Leading Factors for Weight Gain during COVID-19 Lockdown in a Spanish Population: A Cross-Sectional Study.

The increase in sedentary behaviors during the COVID-19-induced lockdown may have led to a significant weight gain. To investigate this hypothesis, a representative sample of the Spanish adult population comprising 1000 subjects was enrolled in a cross-sectional study between 26 May and 10 June 2020. Computer-assisted telephone interviews were conducted consisting of 29 questions on the topic of lifestyle habits during the lockdown. The cohort comprised 51.5% women and 51% overweight or obese subjects and had a mean age of 50 ± 18 years. Of the respondents, 44.5% self-reported weight gain during the lockdown; of these, 58.0% were women, 69.9% had previous excess weight, 44.7% lived with a relative who also gained weight, and 73.5 experienced increased appetite. Further, an increased consumption of energy-dense products was found relative to respondents who did not gain weight (p ≤ 0.016 for all). Additionally, respondents were unaware that obesity is a poor prognostic factor for COVID-19 infection, lived in smaller flats, and had a lower level of education and lower monthly income. The factors independently associated with weight gain were female gender, previous overweight or obesity, lack of food care, increased appetite, and increased consumption of sugar-sweetened beverages, alcoholic beverages, and snacks (p ≤ 0.023 for all). Should another lockdown be mandated, extra caution is warranted to prevent weight gain.

Factors Accounting for Obesity and Its Perception among the Adult Spanish Population: Data from 1,000 Computer-Assisted Telephone Interviews.

OBJECTIVE: Our aim was to go deeper in the self-perception of weight and health status among the Spanish population, together with the connections of familiar relationships, physical activity practice, nutritional habits, and sleep patterns with the presence of obesity. METHODS: A total of 1,000 subjects were enrolled in April 2017 in a representative adult Spanish population sample. Computer-assisted telephone interviewing was used and self-reported anthropometric data was obtained. RESULTS: The population was composed of 51.3% women, with a mean age of 48 (36-63) years and a BMI of 23.2 (20.3-26.6). Although only 17.7% of subjects with self-reported obesity exhibited the self-perception to suffer from obesity, they referred a bad (16%) or regular (47%) self-perceived health status. Subjects who considered themselves as people with overweight and obesity displayed a BMI of 30.5 (28.7-32.2) and 37.1 (34.8-41.5), respectively. The obesity group displayed the highest percentage (71.9%) of participants with some first-degree relative with overweight or obesity (p < 0.001) in comparison with the other groups. The main reason put forward of preventing healthy eating among subjects with obesity was that they dislike healthy food. The multivariable logistic regression model for presence of obesity showed that there was a significant association with older age, presence of a first-degree relative with weight excess, a positive snacking habit, and daily alcohol consumption (p ≤ 0.019). CONCLUSION: The Spanish population has a low self-perception of obesity. Our data also reinforces the strong association between obesity and age, family interactions, usual snacking, and daily consumption of wine or beer.

Factores predictores de diabetes mellitus posparto en pacientes con diabetes gestacional / Predictors of postpartum diabetes mellitus in patients with gestational diabetes

