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

RESUMO

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.


Assuntos
Doenças Cardiovasculares , Hipertensão , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , China , Seguimentos , Humanos , Hipertensão/complicações , Incidência , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Fatores de Risco
2.
Adv Exp Med Biol ; 1232: 223-229, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893414

RESUMO

The aim of this study was to compare muscle O2 dynamics during exercise between aerobic capacity-matched overweight and normal-weight adults. Overweight women (OW, n = 9) and normal-weight women (NW, n = 14) performed graded treadmill exercise until exhaustion. Muscle O2 saturation (SmO2) and relative changes from rest in deoxygenated hemoglobin concentration (∆deoxy-Hb) and total hemoglobin concentration (∆total-Hb) were monitored continuously at gastrocnemius medialis muscle by near infrared spatial resolved spectroscopy. Significantly higher SmO2 and lower ∆deoxy-Hb and ∆total-Hb were observed in OW compared with NW. Pulmonary O2 uptake (VO2) normalized by fat-free mass was matched between groups. In both groups, peak VO2 was significantly correlated with change in SmO2 and ∆deoxy-Hb. Our findings suggest that both muscle blood volume and deoxygenation were lower in overweight adults, compared to aerobic capacity-matched normal-weight adults. Moreover, lowered muscle O2 extraction was related to peak VO2 in overweight adults, as well as in normal-weight adults.


Assuntos
Exercício , Músculo Esquelético , Sobrepeso , Consumo de Oxigênio , Adulto , Teste de Esforço , Feminino , Hemoglobinas , Humanos , Músculo Esquelético/metabolismo , Sobrepeso/metabolismo
3.
EuroIntervention ; 15(13): 1199-1208, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31659983

RESUMO

AIMS: The aim of this study was to evaluate the relationship between body mass index (BMI) and outcomes in patients with coronary artery disease undergoing percutaneous revascularisation. METHODS AND RESULTS: In 13 randomised trials, 22,922 patients were stratified (in kg/m2) as underweight (BMI <18.5), normal weight (18.5 ≤BMI <25, used as reference), overweight (25 ≤BMI <30), and obese (Class I [30 ≤BMI <35], Class II [35 ≤BMI <40], or Class III [BMI ≥40]). The primary endpoint was all-cause death at five years. Secondary endpoints were cardiac and non-cardiac death, target (TLR) and non-target lesion revascularisation (NTLR), myocardial infarction (MI), and definite/probable stent thrombosis. Despite adjustment for multiple confounders, overweight and Class I obesity were associated with lower all-cause mortality versus normal weight (HR 0.83, 95% CI: 0.71-0.96, and HR 0.83, 95% CI: 0.69-0.96, respectively); however, non-cardiac death was the major contributor to this effect (HR 0.77, 95% CI: 0.63-0.94 for overweight). Conversely, cardiac mortality was higher in severely obese individuals (HR 1.62, 95% CI: 1.05-2.51 for Class III obesity). Obesity was associated with higher rates of NTLR (HR 1.28, 95% CI: 1.04-1.58 for Class II obesity) but not with TLR, MI and stent thrombosis. CONCLUSIONS: Moderately increased BMI is associated with improved survival post PCI, mostly due to lower non-cardiac but not cardiac mortality.


Assuntos
Doença da Artéria Coronariana , Obesidade , Intervenção Coronária Percutânea , Índice de Massa Corporal , Humanos , Sobrepeso , Fatores de Risco , Resultado do Tratamento
4.
Vasa ; 49(1): 50-56, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31621522

RESUMO

Background: There is no study available concerning specifically the role of underweight in PAD prevalence. Patients and methods: Individuals ≥ 65 years living in urban and rural areas of two countries in Central Africa (Central African Republic and the Republic of Congo) were invited. Demographic, clinical and biological data were collected, and ankle-brachial index measured. BMI was calculated as weight/height2 and participants were categorized according to the World Health Organization as with underweight (< 18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥ 30 kg/m2). Results: Among the 1815 participants (age 73.0 years, 61.8 % females), the prevalence of underweight was 34.1 %, higher in subjects with PAD than in PAD free subjects (37.1 % vs. 33.5 %, p = 0.0333). The overall prevalence of PAD was 14.3 %. Underweight and obesity were still significantly associated with PAD after adjustment to all potential confounding factors (OR: 2.09, p = 0.0009 respectively OR: 1.90, p = 0.0336) while overweight was no more significantly associated with PAD after multivariate analysis. Conclusions: While obesity is a well-known PAD associated marker, low BMI provides novel independent and incremental information on African subject's susceptibility to present PAD, suggesting a "U-shaped" relationship between BMI and PAD in this population.


