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Aim: To investigate the effect of different physical activity patterns on obesity. Materials and methods: Data from adults aged 17–79 years were extracted from the Hong Kong Territory‐Wide Physical Fitness Survey conducted in 2011–2012 and 2021–2022. Moderate to vigorous physical activity (MVPA) patterns were collected through questionnaires and categorized as inactive (no MVPA ≥10 min), insufficiently active (<150 min MVPA/week), weekend warriors (≥150 min MVPA/week from 1 to 2 days) and regularly active (≥150 min MVPA/week from ≥3 days). The association between these activity patterns with obesity risk and body fat percentage was analysed. Results: This study included 9863 obesity data (including valid waist circumference and body mass index) and 7496 body fat data. Compared with the inactive group, the weekend warriors and regularly active individuals had lower risks of general and abdominal obesity, as well as reduced body fat. Furthermore, individuals who were insufficiently active but engaged in ≥3 days of MVPA showed significantly lower body fat and obesity risk than their inactive counterparts. Conclusion: Engaging in physical activity even once or twice a week can positively impact weight control. [ABSTRACT FROM AUTHOR]

Excess body fatness in late adulthood has been observed to increase ovarian cancer risk, but the association is relatively weak. Body fatness can change over time, and timing may differently influence risk. We used a life course epidemiology approach to identify whether the relation between body fatness and ovarian cancer risk is best described by a critical period, accumulation or sensitive period hypothesis. In a population-based case-control study of ovarian cancer in Montreal, Canada (2011-16), data on body mass index (BMI) at each decade starting at age 20 was available. Among 363 cases and 707 controls aged ≥ 50 years, we used a Bayesian relevant life course exposure model to estimate the relative importance of BMI for three pre-specified periods across the adult life course, i.e., early childbearing years, late childbearing years, and peri/postmenopause, on ovarian cancer risk. The accumulation hypothesis best described BMI in relation to ovarian cancer overall, with an odds ratio (OR) for the lifetime effect of BMI (per 5 kg/m2 increase) of 1.10 (95% credible interval [CrI]: 0.90–1.35). For invasive ovarian cancer, the OR (95% CrI) for the lifetime effect was 1.16 (0.92–1.48), with BMI during early childbearing years showing the highest relative importance, suggesting this may be a sensitive period. For borderline cancer, the lifetime effect OR was not strongly supportive of an association (OR: 0.90, 95% CrI: 0.53–1.32). The results suggest that a sensitive period of early childbearing years is a candidate hypothesis for further investigation. [ABSTRACT FROM AUTHOR]

There is still insufficient knowledge about the potential benefits of physical activity and fitness or the adverse impact of sedentary behaviours on body composition at preschool age. Therefore, we aimed to study the relationships of moderate-to-vigorous physical activity (MVPA), sedentary time (ST), cardiorespiratory fitness (CRF), and muscular fitness (MF) with body fat percentage (BF%) in boys and girls. Participants were investigated twice: in the final year of kindergarten, when the boys' median age was 7 years and the girls' median age was 6 years (p = 0.240), and again in the first grade of school. MVPA and ST were measured with an accelerometer, BF% was derived from skinfold thicknesses, CRF was measured with a 20 m shuttle run test, and MF was represented by the mean z-scores from standing long jump and relative upper-limb strength. In girls, higher ST (β = 0.587, p = 0.021) and lower MF (β = −0.231, p = 0.009) at preschool age were related to higher BF% in the first grade of school after adjustment for confounders. MVPA and CRF in preschool children were unrelated to BF% in school among boys and girls. In conclusion, sitting less and having greater muscular fitness at preschool age appear to be beneficial for lower body fatness in the first grade among girls, but not in boys. MVPA and CRF at preschool age are unrelated to body fatness at school age in boys and girls. Our results indicate that girls may especially benefit from decreasing sedentary behaviours and increasing upper- and lower-limb muscular strength at preschool age for a healthy weight profile in the first grade of school. [ABSTRACT FROM AUTHOR]

A good cognitive status predicts academic, professional, and health outcomes. However, longitudinal data regarding the associations of body fatness, physical fitness, and cognition are relatively scarce and mixed. The purpose of this longitudinal study was to investigate whether body fatness, cardiorespiratory fitness (CRF), and muscular fitness (MF) in preschool are associated with cognitive skills in the first grade of school. A total of 133 South Estonian children whose age was 6–7 years were recruited from 13 kindergartens and again at 7–8 years after they had entered school. Body fat percentage (BF%), CRF, MF as the mean of z-scores of relative upper-limb strength, standing long jump results, and cognitive skills (verbal, conceptual, and perceptual) were studied. There were no associations between BF% and CRF in preschool with perceptual, conceptual, or verbal skills in school in boys and girls. In boys, a higher MF in preschool was associated with higher verbal skills (β = 0.293, p = 0.021) in school after adjustment for confounders. Cognitive skills at baseline seemed to be frequently associated with cognitive performance in school. In conclusion, higher MF in preschool was associated with better verbal skills in the first grade of school in boys but not in girls. Body fatness and cardiorespiratory fitness in preschool were not associated with cognitive skills in school. [ABSTRACT FROM AUTHOR]

There is still insufficient knowledge about the potential benefits of physical activity and fitness or the adverse impact of sedentary behaviours on body composition at preschool age. Therefore, we aimed to study the relationships of moderate-to-vigorous physical activity (MVPA), sedentary time (ST), cardiorespiratory fitness (CRF), and muscular fitness (MF) with body fat percentage (BF%) in boys and girls. Participants were investigated twice: in the final year of kindergarten, when the boys’ median age was 7 years and the girls’ median age was 6 years (p = 0.240), and again in the first grade of school. MVPA and ST were measured with an accelerometer, BF% was derived from skinfold thicknesses, CRF was measured with a 20 m shuttle run test, and MF was represented by the mean z-scores from standing long jump and relative upper-limb strength. In girls, higher ST (β = 0.587, p = 0.021) and lower MF (β = −0.231, p = 0.009) at preschool age were related to higher BF% in the first grade of school after adjustment for confounders. MVPA and CRF in preschool children were unrelated to BF% in school among boys and girls. In conclusion, sitting less and having greater muscular fitness at preschool age appear to be beneficial for lower body fatness in the first grade among girls, but not in boys. MVPA and CRF at preschool age are unrelated to body fatness at school age in boys and girls. Our results indicate that girls may especially benefit from decreasing sedentary behaviours and increasing upper- and lower-limb muscular strength at preschool age for a healthy weight profile in the first grade of school.

Abstract Background Body fatness is a dynamic exposure throughout life. To provide more insight into the association between body mass index (BMI) and postmenopausal breast cancer, we aimed to examine the age at onset, duration, intensity, and trajectories of body fatness in adulthood in relation to risk of breast cancer subtypes. Methods Based on self-reported anthropometry in the prospective Norwegian Women and Cancer Study, we calculated the age at onset, duration, and intensity of overweight and obesity using linear mixed-effects models. BMI trajectories in adulthood were modeled using group-based trajectory modeling. We used Cox proportional hazards models to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between BMI exposures and breast cancer subtypes in 148,866 postmenopausal women. Results A total of 7223 incident invasive postmenopausal breast cancer cases occurred during follow-up. Increased overweight duration and age at the onset of overweight or obesity were associated with luminal A-like breast cancer. Significant heterogeneity was observed in the association between age at overweight and overweight duration and the intrinsic-like subtypes (p heterogeneity 0.03). Compared with women who remained at normal weight throughout adulthood, women with a descending BMI trajectory had a reduced risk of luminal A-like breast cancer (HR 0.54, 95% CI 0.33–0.90), whereas women with ascending BMI trajectories were at increased risk (HR 1.09; 95% CI 1.01–1.17 for “Normal-overweight”; HR 1.20; 95% CI 1.07–1.33 for “Normal-obesity”). Overweight duration and weighted cumulative years of overweight and obesity were inversely associated with luminal B-like breast cancer. Conclusions In this exploratory analysis, decreasing body fatness from obesity in adulthood was inversely associated with overall, hormone receptor-positive and luminal A-like breast cancer in postmenopausal women. This study highlights the potential health benefits of reducing weight in adulthood and the health risks associated with increasing weight throughout adult life. Moreover, our data provide evidence of intrinsic-like tumor heterogeneity with regard to age at onset and duration of overweight.