Introducción: La diabetes gestacional (DG) está relacionada con el desarrollo de la diabetes mellitus (DM) tras el parto. Los predictores en esta asociación aún no están bien definidos. El objetivo de nuestro trabajo es estudiar los factores predictores de disglucosis en el posparto en una muestra de pacientes con DG. Material y métodos: Un total de 1.765 mujeres con DG fueron estudiadas. Variables analizadas: datos antropométricos y antecedentes maternos. Glucemia en sobrecarga de glucosa (SOG) con 100g (basal: 1, 2 y 3h) y HbA1c. Uso de insulina en la gestación. La SOG con 75g y HbA1c a los 3 meses tras el parto. Resultados: Prevalencia DM posparto: 2,1%. Entre estas pacientes hubo mayor porcentaje de pacientes con antecedentes de DG (25,9 vs. 12,9%; p<0,05), obesidad pregestacional (20,8 vs. 14,9%; p<0,05) y uso de insulina durante el embarazo (79,2 vs. 20%; p<0,01). En la SOG con 100g, el número de puntos patológicos fue mayor (3,18±0,69 en DM vs. 2,3±0,28 normal, 2,6±0,47 GBA, 2,5±0,32 IHC; p<0,001). En la SOG con 100g, el nivel de glucemia por encima del cual es más probable el diagnístico de DM posparto es 189mg/dl en la determinación a las 2h (S: 86,2%; E: 72%). Un nivel de HbA1c>5,9% durante la gestación tiene una especificidad del 95,9% para el diagnóstico de DM posparto en nuestra muestra. Conclusión: Evidenciamos factores asociados al diagnóstico de DM posparto entre los que se encuentran determinaciones cuantitativas como la glucemia a las 2h de la SOG con 100g y la HbA1c durante la gestación en pacientes con DG

Introduction: Gestational diabetes (GD) is related to development of diabetes mellitus (DM) after delivery. The predictive factors in this association are not yet well defined. Objetive: to study the predictive factors of dysglucosis in the postpartum period in a sample of patients with GD. Material and methods: A total of 1765 women with DG were studied. Variables analyzed: anthropometric data and maternal history. Glycemia in OGTT with 100g (basal: 1, 2 and 3h) and HbA1c. Use of insulin in pregnancy. The OGTT with 75g and HbA1c at 3 months after delivery. Results: Postpartum DM prevalence 2.1%. Among these patients, there was a higher percentage of patients with a history of GD (25.9 vs. 12.9%; P<.05), pre-pregnancy obesity (20.8 vs. 14.9%; P<.05) and insulin use during pregnancy (79.2 vs. 20%; P<.01). In the OGTT with 100g, the number of pathological points was higher (3.18±0.69 in DM vs. 2.3±0.28 normal, 2.6±0.47 IFG, 2.5±0.32 IGT; P<.001). In the OGTT 100g, the blood glucose level above which the diagnosis of postpartum DM is most likely is 189mg/dl in the 2h determination (S: 86.2%, E: 72%). A level of HbA1c>5.9% during pregnancy has a specificity of 95.9% for the diagnosis of postpartum DM in our sample. Conclusion: We show factors associated with the diagnosis of postpartum DM, among which are quantitative determinations such as glycemia at 2h of the OGTT with 100g and HbA1c during pregnancy in patients with DG

Predictors of postpartum diabetes mellitus in patients with gestational diabetes. / Factores predictores de diabetes mellitus posparto en pacientes con diabetes gestacional.

INTRODUCTION: Gestational diabetes (GD) is related to development of diabetes mellitus (DM) after delivery. The predictive factors in this association are not yet well defined. Objetive: to study the predictive factors of dysglucosis in the postpartum period in a sample of patients with GD. MATERIAL AND METHODS: A total of 1765 women with DG were studied. Variables analyzed: anthropometric data and maternal history. Glycemia in OGTT with 100g (basal: 1, 2 and 3h) and HbA1c. Use of insulin in pregnancy. The OGTT with 75g and HbA1c at 3 months after delivery. RESULTS: Postpartum DM prevalence 2.1%. Among these patients, there was a higher percentage of patients with a history of GD (25.9 vs. 12.9%; P<.05), pre-pregnancy obesity (20.8 vs. 14.9%; P<.05) and insulin use during pregnancy (79.2 vs. 20%; P<.01). In the OGTT with 100g, the number of pathological points was higher (3.18±0.69 in DM vs. 2.3±0.28 normal, 2.6±0.47 IFG, 2.5±0.32 IGT; P<.001). In the OGTT 100g, the blood glucose level above which the diagnosis of postpartum DM is most likely is 189mg/dl in the 2h determination (S: 86.2%, E: 72%). A level of HbA1c>5.9% during pregnancy has a specificity of 95.9% for the diagnosis of postpartum DM in our sample. CONCLUSION: We show factors associated with the diagnosis of postpartum DM, among which are quantitative determinations such as glycemia at 2h of the OGTT with 100g and HbA1c during pregnancy in patients with DG.

