Prevalence, trend and associated factors of obesity-related cancers among U.S. adults with metabolic syndrome: Evidence from the National Health and Nutrition Examination Survey 2001-2018.

INTRODUCTION: This study evaluated the prevalence, associated factors and trends in the prevalence of obesity-related cancer (ORC) among U.S. adults with metabolic syndrome (MetS) and age ≥20 years. METHODS: This study used cross-sectional data from the 2001-2018 National Health and Nutrition Examination Survey. The total period analyses included prevalence estimation, chi-square tests for comparing ORC vs non-ORC within subgroups, and a multivariable-logistic regression model to evaluate associated factors of ORC. For trend analysis, the total period was divided into three time periods: 2001-2006, 2007-2012 and 2013-2018. Age-standardized prevalence of ORC in each time period was calculated. RESULTS: The ORC prevalence was 35.8% representing 4463614 adults with MetS. A higher odds of ORC was observed among females (OR = 7.1, 95% CI = 4.9-10.3) vs males, Hispanic (OR = 2.9, 95% CI = 1.7-4.8) and non-Hispanic Black (OR = 2.7, 95% CI = 1.8-4) vs non-Hispanic White, age ≥60 (OR = 5.4, 95% CI = 1.9-15.4) vs age 20-39 years. Individual ORCs were thyroid (10.95%), breast (10%), uterine (9.18%), colorectal (7.86%), ovarian (5.74%), and stomach (0.80%). The age-standardized prevalence of ORC was observed stable in three time periods (30.6%, 30.3% and 30.7%). However, an increasing trend was seen for thyroid, uterine, colorectal and ovarian cancers while decreasing trend for breast cancer. Hispanic people showed a significant increasing trend of ORC (p = 0.004). CONCLUSIONS: ORC was found significantly higher among female, Hispanic, non-Hispanic black and older people with MetS. The stable temporal trend of overall ORC, with an increasing trend in certain ORCs, makes the disease spectrum a public health priority. The findings imply the importance of intensifying efforts to reduce the burden of MetS comorbidities among U.S. adults.

Maternal Obesity and Patterns in Postnatal Diet, Physical Activity and Weight among a Highly Deprived Population in the UK: The GLOWING Pilot Trial.

Preconception obesity is associated with adverse pregnancy outcomes and deprivation. The postnatal period provides an opportunity for preconception intervention. There is a lack of published postnatal behaviour and weight data to inform intervention needs. Secondary analysis of the GLOWING study explored postnatal diet, physical activity (PA) and weight among women living with obesity in deprivation. Thirty-nine women completed food frequency and PA questionnaires and provided weight measurement(s) between 3-12 months postnatal. Women's diet and PA fell short of national guidelines, especially for fruit/vegetables (median 1.6-2.0 portions/day) and oily fish (0-4 g/day). PA was predominantly light intensity. Patterns in weight change across time points indicated postnatal weight loss compared with 1st (median -0.8 to -2.3 kg) and 3rd-trimester weights (-9.0 to -11.6 kg). Weight loss was higher among women without excessive gestational weight gain (GWG) (-2.7 to -9.7 kg) than those with excessive GWG (2.3 to -1.8 kg), resulting in postnatal weight measurements lower than their 1st trimester. These pilot data suggest preconception interventions should commence in pregnancy with a focus on GWG, and postnatal women need early support to achieve guideline-recommendations for diet and PA. Further research in a larger population could inform preconception intervention strategies to tackle inequalities in maternal obesity and subsequent pregnancy outcomes.

Emotional Overeating during the COVID-19 Pandemic: Polish Adolescents' COVID-19 Experience (PLACE-19) Study.

