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Background: Recently, weight-adjusted-waist index (WWI), a new index for evaluating obesity, has been developed. This study aimed to examine the association between WWI and T2DM in Chinese urban adults. Method: A total of 5,0978 eligible participants drawn from the prospective REACTION study (Cancer Risk Assessment in Chinese People with Diabetes) were included in this study. Participants were divided into 3 groups based on baseline WWI levels. Pearson correlation analysis and binary logistic regression analysis were conducted to explore the association of WWI with T2DM risk factors and with T2DM risk. Results: The prevalence of obesity, central obesity and T2DM was 14.2%, 46.8% and 11.0% respectively, with a median age of 57 years. Logistic analysis showed that the WWI was significantly associated with the risk of T2DM. Compared to the lowest tertile of WWI (T1) serving as the reference group, the second tertile (T2) and the third tertile (T3) were associated with a 0.218-fold [1.218 (1.152, 1.288), P < 0.001] and 0.286-fold [1.286 (1.212, 1.364), P < 0.001] increase in the odds of developing T2DM respectively. After adjusting for all factors with the exception of the stratified variable, this association held true in age, sex, BMI, hypertension, and hyperlipidemia subgroup and was especially pronounced in those aged <60 years, BMI ≥24 kg/m2, and males, with interactions between WWI and age, sex, and BMI (P for interaction <0.05). Conclusion: WWI was positively associated with T2DM in Chinese urban adults, especially in young and middle-aged males with BMI ≥24 kg/m2. [ABSTRACT FROM AUTHOR]

Objective: The weight-adjusted-waist index (WWI) is a novel measure of central adiposity, potentially linked to various sleep disturbances. This study explores the relationship between WWI and sleep outcomes, such as trouble sleeping, sleep disorder, and sleep duration. Methods: Data from the National Health and Nutrition Examination Survey 2007–2012 were analyzed, including 13,494 participants. The analysis focused on individuals aged 20 years and older who provided information on WWI and sleep. Sleep status was determined based on responses to the following questions: (1) "How many hours do you sleep?"; (2) if they reported trouble sleeping; and (3) if they had physician-diagnosed sleep disorders. Regression models assessed the association between WWI and sleep outcomes across the entire population and within subgroups. Restricted cubic spline (RCS) analysis was conducted to examine potential non-linear relationships between WWI and sleep outcomes. Results: A higher WWI was significantly correlated with an increased likelihood of trouble sleeping (OR = 1.26, 95% CI: 1.16, 1.36; p < 0.001) and sleep disorder (OR = 1.71, 95% CI: 1.50, 1.95; p < 0.001) in the overall population. RCS analysis indicated a linear relationship between WWI and these sleep outcomes. Subgroup analysis identified that the connection between WWI and trouble sleeping was most pronounced among Non-Hispanic Blacks and individuals with lower educational levels. For sleep disorder, the association was stronger in males and Non-Hispanic Blacks. A slight negative association between WWI and sleep duration was found, especially among non-drinkers (β = − 0.13, 95% CI: − 0.24, − 0.02; p = 0.028). Conclusion: The findings highlight a significant and linear relationship between elevated WWI and an increased likelihood of experiencing trouble sleeping and sleep disorder, with variations observed across different demographic and lifestyle subgroups. These results imply that central adiposity, as measured by WWI, plays an important role in sleep health. Level of evidence: Level III: Evidence obtained from well-designed cohort or case–control analytic studies. [ABSTRACT FROM AUTHOR]

Abstract Objective The weight-adjusted-waist index (WWI) is a novel measure of central adiposity, potentially linked to various sleep disturbances. This study explores the relationship between WWI and sleep outcomes, such as trouble sleeping, sleep disorder, and sleep duration. Methods Data from the National Health and Nutrition Examination Survey 2007–2012 were analyzed, including 13,494 participants. The analysis focused on individuals aged 20 years and older who provided information on WWI and sleep. Sleep status was determined based on responses to the following questions: (1) “How many hours do you sleep?”; (2) if they reported trouble sleeping; and (3) if they had physician-diagnosed sleep disorders. Regression models assessed the association between WWI and sleep outcomes across the entire population and within subgroups. Restricted cubic spline (RCS) analysis was conducted to examine potential non-linear relationships between WWI and sleep outcomes. Results A higher WWI was significantly correlated with an increased likelihood of trouble sleeping (OR = 1.26, 95% CI: 1.16, 1.36; p

Abstract Studies investigating the association between type 2 diabetes mellitus and central adiposity are lacking. Therefore, this study aimed to investigate trends in type 2 diabetes mellitus stratified by central adiposity using waist-to-height ratio (WHtR). Trends in type 2 diabetes mellitus were examined by central adiposity, using WHtR, with data from the Korea National Health and Nutrition Examination Survey (2005–2022). Individuals aged 30 years and over who participated in the survey were selected. Type 2 diabetes mellitus was identified based on serum glucose or HbA1c levels, the use of diabetes medications, or a prior diagnosis by a physician. Weighted β-coefficients or odd ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess changes in disease prevalence. A total of 79,368 participants were included in the database (female: 45,163 [56.9%]). from 2005 to 2022, the prevalence of type 2 diabetes mellitus increased from 3.3 to 5.8% in the healthy central adiposity group, from 11.2 to 17.1% in the increased central adiposity group, and from 18.0 to 26.7% in the high central adiposity group. Males, older population, lower education level, lower household income, and smoking are associated with a higher risk of type 2 diabetes. In the high central adiposity group, overweight and obese individuals had higher susceptibility than underweight or normal-weight individuals, with ORs of 5.85 (95% CI, 2.54–13.47) and 8.24 (3.79–17.94), respectively. The prevalence of type 2 diabetes mellitus has increased in all central adiposity groups in the past decade. This underscores the need for tailored interventions to address disparities and improve diabetes management in at-risk populations.

Abstract Objective To investigate the factors associated with diabesity in older women. Methods This epidemiological study used a cross‐sectional design and included 196 older women (72.70 ± 7.20 years) from Jequié, Bahia, Brazil. Diabesity was defined as having both an elevated abdominal circumference (≥88 cm) and diabetes mellitus. For the inferential analyses, we constructed crude models followed by a multiple hierarchical explanatory model, with the following levels: Level 1 (socioeconomic variables), Level 2 (behavioral aspects), and Level 3 (health conditions). Poisson regression with a robust estimator was employed, and we calculated Prevalence Ratios (PR) with 95% Confidence Intervals (CI). Results The prevalence of abdominal obesity, diabetes mellitus, and diabesity were 79.60%, 27.80%, and 22.40%, respectively. Women who were insufficiently active had a higher likelihood of diabesity (PR: 2.04; 95% CI: 1.22–3.41), as did those who spent more time in sedentary behavior (PR: 1.81; 95% CI: 1.04–3.16), used three or more continuous medications (PR: 2.51; 95% CI: 1.29–4.89), or reported a negative self‐perception of health (PR: 2.57; 95% CI: 1.03–5.80). Conclusion The study identified several factors associated with diabesity in older women: insufficient physical activity, prolonged sedentary behavior, polypharmacy, and negative self‐perception of health.

