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1.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(1): 47-53, 2020 Jan 24.
Artículo en Chino | MEDLINE | ID: mdl-32008295

RESUMEN

Objective: To identify the incidence of hypertension, overweight/obesity in middle-aged population in China, and explore their impact on cardiovascular events. Methods: From 2009 to 2010, 12 areas were sampled in China, and about 1 000 subjects aged 35 - 64 from each area were enrolled to collect the basic information, physical examination and blood tests were also performed. From 2016 to 2017, data from 8 835 subjects, who completed the 6 years follow-up, were analyzed.Blood pressure and body mass index(BMI) at both baseline and the follow-up, as well as incidence of hypertension, overweight and obesity, were calculated. Cox proportional hazard model was used to investigate the impacts of hypertension, overweight and obesity on cardiovascular events after adjusting confounders. Results: At the end of follow-up, both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels (all P<0.001). The cumulative incidence of hypertension, overweight and obesity within 6 years was 39.3%(1 146/2 918), 11.5%(406/3 544) and 4.3%(302/7 025), respectively. Compared with subjects with both normal BMI and blood pressure, people with overweight, obesity, hypertension, overweight with hypertension, and obesity with hypertension faced significantly increased risk of cardiovascular disease (HRs (95%CIs) were 2.394(1.130-5.073), 3.341(1.454-7.674), 6.047(2.978-12.279), 5.808(2.924-11.539) and 8.716(4.391-17.302), respectively, all P<0.05), after adjusting for other confounders. Conclusions: The incidence of overweight, obesity, and hypertension is high in middle-aged people in China. Overweight, obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.


Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , China , Estudios de Seguimiento , Humanos , Hipertensión/complicaciones , Incidencia , Persona de Mediana Edad , Obesidad/complicaciones , Sobrepeso/complicaciones , Factores de Riesgo
2.
Am Surg ; 86(2): 158-163, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32106910

RESUMEN

Obesity is a major health issue in the modern world population and a risk factor for surgical procedures. This study examined perioperative and oncologic results of gastrectomy in obese patients diagnosed with gastric cancer. BMI ≥30 kg/m² was used to designate obesity. Five hundred and one patients were operated throughout the study period (2009-2018). The outcomes in obese patients (n = 205) were compared with those with normal weight (n = 171) and overweight (n = 125). The mean BMI was significantly different between the groups: 21.9 versus 26.7 versus 33.3 kg/m² (P < 0.01), respectively. Obesity was associated with higher incidence of comorbidities, longer operative time, and increased blood loss. Postoperative and short-term oncologic outcomes were similar. Median follow-up was 24 months with similar recurrence rates in the three groups. Median survival was comparable between the normal weight, overweight, and obese patients-36 (27-45) versus 42 (30-53) versus 32 (17-47) months, respectively (P = 0.63). Obesity itself does not deteriorate the surgical outcomes of gastrectomy in patients with gastric cancer. Although technically demanding in obese patients, adequate lymph node yield and satisfactory long-term oncologic outcomes can be achieved in this group.


Asunto(s)
Índice de Masa Corporal , Gastrectomía , Obesidad/complicaciones , Neoplasias Gástricas/cirugía , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Comorbilidad , Femenino , Gastrectomía/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Obesidad/mortalidad , Tempo Operativo , Sobrepeso/complicaciones , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/mortalidad , Resultado del Tratamiento
3.
Int J Cancer ; 146(3): 874-883, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-31107541

RESUMEN

Substantial changes in the prevalence of the principal kidney and bladder cancer risk factors, smoking (both cancers) and body fatness (kidney cancer), have occurred but the contemporary cancer burden attributable to these factors has not been evaluated. We quantified the kidney and bladder cancer burden attributable to individual and joint exposures and assessed whether these burdens differ between population subgroups. We linked pooled data from seven Australian cohorts (N = 367,058) to national cancer and death registries and estimated the strength of the associations between exposures and cancer using adjusted proportional hazards models. We estimated exposure prevalence from representative contemporaneous health surveys. We combined these estimates to calculate population attributable fractions (PAFs) with 95% confidence intervals (CIs), accounting for competing risk of death, and compared PAFs for population subgroups. During the first 10-year follow-up, 550 kidney and 530 bladder cancers were diagnosed and over 21,000 people died from any cause. Current levels of overweight and obesity explain 28.8% (CI = 17.3-38.7%), current or past smoking 15.5% (CI = 6.0-24.1%) and these exposures jointly 39.6% (CI = 27.5-49.7%) of the kidney cancer burden. Current or past smoking explains 44.4% (CI = 35.4-52.1%) of the bladder cancer burden, with 24.4% attributable to current smoking. Ever smoking explains more than half (53.4%) of the bladder cancer burden in men, and the burden potentially preventable by quitting smoking is highest in men (30.4%), those aged <65 years (28.0%) and those consuming >2 standard alcoholic drinks/day (41.2%). In conclusion, large fractions of kidney and bladder cancers in Australia are preventable by behavior change.