Prevención, diagnóstico y tratamiento de la obesidad. Posicionamiento de la Sociedad Española para el Estudio de la Obesidad de 2016 / Prevention, diagnosis, and treatment of obesity. 2016 position statement of the Spanish Society for the Study of Obesity

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Declaración sobre el tratamiento actual de la obesidad grave en España / Statement on the current treatment of severe obesity in Spain

No disponible

Maternal and perinatal outcomes after bariatric surgery: a Spanish multicenter study.

BACKGROUND: Bariatric surgery (BS) has become more frequent among women of child-bearing age. Data regarding the underlying maternal and perinatal risks are scarce. The objective of this nationwide study is to evaluate maternal and perinatal outcomes after BS. METHODS: We performed a retrospective observational study of 168 pregnancies in 112 women who underwent BS in 10 tertiary hospitals in Spain over a 15-year period. Maternal and perinatal outcomes, including gestational diabetes mellitus (GDM), pregnancy-associated hypertensive disorders (PAHD), pre-term birth cesarean deliveries, small and large for gestational age births (SGA, LGA), still births, and neonatal deaths, were evaluated. Results were further compared according to the type of BS performed: restrictive techniques (vertical-banded gastroplasty, sleeve gastrectomy, and gastric banding), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion (BPD). RESULTS: GDM occurred in five (3 %) pregnancies and there were no cases of PAHD. Women whose pregnancies occurred before 1 year after BS had a higher pre-gestational body mass index (BMI) than those who got pregnant 1 year after BS (34.6 ± 7.7 vs 30.4 ± 5.3 kg/m(2), p = 0.007). In pregnancies occurring during the first year after BS, a higher rate of stillbirths was observed compared to pregnancies occurring after this period of time (35.5 vs 16.8 %, p = 0.03). Women who underwent BPD delivered a higher rate of SGA babies than women with RYGB or restrictive procedures (34.8, 12.7, and 8.3 %, respectively). CONCLUSIONS: Pregnancy should be scheduled at least 1 year after BS. Malabsorptive procedures are associated to a higher rate of SGA births.

Adrenal insufficiency and adrenal replacement therapy. Current status in Spain.

Adrenal insufficiency (AI) is a rare endocrine disease, associated to increased mortality if left untreated. It can be due to a primary failure of the adrenal glands (primary AI) or malfunctioning of the hypothalamic-pituitary-adrenal axis (HPA) (secondary AI). The lack of data on incidence/prevalence of adrenal insufficiency in Spain complicates any evaluation of the magnitude of the problem in our country. Initial symptoms are non-specific, so often there is a delay in diagnosis. Current therapy with available glucocorticoids is associated with decreased quality of life in patients with treated AI, as well as with increased mortality and morbidity, probably related to both over-treatment and lack of hydrocortisone, associated with non-physiological peaks and troughs of the drug over the 24 hours. The availability of a new drug with a modified dual release (immediate and retarded), that requires one only daily dose, improves and simplifies the treatment, increases compliance as well as quality of life, morbidity and possibly mortality. This revision deals with the knowledge on the situation both globally and in Spain, prior to the availability of this new drug.

Insuficiencia suprarrenal y su tratamiento sustitutivo. Su realidad en España / Adrenal insufficiency and adrenal replacement therapy. Current status in Spain

