear and Poisson models to examine the independent and joint associations between PA and DST changes with BMI and WC and incident obesity, respectively. Development of a BMI ≥ 30 kg/m2 was defined as incident obesity. Results: Among 30,735 participants, 1,628 (5.3%) developed incident obesity over a mean follow-up of 6.9 (2.2) years. In the independent association analyses, improving PA (Incident Rate Ratio (IRR) 0.46 (0.38–0.56)) was associated with a lower risk of incident obesity than maintaining PA, maintaining DST, or improving DST. Compared to the referent group (both PA and DST worsened), all other combinations of PA and DST changes were associated with lower incident obesity risk in the joint association analyses. We observed substantial beneficial associations in the improved PA groups, regardless of DST change [e.g., DST worsened (IRR 0.31 (0.21–0.44)), maintained (IRR 0.34 (0.25–0.46)), or improved (IRR 0.35 (0.22–0.56)]. The most pronounced decline in BMI and WC was observed when PA was maintained or improved and DST was maintained. Conclusion: We found that improved PA had the most pronounced beneficial associations with incident obesity, irrespective of DST changes. Improvements in PA or DST mutually attenuated the deleterious effects of the other behaviour’s deterioration.

Purpose: to evaluate the effect of low-calorie diet on 24-hour urinary metabolic parameters of obese adults with idiopathic calcium oxalate kidney stones. Materials and Methods: Adult idiopathic calcium oxalate stone formers, with body mass index (BMI) ≥30kg/m2 and a known lithogenic metabolic abnormality, were submitted to low-calorie diet for twelve weeks. After enrolment, anthropometric measures, serum exams, 24-hour urinary metabolic parameters and body impedance were collected one month prior to dietary intervention and at the end of twelve weeks. Correlations between weight loss, waist circumference loss, fat loss and variation in 24-hour urinary lithogenic parameters and calcium oxalate urinary supersaturation (CaOx SS) as per Tiselius equation were analysed. Results: From January 2017 to January 2018, 39 patients were enrolled to participate in this study. Median (range) prescribed diet was 1300 (1100-2100) Kcal/day. Mean age was 51.7±11.0 (29-68) years old and 69.2% were female. 30.8% of the participants shifted from obesity to BMI

Churong Lin,1,&ast; Ling Sun,2,&ast; Qinchang Chen2 1Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Pediatric Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Structural Heart Disease, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qinchang ChenDepartment of Pediatric Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Structural Heart Disease, No. 106 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, People’s Republic of ChinaEmail chenqinchang@gdph.org.cnObjective: In this study, we aimed to use a two sample Mendelian randomization (MR) method to identify a potentially causality between waist circumference and the risk of deep vein thrombosis (DVT).Methods: With a two‐sample MR approach, we analyzed the summary data. The main analysis was performed by using the summary genetic data from two large consortium cohorts. Three MR approaches were used to explore MR estimates of waist circumference for DVT (inverse‐variance weighted [IVW] approach, weighted median method and MR‐Egger method). A total of 224 single nucleotide polymorphisms (SNPs) were identified associated with the level of waist circumference at statistical significance (P < 5&ast;10− 8; linkage disequilibrium r2 < 0.1).Results: The result of IVW indicated the positive association between waist circumference and the risk of DVT (OR 1.012, 95% CI 1.009– 1.014, P 7.627E-17). The other two methods were observed with consistent result. MR-Egger regression analysis indicated that no evidence for the presence of directional horizontal pleiotropy. Additionally, DVT was not a causal factor for waist circumference.Conclusion: In summary, we used the GWAS genetic data from two large consortium cohorts and indicated the positive association between waist circumference and DVT. Further researches are needed to investigate potential mechanism and clarify the role of waist circumference on DVT.Keywords: waist circumference, deep vein thrombosis, coronary heart disease, Mendelian randomization, causality, MR, DVT