Purpose: Data on associations between adiposity and heart rate variability (HRV) in prepubertal children are limited. We examined the associations between adiposity indices and HRV, independent of lifestyle behaviors, comparing multiple indicators of adiposity, and explored differences between boys and girls. Methods: Data stem from 469 participants of the QUALITY cohort (630 children aged 8–10 years with a parental history of obesity). Adiposity indices included waist-to-height ratio, body mass index (BMI) percentiles and categories (overweight, obesity), dual-energy x-ray absorptiometry (DEXA) defined fat mass percentage and android/gynoid ratio. HRV indices in the frequency and the spectral domain were derived from a daytime 3-h Holter recording. Multivariable linear regression models were adjusted for age, sex, Tanner stage, physical activity, screen time, and fitness. Interactions between sex and adiposity were tested. Results: Greater adiposity was associated with decreased parasympathetic modulation and increased sympathetic dominance. Waist-to-height ratio was associated with lower parasympathetic activity: root mean square of the successive differences (RMSSD) [B = −23.32, 95% confidence interval (CI) −42.42, −4.22], pNN50 (B = −16.93, 95% CI − 28.58, − 5.27), LF/HF ratio (B = 1.83, 95% CI 0.97–2.70). Patterns of association were similar for android/gynoid ratio. Overweight was not associated with altered HRV. Obesity was negatively associated with RMSSD and pNN50 and positively with LF/HF ratio. Greater fat mass percentage was associated with lower RMSSD, pNN50, and HF, and increased LF/HF ratio. There were no differences between boys and girls. Conclusions: Specific markers of adiposity relate to altered HRV in childhood, with waist-to-height ratio being potentially a more relevant marker of HRV than BMI and more pragmatic than percent body fat. Trial registration: NCT03356262, 11 November 2017. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is associated with faster linear growth; nonetheless, its benefit to the mature height of Indonesian children is questionable. This study aimed to evaluate the relationship between adiposity and height growth of Indonesian children, adolescents, and young adults aged 7 to 23 years. Methods: Height and skinfolds at triceps, subscapular, suprailiac, and calf were measured in 2,520 children, adolescents, and young adults aged 7 to 23 years (boys = 1,116, girls = 1,404). Central adiposity (subscapular and suprailiac skinfolds) and peripheral adiposity (triceps and calf skinfolds) were projected against heights in each age group. The ANCOVA test and partial correlation were used for statistical analysis. Results: With the exception of ages 8 to 12 years, boys were always taller than girls after controlling for age and central or peripheral adiposity. Boys with higher central and peripheral adiposity were taller than their peers up to the age of 17 (r = 0.30-0.72, P < 0.05, P < 0.01). Girls with central adiposity grew taller than their thinner peers until the age of 14 (r = 0.17-0.50, P < 0.05, P < 0.01), whereas girls with peripheral adiposity benefit from this advantage over a more extended period of time. Afterward, adiposity did not offer any benefit on heights. Conclusions: Children with high adiposity who were taller at an earlier age have no significant advantage over their thinner peers in terms of adult height. [ABSTRACT FROM AUTHOR]

Studies investigating the association between type 2 diabetes mellitus and central adiposity are lacking. Therefore, this study aimed to investigate trends in type 2 diabetes mellitus stratified by central adiposity using waist-to-height ratio (WHtR). Trends in type 2 diabetes mellitus were examined by central adiposity, using WHtR, with data from the Korea National Health and Nutrition Examination Survey (2005–2022). Individuals aged 30 years and over who participated in the survey were selected. Type 2 diabetes mellitus was identified based on serum glucose or HbA1c levels, the use of diabetes medications, or a prior diagnosis by a physician. Weighted β-coefficients or odd ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess changes in disease prevalence. A total of 79,368 participants were included in the database (female: 45,163 [56.9%]). from 2005 to 2022, the prevalence of type 2 diabetes mellitus increased from 3.3 to 5.8% in the healthy central adiposity group, from 11.2 to 17.1% in the increased central adiposity group, and from 18.0 to 26.7% in the high central adiposity group. Males, older population, lower education level, lower household income, and smoking are associated with a higher risk of type 2 diabetes. In the high central adiposity group, overweight and obese individuals had higher susceptibility than underweight or normal-weight individuals, with ORs of 5.85 (95% CI, 2.54–13.47) and 8.24 (3.79–17.94), respectively. The prevalence of type 2 diabetes mellitus has increased in all central adiposity groups in the past decade. This underscores the need for tailored interventions to address disparities and improve diabetes management in at-risk populations. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors associated with diabesity in older women. Methods: This epidemiological study used a cross‐sectional design and included 196 older women (72.70 ± 7.20 years) from Jequié, Bahia, Brazil. Diabesity was defined as having both an elevated abdominal circumference (≥88 cm) and diabetes mellitus. For the inferential analyses, we constructed crude models followed by a multiple hierarchical explanatory model, with the following levels: Level 1 (socioeconomic variables), Level 2 (behavioral aspects), and Level 3 (health conditions). Poisson regression with a robust estimator was employed, and we calculated Prevalence Ratios (PR) with 95% Confidence Intervals (CI). Results: The prevalence of abdominal obesity, diabetes mellitus, and diabesity were 79.60%, 27.80%, and 22.40%, respectively. Women who were insufficiently active had a higher likelihood of diabesity (PR: 2.04; 95% CI: 1.22–3.41), as did those who spent more time in sedentary behavior (PR: 1.81; 95% CI: 1.04–3.16), used three or more continuous medications (PR: 2.51; 95% CI: 1.29–4.89), or reported a negative self‐perception of health (PR: 2.57; 95% CI: 1.03–5.80). Conclusion: The study identified several factors associated with diabesity in older women: insufficient physical activity, prolonged sedentary behavior, polypharmacy, and negative self‐perception of health. [ABSTRACT FROM AUTHOR]

BackgroundRecently, weight-adjusted-waist index (WWI), a new index for evaluating obesity, has been developed. This study aimed to examine the association between WWI and T2DM in Chinese urban adults.MethodA total of 5,0978 eligible participants drawn from the prospective REACTION study (Cancer Risk Assessment in Chinese People with Diabetes) were included in this study. Participants were divided into 3 groups based on baseline WWI levels. Pearson correlation analysis and binary logistic regression analysis were conducted to explore the association of WWI with T2DM risk factors and with T2DM risk.ResultsThe prevalence of obesity, central obesity and T2DM was 14.2%, 46.8% and 11.0% respectively, with a median age of 57 years. Logistic analysis showed that the WWI was significantly associated with the risk of T2DM. Compared to the lowest tertile of WWI (T1) serving as the reference group, the second tertile (T2) and the third tertile (T3) were associated with a 0.218-fold [1.218 (1.152, 1.288), P

Objective: This review aims to provide an overview of the factors contributing to central obesity, particularly in postmenopausal women, who are affected at a global rate of 26%. It emphasizes the heterogeneity of adipocytes, the impact of prenatal genetic factors, and the role of estrogenic neuroendocrine regulation. Additionally, the review explores the paradoxical functions of visceral fat and identifies the primary depots that may contribute to its overall function. Mechanism: Estrogen deficiency is a key factor in central adiposity among postmenopausal women, leading to a reduction in subcutaneous adipose tissue (SAT) and an increase in visceral adipose tissue (VAT) compared to premenopausal women. This deficiency deactivates pro-opiomelanocortin (POMC) neurons and steroidogenic factor-1 (SF1) neurons via estrogen receptor alpha (ERα), desensitizes vagal cholecystokinin-A (CCK-A) receptors, and hyperactivates the hypothalamic-pituitary-ovary (HPO) axis, resulting in increased food intake and decreased energy expenditure. The differences between VAT and SAT, such as expandability, anatomic location, free fatty acid (FFA) mobility, facilitate energy transfer from SAT to VAT, thereby contributing to central obesity. VAT also compensates for estrogen deficiency by releasing estradiol, inflammatory and anti-inflammatory adipocytokines, and increasing 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) activity, which potentiates glucocorticoid functions and ultimately leading to the development of metabolic syndromes. VAT is heterogeneous, including distinct depots such as mesenteric, gonadal, and perirenal fat. Mesenteric fat may play a significant role in body weight regulation and insulin resistance, while other fat depots interact more closely with surrounding organs to regulate various physiological functions. Understanding VAT heterogeneity is crucial for identifying adiposopathy markers associated with various metabolic syndromes. This knowledge can inform holistic, personalized therapeutic and bodybuilding approaches, helping patients to mitigate the risks associated with current hormone therapies. Findings in Brief: The ratio of SAT to VAT is shaped by a combination of prenatal genetics, neuroendocrine regulation, and postnatal epigenetic factors influenced by environmental energy availability and estrogen deficiency. VAT accumulation exhibits paradoxical roles, aiding adaption to energy surplus stress while simultaneously contributing to postmenopausal syndromes. Within VAT, heterogeneity exists, with mesenteric fat depots playing a key role in its overall function. Long-term protective strategies during the perimenopausal and menopausal periods may include energy restriction and the maintenance of normal estrogen levels. Personalized diets and estrogen supplementation hold promise in alleviating associated syndromes. Further exploration of the relationship between mesenteric fat, VAT accumulation, and menopausal syndromes could help clarify existing contradictory evidence and position mesenteric fat as a potential target for effective interventions aimed at alleviating postmenopausal symptoms with fewer side effects. Conclusions: Visceral fat accumulation in postmenopausal women is a consequence of energy stress due to estrogen deficiency, followed by the energy transfer from SAT to VAT. The heterogeneity of VAT suggests that its components may have different roles in body weight regulation. Mesenteric fat may play a major role among the depots.

