Fourteen-year trends in overweight, general obesity, and abdominal obesity in Amazonian indigenous peoples.

BACKGROUND: Available data show that the epidemiological profile of most indigenous Brazilian populations is characterized by the coexistence of long-standing health problems (high prevalence of infectious and parasitic diseases, malnutrition, and deficiency diseases, such as anemia in children and women of reproductive age), associated with new health problems, especially those related to obesity (hypertension, type 2 diabetes mellitus and dyslipidemia). Based on this scenario, this study analyzed the nutritional profile of the adult population of seven indigenous peoples from the Brazilian Amazon in the years 2007 and 2021. METHODS: A total of 598 adults individuals were analyzed in 2007 (319 women and 279 men) and 924 in 2021 (483 women and 441 men), from seven indigenous peoples located in the state of Pará, who were assisted during health actions carried out in 2007 and in 2021. Body mass index classification used the World Health Organization criteria for adults: low weight, < 18.5 kg/m2; normal weight, ≥ 18.5 and < 25 kg/m2); overweight, ≥ 25 and < 30 kg/m2, and obesity, ≥ 30 kg/m2. A waist circumference (WC) < 90 cm in men and < 80 cm in women was considered normal. RESULTS: The data revealed heterogeneous anthropometric profiles, with a low prevalence of nutritional changes in the Araweté, Arara and Parakanã peoples, and high proportions of excess weight and abdominal obesity in the Kararaô, Xikrin do Bacajá, Asurini do Xingu and Gavião peoples, similar to or even higher than the national averages. CONCLUSION: Different stages of nutritional transition were identified in the indigenous peoples analyzed, despite apparently having been subjected to the same environmental pressures that shaped their nutritional profile in recent decades, which may indicate different genetic susceptibilities to nutritional changes. The evidence shown in this study strongly suggests the need to investigate in greater depth the genetic and environmental factors associated with the nutritional profile of Brazilian indigenous peoples, with assessment of diet, physical activity and sociodemographic and socioeconomic variables that enable the development of appropriate prevention and monitoring measures.

Alanine aminotransferase elevation varies by ethnicity among Asian and Pacific Islander children with overweight or obesity.

BACKGROUND: Limited research on alanine aminotransferase (ALT) screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among US Asian/Pacific Islander (PI) children necessitates investigation in this heterogeneous population. OBJECTIVE: Examine ALT elevation among Asian/PI children with overweight or obesity. METHODS: Elevated ALT prevalence (clinical threshold) and association with body mass index ≥85th percentile were compared among 18 402 Asian/PI and 25 376 non-Hispanic White (NHW) children aged 9-17 years using logistic regression. RESULTS: ALT elevation was more prevalent among Asian/PI (vs. NHW) males with overweight (4.0% vs. 2.7%), moderate (7.8% vs. 5.3%) and severe obesity (16.6% vs. 11.5%), and females with moderate (5.1% vs. 3.0%) and severe obesity (10.2% vs. 5.2%). Adjusted odds of elevated ALT were 1.6-fold and ~2-fold higher for Asian/PI (vs. NHW) males and females (with obesity), respectively. Filipino, Chinese and Southeast Asian males had 1.7-2.1-fold higher odds, but Native Hawaiian/PI (NHPI) and South Asian males did not significantly differ (vs. NHW). Filipina and Chinese females with obesity had >2-fold higher odds, Southeast and South Asian females did not differ and NHPI findings were mixed (vs. NHW). CONCLUSION: High elevated ALT prevalence among Asian/PI children with overweight and obesity emphasizes the need for MASLD risk assessment and examination of ethnic subgroups.

Impact of the COVID-19 Pandemic on Physical Activity among Mostly Older, Overweight Black Women Living in the Rural Alabama Black Belt.

Despite well-documented global declines in physical activity (PA) during the COVID-19 pandemic, little is known regarding the specific impact among underserved, rural Alabama counties. This is concerning as this region was already disproportionately burdened by inactivity and related chronic diseases and was among the hardest hit by COVID-19. Thus, the current study examined the effect of COVID-19 on PA in four rural Alabama counties. An ancillary survey was administered between March 2020 and August 2021 to the first cohort (N = 171) of participants enrolled in a larger PA trial. Main outcomes of this survey included the perceived impact of COVID-19 on PA, leisure-time PA, and social cognitive theory (SCT) constructs at 3 months. Almost half of the participants reported being less active during the pandemic (49.7%) and endorsed that COVID-19 made PA more difficult (47.4%), citing concerns such as getting sick from exercising outside of the home (70.4%) and discomfort wearing a face mask while exercising (58%). Perceived COVID-19 impact on PA was significantly associated with education, household dependents, and gender (p's < 0.05). More women, parents, and college graduates reported that the COVID-19 pandemic made PA more difficult. Overall, there were no significant associations between PA, SCT constructs, or perceived COVID-19 impact on PA scores at 3 months. While the pandemic made PA difficult for many participants, these barriers were not associated with leisure-time PA levels or related theoretical mechanisms of action, which bodes well for the success of our ongoing intervention efforts and the resiliency of these communities.

