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The document is a preliminary program for the 31st European Congress on Obesity (ECO 2024) taking place in Venice, Italy from May 12-15, 2024. The abstracts included in the program were peer-reviewed and selected by the EASO Executive Committee and ECO 2024 Programme Organizing Committee. The program includes plenary lectures, EASO sessions, joint sessions, special sessions, topic sessions, and abstract sessions covering a wide range of topics related to obesity. The document also provides information about the EASO Executive Committee and the trustees. [Extracted from the article]

Background and aim: Metabolic syndrome is one of the major public-health challenges, affecting one-quarter of the world population. Fatty acid quality indices are novel determinants of this disease and their interactions with genetic factors may have an impact on metabolic syndrome risk. Therefore, we aimed to investigate the interaction between genetic risk score (GRS) and fatty acid quality indices with metabolic syndrome (MetS) among overweight and obese women. Methods: In the present cross-sectional study, 279 overweight and obese women (18–48 years old) were included. Several anthropometric measurements such as weight, height, body mass index (BMI), waist circumference (WC), and body fat percent (BF%) were measured. Also, systolic and diastolic blood pressure (SBP and DBP) were measured. Biochemical determination was performed for fasting blood glucose (FBS), triglyceride (TG), and high-density lipoprotein (HDL). MetS was determined according to National Cholesterol Education Program (NCEP ATP III) criteria. Dietary intake was evaluated by a validated and reliable 147-item semi-quantitative food frequency questionnaire. Cholesterol-saturated fat index (CSI) and the ratio of omega-6/omega-3 (ω-6/ω-3) essential fatty acids were considered as fat quality indices. The salting-out method was used to extract the total DNA. The unweighted GRS was calculated using the risk alleles of the three single nucleotide polymorphisms. The total average GRS value was 2 and the sum of the risk alleles of the 3 polymorphisms was 6. Result: The results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was a positive interaction between T2 of GRS and T2 of N6/N3 ratio on WC (β = 7.95, 95%CI = 0.83,15.08, P = 0.029), T3 of GRS and T2 of N6/N3 ratio on DBP (β = 5.93, 95%CI= -0.76,12.63, P = 0.083), and FBS (β = 6.47, 95%CI = 0.59,13.53, P = 0.073), T3 of GRS and T3 of N6/N3 ratio on TG (β = 54.42, 95%CI = 1.76,107.08, P = 0.043), and T3 of GRS and T3 of CSI on BF% (β = 3.55, 95%CI= -0.35,7.45, P = 0.075). Also T2 of GRS in the interaction with T3 of CSI leads to an decrease − 8.35 mg/dl in HDL level after adjustment in (β= -8.35, 95%CI= -17.34,0.62, P = 0.068). Conclusion: It seems the interaction of GRS and fatty acid quality indices is positively associated with several components of metabolic syndrome such as WC, TG and BF%. Our findings are of importance to public health, considering the high consumption of foods that are high on fatty acids. Conflicting evidence of many previous studies regarding the effect of fat intake and obesity and cardiovascular diseases could be because of the gene-diet interactions and genetic heterogeneity across various ethnic groups. Hence, the synergism effect of genetic and dietay intakes should be considered in future studies. [ABSTRACT FROM AUTHOR]

Background: Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia. Methods: We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age. Results: The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97–46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20–24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25–29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30–34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35–39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40–44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45–49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia. Conclusion: In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women. [ABSTRACT FROM AUTHOR]

Objective: Congenital defects/diseases Background: Bariatric surgery (BS) has a lower percentage of complications than other abdominal surgeries. Hemorrhage in one of the most common complications and can be life-threatening. Hereditary factor XI (FXI) deficiency is a coagulation disorder that can result in excessive bleeding requiring intervention to restore hemostasis. Risks over benefits in patients with morbid obesity with BS indication, as well as those with FXI deficiency, should be carefully evaluated. This article reports the case of an obese woman with FXI deficiency undergoing SG. Case Report: A 49-year-old woman with a BMI of 51 kg/m² was diagnosed as having severe FXI deficiency during preoperative exams prior to bariatric surgery. Virus-inactivated homo-group plasma 10 ml/kg infusion was administrated 1 h before surgery, during the entire procedure, and continuing until postoperative day (POD) 4. A very low-calorie ketogenic diet (VLCKD) was proposed to the patient 4 weeks before surgery. Laparoscopic sleeve gastrectomy was performed with staple-line reinforcement by oversewing the seromuscular layer using continuous suture. Subcutaneous enoxaparin 4000 U.I. was administered from POD 1 until POD 25 to prevent any thromboembolic event. The patient was discharged on POD 5 in good clinical condition. Conclusions: Risks of bleeding and\or thromboembolic events before or after BS are increased in patient with FXI deficiency. Bariatric surgery in these patients is safe in experienced BS centers, and the risks associated with the obesity seem to exceed those of the coagulopathy and surgery. Careful preoperative counseling, extensive hematological checks, and meticulous surgery are essential to reduce BS risks. Sleeve gastrectomy oversewing the stapler line seems a reasonable choice. [ABSTRACT FROM AUTHOR]

Background: Iran is facing an epidemiological transition with the increasing burden of non-communicable diseases, such as obesity-related disorders and cardiovascular diseases (CVDs). We conducted a population-based prospective study to assess the prevalence and incidence rates of CVDs and obesity-related metabolic disorders and to evaluate the predictive ability of various CVD risk assessment tools in an Iranian population. Method: We enrolled 5,799 participants in Amol, a city in northern Iran, in 2009– 2010 and carried out the first repeated measurement (RM) after seven years (2016–2017). For all participants, demographic, anthropometric, laboratory, hepatobiliary imaging, and electrocardiography data have been collected in the enrollment and the RM. After enrollment, all participants have been and will be followed up annually for 20 years, both actively and passively. Results: We adopted a multidisciplinary approach to overcome barriers to participation and achieved a 7-year follow-up success rate of 93.0% with an active follow-up of 5,394 participants aged 18–90 years. In the RM, about 64.0% of men and 81.2% of women were obese or overweight. In 2017, about 16.2% and 5.2% of men had moderate or severe non-alcoholic fatty liver disease, while women had a significantly higher prevalence of metabolic syndrome (35.9%), and type 2 diabetes mellitus (20.9%) than men. Of 160 deceased participants, 69 cases (43.1%) died due to CVDs over seven years. Conclusion: The most prevalent obesity-related chronic disease in the study was metabolic syndrome. Across the enrollment and RM phases, women exhibited a higher prevalence of obesity-related metabolic disorders. Focusing on obesityrelated metabolic disorders in a population not represented previously and a multidisciplinary approach for enrolling and following up were the strengths of this study. The study outcomes offer an evidence base for future research and inform policies regarding non-communicable diseases in northern Iran. [ABSTRACT FROM AUTHOR]

Background: Withdrawal of semaglutide is frequently followed by weight regain due to compensatory biological changes that prevent the maintenance of longterm weight loss. There are some studies implying that metformin might attenuate weight regain. The weight trajectory after discontinuation of shortterm semaglutide treatment in obese women with PCOS who continued metformin treatment has not yet been evaluated. Aims: We explored changes in body weight, cardiometabolic and endocrine parameters in obese women with PCOS who continued treatment with metformin 2 years after discontinuation of short-term intervention with semaglutide. Methods: 25 women with PCOS and obesity, aged 33.7 ± 5.3 years (mean ± SD), were treated with once-weekly subcutaneous semaglutide 1.0 mg as an adjunct to metformin 2000 mg/day and lifestyle intervention for 16 weeks. At week 16, semaglutide was discontinued. Treatment with metformin 2000 mg/day and promotion of lifestyle intervention were continued during the 2-year follow-up period. Weight change, cardiometabolic, and endocrine parameters were assessed 2 years after semaglutide discontinuation. Results: During semaglutide treatment phase, weight decreased from 101 (90-106.8) kg to 92 (83.3-100.8) kg. Two years after semaglutide withdrawal, weight was 95 (77-104) kg. The net weight loss 2 years after discontinuation of semaglutide remained significant when compared to baseline (p=0.003). At the end of the study, 21 out of 25 subjects had lower body weight compared to baseline. Improvements in cardiometabolic parameters including decrease in total and LDL cholesterol, fasting glucose, and glucose after OGTT that had been seen during semaglutide-treatment phase reverted towards baseline two years after semaglutide cessation. Free testosterone levels significantly decreased during semaglutide treatment from 6.16 (4.07-9.71) to 4.12 (2.98-6.93) nmol/l, (p= 0.012) and did not significantly deteriorate after semaglutide discontinuation. Conclusion: Two years after semaglutide withdrawal, women with PCOS who continued with metformin regained about one-third of the semaglutide-induced weight loss. At the end of the follow up, 84% of women had a lower body weight than at baseline. [ABSTRACT FROM AUTHOR]