Background: Body fatness is a dynamic exposure throughout life. To provide more insight into the association between body mass index (BMI) and postmenopausal breast cancer, we aimed to examine the age at onset, duration, intensity, and trajectories of body fatness in adulthood in relation to risk of breast cancer subtypes. Methods: Based on self-reported anthropometry in the prospective Norwegian Women and Cancer Study, we calculated the age at onset, duration, and intensity of overweight and obesity using linear mixed-effects models. BMI trajectories in adulthood were modeled using group-based trajectory modeling. We used Cox proportional hazards models to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between BMI exposures and breast cancer subtypes in 148,866 postmenopausal women. Results: A total of 7223 incident invasive postmenopausal breast cancer cases occurred during follow-up. Increased overweight duration and age at the onset of overweight or obesity were associated with luminal A-like breast cancer. Significant heterogeneity was observed in the association between age at overweight and overweight duration and the intrinsic-like subtypes (pheterogeneity 0.03). Compared with women who remained at normal weight throughout adulthood, women with a descending BMI trajectory had a reduced risk of luminal A-like breast cancer (HR 0.54, 95% CI 0.33–0.90), whereas women with ascending BMI trajectories were at increased risk (HR 1.09; 95% CI 1.01–1.17 for "Normal-overweight"; HR 1.20; 95% CI 1.07–1.33 for "Normal-obesity"). Overweight duration and weighted cumulative years of overweight and obesity were inversely associated with luminal B-like breast cancer. Conclusions: In this exploratory analysis, decreasing body fatness from obesity in adulthood was inversely associated with overall, hormone receptor-positive and luminal A-like breast cancer in postmenopausal women. This study highlights the potential health benefits of reducing weight in adulthood and the health risks associated with increasing weight throughout adult life. Moreover, our data provide evidence of intrinsic-like tumor heterogeneity with regard to age at onset and duration of overweight. [ABSTRACT FROM AUTHOR]

Body weight and fatness appear to be regulated phenomena. Several different theoretical models are available to capture the essence of this idea. These include the set-point, dynamic equilibrium, adiposity force, control theory-settling point, Hall–Guo, operation point and dual intervention point (DIP) models. The set-point model posits a single reference point around which levels of fat are regulated. The dynamic equilibrium model suggests that the apparent regulation of body fat around a reference point is an illusion owing to the necessary impacts of weight change on energy expenditure. Control theory focuses on the importance of feedback gain and suggests set-point and dynamic equilibrium are ends of a continuum of feedback gain. Control theory models have also been called 'settling point' models. The Hall–Guo, operation point and DIP models also bring together the set-point and dynamic equilibrium ideas into a single framework. The DIP proposes a zone of indifference where dynamic equilibrium 'regulation' predominates, bounded by upper and lower intervention points beyond which physiological mechanisms are activated. The drifty gene hypothesis is an idea explaining where this individual variation in the upper intervention point might come from. We conclude that further experiments to test between the models are sorely required. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'. [ABSTRACT FROM AUTHOR]

Studies of environment and obesity usually use epidemiologically tractable measures that are proxies for energy balance or macronutrient composition intake, mostly to identify individual behavioural changes for prevention or reduction of obesity, or inform policy. Of environments external to the body as they relate to obesity, the built environment and the food environment are considered among the most important. Incorporating human sociality into obesity and environments research enriches the field by offering possible ways for understanding obesity production via social stress, dietary preference, food consumption and physical activity. External environments are in flux, however, especially with changing urban form and social environmental hybridity since Web 2.0, with urban polycentricity and networked and online activity influencing obesity production in new ways. While the world's rural populations are experiencing the fastest increases in obesity, large urban populations benefit from scale in setting the physical conditions for physical activity and healthy food availability, with larger and polycentric cities having lower rates of obesity than smaller monocentric or dispersed cities. It is argued that built, food and social environments set the context for obesity production or its amelioration, with sociodemographic factors being more important than new phenomena such as digital and smart technologies. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'. [ABSTRACT FROM AUTHOR]

Abstract Background The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index has been recommended as an ideal indicator of body fat and exhibited significant correlation with cardiometabolic risk factors. However, whether the CUN-BAE index correlates with incident diabetes in Asian populations is unknown. Therefore, this longitudinal study was designed to evaluate the association between baseline CUN-BAE index and type 2 diabetes mellitus (T2DM). Methods This retrospective longitudinal study involved 15,464 participants of 18–79 years of age in the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study over the period of 2004–2015. Cox proportional hazards regression was performed to test the relationship between the baseline CUN-BAE index and diabetes incidence. Further stratification analysis was conducted to ensure that the results were robust. The diagnostic utility of the CUN-BAE index was tested by the receiver operating characteristic (ROC) curve. Results Over the course of an average follow-up of 5.4 years, 373 (2.41%) participants developed diabetes. A higher diabetes incidence was associated with higher CUN-BAE quartiles (P for trend

Evidence linking body fatness to breast cancer (BC) prognosis is limited. While it seems that excess adiposity is associated with poorer BC survival, there is uncertainty over whether weight changes reduce mortality. This study aimed to assess the association between body fatness and weight changes pre- and postdiagnosis and overall mortality and BC-specific mortality among BC survivors. Our study included 13,624 BC survivors from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with a mean follow-up of 8.6 years after diagnosis. Anthropometric data were obtained at recruitment for all cases and at a second assessment during follow-up for a subsample. We measured general obesity using the body mass index (BMI), whereas waist circumference and A Body Shape Index were used as measures of abdominal obesity. The annual weight change was calculated for cases with two weight assessments. The association with overall mortality and BC-specific mortality were based on a multivariable Cox and Fine and Gray models, respectively. We performed Mendelian randomization (MR) analysis to investigate the potential causal association. Five-unit higher BMI prediagnosis was associated with a 10% (95% confidence interval: 5–15%) increase in overall mortality and 7% (0–15%) increase in dying from BC. Women with abdominal obesity demonstrated a 23% (11–37%) increase in overall mortality, independent of the association of BMI. Results related to weight change postdiagnosis suggested a U-shaped relationship with BC-specific mortality, with higher risk associated with losing weight or gaining > 2% of the weight annually. MR analyses were consistent with the identified associations. Our results support the detrimental association of excess body fatness on the survival of women with BC. Substantial weight changes postdiagnosis may be associated with poorer survival. [ABSTRACT FROM AUTHOR]

A good cognitive status predicts academic, professional, and health outcomes. However, longitudinal data regarding the associations of body fatness, physical fitness, and cognition are relatively scarce and mixed. The purpose of this longitudinal study was to investigate whether body fatness, cardiorespiratory fitness (CRF), and muscular fitness (MF) in preschool are associated with cognitive skills in the first grade of school. A total of 133 South Estonian children whose age was 6–7 years were recruited from 13 kindergartens and again at 7–8 years after they had entered school. Body fat percentage (BF%), CRF, MF as the mean of z-scores of relative upper-limb strength, standing long jump results, and cognitive skills (verbal, conceptual, and perceptual) were studied. There were no associations between BF% and CRF in preschool with perceptual, conceptual, or verbal skills in school in boys and girls. In boys, a higher MF in preschool was associated with higher verbal skills (β = 0.293, p = 0.021) in school after adjustment for confounders. Cognitive skills at baseline seemed to be frequently associated with cognitive performance in school. In conclusion, higher MF in preschool was associated with better verbal skills in the first grade of school in boys but not in girls. Body fatness and cardiorespiratory fitness in preschool were not associated with cognitive skills in school.