Assuntos
Doença Arterial Periférica , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Obesidade , Sobrepeso , Prevalência , Magreza
5.
J Sports Sci ; 38(1): 13-20, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31597515

RESUMO

Cross-sectional study aimed to analyse differences in cognitive performance across fitness components categories (cardiorespiratory fitness [CRF], speed-agility and muscular fitness [MF]) and weight status in children, and to determine whether physical fitness mediates the association between body mass index (BMI) and cognitive performance. Fitness components and BMI were measured using standard procedures in 630 children aged 5-to-7 years from the provinces of Cuenca and Ciudad Real, Spain. BADyG was used to assess cognitive performance. We used ANCOVA models to test mean differences in cognition scores by BMI and fitness categories. Hayes's PROCESS macro was used for mediation analyses. Children with normal weight scored better in spatial factor and general intelligence than their overweight/obese peers (p < 0.05), but differences were attenuated when controlling for CRF (p > 0.05). Children with better results in CRF and speed-agility scored better in all cognitive dimensions even after controlling for BMI (p < 0.05). Similarly, children with high MF obtained better scores in verbal factor (p < 0.05). All fitness components acted as mediators of the relationship between BMI and general intelligence (p < 0.05). These findings highlight the crucial role of fitness in minimising the negative effect of excess weight on children's cognition.Abbreviations: BMI: Body mass index; CRF: Cardiorespiratory fitness; MF: Muscular fitness; BADyG E1: Battery of general and differential aptitudes; SES: Socioeconomic status; SD: Standard deviation; IE: Indirect effect.


Assuntos
Peso Corporal/fisiologia , Cognição/fisiologia , Aptidão Física/psicologia , Índice de Massa Corporal , Aptidão Cardiorrespiratória/psicologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Inteligência/fisiologia , Masculino , Músculo Esquelético/fisiologia , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Classe Social
6.
Sci Total Environ ; 699: 134397, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31677469

RESUMO

Children are vulnerable to air pollution-induced lung function deficits, and the prevalence of obesity has been increasing in children. To evaluate the joint effects of long-term PM1 (particulate matter with an aerodynamic diameter ≤ 1.0 µm) exposure and obesity on children's lung function, a cross-sectional sample of 6740 children (aged 7-14 years) was enrolled across seven northeastern Chinese cities from 2012 to 2013. Weight and lung function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF), were measured according to standardized protocols. Average PM1, PM2.5, PM10 and nitrogen dioxide (NO2) exposure levels were estimated using a spatiotemporal model, and sulphur dioxide (SO2) and ozone (O3) exposure were estimated using data from municipal air monitoring stations. Two-level logistic regression and general linear models were used to analyze the joint effects of body mass index (BMI) and air pollutants. The results showed that long-term air pollution exposure was associated with lung function impairment and there were significant interactions with BMI. Associations were stronger among obese and overweight than normal weight participants (the adjusted odds ratios (95% confidence intervals) for PM1 and lung function impairments in three increasing BMI categories were 1.50 (1.07-2.11) to 2.55 (1.59-4.07) for FVC < 85% predicted, 1.44 (1.03-2.01) to 2.51 (1.53-4.11) for FEV1 < 85% predicted, 1.34 (0.97-1.84) to 2.04 (1.24-3.35) for PEF < 75% predicted, and 1.34 (1.01-1.78) to 1.93 (1.26-2.95) for MMEF < 75% predicted). Consistent results were detected in linear regression models for PM1, PM2.5 and SO2 on FVC and FEV1 impairments (PInteraction < 0.05). These modification effects were stronger among females and older participants. These results can provide policy makers with more comprehensive information for to develop strategies for preventing air pollution induced children's lung function deficits among children.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Obesidade/epidemiologia , Adolescente , Poluentes Atmosféricos/análise , Criança , China/epidemiologia , Cidades , Feminino , Volume Expiratório Forçado , Humanos , Pulmão/efeitos dos fármacos , Masculino , Dióxido de Nitrogênio/análise , Sobrepeso , Ozônio/análise , Material Particulado/análise , Testes de Função Respiratória , Dióxido de Enxofre , Capacidade Vital
7.
Lancet ; 395(10218): 156-164, 2020 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-31852601

RESUMO

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.


Assuntos
Custos e Análise de Custo/métodos , Desnutrição/prevenção & controle , Doenças Transmissíveis/etiologia , Desenvolvimento Econômico , Transtornos do Crescimento/complicações , Transtornos do Crescimento/economia , Transtornos do Crescimento/prevenção & controle , Humanos , Desnutrição/complicações , Desnutrição/economia , Modelos Econômicos , Estado Nutricional , Obesidade/complicações , Obesidade/economia , Obesidade/prevenção & controle , Sobrepeso/complicações , Sobrepeso/economia , Sobrepeso/prevenção & controle , Prevalência
8.
Lancet ; 395(10217): 65-74, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31852602

RESUMO

The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.


