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1.
Nutrients ; 16(5)2024 Feb 28.
Article in English | MEDLINE | ID: mdl-38474809

ABSTRACT

BACKGROUND: Proper nutrition has a positive impact on health. Paradoxically, excessive preoccupation with healthy eating may lead to the emergence of abnormal eating behaviours and increase the risk of developing disorders. The aim of this study was to assess the risk of orthorexia (ON) and the prevalence of emotional eating (EE) in military flying personnel of the Polish Air Force in relation to BMI and sociodemographic factors. METHODS: This study included 760 soldiers (including 60 females) taking part in the National Health Programme 2021-2025. The ORTO-15 questionnaire and EEQ were used to assess the risk of ON and EE. RESULTS: The risk of ON occurred in 28.9% of military flying personnel and was significantly more frequent in soldiers with a normal weight (46.4%), under 40 years of age (42.7%), and with higher education (42.7%). The prevalence of EE was found in approximately 12.3% of the respondents and was significantly more common in soldiers with diagnosed obesity (17.5%), women (21.7%), and soldiers with higher education (13.6). Other sociodemographic variables did not differentiate the results of the ORTO-15 questionnaire and EEQ. CONCLUSIONS: The obtained results indicate that the problem of eating disorders also occurs in military populations. The necessity of continuing research in this area is discussed.


Subject(s)
Feeding and Eating Disorders , Military Personnel , Female , Humans , Body Mass Index , Feeding Behavior/psychology , Health Behavior , Orthorexia Nervosa , Poland/epidemiology , Prevalence , Sociodemographic Factors , Surveys and Questionnaires , Male
2.
Metabolites ; 13(10)2023 Oct 21.
Article in English | MEDLINE | ID: mdl-37887427

ABSTRACT

(1) Background: Military personnel worldwide exhibit high rates of obesity. Obesity, and especially visceral obesity, contribute to various health issues, including type 2 diabetes and cardiovascular diseases (CVD). While BMI is commonly used to diagnose obesity, it has limitations and does not consider factors like fat distribution or muscle mass. This study aims to assess the relationship between BMI, percent body fat, waist circumference (WC), waist-to-height ratio (WHtR), and cardiovascular risk factors in Polish military flying personnel. Methods: This study involved 200 men from the Polish Air Force aged 38.8 ± 8.5 years. Anthropometric tests, body composition tests, and tests of biochemical markers of CVD were conducted. (2) Results: The prevalence of overweight and obesity varied based on the evaluation criterion; they were present in 63.5% of soldiers by BMI and in 52.5% by percent body fat; abdominal obesity was present in almost half (47%) of the surveyed soldiers according to WC and in 62.5% according to WHtR. All markers of obesity correlated positively with various biochemical markers of CVD, and 8.5% of subjects met the criteria for metabolic syndrome. (3) Conclusions: The prevalence of obesity in Polish military flying personnel, regardless of the evaluation criterion, is associated with significant metabolic complications in the form of lipid disorders and insulin resistance.

3.
Int J Occup Med Environ Health ; 36(4): 437-449, 2023 Nov 13.
Article in English | MEDLINE | ID: mdl-37184148

ABSTRACT

OBJECTIVES: The aim of this article is to assess the health behaviors of Polish Army soldiers participating in the National Health Programme 2016-2020 in relation to types of armed forces, BMI and selected demographic factors. MATERIAL AND METHODS: Anthropometric and questionnaire data were obtained in a group of 1229 soldiers of the Polish Armed Forces (PAF) from military units from all over Poland. Health behaviors patterns were assessed using the Health Behavior Inventory (HBI), developed by Juczynski. RESULTS: The HBI of PAF soldiers was 79.9±12.68, indicating an aver- age score. Statistically significant differences were found in the HBI values and in the individual categories of health behaviors according to the type of armed forces. The highest scores in each category of health behaviors were obtained by the Air Force (AF) soldiers. The lowest HBI score was obtained by the Land Forces and Territorial Defence Forces soldiers. Soldiers with higher education obtained significantly higher scores in such health categories as proper eating habits, preventive behaviors and health practices, compared to respondents with secondary education. Soldiers residing in cities had statistically significantly higher health behaviors intensities in all categories, compared to village residents. A significantly higher score in all health categories was noted in soldiers with normal body weight compared to those with diagnosed obesity. There was no significant relationship between the age of the respondents and health behaviors. CONCLUSIONS: The study found that factors such as type of armed forces, BMI, place of residence and education level were significant for the adoption of health behaviors by PAF. The level of health practices was significant- ly higher among AF soldiers compared to other types of armed forces. It seems necessary to further disseminate education on pro-health behaviors, especially among soldiers with obesity through participation in organized training and psychodietetic consultations as part of the National Health Programme. Int J Occup Med Environ Health. 2023;36(4):437-49.


