Metabolically healthy obesity and health risks - a review of meta-analyses.

OBJECTIVE: This article briefly summarizes the results of existing research on metabolically healthy obesity in the context of health risks. METHODS: The PubMed database was searched for relevant meta-analyses addressing metabolically healthy obesity in the context of health risks. RESULTS: We included a total of 17 relevant meta-analyses in this review. The results of the studied meta-analyses showed that metabolically healthy obesity may be only a transient condition associated with an increased risk of developing metabolic abnormalities in the future. People with obesity without metabolic abnormalities have an increased risk of type 2 diabetes, cardiovascular disease, cancer, chronic kidney disease, and depressive syndrome. In addition, all people with obesity are at risk of pathogenesis resulting from the mechanical stress caused by presence of abnormal adipose tissue, such as sleep apnoea syndrome or skin problems. CONCLUSION: Based on the results of meta-analyses, we recommend motivating all obese patients to change their lifestyle regardless of the presence of metabolic defects.

Changes in Segmental Impedances and Selected Body Composition Parameters Assessed by Multi-Frequency Bioimpedance Analysis after Fluid Consumption in Healthy Young Population.

Objectives: Body composition (BC) analysis is a routine part of comprehensive public health care. Assessment of BC is more important source of information than BMI. Adherence to the standard measurement conditions is essential for the correct results. Our study aimed to examine the effect of acute fluid consumption on measures of body mass (BM), percentage of body fat (%BF), visceral fat (VF), percentage of body water (%BW), and impedance at 100 kHz (I100) and 20 kHz (I20) using segmental multi-frequency bioelectrical impedance analysis (SMF-BIA) in a general healthy population. Methods: 95 consecutive healthy normal-weight adults (42 men; 53 women) were involved in the study (mean ± s.d.; age 23.9±1.6 years; body mass 68.3±14.1 kg). All subjects underwent two separate series of body composition (BC) measurements at 0 (BASELINE), 30, 60, 90 min (POST): the first series after drinking 600 ml of isotonic carbohydrate/electrolyte drink (IST) and the second after no fluid administration (CON). Individual measurements were performed in the morning on two consecutive days. Results: In the IST group, BM, VF (both P<0.001), and %BF (P<0.05) increased significantly at 30 min POST compared to BASELINE. BM and VF remained elevated at 90 min POST (both P<0.001). %BW decreased significantly at 30 min POST (P<0.01) then increased at 60 min (P<0.001) and 90 min (P<0.01) POST. There were no significant changes in I100. I20 increased significantly at 30 min POST (P<0.001) then decreased at 60 min (P<0.001) and 90 min POST (P<0.01) compared to BASELINE. In the CON group, BM and VF decreased below BASELINE at 90 min POST (P<0.001), %BF, %BW and I100 did not change significantly. The difference between IST and CON was statistically significant for all POST measurement times only in BM and VF (both P<0.001). The VF results are also underlined by the detected impedance changes in the trunk area at 20 kHz (B20) and 100 kHz (B100) at 60 min and 90 min (both P<0.001). Conclusions: Our study suggests that segmental impedances and BC measurement in healthy young normal-weight adults requires strict adherence to fluid restriction at least 90 min before the measurement to avoid false impedance values and overestimation of BM and VF.

Factors influencing basal metabolism of Czechs of working age from South Moravia.

OBJECTIVE: Basal metabolic rate (BMR) is the main part of the total body energy expenditure. The value of BMR is individual and depends on a lot of factors. The goal of the research was to discover the influence of anthropometric parameters, age and gender, on changes of the BMR values. METHODS: A total of 177 individuals of Czech Caucasian origin from South Moravia (BMI 27.3 ± 7.88 kg/m2) aged 18-55 (117 women, 60 men) were included in the study. Selected anthropometric characteristics were measured using a stadiometer (SECA 213) and bioelectrical impedance analysis (Inbody 230). BMR was measured by indirect calorimetry (Cortex Metalyzer 3B). The measured values were statistically evaluated by the regression analysis and least square method (LSM). RESULTS: From the following results that the factors that influence the BMR value statistically significantly (p < 0.05) are: age, gender, body mass index, total body water, and percent of body fat. CONCLUSION: Body fat and age have both an indirect impact on the basal metabolic rate of the Czech population in working age. However, BMI and the total body water were discovered to have a direct influence on the BMR.