Emotional overeating is the most frequently noted type of emotional eating, being commonly associated with increased consumption of energy-dense products, as well as excessive body mass, and weight gain. Even though a number of studies assessed emotional overeating during the COVID-19 pandemic in adult populations, studies of children and adolescents are scarce. The aim of the present study was to assess emotional overeating background, including consumption in response to six emotions (anxiety, sadness, loneliness, tiredness, anger, and happiness), in the population of Polish adolescents within the PLACE-19 Study during the COVID-19 pandemic. The PLACE-19 Study is a national Polish population-based study of adolescents gathered upon recruitment based on a random quota sampling of secondary schools, conducted in a population of 1126 students (818 females and 308 males, a median of age 17.0 and 16.5 years, respectively). Emotional overeating was assessed while using the Emotional Overeating Questionnaire (EOQ), and as additional factors, the following were assessed: gender, body mass, body mass change during the COVID-19 pandemic, and declared tempting food products. Female participants declared a higher frequency of overeating in response to feelings of anxiety, sadness, loneliness, and happiness, and were characterized by a higher total score than male participants, while p ≤ 0.05 was interpreted as a statistical significance. Obese participants declared a higher frequency of overeating in response to feelings of sadness, and loneliness than normal weight participants. Participants gaining weight declared a higher frequency of overeating in response to feelings of anxiety, sadness, loneliness, tiredness, and anger, and were characterized by a higher total score than participants losing weight or maintaining a stable weight, while participants gaining weight declared a higher frequency of overeating in response to feelings of happiness than participants losing weight. Participants declaring both sweet and salty products as tempting declared a higher frequency of overeating in response to feelings of anxiety, and sadness than participants declaring no tempting products; participants declaring both sweet and salty products declared a higher frequency of overeating in response to feelings of tiredness than participants declaring only salty products and those declaring no tempting products, as well as declared a higher frequency of overeating in response to feelings of happiness than participants declaring only sweet products, and those declaring no tempting products; participants declaring sweet products declared a higher frequency of overeating in response to feelings of anger than participants declaring no tempting products, while participants declaring both sweet and salty products declared a higher frequency of overeating in response to feelings of loneliness, and were characterized by a higher total score than all other respondents. The sub-groups with the highest frequency of emotional overeating were the female respondents, obese participants, those gaining weight, and those declaring both sweet and salty products as tempting, while among the emotions most often causing emotional overeating, there were sadness and loneliness.

Ethnicity/race, parent educational attainment, and obesity associated with prediabetes in children.

BACKGROUND/OBJECTIVES: Obesity and other predictors of type 2 diabetes disproportionally affect Hispanic and Black children in the US compared to non-Hispanic White (NHW) children. Yet, the prevalence of prediabetes in children remains unestablished, and guidelines for screening young children are lacking. This study examined the relationships between demographic factors and prediabetes in vulnerable youth in central Texas. SUBJECTS/METHODS: This is a cross-sectional analysis of baseline data from 976 3rd-5th graders (7-12 years) who participated in TX Sprouts, a school-based gardening, nutrition, and cooking trial in 16 elementary schools serving mainly children from minority backgrounds and lower-income households. Measures collected included age, sex, ethnicity, free/reduced-priced school lunch (FRL) status, parent educational attainment (questionnaires), BMI from height (stadiometer) and weight (TANITA scale), and prediabetes status from fasting plasma glucose (FPG) and HbA1c. Regressions examined cross-sectional associations between demographics and FPG, HbA1c, and prediabetes. RESULTS: Children were 47% male, 67% Hispanic, and 10% Black, with a mean age of 9.3 years; 71% received FRL, 50% had overweight/obesity, and 26% had prediabetes. Prediabetes rates were 2.8 and 4.8 times higher in Hispanic and Black children compared to NHW children, respectively (p ≤ 0.001), and 1.5 times higher in children with obesity versus normal BMI (p = 0.02). Children of parents with only an 8th-grade education, some high school education, or a high school degree had 3.1, 2.7, and 2.2 times higher odds of having prediabetes compared to children of college graduates, respectively (p ≤ 0.004). Analyses with FPG and HbA1c yielded similar results. CONCLUSION: These findings suggest a potential need for earlier screening, more comprehensive testing guidelines, and prevention programs tailored toward minority children, children with obesity, and children of parents with low educational attainment. Future research should explore this finding in a larger, nationally representative sample.

An examination of the relationships between the neighborhood social environment, adiposity, and cardiometabolic disease risk in adolescence: a cross-sectional study.