Subject(s)
Military Personnel , Humans , Poland/epidemiology , Obesity/epidemiology , Health Behavior , Demography
4.
Nutrients ; 14(20)2022 Oct 11.
Article in English | MEDLINE | ID: mdl-36296911

ABSTRACT

A rise in the incidence of infections with severe acute respiratory syndrome coronavirus 2 has sparked the search for protective strategies against the new pathogen. It is known that individual food components can interact with different immune cells, modulating the immune response of the body. The aim of this study was to develop an index assessing the immunomodulatory potential of diet (POLA index) and to test its utility for the prediction of coronavirus disease 2019 (COVID-19) in a group of healthy young people following a traditional or vegetarian diet. Data on body composition, anthropometric measurements, physical activity, dietary intake, and gut microbiota were obtained from 95 adults (mean age, 34.66 ± 5.76 years). There was a strong correlation between the dietary inflammatory index and the POLA index (r = 0.90; p < 0.0001). Based on Cohen's kappa statistic, there was a good agreement in qualitative interpretation between the two indices (kappa = 0.61; p < 0.0001). People on a diet with beneficial immunomodulatory effects had a lower risk of COVID-19 of approximately 80%, as compared with those on a diet with highly unbeneficial immunomodulatory effects. In daily practice, the POLA index might serve as a useful tool for dietitians to identify individuals whose diet is deficient in ingredients for optimal immune system function and change their dietary behavior to ensure optimal immune function that reduces the risk of infection.


Subject(s)
COVID-19 , Gastrointestinal Microbiome , Adult , Humans , Adolescent , COVID-19/epidemiology , Incidence , Diet , Immunity
5.
Article in English | MEDLINE | ID: mdl-35886262

ABSTRACT

Level of physical activity positively affects health condition, correlates highly with level of physical fitness and contributes to the efficient performance of military tasks. The aim of the study was to assess the level of physical activity and body mass index of the Polish Air Force soldiers. A total of 543 professional soldiers (men) doing military service in military units of the Polish Air Force underwent the examination. The average age of examined soldiers amounted to 34.8 ± 9.0 years. In order to carry out the research, the long version of the International Physical Activity Questionnaire was used. Out of the total of 477 questionnaires that qualified for the analysis, a high level of physical activity was found among 81.1% of subjects, moderate 10.5% and low 8.4%. Average MET values were obtained in the following: job-related, relocation (transportation), housekeeping, recreation (leisure activities and sport). The average MET values were 4173 ± 5306 MET; 2371 ± 2725 MET; 2455 ± 4843 MET; 2421 ± 2802 MET, respectively. The average level of body mass index amounted to 25.98 ± 3.38 kg/m2. The tested Air Force soldiers were generally characterized by a high and moderate level of physical activity. Generally, there was no difference in the level of physical activity between the flight crew and the ground staff.


Subject(s)
Military Personnel , Body Mass Index , Exercise , Humans , Male , Physical Fitness , Poland
6.
Article in English | MEDLINE | ID: mdl-35682416

ABSTRACT

Knowledge of the energy expenditure related to the training of policemen allows for assessment of the intensity of the work performed and is an indispensable element of planning and implementing nutrition. This study on energy expenditure comprised a total of 280 persons, students of two Polish police schools and two police training centers. The energy expenditure of policemen was determined based on measurements of the heart rate using Polar RC3 GPS heart rate monitors. The energy expenditure of policemen associated with the training process in the police schools and training centers ranged from 1793 to 3043 kcal/8 h and amounted to 2314 ± 945 kcal/8 h during training on average. The values of energy expenditure related to a typical training day in Polish institutions conducting police training are diverse and depend on the specificity and nature of the training. According to the criteria for assessing the burden of work, the work performed by police officers can be classified as hard work and very hard work.