Asunto(s)
Terapia Conductista , Costo de Enfermedad , Neoplasias Renales/epidemiología , Neoplasias de la Vejiga Urinaria/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Australia/epidemiología , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Predicción , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Neoplasias Renales/prevención & control , Estilo de Vida , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Prevalencia , Sistema de Registros/estadística & datos numéricos , Factores de Riesgo , Fumar/efectos adversos , Fumar/epidemiología , Fumar/terapia , Cese del Hábito de Fumar , Neoplasias de la Vejiga Urinaria/prevención & control , Adulto Joven
4.
Lancet ; 395(10218): 156-164, 2020 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-31852601

RESUMEN

Observations from many countries indicate that multiple forms of malnutrition might coexist in a country, a household, and an individual. In this Series, the double burden of malnutrition (DBM) encompasses undernutrition in the form of stunting, and overweight and obesity. Health effects of the DBM include those associated with both undernutrition, such as impaired childhood development and greater susceptibility to infectious diseases, and overweight, especially in terms of increased risk of added visceral fat and increased risk of non-communicable diseases. These health effects have not been translated into economic costs for individuals and economies in the form of lost wages and productivity, as well as higher medical expenses. We summarise the existing approaches to modelling the economic effects of malnutrition and point out the weaknesses of these approaches for measuring economic losses from the DBM. Where population needs suggest that nutrition interventions take into account the DBM, economic evaluation can guide the choice of so-called double-duty interventions as an alternative to separate programming for stunting and overweight. We address the evidence gap with an economic analysis of the costs and benefits of an illustrative double-duty intervention that addresses both stunting and overweight in children aged 4 years and older by providing school meals with improved quality of diet. We assess the plausibility of our method and discuss how improved data and models can generate better estimates. Double-duty interventions could save money and be more efficient than single-duty interventions.


Asunto(s)
Costos y Análisis de Costo/métodos , Desnutrición/prevención & control , Enfermedades Transmisibles/etiología , Desarrollo Económico , Trastornos del Crecimiento/complicaciones , Trastornos del Crecimiento/economía , Trastornos del Crecimiento/prevención & control , Humanos , Desnutrición/complicaciones , Desnutrición/economía , Modelos Económicos , Estado Nutricional , Obesidad/complicaciones , Obesidad/economía , Obesidad/prevención & control , Sobrepeso/complicaciones , Sobrepeso/economía , Sobrepeso/prevención & control , Prevalencia
5.
Int J Cancer ; 146(3): 664-670, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-30895617

RESUMEN

Breast cancer is the most common cancer and the second-leading cause of cancer-related death among women. Inconsistent findings for the relationship between melatonin levels, sleep duration and breast cancer have been reported. We investigated the association of sleep duration at cohort entry and its interaction with body mass index (BMI) with risk of developing breast cancer in the large population-based Multiethnic Cohort study. Among the 74,481 at-risk participants, 5,790 breast cancer cases were identified during the study period. Although we detected no significant association between sleep duration and breast cancer incidence, higher risk estimates for short (HR = 1.03; 95% CI: 0.97-1.09) and long sleep (HR = 1.05; 95% CI: 0.95-1.15) compared to normal sleep (7-8 hr) were found. The patterns for models stratified by age, BMI, ethnicity and hormone receptor status were similar but did not indicate significant interaction effects. When examining the combined sleep duration and BMI interaction effect, in comparison to the normal BMI-normal sleep group, risk estimates for underweight, overweight and obesity were similar across categories of sleep duration (≤6, 7-8, and ≥9 hr). The underweight-normal sleep group had lower breast cancer incidence (HR = 0.66, 95% CI: 0.50-0.86), whereas the overweight-short sleep, overweight-normal sleep group and all obese women experienced elevated breast cancer incidence. The respective HRs for short, normal and long sleep among obese women were 1.35 (95% CI: 1.20-1.53), 1.27 (95% CI: 1.15-1.42) and 1.46 (95% CI: 1.21-1.76). Future perspectives need to examine the possibility that sleep quality, variations in circadian rhythm and melatonin are involved in breast cancer etiology.


Asunto(s)
Neoplasias de la Mama/epidemiología , Sobrepeso/epidemiología , Sueño/fisiología , Delgadez/epidemiología , Anciano , Índice de Masa Corporal , Neoplasias de la Mama/etiología , California/epidemiología , Ritmo Circadiano/fisiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Persona de Mediana Edad , Sobrepeso/complicaciones , Medición de Riesgo , Factores de Riesgo , Delgadez/complicaciones , Factores de Tiempo
6.
J Matern Fetal Neonatal Med ; 33(1): 120-126, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30032681

RESUMEN

Objective: Women with gestational diabetes (GDM) have a 7-12-fold increased risk for developing type 2 diabetes later in life. Postpartum weight retention is highly predictive for future obesity, and further increases risk for type 2 diabetes. We sought to identify predictors of losing at least 75% of gestational weight gain by very early postpartum in women with recent GDM.Methods: We recruited women with GDM during pregnancy or just after delivery. Prepregnancy weight was self-reported at recruitment; gestational weight gain, mode of delivery, and insulin use were extracted from medical records. At a mean of 7.2 (±2.1) weeks postpartum we measured weight and height and administered questionnaires, including demographics, breastfeeding, Edinburgh Postnatal Depression Scale, sleep, Harvard Food Frequency, and the International Physical Activity Questionnaire. We modeled the odds of 75% loss of gestational weight gain at the study visit using multivariable logistic regression models and selected the model with the lowest Akaike information criterion (AIC) as our final model. Analyses were conducted using JMP 10-13 Pro (SAS Institute Inc.)Results: Seventy-five women with recent GDM were included in the study. The mean age of study participants was 33 (SD ±5) years old, of whom 57% were white, 30% were African American, and 20% of the women identified as Hispanic. The mean prepregnancy BMI was 31.4 kg/m2 (SD ±5.6) and the mean pregnancy weight gain was 12.5 kg (SD ±7.8). Fifty-two percent of participants lost at least 75% of their pregnancy weight gain by the early postpartum study visit. Thirty-seven women (49%) exceeded Institute of Medicine (IOM) guidelines for gestational weight gain. In a multivariate model adjusting for weeks postpartum at the time of the study visit, less gestational weight gain (OR 0.56; 95% CI 0.39-0.73), increased age (OR 1.48; 95% CI 1.13-2.20), and lack of insulin use during pregnancy (OR 0.08 for use of insulin; 95% CI 0.00-0.73) were associated with at least 75% postpartum weight loss. Prepregnancy BMI and sleep were not retained in the model. Race/ethnicity, education, breastfeeding, nulliparity, cesarean section, depressive symptoms, dietary composition, glycemic index, and physical activity did not meet criteria for inclusion in the model.Conclusions: A substantial proportion of women with recent GDM lost at least 75% of their gestational weight gain by early postpartum. Older women, those who did not use insulin during pregnancy and those who gained less weight during pregnancy were significantly more likely to have lost 75% of gestational weight by very early postpartum.


Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Gestacional , Periodo Posparto/fisiología , Pérdida de Peso/fisiología , Adolescente , Adulto , Diabetes Mellitus Tipo 2/etiología , Diabetes Gestacional/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico , Sobrepeso/complicaciones , Sobrepeso/diagnóstico , Embarazo , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Aumento de Peso , Adulto Joven
7.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 611-619, dic. 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-184788

RESUMEN

Antecedentes: El ejercicio intervalado de alta intensidad (HIIT) ha sido utilizado ampliamente para combatir los factores de riesgo cardiovascular en población adolescente y adulta, existiendo un vacío de su aplicabilidad en población infantil. Objetivos: Determinar los efectos de un HIIT sobre distintos parámetros antropométricos y cardiovasculares de niños con sobrepeso y obesidad de entre 7 y 9 años de edad. Material y métodos: Cuatro grupos fueron formados: 1) grupo control con sobrepeso (GCS, n = 30, IMC = 21,60 ± 3,72 kg/m2); 2) grupo control con obesidad (GCO, n = 34, IMC = 23,92 ± 3,11 kg/m2); 3) grupo intervención con sobrepeso (GIS, n = 69, IMC = 20,01 ± 1,88 kg/m2), y 4) grupo intervención con obesidad (GIO, n = 141, IMC=24,12 ± 2,66 kg/m2). El IMC, grasa corporal (GC), circunferencia de cintura, razón cintura-estatura, presión arterial sistólica y diastólica, y capacidad cardiorrespiratoria (CRF), fueron evaluadas pre- y postintervención. Resultados: Existieron diferencias significativas en las variables IMC (p < 0,001), GC (p < 0,001) y CRF (p < 0,001) en la comparación entre grupos (control vs. intervención) en pre- y postintervención (GCS vs. GIS y GCO vs. GIO). El GIS (IMC; pre = 20,01 ± 1,88 vs. post = 19,00 ± 2,02, p < 0,001) y el GIO (IMC; pre = 24,12 ± 2,66 vs. post = 23,23 ± 3,23, p < 0,001) disminuyeron su IMC. De igual forma, en el GIS (GC; pre = 21,84 ± 4,97 vs. post = 19,55±4,81%, p < 0,001) y en el GIO (GC; pre = 30,26 ± 11,49 vs. post =26,81 ± 6,80%, p < 0,001) la GC disminuyó. Ambos grupos intervenidos mejoraron su CRF (p < 0,001). Existió una disminución significativa de escolares con obesidad (pre = 66,4% vs. post = 49,6%) (p < 0,001). Conclusión: La intervención realizada en el contexto escolar mejora los parámetros antropométricos y cardiovasculares de los escolares, permitiendo además disminuir la proporción de escolares con obesidad


Background: High-intensity interval training (HIIT) has been widely used to fight cardiovascular risk factors in adolescents and adults, but no data are available on its applicability in children. Objectives: To assess the effects of HIIT on different anthropometric and cardiovascular parameters of overweight and obese children aged 7-9 years. Material and methods: Four groups were formed: 1) an overweight control group (OWCG, n = 30, BMI = 21.60 ± 3.72 kg/m2); 2) an obesity control group (OCG, n = 34, BMI = 23.92 ± 3.11 kg/m2); 3) an overweight intervention group (OWIG, n = 69, BMI = 20.01 ± 1.88 kg/m2), and 4) an obesity intervention group (OIG, n = 141, BMI = 24.12 ± 2.66 kg/m2). BMI, body fat (BF), waist circumference, height-waist ratio, systolic and diastolic blood pressure and cardiorespiratory fitness (CRF) were assessed before and after intervention. Results: There were significant differences in BMI (P < .001), BF (P < .001), and CRF (P < .001) between the groups (control vs. intervention) before and after intervention (OWCG vs. OWIG and OCG vs. OIG). BMI decreased in the OWIG (BMI, 20.01 ± 1.88 at baseline vs. 19.00 ± 2.02 after HIIT, P < .001) and OIG (BMI, 24.12 ± 2.66 at baseline vs. 23.23 ± 3.23 after HIIT, P < .001) groups. Similarly, BF decreased in the OWIG (BF, 21.84 ± 4.97 at baseline vs. 19.55 ± 4.81% after HIIT, P < .001) and OIG (BF, 30.26 ± 11.49 at baseline vs. 26.81 ± 6.80% after HIIT, P < .001) groups. CRF improved in both intervention groups (P < .001). There was a significant decrease in the prevalence rate of schoolchildren with obesity (from 66.4% to 49.6%) (P < .001). Conclusion: The intervention conducted in the school setting improved the anthropometric and cardiovascular parameters of schoolchildren, and also allowed for reducing the proportion of schoolchildren with obesity