Background: Referees' activity can be an instrument for training students with an impact on health-related physical fitness (PF). This study aimed to investigate the differences in PF and body composition between students without sports practice (G1), students with regular sports practice (G2), and student referees in team invasion games (G3). Methods: This study followed a cross-sectional design. The sample comprised 45 male students between 14 and 20 years old (16.40 ± 1.85). Three groups (G1, G2, and G3) of 15 participants each were selected. PF was assessed by a 20 m shuttle run, change-of-direction test, and standing long jump. Body composition was determined by body mass index (BMI; kg/m2) and the percentage of body fat (%BF) predicted by skinfold. Results: After controlling for age as a covariate, the block of variables used to characterize PF was statistically different between sports practice groups favoring student referees (p < 0.001; r = 0.26). Similar results were achieved for body composition (i.e., BMI and %BF) (p < 0.001; r = 0.17). However, when the dependent variables were evaluated separately, there were only differences between groups in %BF (p = 0.007; r = 0.21). Student referees had statistically significantly lower values than the remaining groups. Conclusion: Refereeing activity benefits PF related to health and performance, including body composition. This study confirms the benefits related to health in children and adolescents who are involved in refereeing activity. [ABSTRACT FROM AUTHOR]

Background : The association of dietary patterns and resting metabolic rate is still unclear. Aim : To study the relationship between the major dietary patterns, resting metabolic rate, and adiposity measures in Iranian adults. Methods : This is a cross-sectional study of 270 adults aged between 18–45 years old who lived in Tehran. Dietary intakes were achieved using food frequency questionnaire. Resting metabolic rate was measured using indirect calorimetry. Anthropometric measures were recorded using body composition analyzer. Results : Three major dietary patterns were identified by factor analysis labeled as healthy pattern (vegetables, fruits, and fruits juices, legumes, poultry, nuts, fish, egg, low fat dairy product, olive, and olive oil), mixed pattern (non-refined cereals, vegetables, vegetable oils, mayonnaise, high fat dairy product and, pickles), Western pattern (refined cereals, red or processed meat, soft drinks, sweets and desserts, Tea and coffee, salty snacks and French fries). After adjusting for covariates higher score of the Western dietary pattern was associated with lower resting metabolic rate (p = 0.023). There was significant decreasing difference in means for fat free mass across tertiles of mixed pattern when the first tertile was compared to the third tertile (p = 0.046). Higher adherence to healthy pattern was associated with lower body weight (p = 0.034), body mass index (p = 0.021), and higher resting metabolic rate (p = 0.033). Conclusions : Higher adherence to the Western dietary pattern was associated with a lower amount of resting metabolic rate. Also higher adherence to the healthy dietary pattern was associated with higher resting metabolic rate and lower body weight and body mass index. Further studies are required to examine the causal relationship between dietary patterns and resting metabolic rate. [ABSTRACT FROM AUTHOR]

Previous evidence on postdiagnosis body fatness and mortality after breast cancer was graded as limited‐suggestive. To evaluate the evidence on body mass index (BMI), waist circumference, waist‐hip‐ratio and weight change in relation to breast cancer prognosis, an updated systematic review was conducted. PubMed and Embase were searched for relevant studies published up to 31 October, 2021. Random‐effects meta‐analyses were conducted to estimate summary relative risks (RRs). The evidence was judged by an independent Expert Panel using pre‐defined grading criteria. One randomized controlled trial and 225 observational studies were reviewed (220 publications). There was strong evidence (likelihood of causality: probable) that higher postdiagnosis BMI was associated with increased all‐cause mortality (64 studies, 32 507 deaths), breast cancer‐specific mortality (39 studies, 14 106 deaths) and second primary breast cancer (11 studies, 5248 events). The respective summary RRs and 95% confidence intervals per 5 kg/m2 BMI were 1.07 (1.05‐1.10), 1.10 (1.06‐1.14) and 1.14 (1.04‐1.26), with high between‐study heterogeneity (I2 = 56%, 60%, 66%), but generally consistent positive associations. Positive associations were also observed for waist circumference, waist‐hip‐ratio and all‐cause and breast cancer‐specific mortality. There was limited‐suggestive evidence that postdiagnosis BMI was associated with higher risk of recurrence, nonbreast cancer deaths and cardiovascular deaths. The evidence for postdiagnosis (unexplained) weight or BMI change and all outcomes was graded as limited‐no conclusion. The RCT showed potential beneficial effect of intentional weight loss on disease‐free‐survival, but more intervention trials and well‐designed observational studies in diverse populations are needed to elucidate the impact of body composition and their changes on breast cancer outcomes. [ABSTRACT FROM AUTHOR]

Based on the Global Cancer Update Programme, formally known as the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, we performed systematic reviews and meta‐analyses to investigate the association of postdiagnosis body fatness, physical activity and dietary factors with breast cancer prognosis. We searched PubMed and Embase for randomised controlled trials and longitudinal observational studies from inception to 31 October 2021. We calculated summary relative risks (RRs) and 95% confidence intervals (CIs) using random‐effects meta‐analyses. An independent Expert Panel graded the quality of evidence according to predefined criteria. The evidence on postdiagnosis body fatness and higher all‐cause mortality (RR per 5 kg/m2 in body mass index: 1.07, 95% CI: 1.05‐1.10), breast cancer‐specific mortality (RR: 1.10, 95% CI: 1.06‐1.14) and second primary breast cancer (RR: 1.14, 95% CI: 1.04‐1.26) was graded as strong (likelihood of causality: probable). The evidence for body fatness and breast cancer recurrence and other nonbreast cancer‐related mortality was graded as limited (likelihood of causality: limited‐suggestive). The evidence on recreational physical activity and lower risk of all‐cause (RR per 10 metabolic equivalent of task‐hour/week: 0.85, 95% CI: 0.78‐0.92) and breast cancer‐specific mortality (RR: 0.86, 95% CI: 0.77‐0.96) was judged as limited‐suggestive. Data on dietary factors was limited, and no conclusions could be reached except for healthy dietary patterns, isoflavone and dietary fibre intake and serum 25(OH)D concentrations that were graded with limited‐suggestive evidence for lower risk of the examined outcomes. Our results encourage the development of lifestyle recommendations for breast cancer patients to avoid obesity and be physically active. [ABSTRACT FROM AUTHOR]

Background: The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index has been recommended as an ideal indicator of body fat and exhibited significant correlation with cardiometabolic risk factors. However, whether the CUN-BAE index correlates with incident diabetes in Asian populations is unknown. Therefore, this longitudinal study was designed to evaluate the association between baseline CUN-BAE index and type 2 diabetes mellitus (T2DM). Methods: This retrospective longitudinal study involved 15,464 participants of 18–79 years of age in the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study over the period of 2004–2015. Cox proportional hazards regression was performed to test the relationship between the baseline CUN-BAE index and diabetes incidence. Further stratification analysis was conducted to ensure that the results were robust. The diagnostic utility of the CUN-BAE index was tested by the receiver operating characteristic (ROC) curve. Results: Over the course of an average follow-up of 5.4 years, 373 (2.41%) participants developed diabetes. A higher diabetes incidence was associated with higher CUN-BAE quartiles (P for trend< 0.001). Each 1 unit increase in CUN-BAE index was associated with a 1.08-fold and 1.14-fold increased risk of diabetes after adjustment for confounders in males and females, respectively (both P < 0.001). Stratification analysis demonstrated a consistent positive correlation between baseline CUN-BAE and diabetes incidence. Moreover, based on ROC analysis, CUN-BAE exhibited a better capacity for diabetes prediction than both body mass index (BMI) and waist circumference (WC) in both sexes. Conclusions: The baseline CUN-BAE level was independently related to the incidence of diabetes. Increased adiposity determined by CUN-BAE could be used as a strong nonlaboratory predictor of incident diabetes in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine the cross-sectional and longitudinal associations of 24-h movement behaviors (sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) with body composition and cardiometabolic health in i) early and ii) late pregnancy (gestational weeks 14 and 37). Methods: This observational study utilized cross-sectional (n = 273) and longitudinal data (n = 242) from the HealthyMoms trial. Time spent in movement behaviors over seven consecutive 24-h periods (ActiGraph wGT3x-BT accelerometer), body composition (Bod Pod), and cardiometabolic health indicators (glucose levels, homeostatic model for insulin resistance (HOMA-IR), systolic and diastolic blood pressure, metabolic syndrome (MetS) score) were measured in early and late pregnancy. Results: In early pregnancy, reallocating time to MVPA from LPA, SB, and sleep was associated with lower MetS score (adjusted γ = −0.343, P = 0.002). Correspondingly, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower body weight (adjusted γ = −5.959, P = 0.047) and HOMA-IR (adjusted γ = −0.557, P = 0.031) at the same time point. Furthermore, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower fat mass index (adjusted γ = −0.668, P = 0.028), glucose levels (adjusted γ = −0.315, P = 0.006), HOMA-IR (adjusted γ = −0.779, P = 0.004), and MetS score (adjusted γ = −0.470, P = 0.027) in late pregnancy. The changes in behaviors throughout pregnancy were not associated with body weight, body composition, and MetS score in late pregnancy. Conclusions: Our results demonstrated that increasing LPA or MVPA while reducing SB and sleep was associated with lower weight and more favorable cardiometabolic health in early pregnancy. In contrast, LPA in early pregnancy seems to be a stimulus of enough intensity to improve body composition and cardiometabolic health indicators in late pregnancy. [ABSTRACT FROM AUTHOR]