Subject(s)
Police , Schools , Energy Metabolism , Humans , Poland , Police/education , Students
7.
Article in English | MEDLINE | ID: mdl-35742406

ABSTRACT

The 21st century is considered the age of malnutrition resulting in the unprecedented frequency of civilization diseases. Among these disorders, obesity is particularly distinguished and considered an epidemic-scale disease. For this reason, conducting studies on obesity and counteracting this phenomenon is essential. Research from recent years indicates a problem of excessive body weight among officers of uniformed services, who should be characterized by good health and fitness level due to the specificity of the work. As the problem of obesity affects every fourth Pole, research in uniformed services seems to be essential from health and national security perspectives. The presented study aimed to determine the elements of nutritional status in 289 students of Polish police schools and police training centers. Body composition was determined by bioelectrical impedance analysis, and bone calcification assessment was conducted by the DXA densitometric method. Based on BMI and body fat content, body weight disorders were found in 31.8% of all examined students. Densitometric test results showed changes in bone calcification of varying severity in 26.6% of the total number of respondents. The presence of obesity in students of police schools and training centers proves that the present nutrition model is energetically unbalanced, while the demonstrated disorders of bone calcification indicate an improper condition of mineral nutrition.


Subject(s)
Body Composition , Police , Body Mass Index , Cross-Sectional Studies , Humans , Obesity/epidemiology , Poland/epidemiology , Schools , Students
8.
Article in English | MEDLINE | ID: mdl-35270758

ABSTRACT

The aim of this study was to assess the prevalence of overweight and obesity among Polish Armed Forces soldiers and to analyze risk factors impacting body mass. In total, 1096 male, Caucasian soldiers (36.31 ± 8.03 years) participated in this study. Anthropometric data were obtained, and questionnaires evaluated sociodemographic, environmental, behavioral and biological factors known to be associated with obesity. Only 33% of the total number of participants had normal body weight, and 17.3% were considered obese (according to WHO criteria). The results showed that being 40 years or older, sleeping six hours or less per day, more frequent reaching for food in stressful situations, having a mother with excessive body weight, not exercising or exercising at most two days per week, and spending two hours a day or more in front of the TV increase the risk of obesity. Taken together, the results show that factors such as family history of obesity, dietary habits, physical activity, length of sleep and ability to cope with stress could be used to identify soldiers at higher risk of developing obesity in order to provide them with personalized prevention programs.


Subject(s)
Military Personnel , Overweight , Body Mass Index , Humans , Male , National Health Programs , Obesity/complications , Obesity/epidemiology , Overweight/complications , Overweight/epidemiology , Poland/epidemiology , Risk Factors
9.
Obes Res Clin Pract ; 15(5): 455-460, 2021.
Article in English | MEDLINE | ID: mdl-34426101

ABSTRACT

OBJECTIVE: We simultaneously performed structural MRI, 1H magnetic resonance spectroscopy, and whole-body hydration status assessment to evaluate brain changes in patients with morbid obesity treated with intra-gastric balloon (IGB) for six months. We asked, if changes in myo-inositol ratios (marker of neuroinflammation) are related to brain volume increases accompanying IGB-induced weight loss. METHODS: Twenty five patients with morbid obesity (OB, 43.9 ± 11.8 years, BMI = 49.1 ± 7.2, 12 females, 9 without co-morbid conditions) were treated with IGB for six months. They underwent magnetic resonance imaging at 3T one month before IGB insertion, three months after insertion (N = 19), and one month after IGB removal (N = 14). RESULTS: Insertion of IGB lead to 8.9% and 12.3% weight reduction over the first three months and over the entire treatment, respectively. Over the entire treatment, total gray matter volume increased by 2.0% (p = 0.009). These changes were mostly pronounced in the left precuneus and in the right frontal pole (>1.9%, p < 0.009). The increases in cortical volume in the right hemisphere and the left posterior cingulate cortical thickness over the entire treatment were significantly related to decreases in myo-inositol ratios measured over the first three months of the treatment (r < -0.740, p < 0.006). CONCLUSIONS: IGB treatment lead to brain structural improvements consistent with earlier studies of bariatric patients without co-morbid conditions. Our results also pointed to improvements in brain regions, where atrophy in other studies was related to type 2 diabetes and hypertension. The correlations point to neuroinflammation as one of the potential processes behind brain volume reductions in patients with morbid obesity.