Summary: Central adiposity, which is visceral and subcutaneous adiposity in the abdominal region, is a known risk factor for developing chronic cardiometabolic diseases. Central adiposity can be measured relatively inexpensively using ultrasound. Ultrasound has been shown to be precise and reliable, with measurement accuracy comparable to computed tomography and magnetic resonance. Despite the advantages conferred by ultrasound, widespread adoption has been hindered by lack of reliable standard operating procedures. To consolidate the literature and bring clarity to the use of ultrasound‐derived measures of central adiposity, this review outlines (i) the [patho]physiological importance of central adiposity to cardiometabolic disease risk; (ii) an overview of the history and main technical aspects of ultrasound methodology; (iii) key measurement considerations, including transducer selection, subject preparation, image acquisition, image analysis, and operator training; and (iv) guidelines for standardized ultrasound protocols for measuring central adiposity. [ABSTRACT FROM AUTHOR]

Individual sleep dimensions have been linked to cardiovascular disease (CVD) risk and cardiometabolic health (CMH), but sleep health is multifaceted. We investigated associations of a multidimensional sleep health (MDSH) score, enabling the assessment of sleep health gradients, with CVD and CMH. Participants were 4555 adults aged ≥20 years from the 2017-2018 National Health and Nutrition Examination Survey. A MDSH score, capturing poor, moderate, and ideal sleep was computed from self-reported sleep duration, sleep regularity, difficulty falling asleep, symptoms of sleep disorders, and daytime sleepiness. Survey-weighted multivariable linear and logistic models examined associations of MDSH with CVD and CMH. Ideal and moderate vs. poor MDSH were related to lower odds of hypertension (62% and 41%), obesity (73% and 56%), and central adiposity (68% and 55%), respectively; a statistically significant linear trend was observed across gradients of MDSH (p-trend < 0.001). Ideal vs. moderate/poor MDSH was associated with 32% and 40% lower odds of prevalent CVD and type 2 diabetes, respectively. More favorable MDSH was associated with lower blood pressure, BMI, waist circumference, and fasting glucose. In sex-stratified analyses, ideal vs. moderate/poor MDSH was associated with lower CVD odds and blood pressure in women only. The MDSH framework may be more than just the sum of its parts and could better capture information regarding CVD risk.

ObjectiveWe investigated the role of chronic stress burden on adiposity and adiposity-related inflammation with two hypotheses: a) greater chronic stress is associated with higher central adiposity and selective accumulation of visceral adipose tissue (VAT) compared with subcutaneous adipose tissue (SAT), and b) associations between VAT and inflammatory biomarkers are exacerbated when chronic stress is high.MethodsData come from 1809 participants included in a Multi-Ethnic Study of Atherosclerosis ancillary study of body composition and adiposity-related inflammation. Chronic psychosocial stress was measured with a five-item version of the Chronic Stress Burden Scale. First, we tested associations between chronic stress (three-level categorical variable) and VAT, SAT, and VAT/SAT ratio. Second, we tested whether associations between VAT and inflammatory biomarkers varied by level of chronic stress.ResultsParticipants were approximately 65 years, 50% female, and 40.5% White, 25.6% Hispanic, 21.2% African American, and 12.8% Chinese American. About half of the sample reported little to no stress, and a quarter and a fifth of the sample reported medium and high levels of stress. Higher levels of chronic stress were associated with greater VAT and SAT, but not VAT/SAT ratio. Greater levels of VAT were associated with increased levels of adiposity-related inflammation in a graded pattern. These associations did not vary by stress level.ConclusionsGreater chronic stress burden is associated with both central and subcutaneous adiposity. We found no evidence that the associations between VAT and inflammatory biomarkers are exacerbated by chronic stress. Findings contribute to ongoing literature untangling pathways in which psychosocial stress contributes to adiposity-related inflammation.

Background Rest‐activity rhythms (RARs), a measure of circadian rhythmicity in the free‐living setting, are related to mortality risk, but evidence is limited on associations with cardiovascular disease (CVD) and its risk factors. Methods and Results Participants included 4521 adults from the 2013 to 2014 National Health and Nutrition Examination Survey physical activity monitoring examination. Wrist‐worn ActiGraph GT3X+ data were used to estimate RARs. Multivariable logistic models evaluated associations of RARs with prevalent CVD, hypertension, obesity, and central adiposity. Participants (mean age, 49 years) in the highest versus lowest tertile of relative amplitude (greater circadian rhythmicity) had 39% to 62% lower odds of prevalent CVD, hypertension, obesity, and central adiposity. A more active wake period was associated with 19% to 72% lower CVD, hypertension, obesity, and central adiposity odds. Higher interdaily stability (regular sleep‐wake and rest‐activity patterns) was related to 52% and 23% lower CVD and obesity odds, respectively. In contrast, participants in the highest versus lowest tertile of intradaily variability (fragmented RAR and inefficient sleep) had >3‐fold and 24% higher CVD and obesity odds, respectively. A later and less restful sleep period was associated with 36% to 2‐fold higher CVD, hypertension, obesity, and central adiposity odds. A statistically significant linear trend was observed for all associations (P‐trend

Abstract Background Adiposity is widely recognized as one of the risk factors for high blood pressure (BP) and increasing adiposity is associated with elevated BP. However, which measures of adiposity could be most strongly associated with BP in multi-ethnic population remains uncertain, giving rise to implications that population-based adiposity measures could be necessary. Methods 80,000 multi-ethnic adults recruited from 5 provinces across Southwest China during 2018 ~ 2019 were studied. Multiple linear regression was applied to investigate the associations of systolic blood pressure (SBP) with: (1) two measures of general adiposity, body mass index (BMI) and height-adjusted weight; and (2) three measures of central adiposity, waist circumference (WC), hip circumference (HC) and waist hip ratio (WHR). Results Two distinct population-specific patterns were identified, as “BMI to SBP” and “WC to SBP”. 90% of the participants fall into “BMI to SBP” pattern, in which the associations of SBP with BMI were independent of WC, and SBP-WC associations were considerably decreased by adjustment for BMI. And in this pattern, 10 kg/m2 greater BMI was associated with 11.9 mm Hg higher SBP on average. As for the rest population (Han males in Yunnan and Tibetans in Lhasa), they are suited for “WC to SBP” pattern, 10 cm wider WC was associated with 3.4 mm Hg higher SBP. Conclusion Our results indicated that when selecting proper predictors for BP, population-specific adiposity measures are needed, considering ethnicity, sex and residing regions. A better understanding of adiposity and BP may better contribute to the potential clinical practices and developing precision application strategies.

Abstract Background An “obesity paradox” for mortality has been shown in chronic disorders such as diabetes, and attributed to methodological bias, including the use of body mass index (BMI) for obesity definition. This analysis investigated the independent association of BMI versus surrogate measures of central adiposity with all-cause mortality in individuals with type 2 diabetes. Methods The Renal Insufficiency And Cardiovascular Events Italian Multicentre Study is a prospective cohort study that enrolled 15,773 patients in 19 Italian centres in 2006–2008. Exposures were BMI and the surrogate measures of central adiposity waist circumference (WC), waist-to-height ratio (WHtR), and A Body Shape Index (ABSI). Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%), Results Age- and sex-adjusted hazard ratios and 95% confidence intervals were significantly higher in BMI-based underweight (1.729 [1.193–2.505), P = 0.004), moderately obese (1.214 [1.058–1.392), P = 0.006) and severely obese (1.703 [1.402–2.068), P

Shorter telomere length is associated with numerous comorbidities; central obesity might trigger leukocyte telomere shortening; in the current meta-analysis we evaluated the association of central obesity with leukocyte telomere length among adults. A systematic search from Scopus, PubMed, Embase and Proquest electronic databases up to May 2021 was done. The final screening, provided five articles to be included in final meta-analysis. Those in the highest category of telomere length had 3.72 cm lower waist circumference (WC) compared with those in the lowest category (WMD=-3.718; CI=-7.180, −0.257 P = 0.035; I2 = 95.4%). Also, those in the highest LTL category had 0.02 lower waist to hip ratio (WHR) compared with those in the lowest category, although this association was not significant (WMD: −0.02; CI=-0.04, 0.01; P = 0.19; I2= 90.7%). In quality assessment of included studies, all of the studies had moderate or high quality score and there was no study with poor quality. Higher leukocyte telomere length was accompanied with lower WC among adults. This association was not significant for difference in WHR. Because of the high heterogeneity values and also because of the observational design of included studies, the inference of causality of these associations needs further investigations. Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1971155. [ABSTRACT FROM AUTHOR]