Con las pautas actuales sustitutivas de glucocorticoides en los pacientes con IS tratados la calidad de vida está disminuida y existe una mayor morbimortalidad, probablemente en relación tanto con la sobredosificación como con la falta de glucocorticoides con picos y nadires no fisiológicos a lo largo de las 24h. La disponibilidad de un nuevo fármaco con liberación modificada dual (inmediata y retardada) que requiere una sola dosis diaria mejora y simplifica el tratamiento, incrementa la adherencia, mejora la calidad de vida, la morbilidad y posiblemente la mortalidad. Esta revisión repasa la realidad y conocimientos sobre el tema tanto globalmente como en España ante la situación previsible de disponer en el futuro de este nuevo fármaco. La insuficiencia suprarrenal (IS) es una enfermedad poco frecuente pero con riesgo vital si no se trata. Puede ser por fallo primario de las glándulas suprarrenales (IS primaria) o por mal funcionamiento del eje hipotalámico-hipófiso-adrenal (HPA) (IS secundaria). La carencia de datos sobre la incidencia/prevalencia de la IS en España dificulta apreciar la magnitud del problema en nuestro país. Los síntomas iniciales son inespecíficos, por lo que con frecuencia se retrasa el diagnóstico (AU)

Adrenal insufficiency (AI) is a rare endocrine disease, associated to increased mortality if left untreated. It can be due to a primary failure of the adrenal glands (primary AI) or malfunctioning of the hypothalamic-pituitary-adrenal axis (HPA) (secondary AI). The lack of data on incidence/prevalence of adrenal insufficiency in Spain complicates any evaluation of the magnitude of the problem in our country. Initial symptoms are non-specific, so often there is a delay in diagnosis. Current therapy with available glucocorticoids is associated with decreased quality of life in patients with treated AI, as well as with increased mortality and morbidity, probably related to both over-treatment and lack of hydrocortisone, associated with non-physiological peaks and troughs of the drug over the 24hours. The availability of a new drug with a modified dual release (immediate and retarded), that requires one only daily dose, improves and simplifies the treatment, increases compliance as well as quality of life, morbidity and possibly mortality. This revision deals with the knowledge on the situation both globally and in Spain, prior to the availability of this new drug (AU)

Weight-related quality of life in Spanish obese subjects suitable for bariatric surgery is lower than in their North American counterparts: a case-control study.

BACKGROUND: Obesity impairs quality of life, but the perception of the impairment could be different from one country to another. The purpose was to compare weight-related quality of life (QOL) between cohorts from Spain and North America. METHODS: A cross-sectional case-control study was performed between two populations. Four hundred Spanish and 400 North American obese subjects suitable for bariatric surgery closely matched for race, gender, age, and body mass index (BMI) were included. Two non-obese control groups matched for gender, age, and BMI from each population were also evaluated (n = 400 in each group). The participants completed the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, a measure of weight-related QOL. RESULTS: Spanish morbidly obese patients showed poorer QOL than their North American counterparts in physical function, sexual life, work, and total score. By contrast, Spanish non-obese control subjects reported better QOL in all domains than their North American counterparts. Women, both in Spain and North America, reported reduced QOL compared to men on the domain of self-esteem. In addition, North American women reported reduced QOL on the sexual life domain compared to men. BMI correlated negatively with all domains of QOL except for self-esteem in both national groups. CONCLUSIONS: Spanish obese subjects suitable for bariatric surgery report poorer weight-related quality of life than their North American counterparts, and obese women, regardless of nationality, perceive a reduced quality of life compared to men.

Effects of orlistat on visceral fat after liposuction.

BACKGROUND: Liposuction can aggravate metabolic complications associated with obesity. It has been shown that the recovery of weight lost through these interventions is associated with body fat redistribution toward the visceral cavity, increasing metabolic risk factors for coronary heart disease such as insulin resistance and high triglyceride levels. OBJECTIVES: The aim of this study was to evaluate the consequences of liposuction on body mass redistribution and metabolic parameters 6 months after surgery and to evaluate the use of orlistat treatment (tetrahydrolipstatin) in controlling these parameters. METHODS: A population of 31 women with a mean body mass index of 26.17+/-3.9 kg/m(2) and undergoing liposuction of more than 1,000 cm(3), was studied. Twelve of them were treated postsurgery with 120 mg of orlistat every 8 hours for the following 6 months. Anthropometric, analytical, and radiological (computed tomography) tests were performed to quantify visceral fat area before surgery and 6 months after surgery. RESULTS: Despite weight loss after liposuction, visceral fat was not modified. Patients treated with orlistat showed a greater reduction in visceral fat, although not statistically significant. Orlistat use induced a reduction in low-density lipoprotein cholesterol values of 20.0+/-22.5 mg/dL, compared with an increase of 8.46+/-20.1 mg/dL in controls (p=.07). CONCLUSIONS: Visceral fat does not decrease despite weight loss after liposuction. Orlistat use postliposuction might be a useful tool because it shows a tendency to reduce visceral fat and improve blood lipids profile.