BACKGROUND: Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years. METHODS: This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey five-year block group estimates, 2012-2016. Multilevel linear regression models were used to examine whether neighborhood concentrated disadvantage index and perceived neighborhood disorder were associated with body mass index, waist circumference, body fat, adipose tissue, blood pressure, and lipids. We performed multilevel logistic regression to determine the odds of elevated adiposity and cardiometabolic disease risk for adolescents living in neighborhoods with varying levels of neighborhood concentrated disadvantage and disorder. RESULTS: Adolescents living in neighborhoods with higher disadvantage or disorder had greater waist circumference and total percent body fat compared to those in less disadvantaged and disordered neighborhoods (p for trend < 0.05). Neighborhood disadvantage was also positively associated with percentage of the 95th Body Mass Index percentile and visceral abdominal adipose tissue mass while greater perceived neighborhood disorder was related to higher trunk fat mass and diastolic blood pressure (p for trend < 0.05). Living in the most disadvantaged was associated with greater odds of obesity (OR: 2.9, 95% CI:1.3, 6.5) and being in the top tertile of body fat mass (OR: 3.0, 95% CI: 1.4, 6.6). Similar results were found with neighborhood disorder for odds of obesity (OR: 2.1, 95% CI:1.1, 4.2) and top tertile of body fat mass (OR: 2.1, 95% CI:1.04, 4.1). CONCLUSIONS: Neighborhood social environment measures of chronic stress exposure were associated with excess adiposity during adolescence, and relationships were most consistently identified among adolescents living in the most disadvantaged and disordered neighborhoods. Future studies should account for the influences of the neighborhood environment to stimulate equitable improvements in adolescent health. CLINICAL TRIALS REGISTRATION: # NCT02784509.

Association between the weight-adjusted waist index and stroke: a cross-sectional study.

BACKGROUND: The weight-adjusted waist index (WWI) is a new measure of obesity, and this study aimed to determine the association between the WWI and stroke. METHODS: Using the National Health and Nutrition Examination Survey (NHANES) 2011-2020 dataset, cross-sectional data from 23,389 participants were analysed. The correlation between the WWI and stroke was investigated through multivariate logistic regression and smoothing curve fitting. Subgroup analysis and interaction tests were also carried out. RESULTS: The research involved 23,389 participants, of whom 893 (3.82%) had a stroke. The fully adjusted model revealed a positive correlation between the WWI and stroke [1.25 (1.05, 1.48)]. Individuals who were in the highest quartile of WWI exhibited a 62% higher likelihood of experiencing a stroke than those in the lowest quartile [1.62 (1.06, 2.48)]. Subgroup analysis and interaction tests revealed that this positive correlation was similar in different population settings (all P for interaction > 0.05). CONCLUSION: A higher WWI was associated with a higher prevalence of stroke. The results of this study underscore the value of the WWI in stroke prevention and management.

From Pleasure to Pathology: Understanding the Neural Basis of Food Addiction in the Context of Obesity.

As rates of severe obesity continue to rise globally, intense efforts are required both from the scientific community, physicians and health policy makers to better understand the mechanisms, prevent and treat obesity in order to stop the upcoming pandemic. Obesity is known to significantly reduce life expectancy and overall quality of life, thus becoming a leading cause of preventable deaths. This article focuses on the relationship between obesity and food addiction, the main neural mechanisms, brain regions, genes, hormones and neurotransmitters involved and on the similarities between food addiction and substance abuse. The definition of obesity is based on the body mass index (BMI). A BMI of 30 or higher is classified as obese. Obesity is not solely a result of overeating, but has multifactorial causes, thus, prevention being extremely difficult. The concept of food addiction implies extreme cravings, lack of self-control, and overeating, especially involving tasty foods. The addiction concept is supported both by clinicalbehavioural research and neurobiological research. These studies demonstrate similarities between binge eating and drug addiction, including cravings, loss of control, excessive intake, tolerance, withdrawal, and distress/dysfunction. Although generally food addiction is thought to be distinct from obesity, most studies identify that a significant percentage of individuals with food addiction are obese. Our aim was to emphasize the need to better understand the neurological basis of obesity and addiction, and its implications for research, treatment, and public health initiatives. Understanding the neural mechanisms underlying food addiction can inform future healthcare policies and interventions aimed at addressing the global obesity epidemic.