BackgroundObesity is associated with premature mortality in adults; however, this association has been inconsistent in the older adult population. In addition, there is a lack of specific cutoff points for indicators of negative health outcomes in older adults. Methods: This is a prospective study with 796 non-institutionalized older adults. Data on sociodemographic characteristics, lifestyle, food consumption, and nutritional status were obtained at baseline. Generalized additive models were used to identify cutoff points for the waist circumference (WC) and waist-to-height ratio (WHtR) and Cox proportional hazards models to assess the independent association between adiposity and mortality.ResultsOver the 9 years of follow-up, 197 deaths (24.7%) occurred, of which 51.8% were men, with a mean age of 76.1 ± 9.0 years. Older adults at higher risk of death had WHtR of

BackgroundThis study investigates the association of clinical and demographic predictors with abdominal fat gain, measured using waist circumference (WC) and self-reported abdominal size.MethodsWe analyzed data from ACTG A5257, a clinical trial that randomized treatment-naïve HIV-infected participants to 1 of 3 antiretroviral regimens: raltegravir (RAL) or the protease inhibitors (PIs) atazanavir/ritonavir (ATV/r) or darunavir/ritonavir (DRV/r), each in combination with tenofovir disoproxil fumarate/emtricitabine. Associations of treatment and baseline/demographic characteristics with 96-week WC change were assessed using repeated-measures models. Ordinal logistic regression was used to examine the associations of predictors with week 96 self-reported abdominal changes.ResultsThe study population (n = 1809) was 76.0% male and predominantly black non-Hispanic (41.9%) and white non-Hispanic (34.1%). Mean baseline WC was 90.6 cm, with an average 96-week increase of 3.4 cm. WC increases were higher in the RAL arm compared with DRV/r (P = .0130). Females experienced greater increases in WC on RAL vs ATV/r than males (P = .0065). Similarly, a larger difference in WC change was found for RAL vs DRV/r for black vs nonblack individuals (P = .0043). A separate multivariable model found that in addition to the treatment regimen, higher baseline viral load and lower CD4+ were also associated with WC increases.ConclusionsWith antiretroviral therapy initiation, higher WC increases in the RAL arm compared with PIs were more pronounced in female and black participants, and a more advanced baseline HIV disease state was a strong predictor of larger abdominal increases. Understanding factors predisposing individuals to abdominal fat gain could inform health management after therapy initiation.

Background: Adiposity is widely recognized as one of the risk factors for high blood pressure (BP) and increasing adiposity is associated with elevated BP. However, which measures of adiposity could be most strongly associated with BP in multi-ethnic population remains uncertain, giving rise to implications that population-based adiposity measures could be necessary. Methods: 80,000 multi-ethnic adults recruited from 5 provinces across Southwest China during 2018 ~ 2019 were studied. Multiple linear regression was applied to investigate the associations of systolic blood pressure (SBP) with: (1) two measures of general adiposity, body mass index (BMI) and height-adjusted weight; and (2) three measures of central adiposity, waist circumference (WC), hip circumference (HC) and waist hip ratio (WHR). Results: Two distinct population-specific patterns were identified, as "BMI to SBP" and "WC to SBP". 90% of the participants fall into "BMI to SBP" pattern, in which the associations of SBP with BMI were independent of WC, and SBP-WC associations were considerably decreased by adjustment for BMI. And in this pattern, 10 kg/m2 greater BMI was associated with 11.9 mm Hg higher SBP on average. As for the rest population (Han males in Yunnan and Tibetans in Lhasa), they are suited for "WC to SBP" pattern, 10 cm wider WC was associated with 3.4 mm Hg higher SBP. Conclusion: Our results indicated that when selecting proper predictors for BP, population-specific adiposity measures are needed, considering ethnicity, sex and residing regions. A better understanding of adiposity and BP may better contribute to the potential clinical practices and developing precision application strategies. [ABSTRACT FROM AUTHOR]

Summary: Background: Childhood obesity has been associated with prenatal exposure to maternal hyperglycaemia, but we lack understanding about maternal insulin physiologic components that contribute to this association. Objectives: Evaluate the association between maternal insulin sensitivity during pregnancy and adiposity measures in childhood. Methods: In 422 mother–child pairs, we tested associations between maternal insulin sensitivity measures at ~26 weeks of pregnancy and child adiposity measures, including dual‐energy X‐ray absorptiometry body composition and anthropometry (body mass index and waist circumference) at ~5 years. We used linear regression analyses to adjust for maternal age, ethnicity, gravidity, first‐trimester body mass index, and child sex and age at mid‐childhood. Results: In early pregnancy, maternal mean age was 28.6 ± 4.3 years and median body mass index was 24.1 kg/m2. Lower maternal insulin sensitivity indices were correlated with greater child adiposity based on anthropometry measures and on dual‐energy X‐ray absorptiometry total and trunk % fat in univariate associations (r = −0.122 to −0.159). Lower maternal insulin sensitivity was specifically associated with higher dual‐energy X‐ray absorptiometry trunk % fat (n = 359 for Matsuda; β = −0.034 ± 0.013; p = 0.01) after adjustment for covariates, including maternal body mass index. Conclusions: Maternal insulin sensitivity during pregnancy may contribute to increased risk for higher offspring central adiposity in middle childhood. [ABSTRACT FROM AUTHOR]

To a) demonstrate that adopting 'at risk' waist-to-height ratio (WHTR) cut-off points, recently approved by National Institute for Health and Care Excellence (NICE) and the United States Department of Defense (USDoD), will unfairly penalize shorter individuals and will be too lenient for taller individuals, b) to confirm that waist circumference (WC) of a sample of US service personnel, scales to approximately height0.5, supporting the notion that WC, to be independent of height (HT), should be normalized using WC.HT−0.5 (WHT•5R), and c) to identify the WHT•5R cut-off points that will reduce or eliminate this unwanted bias. We employed a three independent cross-sectional sample design. All n = 58,742 participants underwent anthropometric assessment of body mass, stature and waist circumference. The allometric power-law model WC=a.HT^b for US service personnel identified the height exponent to be b= 0.418 (95 % CI 0.251–0.585), confirming that the simple body-shape index for WC to be independent of HT, should be WC.HT−0.5. Chi-square tests of independence and for linear trend confirmed that by adopting WHTR cut-off point, shorter individuals (both service personnel and non-service participants) will be over penalized (classified as being 'at risk'). New WC independent-of-height ratio cut-off points were found to resolve this problem. Adopting WHTR cut-off thresholds (either 0.5 or 0.55) will lead to shorter adults being unfairly classified as being 'at risk' in terms of their central adiposity and general health status. Adopting new WHT•5R cut-off point thresholds were found to greatly reduce or eliminate this bias. [ABSTRACT FROM AUTHOR]

Background: An "obesity paradox" for mortality has been shown in chronic disorders such as diabetes, and attributed to methodological bias, including the use of body mass index (BMI) for obesity definition. This analysis investigated the independent association of BMI versus surrogate measures of central adiposity with all-cause mortality in individuals with type 2 diabetes. Methods: The Renal Insufficiency And Cardiovascular Events Italian Multicentre Study is a prospective cohort study that enrolled 15,773 patients in 19 Italian centres in 2006–2008. Exposures were BMI and the surrogate measures of central adiposity waist circumference (WC), waist-to-height ratio (WHtR), and A Body Shape Index (ABSI). Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%), Results: Age- and sex-adjusted hazard ratios and 95% confidence intervals were significantly higher in BMI-based underweight (1.729 [1.193–2.505), P = 0.004), moderately obese (1.214 [1.058–1.392), P = 0.006) and severely obese (1.703 [1.402–2.068), P < 0.0001), lower in overweight (0.842 [0.775–0.915), P < 0.0001) and similar in mildly obese (0.950 [0.864–1.045), P = 0.292), compared to normal-weight individuals. When further adjusting for smoking, physical activity (PA), and comorbidities, risk was lower also in mildly obese versus normal-weight patients. The BMI-mortality relationship did not change after sequentially excluding ever smokers, individuals with comorbidities, and those died within two years from enrollment and when analyzing separately participants below and above the median age. Conversely, a paradox relationship was observed among inactive/moderately inactive, but not moderately/highly active patients. Mortality risk adjusted for age, gender, smoking, PA and comorbidities was significantly higher in the highest tertile of WC (1.279 [1.089–1.501], P = 0.003), WHtR (1.372 [1.165–1.615], P < 0.0001), and ABSI (1.263 [1.067–1.495], P = 0.007) versus the lowest tertile. However, risk was lower in the intermediate versus lowest tertile for WC (0.823 [0.693–0.979], P = 0.028), similar for WHtR, and higher, though not significantly, for ABSI. Conclusions: An "overweight paradox" remained after controlling for age, smoking, and comorbidities, arguing against a collider bias or reverse causation. However, it could be partly explained by confounding from PA level, possibly through its impact on lean mass and cardiorespiratory fitness. No obesity paradox was observed with WHtR and especially ABSI, which predicted mortality risk associated with central adiposity better than WC. Trial registration ClinicalTrials.gov, NCT00715481, 15 July, 2008 [ABSTRACT FROM AUTHOR]