Unhealthy weight among young children in the Middle East and North African region.

OBJECTIVE: To understand early-life growth in the Middle East and North Africa (MENA) region, and how it has changed over time, we estimated the prevalence of wasting and overweight at ages under 5 years. DESIGN: Cross-sectional data from twenty-nine Demographic and Health Surveys with direct anthropometric data and parent-reported demographic information were examined. The study utilised the WHO Child Growth Standards to classify overweight (weight-for-height z-score ≥ 2 sd above the median), wasting (weight-for-height z-score ≤ 2 sd below the median) and unhealthy weight defined as either wasting or overweight. SETTING: Nationally representative for nine of the MENA countries (Armenia, Azerbaijan, Egypt, Jordan, Mauritania, Morocco, Tunisia, Turkey and Yemen). PARTICIPANTS: Children under age 5 from nine MENA countries between 1987 and 2016 (n 155 961). RESULTS: Across the region, at the most recent time point, between 7·3 and 23·6 % of children experienced unhealthy weight (Jordan - 7·3 %, Egypt -23·6 %); 1·7 and 16·6 % had wasting (Turkey, Yemen) and 2·0 and 15·0 % had overweight (Yemen, Egypt). Overweight was more common than wasting in all countries except Yemen and Mauritania. Between 1987 and 2016, the prevalence of unhealthy weight in the region increased (10·0-18·4 %) due to increases in both wasting and overweight. Boys had a higher prevalence of unhealthy weight than girls. CONCLUSION: Undernutrition continues to be a problem in some countries in the MENA region, and overnutrition is emerging as a health concern in many countries in the region. Countries in the region must advance programmes that reduce undernutrition while not overlooking or inadvertently promoting overnutrition.

Incidence of obesity across adulthood in the United States, 2001-2017-a national prospective analysis.

BACKGROUND: In the United States, the prevalence of obesity among adults has increased 3-fold since the 1980s, but patterns of incidence of new cases of obesity are not known. OBJECTIVES: To examine the incidence of new cases of obesity: overall, by demographic and educational subgroups, by weight status, and changes during this century. METHODS: We analyzed adult (≥20 y) anthropometric records from the US nationally representative Panel Study of Income Dynamics from 2001 to 2017. Among those not having obesity (body mass index, BMI, ≥30 kg/m2) at first observation, we used Poisson models to estimate the incidence of obesity [cases/1000 person-years (PYs)] and incidence rate ratio (IRR). RESULTS: Among 13,888 adults followed for 115,797 PYs, the incidence of obesity in 2001-2017 was 28.1/1000 PYs (95% CI: 26.7, 29.7). Over the periods 2001-2005, 2005-2009, and 2009-2013, the incidence of obesity was stable, but in 2013-2017 the incidence increased by 18% compared to 2009-2013 [IRR: 1.18 (95% CI: 1.06, 1.30)]. Blacks had higher obesity incidence [47.9/1000 PYs (95% CI: 42.7, 53.1)] than Whites [26.2/1000 PYs (95% CI: 24.6, 27.9)]. Risk was particularly high among Black females [57.9/1000 PYs (95% CI: 49.1, 66.8)] and Black young adults (20-29 y) [65.5/1000 PYs (95% CI: 54.2, 76.7)]. Across race, obesity incidence was highest in young adults (20-29 y) [34.1/1000 PYs (95% CI: 31.5, 36.7)] and declined with age [age 70+ y: 18.9/1000 PYs (95% CI: 16.6, 21.8)]. Those with overweight had an obesity risk 7 times higher than those with normal weight [62.1/1000 PYs (95% CI: 58.8, 65.3) vs. 8.8/1000 PYs (95% CI: 8.1, 9.6)]. Those with less than high-school education had higher obesity incidence than those with education beyond high-school [39.4/1000 PYs (95% CI: 34.4, 44.4) vs. 24.7/1000 PYs (95% CI: 23.1, 26.3)]. CONCLUSIONS: Incidence of obesity was stable over the first 13 y of the last 2 decades but increased by 18% in 2013-2017. Blacks and younger adults were at highest risk, and those with overweight were also at high risk for developing obesity.