Background: Overweight/obesity is one of the major public health problems that affect both developed and developing nations. The co-occurrence of overweight/obesity and anemia is thought to be largely preventable if detected early. To date, no spatial analyses have been performed to identify areas of hotspots for the co-occurrence of overweight/obesity and anemia among reproductive women in sub-Saharan Africa. Therefore, this study aimed to assess the spatial distribution and associated factors of the co-occurrence of overweight/obesity and anemia among women of reproductive age. Methods: Data for the study were drawn from the Demographic and Health Survey, a nationally representative cross-sectional survey conducted in the era of Sustainable Development Goals, in which the World Health Assembly decided and planned to cease all forms of malnutrition by 2030. Seventeen sub-Saharan African countries and a total weighted sample of 108,161 reproductive women (15–49 years) were included in our study. The data extraction, recoding and analysis were done using STATA V.17. For the spatial analysis (autocorrelation, hot-spot and interpolation), ArcGIS version 10.7 software, and for the SaTScan analysis, SaTScan version 10.1 software was used. Descriptive statistics were presented using frequency tables and percentages. We employed multilevel logistic regression to investigate associated factors. In the multivariable analysis, variables with a p-value of ≤0.05 are considered as a significant factor associated with co-occurrence of overweight/obesity and anemia among women aged 15–49 years. Results: The overall co-occurrence of overweight/obesity and anemia among women in sub-Saharan Africa was 12% (95%CI: 9–14%). The spatial analysis revealed that the co-occurrence of overweight/obesity and anemia among women significantly varied across sub-Saharan Africa. (Global Moran's I = 0.583163, p<0.001). In the spatial window, the primary-cluster was located in Liberia, Guinea, Gambia, Sira Leon, Mauritania, Mali, Cameron and Nigeria with a Log-Likelihood Ratio (LRR) of 1687.30, and Relative Risk (RR) of 2.58 at a p-value < 0.001. In multilevel analysis, women aged 25–34 years (AOR = 1.91, 95%CI: 1.78, 2.04), women aged 35–49 years (AOR = 2.96, 95% CI: 2.76, 3.17), married (AOR = 1.36, 95% CI: 1.27, 1.46), widowed (AOR = 1.22, 95%CI: 1.06, 1.40), divorced (AOR = 1.36, 95% CI: 1.23, 1.50), media exposure (AOR = 1.31, 95%CI: 1.23, 1.39), middle income (AOR = 1.19, 95%CI: 1.11, 1.28), high income/rich (AOR = 1.36, 95%CI: 1.26, 1.46), not working (AOR = 1.13, 95% CI:1.07, 1.19), traditional contraceptive utilization (AOR = 1.39, 95%CI: 1.23, 1.58) and no contraceptive use (AOR = 1.27, 95%CI: 1.20, 1.56), and no health insurance coverage (AOR = 1.36, 95%CI: 1.25, 1.49), were individual level significant variables. From community-level variables urban residence (AOR = 1.61, 95%CI: 1.50, 1.73), lower middle-income country (AOR = 2.50, 95%CI: 2.34, 2.66) and upper middle-income country (AOR = 2.87, 95%CI: 2.47, 3.34), were significantly associated with higher odds of co-occurrence of overweight/ obesity and anemia. Conclusion and recommendations: The spatial distribution of the co-occurrence of overweight/obesity and anemia was significantly varied across the sub-Saharan African country. Both individual and community-level factors were significantly associated with the co-occurrence of overweight/obesity and anemia. Therefore, public health programmers and other stalk holders who are involved in maternal healthcare should work together and give priority to hotspot areas of co-occurrence in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Obesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression. Methods: We included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (< ± 3% change, n = 117) over 48 months matched for age and sex. In magnetic resonance imaging (MRI) at baseline and 48 months, effusion-synovitis and Hoffa-synovitis using the MRI Osteoarthritis Knee Score (MOAKS) and average joint-adjacent SCF (ajSCF) were assessed. Odds-ratios (ORs) for synovitis progression over 48 months (≥ 1 score increase) were calculated in logistic regression models adjusting for age, sex, baseline BMI, Physical Activity Scale for the Elderly (PASE), and baseline SCF measurements. Mediation of the effect of weight loss on synovitis progression by local SCF change was assessed. Results: Odds for effusion-synovitis progression decreased with weight loss and ajSCF decrease (odds ratio [OR] = 0.61 and 0.56 per standard deviation [SD] change, 95% confidence interval [CI] 0.44, 0.83 and 0.40, 0.79, p = 0.002 and 0.001, respectively), whereas odds for Hoffa-synovitis progression increased with weight loss and ajSCF decrease (OR = 1.47 and 1.48, CI 1.05, 2.04 and 1.02, 2.13, p = 0.024 and 0.038, respectively). AjSCF decrease mediated 39% of the effect of weight loss on effusion-synovitis progression. Conclusions: Effusion-synovitis progression was slowed by weight loss and decrease in local subcutaneous fat. Hoffa-synovitis characterized by fluid in the infrapatellar fat pad increased at the same time, suggesting a decreasing fat pad rather than active synovitis. Decrease in local subcutaneous fat partially mediated the systemic effect of weight loss on synovitis. [ABSTRACT FROM AUTHOR]

This study investigates links between CART and leptin gene expression, FSH receptor Asn680Ser polymorphism, and reproductive hormones in morbidly obese patients under 40 years old, facing infertility, and undergoing bariatric surgery. A total of 29 women were included in this study. A hormonal profile along with detection of CART and leptin gene expression was evaluated before and after bariatric surgery. Additionally, the presence or absence of Asn680Ser of the FSHR gene was studied. Following bariatric surgery, a mean reduction in BMI (16.03 kg/m2) was observed in all women. FSH levels preoperatively varied significantly among genotypes, with medians of 8.1, 9.5, and 10.3 for individuals without polymorphism, heterozygotes, and homozygotes, respectively (p = 0.0408). Post surgery, marginal differences in FSH levels were observed (5.8, 7.1, and 8.2, respectively) (p = 0.0356). E2 and LH levels exhibited no significant genotype-based differences pre and post surgery. Presurgical E2 levels were 29.6, 29.8, and 29.6, respectively (p = 0.91634), while postsurgical levels were 51.2, 47.8, and 47 (p = 0.7720). LH levels followed similar patterns. Our findings highlight bariatric surgery's positive impact on BMI reduction and its potential connection to genetic markers, hormones, and infertility. This suggests personalized treatments and offers a valuable genetic tool for better fertility outcomes in obese individuals. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of gestational weight gain on pregnancy outcomes and determine the optimal range of weight gain during pregnancy for Chinese women with type 2 diabetes mellitus. Methods: This retrospective cohort study included 691 Chinese women with type 2 diabetes mellitus from 2012 to 2020. The study utilized a statistical-based approach to determine the optimal range of gestational weight gain. Additionally, multivariate logistic regression analysis was conducted to assess the impact of gestational weight gain on pregnancy outcomes. Results: (1) In the obese subgroup, gestational weight gain below the recommendations was associated with decreased risks of large for gestational age (adjusted odds ratio [aOR] 0.19; 95% confidence interval [CI] 0.06-0.60) and macrosomia (aOR 0.18; 95% CI 0.05-0.69). In the normal weight subgroup, gestational weight gain below the recommendations of the Institute of Medicine was associated with decreased risks of preeclampsia (aOR 0.18; 95% CI 0.040.82) and neonatal hypoglycemia (aOR 0.38; 95% CI 0.15-0.97). (2) In the normal weight subgroup, gestational weight gain above the recommendations of the Institute of Medicine was associated with an increased risk of large for gestational age (aOR 4.56; 95% CI 1.54-13.46). In the obese subgroup, gestational weight gain above the recommendations was associated with an increased risk of preeclampsia (aOR 2.74; 95% CI 1.02, 7.38). (3) The optimal ranges of gestational weight gain, based on our study, were 9-16 kg for underweight women, 9.5-14 kg for normal weight women, 6.5-12 kg for overweight women, and 3-10 kg for obese women. (4) Using the optimal range of gestational weight gain identified in our study seemed to provide better prediction of adverse pregnancy outcomes. Conclusion: For Chinese women with type 2 diabetes, inappropriate gestational weight gain is associated with adverse pregnancy outcomes, and the optimal range of gestational weight gain may differ from the Institute of Medicine recommendations. [ABSTRACT FROM AUTHOR]

Introduction: Previous research has linked vaginal bacteria to polycystic ovary syndrome (PCOS) and obesity in women, yet the specific disparities in vaginal microbiota between these conditions remain unclear. Methods: In this study, we aimed to elucidate the contribution of dysregulated vaginal microbiota to PCOS and obesity by analyzing the vaginal microbiota in reproductive-aged women with and without PCOS, as well as obese and nonobese women, using shotgun sequencing. Results: Swab specimens were collected from four groups of subjects: PCOS and obese, PCOS and non-obese, non-PCOS and obese, and non-PCOS and non-obese. A total of 333 bacteria and 24 viruses/phages were identified to the species level. Clustering analysis revealed that non-PCOS and non-obese individuals exhibit a similar "healthy" vaginal microbiome, while both obesity and PCOS were associated with microbial dysbiosis. Significant differences in abundancewere observed for 26 bacterial species and 6 phages/viruses between groups. Notably, pathobionts such as Streptococcus pyogenes, Leptospira santarosai, Citrobacter amalonaticus, Listeria ivanovii, and Clostridium perfringens were significantly less abundant or absent in the non-PCOS and non-obese group. Furthermore, the abundance of Lactobacillus, Pseudomonas bacteria, and their corresponding phages exhibited positive correlations. Lactobacillus bacteria, lactobacillus phage, and pseudomonas phage/virus were identified as indicators of a healthy vaginal microbiome. Importantly, the differentially enriched bacteria in the PCOS and obesity groups were distinct. Discussion: This study confirms that PCOS and obesity are associated with differing enrichment of bacteria and viruses/phages, with both conditions linked to microbial dysbiosis. Moreover, our findings suggest that vaginal phage diversity is associated with a healthy vaginalmicrobiota, while dysbiosis is associated with a decrease in phages alongside increased bacterial diversity. [ABSTRACT FROM AUTHOR]

Background: Overweight/obesity remains a major risk factor for non-communicable diseases and their associated morbidities and mortalities. Yet, limited studies have comprehensively examined factors contributing to the rural–urban disparities in overweight/obesity among women in sub-Saharan Africa. Thus, our study sought to decompose the rural–urban disparities in overweight/obesity among women in sub-Saharan Africa (SSA) using nationally representative datasets. Methods: We performed a cross-sectional analysis of data from the Demographic and Health Surveys of 23 sub-Saharan African countries conducted from 2015 to 2022. A sample of 177,329 women was included in the analysis. Percentages with confidence intervals (CIs) were used to summarize the prevalence of overweight/obesity per rural–urban strata and pooled level. A multivariate non-linear decomposition analysis was used to identify the factors contributing to the rural–urban disparities in overweight/obesity. The results were presented using coefficients and percentages. Results: The pooled prevalence of overweight/obesity among the women was higher in urban areas (38.9%; 95% CI = 38.2–39.6) than rural areas (19.1%; 95% CI = 18.7–19.6). This pattern was observed in all the countries surveyed, except in South Africa, where women in rural areas (53.1%; 95% CI = 50.0–56.4) had a higher prevalence of overweight/obesity than those in urban areas (46.0%; 95% CI = 43.2–48.9). Approximately 54% of the rural–urban disparities in overweight/obesity was attributable to the differences in the women's characteristics or explanatory variables. More than half of the rural–urban disparities in overweight/obesity would be reduced if the disparities in women's characteristics were levelled. Among the women's characteristics, frequency of watching television (29.03%), wealth index (26.59%), and level of education (9.40%) explained approximately 65% of the rural–urban differences in overweight/obesity. Conclusion: The prevalence of overweight/obesity among women in SSA remains high and skewed towards women in urban areas. Increased frequency of watching television, high wealth index, and higher educational attainment contributed largely to the rural-urban disparities in overweight/obesity among women in SSA. Thus, interventions aimed at reducing overweight/obesity among women in SSA could be targeted at reducing the frequency of television watching as well as promoting physical activities among wealthy women and those with higher education, particularly in urban areas. [ABSTRACT FROM AUTHOR]