Growing evidence has linked gut microbiota with regulation of adiposity. We aimed to examine whether the genetically determined relative abundance of gut microbial taxa was associated with long-term changes in adiposity and body composition among individuals who were overweight or obese in weight-loss diet interventions. The study included 692 participants with overweight or obese from the POUNDS Lost trial. We created a genetic risk score (GRS) for the relevant abundance of gut microbial taxa using 20 single nucleotide polymorphisms identified from a recent genome-wide association study. Body composition was assessed using dual-energy X-ray absorptiometry. Higher GRS for the relative abundance of gut microbial taxa was significantly associated with greater reductions in waist circumference, total fat mass (FM), whole-body total percentage of fat mass (FM%), and percentage of trunk fat (TF%) at 2 years (p = 0.022, 0.034, 0.023, 0.023, respectively). In addition, dietary protein significantly modified the association between GRS for gut microbial abundance and changes in total FM, FM%, and TF% (p-interactions = 0.04, 0.013, and 0.006, respectively) at 6-month, when the maximum weight loss was achieved, even though such interactions were attenuated at 2 years. In the average-protein diet group, a higher microbial abundance GRS was associated with greater reductions in total FM (p = 0.007), FM% (p = 0.002), and TF% (p < 0.001) at 6 months, while no associations were found in the high-protein diet group (p > 0.05). Our results suggest that the higher genetically determined relative abundance of gut microbial taxa may be related to long-term improvement of whole-body and central fatness and body composition in response to low-calorie diet interventions. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the association of overweight, obesity, excess central adiposity, hyperglycemia, and diabetes mellitus with tumor characteristics in breast cancer. In this retrospective cohort study that enrolled 2127 women with breast cancer, the independent variables collected were fasting blood glucose, body mass index, central adiposity (waist circumference and waist-to-hip circumference ratio (WHR)), and waist-to-height ratio. The tumor characteristics (infiltrating, ductal grade, hormone receptor-positive (HR+), human epidermal growth factor receptor, triple negative, size, lymph node involvement, and clinical stage) were the dependent variables. Most of the women were postmenopausal (73.5%), with an infiltrating tumor (83.0%), HR+ (82.0%), and overweight or obese (71.0%). For the premenopausal women, obesity was associated with grade 3 ductal tumor (odds ratio (OR): 1.70; 95% confidence interval (95% CI): 1.09–2.66), triple negative (OR: 1.37, 95% CI: 1.08–3.24), and size ≥ 2 cm (OR: 2.20, 95% CI: 1.36–3.56). For the postmenopausal women, obesity was associated with WHR, infiltrating tumor (OR: 1.73, 95% CI: 1.56–1.95), size ≥ 2 cm (OR: 1.38, 95% CI: 1.11–1.71), lymph node involvement (OR: 1.24, 95% CI: 1.02–1.56), and stages III–IV (OR: 1.76, 95% CI: 1.30–2.65). Excess body weight and central adiposity were associated with tumor aggressiveness characteristics in women with breast cancer, confirming the importance of nutritional status. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore the association between adiposity and plasma folate deficiency odds among women of reproductive age in China.MethodsA cross-sectional survey on nutritional status among women of reproductive aged 18–30 years in 2005–2006 in China was conducted. General adiposity was defined as body mass index (BMI) ≥24 kg/m2, and central adiposity was defined as waist circumference >80 cm. A plasma folate concentration 80 cm, BMI

Objective: The relationships between cardiometabolic indices and cognition were examined in recently menopausal women.Methods: Cross-sectional analysis of baseline data from the KEEPS (Kronos Early Estrogen Prevention Study)-Cognitive ancillary study (n = 621). Cognitive performance was assessed by the Modified Mini Mental Status (3MS) score (primary outcome). Physical cardiometabolic indices included body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and blood pressure (BP). Biochemical cardiometabolic indices included serum levels of high sensitivity C-reactive protein (hs-CRP), total cholesterol (TC), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), non-HDL (non-HDL-C), triglycerides (TG), fasting serum glucose (FSG), and insulin resistance (HOMA-IR). Socio-demographic variables included age, race/ethnicity, education, and lifestyle (physical activity, smoking). Central adiposity was defined as WC > 88 cm (>35 in) and WHR > 0.8. Separate stepwise multivariable analyses (GLM, ordinal logistic regression and logistic regression) assessed relationships between 3MS scores (as continuous, in tertiles and dichotomized at 90 respectively) with the measures of central adiposity (predictor variables); socio-demographic variables (age, time since menopause, race, educational status and lifestyle) and cardiometabolic variables (BP, lipids, FSG, HOMA-IR and hs-CRP) were examined as covariates. The final multivariable models included time since menopause, race, ethnicity, educational status, strenuous exercise, BMI ≥30 kg/m2, non-HDL-C and hs-CRP as covariates. Due to the high collinearity between the two indices of central adiposity, within each analytic strategy, separate models examined the respective associations of WC > 88 cm and WHR > 0.8 with 3MS score.Results: On adjusted analyses, indices of central adiposity were independent predictors of significantly lower 3MS scores (p < 0.05). Consistency in this relationship was observed across the three different multivariable regression analytic approaches (GLM, ordinal and logistic regression).Conclusions: Among recently menopausal women, WC > 88 cm and WHR > 0.8 were associated with significantly lower cognitive function, as reflected by lower 3MS scores. The mechanisms that might explain the observed negative implications of central adiposity for cognitive function warrant further study. [ABSTRACT FROM AUTHOR]

Background: Treatment with integrase strand transfer inhibitors (INSTIs) has been associated with excess weight gain, however the long-term effect of INSTI-based regimens on adipose tissue (AT) compartments remains unknown. Objectives: To evaluate the effect of switching to an INSTI on visceral (VAT) and subcutaneous (SAT) AT in virologically-suppressed adults with HIV. Methods: We performed a retrospective observational cohort study of ART experienced adults referred to the metabolic Clinic of the University of Modena and Reggio Emilia who had ≥2 assessments of body composition by abdominal computed tomography. An interrupted time series model with mixed-effect model incorporated was used to calculate VAT and SAT change rate, adjusting for smoking status, use of alcohol, and physical activity. Results: A total of 698 patients were included: 156 who switched to an INSTI-based regimen and 542 who did not. After switch to INSTI, mean SAT area increased approximately 3-fold (before 0.27 vs after 0.73 cm2/month; p = 0.011), and VAT area 7-fold (0.18 vs 1.30 cm2/month; p

ObjectiveCentral obesity has been associated with several adverse health events, but little research exists about the longitudinal effects of central obesity on multisite pain. The purpose of this study was to assess if central obesity, as measured by waist circumference measurement, was associated with an increased rate of having multisite pain among older adults aged 65 years and older.DesignThe National Health and Aging Trends Study is a longitudinal cohort study initiated in 2011 and intended to be representative of Medicare beneficiaries in the contiguous United States.MethodsThere were 7,145 community-dwelling participants included in this study. Data for this study were collected annually between 2011 and 2018. Researchers assessed if waist circumference risk level was associated with an increased rate ratio of multisite pain. Weighted data were used in a multivariable generalized estimating equation model that used a log link specified with a Poisson distribution.ResultsParticipants with high-risk waist circumferences (98 cm or greater for women and 109 cm or greater for men) had a 11% higher rate of multisite pain than those with low-risk waist circumferences [rate ratio (RR) 1.11, 95% CI: 1.07–1.15] adjusting for gender, age, race, education, probable major depression, arthritis, and multimorbidity count.ConclusionAs measured by waist circumference, central adiposity is associated with multisite pain in older adults. While more research is needed, reducing waist circumference may prove beneficial in reducing the burden of multisite pain.