Association between Dietary Fatty Acid Intake and Liver Steatosis and Fibrosis in a Sample of Mexican-Origin Hispanic Adults with Overweight or Obesity.

Rates of non-alcoholic fatty liver disease (NAFLD) vary dramatically among Hispanic subpopulations, with Mexican-origin (MO) Hispanics experiencing a disproportionate burden. This study examined dietary fatty acid (FA) intake among overweight and obese MO Hispanic adults in the United States (US) and evaluated its association with liver steatosis and fibrosis. Participants (N = 285, MO Hispanic adults) completed 24-h dietary recalls to assess dietary FA exposure. Liver steatosis and fibrosis were estimated using transient elastography (FibroScan®). Multiple regression analysis tested relationships between FA intakes and liver steatosis or fibrosis, adjusting for age, sex, body mass index (BMI) and total energy. A total of 51% (n = 145) of participants were suspected to have NAFLD and 20% self-reported a type 2 diabetes diagnosis. No significant association was observed between Linoleic Acid and α-Linolenic Acid (LA:ALA) ratio, or omega-6 to omega-3 (n-6:n-3) ratio and liver steatosis. However, a one-point increase in the LA:ALA ratio resulted in a 1.01% increase in the liver fibrosis scores (95% CI: [1.00, 1.03]; p = 0.03), and a one-point increase in the n-6:n-3 ratio resulted in a 1.02% increase in liver fibrosis score (95% CI: [1.01, 1.03]; p = 0.01). Further research is needed to determine if modulation of FA intake could reduce NAFLD risk in this high-risk population.

Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study.

INTRODUCTION: British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner-city areas of Bradford. METHODS: Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. RESULTS: This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women-only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. CONCLUSION: These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. PATIENT OR PUBLIC CONTRIBUTION: Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.

Neck circumference: cutoff points for Brazilian children / Circunferência do pescoço: proposta de pontos de corte para crianças brasileiras

ABSTRACT Objective The objective of the present study was to propose cutoff points of neck circumference for predicting overweight in Brazilian children. Methods We conducted a cross-sectional study with 875 children from public schools in Brazil. Weight, height, and neck circumference were measured. Nutritional status and the risk of complications were assessed based on the values of body mass index and neck circumference. Receiver operating characteristic curve analysis was used to verify the cutoff points. Results The median age was eight years, and the majority of the children had normal weights by body mass index and had no risk of metabolic complications by neck circumference. There was a correlation between neck circumference and body mass index (k=0.689; p<0.005). The mean values proposed for overweight were 29.2 cm for girls and 29.1 cm for boys. Conclusion Neck circumference had a good correlation with body mass index, and the cutoff points proposed can identify overweight in Brazilian children.

RESUMO Objetivo O objetivo do presente estudo foi propor pontos de corte para circunferência do pescoço para predição de excesso de peso em crianças brasileiras. Métodos Estudo transversal realizado com 875 crianças. Foram mensurados peso, estatura e circunferência do pescoço. O diagnóstico do estado nutricional e risco de complicações foi realizado com base nos valores de índice de massa corporal e circunferência de pescoço. Para verificar os pontos de corte foi utilizada a curva Característica de Operação do Receptor. Resultados A mediana de idade foi de oito anos e a maioria das crianças apresentou eutrofia pelo índice de massa corporal e nenhum risco de complicações metabólicas. Observou-se correlação substancial entre a circunferência do pescoço com o índice de massa corporal (k=0,689; p<0,005). Os valores médios de circunferência de pescoço propostos para excesso de peso foi 29,2 cm para meninas e 29,1 cm para meninos. Conclusão A circunferência do pescoço possui boa correlação com o índice de massa corporal e os pontos de corte aqui propostos possuem força para identificar crianças brasileiras com excesso de peso.