Background: Describing correlates of physical activity (PA) and sedentary behavior (SB) among postmenopausal cancer survivors can help identify risk profiles and can be used to support development of targeted interventions to improve PA and reduce SB in this population. Objective: To describe PA/SB and identify correlates of PA/SB among cancer and cancer-free post-menopausal women. Methods: Women from the Women's Health Study (N = 16,629) and Women's Health Initiative/Objective Physical Activity and Cardiovascular Health Study (N = 6,079) were asked to wear an accelerometer on the hip for 7 days. Multiple mixed-effects linear regression models were used to identify sociodemographic-, health-, and chronic condition-related correlates (independent variables) associated with PA and SB (dependent variables) among women with (n = 2,554) and without (n = 20,154) a history of cancer. All correlates were mutually adjusted for each other. Results: In unadjusted analyses, women with a history of cancer took fewer mean daily steps (4,572 (standard deviation 2557) vs 5,029 (2679) steps/day) and had lower mean moderate-to-vigorous PA (74.9 (45.0) vs. 81.6 (46.7) minutes/day) than cancer-free women. In adjusted analyses, for cancer and cancer-free women, age, diabetes, overweight, and obesity were inversely associated with all metrics of PA (average vector magnitude, time in moderate-to-vigorous PA, step volume, time at ≥40 steps/minutes, and peak 30-minute step cadence). In unadjusted analyses, mean SB was similar for those with and without cancer (529.7 (98.1) vs. 521.7 (101.2) minutes/day). In adjusted analyses, for cancer and cancer-free women, age, diabetes, cardiovascular disease, current smoking, overweight, and obesity were positive correlates of SB, while Black or Hispanic race/ethnicity, weekly/daily alcohol intake, and excellent/very good/good self-rated health were inverse correlates of SB. Conclusion: Several sociodemographic, health, and chronic conditions were correlates of PA/SB for postmenopausal women with and without cancer. Future studies should examine longitudinal relationships to gain insight into potential determinants of PA/SB. [ABSTRACT FROM AUTHOR]

Obesity is found to have a significant impact on body image perception and overall well-being. This study examines the impact of body image and perceived stigmatization on the psychological wellbeing of obese women in Kumasi metropolis, Ghana. A sample of 231 obese women was selected from health shops and some fitness centers using snowballing technique (purposive, snowballing technique and convenience). The study employed the descriptive survey design and made use of both descriptive and inferential data analysis approaches. The body shape questionnaire BSQ-34, the inventory of the Stigmatization Situation (SSI) and finally, the psychological well-being tools were used. Also, frequency distributions mean, and standard deviation, Pearson correlation coefficient and simple linear regression analysis were employed using SPSS version 23. Our findings indicated that obese women in the Kumasi metropolis were significantly satisfied with their body image. This is a true reflection of their higher self-esteem and standard of living. The body image and perceived stigmatization on the psychological wellbeing of the obese do have some counselling implications. Counselors, nutritionists, and clinical psychologists address specific schemes such as binge eating, dieting, and exercising to build the self-esteem of obese women. [ABSTRACT FROM AUTHOR]

Pomegranate, recognized as one of the most widely utilized herbal medicines, comprises three components: Pomegranate juice, seeds, and peel. Each part of the fruit contains a range of phytochemical compounds, macronutrients, and micronutrients. With a history dating back to 3000 BC, pomegranate has gained global recognition for its diverse therapeutic effects, attributed to the presence of various phytochemicals such as flavonoids (e.g., flavonols, anthocyanins, ellagitannins, and phenolic acids). These compounds contribute to the herb's antioxidant, anti-inflammatory, anti-cancer, antibacterial, cardioprotective, and other health-promoting properties. The beneficial properties of pomegranate have captured the interest of sports physiologists, who recognize this herb as a promising substance to augment the health-promoting effects of exercise programs. A review of the SID and Google Scholar databases revealed that Iranian sports physiologists have published 25 articles investigating the combinational effects of exercise programs and pomegranate administration. The primary focus of these studies was on metabolic changes, followed by oxidative stress markers. The majority of their participants were obese women with type 2 diabetes. Collectively, these findings indicated that the combination of pomegranate consumption and physical exercises, particularly aerobic exercises, enhanced the beneficial impact of aerobic training on metabolic parameters and anti-oxidative markers. Based on these studies, it can be concluded that pomegranate extract can potentiate the health-enhancing effects of physical exercise. Therefore, it is recommended to consider utilizing pomegranate derivatives in conjunction with exercise programs to maximize their beneficial health effects. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between Body Mass Index (BMI) and self-rated health status among a representative sample of the Brazilian population. Methods: This study consists of a secondary analysis of the existing 2019 Brazilian National Health Survey (PNS). Logistic regression models were then used to examine the association between self-reported health status and BMI, while controlling for obesity-related medical conditions and socio-demographic characteristics. Results: The representative sample included 34,021 men and 34,430 women, comprising a total sample of 68,451. Men living with obesity (BMI ≥ 30 kg/m2) had, on average, a lower self-reported health status score (OR = 0.69, p < 0.01) compared to men within a healthy weight BMI range (18.5–25 kg/m2). Women living with obesity had, on average, a lower self-reported health status score (OR = 0.56, p < 0.01) compared to women within a healthy weight BMI range (18.5–25 kg/m2). There was also a statistically significant negative association (p < 0.01) between our obesity-related medical conditions and self-reported health for men and women. We also find some evidence of a non-linear association between BMI and health status for men. Conclusions: The findings indicate that there is a statistically significant negative association between BMI and self-reported health for Brazilian men and women living with obesity. These findings reinforce the importance of addressing this growing public health challenge and the value of preventive measures and effective public health programs that focus on improving overall health and quality of life for individuals living with obesity. [ABSTRACT FROM AUTHOR]

Early intervention can reduce disability in children diagnosed with autism spectrum disorder. Screening for autism spectrum disorder in young children identifies those at increased likelihood of diagnosis who may need further support. This study assessed in utero exposure to maternal obesity and diabetes and offspring performance on the Quantitative Checklist for Autism in Toddlers, an autism spectrum disorder screening questionnaire administered between 18 and 24 months at well-child visits. This retrospective cohort study included 65,433 singletons born in a single healthcare system. Demographic data, maternal obesity, Type 1/Type 2 and gestational diabetes mellitus information, and Quantitative Checklist for Autism in Toddlers score in children 12–30 months old were extracted from electronic medical records. Negative binomial models were used to estimate incidence rate ratios of associations between maternal obesity and diabetes exposure and continuous offspring Quantitative Checklist for Autism in Toddlers scores. Maternal obesity, Type 1/Type 2 diabetes (incidence rate ratio: 1.13, 1.06–1.21) and gestational diabetes mellitus ⩽ 26 weeks (incidence rate ratio: 1.10, 1.05–1.17) were associated with one-unit increases in Quantitative Checklist for Autism in Toddlers scores. Relationships with obesity and gestational diabetes mellitus ⩽ 26 weeks remained after mutual adjustment and excluding children with autism spectrum disorder diagnoses. No associations were reported for gestational diabetes mellitus > 26 weeks. Maternal obesity and diabetes were associated with higher Quantitative Checklist for Autism in Toddlers scores in children 12–30 months old, suggesting these exposures in pregnancy may be associated with a range of early childhood behavior. Early intervention and treatment can help reduce disability in children diagnosed with autism spectrum disorder. Screening for autism spectrum disorder in young children identifies those at increased likelihood of diagnosis who may need further support. Previous research has reported that exposure to maternal obesity and diabetes during pregnancy is associated with higher likelihood of autism spectrum disorder diagnosis in children. However, little is known about whether these maternal conditions are associated with how very young children score on autism spectrum disorder screening tools. This study examined associations between exposure to maternal obesity and diabetes during pregnancy and offspring scores on the Quantitative Checklist for Autism in Toddlers, an autism spectrum disorder screening questionnaire administered between 18–24 months at well-child visits. A higher score on the Quantitative Checklist for Autism in Toddlers suggests a higher likelihood of autism spectrum disorder; children with scores 3 or greater are referred to developmental pediatricians for evaluation. Our study found that children of mothers with obesity or diabetes during pregnancy had higher scores than children whose mothers did not have these conditions. Associations with maternal obesity and gestational diabetes diagnosed at or before 26 weeks of pregnancy were also present in children who did not have later autism spectrum disorder diagnoses, suggesting that exposure to these conditions during early pregnancy may be associated with a broad range of social and behavioral abilities. Identifying associations between maternal health conditions and early Quantitative Checklist for Autism in Toddlers screening scores could influence future screening and provision of support for children of mothers with these conditions. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Obesity is often labeled as a physical characteristic of a patient rather than a disease and it is subject to obesity bias by health providers, which harms the equality of healthcare in this population. Objective: Identifying whether obesity bias interferes in clinical decision‐making in the treatment of patients with obesity. Methods: A systematic review of observational studies published between 1993 and 2023 in MEDLINE, Embase, and Cochrane Library on obesity bias and therapeutic decisions was carried out. The last search was conducted on June 30, 2023. The main outcome was the difference between clinical decisions in the treatment of individuals with and without obesity. The Newcastle–Ottawa scale for observational studies was used to assess for quality. After the selection process, articles were presented in narrative and thematic synthesis categories to better organize the descriptive analysis. Results: Of the 2546 records identified, 13 were included. The findings showed fewer screening exams for cancer in patients with obesity, who were also susceptible to less frequent pharmacological treatment intensification in the management of diabetes. Women with obesity received fewer pelvic exams and evidence of diminished visual contact and physician confidence in treatment adherence was reported. Some studies found no disparities in treatment for abdominal pain and tension headaches between patients presented with and without obesity. Conclusion: The presence of obesity bias has negative effects on medical decision‐making and on the quality of care provided to patients with obesity. These findings reveal the urgent necessity for reflection and development of strategies to mitigate its adverse impacts. (The protocol was registered with the international prospective register of systematic reviews, PROSPERO, under the number CRD42022307567). [ABSTRACT FROM AUTHOR]