Subject(s)
Diabetes Mellitus, Type 2 , Gastric Balloon , Female , Gray Matter/diagnostic imaging , Humans , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy
10.
Obes Surg ; 30(7): 2826-2827, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32096017

ABSTRACT

In the original article sections of the text include the term "(BLINDED)" rather than the correct text.

11.
Obes Surg ; 30(7): 2821-2825, 2020 07.
Article in English | MEDLINE | ID: mdl-32020503

ABSTRACT

BACKGROUND: We evaluated if the intragastric balloon (IGB) treatment leads to the increase in physical activity (PA) and whether they are related to cognitive improvements. METHODS: Fourteen morbidly obese patients (151 ± 24 kg, BMI = 51.8 ± 6.5, 107 ± 26% excess weight, 43.3 ± 10.6 years) underwent 6-day-long, uninterrupted evaluations of PA 1 month before IGB insertion and 1 month after its removal. RESULTS: Active energy expenditure and physical activity duration increased by more than 80% (p < 0.001) whereas the number of steps per day by 20% (p = 0.016). There was a pattern of relationships between cognitive improvements and increases in PA (p < 0.05). In particular, working memory improvements correlated with the increase in time spent on light physical activities (r = 0.673, p = 0.004). CONCLUSION: The relationships suggest that an increase in physical activity mediates cognitive improvements in bariatric patients.


Subject(s)
Gastric Balloon , Obesity, Morbid , Cognition , Exercise , Humans , Obesity, Morbid/surgery , Quality of Life , Weight Loss
12.
Surg Obes Relat Dis ; 16(1): 34-39, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31734068

ABSTRACT

BACKGROUND: Intragastric balloon (IGB) insertion leads to dietary restriction; however, its neurohormonal actions were also described. Resting metabolic rate (RMR) adjusted for body mass (RMR/mass) seems to increase after bariatric interventions, whereas it generally decreases after caloric restriction-based therapies. However, no studies have evaluated the changes in body composition and RMR over IGB treatment. OBJECTIVE: To evaluate the relationships between changes in body composition, RMR, RMR/mass, and RMR adjusted for fat-free mass (FFM) (RMR/FFM) over IGB treatment lasting 6 months. SETTING: Single-center observational study. METHODS: Twenty-one morbidly obese patients treated with IGB (143 ± 20 kg, body mass index [BMI] = 49.5 ± 7.3, 98% ± 29% percent excess weight, 43.6 ± 12.6 yr) were enrolled. Changes in body composition, RMR, RMR/mass, and RMR/FFM were evaluated between 1 month before IGB insertion (time point 1 [TP1]) and 3 months thereafter (TP2). Fourteen patients were also assessed 1 month after IGB removal (TP3). RESULTS: There was a 9.5% reduction in weight, a 9.4% reduction in BMI, and 19.1% decrease in percent excess weight at TP2 (n = 21; P < .001); a further 6.5% reduction in weight and BMI and a 13.1% drop in percent excess weight (n = 14, P < .001) at TP3. They were accompanied by a 5.4% reduction in FFM between TP1 and TP2 (n = 21, P < .001). Compared with pretreatment values, at TP2 RMR was 12.5% lower (P < .001) but did not change thereafter. RMR/mass increased 12.4% between TP2 and TP3 (n = 14, P = .02) but on average did not change between TP1 and TP3. The results in the smaller cohort (n = 14) between TP1 and TP2 were consistent with results obtained for the entire cohort. Similar findings were obtained for RMR/FFM. The larger increases in RMR/mass between TP1 and TP3 were associated with more weight loss, larger drop in BMI, and more loss of excess weight (r < -.55, P < .03). CONCLUSION: This is the first study to evaluate the relationship between changes in body composition and RMR over IGB treatment. IGB therapy leads to both fat and fat-free mass reductions and RMR decreases. More weight reduction is associated with larger increases in RMR/mass.