To develop and validate an easy-to-use screening tool for identifying adolescents at high-risk for insulin resistance (IR). Α total of 1,053 adolescents (554 females), aged 12.5 to 17.5 years with complete data on glucose and insulin levels were included. Body mass index (BMI), fat mass index (FMI) and the homeostasis model assessment for insulin resistance (HOMA-IR) were calculated. VO2max was predicted using 20 m multi-stage fitness test. The population was randomly separated into two cohorts for the development (n=702) and validation (n=351) of the index, respectively. Factors associated with high HOMA-IR were identified by Spearman correlation in the development cohort; multiple logistic regression was performed for all identified independent factors to develop a score index. Finally, receiver operating characteristic (ROC) analysis was performed in the validation cohort and was used to define the cut-off values that could identify adolescents above the 75th and the 95th percentile for HOMA-IR. BMI and VO2max significantly identified high HOMA-IR in males; and FMI, TV watching and VO2max in females. The HELENA-IR index scores range from 0 to 29 for males and 0 to 43 for females. The Area Under the Curve, sensitivity and specificity for identifying males above the 75th and 95th of HOMA-IR percentiles were 0.635 (95%CI: 0.542–0.725), 0.513 and 0.735, and 0.714 (95%CI: 0.499–0.728), 0.625 and 0.905, respectively. For females, the corresponding values were 0.632 (95%CI: 0.538–0.725), 0.568 and 0.652, and 0.708 (95%CI: 0.559–0.725), 0.667 and 0.617, respectively. Simple algorithms were created using the index cut-off scores. Paediatricians or physical education teachers can use easy-to-obtain and non-invasive measures to apply the HELENA-IR score and identify adolescents at high risk for IR, who should be referred for further tests. [ABSTRACT FROM AUTHOR]

The most widely used method in professional sports for fat percentage assessment is the skinfold method. However, there is the chance of bias and human error. For this reason, other more precise methods are used, such as single-frequency bioelectrical impedance analysis (BIA) or dual energy X-ray absorptiometry (DEXA). However, there are limited data that demonstrate the methodological shortcomings or congruences in fat and fat-free mass estimates including gender differences and differences in athlete populations. Thus, the aim of the present study was to compare total body fat (%BF) estimated by six skinfold thickness measurement (SKF) and single-frequency bioelectrical impedance analysis (BIA) methods, using three different sets of equations, to that assessed by the dual energy X-ray absorptiometry (DEXA) method using a DEXA Hologic Serie Discovery QDR. For this aim, 76 males and 70 females belonging to the professional Spanish football federation were evaluated. We found significant differences between the three measures. BIA significantly underestimates the fat percentage, followed by skinfolds. With DEXA being the more objective or accurate method, an equation is established by means of linear regression analysis that allows the percentage of adipose tissue to be obtained either through anthropometry or electrical bioimpedance and adjusted to that which would be obtained by the DEXA system. [ABSTRACT FROM AUTHOR]

Laboratory rodents spend the entire day housed in standard cages that provide a restricted area for movements and might, therefore, limit physical activity. However, it has not been tested in immature rodents of ages ranging from weaning to adulthood (adolescence period) whether the restricted area per animal does actually reduce physical activity and impact the body composition. We analyzed the spontaneous physical activity and feeding behavior during the adolescence of mice kept in two different housing conditions (standard stocking density (SSD) versus low stocking density (LSD)). We aimed to compare the body composition between SSD and LSD groups before they reached adulthood. Differential housing began at four weeks of age and was maintained for four weeks until euthanasia at eight weeks of age. The SSD group had a floor space of 88 cm2 available per animal, while LSD mice were housed with a floor space of 320 cm2 per animal, increasing the individual radius for movement more than three-fold compared with standard requirements. Mice kept in SSD exhibit lower spontaneous physical activity than mice kept in LSD. Early-life exposure to reduced physical activity in mice housed in SSD resulted in greater visceral fat accumulation before adulthood. An environment enabling/stimulating physical activity should be established for rodents as early as possible. This study will be helpful in showing that mice kept in SSD are early exposed to a reduced physical activity already in the adolescence period. Our findings could raise reflections about the translatability of rodents kept in SSD to healthy active humans. [ABSTRACT FROM AUTHOR]

Abstract Background The mechanistic target of rapamycin (mTOR) pathway promoted by positive energy imbalance and insulin-like growth factors can be a mechanism by which obesity influences breast cancer risk. We evaluated the associations of body fatness with the risk of breast cancer varied with phosphorylated (p)-mTOR protein expression, an indication of the pathway activation. Methods Women with newly diagnosed breast cancer (n = 715; 574 [80%] Black and 141 [20%] White) and non-cancer controls (n = 1983; 1280 [64%] Black and 713 [36%] White) were selected from the Women’s Circle of Health Study. Surgical tumor samples among the cases were immunostained for p-mTOR (Ser2448) and classified as p-mTOR-overexpressed, if the expression level ≥ 75th percentile, or p-mTOR-negative/low otherwise. Anthropometrics were measured by trained staff, and body composition was determined by bioelectrical impedance analysis. Odds ratios (ORs) of p-mTOR-overexpressed tumors and p-mTOR-negative/low tumors compared to controls were estimated using polytomous logistic regression. The differences in the associations by the p-mTOR expression status were assessed by tests for heterogeneity. Results Cases with p-mTOR-overexpressed tumors, but not cases with p-mTOR-negative/low tumors, compared to controls were more likely to have higher body mass index (BMI), percent body fat, and fat mass index (P-heterogeneity

We investigated the impact of short‐term changes in general and central fatness on the risk of hepatocellular carcinoma (HCC) in a large, population‐based cohort. We screened 7 221 479 subjects who underwent health examinations provided by the National Health Insurance Service of South Korea in 2009 and 2011. In total, 6 789 472 subjects were included in the final analysis. General fatness was defined as a body mass index (BMI) ≥25 kg/m2, and central fatness was defined as a waist circumference (WC) ≥90 cm in men and ≥85 cm in women. Subjects were classified according to the change in body fatness between 2009 and 2011, as follows: (a) persistent no fatness as no fatness in both 2009 and 2011, (b) reversed fatness as fatness in 2009, but no fatness in 2011, (c) incident fatness as no fatness in 2009, but fatness in 2011 or (d) persistent fatness as fatness in both 2009 and 2011. During a median 6.4‐year follow‐up, we documented 9952 HCC cases. Compared to subjects with a persistent no general fatness, the risk of HCC significantly increased in those with incident (adjusted hazard ratio [aHR] = 1.10, 95% confidence interval [CI] = 1.01‐1.20) and persistent (aHR = 1.28, 95% CI = 1.23‐1.34) general fatness. Compared to subjects with persistent no central fatness, those with incident and persistent central fatness showed a significantly increased risk of HCC (aHR = 1.19, 95% CI = 1.11‐1.27 and aHR = 1.33, 95% CI = 1.26‐1.40, respectively). Taken together, these findings indicate the importance of strategies for preventing and reversing body fatness to reduce the incidence of HCC. [ABSTRACT FROM AUTHOR]