Independent impact of obesity and fat distribution in hypertension prevalence and control in the elderly.

BACKGROUND: Studies on the impact of weight excess and fat distribution on blood pressure are usually limited to young and middle-aged population, and data on the elderly are scarce. METHODS AND RESULTS: We performed an analysis of the Prevencion de Riesgo de Ictus, a population-based study on individuals aged 60 years or more in Spain, to assess the impact of weight excess, stratified by body mass index (normal <25; overweight 25-29.9; obesity > or =30 kg/m), and waist circumference [increased if > or =88 cm (women) or > or =102 (men)] on the prevalence on hypertension and lack of blood pressure control. In 6263 individuals (mean age 71.9 years old, 53.3% women; 73.0% with diagnosed hypertension), prevalence of obesity was 35.0%, and 65.6% showed an increased waist circumference. Body mass index and waist circumference showed an independent impact on the prevalence and absence of hypertension control. In a multivariate model including age, sex, body mass index, and waist circumference, prevalence of hypertension was higher in the overweight and obesity groups (odds ratio 1.41 and 1.96, respectively, compared to normal weight), and in those with increased waist circumference (odds ratio 1.25) compared with normal waist circumference. After further adjustment for antihypertensive therapy, overweight, and obesity (odds ratio 1.40 and 1.59, respectively) as well as increased waist circumference (odds ratio 1.39) were independently related to absence of blood pressure control. The impact of waist circumference on hypertension and blood pressure control was shown in each category of body mass index. CONCLUSION: In this cross-sectional study in an elderly population, body mass index and waist circumference showed an independent and direct impact on the prevalence of hypertension and on the absence of blood pressure control.

[Prevalence and related factors of overweight and obesity in Spanish population aged 60 years-old or older. The PREV-ICTUS study]. / Prevalencia de sobrepeso y obesidad en población española de 60 años o más y factores relacionados. Estudio PREV-ICTUS.

BACKGROUND AND OBJECTIVE: Data on the prevalence of obesity in elderly population in Spain are scarce. The objective of this work was to describe the prevalence of obesity and the related factors in a random sample of Spanish population aged 60 years-old or more, stratified by autonomous communities. SUBJECTS AND METHOD: We analyzed the PREV-ICTUS study, a population-based study carried out between September and December 2005 in a random sample stratified by autonomous communities according to the census of inhabitants and the habitat in each community. Subjects were classified as with normal weight (body mass index [BMI] < 25 kg), overweight (BMI 25-29.9) and obesity (BMI > or = 30 kg). RESULTS: In 6,843 subjects -mean age (standard deviation): 71.9 (7.1) years-old; 53.3% women-, prevalence of obesity was 34.5% (95% confidence interval [CI], 33.3-35.5%), higher in women (38.4%; 95% CI, 36.8-39.9%) than in men (30.0%; 95% CI, 28.4-31.6%; p < 0.001), with a tendency to decrease in the older population. In total, 81.7% of the population showed overweight (BMI > or = 25). Prevalence differed among communities from 46.4% to 20.7% (p < 0.001). In the multivariate analysis, obesity was inversely related to age (odds ratio [OR] = 0.98 per each year increment), and directly to female gender (OR = 1.25), rural (OR = 1.50) or semi-urban habitat (OR = 1.38), sedentary lifestyle (OR = 1.86) and non-smoking history (OR = 1.19). CONCLUSIONS: Obesity was present in one out of 3 individuals of this reasonably representative sample of the Spanish population in an age range, 60 years-old or more, which concentrates a high cardiovascular risk. Differences in the prevalence among autonomus communities were detected.