Higher Energy Intake Variability as Predisposition to Obesity: Novel Approach Using Interquartile Range.

OBJECTIVE: It is known that total energy intake and its distribution during the day influences human anthropometric characteristics. However, possible association between variability in total energy intake and obesity has thus far remained unexamined. This study was designed to establish the influence of energy intake variability of each daily meal on the anthropometric characteristics of obesity. METHODS: A total of 521 individuals of Czech Caucasian origin aged 16­73 years (390 women and 131 men) were included in the study, 7-day food records were completed by all study subjects and selected anthropometric characteristics were measured. The interquartile range (IQR) of energy intake was assessed individually for each meal of the day (as a marker of energy intake variability) and subsequently correlated with body mass index (BMI), body fat percentage (%BF), waist-hip ratio (WHR), and waist circumference (cW). RESULTS: Four distinct models were created using multiple logistic regression analysis and backward stepwise logistic regression. The most precise results, based on the area under the curve (AUC), were observed in case of the %BF model (AUC=0.895) and cW model (AUC=0.839). According to the %BF model, age (p<0.001) and IQR-lunch (p<0.05) seem to play an important prediction role for obesity. Likewise, according to the cW model, age (p<0.001), IQR-breakfast (p<0.05) and IQR-dinner (p <0.05) predispose patients to the development of obesity. The results of our study show that higher variability in the energy intake of key daily meals may increase the likelihood of obesity development. CONCLUSIONS: Based on the obtained results, it is necessary to emphasize the regularity in meals intake for maintaining proper body composition.

The common polymorphism Val109Asp in the omentin gene is associated with daily energy intake in the Central-European population.

BACKGROUND: Omentin is an adipokine expressed predominantly in visceral adipose tissue, with adipose tissue stromal cells being the main source. Very little is known about the relationship between the genetic variability of the omentin gene and pathophysiology of obesity, although omentin is believed to play an important role in visceral obesity development. The aim of the study was to investigate two common polymorphisms in the omentin gene (rs2274908 and rs2274907) and dietary composition and anthropometric parameters of obesity in the Central European population. MATERIAL AND METHODS: A total of 495 subjects were included into the study, they were further dividend into the non-obese, obese, and morbidly obese cohorts. Dietary habits were established using the 7-day food records and selected anthropometric parameters were measured. RESULTS: There were significant differences in genotype distributions of rs2274907 between the obese and morbidly obese cohorts (P = 0.01). In the multivariate modelling, the rs2274907 polymorphism expressed independent prediction role for the daily energy intake, independently on the age and gender (P = 0.03); the TT genotype associated with the lowest (7877 ± 2780 J/day) and the AA genotype with the highest (8764 ± 2467 J/day) average energy intake. The rs2274907 also significantly associated with the daily consumption of fat and proteins. CONCLUSION: This is, so far, the first study to investigate the polymorphisms in the omentin gene in a large population cohort of obese and non-obese individuals. Based on our results, the rs2274907 polymorphism is associated with the daily energy intake as well as daily intake of fat and protein.

Variability in CNR1 locus influences protein intake and smoking status in the Central-European population.