Meal intake in an adult Moroccan population: determinants and implications for weight status.

Background: In recent decades, the Moroccan population has changed its dietary practices, particularly those related to meal-taking. It is about irregular meal schedules, reduced frequency and shorter time of meal taking times, as well as a decrease in family meal-taking. All these factors are likely to influence its nutritional status. Objective: The aim is to study meal-taking practices, their determinants and their implications on weight status. In this study, meal-taking practices are defined by the regularity of the schedule, the frequency and the duration of the meals as well as the family commensality. Material and Methods: This work data are part of a study conducted among 507 households in the region of Rabat-SaléKenitra in Morocco, with a validated conceptual and methodological framework. The questionnaire was completed with one member of each household and the body mass index (BMI) was determined by an impedance meter. Results: The main results indicate that the majority of the surveyed population was aged 35 years (59%), female (52%), urban (70%), with a BMI ≥25 kg/m2 (51%), took usually three meals a day (89%), spent less than 90 minutes a day in meals and snacks (60%), had irregular meal schedule (69%), and usually eat at least two meals or snacks a day with family (49%). The univariate analysis showed that urban area was a factor favoring variations of meal times, the male sex was a factor favoring three meals a day, the level of higher education was a factor penalizing the daily duration of meals, and that marital status "married" was a factor favoring family commensality. In addition, variable meal times were revealed as a factor contributing to overweight/obesity, and meal times ≥90 min were revealed as a protective factor of overweight/obesity. Conclusion: The study identified factors associated with meal times, frequency and duration. The results obtained will serve as a basis for the development of educational actions for a change in behavior conducive to health.

Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study.

Percutaneous nephrolithotomy (PCNL) is considered gold standard treatment of renal stones larger than 20 mm. Several studies have shown that ultrasound guidance during this procedure is more effective and safer than fluoroscopy. A higher body mass index (BMI) can make ultrasound-guided renal access more difficult and unsuccessful. We present a prospective analysis and comparison of ultrasound-guided PCNL in patients with normal and increased body mass index. We performed a prospective comparison of patients who underwent ultrasound-guided PCNL to remove renal stones by a single surgeon between 2020 and 2022. Patients with BMIs greater than 30 (mean 33.87-obese) were compared to those with BMIs less than 30 (mean 25.69-non-obese). Demographic, perioperative, and follow-up data were collected, analyzed, and included in this study. Total of 98 consecutive patients, with 49 patients in each group were analyzed. No statistically significant differences were observed in terms of stone volume (P = 0.085), stone density (P = 0.5590), location of renal access (P = 0.108), surgery duration (P = 0.38), blood loss (P = 0.54), or laboratory changes after surgery (P = 0.60). 87.76% of obese patients were stone free per CT scan at follow-up, compared to 73.47% of normal-weight patients (P = 0.1238). According to Clavien-Dindo classification, six patients in the non-obese group experienced grade II (10%) and grade III (2%) complications, as opposed to six patients in the obese group with grade I (2%), grade II (6%), and grade III (2%) complications. There was no significant correlation between body mass index and the success or safety of ultrasound-guided PCNL. Although more challenging, a higher BMI should not be an impediment to performing this approach. This method is safe, with no increased incidence of postoperative complications or compromise in stone-free status postoperatively and can diminish or avoid both patient's and medical team's exposure to ionizing radiation.

[Secular trend in overweight and obesity among Chinese children and adolescents of 7-18 years old during 2000-2019].