Aim: Obesity has a significant impact on all‐cause mortality rate and overall health care resource use (HCRU). These outcomes are also strongly linked to age, sex and local deprivation of the population. We aimed to establish the lifetime costs of obesity by demographic group/geographic area using published mortality rates and HCRU use for integrated care boards (ICB) in England in the context of costs of therapeutic intervention. Methods: Population and expected mortality rates by age, sex and deprivation were obtained from national data. Obesity class prevalence was taken from the health of the nation study. The published impact of obesity by age, group, sex and deprivation on mortality and HCRU were applied to estimate life years lost and lifetime HCRU [by sex, age band and body mass index (BMI) class for each ICB]. The year 2019 was chosen as the study basis data to avoid influences of COVID‐19 pandemic on obesity rates with application of 2022/23 HCRU values. Outcomes including prevalence, deaths, life years lost, HCRU and lifetime HCRU were compared by age and sex groups across four BMI classes normal/underweight (BMI <25 kg/m2), overweight (25‐29.9 kg/m2), obese class I and II (30‐39.9 kg/m2), and obese class III (≥40), with benchmarking being set against all population being BMI <25 kg/m2 overall and by each of the 42 ICBs. We also associated future life with deaths to provide an estimate of 'future life years lost' occurring each year. Results: Total population aged >16 years was 45.4 million (51% female). Prevalence: 13.7 million (28% of the total adult population) had a BMI ≥30 mg/m2 and BMI ≥40 kg/m2 were 1.50 million (12%) of these 1.0 million (68%) were female and of these 0.6 million 40% were women aged 16‐49 years. In addition, 35% of those with a BMI ≥40 kg/m2 were in the top deprivation quintile (i.e. overall 20%). Mortality was based on expected deaths of 518K/year, and modelling suggested that if a BMI <25 kg/m2 was achieved in all individuals, the death rate would fall by 63K to 455K/year for the English population (12% reduction). For those with a BMI ≥40 kg/m2 the predicted reduction was 12K deaths (54% lower); while in those aged 16‐49 years with a BMI ≥40 kg/m2 72% of deaths were linked to obesity. For future life years lost, we estimated 2.5 years were lost in people with BMI 30‐39.9 kg/m2 6.7 years when BMI ≥40 kg/m2. However, for those aged 16‐49 years with a BMI ≥40 kg/m2, 8.3 years were lost. HCRU, for weight reduction, the annual HCRU decrease from BMI ≥40 kg/m2 to BMI 30‐39.9 kg/m2 was £342 per person and from BMI 30‐39.9 to 25‐29.9 kg/m2 the reduction was £316/person. However, lifetime costs were similar because of reduced life expectancy for obese individuals. In quality adjusted life years (QALY), overall, 791 689 future life years were lost (13.1% of all) in people with BMI ≥25 kg/m2 and were related to excess weight. When the NICE £30 000 per QALY value was applied to the estimated total 791 689 future life years lost then the potential QALY value reduction lost was equivalent to £24 billion/year or £522/person in the obese population. For morbidly obese men and women the potential QALY value lost was £2864/person/year. Regarding geography, across the 42 ICBs, we observed significant variation in the prevalence of BMI ≥40 (1.8%‐4.3%), excess mortality (11.6%‐15.4%) and HCRU linked to higher BMI (7.2%‐8.8%). The areas with the greatest impact on HCRU were in the north‐west, north‐east and Midlands of England, while the south shows less impact. Conclusion: The expected increases in annual HCRU because of obesity, when considered over a lifetime, are being mitigated by the increased mortality of obese individuals. Our data suggest that simple short‐term HCRU reduction brought about through BMI reduction will be insufficient to fund additional specialist weight reduction interventions. The HRCUs associated with BMI are not in most cases related to short‐term health conditions. They are a cumulative result over a number of years, so for age 16‐49 years reducing BMI from ≥40 to 30‐39.9 kg/m2 might show an annual decrease in HCRU/person by £325/year for women and £80/year for men but this might not have immediately occurred within that year. For those aged >70 years reducing BMI from ≥40 to 30‐39.9 kg/m2 might show an annual decrease in HCRU/person by £777/year for women and £796/year for men but also may not be manifest within that year. However, for the morbidly obese men and women, the potential QALY value lost was £2864 per person per year with the potential for these funds to be applied to intensive weight management programmes, including pharmacotherapy. [ABSTRACT FROM AUTHOR]

Kisspeptin is a peptide that plays a crucial function in the regulation of puberty initiation, by sexual immaturity and slowed puberty advancement. Infertility is a result of hyperprolactinemia, which inhibits the pulsatile release of GnRH from the brain and lowers the pulsatile production of LH from the pituitary. In type 1 diabetes, also known as autoimmune diabetes, pancreatic cells die off and the body cannot produce enough insulin, leading to high blood sugar levels. Obese people are more likely to suffer from hyperinsulinemia, hyperlipidemia, hyperleptinemia, chronic inflammation, menstrual abnormalities, pregnancy troubles, and infertility. So, this study aims to know the reproductive status of women by estimating kisspeptin and other hormones. The study was conducted on 92 women, ages (20-40) years, Samples were collected from the AL-Sader Teaching Hospital, Maysan for Child and Birth Hospital, the specialized Centre for Diabetes and Endocrinology and some private clinics and centres, the period June 2022 to February of 2023. The women were divided equally into four groups: control group (with regular menstrual cycles), hyperprolactinemia group (hyper serum prolactin), obesity group (have a BMI over 30 kg.m–2), and type 1 diabetes group. The results showed the values of kisspeptin did not differ significantly (P>0.05) in all groups, values of GnRH in hyperprolactinemia, obesity and type 1 DM groups increased significantly (P≤0.05) compared with the control group, Prolactin, estradiol and progesterone in the hyperprolactinemia group increased significantly (P≤0.05) in comparison with other groups. According to the above results, we conclude that high levels of prolactin, also obesity and type 1 DM influence the reproductive hormones in women. [ABSTRACT FROM AUTHOR]

Tricarboxylic acid cycle intermediates (TCAi) have been proposed to act as myokines that influence energy metabolism. We determined if 2‐weeks of low‐calorie diet with interval exercise (LCD + INT) would increase TCAi more than a low‐calorie diet (LCD). Twenty‐three women were randomized to 2‐weeks of LCD (n = 12, 48.4 ± 2.5 years, 37.8 ± 1.5 kg/m2, ~1200 kcal/d) or LCD + INT (n = 11, 47.6 ± 4.3 years, 37.9 ± 2.3 kg/m2; 60 min/d supervised INT of 3 min 90% & 50% HRpeak). TCAi and amino acids (AA) were measured at 0 min of a 75 g OGTT, while glucose, insulin, and FFA were obtained at 0, 30, 60, 90, 120, and 180 min to assess total area under the curve (tAUC180min) and insulin resistance (IR; tAUC180min of Glucose × Insulin). Fuel use (indirect calorimetry) was also collected at 0, 60, 120, and 180 min as was fitness (VO2peak) and body composition (BodPod). Treatments reduced weight (p < 0.001), fasting RER (p = 0.01), and IR (p = 0.03), although LCD + INT increased VO2peak (p = 0.02) and maintained RER tAUC180min (p = 0.05) versus LCD. Treatments increased FFA tAUC180min (p = 0.005), cis‐aconitate, isocitrate, and succinate (p ≤ 0.02), as well as reduced phenylalanine and tryptophan, cysteine (p ≤ 0.005). However, LCD + INT increased malate, citrate, α‐ketoglutarate, and alanine more than LCD (p ≤ 0.04). Thus, INT enhanced LCD effects on some TCAi in women with obesity independent of IR. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a common endocrinopathy occurring in reproductive-age women. Hyperandrogenism, polycystic ovaries, chronic anovulation, and metabolic aberrations are the common features in PCOS. Hormonal changes are causing pathological symptoms in women with PCOS. The various hormone alterations in PCOS have been demonstrated. Hormones, such as insulin, growth hormones (GH), ghrelin, LEAP-2, gonadotropinreleasing hormone (GnRH), insulin, the luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio, androgens, and estrogens, are all abnormal in PCOS women. These hormones are related to metabolic disorders, such as diabetes and insulin resistance, overweight and obesity, infertility, and disturbed menstrual cycle in PCOS patients. The pathological changes of these hormones, such as increased insulin, reduced GH, increased ghrelin, and leptin resistance, result in an increased prevalence of diabetes and obesity in PCOS women. A reduced GH, increased LEAP-2 levels, high LH basal, increased LH/FSH ratio, high androgens, and low estrogen are demonstrated in PCOS and linked to infertility. This narrative review aims to clarify the changes of hormone profiles, such as insulin, GH, LH, FSH, androgens, estrogen, progesterone, ghrelin, LEAP-2, asprosin, and subfatin, in PCOS, which may reveal novel targets for better diagnosis and treatment of PCOS. [ABSTRACT FROM AUTHOR]