Subject(s)
Basal Metabolism/physiology , Body Composition/physiology , Gastric Balloon , Obesity, Morbid/physiopathology , Obesity, Morbid/surgery , Adult , Bariatric Surgery , Female , Humans , Male , Middle Aged
13.
NMR Biomed ; 31(9): e3957, 2018 09.
Article in English | MEDLINE | ID: mdl-30011110

ABSTRACT

Elevated brain myo-inositol (m-Ins) concentration (a putative marker of neuroinflammation) has been reported in patients suffering from type 2 diabetes mellitus (T2DM). Obesity alone and T2DM have been found to be associated with a lower concentration of N-acetyloaspartate and N-acetylaspartylglutamate (tNAA, a marker of neuronal integrity, reflecting neuronal loss or metabolic derangement). It is not clear if these changes reverse with weight loss. The intra-gastric balloon (IGB) is an endoscopic bariatric therapy that leads to massive weight loss and improvement of glycemic control. In this study we evaluated if tNAA/tCr and m-Ins/tCr metabolite ratios are affected by weight loss, where tCr is the signal of creatine containing compounds. Twenty-three morbidly obese patients, 12 of them with T2DM (OD) and 11 without T2DM (OB), as well as 11 healthy controls of normal weight (CON), underwent single voxel spectroscopy at 3 T. Spectra were obtained within a region in the left parietal white matter one month before IGB insertion, three months after IGB insertion, and one month after IGB removal. Before IGB insertion, m-Ins/tCr was 15% higher in OD than in OB (p = 0.005) and 12% higher in OD than in CON (p = 0.03). m-Ins/tCr decreased significantly by 8% over the first three months after IGB insertion (p = 0.01) and remained normal after IGB removal. tNAA/tCr was normal in all groups throughout the study, pointing to normal brain metabolism. Normalization of m-Ins/tCr is consistent with remission of neuroinflammation in patients with T2DM. An evaluation of long-term effects of IGB treatment is necessary.


Subject(s)
Brain/diagnostic imaging , Diabetes Mellitus, Type 2/complications , Gastric Balloon , Obesity, Morbid/complications , Obesity, Morbid/therapy , Adipose Tissue/metabolism , Body Mass Index , Body Weight , Creatine/metabolism , Female , Humans , Inositol/metabolism , Magnetic Resonance Spectroscopy , Male , Metabolome , Middle Aged
14.
Med Pr ; 66(5): 653-60, 2015.
Article in Polish | MEDLINE | ID: mdl-26647984

ABSTRACT

BACKGROUND: The aim of the study was to evaluate overweight, obesity and the level of physical activity in the study group of 100 cadets of the Air Force Military Academy in Deblin (WSOSP). MATERIAL AND METHODS: Evaluation of overweight and obesity was based on body mass index (BMI) and body fat content. An accelerometer AiperMotion 500TM was used to measure the level of physical activity. There were marked such parameters as the average daily energy consumption, the average distance covered during the day and the whole week and the indicator of physical activity level (PAL). RESULTS: Based on BMI indicators, 71.3% of the cadets had normal body weight, 25.3% were overweight and 3.4% were obese. Assessment of nutritional status showed significant differences between the 1st and 2nd vs. the 4th and 5th years of study. Normal BMI values showed 88% of the 1st and 2nd year students, while of the 4th and 5th years - only 48.6% (p < 0.05). Based on the body fat content, obesity was found only in a group of older students (16.2%) and overweight was 10 times higher in the 4th and 5th years (21.6%) in comparison to younger students (2%). The average distance covered during the day or during the whole week was significantly higher in the 1st and 2nd year students. CONCLUSIONS: It is necessary to implement appropriate measures in the field of nutrition and physical activity to prevent the development of excessive body weight during studies among the military cadets of the Air Force Military Academy in Deblin.


Subject(s)
Energy Metabolism , Military Personnel/statistics & numerical data , Motor Activity , Obesity/epidemiology , Obesity/prevention & control , Overweight/epidemiology , Students/statistics & numerical data , Adult , Age Factors , Aviation , Body Mass Index , Female , Humans , Male , Poland , Prevalence , Time Factors , Young Adult
15.
PLoS One ; 10(10): e0139987, 2015.
Article in English | MEDLINE | ID: mdl-26447788