Background: Given the known relationship between human immunodeficiency virus (HIV), antiretroviral therapies, and excess visceral adipose tissue (VAT), this review sought to characterize risk of negative health outcomes associated with excess VAT and increased waist circumference (WC) in people with HIV (PWH)., Methods: Comprehensive targeted literature searches were conducted in Medline/Embase (27 June 2022), identifying peer-reviewed articles and conference abstracts reporting on cohorts of PWH. Screening was guided by PECOS (Population, Exposure, Comparator, Outcomes, Study design) criteria. From the included studies, outcomes of interest including mortality and morbidity risk by VAT area and WC were extracted, overall, and by sex, race/ethnicity, and duration of HIV. Relationships between outcome and exposure variables were summarized., Results: Thirty-five studies were included (sample size range: 31-1748 PWH). Twenty-five studies characterized the relationship between increased WC and negative health outcomes-cardiovascular disease (CVD), arteriosclerosis, hypertension, diabetes, hepatic fat and fibrosis, and cognitive impairment-among PWH. Fifteen studies reported on increased VAT and negative health outcomes: all-cause mortality, CVD, atherosclerosis, hepatic fat, and fibrosis. Importantly, there was a 2.1-times higher odds of 5-year all-cause mortality among PWH with the highest amount of VAT in the only study identified reporting on mortality. Among the studies characterizing the relationship between morbidity and VAT, for example, 1 found that, for each 10-cm2 increase in VAT, the risk of prevalent CVD increased by 1.05 (95% CI: 1.0-1.1) times., Conclusions: WC may be a useful and cost-effective surrogate for visceral adiposity, which is an important marker of morbidity and mortality among PWH., Competing Interests: Potential conflicts of interest. A. M. B., H. R., and S. M. S. are employees of Broadstreet HEOR, which received funds from Theratechnologies to conduct this study. R. J. B. and D. L. received consulting fees related to this work. R. J. B. reported receiving research grants/grants pending awarded to his institution from Merck & Co, Inc, and serving on the scientific advisory board for Merck & Co, Inc, ViiV Healthcare, Gilead Sciences, Inc, Shionogi, and Janssen Pharmaceuticals. D. L. reports receiving consulting fees from Theratechnologies and EMD Serono and stock ownership in Gilead Sciences. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Overweight/obesity and iron deficiency (ID) are highly prevalent in women of reproductive age (WRA), impacting on women's health. Obesity is a risk factor for nutritional deficiencies but its association with ID is unclear., Objectives: To determine the association between adiposity and markers of iron status and ID prevalence in WRA., Methods: This cross-sectional study analyzed the National Diet and Nutrition Survey (2008-2019) data, focusing on women aged 18-49 y with body mass index (BMI) ≥18.5 kg/m 2 . Prevalence of anemia, iron deficiency anemia (IDA), and ID were analyzed. Ferritin was adjusted for C-reactive protein. Iron status was assessed across high and low BMI, waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR). χ 2 , linear and logistic regressions were performed adjusting for covariates., Results: Among 1098 WRA, 496 normal weight and 602 overweight/obesity, prevalence rates were: anemia 9.2% and IDA 6.8%. Anemia was more prevalent in those with higher WHtR and WHR (11.9% compared with 5.9% and 16.7% compared with 6.5%, both P < 0.001). WRA with increased WC, WHtR, and WHR had higher IDA prevalence than those with lower adiposity (8.5% compared with 4.3%, P = 0.005; 9.4% compared with 3.3%, P < 0.001; 12.1% compared with 4.9%, P < 0.001). ID prevalence was 49.7% (ferritin cutoff 30 μg/L) and 19.6% (ferritin cutoff 15 μg/L), showing similar rates across adiposity groups. ID prevalence defined by soluble transferrin receptor (sTfR) was higher in women with increased WHR (P = 0.001). Higher WHR predicted ID categorized by sTfR (adjusted odds ratio [aOR]: 2.104, P = 0.004), and WHtR and WHR predicted anemia and IDA (anemia: WHtR aOR: 2.006, P = 0.036; WHR aOR: 4.489, P < 0.001 and IDA: WHtR aOR: 2.942, P = 0.012; WHR aOR: 4.142, P < 0.001)., Conclusions: At least 1 in 5 WRA in the UK are iron deficient, highlighting the need to revise current policies. Greater central adiposity was strongly associated with impaired iron status and the development of anemia, IDA, and ID., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

OBJECTIVES: To prospectively assess cognitive function, anthropomorphic measures, and bone mineral density in men receiving androgen deprivation therapy (ADT) for prostate cancer; explore relationships between cognitive function and central adiposity; and gather preliminary data from a personalized education, exercise, and nutrition intervention. SAMPLE & SETTING: 33 participants consented from a randomized controlled intervention trial. METHODS & VARIABLES: Neurocognitive performance and self-report of cognitive function were assessed at baseline and 6 and 12 months. Dual-energy x-ray absorptiometry (DEXA) scans were obtained at baseline and 6 months. RESULTS: No between-group differences in cognitive function were demonstrated. Increased visceral adiposity was not associated with decrements in visuospatial abilities. Significant increases in fat mass without increases in body mass index or waist--hip ratio provided further evidence for DEXA as the preferred central adiposity measure. IMPLICATIONS FOR NURSING: Well-powered prospective research is needed to fully characterize the effects of ADT on cognitive function and the potential benefits of exercise and nutrition-based interventions. [ABSTRACT FROM AUTHOR]

Purpose: African men are disproportionately affected by prostate cancer (PCa). Given the increasing prevalence of obesity in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central obesity with risks of total and aggressive PCa among African men. Methods: Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center, hospital-based case–control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively. Results: Among controls 16.4% were obese (BMI ≥ 30 kg/m2), 26% and 90% had WC > 97 cm and WHR > 0.9, respectively. Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa, suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99–1.93), and central obesity (WC > 97 cm: OR = 1.60, 95% CI 1.10–2.33; and WHtR > 0.59: OR = 1.68, 95% CI 1.24–2.29) were positively associated with D'Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in West versus South Africa, but these differences were not statistically significant. Discussion: The high prevalence of overall and central obesity in African men and their association with intermediate-risk PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of obesity and PCa in various African populations. [ABSTRACT FROM AUTHOR]

The study goal was to determine the impact of cardiorespiratory fitness on the total and abdominal adiposity in a sample of children aged 6 to 10. It was hypothesised that high cardiorespiratory fitness would result in lower total and abdominal obesity. The research was conducted on a sample of 1432 respondents where 717 (50.1%) are boys, and 715 (49.9%) are girls aged 6 to 10. The average age of the respondents was 8.72±1.4 years. Three anthropometric measures (body height, body weight and waist circumference) were considered and the body composition was determined by BIA. Body mass index sex - and age-specific cut-off points were used for overweight and obesity definition and children were placed in two groups: overweight/obese and non overweight. Cardiorespiratory fitness (CRF) was assessed with the endurance shuttle-run test. Participants were grouped into high and low CRF based on age and sex distributions. The results were statistically analyzed by using t-tests and a χ² test, analysis of covariance, Pearson correlation and hierarchical linear regression. On the basis of the obtained results, one can conclude that children who are overweight or obese and have a high level of cardiorespiratory fitness, have lower body mass index values, lower waist circumference, lower body fat percentage and a higher muscle mass percentage compared to children who are classified in the same BMI category, but have low values of cardiorespiratory fitness. The results of this study suggest that an appropriate level of cardiorespiratory fitness can reduce the threats of obesity among the pediatric population. [ABSTRACT FROM AUTHOR]

Objective: We characterized the relationship between circulating C-reactive protein (CRP) levels and nine anthropometric measures of body fat to identify the best anthropometric predictors of CRP in Ni-Vanuatu women. Sample and Methods: Anthropometric data and blood spot samples were collected from sixty-four Ni-Vanuatu female participants (age 35-78 years) on five islands with varying degrees of market integration, cultural change, and obesity. CRP concentration was determined with a high-sensitivity ELISA (hsCRP) assay and then compared to nine different anthropometric measurements. Results: BMI was significantly correlated with CRP (p=0.047). Among the eight additional anthropometrics, the suprailiac skinfold (p=0.003) and waist-circumference (p=0.009) were better predictors of CRP than BMI. Moreover, our stepwise selection model indicated that the suprailiac skinfold explained ~14% of CRP level variance. Conclusions: The BMI-CRP correlation coefficient for Ni-Vanuatu women falls within the range of previously reported values for East Asian populations with whom they share genetic ancestry. However, the best anthropometric predictors of CRP levels were waist circumference and suprailiac skinfold thickness. These measures capture central adiposity and are more closely associated with elevated CRP level and cardiovascular disease risk than fat distributed elsewhere on the body. Ni-Vanuatu in urban settings with high market integration are at greater risk for obesity, which is associated with elevated CRP levels. However, because nearly all Ni-Vanuatu still retain horticultural knowledge and land ownership, consumption of processed, imported foods is largely determined by degree of market integration and personal choice. Therefore, health interventions focusing on sustainable traditional food practices are feasible.