OBJECTIVES: The endocannabinoid receptor 1 (CB1) is encoded by the CNR1 gene and has been recently recognized to play an important role in the regulation of satiety and feeding behaviour with a huge potential of modulating metabolic response and feeding control. The aim of the study was to investigate the potential of three selected single nucleotide polymorphisms (SNPs) in the CNR1 locus on native dietary composition in the Central-European Caucasian population. METHODS: A total of 258 unrelated individuals originating from the Central-European Caucasian population were enrolled into the study and rs1049353, rs12720071, and rs806368 polymorphisms in CNR1 locus were examined in these individuals using PCR-based methodology. Body composition was assessed using a bioimpedance method, various anthropometric parameters were investigated (waist and hip circumference, skin folds), and native dietary composition was analysed using 7-day food records as well as a food frequency questionnaire. RESULTS: Allelic variations and common haplotypes in the CNR1 gene were associated with the daily intake of proteins, fluids, and fibre, regardless of the physical activity of the individuals. The common haplotype in the CNR1 gene was associated with self-reported smoking (number of cigarettes per day, smoking years). DISCUSSION: Our results indicate that specific genetic variations in the CNR1 gene may act as susceptibility markers for specific dietary composition in the Central-European population.

[The relationship between sleep and obesity: current perspective]. / Soucasné poznatky o vztahu spánku a obezity.

Disruption of circadian rhythms negatively affects regulation of metabolism and energy homeostasis. Disrupted metabolism in response to disrupted biological rhythms might lead, together with genetic background, to obesity and to other health complications. Results of epidemiologic surveys are consistent with mechanistic theory showing the interconnection between the biological rhythms, sleep and metabolism. Epidemiologic surveys confirm that sleep duration of less than 6 hours increases significantly the risk of obesity. Systematic reviews of epidemiologic surveys examining association of sleep and obesity refer to large heterogeneity in involved subjects, methodological approaches of measuring obesity and sleep, and confounders. Design of study plays also essential role in interpretation and definition of causal relationship. Reduced sleep duration in relation to obesity is in the literature discussed from different points of view: 1. as a possible primary cause of obesity, 2. as a result of comorbidities resulting from obesity and 3. as an accompanied part of the third factor contributing to obesity (e.g. long working hours, chronic emotional stress, overusing of media). Causal relationship between sleep and obesity is not yet fully elucidated, however the association is supposed to be bidirectional. The article gives an overview of current knowledge concerning the influence of sleep on the development of obesity and points to the critical points of current research.

Genotype x nutrient association of common polymorphisms in obesity-related genes with food preferences and time structure of energy intake.

Personal food preferences can either enhance or suppress the development of obesity and the selection and proportion of macronutrients in the diet seem to have a heritable component. In the present study, we therefore focused on dietary composition as a specific trait related to obesity and we determined whether genetic variations in leptin (LEP), LEP receptor (LEPR), adiponectin (ADIPOQ), IL-6 and pro-opiomelanocortin (POMC) underlie specific native food preferences and obesity-related anthropometric parameters. The total of 409 individuals of Czech Caucasian origin were enrolled into the present study and 7 d food records were obtained from the study subjects along with selected anthropometric measurements. In a subset of study subjects, plasma levels of ADIPOQ, LEP and soluble LEPR were measured. Independently of the BMI of the individuals, common variations in LEP and LEPR genes were associated with specific eating patterns, mainly with respect to timing of eating. The LEP + 19A/G polymorphism served as an independent predictor for BMI, percentage of body fat and skinfold thickness and significantly affected the time structure of the daily energy intake. The POMC RsaI polymorphism was associated with percentage of body fat. The ADIPOQ 45 T/G polymorphism was associated with the thickness of the subscapular skinfold. The LEPR Gln223Arg polymorphism was associated with multiple parameters, including diastolic blood pressure, meal sizes during the day and plasma ADIPOQ levels. In a separate analysis, soluble leptin receptor (sObR) plasma levels and LEP:sObR ratio were significantly correlated with systolic blood pressure (beta = - 0.66, P = 0.002; beta = - 1.23, P = 0.02) and sObR plasma levels also served as an independent predictor for diastolic blood pressure (beta = - 0.50; P = 0.04). To conclude, we report common allelic variants associated with specific feeding behaviour and obesity-related anthropometric traits. Moreover, we identified allelic variants that significantly influence the time structure of food intake during the day.

No association of defined variability in leptin, leptin receptor, adiponectin, proopiomelanocortin and ghrelin gene with food preferences in the Czech population.