Obesity and overweight are common and complex conditions influenced by multiple genetic and environmental factors. Several genetic variants located in the genes involved in clock systems and fat taste perception can affect metabolic health. In particular, the polymorphisms in CLOCK and BMAL1 genes were reported to be significantly related to cardiovascular disease, metabolic syndrome, sleep reduction, and evening preference. Moreover, genetic variants in the CD36 gene have been shown to be involved in lipid metabolism, regulation of fat intake, and body weight regulation. The aim of this study is to evaluate, for the first time, the association between variants in some candidate genes (namely, BMAL1 rs7950226 (G>A), CLOCK rs1801260 (A>G), CLOCK rs4864548 (G>A), CLOCK rs3736544 (G>A), CD36 rs1984112 (A>G), CD36 rs1761667 (G>A)) and overweight/obesity (OB) in pregnant women. A total of 163 normal-weight (NW) and 128 OB participants were included. A significant correlation was observed between A-allele in CLOCK rs4864548 and an increased risk of obesity (OR: 1.97; 95% CI 1.22–3.10, p = 0.005). In addition, we found that subjects carrying the haplotype of rs1801260-A, rs4864548-A, and rs3736544-G are likely to be overweight or obese (OR 1.47, 95% CI 1.03–2.09, p = 0.030), compared with those with other haplotypes. Moreover, a significant relation was observed between third-trimester lipid parameters and genetic variants—namely, CD36 rs1984112, CD36 rs1761667, BMAL1 rs7950226, and CLOCK rs1801260. A multivariate logistic regression model revealed that CLOCK rs4864548 A-allele carriage was a strong risk factor for obesity (OR 2.05, 95% CI 1.07–3.93, p = 0.029); on the other hand, greater adherence to Mediterranean diet (OR 0.80, 95% CI 0.65–0.98, p = 0.038) and higher HDL levels (OR 0.96, 95% CI 0.94–0.99, p = 0.021) were related to a reduced risk of obesity. Interestingly, an association between maternal CLOCK rs4864548 and neonatal birthweight was detected (p = 0.025). These data suggest a potential role of the polymorphisms in clock systems and in fat taste perception in both susceptibility to overweight/obesity and influencing the related metabolic traits in pregnant women. [ABSTRACT FROM AUTHOR]

Background: Traditional transverse incision for mastectomy in women with large breasts or obesity can result in a persistent fold of skin at the lateral end of the scar, causing a dog ear deformity, which is unsightly, interferes with wearing external breast prosthesis, can be an annoying problem for patients, and can be a source of a long-term complaint requiring surgical correction. Evaluate the access to axilla and prevention of lateral dog-ear deformity after mastectomy with a Y-shaped incision and wound closure specially designed for women with obesity in Zagazig university hospitals. Method: This Clinical study was held in the surgery department at Zagazig University Hospital from March 2020 to Oct 2021. Included sixty females (BMI of equal to and more than 35) with breast cancer. Undergoes Y-shaped incision modified mastectomy. Results: There were two cases of hematoma and one case for each of surgical site infection, axillary triangle marginal necrosis, and apex necrosis. Conclusions: According to our research, the operator and all patients were cosmetically satisfied at the end of the surgical fear, with a better outcome, less complications, and a shorter hospital stay. In obese women, a Y-shaped incision can solve cosmetic surgery challenges by providing excellent axilla accessibility, a pleasing scar, and less complications. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to evaluate the diagnostic utility of serial growth ultrasounds for the indication of maternal overweight or obesity. Study Design This is a retrospective cohort study of all women with a body mass index ≥25 kg/m 2 who underwent at least one growth ultrasound at ≥24 weeks gestation and delivered at a single tertiary care institution between January 2010 and December 2013. Women were excluded if they had other medical indications for growth ultrasounds. Ultrasounds were divided into three gestational age epochs: 24 to 31 6/7 weeks, 32 to 35 6/7 weeks, and ≥36 weeks. Outcomes examined included the accuracy of sonographic detection of fetal growth restriction (FGR) and fetal overgrowth compared with diagnoses of small for gestational age (SGA) and large for gestational age (LGA) based on the birth weight. The test characteristics of ultrasound and the number needed to screen (NNS) to detect growth abnormalities at the time of birth were estimated for each condition and gestational age epoch. The NNS for the detection of fluid abnormalities was also assessed. Results During the study period, 3,945 eligible sonograms were performed in 2,928 women. FGR was identified on ultrasound in 42 (1.4%) women, fetal overgrowth in 94 (3.2%) women, oligohydramnios in 35 (1.2%) women, and hydramnios in 41 (1.4%) women. The NNS for the diagnoses of SGA, LGA, oligohydramnios, and hydramnios at delivery was at least 137 prior to 32 weeks of gestation and decreased (i.e., at least 45 and 16, for 32 to 35 6/7 weeks and ≥36 weeks, respectively) with advancing gestational age epochs. Conclusion If growth ultrasounds are to be performed for the sole indication of maternal overweight or obesity, consideration should be given to delaying initiation until at least 32 weeks of gestation given the infrequency of growth and fluid abnormalities identified earlier. Key Points There are limited data to support serial growth ultrasounds in overweight and obese women. The sensitivity of ultrasound for growth abnormalities at <32 weeks is low in women with BMI ≥25 Consideration should be given to delaying initiation of growth ultrasounds until at least 32 weeks [ABSTRACT FROM AUTHOR]

STUDY QUESTION Do antral follicle dynamics change in women with obesity and regular ovulatory cycles after a 6-month hypocaloric dietary intervention? SUMMARY ANSWER After a 6-month hypocaloric dietary intervention, women with obesity and regular ovulatory cycles displayed evidence of improved antral follicle dynamics defined by the emergence of more dominant follicles, larger ovulatory follicle diameter at selection, and increased luteal progesterone concentrations compared to pre-intervention. WHAT IS KNOWN ALREADY Precise events in antral folliculogenesis must occur in order for natural and regular monthly ovulation. In healthy women of reproductive age, antral follicles are recruited for growth in a wave-like fashion, wherein a subset of follicles are selected for preferential growth, and typically, one dominant follicle culminates in ovulation. Women with obesity and regular ovulatory cycles display evidence of suppressed antral follicle development, as evidenced by fewer recruitment events, fewer selectable and dominant follicles, smaller diameter of the ovulatory follicle at selection, and a higher prevalence of luteal phase defects. While improvements in gonadotropin and ovarian steroid hormone concentrations after weight loss have been documented in eumenorrheic women with obesity, the precise impact of weight loss on antral follicle dynamics has not been evaluated. STUDY DESIGN, SIZE, DURATION A pre–post pilot study of 12 women who participated in a 6-month hypocaloric dietary intervention. PARTICIPANTS/MATERIALS, SETTING, METHODS Twelve women with obesity (total body fat ≥35%) underwent transvaginal ultrasonography and venipuncture every-other-day for one inter-ovulatory interval (IOI) both before (baseline) and during the final month (Month 7) of a six-month hypocaloric dietary intervention. Participants were aged 24–34 years and had a self-reported history of regular menstrual cycles (25–35 days). Follicle number and diameter (≥2 mm) were quantified at each study visit, and individual growth profiles for all follicles ≥7 mm were determined. Blood samples were assayed for reproductive hormones. Follicle dynamics and reproductive hormone concentrations were compared pre- and post-intervention. Further, post-intervention follicle and endocrine dynamics (Month 7 IOI) were compared to an age-matched reference cohort of lean women with regular ovulatory cycles (total body fat <35%, N = 21). MAIN RESULTS AND THE ROLE OF CHANCE Participants lost an average of 11% of their original body weight with the hypocaloric dietary intervention. More dominant follicles were detected (≥10 mm) at Month 7 compared to baseline (0. 3 ± 0.4 versus 0.4 ± 0.5 follicles, P  = 0.001), and ovulatory follicles were selected at larger diameters post-intervention (7.3 ± 2.0 versus 10.9 ± 2.6 mm, P  = 0.007). Luteal progesterone concentrations were increased at Month 7 compared to baseline (5.3 ± 3.65 versus 6.3 ± 4.74 ng/ml, P  < 0.0001). However, risk for luteal phase dysfunction as judged by the prevalence of a luteal phase length <10 days, integrated luteal progesterone levels <80 ng/ml or peak progesterone <10 ng/ml did not differ pre- versus post-intervention (all, P  > 0.05). In Month 7, follicle dynamics and endocrine profiles were similar to the reference cohort across all measures. LIMITATIONS, REASONS FOR CAUTION This study does not inform on the earliest stages of ovarian follicle development and is limited to providing knowledge on the later stages of antral follicle development. This study cannot fully address causation between weight loss and sustained improvements in antral follicle dynamics. The data cannot be extrapolated to comment on potential improvements in fertility and fecundity with weight loss. The small group sizes limit statistical power. WIDER IMPLICATIONS OF THE FINDINGS The increasing prevalence of obesity necessitates an understanding of the mechanisms that underlie potential improvements in reproductive health outcomes with weight loss. Women with obesity and regular ovulatory cycles who undertook a 6-month hypocaloric dietary intervention demonstrated improvements consistent with benefits of lifestyle intervention on reproductive health even in those without overt signs of reproductive dysfunction. Potential improvements in the cellular makeup of follicles, which may underlie the restoration of normal follicle development and amelioration of subfertility, require further investigation. STUDY FUNDING/COMPETING INTEREST(S) Cornell University, President's Council of Cornell Women, United States Department of Agriculture (Grant No. 8106), and National Institutes of Health (R01-HD0937848). B.Y.J. and H.V.B. were supported by doctoral training awards from the National Institutes of Health (T32-DK007158) and Canadian Institutes of Health Research (Grant No. 146182), respectively. The authors have no competing interests. TRIAL REGISTRATION NUMBER NCT01927432 and NCT01785719. [ABSTRACT FROM AUTHOR]

Background: One of the most frequent preventable causes of maternal death is still obstetric hemorrhage. The World Health Organization advises using carbetocin to avoid post-partum hemorrhage in all pregnancies, especially in situations when oxytocin is not available. Objective:This study aimed to assess how well carbetocin worked in obese full-term pregnant women to improve uterine contraction and reduce blood loss. Subjects and methods: Between July 2023 and October 2023, 150 pregnant women who were admitted for an elective cesarean section at term, were included in this prospective randomized controlled clinical study. Two equal groups of pregnant women were formed: 75 women in the study group had a body mass index (BMI) of at least 30 kg/m2and 75 women in the control group had a BMI of less than 30 kg/m2. Following cord clamping, each woman received a one-minute intravenous bolus of 100 mcg carbetocin as the research medication. Estimation of blood loss was done by measuring the volume of blood of intraoperatively utilized blood-soaked towels and comparing preoperative and 24-hour post-delivery hemoglobin and hematocrit values. Results:Among the groups being studied, no statistically significant difference was found with respect to hemoglobin level, hematocrit level, uterine tone, mean weighted blood loss, or estimated blood loss at birth. Neither the requirement for blood transfusions nor the adverse effects of the medication varied significantly between the groups under study. No cases indicated that more uterotonic medications were required. Conclusion: Obesity does not appear to have an impact on carbetocin's ability to prevent PPH. [ABSTRACT FROM AUTHOR]