Assuntos
Desnutrição/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , África ao Sul do Saara/epidemiologia , Qualidade dos Alimentos , Humanos , Indonésia/epidemiologia , Desnutrição/etiologia , Estado Nutricional , Valor Nutritivo , Obesidade/etiologia , Sobrepeso/etiologia , Pobreza , Prevalência , Fatores Socioeconômicos
9.
Lancet ; 395(10217): 75-88, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31852605

RESUMO

Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Life-course exposure to early undernutrition followed by later overweight increases the risk of non-communicable disease, by imposing a high metabolic load on a depleted capacity for homoeostasis, and in women increases the risk of childbirth complications. These life-course trajectories are shaped both by societal driving factors-ie, rapidly changing diets, norms of eating, and physical activity patterns-and by broader ecological factors such as pathogen burden and extrinsic mortality risk. Mitigation of the DBM will require major societal shifts regarding nutrition and public health, to implement comprehensive change that is sustained over decades, and scaled up into the entire global food system.


Assuntos
Desnutrição/metabolismo , Obesidade/metabolismo , Sobrepeso/metabolismo , África ao Sul do Saara/epidemiologia , Idade de Início , Exercício , Feminino , Microbioma Gastrointestinal , Humanos , Indonésia/epidemiologia , Masculino , Desnutrição/epidemiologia , Desnutrição/microbiologia , Redes e Vias Metabólicas , Estado Nutricional , Obesidade/epidemiologia , Obesidade/microbiologia , Sobrepeso/epidemiologia , Sobrepeso/microbiologia , Prevalência
10.
Int J Cancer ; 146(3): 664-670, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30895617

RESUMO

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.


Assuntos
Neoplasias da Mama/epidemiologia , Sobrepeso/epidemiologia , Sono/fisiologia , Magreza/epidemiologia , Idoso , Índice de Massa Corporal , Neoplasias da Mama/etiologia , California/epidemiologia , Ritmo Circadiano/fisiologia , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Sobrepeso/complicações , Medição de Risco , Fatores de Risco , Magreza/complicações , Fatores de Tempo
11.
Int J Cancer ; 146(3): 874-883, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31107541

RESUMO

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.


Assuntos
Terapia Comportamental , Efeitos Psicossociais da Doença , Neoplasias Renais/epidemiologia , Neoplasias da Bexiga Urinária/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Austrália/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Previsões , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Neoplasias Renais/prevenção & controle , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações , Sobrepeso/epidemiologia , Prevalência , Sistema de Registros/estatística & dados numéricos , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fumar/terapia , Abandono do Hábito de Fumar , Neoplasias da Bexiga Urinária/prevenção & controle , Adulto Jovem
12.
Lancet ; 395(10218): 142-155, 2020 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-31852603

RESUMO

Actions to address different forms of malnutrition are typically managed by separate communities, policies, programmes, governance structures, and funding streams. By contrast, double-duty actions, which aim to simultaneously tackle both undernutrition and problems of overweight, obesity, and diet-related non-communicable diseases (DR-NCDs) have been proposed as a way to effectively address malnutrition in all its forms in a more holisitic way. This Series paper identifies ten double-duty actions that have strong potential to reduce the risk of both undernutrition, obesity, and DR-NCDs. It does so by summarising evidence on common drivers of different forms of malnutrition; documenting examples of unintended harm caused by some undernutrition-focused programmes on obesity and DR-NCDs; and highlighting examples of double-duty actions to tackle multiple forms of malnutrition. We find that undernutrition, obesity, and DR-NCDs are intrinsically linked through early-life nutrition, diet diversity, food environments, and socioeconomic factors. Some evidence shows that programmes focused on undernutrition have raised risks of poor quality diets, obesity, and DR-NCDs, especially in countries undergoing a rapid nutrition transition. This Series paper builds on this evidence to develop a framework to guide the design of double-duty approaches and strategies, and defines the first steps needed to deliver them. With a clear package of double-duty actions now identified, there is an urgent need to move forward with double-duty actions to address malnutrition in all its forms.