Nutritional status of children under five years of age in Rondônia, Brazil Northern region and in Brazil: 2008 to 2019 / Estado nutricional das crianças menores de cinco anos em Rondônia, região Norte e Brasil: 2008 a 2019

ABSTRACT Objective To describe the nutritional profiles of children under five years of age in the state of Rondônia, comparing them with those from the Northern Region of Brazil and from Brazil. Methods This was a time series ecological study. Data were collected from the Food and Nutrition Surveillance System. The information concerned Body Mass Index by age, gender and place of residence. A time-trend analysis was performed using linear regression applying the Prais-Winsten technique and serial autocorrelation verification using the Durbin and Watson test in Stata®16.0. Results There was an annual increasing trend for the thinness, risk of overweight, overweight and obesity regardless of gender, age and location and for extreme thinness, with the exception of girls and for the age of 2 to 5 years, which revealed a stationary trend. Among boys and children of both genders under two years of age, annual growth trends were higher for non-eutrophic nutritional status when compared to the other groups. The growth rates of nutritional disorders found in the Northern region were higher than in the state of Rondônia and in Brazil. Conclusion It is necessary to review health policies aiming at the promotion and prevention of nutritional problems considering the current situation where extreme conditions such as thinness and obesity coexist, with special attention to male children under 2 years of age.

RESUMO Objetivo Descrever o perfil nutricional de crianças menores de cinco anos no estado de Rondônia comparando com dados da Região Norte e do Brasil. Métodos Estudo ecológico do tipo série temporal. Os dados foram coletados do Sistema de Vigilância Alimentar e Nutricional e utilizou-se o Índice de Massa Corporal por idade, sexo e local de moradia. Foi realizada análise de tendência temporal por meio de regressão linear aplicando a técnica de Prais-Winsten e verificação de autocorrelação serial por meio do teste de Durbin e Watson no Stata®16.0. Resultados Houve tendência anual crescente para a magreza, risco de sobrepeso, sobrepeso e obesidade independente do sexo, idade e local, e para a magreza extrema com exceção das meninas e para a idade de dois a cinco anos, que tiveram tendência estacionária. Entre os meninos e crianças menores de dois anos, as tendências de crescimento foram mais elevadas para o estado nutricional não eutrófico quando comparado aos outros grupos. As taxas de crescimento de agravos nutricionais encontradas na região Norte foram superiores ao estado de Rondônia e ao Brasil. Conclusão É necessário rever as políticas de saúde visando a promoção e prevenção de agravos nutricionais considerando a atualidade e onde coabitam extremos como a magreza e obesidade, com atenção especial às crianças com menos de dois anos e do sexo masculino.

Consumption of differently processed food by public school adolescents / Consumo alimentar de adolescentes de escolas públicas segundo grau de processamento industrial dos alimentos

ABSTRACT Objective To characterize food consumption, considering the degree of industrial food processing by public schools' adolescents. Methods Cross-sectional study involving adolescents aged 14 to 19 years, of both genders, attending public schools in Juiz de Fora, MG. Food consumption was assessed using two 24-hour dietary recalls. Foods were classified into three groups according to the degree of industrial processing: (1) unprocessed foods or minimally processed foods, culinary ingredients and preparations based on these foods; (2) processed foods; (3) ultra-processed foods. In addition, weight and height information was collected, with subsequent calculation of body mass index/age to assess the individuals' nutritional status according to the gender. Pearson's chi-square, Mann-Whitney and Kruskal-Wallis tests were performed, adopting a value of p<0.05. Results The sample consisted of 804 adolescents, with a predominance of females (57.5%). In the sample, 29.9% and 26.1%, of girls and boys, respectively, were overweight. There was a difference in the daily consumption of ready-made sweet-tasting foods, being higher in females (26.2%) when compared to males (18.1%), whereas the consumption of soft drinks (one to four times a week) was 47.2% and 55.6% in girls and boys, respectively (p<0.05). Higher consumption of ultra-processed foods was observed in females (p=0.02) and processed foods in males (p=0.008). Conclusion There was a high contribution of ultra-processed foods in the diet of adolescents in public schools; a high prevalence of overweight was observed in both genders.