Background: Nematodes represent a continuous worldwide challenge with formidable burden on health and economics. Objective: The study aimed to assess the prevalence of nematodes parasitosis (NP) among pregnant women and its relation to the pregnancy-associated complications (PACs). Patients and Methods: In the current study 792 pregnant women were clinically evaluated and gave blood samples and three stool specimens per woman for parasitological evaluation. All women attended the follow-up visits and gave labor at the hospital. The frequency of PACs was determined and its relation to NP was examined statistically. Results: Multiple nematode species were detected in 185 specimens with A. lumbricoides, E. vermicularis, and T. trichiura represented 76.2% of the detected parasites in varied combinations, while T. spiralis was the least and was detected using human anti-trichinella spiralis IgG ELISA kit. The incidence of PACs was significantly higher among infected women with anemia was the commonest. The frequency of low hemoglobin concentration (HBC) was significantly higher, the average HBC was significantly lower, and the frequency of moderate and severe anemia was significantly higher among the infected women. The number of women who had instrumentally aided vaginal delivery or operative delivery was significantly higher among infected women. Conclusion: Nematode parasitosis is an ecological problem and is frequent among pregnant women especially those dependent on outdoor food staffs. Multiple-families NP is significant predictor for upcoming PACs. NP in obese pregnant women especially older ones has more deleterious impact on pregnancy. [ABSTRACT FROM AUTHOR]

• Obesity is a complicated chronic illness that shortens life expectancy, damages health, and raises the chance of long-term medical problems. • Women's quality of life is negatively impacted by urinary incontinence. • Obesity and overweight are significant risk factors for urine incontinence that have an impact on daily living and quality of life. • For this patient group, weight loss ought to be taken into consideration as the initial course of treatment. To evaluate the effect of body mass index (BMI) on the prevalence of overactive bladder syndrome (OAB), severity of symptoms, and quality of life in affected patients. We conducted a prospective cross-sectional study of 1351 consecutive patients who were recruited between June 2021 and May 2022. Patients were divided according to BMI (normal: <25.0, overweight: 25–29.9, obese: ≥30) and menopausal status. The latter were divided according to the presence or absence of urinary incontinence in the normal, wet-OAB and dry-OAB groups. A validated questionnaire, the International Consultation on Incontinence Questionnaire in Overactive Bladder (ICIQ-OAB), in the English and Arabic languages was used. A total of 1351 patients were included. For women who were overweight, there was a greater prevalence of dry-OAB (p = 0.02), However, the prevalence of both dry and wet-OAB were higher in obese women (p < 0.00001). Compared to women with a normal BMI, women who were overweight or obese had a greater likelihood of developing abnormal daytime urine frequency and nocturia, with p values ≤ 0.01. The ORs of overweight and obese women were 3.1 and 5.3, respectively, for experiencing wet OAB in comparison to women with a normal BMI. Additionally, the odds of developing severe OAB in overweight and obese women were 5.8 and 18.6, respectively, which negatively affects their quality of life (QoL). The risk of developing OAB symptomatology is significantly greater in overweight and obese patients. As BMI increases, the symptomatology, perceived discomfort and QoL of patients with OAB worsen. [ABSTRACT FROM AUTHOR]

Objectives: The population attributable fraction (PAF), an epidemiologic measure of exposures and health outcomes, can provide information on the public health impacts of exposures in populations. This study aimed to systematically summarize the PAF estimates of modifiable cancer risk factors in Korea. Methods: This review included studies that determined PAFs of modifiable risk factors for cancer in Korea. We performed systematic searches in EMBASE, MEDLINE, Cochrane library, and Korean databases for studies published up to July 2021. Two reviewers independently screened studies for eligibility, extracted data, and performed quality assessments of the included studies. Due to high variability among the data acquisition methods and PAF estimates, we presented the results qualitatively and did not perform quantitative data synthesis. Results: We reviewed 16 studies that reported the PAFs of risk factors for cancer, including smoking, alcohol consumption, obesity, and various cancer sites. We found considerable variability in the PAF estimates across exposure and cancer pairs. However, PAF estimates for smoking and respiratory cancer were consistently high in men. PAF estimates were higher in men than in women for smoking and alcohol consumption but higher in women for obesity. We found limited evidence for other exposures and cancers. Conclusion: Our findings may be used to prioritize and plan strategies to reduce cancer burden. We encourage further and updated assessments of cancer risk factors, including those not addressed in the studies included in this review, and their potential contributions to cancer burden to better inform strategies for cancer control. [ABSTRACT FROM AUTHOR]

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date, literature on women with obesity has focused upon the evaluation of aerobic‐based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort. Objective: This study aimed to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes. Methods: Sixty‐seven women with obesity were randomly assigned to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups were trained x3 times/week for 12 weeks (up to 150‐min/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass) and strength (5RM bench press, leg dynamometry, grip strength) and self‐reported measures of physical activity, mood, sleep, pain and quality of life. Results: Findings support the feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including body mass index (Effect size [ES] = 0.79, p = 0.04), BW (ES = 0.75, p = 0.05), %BF (ES = 0.77, p = 0.04), FM (ES = 0.83, p = 0.03) and WC (ES = 0.90, p = 0.02), physical activity (i.e., moderate physical activity [ES = 0.69, p = 0.07), mood (ES = 0.83, p = 0.03) and sleep (ES = 0.78, p = 0.04). Resistance was most promising for CRF (ES = 1.47, p = 0.002), strength (i.e., bench press [ES = 2.88, p=<0.001]) and pain (i.e., pain severity [ES = 0.40, p = 0.31]). Conclusions: For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements. CLINICAL TRIAL REGISTRATION: ISRCTN13517067 [ABSTRACT FROM AUTHOR]

Aim: Body mass index and waist circumference are used for obesity diagnosis and screening of visceral fat; however, their evidence in older adults is insufficient. This study investigated the age‐specific association of body mass index and waist circumference with metabolic diseases, assessing their applicability as diagnostic criteria for individuals aged ≥65 years. Methods: Analysis included 46,324 individuals aged ≥18 years, categorized into five age groups: 18–44, 45–54, 55–64, 65–74, and ≥75 years. Logistic regression analyses identified associations between obesity and metabolic diseases, stratified by age and sex. Results: Men with obesity based on body mass index had a significantly high risk of hypertension, diabetes mellitus, and dyslipidemia across all age groups (all, p < 0.05). Obesity based on waist circumference was significantly positively associated with all metabolic diseases (all, p < 0.05). Women with obesity based on body mass index and waist circumference had a significantly high risk of all metabolic diseases across all age groups (all, p < 0.05), except for diabetes mellitus in individuals aged ≥75 years. Conclusions: Participants with obesity based on body mass index and waist circumference exhibited a high risk of hypertension, diabetes mellitus, and dyslipidemia among those aged 18–74 years and men aged ≥75 years. This study contributes to the early prevention and control of metabolic diseases. [ABSTRACT FROM AUTHOR]

Background: There is controversial data on the effects of prebiotic, probiotic, or synbiotic supplementations on overweight/obesity indicators. Thus, we aimed to clarify this role of biotics through an umbrella review of the trials' meta-analyses. Methods: All meta-analyses of the clinical trials conducted on the impact of biotics on overweight/obesity indicators in general populations, pregnant women, and infants published until June 2023 in PubMed, Web of Sciences, Scopus, Embase, and Cochrane Library web databases included. The meta-analysis of observational and systematic review studies without meta-analysis were excluded. We reported the results by implementing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart. The Assessment of Multiple Systematic Reviews-2 (AMSTAR2) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) systems were used to assess the methodological quality and quality of evidence. Results: Overall, 97 meta-analysis studies were included. Most studies were conducted on the effect of probiotics in both genders. Consumption of prebiotic: 8-66 g/day, probiotic: 104 -1.35x1015 colony-forming unit (CFU)/day, and synbiotic: 106-1.5x1011 CFU/day and 0.5-300 g/day for 2 to 104 weeks showed a favorable effect on the overweight/obesity indicators. Moreover, an inverse association was observed between biotics consumption and overweight/obesity risk in adults in most of the studies. Biotics did not show any beneficial effect on weight and body mass index (BMI) in pregnant women by 6.6x105-1010 CFU/day of probiotics during 1-25 weeks and 1x109-112.5x109 CFU/capsule of synbiotics during 4-8 weeks. The effect of biotics on weight and BMI in infants is predominantly non-significant. Prebiotics and probiotics used in infancy were from 0.15 to 0.8 g/dL and 2x106 -6x109 CFU/day for 2-24 weeks, respectively. Conclusion: It seems biotics consumption can result in favorable impacts on some anthropometric indices of overweight/obesity (body weight, BMI, waist circumference) in the general population, without any significant effects on birth weight or weight gain during pregnancy and infancy. So, it is recommended to intake the biotics as complementary medications for reducing anthropometric indices of overweight/obese adults. However, more well-designed trials are needed to elucidate the anti-obesity effects of specific strains of probiotics. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are the fifth greatest risk of global deaths. Over 1.9 billion persons aged 18 and older were overweight in 2016. Over 650 million of these men and women were obese. Instead of changes in dietary intake or other causes, it has been suggested that the increase in body weight in industrialized nations is mostly the result of decreased levels of physical activity. Aim and Objectives: To assess the eating behaviour/pattern and type of physical activity/duration of physical activity among college students in Indore city, and to determine correlation of eating behaviour & physical activity with overweight /obesity. Materials and Methods: A cross–sectional study conducted between January to June 2023 among 200 randomly selected students of age 17 to 25 years of various colleges of Central India in Indore district who gave consent, using a pre-designed, semi-structured, pre-tested questionnaire. Data entered in Microsoft excel was analysed using SPSS software25.0 (trial version). Results: 46% had Body Mass Index (BMI) in normal range and 42.5% were overweight. 60% male participants had their BMI in normal range and 30.4% were overweight whereas 58.8% female participants were overweight. Majority (75.3%) of female participants had low Metabolic Equivalent of Task(MET) score whereas only 48.7% of male participants had low MET score. Both the Three Factor Eating Questionnaire (TFEQ) Scores and International Physical Activity Questionnaire(IPAQ) Scores were found to be statistically significant (p-value <0.05) among BMI categories.100% of obese participants, 91.8% of overweight participants and 32.6% of participants with BMI in normal range had low MET score, found to be statistically significant (p-value<0.001). Conclusion: TFEQ and MET scores were found to be statistically significant (p-value<0.001) among BMI categories suggesting that, both eating behaviour and physical activity were associated with overweight and obesity. [ABSTRACT FROM AUTHOR]