Asunto(s)
Humanos , Niño , Obesidad Pediátrica/diagnóstico , Obesidad Pediátrica/terapia , Ejercicio/fisiología , Capacidad Cardiovascular/fisiología , Antropometría , Sobrepeso/complicaciones , Índice de Masa Corporal , Análisis de Varianza
8.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 833-839, 2019 Dec 25.
Artículo en Chino | MEDLINE | ID: mdl-31874473

RESUMEN

Objective: To examine the association of pre-pregnancy obesity, excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with the risk of large for gestational age (LGA), and assess the dynamic changes in population attributable risk percent (PAR%) for having these exposures. Methods: A retrospective cohort study was conducted to collect data on pregnant women who received regular health care and delivered in Beijing Obstetrics and Gynecology Hospital from January to December in 2011, 2014 and 2017, respectively. Information including baseline characteristics, metabolic indicators during pregnancy, pregnancy complications, and pregnancy outcomes were collected. Multivariate logistic regression model was constructed to assess their association with LGA delivery. Adjusted relative risk and prevalence of these factors were used to calculate PAR%and evaluate the comprehensive risk. Results: (1)The number of participants were 11 132, 13 167 and 4 973 in 2011, 2014 and 2017, respectively. Corresponding prevalence of LGA were 15.19% (1 691/11 132), 14.98% (1 973/13 167) and 16.21% (806/4 973). No significant change in the prevalence of LGA was observed across all years investigated (all P>0.05). (2)According to results from multivariate logistic regression model, advanced maternal age, multiparity, pre-pregnancy overweight or obesity, GWG,GDM and serum triglyceride level≥1.7 mmol/L in the first trimester were associated with high risk of LGA (all P<0.05). Among these factors, pre-pregnancy overweight or obesity, excessive GWG and multiparity were common risk factors of LGA. GDM was not associated with risk of LGA in 2017 database. (3) Dynamic change of PAR% in these years were notable. PAR% of GWG for LGA decreased (32.6%, 27.2% and 22.2% in 2011, 2014 and 2017, respectively), while PAR% of pre-pregnancy overweight or obesity showed an upward trend (4.2%, 3.3% and 8.4%). In addition, PAR% of multiparity increased as well (3.5%, 6.3% and 15.9%). (4) Further analysis showed that excessive GWG in the first and second trimesters contributed the most (20.2% and 19.0% in 2014 and 2017). Conclusions: Excessive GWG, pre-pregnancy overweight or obesity and multiparity are the important risk factors what contribute to LGA. PAR% of excessive GWG for LGA decrease in recent years. However, GWG in the first and second trimesters is a critical factor of LGA. Appropriate weight management in pre-pregnancy, the first or second trimester is the key point to reduce the risk of LGA.


Asunto(s)
Diabetes Gestacional/epidemiología , Macrosomía Fetal/epidemiología , Obesidad/complicaciones , Peso al Nacer , Índice de Masa Corporal , China/epidemiología , Femenino , Macrosomía Fetal/etiología , Edad Gestacional , Humanos , Obesidad/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Retrospectivos , Aumento de Peso
9.
PLoS Med ; 16(12): e1003009, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31887140

RESUMEN

BACKGROUND: Suboptimal weight gain during pregnancy is a potentially modifiable risk factor. We aimed to investigate the association between suboptimal gestational weight gain and severe adverse birth outcomes by pre-pregnancy body mass index (BMI) categories, including obesity class I to III. METHODS AND FINDINGS: We conducted a population-based study of pregnant women with singleton hospital births in Washington State, US, between 2004 and 2013. Optimal, low, and excess weight gain in each BMI category was calculated based on weight gain by gestational age as recommended by the American College of Obstetricians and Gynecologists and the Institute of Medicine. Primary composite outcomes were (1) maternal death and/or severe maternal morbidity (SMM) and (2) perinatal death and/or severe neonatal morbidity. Logistic regression was used to obtain adjusted odds ratios (AORs) and 95% confidence intervals. Overall, 722,839 women with information on pre-pregnancy BMI were included. Of these, 3.1% of women were underweight, 48.1% had normal pre-pregnancy BMI, 25.8% were overweight, and 23.0% were obese. Only 31.5% of women achieved optimal gestational weight gain. Women who had low weight gain were more likely to be African American and have Medicaid health insurance, while women with excess weight gain were more likely to be non-Hispanic white and younger than women with optimal weight gain in each pre-pregnancy BMI category. Compared with women who had optimal weight gain, those with low gestational weight gain had a higher rate of maternal death, 7.97 versus 2.63 per 100,000 (p = 0.027). In addition, low weight gain was associated with the composite adverse maternal outcome (death/SMM) in women with normal pre-pregnancy BMI and in overweight women (AOR 1.12, 95% CI 1.04-1.21, p = 0.004, and AOR 1.17, 95% CI 1.04-1.32, p = 0.009, respectively) compared to women in the same pre-pregnancy BMI category who had optimal weight gain. Similarly, excess gestational weight gain was associated with increased rates of death/SMM among women with normal pre-pregnancy BMI (AOR 1.20, 95% CI 1.12-1.28, p < 0.001) and obese women (AOR 1.12, 95% CI 1.01-1.23, p = 0.019). Low gestational weight gain was associated with perinatal death and severe neonatal morbidity regardless of pre-pregnancy BMI, including obesity classes I, II, and III, while excess weight gain was associated with severe neonatal morbidity only in women who were underweight or had normal BMI prior to pregnancy. Study limitations include the ascertainment of pre-pregnancy BMI using self-report, and lack of data availability for the most recent years. CONCLUSIONS: In this study, we found that most women do not achieve optimal weight gain during pregnancy. Low weight gain was associated with increased risk of severe adverse birth outcomes, and in particular with maternal death and perinatal death. Excess gestational weight gain was associated with severe adverse birth outcomes, except for women who were overweight prior to pregnancy. Weight gain recommendations for this group may need to be reassessed. It is important to counsel women during pregnancy about specific risks associated with both low and excess weight gain.