Prevalencia de sobrepeso y obesidad en población española de 60 años o más y factores relacionados. Estudio PREV-ICTUS / Prevalence and related factors of overweight and obesity in Spanish population aged 60 years-old or older. The PREV-ICTUS study

FUNDAMENTO Y OBJETIVO: Los datos sobre prevalencia de obesidad en población de edad avanzadaen España son escasos. El objetivo de este trabajo ha sido describir la prevalencia de obesidady los factores relacionados en una muestra aleatoria de la población española de 60 años o más, estratificada por comunidades autónomas (CC.AA.).SUJETOS Y MÉTODO: Se analizó el estudio PREV-ICTUS, realizado en una muestra seleccionadaaleatoriamente entre septiembre y diciembre de 2005, estratificada por CC.AA. según el censo yel hábitat de atención. Se clasificó a los sujetos según su índice de masa corporal (IMC) enaquellos con peso normal (IMC < 25), sobrepeso (IMC de 25-29,9) y obesos (IMC 30).RESULTADOS: En 6.843 sujetos –edad media (desviación estándar) de 71,9 (7,1) años; 53,3%mujeres– la prevalencia de obesidad fue del 34,5% (intervalo de confianza [IC] del 95%, 33,3-35,5%), mayor en mujeres (38,4%; IC del 95%, 36,8-39,9%) que en varones (30,0%; IC del95%, 28,4-31,6%; p < 0,001), con tendencia a disminuir en edades más avanzadas. En total,el 81,7% mostró exceso ponderal (IMC 25). La prevalencia varió entre las CC.AA., del 46,4al 20,7% (p < 0,001). En el análisis multivariante, la obesidad guardó una relación inversa conla edad (odds ratio [OR] = 0,98 por cada incremento en un año) y directa con el sexo femenino(OR = 1,25), el medio rural (OR = 1,50) o semiurbano (OR = 1,38), el sedentarismo (OR =1,86) y el antecedente de no fumador (OR = 1,19).CONCLUSIONES: La obesidad estuvo presente en uno de cada 3 individuos en esta muestra razonablementerepresentativa de la población española de un intervalo de edad, 60 años o más, que ademásconcentra un gran riesgo cardiovascular. Se observaron diferencias en la prevalencia entre las CC.AA

BACKGROUND AND OBJECTIVE: Data on the prevalence of obesity in elderly population in Spain are scarce. The objective of this work was to describe the prevalence of obesity and the related factors in a random sample of Spanish population aged 60 years-old or more, stratified by autonomous communities. SUBJECTS AND METHOD: We analyzed the PREV-ICTUS study, a population-based study carried out between September and December 2005 in a random sample stratified by autonomous communities according to the census of inhabitants and the habitat in each community. Subjects were classified as with normal weight (body mass index [BMI] < 25 kg), overweight (BMI 25-29.9) and obesity (BMI 30 kg). RESULTS: In 6,843 subjects –mean age (standard deviation): 71.9 (7.1) years-old; 53.3% women–, prevalence of obesity was 34.5% (95% confidence interval [CI], 33.3-35.5%), higher in women (38.4%; 95% CI, 36.8-39.9%) than in men (30.0%; 95% CI, 28.4-31.6%; p < 0.001), with a tendency to decrease in the older population. In total, 81.7% of the population showed overweight (BMI 25). Prevalence differed among communities from 46.4% to 20.7% (p < 0.001). In the multivariate analysis, obesity was inversely related to age (odds ratio [OR] = 0.98 per each year increment), and directly to female gender (OR = 1.25), rural (OR = 1.50) or semiurban habitat (OR = 1.38), sedentary lifestyle (OR = 1.86) and non-smoking history (OR = 1.19). CONCLUSIONS: Obesity was present in one out of 3 individuals of this reasonably representative sample of the Spanish population in an age range, 60 years-old or more, which concentrates a high cardiovascular risk. Differences in the prevalence among autonomus communities were detected