Fecal incontinence (FI) is highly prevalent with substantial impacts on quality of life and health care utilization. The impact of obesity on FI remains unclear, with differing conclusions using body mass index (BMI) as a risk factor. We aimed to determine the association between obesity and FI, and whether this relationship is dependent on the distribution of adiposity (waist circumference-to-height ratio [WHtR]). This was a population-based analysis of the National Health and Nutrition Examination Survey, including participants who responded to the bowel health survey in 2005 to 2010. FI was defined by the accidental bowel leakage of solid stool, liquid, or mucus at least once in the past month. Stepwise multivariable logistic regression models were constructed to assess risk factors for FI. A total of 7606 participants were included, with an overall FI prevalence of 9.2%. When stratified by quartiles of body measurements, FI was increasingly prevalent from the 1st to the 4th quartile for both WHtR (range, 5.3%–12.5%) and BMI (range, 7.1%–10.5%). WHtR was associated with FI and was a stronger predictor than BMI in all quartiles of body measurement. On multivariable analysis, WHtR remained a significant predictor of FI comparing the 4th with the 1st quartile of body measurements (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.11–2.80; P =.017), whereas BMI was not. A WHtR cutoff of >0.592 optimized the Youden index in prediction of FI in the overall sample. WHtR was independently associated with increased odds of FI in this nationally representative sample of United States adults, whereas BMI was not consistently correlated. This suggests bowel continence may depend more on how body mass is distributed. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: India has >135 million obese individuals at present. Body mass index (BMI) has been used to assess obesity until recent times. Later, studies have shown that central body fat (BF) measurements as a reliable predictor of metabolic diseases. Hence, normal-weight obesity (NWO) is defined. Those with a normal range of BMI but increased fat percentage are found to be having metabolic syndromes at a very early life. The young adult group is specifically focused on the study with diet and physical activity as potential determinants; as an intervention at the right time can prevent the development of many noncommunicable diseases. Objectives: The aim of this study is to estimate the prevalence of obesity and its determinants with special reference to NWO. Materials and Methods: A cross-sectional study was conducted based on diet, physical activity, and other lifestyle factors on a sample of 269 young adults. Using Harpenden skinfold calipers, BF percentage was calculated based on Jackson and Pollock and Siri's equation. Binary logistic regression was also applied appropriately. Results: The proportion of obesity was 42.01%, and that of NWO was 16.1%. Sex, high protein diet, number of restaurant visits, less homemade tiffin intake, heavy physical activity, alcohol intake were found to be significantly associated with obesity. Intake of fish, physical activity, protein diet, day-time sleep were found to be significantly associated with NWO. Conclusion: The study emphasizes the need for including BF percentage in addition to BMI in regular clinical practice. It may help in preventive and promotive efforts.

Adipokines regulate metabolic processes linked to coronary artery (CAC) and abdominal aorta calcification (AAC). Because adipokine and other adiposity-associated inflammatory marker (AAIM) secretions differ between visceral and subcutaneous adipose tissue, we hypothesized that central adiposity modifies associations between AAIMs and CAC and AAC. We evaluated 1878 MESA participants with complete measures of AAIMs, anthropometry, CAC, and AAC. Associations of AAIMs with CAC and AAC prevalence and severity were analyzed per standard deviation of predictors (SD) using log binomial and linear regression models. The waist-to-hip ratio (WHR) was dichotomized at median WHR values based on sex/ethnicity. CAC and AAC prevalence were defined as any calcium (Agatston score >0). Severity was defined as ln (Agatston score). Analyses examined interactions with WHR and were adjusted for traditional cardiovascular disease risk factors. Each SD higher interleukin-6 (IL-6), fibrinogen and CRP was associated with 5% higher CAC prevalence; and each SD higher IL-6 and fibrinogen was associated with 4% higher AAC prevalence. Associations of IL-6 and fibrinogen with CAC severity, but not CAC prevalence, were significantly different among WHR strata. Median-and-above WHR: each SD higher IL-6 was associated with 24.8% higher CAC severity. Below-median WHR: no association (p interaction=0.012). Median-and-above WHR: each SD higher fibrinogen was associated with 19.6% higher CAC severity. Below-median WHR: no association (p interaction=0.034). Adiponectin, leptin, resistin, and tumor necrosis factor-alpha were not associated with CAC or AAC prevalence or severity. These results support findings that adiposity-associated inflammation is associated with arterial calcification, and further add that central adiposity may modify this association.

South Asians constitute one-fourth of the world’s population and are distributed significantly in western countries. With exponentially growing numbers, childhood obesity is of global concern. Children of South Asian ancestry have a higher likelihood of developing obesity and associated metabolic risks. The validity of commonly used measures for quantifying adiposity and its impact on metabolic outcomes differ by race and ethnicity. In this review we aim to discuss the validity of body mass index (BMI) and other tools in screening for adiposity in South Asian children. We also discuss the prevalence of overweight and obesity amongst South Asian children in western countries and the differences in body fat percentage, adiposity distribution, and metabolic risks specific to these children compared to Caucasian children. South Asian children have a characteristic phenotype: lower lean mass and higher body fat percentage favoring central fat accumulation. Hence, BMI is a less reliable predictor of metabolic status in these children than it is for Caucasian children. Furthermore, the relatively lower birth weight and rapid growth acceleration in early childhood of South Asian children increase the risk of their developing cardiometabolic disorders at a younger age than that of Caucasians. We emphasize the need to use modified tools for assessment of adiposity, which take into consideration the ethnic differences and provide early and appropriate intervention to prevent obesity and its complications. [ABSTRACT FROM AUTHOR]

Aim: Waist circumference-to-height ratio (WHt) has been proposed as an alternative measure to BMI due to its focus on central weight distribution and its basic threshold for increased cardiometabolic risk. This study aimed to compare prevalence of overweight including obesity using BMI and WHt, and assess 10-year trends of WHt prevalence, in a representative sample of Irish children.Methods: Children measured during rounds 2-5 of the Childhood Obesity Surveillance Initiative (n = 20037) were classified as healthy weight or overweight including obesity (International Obesity Task Force age and sex BMI cut-offs), and low or high WHt (WHt ≥ 0.5). Differences in prevalence of BMI and WHt classifications were determined for round five in younger (<9 years) and older (≥9 years) children. The prevalence of high WHt was assessed across rounds.Results: Differences in prevalence between overweight including obesity and high WHt were apparent in younger (BMI: 16.7%, WHt: 8.9%; p < .001) and older (BMI: 21.3%, WHt: 12.1%; p < .001) children. An inverse trend for prevalence of high WHt was identified across rounds (p < .001).Conclusion: BMI overestimates overweight including obesity prevalence compared to WHt. Given its ease of use, consideration of the WHt as an additional measure in childhood surveillance and screening is warranted. [ABSTRACT FROM AUTHOR]

Background: Higher body mass index and waist circumference have been associated with increased risk of pancreatitis in several prospective studies; however, the results have not been entirely consistent. Aims: We conducted a systematic review and dose-response meta-analysis of prospective studies on adiposity and risk of pancreatitis to clarify this association. Methods: PubMed and Embase databases were searched for studies on adiposity and pancreatitis up to January 27, 2020. Prospective studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for the association between adiposity and risk of pancreatitis were included, and summary RRs (95% CIs) were calculated using a random effects model. Results: Ten prospective studies with 5129 cases and 1,693,657 participants were included. The summary RR (95% CI) of acute pancreatitis was 1.18 (95% CI: 1.03–1.35, I2 = 91%, n = 10 studies) per 5 kg/m2 increase in BMI and 1.36 (95% CI: 1.29–1.43, I2 = 0%, n = 3) per 10 cm increase in waist circumference. There was evidence of a nonlinear association between BMI and acute pancreatitis, pnonlinearity < 0.0001, with a steeper association at higher levels of BMI, but not for waist circumference, pnonlinearity = 0.19. Comparing a BMI of 35 with a BMI of 22, there was a 58% increase in the RR and there was a fourfold increase in the RR comparing a waist circumference of 110 cm with 69 cm. There was no evidence of publication bias. Conclusions: This meta-analysis suggests that both increasing BMI and waist circumference are associated with a dose-response-related increase in the risk of acute pancreatitis. [ABSTRACT FROM AUTHOR]

Although body mass index (BMI) is widely used as a simple tool to assess obesity, it has certain limitations and inaccuracies. It is known that visceral adipose tissue is closely related to cardiometabolic risks and all-cause mortality; however, precise measurement methods for visceral fat (magnetic resonance imaging and computed tomography) cannot be widely used. Thus, simple but accurate alternatives are valuable. Studies have shown that waist circumference-to-height ratio (WHtR) might be a superior and more accurate variable in assessing central or visceral adiposity as well as predicting risks of diabetes and other cardiometabolic diseases. Furthermore, WHtR cutoff values can be consistent across different races, age, and genders, making it a universal metric worth promoting and applying.

