Waist Circumference as a Preventive Tool of Atherogenic Dyslipidemia and Obesity-Associated Cardiovascular Risk in Young Adults Males: A Cross-Sectional Pilot Study.

Although the correlation coefficient between body mass index (BMI) and poor lipid profile has been reported, representing a cardiovascular risk, the need to find new early detection markers is real. Waist circumference and markers of atherogenic dyslipidemia are not usually measured in medical review appointments. The present study aimed to investigate the relationship between central adiposity and cardiovascular risk. This was a cross-sectional pilot study of 57 young males (age: 35.9 ± 10.85, BMI: 32.4 ± 6.08) recruited from community settings and allocated to non-obese or obese attending to their waist circumference. Total cholesterol (TC), high-density lipoproteins (HDL-C), and low-density lipoproteins (LDL-C) cholesterol and triglycerides (TG) were measured from plasma samples. Patients with at least 100 cm of waist circumference had significantly increased TC, LDL-C, non-HDL-C, and triglycerides and lower levels of HDL-C. The three atherogenic ratios TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C were all optimal in non-obese patients. LDL-C/HDL-C and TG/HDL-C were significantly higher and over the limit when assessing for atherogenic dyslipidemia. The number of patients at risk for cardiovascular events increases 2.5 folds in obese compared to non-obese. Measurement of waist circumference could be adopted as a simpler valid alternative to BMI for health promotion, to alert those at risk of atherogenic dyslipidemia.

[Comparison of classic and new anthropometric indexes for the screening of metabolic syndrome on the working population.] / Comparación de índices antropométricos, clásicos y nuevos, para el cribado de Síndrome Metabólico en población adulta laboral.

OBJECTIVE: Metabolic syndrome (MetS) has become a worldwide epidemy as the result of a high prevalence of obesity and a sedentary lifestyle. This study was aimed to determine the predictive capacity of some anthropometric indexes on the metabolic syndrome MetS. METHODS: A cross-sectional study was carried out in 636 workers with an overall prevalence of MetS of 14.3%. Receiver Operating Characteristic curves have been carried out to determine the cut-off values. Diagnostic accuracy was determined from the sensitivity and specificity, predictive values, validity index, and Youden index. RESULTS: Waist-to-Height Ratio (WHtR) and Body Round Index (BRI) were the variables with the highest area under the curve (AUC) both with 0.89 CI 95% (0.858-0.927), followed by Waist Circumference with 0.87 CI 95% (0.83-0.909). The most outstanding cut-off values were: WtHR (0.54), with a sensitivity of 90.1% and a specificity of 76.1% and BRI (4.15) achieved a sensitivity and specificity of 90.1% and 76.1%, respectively. CONCLUSIONS: WHtR and BRI are the anthropometric indicators that best discriminate the incidence and prevalence of MetS on the working population. In addition, they show a significant discriminatory capability of abdominal obesity.

OBJETIVO: El síndrome metabólico (SMet) se ha convertido en una epidemia a nivel mundial, como resultado de una alta prevalencia de obesidad y de un estilo de vida sedentario. El objetivo de este trabajo fue determinar la capacidad predictiva de los índices antropométricos sobre el SMet. METODOS: Se realizó un estudio transversal en una muestra de 636 trabajadores, con una prevalencia global de SMet del 14,3%. Se realizaron Curvas Operador-Receptor para determinar los valores de corte. La precisión diagnóstica se determinó a partir de la sensibilidad y especificidad, los valores predictivos, el índice de validez y el índice de Youden. RESULTADOS: Las variables con mayor área bajo la curva (ABC) fueron el índice cintura-talla (ICT) y el índice de redondez del cuerpo (BRI) con 0,89 (IC 95% 0,858-0,927), seguidos de la circunferencia de cintura (CC) con 0,87 (IC 95% 0,83-0,909). Los valores de corte fueron: ICT=0,54, con una sensibilidad del 90,1% y una especificidad del 76,1%; BRI=4,15, con una sensibilidad y especificidad del 90,1% y 76,1%, respectivamente. CONCLUSIONES: El ICT y el BRI son los indicadores antropométricos que mejor discriminan la incidencia y prevalencia de SMet en población adulta laboral. Además, muestran una importante capacidad discriminatoria de obesidad abdominal.