RESUMO Objetivo Caracterizar o consumo alimentar através do grau de processamento industrial dos alimentos consumidos por adolescentes matriculados em escolas públicas. Métodos Estudo transversal com adolescentes de 14 a 19 anos de ambos os sexos matriculados em escolas públicas de Juiz de Fora, MG. O consumo alimentar foi avaliado através de dois recordatórios de 24h. Os alimentos foram classificados em três grupos de acordo com o grau de processamento industrial: (1) alimentos in natura ou minimamente processados, ingredientes culinários e preparações a base desses alimentos; (2) alimentos processados; (3) alimentos ultraprocessados. Ademais, foram coletadas informações de peso e altura dos estudantes, com posterior cálculo de índice de massa corporal/idade para avaliação do estado nutricional conforme o sexo. Foram realizados os testes Qui-quadrado de Pearson, Mann-Whitney e Kruskal-Wallis, adotando o valor de p<0,05. Resultados A amostra foi composta por 804 adolescentes, com predomínio do sexo feminino (57,5%). Entre os adolescentes, 29,9% das meninas e 26,1% dos meninos apresentaram excesso de peso. Observou-se diferença no consumo diário de alimentos prontos de sabor doce, sendo maior no sexo feminino (26,2%) quando comparado ao masculino (18,1%), ao passo que o consumo de refrigerantes de uma a quatro vezes na semana foi de 47,2% e 55,6% nas meninas e meninos, respectivamente (p<0,05). Maior consumo de alimentos ultraprocessados foi observado no sexo feminino (p=0,02) e de alimentos processados no sexo masculino (p=0,008). Conclusão Verificou-se elevada contribuição proveniente do grupo dos alimentos ultraprocessados na dieta dos adolescentes de escolas públicas, com altas prevalências de excesso de peso em ambos os sexos.

Analysis of Eating Habits and Body Composition of Young Adult Poles.

BACKGROUND: Obesity and overweight affect a large proportion of the world's population. Increasingly, this problem can be observed among young adults. The aim of the study was to identify the motivations and barriers to healthy eating habits among young Poles, the relationship between physical activity and healthy eating and the impact of healthy eating on the body composition of the young. METHODS: The method used in the research was a diagnostic survey using direct personal interviews. The research was conducted in the years 2016-2019 on a group of 399 young Poles aged 18-26. Their body composition was analyzed by determining resistance and reactance using the biological impedance method, with a TANITA SC-330ST Body Composition Analyzer. RESULTS AND CONCLUSION: The main reasons for healthy eating among young Poles are the intent to follow a doctor's recommendations, to lose weight and to live a healthy lifestyle and to follow a trend. On the other hand, the largest barriers to proper nutrition are: lack of time to prepare healthy meals and of financial resources, inability to prepare meals and limited knowledge of the principles of healthy eating. The eating behavior varied significantly in relation to the physical activity of the respondents. Active people's eating habits were the best, and those of sedentary people the worst. Healthy eaters also had normal body composition indicators (adipose tissue level, BMI, body type). Young adults should be educated on the principles of healthy eating and have access to healthy food in canteens and vending machines, both at work and at university.

Stunting and Combined Overweight with Stunting among Schoolchildren in Kuwait: Trends over a 13-Year Period.

OBJECTIVES: This study aimed to investigate the sex- and age-specific trends of stunting and combined overweight with stunting among schoolchildren over a 13-year period in Kuwait. SUBJECTS AND METHODS: The Kuwait Nutrition Surveillance System objectively measured the height of 172,573 schoolchildren (5-19 years) over a 13-year period (2007-2019). Data on gender and date of birth were extracted from school records. Stunting was defined as height 2 standard deviations (SD) below the World Health Organization growth reference median. Logistic regression models were used to examine the trends of stunting over the study period while stratifying by gender. RESULTS: In males, the prevalence of stunting increased from 2.46% in 2007 to 4.18% in 2019 (p for trend <0.001). In females, the prevalence of stunting fluctuated but remained around 3.80% in both 2007 and 2019. The odds of stunting significantly increased in the period 2017-2019 compared to the period 2007-2010 among males, adjusted odds ratio (AOR) 1.04 (95% confidence interval [CI]: 1.14-1.76); p = 0.009, but not females, AOR 0.89 (95% CI: 0.73-1.07); p = 0.176. Although not statistically significant, there was a tendency for the odds of combined overweight with stunting to increase in males, AOR 1.65 (95% CI: 0.90-3.04); p = 0.087, but not females, AOR 1.13 (95% CI: 0.88-1.45); p = 0.248. CONCLUSION: Although the prevalence of stunting and combined stunting with overweight is low, there is an emerging upward trend in schoolboys that warrants further investigation and monitoring. This highlights the need for gender-specific interventions to reduce nutritional abnormalities in high-income countries in the Middle East countries like Kuwait.

Prevalence and Determinants of the Co-Occurrence of Overweight or Obesity and Micronutrient Deficiencies among Adults in the Philippines: Results from a National Representative Survey.