Introduction: Polycystic Ovarian Syndrome (PCOS) is the most frequent gynaecological endocrinopathy characterised mainly by anovulation and hyperandrogenism. Women with PCOS are at higher risk of developing Cardiovascular Disease (CVD) due to a number of risk factors associated with this disease. Obesity, especially central adipose tissue accumulation, plays a major role in the pathophysiology of this disease. Lipid Accumulation Product (LAP) is a simple, inexpensive index to estimate cardiovascular risk and is based on fasting triglyceride and Waist Circumference (WC). Aim: To find out the association between LAP and cardiovascular risk factors in women with PCOS. Materials and Methods: This case-control study was conducted in the Department of Biochemistry and Department of Gynaecology, Government Medical College, Thiruvananthapuram, Kerala, India. Study subjects included 48 women with PCOS and 48 age and Body Mass Index (BMI) matched controls. Clinical and demographic data and medical history were evaluated. Duration of the study was six months. Anthropometric measurements, Blood Pressure (BP) and biochemical parameters like Fasting Plasma Glucose (FPG), lipid profile were recorded. LAP was calculated using the formulaFemale LAP= {waist (cm) -58} × Triglyceride (TG) concentration (mmol/L). The quantitative variables were expressed as mean and standard deviation. Comparison of continuous variables between two groups was analysed by unpaired t-test. Categorical variables were analysed by Chi-square test. Correlations between continuous variables were tested using the Pearson correlation or Spearman correlation coefficient (r) analysis. The p-value

Overweight and obesity during pregnancy are risk factors for a large number of perinatal complications, both for the mother and the infant. Risk stratification and early interventions are therefore highly clinically important to minimize future complications. Currently, body mass index (BMI) in early pregnancy is used for risk stratification of pregnant women, but a disadvantage of BMI is that it does not distinguish muscle from fat tissue and central from peripheral adiposity. Maternal fat distribution is suggested to be a better predictor than BMI of obesity-related adverse pregnancy outcomes, with central adiposity posing a greater risk than peripheral subcutaneous fat. With this study, we aimed to systematically review the evidence of what impact maternal central adiposity in early to mid-pregnancy or at most 365 days prior to conception has on infant anthropometry and perinatal morbidity.The databases PubMed/MEDLINE, Web of Science Core Collection, CINAHL, SCOPUS, Clinical Trials, and Open Grey were searched from inception until November 2019. Eligible studies assessed the association between maternal central adiposity, in early to mid-pregnancy or at most 365 days prior to conception, and any of the following infant outcomes: preterm delivery (< 37 weeks of gestation), birthweight, macrosomia, large for gestational age, congenital malformations, hypoglycemia, hyperbilirubinemia, care at neonatal intensive care unit, and death. Two authors independently screened titles and abstracts, read the included full-text studies, and extracted data. The Newcastle-Ottawa Quality Assessment Scale for cohort studies was used to evaluate the quality of and risk of bias in the studies.A total of 720 records were identified, 20 full-text studies assessed for eligibility, and 10 cohort studies included in the review. The results suggest that central adiposity in early to mid-pregnancy or at most 365 days prior to conception may contribute to increased birthweight and increased likelihood of delivery by cesarean section. There is also some evidence of associations between central adiposity and preterm delivery (< 37 weeks of gestation), and admission to neonatal intensive care unit. A meta-analysis was not possible to perform due to substantial heterogeneity among the included studies regarding the exposure, outcome, and statistical methods used.Hence, central adiposity in early to mid-pregnancy or at most 365 days prior to conception could be a possible risk marker in addition to BMI for risk stratification of pregnant women. However, since the topic is only scarcely researched, and the results not unanimous, more studies are needed to further clarify the associations between maternal central adiposity and adverse neonatal complications, before any altered recommendations of guidelines could be made. To enable a future meta-analysis, studies using similar methods for central adiposity assessment,and similar outcome measures, are required.

Introduction: Polycystic Ovarian Syndrome (PCOS) is the most frequent gynaecological endocrinopathy characterised mainly by anovulation and hyperandrogenism. Women with PCOS are at higher risk of developing Cardiovascular Disease (CVD) due to a number of risk factors associated with this disease. Obesity, especially central adipose tissue accumulation, plays a major role in the pathophysiology of this disease. Lipid Accumulation Product (LAP) is a simple, inexpensive index to estimate cardiovascular risk and is based on fasting triglyceride and Waist Circumference (WC). Aim: To find out the association between LAP and cardiovascular risk factors in women with PCOS. Materials and Methods: This case-control study was conducted in the Department of Biochemistry and Department of Gynaecology, Government Medical College, Thiruvananthapuram, Kerala, India. Study subjects included 48 women with PCOS and 48 age and Body Mass Index (BMI) matched controls. Clinical and demographic data and medical history were evaluated. Duration of the study was six months. Anthropometric measurements, Blood Pressure (BP) and biochemical parameters like Fasting Plasma Glucose (FPG), lipid profile were recorded. LAP was calculated using the formula-Female LAP= {waist (cm) -58} × Triglyceride (TG) concentration (mmol/L). The quantitative variables were expressed as mean and standard deviation. Comparison of continuous variables between two groups was analysed by unpaired t-test. Categorical variables were analysed by Chi-square test. Correlations between continuous variables were tested using the Pearson correlation or Spearman correlation coefficient (r) analysis. The p-value <0.05 was considered as statistically significant. Variables which were statistically significant in univariate analysis were subjected to multivariate analysis. Results: The results of this study showed that the PCOS group had significantly higher WC than BMI matched control group. PCOS group had significantly higher mean TG level (p<0.05), mean FPG level (p<0.05) and lower mean High Density Lipoprotein (HDL) level (p<0.05) than the control group. LAP value (p<0.001) was significantly higher in PCOS group compared to control group. The prevalence of Metabolic Syndrome (MetS) was higher in women with PCOS. LAP values too were significantly higher in PCOS women with MetS. All CVD risk parameters except age showed a significant relationship with LAP values. Multiple linear regression model was done and LAP (p<0.001) was found to be an independent risk factor for CVD, adjusting for other factors. Conclusion: The study results shows that there is a significant association between LAP and cardiovascular risk markers. High LAP index is associated with cardiovascular risk markers in PCOS women irrespective of obesity. [ABSTRACT FROM AUTHOR]

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Objective: This article explores the relationship between childhood obesity and educational outcomes in Mexico, a country where excess weight is predominant.Design: Using complementary multivariate estimators, we empirically investigate the association between childhood excess weight, measured in 2002, and schooling attainment measured 10 years later. Non-linear specifications are tested, and heterogeneous effects according to gender, living area and economic backgrounds are investigated.Setting: To fill the literature gap, this study focuses on the understudied context of emerging countries such as Mexico.Participants: Panel data from the Mexican Family Life Survey (2002-2012) are used. We restricted the sample to adolescent individuals who had between 9 and 15 years old in 2002 (attended primary or secondary school in 2002). The survey provides an accurate follow-up information on weight, height and waist circumference for each individual.Results: Controlling for a comprehensive set of covariates, we find that the relationship is non-linear in Mexico. While weight-based childhood obesity and abdominal adiposity are significantly associated with lower school attainment, at least in urban settings, no schooling gap is found between overweight students and their normal-weight counterparts. Along with rural-urban heterogeneity, obesity-based educational penalties appear to be stronger for girls and students from privileged economic backgrounds.Conclusions: These results emphasise the co-occurrence of anti-fat and pro-fat social norms in Mexican schools: while anti-fat norms may particularly concern female, richer and urban students, pro-fat norms might persist among male, poorer and rural students. These findings have important implications for public policy, namely about awareness anti-obesity programmes. [ABSTRACT FROM AUTHOR]