Waist to Height Ratio and Metabolic Syndrome as lung dysfunction predictors.

Metabolic Syndrome (MetS) has been related to pulmonary diseases but its relationship with lung age has not been sufficiently studied. In addition, anthropometric variables have been associated with pulmonary dysfunction, highlighting the waist-to-height ratio (WHtR). The aim was to evaluate the relationship between MetS and: lung age, anthropometric variables and the alteration of lung function. A cross-sectional study was carried out in 1901 workers, evaluating lung function through lung age (Morris & Temple equation) and spirometric values. The diagnosis of MetS was based on the harmonized criteria. We measured anthropometric variables (WHtR, waist circumference, body mass index, waist to hip ratio), blood pressure and biochemical variables (glucose, cholesterol total, HDL, triglycerides). Workers suffering from MetS showed an accelerated lung aging (59.4 ± 18.7 years vs 49 ± 18.4 years). The WHtR ≥ 0.55 was significantly related to an increase in lung age (ß = 6.393, p < 0.001). In addition, a significant linear trend was found between clinical categories of WHtR and lung dysfunction, restrictive and mixed pattern. MetS caused an accelerated lung aging and favored the presence of restrictive lung impairment. In addition, WHtR ≥ 0.55 has been shown as the best predictor for pulmonary health.

Proposal for the User-Centered Design Approach for Health Apps Based on Successful Experiences: Integrative Review.

BACKGROUND: Different strategies encompassed within mHealth have shown themselves to be effective for maintaining good health or controlling certain diseases. However, there is usually a very high rate of abandonment of health apps. Therefore, it would seem obvious that there is a need for involving the end users (whether they are health professionals, patients, or both) in the design process from the early stages in order to enable their needs and characteristics to be identified. In this sense, it is common knowledge that focusing on the user permits the consideration of valuable details aimed at making the correct adjustment between the patient, the technology, and the organization of attention. OBJECTIVE: The goal of the research was to propose a methodology based on the review of previous successful user experiences in setting up health apps by using qualitative techniques (focus groups and discussion groups) that includes the participation of information technology and health professionals and the patients themselves. METHODS: An integrative review was made of studies in which a qualitative methodology was employed mainly through focus and/or discussion groups for the design and development of health apps, consulting diverse databases (PubMed, Scopus, and Proquest) with the following search strategy: "mHealth AND apps AND focus group OR discussion group." A total of 69 papers were included in the review. RESULTS: A proposal structured in 4 sessions of variable duration was made in which information technology and health professionals and patients take part: composing, preparing, and organizing contents (session 1); testing structure and usability (session 2); does the app fit the needs of end users? (session 3); and last testing-keep on improving (session 4). Throughout the sessions, we propose studying aspects like previous user experiences in mHealth, barriers to the adoption of mHealth, interface contents, management and browsability, usability, perceived quality, security and privacy, capacity to self-manage disease with the app, ergonomics, and glanceability, etc. Specific tools that have proved useful in previous research for measuring these aspects are presented. CONCLUSIONS: These work sessions would be based on predominantly qualitative methodologies although, as they evolve, validated questionnaires permitting the assessment of the objectivity of certain technical aspects could be incorporated. With this proposal, a project centered on end users could be effected, responding to their needs. However, this requires validation that will be made via implementation in the development of health apps, with the subsequent measurement of results in terms of adherence and improvement in the clinical variables of the end users.

Effect of an mHealth Intervention Using a Pedometer App With Full In-Person Counseling on Body Composition of Overweight Adults: Randomized Controlled Weight Loss Trial.