OBJECTIVE: To understand the current situation and trend of overweight and obesity among Chinese children and adolescents aged 7-18 years from 2000 to 2019. METHODS: The body mass index(BMI) data of 1 100 303 Han children and adolescents aged 7-18 years by national students fitness and health survey report in 2000, 2005, 2010, 2014 and 2019 were selected. The "1985 height standard weight method" was used to screen overweight and obesity, and the detection rate, growth rang and growth rate of overweight and obesity were calculated by sex and age. Statistical analysis was performed by t-test, general linear regression, chi square test, chi square trend test. RESULTS: From 2000 to 2019, BMI of Chinese children and adolescents aged 7-18 years showed an increasing trend(all P-trend< 0.001). The overweight rate of boys and girls increased from 9.42% and 7.23% in 2000 to 15.44% and 13.34% in 2019(χ~(2 )linear trend = 2531.626 and 2955.485, all P<0.001). The obesity rate increased from 6.57% and 3.43% in 2000 to 18.41% and 10.23% in 2019(χ~2 linear trend = 9101.419 and 5300.488, all P<0.001). The obesity rate of boys and girls at different ages in each year was statistically significant(all P<0.001). From 2000 to 2014, the growth rate of overweight rate of boys and girls continued to increase, reaching the maximum growth rate of 0.52%/year and 0.50%/year from 2010 to 2014, and then dropped to 0.09%/year and 0.29%/year in 2019. From 2014 to 2019, the growth rate of obesity of boys and girls(0.70%/year for boys and 0.51%/year for girls) was slightly lower than the maximum value from 2010 to 2014(0.92%/year for boys and 0.58%/year for girls), but still higher than that before 2010. From the perspective of age, the growth rate of overweight rate of boys and girls in the low age group decreased significantly, but the growth rate of obesity rate in the high age group increased significantly, and obesity showed a trend of changing from low age to old age. CONCLUSION: The detection rate of overweight and obesity among Chinese children and adolescents continued to increase from 2000 to 2019, and the growth rate from 2014 to 2019 was less than the maximum value reached in 2010 to 2014. From 2014 to 2019, the overweight of boys and girls in the low age group was effectively suppressed, and the obesity rate of boys and girls in the high age group accelerated, it is not optimistic.

A cross-sectional study from NHANES found a positive association between obesity with bone mineral density among postmenopausal women.

PURPOSE: Obesity has been demonstrated to improve bone mineral density (BMD), according to previous research. Nevertheless, there is a dearth of clarity regarding the optimal body mass index (BMI) and waist circumference (WC) for achieving the highest beneficial BMD in postmenopausal women. The objective of this study was to establish the correlation between obesity and BMD. METHODS: The relationship between BMI, WC, and BMD was examined by using multivariate logistic regression models, fitting smoothing curves and utilizing the latest data from the National Health and Nutrition Examination Survey (NHANES) survey conducted between 2007 and 2018. Furthermore, the analysis of saturation effects was employed to examine the association of nonlinear connections among BMI, WC, and BMD. RESULTS: The research examined information from a combination of 564 participants. A significant correlation between BMD and BMI as well as WC was observed in our findings. The enduring correlation between BMI and WC with BMD was demonstrated across subgroup analyses categorized by age and race, except among other Hispanic and other race. Furthermore, the smoothing curve fitting indicated that there existed not just a linear correlation among BMI, WC, and BMD, but also a saturation threshold in the association of these three factors. CONCLUSIONS: Based on our study, we have found a strong and positive relationship between obesity and BMD. According to the results of this research, maintaining obesity at a moderate level in postmenopausal women would result in achieving an optimal equilibrium between obesity and BMD.

Gene-environment interactions and the effect on obesity risk in low and middle-income countries: a scoping review.

Background: Obesity represents a major and preventable global health challenge as a complex disease and a modifiable risk factor for developing other non-communicable diseases. In recent years, obesity prevalence has risen more rapidly in low- and middle-income countries (LMICs) compared to high-income countries (HICs). Obesity traits are shown to be modulated by an interplay of genetic and environmental factors such as unhealthy diet and physical inactivity in studies from HICs focused on populations of European descent; however, genetic heterogeneity and environmental differences prevent the generalisation of study results to LMICs. Primary research investigating gene-environment interactions (GxE) on obesity in LMICs is limited but expanding. Synthesis of current research would provide an overview of the interactions between genetic variants and environmental factors that underlie the obesity epidemic and identify knowledge gaps for future studies. Methods: Three databases were searched systematically using a combination of keywords such as "genes", "obesity", "LMIC", "diet", and "physical activity" to find all relevant observational studies published before November 2022. Results: Eighteen of the 1,373 articles met the inclusion criteria, of which one was a genome-wide association study (GWAS), thirteen used a candidate gene approach, and five were assigned as genetic risk score studies. Statistically significant findings were reported for 12 individual SNPs; however, most studies were small-scale and without replication. Conclusion: Although the results suggest significant GxE interactions on obesity in LMICs, updated robust statistical techniques with more precise and standardised exposure and outcome measurements are necessary for translatable results. Future research should focus on improved quality replication efforts, emphasising large-scale and long-term longitudinal study designs using multi-ethnic GWAS.