BACKGROUND: Previously, it has been reported that mutations in the genes encoding for adipokines may be associated with impaired food intake and may serve as potential obesity biomarkers. The aim of this study was to investigate the possible associations of defined variability in leptin, leptin receptor, adiponectin, proopiomelanocortin and ghrelin genes with food preferences in the obese and non-obese Czech population and evaluate their potential as the obesity susceptibility genes. PATIENTS AND METHODS: Using PCR followed by restriction analysis, we studied 185 volunteers. Basic anthropometrical characteristics associated to obesity were measured and the food intake was monitored using a 7-day record method. In the group of obese individuals, a subset of 34 morbidly obese patients was studied for plasma leptin and soluble leptin receptor levels. RESULTS: None of the examined polymorphisms was associated to anthropometrical or demographic characteristics of the study subjects. The Gln223Arg polymorphism within the leptin receptor gene was significantly associated with lower plasma leptin levels (the RR genotype being more frequent in patients with lower plasma leptin levels; P = 0.001). No associations of the examined polymorphisms with food preferences was observed. CONCLUSIONS: Based on our results, the examined polymorphisms in the adipokine genes do not seem to be the major risk factor for obesity development in the Czech population nor significantly affect food preferences.

Aerobic steps as measured by pedometry and their relation to central obesity.

BACKGROUND: The purpose of this study was to examine the relation between daily steps and aerobic steps, and anthropometric variables, using the waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). METHODS: The participants in this cross-sectional study were taken the measurements of by a trained anthropologist and then instructed to wear an Omron pedometer for seven consecutive days. A series of statistical tests (Mann-Whitney U test, Kruskal-Wallis ANOVA, multiple comparisons of z' values and contingency tables) was performed in order to assess the relation between daily steps and aerobic steps, and anthropometric variables. RESULTS: A total of 507 individuals (380 females and 127 males) participated in the study. The average daily number of steps and aerobic steps was significantly lower in the individuals with risky WHR and WHtR as compared to the individuals with normal WHR (P=0.005) and WHtR (P=0.000). A comparison of age and anthropometric variables across aerobic steps activity categories was statistically significant for all the studied parameters. According to the contingency tables for normal steps, there is a 5.75x higher risk in the low-activity category of having WHtR>0.50 as compared to the high-activity category. CONCLUSIONS: Both normal and aerobic steps are significantly associated with central obesity and other body composition variables. This result is important for older people, who are more likely to perform low-intensity activities rather than moderate- or high-intensity activities. Our results also indicate that risk of having WHtR>0.50 can be reduced by almost 6x by increasing daily steps over 8985 steps per day.

The prediction role of indexes of circulating adipokines for common anthropometric and nutritional characteristics of obesity in the obese Central European population.

AIMS: This study was designed to investigate the relationship between 8 selected adipokines (leptin, leptin receptor, adiponectin, agouti-related peptide, omentin, visfatin, adipsin and resistin), dietary composition and anthropometric parameters found in the Central European obese population. METHODS: A total of 65 unrelated obese Central European Caucasian individuals were recruited for the study. Phenotypic measurements included weight, height, BMI, lean body mass, fat mass, body fat, waist and hip circumference, waist-hip ratio (WHR) and skinfold thickness. Participants completed standardized self-reported 7-day food records. Plasma levels of leptin, leptin receptor, adiponectin, agouti-related peptide (AgRP), resistin, adipsin, omentin and visfatin were examined using ELISA. RESULTS: Multiple associations (weight, height, percentage of body fat, waist circumference, hip circumference, WHR and sum of skinfold thickness) with the circulation levels of the investigated adipokines were identified. Leptin-Leptin receptor (L-LR) levels were found to correlate with total energy intake and macronutrients while adipsin was found to strongly correlate with multiple adipokines. Furthermore, the L-LR index was found to constitute a more accurate description of the relationship between BMI and body weight than individual measurements and the Ag-LR index was found to strongly correlate with both anthropometric and dietary characteristics. CONCLUSION: Following confirmation on larger population samples and on samples of different ethnicities, the reported adipokine indexes could become a useful tool for estimating nutritional status and predicting the body composition of specific patient groups.