BACKGROUND: In clinical practice, it is difficult to convey the benefits of sustained physical activity to adult patients with excess weight or obesity. For this purpose, a goal-setting walking prescription may be an effective strategy. OBJECTIVE: This study aimed to determine the efficacy of the intervention of a pedometer app in setting a goal to reach 10,000 steps per day in adults. METHODS: Overweight adults (n=98; mean body mass index 32.53 [SD 4.92] kg/m2) were randomized to one of two conditions (control or intervention). Both groups downloaded a pedometer app that recorded their daily step counts and were given a daily walking goal of 10,000 steps. Subjects participated in a 24-week in-person behavioral weight control program and were asked to monitor their daily levels using the pedometer app. Baseline data were recorded and followed up weekly. Only the intervention group had structured information delivery, a personalized physical activity prescription, and follow-up on number of steps per day. RESULTS: The results show that regardless of sex or age, prescribing walking increased the number of steps per day by 4806 step on average (standardized ß coefficient=-0.813, SE=427.586, t=-11.242, P<.001). CONCLUSIONS: These results could have implications for improving self-monitoring in overweight adults during periods of weight loss. Health professionals should analyze the implementation of tools that permit them to prescribe, follow up, and encourage the achievement of a goal of physical activity in overweight or obese patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT03845478; https://clinicaltrials.gov/ct2/show/NCT03845478.

Effects of Self-Weighing During Weight Loss Treatment: A 6-Month Randomized Controlled Trial.

OBJECTIVE: To examine the effectiveness of self-weighing for weight loss in men for 6 months. METHODS: In the present study, 54 men, mean age of 40.1 ± 11.1 years, with overweight or obesity, were recruited and randomly assigned into two groups: control group (CG), without weight self-monitoring and intervention group (IG), with weight self-monitoring. Both groups received the same nutritional and educational advice and the establishment of a weight target to reach in the weight loss program. Subjects of IG also had individualized motivating content to improve self-management for 24 weeks. Anthropometric indices were measured at baseline and weekly for 24 weeks. RESULTS: When the group assigned after randomization was introduced in the analysis, its influence was significant in weight loss (F1.52 = 19.465, ± 2 = 0.272, p < 0.001) and in the decrease in body fat percentage (F1.52 = 8,306, ± 2 = 0.132, p < 0.01). CONCLUSION: Study results indicate that self-weighing can help patients to lose additional weight. Our findings have implications in the emerging area of the behavioral approach of patients undergoing weight-loss treatment, as well as clinical care processes. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT04032249.

Push Notifications From a Mobile App to Improve the Body Composition of Overweight or Obese Women: Randomized Controlled Trial.

BACKGROUND: Technology-in particular, access to the Internet from a mobile device-has forever changed the way we relate to others and how we behave in our daily life settings. In recent years, studies have been carried out to analyze the effectiveness of different actions via mobile phone in the field of health: telephone calls, short message service (SMS), telemedicine, and, more recently, the use of push notifications. We have continued to explore ways to increase user interaction with mobile apps, one of the pending subjects in the area of mHealth. By analyzing the data produced by subjects during a clinical trial, we were able to extract behavior patterns and, according to them, design effective protocols in weight loss programs. OBJECTIVE: A clinical trial was proposed to (1) evaluate the efficacy of push notifications in an intervention aimed at improving the body composition of adult women who are overweight or obese, through a dietary procedure, and (2) analyze the evolution of body composition based on push notifications and prescribed physical activity (PA). METHODS: A two-arm randomized controlled trial was carried out. A sample size of 117 adult obese women attended a face-to-face, 30-minute consultation once a week for 6 months. All patients were supplied with an app designed for this study and a pedometer. The control group did not have access to functionalities related to the self-monitoring of weight at home, gamification, or prescription of PA. The intervention group members were assigned objectives to achieve a degree of compliance with diet and PA through exclusive access to specific functionalities of the app and push notifications. The same diet was prescribed for all patients. Three possible PA scenarios were studied for both the control and intervention groups: light physical activity (LPA), moderate physical activity (MPA), and intense physical activity (IPA). For the analysis of three or more means, the analysis of variance (ANOVA) of repeated means was performed to evaluate the effects of the intervention at baseline and at 3 and 6 months. RESULTS: Receiving notifications during the intervention increased body fat loss (mean -12.9% [SD 6.7] in the intervention group vs mean -7.0% [SD 5.7] in the control group; P<.001) and helped to maintain muscle mass (mean -0.8% [SD 4.5] in the intervention group vs mean -3.2% [SD 2.8] in the control group; P<.018). These variations between groups led to a nonsignificant difference in weight loss (mean -7.9 kg [SD 3.9] in the intervention group vs mean -7.1 kg [SD 3.4] in the control group; P>.05). CONCLUSIONS: Push notifications have proven effective in the proposed weight loss program, leading women who received them to achieve greater loss of fat mass and a maintenance or increase of muscle mass, specifically among those who followed a program of IPA. Future interventions should include a longer evaluation period; the impact of different message contents, as well as message delivery times and frequency, should also be researched. TRIAL REGISTRATION: ClinicalTrials.gov NCT03911583; https://www.clinicaltrials.gov/ct2/show/NCT03911583.