Asunto(s)
Edad Gestacional , Ganancia de Peso Gestacional/fisiología , Complicaciones del Embarazo/etiología , Resultado del Embarazo/epidemiología , Adulto , Peso al Nacer/fisiología , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Obesidad/complicaciones , Sobrepeso/complicaciones , Embarazo , Estudios Retrospectivos , Factores de Riesgo , Washingtón , Adulto Joven
10.
Medicine (Baltimore) ; 98(46): e17642, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31725607

RESUMEN

The sleep allows many psychological processes, such as immune system activity, body metabolism and hormonal balance, emotional and mental health, learning, mnemonic processes. The lack of sleep could undermine mental and physical purposes, causing an alteration in cognitive functions or metabolic disorders. In our study, we have examined the irregular sleep effects with the overweight and obesity risk in children and adults.The sample was composed of 199 subjects, of which 71 adults, (29 males and 42 females), and 128 children (73 males and 55 females). We have measured the weight and height with standard techniques; we also have measured the body mass index dividing the weight in kg with the height square expressed in meters (kg/m). Subjects were divided into underweight, normal weight, overweight, and obese. Were administered some questionnaires to measure the quantity and quality of sleep, and eating habits and individual consumption of food.Analysis of demographic variables not showed significant differences between male and female groups but highlighted a significant trend differences in normal-weight score. The clinical condition has a substantial impact on body mass index score and sleep hours were significant predictor on this.Quantity and quality sleep can also represent a risk factor of overweight and obesity, so sufficient sleep is a factor that influence a normal weight. Adults and children that sleep less, have an increase in obesity and overweight risk with dysfunctional eating behaviors, decreased physical activity, and metabolic changes.


Asunto(s)
Obesidad/fisiopatología , Sobrepeso/fisiopatología , Trastornos del Sueño-Vigilia/fisiopatología , Sueño/fisiología , Delgadez/fisiopatología , Adulto , Índice de Masa Corporal , Niño , Conducta Alimentaria , Femenino , Humanos , Masculino , Obesidad/complicaciones , Sobrepeso/complicaciones , Factores de Riesgo , Trastornos del Sueño-Vigilia/complicaciones , Encuestas y Cuestionarios , Delgadez/complicaciones
11.
Int Heart J ; 60(6): 1381-1386, 2019 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-31735787

RESUMEN

The association between changes in body weight and blood pressure (BP) in overweight people in the general population still remains unclear. We sought to clarify the effect of body weight change on BP using a community-based cohort. We studied 1,170 overweight subjects with a body mass index (BMI) ≥ 22 kg/m2 who underwent health check-ups. Among the study subjects, 175 (15%) were categorized in the weight loss group (weight loss ≥ 5%), 869 (74%) in the weight stable group, and 126 (11%) in the weight gain group (weight gain ≥ 5%). There were no significant differences in baseline BP between the 3 groups. In the weight loss group, systolic and diastolic BP, and the rates of stage 2 (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) and stage 1 hypertension (130 mmHg≤ systolic BP < 140 mmHg or 80 mmHg≤ diastolic BP < 90 mmHg) decreased. In contrast, in the weight gain group, systolic and diastolic BP and the rate of stage 2 hypertension increased. Subgroup analysis showed that the correlation between change in body weight and BP was seen in each subgroup according to age, sex, and BMI. The results of the present study suggest the significance of body weight control for BP control in subjects with BMI ≥ 22 kg/m2.


Asunto(s)
Presión Sanguínea , Índice de Masa Corporal , Hipertensión/epidemiología , Sobrepeso/fisiopatología , Aumento de Peso , Pérdida de Peso , Adulto , Anciano , Estudios de Cohortes , Femenino , Frecuencia Cardíaca , Humanos , Japón , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones
12.
Medicine (Baltimore) ; 98(38): e17274, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31568007