Association of genetic variability in selected regions in visfatin (NAMPT) gene with anthropometric parameters and dietary composition in obese and non-obese Central-European population.

AIMS: Visfatin (NAMPT/PBEF) is a recently identified adipocytokine which harbors strong insulin-mimetic activity and was reported to be associated with obesity. However, nothing is known about whether visfatin is related to specific nutritional behavior which may result in obesity development. This is the first study focusing on genetic variability of the visfatin gene and its association with circulating visfatin, anthropometric parameters and dietary composition. MATERIALS AND METHODS: We analyzed a total of 11 exons and adjacent non-coding regions of the NAMPT gene in 20 extremely obese Czech individuals (mean BMI 52.2±5.0 SD) using direct sequencing and a frequency of rs2302559 was established in the validation cohort of another 605 individuals with completed 7-day food records and complex anthropometric measurements. Serum levels of visfatin, leptin and leptin-receptor were measured in all sequenced individuals and in part of the validation cohort. RESULTS: Three common polymorphisms were identified, two in non-coding regions (rs78411774 A/C, rs71564769 A/C) and one synonymous SNP in exon 7 (rs2302559 A/G). The rs2302559 showed significant correlation with visfatin serum level throughout the entire study cohort (p<0.001); there was a significant tendency toward higher visfatin levels in G allele carriers with GG homozygotes having the highest visfatin serum levels. Furthermore, a negative correlation was observed between visfatin and leptin serum level (p=0.01). No association between investigated SNPs and anthropometric parameters or native dietary composition was observed. CONCLUSION: This is the first study to demonstrate that the rs2302559 polymorphism in the PBEF gene is related to circulating levels of visfatin. As the SNP is synonymous, we hypothesize it might be linked to another SNP in the PBEF gene which controls visfatin serum levels.

Relation between adiponectin 45 T/G polymorphism and dietary composition in the Czech population.

In this study on 138 Czech Caucasians, the ADIPOQ 45T/G polymorphism was associated with the dietary composition. As the GG homozygotes were associated with the increased intake of carbohydrates, we suggest that a proportion of the prodiabetogenic effect of the polymorphism might be due to its influence on eating behaviour.

Effect of ID ACE gene polymorphism on dietary composition and obesity-related anthropometric parameters in the Czech adult population.

The aim of this study was to investigate the possible associations between insertion/deletion (ID) polymorphism in angiotensin-converting enzyme (ACE) (dbSNP rs 4646994) with the food intake and body composition in the Czech non-obese, obese and extremely obese populations. A total of 453 various-weighted individuals were enrolled in the study and were according to their BMI assigned into following subgroups, such as obese (30 /=40) and non-obese (20 < BMI < 30) subjects. Both the obese cases and the non-obese controls underwent the identical subset of standardized examinations (BMI, % body fat, waist-to-hip ratio, skin fold thickness, native dietary composition examined by 7-day food records, etc.). No significant case-control differences in genotype distributions or allelic frequencies were observed. There were no differences in genotype frequencies between males and females either. The prevalence of obesity was significantly higher among subjects with the II genotype (42 %) when compared with those with DD (36%) and those with ID (37%) genotypes (P = 0.04). When compared with carbohydrate intake in the whole studied cohort, the odds ratios of carrying the DD allele in the morbidly obese cohort were 0.84 (95% CI 0.34, 2.10, P = 0.17), 0.27 (0.07, 0.98, P = 0.02), and 4.25 (1.44, 12.51, P = 0.005) in those individuals consuming <210, 210-260, and >260 g of carbohydrates/day, respectively. Based on our findings, the ID ACE polymorphism could represent a gene modulator of carbohydrate intake in morbidly obese Czech population; the strong significant effect of DD genotype was observed in the phenotypes of extreme obesity with the highest carbohydrate intake.