The double burden of malnutrition (DBM) affects many low- and middle-income countries. However, few studies have examined DBM at the individual level, or undernutrition and overnutrition co-occurring within the same person. This study aims to investigate the prevalence and determinants of DBM among adults in the Philippines. Data from the 2013 National Nutrition Survey were used. The sample size in the analysis was 17,010 adults aged ≥20 years old, after excluding pregnant and lactating women. DBM was defined as the co-occurrence of overweight/obesity and anemia (definition #1), overweight/obesity and anemia or vitamin A deficiency (definition #2), and overweight/obesity and anemia or vitamin A deficiency or iodine insufficiency (definition #3). Anthropometric measurements and biochemical markers were used for DBM assessment. Data were analyzed using descriptive statistics, the chi-square test, and logistic regression by R software. Results showed that definition #3 is the predominant type of DBM (7.0%) in the general population, whereas the prevalence of DBM has increased to 23.7% in overweight/obese persons. Sex, age, educational attainment, marital status, household size, wealth quintile, and smoking status were the determinants of DBM. This study revealed that Filipino adults experience malnutrition critically and must be addressed through food and nutrition interventions.

Allostatic load, metabolic syndrome and self-rated health in overweight/obese Non-Hispanic White, non-Hispanic Black and Mexican American adults.

AIM: This study examined the associations of high allostatic load (h_ALS) and metabolic syndrome (MetS) with and self-rated poor health (SRPH) in overweight/obese non-Hispanic White (NHW), non-Hispanic Black (NHB), and Mexican American (MA) adults. METHODS: The 2015-16 and 2017-18 US National Health and Nutrition Examination Survey data (n = 4403) were used for this study. RESULTS: Rates of h_ALS in overweight/obese NHW, NHW, and MA participants were 56.9%, 58.8%, and 51.9%, respectively (P < .05). The corresponding rates for MetS were 26.9%, 31.9%, and 46.5%, respectively. High ALS was associated with 2.19 (95% CI: 1.87-4.59), 1.82 (1.42-2.58), and 1.47 (95% CI: 1.08-1.64) increased odds of SRPH in overweight/obese NHW, NHB, and MA, respectively, after adjusting for age, education, gender, income, lifestyle behaviors, and marital status. The corresponding values for MetS were 1.86 (95% CI: 1.54-2.40), 2.77 (95% CI: 1.36-5.63), and 1.22 (95% CI: 1.06-2.32), respectively. CONCLUSIONS: The effect of h_ALS on SRPH was much stronger in NHW, while the effect of MetS was strongest among NHB overweight/obese adults. The result of this study provides further evidence in favor of race/ethnic-tailored interventions, including education and weight control to reduced risks of bodywear and tear and SRPH.

A community-based, multi-level, multi-setting, multi-component intervention to reduce weight gain among low socioeconomic status Latinx children with overweight or obesity: The Stanford GOALS randomised controlled trial.

BACKGROUND: There are few long-term studies of interventions to reduce in low socioeconomic status children with overweight or obesity. The Stanford GOALS trial evaluated a 3-year, community-based, multi-level, multi-setting, multi-component (MMM) systems intervention, to reduce weight gain among low socioeconomic status, Latinx children with overweight or obesity. METHODS: We did a two-arm, parallel group, randomised, open-label, active placebo-controlled trial with masked assessment over 3 years. Families from low-income, primarily Latinx communities in Northern California, CA, USA, with 7-11-year-old children with overweight or obesity were randomly assigned to a MMM intervention or a Health Education (HE) comparison intervention. The MMM intervention included home environment changes and behavioural counselling, community after school team sports, and reports to primary health-care providers. The primary outcome was child BMI trajectory over three years. Secondary outcomes included one- and two-year changes in BMI. This trial is registered with ClinicalTrials.govNCT01642836. FINDINGS: Between July 13, 2012, and Oct 3, 2013, 241 families were recruited and randomly assigned to MMM (n=120) or HE (n=121). Children's mean age was 9·5 (SD 1·4) years, 134 (56%) were female and 107 (44%) were male, and 236 (98%) were Latinx. 238 (99%) children participated in year 1, 233 (97%) in year 2, and 227 (94%) in year 3 of follow-up assessments. In intention-to-treat analysis, over 3 years, the difference between intervention groups in BMI trajectory was not significant (mean adjusted difference -0·25 [95% CI -0·90 to 0·40] kg/m2; Cohen's d=0.10; p=0·45). Children in the MMM intervention group gained less BMI over 1 year than did children in the HE intervention group (-0·73 [-1·07 to -0·39] kg/m2, d=0.55); the same was true over 2 years (-0·63 [-1·13 to -0·14] kg/m2; d =0.33). No differential adverse events were observed. INTERPRETATION: The MMM intervention did not reduce BMI gain versus HE over 3 years but the effects over 1 and 2 years in this rigorous trial show the promise of this systems intervention approach for reducing weight gain and cardiometabolic risk factors in low socioeconomic status communities. FUNDING: US National Institutes of Health.