Background: Globally, the prevalence of metabolic syndrome (MS) is rising because of increased levels of physical inactivity and obesity. In South Africa, information about teachers’ physical activity (PA), body fatness and MS is limited. Aim: To assess the relationship between PA, body fatness and MS in urban South African teachers. Setting: The study setting was in Dr Kenneth Kaunda District in the North West province of South Africa. Methods: A cross-sectional study was conducted using secondary data drawn from the sympathetic activity and ambulatory blood pressure in Africans (SABPA) study of 216 teachers (aged 25–65 years). Variables included anthropometry, biochemical measurements, objectively measured PA and lifestyle behaviours. Results: Twenty-nine percent of the total participants were classified with MS, with 46% in men compared to 13% in women; 33% were sedentary and 67% participated in light activity. A weak significant negative relationship was found between the mean 7-day awake metabolic equivalent of tasks (METs) and triglycerides (r = −0.29; p = 0.02) and gamma-glutamyl transferase (r = −0.25; p = 0.06), activity energy expenditure (r = −0.24; p = 0.06) and PA level (r = −0.23; p = 0.07). After adjusting for age, self-reported smoking and alcohol use or consumption, a weak significant negative relationship between mean 7-day awake METs and triglycerides (r = −0.28; p 0.01) was observed. Conclusion: In the teachers with MS, only one MS marker (triglycerides) showed a negative association with PA. Physical activity could therefore be beneficial in the regulation of triglycerides. Participation in regular PA could be beneficial in the regulation of triglycerides. Focused PA interventions in school teachers that advocate the benefits of PA and healthy lifestyle choices to reduce dietary fat intake (and alcohol) are recommended.

Study aim: Numerous data have indicated that body fat stores undergo complicated regulation by genetic and environmental factors, including physical activity. However, the majority of studies did not take into account this aspect of lifestyle in proposed body fat limits. In this context it seems that a more precise and reliable classification of body fat is provided by the American Council on Exercise (ACE), which distinguishes individuals not only with respect to sex but also activity level.

Thyroid cancer incidence and the prevalence of overweight and obesity are increasing, but the future thyroid cancer burden attributable to contemporary levels of overweight and obesity has not been evaluated before. We quantified this burden in Australia, and assessed whether the overweight/obesity‐attributable burden differed by sex or other population subgroupings. We estimated the strength of the associations of overweight and obesity with thyroid cancer with adjusted proportional hazards models using pooled data from seven Australian cohorts (N = 367 058) with 431 thyroid cancer cases ascertained from linked national cancer registry data during a maximum 22‐year follow‐up. We combined these estimates with nationally representative 2017 to 2018 estimates of overweight and obesity prevalence to estimate population attributable fractions (PAFs) of future thyroid cancers attributable to overweight and obesity, accounting for competing risk of death, and compared PAFs for population subgroups. Contemporary levels of overweight and obesity explain 18.6% (95% confidence interval [CI] = 5.2%‐30.2%), and obesity alone 13.7% (95% CI: 5.2%‐21.4%), of the future thyroid cancer burden. The obesity‐attributable thyroid cancer burden is 21.4% (95% CI: 2.8%‐36.5%) for men and 10.1% (95% CI: 0.8%‐18.6%) for women. Were the currently obese overweight instead, 9.9% (95% CI: 1.0%‐18.1%) of thyroid cancers could be avoided. The relative overweight/obesity‐attributable burden is higher for those consuming on average more than two alcoholic drinks per day (63.4%) and for those who are not married/co‐habiting (33.2%). In conclusion, avoiding excess weight, especially obesity, should be a priority for thyroid cancer prevention. Further studies, with findings stratified by tumour size, may reveal the potential role of overdiagnosis in our results. What's new? As the incidence of thyroid cancer has increased, questions have arisen regarding possible associations with increasing incidence of overweight and obesity. Here, the authors projected the future burden of thyroid cancer in Australia with regard to incidence of overweight and obesity. Analyses show that current levels of overweight and obesity in Australia explain about 19% of future thyroid cancers, with 14% of cancers attributed to obesity alone. Moreover, if currently obese individuals were instead overweight, nearly 10% of thyroid cancers could be avoided. The findings suggest that many thyroid cancers could be prevented through improved weight management. [ABSTRACT FROM AUTHOR]

Background: Referees’ activity can be an instrument for training students with an impact on health-related physical fitness (PF). This study aimed to investigate the differences in PF and body composition between students without sports practice (G1), students with regular sports practice (G2), and student referees in team invasion games (G3). Methods: This study followed a cross-sectional design. The sample comprised 45 male students between 14 and 20 years old (16.40 ± 1.85). Three groups (G1, G2, and G3) of 15 participants each were selected. PF was assessed by a 20 m shuttle run, change-of-direction test, and standing long jump. Body composition was determined by body mass index (BMI; kg/m2) and the percentage of body fat (%BF) predicted by skinfold. Results: After controlling for age as a covariate, the block of variables used to characterize PF was statistically different between sports practice groups favoring student referees (p < 0.001; r = 0.26). Similar results were achieved for body composition (i.e., BMI and %BF) (p < 0.001; r = 0.17). However, when the dependent variables were evaluated separately, there were only differences between groups in %BF (p = 0.007; r = 0.21). Student referees had statistically significantly lower values than the remaining groups. Conclusion: Refereeing activity benefits PF related to health and performance, including body composition. This study confirms the benefits related to health in children and adolescents who are involved in refereeing activity.

Background: Our aim was to investigate the association between different components of physical activity (PA) and health-related fitness in 10-to 14-year-old children. Methods: 241 children were recruited from 15 primary and 15 secondary schools. PA was assessed using the Sense Wear Mini and an electronic diary. Health-related fitness was assessed using Eurofit and translated into indicators of body fatness, cardiorespiratory fitness and muscular fitness. Associations between PA intensity and physical fitness components were determined using multiple linear regression models adjusted for possible confounders and the contribution of PA domains per intensity categories was calculated. Results: Associations between PA intensities and body fatness were low to moderate (|β| = 0.09 to 0.44), explaining up to 6% of the variance in boys and 17% in girls. For cardiorespiratory fitness, associations were higher (|β| = 0.17 to 0.56), with PA explaining up to 6% of the variance in boys and β% in girls. Low-tomoderate associations (|β| = 0.06 to 0.43) were found for muscular fitness, with PA explaining up to 7% in boys and 13% in girls. Stronger associations were found for sedentary and light activities. Conclusions: Low-to-moderate associations between PA and fitness components were observed, with higher associations in girls. Sedentary and light intensity activity showed the strongest link with body fatness, cardiorespiratory fitness and muscular fitness. [ABSTRACT FROM AUTHOR]

Background Data from the NHANES indicate that BMI has increased in some subgroups of children and adolescents in the United States over the past 20 y; however, BMI is an indirect measure of body fatness. Objectives We assessed changes in DXA-derived measures of adiposity in a nationally representative population of US children and adolescents aged 8–19 y from 1999–2006 to 2011–2018. Methods Using data from the NHANES, we compared the means and distributions of DXA-derived percentage body fat (%BF) and fat mass index (FMI; fat mass/height2 in kg/m2) between 1999–2006 (n  = 10,231) and 2011–2018 (n  = 6923) among males and females by age group, race and Hispanic origin, and BMI categories. Estimates were standardized by age and race and Hispanic origin. Results From 1999–2006 to 2011–2018, mean %BF increased from 25.6% to 26.3% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P  < 0.01) among all males, whereas mean %BF increased from 33.0% to 33.7% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P  = 0.01) and mean FMI increased from 7.7 to 8.0 fat mass kg/m2 (change in FMI: 0.3 fat mass kg/m2; 95% CI: 0.0, 0.6 fat mass kg/m2; P  = 0.02) among all females. Changes were not consistent across all age, race and Hispanic origin, and BMI categories. Both %BF and FMI increased among Mexican-American children and adolescents, but not other race and Hispanic origin groups. Conclusions Among US children and adolescents, DXA-derived measures of adiposity increased from 1999–2006 to 2011–2018, albeit not consistently in every age, race and Hispanic origin, and BMI subgroup. These data reinforce the need to consider other measures, besides BMI categories, when studying adiposity in children and adolescents. [ABSTRACT FROM AUTHOR]