Prevalence of comorbidities and its associated factors among type-2 diabetes patients: a hospital-based study in Jashore District, Bangladesh.

OBJECTIVE: This study aimed to estimate the prevalence of comorbidity and its associated factors among Bangladeshi type-2 diabetes (T2D) patients. DESIGN: A hospital-based cross-sectional study. SETTING: This study was conducted in two specialised diabetic centres residing in the Jashore District of Bangladesh. A systematic random sampling procedure was applied to identify the T2D patients through a face-to-face interview. PARTICIPANTS: A total of 1036 patients with T2D were included in this study. A structured questionnaire was administered to collect data on demographic, lifestyle, medical and healthcare access-related data through face-to-face and medical record reviews. OUTCOME MEASURES AND ANALYSES: The main outcome variable for this study was comorbidities. The prevalence of comorbidity was measured using descriptive statistics. A logistic regression model was performed to explore the factors associated with comorbidity among Bangladeshi T2D patients. RESULTS: The overall prevalence of comorbidity was 41.4% and the most prevalent conditions were hypertension (50.4%), retinopathy (49.6%), obesity (28.7%) and oral problem (26.2). In the regression model, the odds of comorbidities increased with gender (male: OR: 1.27, 95% CI 0.62 to 1.87), age (50-64 years: OR: 2.14, 95% CI 1.32 to 2.93; and above 65 years: OR: 2.96, 95% CI 1.83 to 4.16), occupation (unemployment: OR: 3.32, 95% CI 0.92 to 6.02 and non-manual worker: OR: 2.31, 95% CI 0.91 to 5.82), duration of diabetes (above 15 years: OR: 3.28, 95% CI 1.44 to 5.37), body mass index (obese: OR: 2.62, 95% CI 1.24 to 4.26) of patients. We also found that individuals with recommended moderate to vigorous physical activity levels (OR: 0.41, 95% CI 1.44 to 5.37) had the lowest odds of having comorbidity. Meanwhile, respondents with limited self-care practice, unaffordable medicine and financial problems had 1.82 times, 1.94 times and 1.86 times higher odds of developing comorbidities. CONCLUSION: The findings could be useful in designing and implementing effective intervention strategies and programmes for people with T2D to reduce the burden of comorbidity.

Association between obesity and likelihood of remission or low disease activity status in psoriatic arthritis applying index-based and patient-based definitions of remission: a cross-sectional study.

OBJECTIVES: We aimed to evaluate whether obese patients with psoriatic arthritis (PsA) were less likely to be in remission/low disease activity (LDA). METHODS: We used data from the ReFlaP, an international multi-centre cohort study (NCT03119805), which recruited consecutive adults with definite PsA (disease duration ≥ 2 years) from 14 countries. Demographics, clinical data, comorbidities, and patient-reported outcomes were collected. Remission/LDA was defined as Very Low Disease Activity (VLDA)/minimal disease activity (MDA), Disease Activity in PSoriatic Arthritis (DAPSA) ≤4/≤14, or by patients' opinion. Obesity was defined as physician-reported and/or body mass index ≥30 kg/m2. We evaluated the association between obesity and the presence of remission/LDA, with adjustment in multivariable regression models. RESULTS: Among 431 patients (49.3% women), 136 (31.6%) were obese. Obese versus non-obese patients were older, more frequently women, had higher tender joint and enthesitis counts and worse pain, physical function and health-related quality of life. Obese patients were less likely to be in VLDA; DAPSA remission and MDA, with adjusted ORs of 0.31 (95% CI 0.13 to 0.77); 0.39 (95% CI 0.19 to 0.80) and 0.61 (95% CI 0.38 to 0.99), respectively. Rates of DAPSA-LDA and patient-reported remission/LDA were similar for obese and non-obese patients. CONCLUSION: PsA patients with comorbid obesity were 2.5-3 folds less likely to be in remission/LDA by composite scores compared with non-obese patients; however, remission/LDA rates were similar based on the patients' opinion. PsA patients with comorbid obesity may have different disease profiles and require individualised management.