Obesity-Related Changes in Human Plasma Lipidome Determined by the Lipidyzer Platform.

Obesity is an increasing public health concern both in the developed and developing countries. Previous studies have demonstrated that considerable alterations in lipid metabolism and consequently marked changes in lipid profile are associated with the onset and progression of obesity-related complications. To characterize the full spectrum of obesity-induced changes in lipid metabolism, direct infusion tandem mass spectrometry analysis is the most promising approach. To better understand which of the many lipid species are the most strongly associated with obesity, the aim of our work was to measure and profile plasma lipids in normal (n = 57), overweight (n = 31), and obese (n = 48) individuals randomly selected from samples of Hungarian general and Roma populations by using the targeted quantitative lipidomics platform, the Lipidyzer. Principal component and stepwise regression analyses were used to identify the most significant clusters and species of lipids by increasing body mass index (BMI). From the 18 clusters identified four key lipid species (PE P-16:0/20:3, TG 20:4_33:1, TG 22:6_36:4, TG 18:3_33:0) showed a strong significant positive and three others (Hex-Cer 18:1;O2/22:0, LPC 18:2, PC 18:1_18:1) significant negative association with BMI. Compared to individual lipid species alone, the lipid species ratio (LSR) we introduced showed an extremely strong, at least 9 orders of magnitude stronger, association with BMI. The LSR can be used as a sensitive and predictive indicator to monitor obesity-related alterations in human plasma and control the effectiveness of treatment of obesity associated non-communicable diseases.

Investigating IGF-II and IGF2R serum markers as predictors of body weight loss following an 8-week acute weight loss intervention: PREVIEW sub-study.

BACKGROUND: Weight reduction is effective in preventing T2D however, weight reduction and maintenance is difficult to achieve on a population scale. Serum insulin-like growth factor II (IGF-II) and IGF-II receptor (IGF2R) have been associated with diabetic status and body weight in prior studies and, in addition, IGF-II has been indicated as predictive of future weight change. We measured these serum markers in participants with obesity/overweight and prediabetes from the New Zealand arm of the PREVIEW lifestyle intervention randomised trial before and after an 8-week low energy diet (LED). METHODS: Total IGF-II (n = 223) and soluble IGF2R (n = 151) were measured using commercial ELISA kits on fasted serum samples taken prior to an 8-week LED and also from participants completing the LED. RESULTS: IGF-II levels were not correlated with baseline body weight although mean levels did significantly decrease following the LED. Change in IGF-II serum level was correlated to fasting glucose change (p = 0.04) but not to weight change. Baseline serum IGF2R was correlated with BMI (p = 0.007) and was significantly higher in Maori compared to European Caucasian participants independent of body weight (p = 0.0016). Following LED, IGF2R change was positively associated with weight change (p = 0.02) when corrected for ethnicity. Pre-LED levels of these serum markers were not predictive of the magnitude of weight loss over the 8 weeks. CONCLUSION: Neither marker was useful in predicting magnitude of short-term weight loss. IGF2R is positively associated with BMI and is higher in Maori compared to European Caucasian individuals.

Dietary Patterns with Healthy and Unhealthy Traits Among Overweight/Obese Hispanic Women with or at High Risk for Type 2 Diabetes.

Hispanic women are at high risk for type 2 diabetes (T2D), with obesity and unhealthy eating being important contributing factors. A cross-sectional design was used in this study to identify dietary patterns and their associations with diabetes risk factors. Participants completed a culturally adapted Food Frequency Questionnaire capturing intake over the prior 3 months. Overweight/obese Hispanic women (n = 191) with or at risk for T2D were recruited from a community clinic into a weight loss intervention. Only baseline data was used for this analysis. Dietary patterns and their association with diabetes risk factors (age, body mass index, abdominal obesity, elevated fasting blood glucose [FBG], and hemoglobin A1c). An exploratory factor analysis of dietary data adjusted for energy intake was used to identify eating patterns, and Pearson correlation coefficient (r) to assess the association of the eating patterns with the diabetes risk factors. Six meaningful patterns with healthful and unhealthful traits emerged: (1) sugar and fat-laden, (2) plant foods and fish, (3) soups and starchy dishes, (4) meats and snacks, (5) beans and grains, and (6) eggs and dairy. Scores for the "sugar and fat-laden" and "meats and snacks" patterns were negatively associated with age (r = - 0.230, p = 0.001 and r = - 0.298, p < 0.001, respectively). Scores for "plant foods and fish" were positively associated with FBG (r = 0.152, p = 0.037). Being younger may be an important risk factor for a diet rich in sugar and fat; this highlights the need to assess dietary patterns among younger Hispanic women to identify traits potentially detrimental for their health.