Comparación de índices antropométricos, clásicos y nuevos, para el cribado de síndrome metabólico en población adulta laboral / Comparison of classic and new anthropometric indexes for the screening of metabolic syndrome on the working population

OBJETIVO: El síndrome metabólico (SMet) se ha convertido en una epidemia a nivel mundial, como resultado de una alta prevalencia de obesidad y de un estilo de vida sedentario. El objetivo de este trabajo fue determinar la capacidad predictiva de los índices antropométricos sobre el SMet. MÉTODOS: Se realizó un estudio transversal en una muestra de 636 trabajadores, con una prevalencia global de SMet del 14,3%. Se realizaron Curvas Operador-Receptor para determinar los valores de corte. La precisión diagnóstica se determinó a partir de la sensibilidad y especificidad, los valores predictivos, el índice de validez y el índice de Youden. RESULTADOS: Las variables con mayor área bajo la curva (ABC) fueron el índice cintura-talla (ICT) y el índice de redondez del cuerpo (BRI) con 0,89 (IC 95% 0,858-0,927), seguidos de la circunferencia de cintura (CC) con 0,87 (IC 95% 0,83-0,909). Los valores de corte fueron: ICT=0,54, con una sensibilidad del 90,1% y una especificidad del 76,1%; BRI=4,15, con una sensibilidad y especificidad del 90,1% y 76,1%, respectivamente. CONCLUSIONES: El ICT y el BRI son los indicadores antropométricos que mejor discriminan la incidencia y prevalencia de SMet en población adulta laboral. Además, muestran una importante capacidad discriminatoria de obesidad abdominal

OBJECTIVE: Metabolic syndrome (MetS) has become a worldwide epidemy as the result of a high prevalence of obesity and a sedentary lifestyle. This study was aimed to determine the predictive capacity of some anthropometric indexes on the metabolic syndrome MetS. METHODS: A cross-sectional study was carried out in 636 workers with an overall prevalence of MetS of 14.3%. Receiver Operating Characteristic curves have been carried out to determine the cut-off values. Diagnostic accuracy was determined from the sensitivity and specificity, predictive values, validity index, and Youden index. RESULTS: Waist-to-Height Ratio (WHtR) and Body Round Index (BRI) were the variables with the highest area under the curve (AUC) both with 0.89 CI 95% (0.858-0.927), followed by Waist Circumference with 0.87 CI 95% (0.83-0.909). The most outstanding cut-off values were: WtHR (0.54), with a sensitivity of 90.1% and a specificity of 76.1% and BRI (4.15) achieved a sensitivity and specificity of 90.1% and 76.1%, respectively. CONCLUSIONS: WHtR and BRI are the anthropometric indicators that best discriminate the incidence and prevalence of MetS on the working population. In addition, they show a significant discriminatory capability of abdominal obesity