Effect of the GHRL gene (rs696217) polymorphism on the metabolic disorders in patients with obesity in the Ukrainian population.

Objective. Over the past four decades, the prevalence of obesity has tripled and limited genetic studies with specific SNPs have been conducted, but no investigations using ghrelin and obestatin prepropeptide (GHRL) gene have been reported in the Ukrainians population. The aim of this study was to evaluate changes in the level of metabolic hormones in the blood of obese patients in relation to the GHRL (rs696217) polymorphism. Methods. The study involved 53 obesity cases and 48 non-obesity subjects (controls). The GHRL (rs696217) polymorphism was genotyped using a TaqMan real-time polymerase chain reaction method. Blood hormones were determined with commercially available kits using a Multi-skan FC analyzer. Results. Carriers of the T allele of the GHRL (rs696217) polymorphism were statistically significantly more in patients diagnosed with obesity compared to controls indicating a genetically determined cause of obesity. We also established a significant effect of the presence of the T allele of the GHRL (rs696217) polymorphism on the decrease in the adiponectin level and the increase of resistin level in obese patients. The study of the effect of genotypes (TT, GT, GG) of the GHRL (rs696217) polymorphism on the metabolic hormone levels in the blood of obese patients did not show reliably significant differences. Conclusions. The presence of the T allele of the GHRL (rs696217) polymorphism in Ukrainian population indicates an increased risk of the obesity development regardless on the homozygous or heterozygous genotype.

Obesity and psychological distress.

The relationship between high body weight and mental health has been studied for several decades. Improvements in the quality of epidemiological, mechanistic and psychological research have brought greater consistency to our understanding of the links. Large-scale population-based epidemiological research has established that high body weight is associated with poorer mental health, particularly depression and subclinical depressive symptoms. There is some evidence for bidirectional relationships, but the most convincing findings are that greater body weight leads to psychological distress rather than the reverse. Particular symptoms of depression and distress may be specifically related to greater body weight. The psychological stress induced by weight stigma and discrimination contributes to psychological distress, and may in turn handicap efforts at weight control. Heightened systemic inflammation and dysregulation of the hypothalamic-pituitary-adrenal axis are biological mechanisms that mediate in part the relationship of greater body weight with poorer mental health. Changing negative societal attitudes to high body weights would improve the wellbeing of people living with obesity, and promote more effective weight-inclusive attitudes and behaviours in society at large, particularly in healthcare settings. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.

The provisioned primate: patterns of obesity across lemurs, monkeys, apes and humans.

Non-human primates are potentially informative but underutilized species for investigating obesity. I examined patterns of obesity across the Primate order, calculating the ratio of body mass in captivity to that in the wild. This index, relative body mass, for n = 40 non-human primates (mean ± s.d.: females: 1.28 ± 0.30, range 0.67-1.78, males: 1.24 ± 0.28, range 0.70-1.97) overlapped with a reference value for humans (women: 1.52, men: 1.44). Among non-human primates, relative body mass was unrelated to dietary niche, and was marginally greater among female cohorts of terrestrial species. Males and females had similar relative body masses, but species with greater sexual size dimorphism (male/female mass) in wild populations had comparatively larger female body mass in captivity. Provisioned populations in wild and free-ranging settings had similar relative body mass to those in research facilities and zoos. Compared to the wild, captive diets are unlikely to be low in protein or fat, or high in carbohydrate, suggesting these macronutrients are not driving overeating in captive populations. Several primate species, including chimpanzees, a sister-species to humans, had relative body masses similar to humans. Humans are not unique in the propensity to overweight and obesity. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.