ABSTRACT

BACKGROUND: Obesity is a worldwide epidemic with more than 600 million affected individuals. Human studies have demonstrated some alterations in brains of otherwise healthy obese individuals and elevated risk of neurodegenerative disease of old age; these studies have also pointed to slightly diminished memory and executive functions among healthy obese individuals. Similar findings were obtained in animal models of obesity induced by high fat diet. On the other hand, low carbohydrate high fat diets are currently promoted for losing weight (e.g., Atkin's style diets). However, the long-term effects of such diets are not known. Additionally, high fat diets leading to (mild) ketonemia were shown to improve brain function in elderly humans and in some animal models. AIM: To evaluate the hypothesis that long-term use of a high fat diet was associated with decreases in spatial memory, smaller hippocampi and hippocampi metabolite concentrations in Wistar rats. METHODS: Twenty five male Wistar rats were put on high fat diet (HFD; 60% calories from fat, 30% from carbohydrates) on their 55th day of life, while 25 control male rats (CONs) remained on chow. Adequate levels of essential nutrients were provided. Both groups underwent memory tests in 8-arm radial maze at 3rd, 6th, 9th, and 12th month. 1H magnetic resonance spectroscopy was employed to measure concentrations of tNAA (marker of neuronal integrity) at one month and one year, whereas MRI was used to evaluate hippocampal volumes. RESULTS: Obese rats (OBRs) consumed similar amount of calories as CONs, but less proteins. However, their protein intake was within recommended amounts. Throughout the experiment OBRs had statistically higher concentrations of blood ketone bodies than CONs, but still within normal values. At post-mortem assessment, OBRs had 38% larger fat deposits than CONs (p<0.05), as evaluated by volume of epididymis fat, an acknowledged marker of fat deposits in rats. Contrary to our expectations, OBRs had better scores of memory behavioral tasks than CONs throughout the experiment. At one year, their hippocampi were by 2.6% larger than in CONs (p = 0.05), whereas concentration of tNAA was 9.8% higher (p = 0.014). CONCLUSION: Long-term HFD in our study resulted in better memory, larger hippocampal volumes, as well as higher hippocampal metabolite concentrations, possibly due to increased levels of blood ketone bodies. The results should be interpreted with caution, as results from animal models do not necessarily directly translate in human condition.


Subject(s)
Diet, High-Fat/adverse effects , Dipeptides/metabolism , Hippocampus/pathology , Obesity/pathology , Animals , Body Weight , Glutamic Acid/metabolism , Hippocampus/metabolism , Male , Maze Learning , Memory Disorders/etiology , Memory Disorders/metabolism , Obesity/etiology , Obesity/psychology , Organ Size , Rats, Wistar , Spatial Memory
16.
Ann Agric Environ Med ; 22(3): 542-5, 2015.
Article in English | MEDLINE | ID: mdl-26403131

ABSTRACT

INTRODUCTION: Obesity now affects people from all walks of life, including those who work in the field of medical aid provision on a daily basis. So far, there has been no research assessing the nutrition status of Helicopter Emergency Medical Service (HEMS) crews. OBJECTIVES: To evaluate the degree to which overweight and obesity prevail among Helicopter Emergency Medical Service Air Ambulances (HEMS LPR) crew members, and determine the overall excess body fat and fatty tissue distribution in the subjects. MATERIAL AND METHODS: In order to evaluate the prevalence of overweight and obesity in HEMS crew members, the following anthropometric measurements were used: height, body mass, waist and hip circumferences. Assessment of their nutritional status was made by using some generally used indicators, i.e. calculating the subjects' BMI, WHR and WHtR. RESULTS: Pilots were older than the paramedics in a statistically significant way. On the basis of using the BMI indicator, it was shown that only 36% of HEMS crew members had normal body weight. Analysis of the percentage of body fat determined that 61.5% of the paramedics and 39.4% of the pilots had normal weight. 26.2% paramedics and 28.8% pilots were diagnosed as overweight. Obesity characterised 12.3% of paramedics and 31.8% of pilots. The above were statistically significant differences (p= 0.0117). Waist circumference exceeded 102 cm in 25.9% of the subjects and WHR>1 characterised 20.6% of those examined. CONCLUSIONS: Analysis of the results obtained revealed that an alarmingly high percentage of crew members suffer from excessive body mass and fat, particularly in the group of pilots. Immediate action should be taken in order to reduce the body mass and introduce preventive measures among the subjects.


Subject(s)
Body Fat Distribution , Emergency Medical Services , Obesity/epidemiology , Overweight/epidemiology , Adult , Air Ambulances , Female , Humans , Male , Middle Aged , Nutritional Status , Obesity/etiology , Overweight/etiology , Poland/epidemiology , Prevalence
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