In studies of anthropometric measures and prostate cancer risk, conducted primarily in White men, positive associations with advanced disease have been reported. We assessed body size in relation to incident prostate cancer risk in 79,950 men from the Multiethnic Cohort, with 8,819 cases identified over 22 years (1993–2015). Height was associated with increased risk of advanced prostate cancer (≥68 inches (≥ 173 cm) vs. < 66 inches (168 cm); hazard ratio (HR) = 1.24, 95% confidence interval (CI): 1.04, 1.48) and high-grade disease (HR = 1.15, 95% CI: 1.02, 1.31). Compared with men of normal weight, men overweight at baseline were at higher risk of high-grade cancer (HR = 1.15, 95% CI: 1.04, 1.26). Greater weight was positively associated with localized and low-grade disease in Blacks and Native Hawaiians (by race, P for heterogeneity = 0.0002 and 0.008, respectively). Weight change since age 21 years was positively associated with high-grade disease (for ≥ 40 pounds (18 kg) vs. 10 pounds (4.5 kg), HR = 1.20, 95% CI: 1.05, 1.37; P for trend  =  0.005). Comparing highest versus lowest quartile, waist-to-hip ratio was associated with a 1.78-fold increase (95% CI: 1.28, 2.46) in the risk of advanced prostate cancer. Positive associations with the majority of anthropometric measures were observed in all 5 racial/ethnic groups, suggesting a general impact of anthropometric measures on risk across populations. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to analyse the dietary habits identified by diet quality scores (DQS) in the scope of body fatness (BF) and nutritional knowledge (NK) of polycystic ovary syndrome (PCOS) women.Design: Case-control study. The DQS were accessed by Dietary Habits, and Nutrition Beliefs Questionnaire (KomPAN, The Committee of Human Nutrition, Polish Academy of Science) included food frequency consumption of thirty-three food items and was formulated by six diet indexes: Pro-Healthy-Diet-Index (pHDI-10), Non-Healthy-Diet-Index (nHDI-14), High-Glycemic-Diet-Index-7 (hGIDI-7), Low-Glycemic-Diet-Index-4 (lGIDI-4), High-Sugar-Diet-Index-4 (hSDI-4) and High-Saturated-Fats-Diet-Index-8 (hSFDI-8). The BF was analysed by air displacement plethysmography (BodPod, Life Measurement Inc.). NK was assessed by using the twenty-five 'true or false' statements included in the KomPAN questionnaire.Setting: Poland, Clinical Hospital, Department of Endocrinology, Metabolism, and Internal Diseases.Participants: The study group included 122 PCOS women and 116 age- and socio-economic status-matched healthy controls (CON) aged 17-44 years.Results: Higher BF and lower NK in PCOS women v. controls were observed. PCOS women had a lower pHDI-10 and LGIDI-4 than CON. There was no relation between NK and DQS in PCOS women. The higher NK in the CON group was associated with increased intensity of pHDI-10 and lower frequency of hSFDI-8 levels.Conclusions: Pro-healthy DQS and NK of PCOS women in this study were lower than CON. Professional dietary education might improve dietary behaviours and understanding of the necessity of dietary habits modification in this group. A multidisciplinary approach is needed in the treatment of PCOS women. [ABSTRACT FROM AUTHOR]

The most widely used method in professional sports for fat percentage assessment is the skinfold method. However, there is the chance of bias and human error. For this reason, other more precise methods are used, such as single-frequency bioelectrical impedance analysis (BIA) or dual energy X-ray absorptiometry (DEXA). However, there are limited data that demonstrate the methodological shortcomings or congruences in fat and fat-free mass estimates including gender differences and differences in athlete populations. Thus, the aim of the present study was to compare total body fat (%BF) estimated by six skinfold thickness measurement (SKF) and single-frequency bioelectrical impedance analysis (BIA) methods, using three different sets of equations, to that assessed by the dual energy X-ray absorptiometry (DEXA) method using a DEXA Hologic Serie Discovery QDR. For this aim, 76 males and 70 females belonging to the professional Spanish football federation were evaluated. We found significant differences between the three measures. BIA significantly underestimates the fat percentage, followed by skinfolds. With DEXA being the more objective or accurate method, an equation is established by means of linear regression analysis that allows the percentage of adipose tissue to be obtained either through anthropometry or electrical bioimpedance and adjusted to that which would be obtained by the DEXA system.

Background: The mechanistic target of rapamycin (mTOR) pathway promoted by positive energy imbalance and insulin-like growth factors can be a mechanism by which obesity influences breast cancer risk. We evaluated the associations of body fatness with the risk of breast cancer varied with phosphorylated (p)-mTOR protein expression, an indication of the pathway activation.Methods: Women with newly diagnosed breast cancer (n = 715; 574 [80%] Black and 141 [20%] White) and non-cancer controls (n = 1983; 1280 [64%] Black and 713 [36%] White) were selected from the Women's Circle of Health Study. Surgical tumor samples among the cases were immunostained for p-mTOR (Ser2448) and classified as p-mTOR-overexpressed, if the expression level ≥ 75th percentile, or p-mTOR-negative/low otherwise. Anthropometrics were measured by trained staff, and body composition was determined by bioelectrical impedance analysis. Odds ratios (ORs) of p-mTOR-overexpressed tumors and p-mTOR-negative/low tumors compared to controls were estimated using polytomous logistic regression. The differences in the associations by the p-mTOR expression status were assessed by tests for heterogeneity.Results: Cases with p-mTOR-overexpressed tumors, but not cases with p-mTOR-negative/low tumors, compared to controls were more likely to have higher body mass index (BMI), percent body fat, and fat mass index (P-heterogeneity < 0.05), although the OR estimates were not significant. For the measurement of central adiposity, cases with p-mTOR overexpressed tumors had a higher odds of being at the Q3 (OR = 2.52, 95% CI = 1.46 to 4.34) and Q4 (OR = 1.99, 95% CI = 1.12 to 3.50) of waist circumference (WC) compared to controls. Similarly, cases with p-mTOR overexpressed tumors had a higher odds of being at the Q3 (OR = 1.82, 95% CI = 1.11 to 2.98) and Q4 (OR = 1.81, 95% CI = 1.11 to 2.98) of WHR compared to controls. These associations of WC and waist-to-hip ratio (WHR) did not differ by tumor p-mTOR status (P-heterogeneity = 0.27 and 0.48, respectively).Conclusions: Our findings suggest that in this population composed of predominately Black women, body fatness is associated with breast cancer differently for p-mTOR overexpression and p-mTOR negative/low expression. Whether mTOR plays a role in the obesity and breast cancer association warrants confirmation by prospective studies. [ABSTRACT FROM AUTHOR]