RESUMEN

BACKGROUND: Weight status and autism spectrum disorder (ASD) are rising public health concerns. An increasing number of reports indicate that individuals with ASD may have unhealthy weight status, but the evidence is mixed. To understand the weight status in individuals with ASD and provide strategies for prevention and intervention, we describe the protocol for a systematic review and meta-analysis aimed at assessing the prevalence of obesity, overweight, and underweight in ASD. METHODS: A broad range of key bibliographic databases including MEDLINE (PubMed), Embase, Cochrane, and ISI Web of Science will be searched to identify studies reporting the prevalence of obesity, overweight, and underweight in patients with ASD. Retrieved records will be independently screened by 2 authors and relevant estimates will be extracted from studies reporting data on obesity, overweight, and underweight prevalence among individuals with ASD. The assessment of study quality will be conducted primarily using the Newcastle-Ottawa scale and checklist proposed by the Joanna Briggs Institute. Prevalence estimates of obesity and overweight will be separately pooled using random-effects model. The pooled estimates will be summarized and presented by regional groupings. Subgroup analysis will be conducted for variables (such as study setting, participants' age, and geographical region) across studies, depending on data availability. Between-study heterogeneity will be assessed using the I statistic and explored through subgroup analyses. This systematic review and meta-analysis will be reported following the preferred reporting items for systematic reviews and meta-analyses checklist and the meta-analysis of observational studies in epidemiology statements guidelines for meta-analysis and systematic reviews of observational studies. RESULTS: In this study, we will outline details of the aims and methods on the meta-analysis of weight status of individuals with ASD. CONCLUSION: The results of this study will summarize the current data of weight status of individuals with ASD. REGISTRATION: PROSPERO-National Institute of Health Research (NIHR) Prospective Register of Systematic Reviews (CRD42019130790).


Asunto(s)
Trastorno del Espectro Autista/complicaciones , Peso Corporal , Niño , Humanos , Obesidad/complicaciones , Obesidad/psicología , Sobrepeso/complicaciones , Sobrepeso/psicología , Obesidad Pediátrica/complicaciones , Obesidad Pediátrica/psicología , Delgadez/complicaciones , Delgadez/psicología
13.
Mayo Clin Proc ; 94(10): 1951-1959, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31585579

RESUMEN

OBJECTIVE: To investigate the effect of supervised moderate to vigorous exercise on gestational weight gain, its related risks (gestational diabetes [GD]), macrosomia, and type of delivery), and the preventive effects on women who exceed the weight gain recommendations. PATIENTS AND METHODS: We conducted a single-center, 2-armed, randomized controlled trial between October 1, 2009, and June 30, 2011, in which 678 women were assessed and 345 were randomized by a central computer system to an intervention group (N=115) or a standard care group (N=230). The intervention exercise program consisted of 70 to 78 sessions (24 weeks, 3 times per week, 60-65 minutes per session, moderate to vigorous intensity). The standard care group received usual care. Excessive gestational weight (EGW) gain was calculated on the basis of the 2009 Institute of Medicine (IOM) recommendations. RESULTS: Of the 345 women randomized for treatment, 44 were lost to follow-up, leaving 301 women for analysis (intervention, 100; standard care, 201). Fewer women in the intervention group exceeded IOM recommendations (22 [22.0%] vs 69 [34.3%]; P=.03), including overweight and obese women (15 of 35 [42.9%] vs 40 of 50 [80.0%]; P=.001). Analysis of women exceeding weight recommendations revealed that the 3 main related risks were directly related to EGW gain in the standard care group (GD, P=.003; macrosomia, P<.001; type of delivery, P<.001) but not in the intervention group (GD, P>.99; macrosomia, 0%; type of delivery, P=.46). CONCLUSION: Supervised moderate to vigorous exercise performed throughout gestation was effective in the prevention of EGW gain even for women with a pregestational body mass index greater than 25 kg/m2. It also prevented its related risks (GD, macrosomia, and type of delivery) including for women exceeding the IOM recommendations, so we suggest that being active outweighs the effect of possible weight gain. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01477372.


Asunto(s)
Ejercicio , Ganancia de Peso Gestacional , Complicaciones del Embarazo/prevención & control , Adulto , Femenino , Humanos , Sobrepeso/complicaciones , Embarazo , Complicaciones del Embarazo/etiología
14.
Rev Saude Publica ; 53: 86, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31644769

RESUMEN

OBJECTIVE: To estimate the co-occurrence of the major risk factors for chronic diseases in adults (18-59 years old) and older people (≥ 60 years old) living in Brazilian state capitals and the Federal District. METHODS: Cross-sectional study with population-based data from 35,448 adults and 18,726 older people collected in the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (System of Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey - Vigitel) in 2015. The prevalence of each of the five risk factors (smoking, overweight, physical inactivity, alcohol and unhealthy diet) was estimated, as well as their co-occurrence for the different possible combinations, according to socioeconomic and health self-assessment variables. The independent associations were verified via multinomial logistic regression to obtain the estimates of the odds ratio (OR) and corresponding 95% confidence intervals. RESULTS: At least two risk factors were present in 38.5% of the adults and 37.0% of the older participants. The male adults and older participants who did not have private health insurance and classified their health as average or poor/very poor were more likely to have two or more concurrent risk behaviors. The greater chance of co-occurrence of smoking and alcohol abuse in adults (adjusted OR = 3.52) and older people (adjusted OR = 2.94) stands out. CONCLUSIONS: The subgroups with increased risk of developing multiple unhealthy behaviors and the most prevalent behaviors were identified. These findings are expected to contribute to the better targeting of health promotion and preventive care. It is worth noting that, for the adoption of healthy lifestyle habits, macro-social and inter-sectoral policies are more effective.