BMI-based obesity classification misses children and adolescents with raised cardiometabolic risk due to increased adiposity.

OBJECTIVE: To assess how inaccurately the body mass index (BMI) is used to diagnose obesity compared to body fat percentage (BF%) measurement and to compare the cardiometabolic risk in children and adolescents with or without obesity according to BMI but with a similar BF%. METHODS: A retrospective cross-sectional investigation was conducted including 553 (378 females/175 males) white children and adolescents aged 6-17 years, 197 with normal weight (NW), 144 with overweight (OW) and 212 with obesity (OB) according to BMI. In addition to BMI, BF% measured by air displacement plethysmography, as well as markers of cardiometabolic risk had been determined in the existing cohort. RESULTS: We found that 7% of subjects considered as NW and 62% of children and adolescents classified as OW according to BMI presented a BF% within the obesity range. Children and adolescents without obesity by the BMI criterion but with obesity by BF% exhibited higher blood pressure and C-reactive protein (CRP) in boys, and higher blood pressure, glucose, uric acid, CRP and white blood cells count, as well as reduced HDL-cholesterol, in girls, similar to those with obesity by BMI and BF%. Importantly, both groups of subjects with obesity by BF% showed a similarly altered glucose homeostasis after an OGTT as compared to their NW counterparts. CONCLUSIONS: Results from the present study suggest increased cardiometabolic risk factors in children and adolescents without obesity according to BMI but with obesity based on BF%. Being aware of the difficulty in determining body composition in everyday clinical practice, our data show that its inclusion could yield clinically useful information both for the diagnosis and treatment of overweight and obesity.

Racial Disparities in Obesity-Related Cardiovascular Mortality in the United States: Temporal Trends From 1999 to 2020.

Background Obesity is a major risk factor for cardiovascular disease, with differential impact across populations. This descriptive epidemiologic study outlines trends and disparities in obesity-related cardiovascular mortality in the US population between 1999 and 2020. Methods and Results The Multiple Cause of Death database was used to identify adults with primary cardiovascular death and obesity recorded as a contributing cause of death. Cardiovascular deaths were grouped into ischemic heart disease, heart failure, hypertensive disease, cerebrovascular disease, and other. Absolute, crude, and age-adjusted mortality rates (AAMRs) were calculated by racial group, considering temporal trends and variation by sex, age, and residence (urban versus rural). Analysis of 281 135 obesity-related cardiovascular deaths demonstrated a 3-fold increase in AAMRs from 1999 to 2020 (2.2-6.6 per 100 000 population). Black individuals had the highest AAMRs. American Indian or Alaska Native individuals had the greatest temporal increase in AAMRs (+415%). Ischemic heart disease was the most common primary cause of death. The second most common cause of death was hypertensive disease, which was most common in the Black racial group (31%). Among Black individuals, women had higher AAMRs than men; across all other racial groups, men had a greater proportion of obesity-related cardiovascular mortality cases and higher AAMRs. Black individuals had greater AAMRs in urban compared with rural settings; the reverse was observed for all other races. Conclusions Obesity-related cardiovascular mortality is increasing with differential trends by race, sex, and place of residence.

Emergence of the obesity epidemic preceding the presumed obesogenic transformation of the society.

The obesity epidemic, evolving in many countries since the 1970s, has been attributed to the widespread contemporary so-called obesogenic transformation of the societies, but what preceded the epidemic? Using quantile regression, we studied the trends by year of birth in the percentile distribution of body mass index (BMI = weight/height2) of 320,962 Danish school children, born from 1930 to 1976, and of 205,153 Danish young conscripts, born from 1939 to 1959. The overall trend of the percentiles of the BMI distributions were found to be linear across the years of birth. While the percentiles below the 75th were almost stable, those above showed a steadily steeper rise the more extreme the percentile among both school children and young men is. These changes, indicating the emergence of the obesity epidemic, preceded the presumed obesogenic transformation of the society by several decades and imply that other, so far unknown, factors have been involved.