Purpose: Rates of obesity and obesity-related health consequences, including type 2 diabetes (T2D) and cancer, continue to rise. While cancer patients are at an increased risk of developing T2D, the prevalence of T2D and insulin prescription among young patients with cancer remains unknown. Methods: Using the Total Cancer Care Study cohort at Huntsman Cancer Institute (Salt Lake City, UT), we identified individuals age 18–39 years at cancer diagnosis between 2009 and 2019. Multivariable logistic regression was used to investigate associations between body mass index (BMI) with insulin prescription within 1 year of cancer diagnosis. Results: In total, 344 adolescents and young adults (AYAs) were diagnosed with primary invasive cancer. Within this cohort, 19 patients (5.5%) were ever diagnosed with T2D, 48 AYAs ever received an insulin prescription (14.0%), and 197 were overweight or obese (BMI: 25+ kg/m2) at cancer diagnosis. Each kg/m2 unit increase in BMI was associated with 6% increased odds of first insulin prescription within 1 year of cancer diagnosis among AYAs, even after adjustment for age, sex, smoking history, marital status, glucocorticoid prescription, and cancer treatments (odds ratio = 1.06, 95% confidence interval 1.02–1.11; p = 0.005). Conclusion: One in every 18 AYAs with cancer ever had T2D, 1 in 7 AYA patients with cancer ever received an insulin prescription, and higher BMI was associated with increased risk of insulin prescription within a year of cancer diagnosis among AYAs. Understanding the incidence of T2D and insulin prescription/use is critical for short-term and long-term clinical management of AYAs with cancer. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this meta-analysis was to investigate the associations between combined cardiovascular fitness, obesity, and the risk of metabolic syndrome.Data Sources: The MEDLINE and EMBASE databases were used to select relevant studies that included the relative risk (RRs) of metabolic syndrome based on the combined effects of cardiovascular fitness and obesity from January 1990 to July 2019.Study Inclusion and Exclusion Criteria: The inclusion criteria were providing the RRs for the associations between combined cardiovascular fitness and obesity and the risk of metabolic syndrome. The exclusion criteria were review studies, duplicated studies, and no RRs reported for those associations.Data Extraction: All selected studies categorized levels of cardiovascular fitness (high cardiovascular fitness vs low cardiovascular fitness) and obesity (normal vs obesity) and directly extracted the RRs for the risk of metabolic syndrome from these data. All selected studies were cross-sectional studies.Data Synthesis: All RRs and 95% CIs from the selected studies were computed to find the associations between combined cardiovascular fitness and obesity and the risk of metabolic syndrome.Results: A total of 8 studies were selected for this meta-analysis. Low cardiovascular fitness was associated with 3. Fifty-nine times increased metabolic syndrome risk regardless of obesity (3.59, 95% CI: 3.07-4.20; P = .00). And obesity was associated with 1.62 times increased metabolic syndrome risk regardless of cardiovascular fitness level (1.62, 95% CI: 1.32-1.98; P = .00). Lastly, the risk of metabolic syndrome decreased by 77% with high cardiovascular fitness regardless of obesity (0.23, 95% CI: 0.12-0.43; P = .00).Conclusions: The combined effects of cardiovascular fitness and obesity are important factors when determining metabolic syndrome risk. The minimum level of cardiovascular fitness is 8.39 metabolic equivalent (METs) for adults to lower the risk of metabolic syndrome. Enhanced cardiovascular fitness and maintaining normal weight should be recommended for individuals to reduce the risk of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Purpose: Excess body weight has been associated with increased risk of 13 cancer types and is a particularly strong risk factor for endometrial cancer (EC). Only a few previous studies have assessed the relationship between excess body weight and EC subtypes. In this study, we aimed to investigate the associations between excess weight and incidence of type 1 and type 2 EC. Patients and Methods: We used data from 151,537 participants in the Norwegian Women and Cancer (NOWAC) cohort of which 935 were diagnosed with type 1 and 263 with type 2 EC during follow-up. Height and body weight were self-reported. Multivariable Cox proportional hazard regression was used to assess the associations between body mass index (BMI) and type 1 and type 2 EC. Results: For every 2 kg/m2 increase in BMI, the risk of type 1 EC increased by 21% (HR=1.21, 95% CI: 1.18, 1.24) and the risk of type 2 EC by 10% (HR=1.10, 95% CI: 1.03, 1.16) (pheterogeneity = 0.009). During the period 1991 to 2016, 24.0% (95% CI: 20.0% to 27.8%) of type 1 EC cases was attributable to excess body weight. Avoiding obesity could have prevented 6.6% (95% CI: 3.4% to 9.7%) of type 2 EC cases. Conclusion: Excess body weight was associated with both type 1 and type 2 EC in a dose-dependent manner and the association was significantly stronger in type 1 EC. These findings could support the hypothesis that estrogen plays a more important role in the development of type 1 ECs than in type 2 EC. [ABSTRACT FROM AUTHOR]

High body mass index (BMI) has been associated with an increased risk of several cancers. Evidence relating body fatness, especially based on different anthropometric measures, to risk of major cancers in China from prospective cohort studies is lacking. The prospective China Kadoorie Biobank study recruited 0.5 million adults aged 30–79 years from 10 diverse areas across China during 2004–2008, recording 21,474 incident cancers during 8.95 years of follow‐up. BMI, body fat percentage (BFP), waist circumference (WC) and waist‐to‐hip ratio (WHR) were measured at baseline. We assessed the associations of body fatness with 15 major cancers by calculating Cox regression yielded adjusted hazard ratios (HRs). Each 5 kg/m2 increase in BMI was associated with an increased risk of endometrial (HR, 2.01; 95% CI, 1.72–2.35), postmenopausal breast (HR, 1.29; 95% CI, 1.18–1.40), colorectal (HR, 1.17; 95% CI, 1.10–1.25) and cervical (HR, 1.15; 95% CI, 1.03–1.29) cancer, whereas it was associated with a reduced risk of esophageal (HR, 0.73; 95% CI, 0.67–0.79), lung (HR, 0.78; 95% CI, 0.74–0.82), liver (HR, 0.85; 95% CI, 0.79–0.92) and gastric (HR, 0.88; 95% CI, 0.82–0.94) cancer. Significant linear trends of BMI‐cancer associations were observed, excluding for lung, gastric and cervical cancer (both overall and nonlinear p < 0.05). The relation between BFP, WC and WHR and the above cancers was similar to that of BMI. Our study indicates that either high or low body fatness contributes to the incidence of different types of cancer in China. What's new? Obesity and overweight are associated with an increased risk of several cancers. However, most studies have focused only on Caucasian populations. In this large, prospective study of people in China, the authors found that a high BMI was again associated with significantly increased risks, specifically for endometrial, breast, colorectal, and cervical cancers. (Surprisingly, high BMI appeared to reduce the risk of esophageal, lung, liver, and gastric cancers.) These results highlight the importance of encouraging healthy levels of body fat in the Chinese population. [ABSTRACT FROM AUTHOR]

Obesity and excess adiposity account for approximately 20% of all cancer cases; however, biomarkers of risk remain to be elucidated. While fibroblast growth factor-2 (FGF2) is emerging as an attractive candidate biomarker for visceral adipose tissue mass, the role of circulating FGF2 in malignant transformation remains unknown. Moreover, functional assays for biomarker discovery are limited. We sought to determine if human serum could stimulate the 3D growth of a non-tumorigenic cell line. This type of anchorage-independent 3D growth in soft agar is a surrogate marker for acquired tumorigenicity of cell lines. We found that human serum from cancer-free men and women has the potential to stimulate growth in soft agar of non-tumorigenic epithelial JB6 P+ cells. We examined circulating levels of FGF2 in humans in malignant transformation in vitro in a pilot study of n = 33 men and women. Serum FGF2 levels were not associated with colony formation in epithelial cells (r = 0.05, p = 0.80); however, a fibroblast growth factor receptor-1 (FGFR1) selective inhibitor significantly blocked serum-stimulated transformation, suggesting that FGF2 activation of FGFR1 may be necessary, but not sufficient for the transforming effects of human serum. This pilot study indicates that the FGF2/FGFR1 axis plays a role in JB6 P+ malignant transformation and describes an assay to determine critical serum factors that have the potential to promote tumorigenesis.

Excess body weight is thought to increase the risk of aggressive prostate cancer (PCa), although the biological mechanism is currently unclear. Body fatness is positively associated with a diminished cellular response to insulin and biomarkers of insulin signalling have been positively associated with PCa risk. We carried out a two-pronged systematic review of (a) the effect of reducing body fatness on insulin biomarker levels and (b) the effect of insulin biomarkers on PCa risk, to determine whether a reduction in body fatness could reduce PCa risk via effects on the insulin signalling pathway. We identified seven eligible randomised controlled trials of interventions designed to reduce body fatness which measured insulin biomarkers as an outcome, and six eligible prospective observational studies of insulin biomarkers and PCa risk. We found some evidence that a reduction in body fatness improved insulin sensitivity although our confidence in this evidence was low based on GRADE (Grading of Recommendations, Assessment, Development and Evaluations). We were unable to reach any conclusions on the effect of insulin sensitivity on PCa risk from the few studies included in our systematic review. A reduction in body fatness may reduce PCa risk via insulin signalling, but more high-quality evidence is needed before any conclusions can be reached regarding PCa.