The purpose of this work was to find a link between the breast cancer (BC)-risk effects of sex hormone-binding globulin (SHBG)-associated polymorphisms and obesity. The study was conducted on a sample of 1498 women (358 BC; 1140 controls) who, depending on the presence/absence of obesity, were divided into two groups: obese (119 BC; 253 controls) and non-obese (239 BC; 887 controls). Genotyping of nine SHBG-associated single nucleotide polymorphisms (SNP)—rs17496332 PRMT6, rs780093 GCKR, rs10454142 PPP1R21, rs3779195 BAIAP2L1, rs440837 ZBTB10, rs7910927 JMJD1C, rs4149056 SLCO1B1, rs8023580 NR2F2, and rs12150660 SHBG—was executed, and the BC-risk impact of these loci was analyzed by logistic regression separately in each group of obese/non-obese women. We found that the BC-risk effect correlated by GWAS with the SHBG-level polymorphism rs10454142 PPP1R21 depends on the presence/absence of obesity. The SHBG-lowering allele C rs10454142 PPP1R21 has a risk value for BC in obese women (allelic model: CvsT, OR = 1.52, 95%CI = 1.10–2.11, and pperm = 0.013; additive model: CCvsTCvsTT, OR = 1.71, 95%CI = 1.15–2.62, and pperm = 0.011; dominant model: CC + TCvsTT, OR = 1.95, 95%CI = 1.13–3.37, and pperm = 0.017) and is not associated with the disease in women without obesity. SNP rs10454142 PPP1R21 and 10 proxy SNPs have adipose-specific regulatory effects (epigenetic modifications of promoters/enhancers, DNA interaction with 51 transcription factors, eQTL/sQTL effects on five genes (PPP1R21, RP11-460M2.1, GTF2A1L, STON1-GTF2A1L, and STON1), etc.), can be "likely cancer driver" SNPs, and are involved in cancer-significant pathways. In conclusion, our study detected an obesity-dependent association of the rs10454142 PPP1R21 with BC in women. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Urinary incontinence is a common disease among middle-aged and elderly women, which not only affects the physical and mental health of patients, but also brings a great medical burden to society. Obesity is a known risk factor for urinary incontinence and is the most common secondary cause of hyperlipidemia. Most obese patients also suffer from hyperlipidemia in the clinic. However, few studies have explored the role of hyperlipidemia in women with urinary incontinence. Using data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES), we aimed to evaluated the independent associations of high body mass index and hyperlipidemia with urinary incontinence in Americans by conducting a weighted multivariate logistic regression model. Additive interactions were also assessed using the relative excess risk due to interaction (RERI), attributed proportion of interaction (AP) and synergy index (S). This study demonstrated that hyperlipidemia was associated with a higher risk of stress urinary incontinence among women with obesity (OR = 1.52, 95% CI = 1.03–2.25), and there was a significant synergistic effect of hyperlipidemia and obesity on stress urinary incontinence(adjusted RERI: 3.75, 95% CI 0.30–7.20; adjusted AP: 0.67, 95% CI 0.54–0.80; adjusted S: 5.49, 95% CI 4.15–7.27). Moreover, fasting serum triglyceride lipids were the most relevant blood lipid indicator for the risk of stress urinary incontinence, especially among obese women younger than 50 years old, which contributes to the development of more refined lipid control protocols for patients with urinary incontinence in different age groups. [ABSTRACT FROM AUTHOR]

Background and Aims High-risk human papillomavirus (HR-HPV) infection—a well-established risk factor for cervical cancer—has associations with cardiovascular disease (CVD). However, its relationship with CVD mortality remains uncertain. This study examined the associations between HR-HPV infection and CVD mortality. Methods As part of a health examination, 163 250 CVD-free Korean women (mean age: 40.2 years) underwent HR-HPV screening and were tracked for up to 17 years (median: 8.6 years). National death records identified the CVD mortality cases. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD mortality were estimated using Cox proportional hazard regression analyses. Results During 1 380 953 person-years of follow-up, 134 CVD deaths occurred, with a mortality rate of 9.1 per 105 person-years for HR-HPV(−) women and 14.9 per 105 person-years for HR-HPV(+) women. After adjustment for traditional CVD risk factors and confounders, the HRs (95% CI) for atherosclerotic CVD (ASCVD), ischaemic heart disease (IHD), and stroke mortality in women with HR-HPV infection compared with those without infection were 3.91 (1.85–8.26), 3.74 (1.53–9.14), and 5.86 (0.86–40.11), respectively. The association between HR-HPV infection and ASCVD mortality was stronger in women with obesity than in those without (P for interaction =.006), with corresponding HRs (95% CI) of 4.81 (1.55–14.93) for obese women and 2.86 (1.04–7.88) for non-obese women. Conclusions In this cohort study of young and middle-aged Korean women, at low risks for CVD mortality, those with HR-HPV infection had higher death rates from CVD, specifically ASCVD and IHD, with a more pronounced trend in obese individuals. [ABSTRACT FROM AUTHOR]

Background: Morbid Obesity (MO) is a public health problem that affects a person's physical, psychological and sexual well-being. Women with MO are affected by their body image and self-concept, and obesity stigma may affect women in social and sexual relationships. Objective: To describe and understand the experiences of morbidly obese heterosexual women (who are sexually attracted to men) in relation to their body image and sexuality after bariatric surgery. Methodology: Qualitative study using Merleau-Ponty's hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached. Results: Two main themes were identified: (1) "Escaping from a cruel environment": weight loss to increase self-esteem; with the sub-themes: 'I love myself now', and 'Body image and social relationships; a vicious circle; (2) "Now, I am truly me": accepting my body to reclaim my sexuality, with the sub-themes: 'The body as the focal point of sexuality', and 'When regaining your sex drive reignites your sex life and relationship'. Conclusion: Weight loss and body acceptance radically change morbidly obese women's sex lives after bariatric surgery. They rediscover their bodies, have increased self-esteem, and see improvements in their social relationships and sexuality. These women feel seen, loved and desired, and now value their body image and femininity. As they go through continuous improvements following bariatric surgery, they gradually regain self-esteem, acceptance of their bodies and control over their sex life. Even though the women's partners benefit from these improvements, they seem to be afraid of being left. Plain English Summary: Obesity is a problem that affects women's physical, psychological and sexual well-being, as well as their social relationships. It is important to explore and understand the experiences of heterosexual women regarding their body and sexuality. After other treatments, women undergo surgery to reduce their obesity. After bariatric surgery women feel happier about themselves, experience less stigma and progressively recover their social and sex lives. [ABSTRACT FROM AUTHOR]

Objectives: This study was aimed to develop a nomogram that can accurately predict the likelihood of cognitive dysfunction in individuals with abdominal obesity by utilizing various predictor factors. Methods: A total of 1490 cases of abdominal obesity were randomly selected from the National Health and Nutrition Examination Survey (NHANES) database for the years 2011-2014. The diagnostic criteria for abdominal obesity were as follows: waist size = 102 cm for men and waist size = 88 cm for women, and cognitive function was assessed by Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Word Learning subtest, Delayed Word Recall Test, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The cases were divided into two sets: a training set consisting of 1043 cases (70%) and a validation set consisting of 447 cases (30%). To create the model nomogram, multifactor logistic regression models were constructed based on the selected predictors identified through LASSO regression analysis. The model's performance was assessed using several metrics, including the consistency index (C-index), the area under the receiver operating characteristic (ROC) curve (AUC), calibration curves, and decision curve analysis (DCA) to assess the clinical benefit of the model. Results: The multivariate logistic regression analysis revealed that age, sex, education level, 24-hour total fat intake, red blood cell folate concentration, depression, and moderate work activity were significant predictors of cognitive dysfunction in individuals with abdominal obesity (p < 0.05). These predictors were incorporated into the nomogram. The C-indices for the training and validation sets were 0.814 (95% CI: 0.875-0.842) and 0.805 (95% CI: 0.758-0.851), respectively. The corresponding AUC values were 0.814 (95% CI: 0.875-0.842) and 0.795 (95% CI: 0.753-0.847). The calibration curves demonstrated a satisfactory level of agreement between the nomogram model and the observed data. The DCA indicated that early intervention for at-risk populations would provide a net benefit, as indicated by the line graph. Conclusion: Age, sex, education level, 24-hour total fat intake, red blood cell folate concentration, depression, and moderate work activity were identified as predictive factors for cognitive dysfunction in individuals with abdominal obesity. In conclusion, the nomogram model developed in this study can effectively predict the clinical risk of cognitive dysfunction in individuals with abdominal obesity. [ABSTRACT FROM AUTHOR]