Asunto(s)
Enfermedad Crónica/epidemiología , Medición de Riesgo/métodos , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Brasil/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Conductas de Riesgo para la Salud , Humanos , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Prevalencia , Factores de Riesgo , Conducta Sedentaria , Distribución por Sexo , Fumar/efectos adversos , Fumar/epidemiología , Factores Socioeconómicos , Organización Mundial de la Salud , Adulto Joven
15.
PLoS Med ; 16(10): e1002953, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31652273

RESUMEN

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with increased metabolic risk, though data on long-term follow-up of cardiometabolic traits are limited. We postulated that Chinese women with PCOS would have higher risk of incident diabetes and cardiometabolic abnormalities than those without PCOS during long-term follow-up. METHODS AND FINDINGS: One hundred ninety-nine Chinese women with PCOS diagnosed by the Rotterdam criteria and with a mean age of 41.2 years (SD = 6.4) completed a follow-up evaluation after an average of 10.6 ± 1.3 years. Two hundred twenty-five women without PCOS (mean age: 54.1 ± 6.7 years) who underwent baseline and follow-up evaluation over the same period were used for comparison. Progression of glycaemic status of women both with and without PCOS was assessed by using 75-g oral glucose tolerance test (OGTT) screening with the adoption of 2009 American Diabetes Association diagnostic criteria. The frequency of impaired glucose regulation, hypertension, and hyperlipidaemia of women with PCOS at follow-up has increased from 31.7% (95% CI 25.2%-38.1%) to 47.2% (95% CI 40.3%-54.2%), 16.1% (95% CI 11.0%-21.2%) to 34.7% (95% CI 28.1%-41.3%), and 52.3% (95% CI 45.3%-59.2%) to 64.3% (95% CI 57.7%-71.0%), respectively. The cumulative incidence of diabetes mellitus (DM) in follow-up women with PCOS is 26.1% (95% CI 20.0%-32.2%), almost double that in the cohort of women without PCOS (p < 0.001). Age-standardised incidence of diabetes among women with PCOS was 22.12 per 1,000 person-years (95% CI 10.86-33.37) compared with the local female population incidence rate of 8.76 per 1,000 person-years (95% CI 8.72-8.80) and 10.09 per 1,000 person-years (95% CI 4.92-15.26, p < 0.001) for women without PCOS in our study. Incidence rate for women with PCOS aged 30-39 years was 20.56 per 1,000 person-years (95% CI 12.57-31.87), which is approximately 10-fold higher than that of the age-matched general female population in Hong Kong (1.88 per 1,000 person-years, [95% CI 1.85-1.92]). The incidence rate of type 2 DM (T2DM) of both normal-weight and overweight women with PCOS was around double that of corresponding control groups (normal weight: 8.96 [95% CI 3.92-17.72] versus 4.86 per 1,000 person-years [95% CI 2.13-9.62], p > 0.05; overweight/obese: 28.64 [95% CI 19.55-40.60] versus 14.1 per 1,000 person-years [95% CI 8.20-22.76], p < 0.05). Logistic regression analysis identified that baseline waist-to-hip ratio (odds ratio [OR] = 1.71 [95% CI 1.08-2.69], p < 0.05) and elevated triglyceride (OR = 6.63 [95% CI 1.23-35.69], p < 0.05) are associated with the progression to T2DM in PCOS. Limitations of this study include moderate sample size with limited number of incident diabetes during follow-up period and potential selection bias. CONCLUSIONS: High risk of diabetes and increased cardiovascular disease risk factors among Chinese women with PCOS are highlighted in this long-term follow-up study. Diabetes onset was, on average, 10 years earlier among women with PCOS than in women without PCOS.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Intolerancia a la Glucosa , Síndrome del Ovario Poliquístico/sangre , Síndrome del Ovario Poliquístico/complicaciones , Adulto , Antropometría , Glucemia/análisis , Enfermedades Cardiovasculares/complicaciones , Estudios de Casos y Controles , China/epidemiología , Comorbilidad , Complicaciones de la Diabetes/terapia , Diabetes Mellitus Tipo 2/complicaciones , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Prueba de Tolerancia a la Glucosa , Humanos , Incidencia , Persona de Mediana Edad , Obesidad/complicaciones , Sobrepeso/complicaciones , Síndrome del Ovario Poliquístico/terapia , Estado Prediabético/diagnóstico , Estudios Prospectivos , Análisis de Regresión , Factores de Riesgo , Encuestas y Cuestionarios , Resultado del Tratamiento , Triglicéridos/sangre , Adulto Joven
16.
Nutr. hosp ; 36(5): 1055-1060, sept.-oct. 2019. tab
Artículo en Español | IBECS | ID: ibc-184626

RESUMEN

Introducción: el sobrepeso y la obesidad alcanzan una alta prevalencia desde la infancia en España. Objetivo: describir el efecto del sobrepeso y la obesidad en niños escolares de once años de edad, en pruebas que valoran la fuerza, tanto de las extremidades inferiores como de las superiores, así como la velocidad. Método: participaron en el estudio 423 escolares de once años de edad. Se obtuvieron características básicas antropométricas y desarrollaron diversos test de la batería EUROFIT. Resultados: los niños y niñas que se encuentran en normopeso poseen mejores puntuaciones en las pruebas de condición física en general. De este modo, los saltos verticales y horizontales, suspensión en barra y abdominales son superiores en los participantes con normopeso (p < 0,05). Además, recorren en menos tiempo un circuito de velocidad en ambos sexos (p < 0,001); sin embargo, en la fuerza isométrica manual, en el grupo de niñas poseen mejores resultados aquellas que se encuentran en sobrepeso u obesidad (p < 0,01). Conclusiones: los niños de once años con sobrepeso y obesidad muestran una menor prestación muscular, salvo en el caso de la fuerza isométrica manual. También se han determinado diversas ecuaciones de predicción de resultados de las pruebas físicas llevadas a cabo, como saltos, dinamometría y velocidad, a través del sexo e índice de masa corporal (IMC)