Advanced prostate cancer etiology is poorly understood. Few studies have examined associations of anthropometric factors (e.g. early adulthood obesity) with advanced prostate cancer risk. We carried out pooled analyses to examine associations between body fatness, height, and prostate cancer risk. Among 830 772 men, 51 734 incident prostate cancer cases were identified, including 4762 advanced (T4/N1/M1 or prostate cancer deaths) cases, 2915 advanced restricted (same as advanced, but excluding localized cancers that resulted in death) cases, 9489 high-grade cases, and 3027 prostate cancer deaths. Cox proportional hazards models were used to calculate study-specific hazard ratios (HR) and 95% confidence intervals (CI); results were pooled using random effects models. No statistically significant associations were observed for body mass index (BMI) in early adulthood for advanced, advanced restricted, and high-grade prostate cancer, and prostate cancer mortality. Positive associations were shown for BMI at baseline with advanced prostate cancer (HR = 1.30, 95% CI = 0.95–1.78) and prostate cancer mortality (HR = 1.52, 95% CI = 1.12–2.07) comparing BMI ≥35.0 kg/m2 with 21–22.9 kg/m2. When considering early adulthood and baseline BMI together, a 27% higher prostate cancer mortality risk (95% CI = 9% to 49%) was observed for men with BMI <25.0 kg/m2 in early adulthood and BMI ≥30.0 kg/m2 at baseline compared with BMI <25.0 kg/m2 in early adulthood and BMI <30.0 kg/m2 at baseline. Baseline waist circumference, comparing ≥110 cm with <90 cm, and waist-to-hip ratio, comparing ≥1.00 with <0.90, were associated with significant 14%–16% increases in high-grade prostate cancer risk and suggestive or significant 20%–39% increases in prostate cancer mortality risk. Height was associated with suggestive or significant 33%–56% risks of advanced or advanced restricted prostate cancer and prostate cancer mortality, comparing ≥1.90 m with <1.65 m. Our findings suggest that height and total and central adiposity in mid-to-later adulthood, but not early adulthood adiposity, are associated with risk of advanced forms of prostate cancer. Thus, maintenance of healthy weight may help prevent advanced prostate cancer. • Few have examined the role of early adulthood BMI and adult BMI changes on risk of advanced forms of prostate cancer. • Height in mid/late adulthood was positively associated with advanced prostate cancer risk and mortality. • BMI and waist circumference in mid/late adulthood was positively associated with advanced prostate cancer risk and mortality. • Change in BMI from early to mid/late adulthood were positively associated with advanced prostate cancer risk and mortality. • BMI in early adulthood was not associated with risk of advanced forms of prostate cancer and prostate cancer mortality. [ABSTRACT FROM AUTHOR]

Cross-sectional study aimed to analyse differences in cognitive performance across fitness components categories (cardiorespiratory fitness [CRF], speed-agility and muscular fitness [MF]) and weight status in children, and to determine whether physical fitness mediates the association between body mass index (BMI) and cognitive performance. Fitness components and BMI were measured using standard procedures in 630 children aged 5-to-7 years from the provinces of Cuenca and Ciudad Real, Spain. BADyG was used to assess cognitive performance. We used ANCOVA models to test mean differences in cognition scores by BMI and fitness categories. Hayes's PROCESS macro was used for mediation analyses. Children with normal weight scored better in spatial factor and general intelligence than their overweight/obese peers (p < 0.05), but differences were attenuated when controlling for CRF (p > 0.05). Children with better results in CRF and speed-agility scored better in all cognitive dimensions even after controlling for BMI (p < 0.05). Similarly, children with high MF obtained better scores in verbal factor (p < 0.05). All fitness components acted as mediators of the relationship between BMI and general intelligence (p < 0.05). These findings highlight the crucial role of fitness in minimising the negative effect of excess weight on children's cognition. Abbreviations: BMI: Body mass index; CRF: Cardiorespiratory fitness; MF: Muscular fitness; BADyG E1: Battery of general and differential aptitudes; SES: Socioeconomic status; SD: Standard deviation; IE: Indirect effect [ABSTRACT FROM AUTHOR]

Background: The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). Methods: The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. Results: The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07–1.21) and MetS (OR 1.48, 1.37–1.60), but not with diabetes (OR 1.05, 0.94–1.16). In subjects with a BMI < 25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. Conclusions: The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings. [ABSTRACT FROM AUTHOR]

Background Reduced net acid excretion (NAE) capacity indicates a decrease in renal function. This reduction manifests as a disproportionally low 24-h urine pH in relation to the sum of actually excreted ammonium and titratable acidity by the kidney. Objective The aim of this study was to test the hypothesis that higher body fatness is one determinant of kidney function impairment with a lowered urine pH even at a young age. Methods NAE, pH, urea, and creatinine were measured in 24-h urine samples from 524 healthy children and adolescents (aged 6–17 y) participating in the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study. Body fatness was assessed anthropometrically by body mass index-standard deviation score (BMI-SDS), fat mass index (FMI), body fat % (BF%), and waist circumference (WC). Multivariable linear and mixed linear regressions were used to examine cross-sectionally (n  = 524 urine samples; age groups: 6–8, 9–11, 12–14, 15–17 y) and longitudinally (n  = 1999 urine samples) the associations of body fatness with 24-h urine pH as the outcome variable, respectively. Results After adjusting for the kidneys' total net acid load (24-h urinary NAE) and further relevant covariates, FMI showed significant inverse relations with urinary pH in all 4 age groups, and BMI-SDS, BF%, and WC each in 3 out of these 4 groups (P  ≤ 0.02). Longitudinal results substantiated these interindividual relations and further showed intraindividual increases in body fatness to be paralleled by urine pH decreases (P  ≤ 0.0002). Conclusions Independent of underlying acid load, an early increase in body fatness is associated with increased free proton excretion, and thus with a decline in the kidney's acid excretion function, which could potentiate the risk of renal nephrolithiasis. [ABSTRACT FROM AUTHOR]

The prevalence of excess body weight and the associated cancer burden have been rising over the past several decades globally. Between 1975 and 2016, the prevalence of excess body weight in adults-defined as a body mass index (BMI) ≥ 25 kg/m2 -increased from nearly 21% in men and 24% in women to approximately 40% in both sexes. Notably, the prevalence of obesity (BMI ≥ 30 kg/m2 ) quadrupled in men, from 3% to 12%, and more than doubled in women, from 7% to 16%. This change, combined with population growth, resulted in a more than 6-fold increase in the number of obese adults, from 100 to 671 million. The largest absolute increase in obesity occurred among men and boys in high-income Western countries and among women and girls in Central Asia, the Middle East, and North Africa. The simultaneous rise in excess body weight in almost all countries is thought to be driven largely by changes in the global food system, which promotes energy-dense, nutrient-poor foods, alongside reduced opportunities for physical activity. In 2012, excess body weight accounted for approximately 3.9% of all cancers (544,300 cases) with proportion varying from less than 1% in low-income countries to 7% or 8% in some high-income Western countries and in Middle Eastern and Northern African countries. The attributable burden by sex was higher for women (368,500 cases) than for men (175,800 cases). Given the pandemic proportion of excess body weight in high-income countries and the increasing prevalence in low- and middle-income countries, the global cancer burden attributable to this condition is likely to increase in the future. There is emerging consensus on opportunities for obesity control through the multisectoral coordinated implementation of core policy actions to promote an environment conducive to a healthy diet and active living. The rapid increase in both the prevalence of excess body weight and the associated cancer burden highlights the need for a rejuvenated focus on identifying, implementing, and evaluating interventions to prevent and control excess body weight. [ABSTRACT FROM AUTHOR]