Objectives: While previous research has utilized remote delivery of yoga interventions, no research has specifically interrogated the effectiveness of remote yoga intervention delivery. In this secondary analysis of weight-maintenance trial data, we examined participant perceptions of essential yoga properties across in-person and remote formats, hypothesizing that perceptions would not differ following remote delivery. Methods: 24 women with overweight or obesity (34.6±4.1 kg/m2, 48.2±9.9 years) received a 12-week Iyengar yoga intervention (2x/week) following a 3-month behavioral weight loss program. Of 23 participants who completed follow-up questionnaires, 12 received the planned in-person intervention and 11 received a remote intervention (delivered live) due to the COVID-19 pandemic. The Essential Properties of Yoga Questionnaire (EPYQ) was completed online by participants and by the instructors to measure the perceptions of the relative emphasis placed on the essential components of the yoga intervention via 14 subscales. Linear regression models were used to compare perceptions of each EPYQ dimension across in-person and remote delivery methods, as well as between participants and instructors, independent of delivery method. Results: 13 of the 14 subscales did not differ between delivery modalities (p>0.05). Participants perceived more individual attention within in-person yoga (p = 0.003). For both delivery methods, instructors perceived breathwork, restorative postures, and body locks to be incorporated to a lesser degree compared to participants (β = -1.28, p = 0.003; β = -1.57, p = 0.019; β = -1.39, p = 0.036; respectively). No other significant differences across the participant and instructor scores were observed. Conclusions: Findings provide preliminary support for the use of live remote delivery of yoga, effectively communicating most essential yoga properties when compared to in-person classes. However, participants perceived more individual attention with in-person versus remote delivery; thus, future remote-based yoga interventions may benefit from providing additional individualized feedback. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is known as a chronic systemic autoimmune disorder that primarily targets synovial joints, and may cause pain and functional limitations. Studies show diet can have beneficial effects on symptoms and oxidative stress of this disease. Intermittent fasting (IF) is a dietary approach with cycles of fasting and intake. The current study aims to investigate the effect of IF on quality of life, clinical symptoms, inflammation, and oxidative stress in overweight and obese postmenopausal women with RA. Methods: The current study is a randomized clinical trial, in which 44 patients with mild to moderate severity of RA will be randomly allocated to receive either IF (n = 22) or the usual diet (n = 22) for 8 weeks. Anthropometric measures and biochemical indicators including serum concentrations of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and total oxidant and antioxidant capacity (TOC and TAC) will be assessed at the baseline and end of the study. Also, disease severity will be assessed by Disease Activity Score-28 (DAS-28) and clinical disease activity index (CDAI), and disability index will be assessed by Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaire. Discussion: Studies show fasting has beneficial effects on inflammatory markers and results in an improvement in the health of different populations. Literature review shows it seems there is no study in this field to evaluate the effects of IF on RA patients, and they are limited to other types of fasting. However, studies show IF can have many positive effects on chronic and autoimmune diseases. Therefore, IF may have positive effects on these patients. Trial registration: IRCT20230217057441N1. Registered on 14 February 2023. https://en.irct.ir/user/trial/68669. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is defined as a cluster of glucose intolerance, hypertension, dyslipidemia, and central obesity with insulin resistance. The role of gut microbiota in metabolic disorders is increasingly considered. To investigate the effects of probiotic supplements and hypocaloric high fiber regimen on MetS in obese Egyptian women. A longitudinal follow-up intervention study included 58 obese Egyptian women, with a mean age of 41.62 ± 10.70 years. They were grouped according to the criteria of MetS into 2 groups; 23 obese women with MetS and 35 ones without MetS. They followed a hypocaloric high fiber regimen weight loss program, light physical exercise, and received a probiotic supplement daily for 3 months. For each participating woman, blood pressure, anthropometric measurements, basal metabolic rate (BMR), dietary recalls, laboratory investigations, and microbiota analysis were acquired before and after 3 months of follow-up. After intervention by the probiotic and hypocaloric high fiber regimen and light exercise, reduction ranged from numerical to significant difference in the anthropometric parameters, blood pressure, and BMR was reported. All the biochemical parameters characterized by MetS decreased significantly at p ≤ 0.05–0.01. Before the intervention, results revealed abundant of Bacteroidetes bacteria over Firmicutes with a low Firmicutes/Bacteroidetes ratio. After the intervention, Log Lactobacillus, Log Bifidobacteria, and Log Bacteroidetes increased significantly in both groups, while Log Firmicutes and the Firmicutes/Bacteroidetes Ratio revealed a significant decrease. In conclusion, this study's results highlight a positive trend of probiotics supplementation with hypocaloric high-fiber diets in amelioration of the criteria of the Mets in obese Egyptian women. [ABSTRACT FROM AUTHOR]

Obesity is recognized by the World Health Organization (WHO) as a disease in its own right. Moreover, obesity is an increasingly concerning public health issue across the world and its prevalence is rising amongst women of reproductive age. The fertility of over-weight and obese women is reduced and they experience a higher rate of miscarriage. In pregnant women obesity not only increases the risk of antenatal complications, such as preeclampsia and gestational diabetes, but also fetal abnormalities, and consequently the overall feto-maternal mortality. Ultrasound is one of the most valuable methods to predict and evaluate pregnancy complications. However, in overweight and obese pregnant women, the ultrasound examination is met with several challenges, mainly due to an impaired acoustic window. Overall obesity in pregnancy poses special challenges and constraints to the antenatal care and increases the rate of pregnancy complications, as well as complications later in life for the mother and child. [ABSTRACT FROM AUTHOR]

During the early COVID-19 pandemic, an increase in weight gain among the general population was observed; however, gestational weight gain (GWG) was not thoroughly evaluated. We evaluated changes in GWG during the pandemic closures in South Carolina. We used live, singleton birth records to compare GWG outcomes among three pregnancy groups occurring before (January 2018–February 2020), during (March–May 2020), and after (June 2020–December 2021) pandemic closures. GWG categories were defined by the Institute of Medicine (IOM) recommendations. We used multinomial logistic regression models to calculate prevalence ratios (PRs) of GWG categories stratified by prepregnancy body mass index (BMI) category. We analyzed 177,571 birth records. Women with normal weight (n = 64,491, 36%) had a slightly lower prevalence of excessive GWG during and after the pandemic closures (PR 0.94; 95% CI: 0.91–0.98 and PR 0.95; 95% CI: 0.93–0.98, respectively). We observed no changes in GWG patterns for women with overweight and obesity. We found limited changes in GWG patterns for a subset of pregnant women during and after pandemic closures, compared with prepandemic period in South Carolina, countering findings of weight changes among the general population. [ABSTRACT FROM AUTHOR]

Resveratrol, a natural polyphenol compound contained in numerous plants, has been proposed as a treatment for obesityrelated disease processes such as insulin resistance. However, in humans there are conflicting results concerning the efficacy of resveratrol in improving insulin action; the purpose of the present study was to determine whether obesity status (lean, severely obese) affects the response to resveratrol in human skeletal muscle. Primary skeletal muscle cells were derived from biopsies obtained from age-matched lean and insulin-resistant women with severe obesity and incubated with resveratrol (1 µM) for 24 h. Insulin-stimulated glucose oxidation and incorporation into glycogen, insulin signal transduction, and energy-sensitive protein targets [AMP-activated protein kinase (AMPK), Sirt1, and PGC1α] were analyzed. Insulin-stimulated glycogen synthesis, glucose oxidation, and AMPK phosphorylation increased with resveratrol incubation compared with the nonresveratrol conditions (main treatment effect for resveratrol). Resveratrol further increased IRS1, Akt, and TBC1D4 insulin-stimulated phosphorylation and SIRT1 content in myotubes from lean women, but not in women with severe obesity. Resveratrol improves insulin action in primary human skeletal myotubes derived from lean women and women with severe obesity. In women with obesity, these improvements may be associated with enhanced AMPK phosphorylation with resveratrol treatment. [ABSTRACT FROM AUTHOR]

Background: Inappropriate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are both linked to preterm birth (PTB); however, which one plays a dominant role in PTB risk is not yet sure. We aimed to evaluate the combined effect of pre-pregnancy BMI and GWG on the risk of PTB in singleton pregnancies conceived both spontaneously and through assisted reproductive technology (ART). Methods: The data included all mothers (n = 17,540,977) who had a live singleton birth from the US National Vital Statistics System (NVSS) 2015–2019. Logistic regression models, quantile-g-computation, and generalized additive model were used to analyze the combined association of pre-pregnancy BMI and GWG with PTB. Results: The singleton PTB rate was significantly higher in ART pregnancies (11.5%) than in non-ART pregnancies (7.9%). When compared to those women with pre-pregnancy normal weight and GWG within Institute of Medicine (IOM) guidelines, the highest PTB risk was observed in non-ART women with pre-pregnancy underweight and GWG below IOM guidelines (aOR 2.56; 95% CI 2.53–2.60) and in ART women with pre-pregnancy obese and GWG below IOM guidelines (aOR 2.56; 95%CI 2.36–2.78). GWG dominated the combined effect with its joint effect coefficient of − 0.281 (P < 0.05) in non-ART women and − 0.108 (P < 0.05) in ART women. Conclusions: Inappropriate GWG played a dominant role in increasing the risk of PTB in both non-ART and ART populations. Counseling regarding pre-pregnancy BMI and especially GWG appears to be even more crucial for pregnancies conceived via ART, given their impact on PTB. [ABSTRACT FROM AUTHOR]

Summary: Previous work has found adverse mental health symptomology in women living with obesity, compared with those of healthy weight, around the time of pregnancy. This meta‐analysis aimed to explore the association between anxiety, depression, and weight status in women living with obesity before, during, and after pregnancy. Bibliographic databases were systematically searched, and 14 studies were included, which aimed to assess the association between excess weight and anxiety or depression outcomes in women before, during, or after pregnancy. Data were analyzed via narrative synthesis and random effects multi‐level meta‐analyses. Scores on mental health indices were significantly greater (indicative of worse anxiety/depression) in women with obesity compared to women of a healthy weight, around the time of pregnancy (SMD = 0.21 [95% CI: 0.11–0.31; 95% prediction intervals: 0.13–0.56], I2 = 73%, p < 0.01). Depressive symptoms were greater during and after pregnancy (SMD = 0.23 [95% CI: 0.13–0.34; 95% prediction intervals: −0.12 to 0.59], I2 = 75.0%, p < 0.01), and trait anxiety symptoms were greater during pregnancy (SMD = 0.24 [95% CI: 0.01–0.47; 95% prediction intervals: −0.25 to 0.72], I2 = 83.7%, p = 0.039) in women living with obesity, compared to those of healthy weight. Narrative evidence suggests that socioeconomic status and ethnicity may modify the relationship between obesity and mental health symptomology. The findings indicate that maternal obesity is associated with greater anxiety and depression symptoms. These findings may inform the design of maternal weight management interventions. [ABSTRACT FROM AUTHOR]