Introduction: overweight and obesity reach a high prevalence since childhood in Spain. Objective: to describe the effect of overweight and obesity, in schoolchildren of eleven years of age, in tests that assess the strength of both the lower and upper extremities, as well as speed. Method: four hundred and twenty-three schoolchildren of eleven years of age participated in the study. Basic anthropometric characteristics were obtained and several tests of the EUROFIT battery were developed. Results: normal-weight boys and girls had better scores in physical condition tests in general. Therefore, the vertical and horizontal jumps, bar suspension and abdominals were higher in the participants with normal-weight (p < 0.05). In addition, they performed in less time a speed circuit in both sexes (p < 0.001); however, in relation to the manual isometric strength, in the group of girls those who are overweight or obese have better results (p < 0.01). Conclusions: overweight and obese children of eleven year-olds showed a lower muscular performance, except in the case of manual isometric strength. Several equations haven been also determined for predicting the results of physical tests carried out such as jumps, dynamometry and speed, through sex and body mass index (BMI)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Obesidad Pediátrica/epidemiología , Sobrepeso/epidemiología , Fuerza Muscular/fisiología , Dinamómetro de Fuerza Muscular , Obesidad Pediátrica/complicaciones , Sobrepeso/complicaciones , Índice de Masa Corporal , Análisis de Clases Latentes
18.
Acta Diabetol ; 56(12): 1333-1339, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31506721

RESUMEN

AIMS: This study aimed to evaluate the effect of pioglitazone on brown adipose tissue function and hypothalamic gliosis in humans. Brown adipose tissue and the hypothalamus are regarded as important potential pharmacological targets to metabolic diseases, and defining the impact of current therapies on their structure and/or function could provide therapeutic advance in this field. METHODS: Six patients with type 2 diabetes were treated for 24 weeks with pioglitazone 30 mg/day as an add-on therapy. Brown adipose tissue glucose uptake and volume were determined using 18F-FDG PET/CT scans; hypothalamic gliosis was determined using MRI scans; blood was collected for hormone and biochemistry measurements. All tests were performed at inclusion and six months after pioglitazone introduction. RESULTS: Pioglitazone treatment led to a significant 3% body mass increase. There were neither changes in cold-induced brown adipose tissue glucose uptake and volume nor changes in hypothalamic gliosis. CONCLUSIONS: This is a proof-of-concept study that provides clinical evidence for a lack of action of a thiazolidinedione, pioglitazone, to promote homogeneous and measurable changes in brown adipose tissue volume and also in hypothalamic gliosis after 6 months of treatment.


Asunto(s)
Tejido Adiposo Pardo/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Gliosis/prevención & control , Hipotálamo/efectos de los fármacos , Hipotálamo/patología , Pioglitazona/farmacología , Tejido Adiposo Pardo/diagnóstico por imagen , Tejido Adiposo Pardo/patología , Adulto , Anciano , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/patología , Quimioterapia Combinada , Femenino , Fluorodesoxiglucosa F18 , Gliosis/diagnóstico , Gliosis/patología , Humanos , Hipotálamo/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico , Obesidad/tratamiento farmacológico , Obesidad/patología , Tamaño de los Órganos/efectos de los fármacos , Sobrepeso/complicaciones , Sobrepeso/diagnóstico , Sobrepeso/tratamiento farmacológico , Sobrepeso/patología , Pioglitazona/administración & dosificación , Tomografía Computarizada por Tomografía de Emisión de Positrones , Prueba de Estudio Conceptual , Tiazolidinedionas/administración & dosificación , Tiazolidinedionas/farmacología
19.
BMC Res Notes ; 12(1): 603, 2019 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-31533851

RESUMEN

OBJECTIVE: The objective of this study was to assess magnitude of metabolic syndrome and its associated factors among type 2 diabetes mellitus patients in Ayder Comprehensive Specialized Hospital. A hospital based cross sectional study design was used. Binary logistic regression model was used. RESULT: A total of 419 respondents (208 males and 211 females) were enrolled; the mean age was 56.39 (SD 10.18), 51.1% of the respondents had metabolic syndrome according to international diabetes federation. Sex and age were statistically associated with metabolic syndrome with [AOR (95% CI) 1.93 (1.057, 3.533) and 1.04 (1.012, 1.072)] respectively. Regular physical exercise, overweight and obesity were statistically associated with metabolic syndrome with [AOR (95% CI) 1.84 (1.002, 3.362), 2.68 (1.518, 4.747) and 3.55 (1.254, 10.074)] respectively. To conclude, Magnitude of metabolic syndrome was high. The associated factors for metabolic syndrome are physical inactivity, inadequate intake of fruits, family history, overweight, and obesity.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Hospitales Especializados , Síndrome Metabólico/complicaciones , Anciano , Estudios Transversales , Diabetes Mellitus Tipo 2/metabolismo , Etiopía , Ejercicio/fisiología , Femenino , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólico/patología , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/fisiopatología , Sobrepeso/complicaciones , Sobrepeso/fisiopatología , Factores de Riesgo
20.
Rev Saude Publica ; 53: 66, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31553376

RESUMEN

OBJECTIVE: To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS: A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS: The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS: The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.


Asunto(s)
Sobrepeso/complicaciones , Medición de Riesgo/métodos , Relación Cintura-Estatura , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Sobrepeso/fisiopatología , Distribución de Poisson , Valores de Referencia , Factores de Riesgo , Distribución por Sexo , Factores Sexuales , Circunferencia de la Cintura , Adulto Joven
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