Assuntos
Doenças não Transmissíveis/prevenção & controle , Política Nutricional/legislação & jurisprudência , Estado Nutricional , Medicina Baseada em Evidências , Qualidade dos Alimentos , Humanos , Desnutrição/etiologia , Desnutrição/prevenção & controle , Obesidade/etiologia , Obesidade/prevenção & controle , Sobrepeso/etiologia , Sobrepeso/prevenção & controle , Fatores Socioeconômicos
16.
Niger J Clin Pract ; 22(12): 1685-1692, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31793475

RESUMO

Objectives: Obesity was previously seen as a problem in high-income countries. It is also a problem in low and middle-income countries today. The sedentary lifestyle has made this situation more pronounced. Childhood obesity continues in adulthood. Adequate and balanced nutrition and mobile lifestyle have a great role in the prevention and treatment of obesity. The aim of this study was to determine the prevalence of obesity among primary and secondary school students and related factors. Methods: The sample size was calculated as 1278 (213 × 6) for the gender distribution to be appropriate and for the primary and secondary school students to be included in the district center and villages. Considering 15% of the students' non-response rate, the number of students planned to be reached is 1500. Selection was made after the students were ranked by class, gender and place of residence. Of the 1500 students who were sampled, 1298 (86.53%) were evaluated. Results: There was no difference in body mass index between gender and place of residence. The prevalence of being overweight or obesity among secondary school students (25.2%) was significantly higher than primary school students (20.5%). Conclusion: In the childhood age group; sedentary lifestyle, having breakfast and obesity in parents had a significant effect on obesity. It is considered important for children and family members to have proper nutrition and mobile life behaviors.


Assuntos
Estilo de Vida , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Índice de Massa Corporal , Criança , Feminino , Humanos , Masculino , Prevalência , Instituições Acadêmicas
17.
J Assoc Physicians India ; 67(12): 25-30, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31801326

RESUMO

Background and Objectives: Medical nutrition therapy plays a crucial role achievement of optimal glycemic control in individuals with diabetes. This study aims to evaluate the effects of diabetes specific nutrition supplement (DSNS) along with lifestyle intervention in overweight and obese adults with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 120 overweight or obese individuals aged 30 - 65 years with T2DM, were randomly allocated to intervention (IG, n=60) and control (CG, n=60) groups in this 12-week study. All participants received dietary counselling with diet chart of 1400 kcal/day and recommendations for physical activity. DSNS was included in the dietary regimen adjusted within the daily calorie recommendations for intervention group. All participants were followed up monthly for anthropometric, biochemical and clinical assessments. Continuous glucose monitoring was performed during the initial 2 weeks and last 2 weeks of the study in a sub- sample using Flash Glucose Monitoring device to study glycemic excursions. Data was analyzed for the differences between intervention vs. control group using linear models. Results: Compared to the control group, the intervention group showed significant reduction in glycosylated haemoglobin (IG: -0.95% vs. CG: -0.48%; p=0.020) and fasting blood glucose (IG: -18.47 mg/dL vs. CG: 1.34mg/dL; p=0.03) as well as a greater reduction in postprandial plasma glucose (IG: -29.77mg/dL vs. CG: -2.64mg/dL; p=0.053). There was also a significant reduction from baseline in incremental Area under the Curve (iAUC) (p=0.01) in the intervention group (Δ -22 mg) compared to the control group (Δ -7.9 mg) with a corresponding reduction in the Mean Amplitude of Glycemic Excursion (MAGE) (P=0.04). There was no difference between groups in body weight, waist circumference, blood pressure, and lipid profile. None of the subjects in the study reported serious adverse events. Conclusion: This pilot study showed that a diabetes specific nutritional supplement was useful in improving glycemic control and reducing glycemic response in overweight and obese Asian Indian adults with T2DM.


Assuntos
Glicemia , Diabetes Mellitus Tipo 2 , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Automonitorização da Glicemia , Hemoglobina A Glicada , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Obesidade , Sobrepeso , Projetos Piloto
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1386-1391, 2019 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-31838809

RESUMO

Objective: To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors. Methods: A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting. Results: The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement. Conclusion: It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.


Assuntos
Obesidade , Sobrepeso , Adolescente , Adulto , Idoso , Índice de Massa Corporal , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Vigilância da População/métodos , Prevalência , Fatores de Risco
19.
MMW Fortschr Med ; 161(21-22): 31, 2019 12.
Artigo em Alemão | MEDLINE | ID: mdl-31828642
20.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 833-839, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31874473

RESUMO

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.


Assuntos
Diabetes Gestacional/epidemiologia , Macrossomia Fetal/epidemiologia , Obesidade/complicações , Peso ao Nascer , Índice de Massa Corporal , China/epidemiologia , Feminino , Macrossomia Fetal/etiologia , Idade Gestacional , Humanos , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Retrospectivos , Ganho de Peso
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