Leptin G-2548A and Leptin Receptor Q223R Gene Polymorphisms are Differently Associated with Oxidative Process in Mexican Mestizo and Indigenous with Obesity.

Leptin levels and oxidative stress are implicated in obesity risk. Reports of association of leptin gene (LEP) and leptin receptor gene (LEPR) polymorphisms with leptin elevation are contradictory in a diverse population. Only a few studies report the linkage of obesity with biochemical markers and genetic factors. OBJECTIVE: The aim of this study was to examine whether plasma lipid peroxidation, antioxidant capability, leptin levels are associate selected LEP -2548 A/G and LEPR Q223R polymorphisms in mestizo and indigenous obesity Mexican population. METHODS: We identified and characterized 50 overweight or obese subjects and 50 healthy, normal- weight volunteers with indigenous Tepehuana or Mexican mestizo ethnicity from Durango, Mexico. LEP -2548 A/G and LEPR Q223R polymorphisms were determined by genotyping. Concentrations of leptin, antioxidant capacity (CA) and lipoperoxidation (LIPX) were determined in fast conditions on plasma with Enzyme-Linked ImmunoSorbent Assay (ELISA) in all participants. RESULTS: The highest genotype frequency was the heterozygous LEPR, which was associated with lipid peroxidation levels in normal-weight Tepehuan populations. A positive correlation was observed (r = 0.5; p <0.01) between LEP polymorphism and lipoperoxidation in normal weight Tepehuan subjects. On the other hand, the LEPR polymorphism was associated with the level of lipoperoxidation (r = 0.13; P <0.05) in mestizo populations of normal weight. CONCLUSION: It is probable that there is a synergistic effect for obesity, where the presence of oxidative stress and single nucleotide polymorphisms (SNP) of leptin and its receptor contributes to the generation of pathological subcutaneous fat of obesity, together with the environmental conditions of the populations.

How does traditional knowledge of Cassiae semen shed light on weight management? - A classical and modern literature review.

ETHNOPHARMACOLOGICAL RELEVANCE: The seed of Senna obtusifolia (L.) H. S. Irwin & Barneby (Cassiae semen, CS) also known as Jue ming zi in China, has been traditionally used for weight management by purging the liver and improving the liver functions to support digestion. In the past decades, it has been used for hepatoprotection and treatment of overweight and other metabolic disorders such as hyperlipidaemia and diabetes. AIM OF THE REVIEW: This review aimed at providing comprehensive information on the traditional usages, pharmacology, phytochemistry and toxicology of CS and critically exploring its potential usage for clinical weight management from both traditional and modern application perspectives. MATERIALS AND METHODS: In order to fully understand the properties, actions and indications of CS, two sets of Chinese classical texts were searched, namely: Zhong Hua Yi Dian (Encyclopedia of Traditional Chinese Medicine) and Zhong Guo Ben Cao Quan Shu (Complete Collection of Traditional Texts on Chinese Materia Medica). The purpose of studying these classical texts was to determine the traditional use of CS in weight management. Comprehensive searches were also performed on seven databases for publications on original randomised clinical trials (RCT), in vivo, in vitro or in silico studies related to pharmacological effects of CS. Detailed information about the phytochemistry of CS was collected from books, encyclopedia, online databases and journal literature. FINDINGS: In classical literature review, 89 classic texts provided information of properties, actions and indications of CS. In modern literature review, 44 studies were included for analysis, including 5 RCTs, 7 in vivo studies, 14 in vitro studies, 2 in silico studies and 16 studies of mixed types. Chinese classic literature has provided traditional evidence of the usage of CS for weight management. Contemporary studies have revealed that CS has weight loss effects and possesses some other pharmacological activities supporting weight management. Some chemical compounds of CS have been hypothesised to have a direct or indirect contribution to weight control. CONCLUSIONS: The relationships between chemical compounds and the corresponding weight-loss target proteins are not fully understood. Therefore, CS constituents should be further explored for the development of novel therapeutic or preventive agents for the treatment of overweight and obesity.