Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.897
Filtrar
1.
Pan Afr Med J ; 39: 94, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34466196

RESUMO

Introduction: different studies have shown a relationship between depression and nutrition, but there seems to be no consistent consensus on this. This study therefore investigated the relationship of nutrition status and depression among workers in tertiary educational institutions in Southwestern Nigeria. Methods: this was a cross-sectional study conducted among 399 members of staff of three tertiary educational institutions in Osun State, Southwestern Nigeria. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), while nutritional status was assessed using the body mass index (BMI), waist circumference and waist hip ratio (WHR). The respondents were selected using multi-stage sampling technique, and data were collected using pre-tested structured questionnaires. Analysis was done using IBM SPSS. Results: the mean age of the respondents was 45.8 ± 10.4 years. The prevalence of depression was 23.8%. Concerning the nutritional status of respondents, 2.3% were underweight and 69.7% were overweight/obese. There were statistically significant associations between depression and the nutritional status of the respondents using BMI (p = 0.001), WHR (p = 0.015) and waist circumference (p = 0.036). After controlling for other factors, only the BMI was still significantly associated with depression, such that those underweight were more likely to be depressed (Odds ratio: 7.9; p-value: 0.009). Conclusion: the prevalence of depression among the respondents was relatively high, and this was significantly associated with the BMI, even after controlling for co-founders.


Assuntos
Depressão/epidemiologia , Estado Nutricional , Magreza/complicações , Adulto , Índice de Massa Corporal , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Prevalência , Inquéritos e Questionários , Magreza/epidemiologia , Relação Cintura-Quadril
2.
JAMA ; 326(8): 736-743, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34427594

RESUMO

Importance: An estimated 13% of all US adults (18 years or older) have diabetes, and 34.5% meet criteria for prediabetes. The prevalences of prediabetes and diabetes are higher in older adults. Estimates of the risk of progression from prediabetes to diabetes vary widely, perhaps because of differences in the definition of prediabetes or the heterogeneity of prediabetes. Diabetes is the leading cause of kidney failure and new cases of blindness among adults in the US. It is also associated with increased risks of cardiovascular disease, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis and was estimated to be the seventh leading cause of death in the US in 2017. Screening asymptomatic adults for prediabetes and type 2 diabetes may allow earlier detection, diagnosis, and treatment, with the ultimate goal of improving health outcomes. Objective: To update its 2015 recommendation, the USPSTF commissioned a systematic review to evaluate screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant adults and preventive interventions for those with prediabetes. Population: Nonpregnant adults aged 35 to 70 years seen in primary care settings who have overweight or obesity (defined as a body mass index ≥25 and ≥30, respectively) and no symptoms of diabetes. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for prediabetes and type 2 diabetes and offering or referring patients with prediabetes to effective preventive interventions has a moderate net benefit. Conclusions and Recommendation: The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions. (B recommendation).


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Programas de Rastreamento/normas , Estado Pré-Diabético/diagnóstico , Adulto , Idoso , Glicemia/análise , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/terapia , Progressão da Doença , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Estado Pré-Diabético/terapia , Comportamento de Redução do Risco
3.
JAMA ; 326(8): 744-760, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34427595

RESUMO

Importance: Type 2 diabetes is common and is a leading cause of morbidity and disability. Objective: To review the evidence on screening for prediabetes and diabetes to inform the US Preventive Services Task Force (USPSTF). Data Sources: PubMed/MEDLINE, Cochrane Library, and trial registries through September 2019; references; and experts; literature surveillance through May 21, 2021. Study Selection: English-language controlled studies evaluating screening or interventions for prediabetes or diabetes that was screen detected or recently diagnosed. Data Extraction and Synthesis: Dual review of abstracts, full-text articles, and study quality; qualitative synthesis of findings; meta-analyses conducted when at least 3 similar studies were available. Main Outcomes and Measures: Mortality, cardiovascular morbidity, diabetes-related morbidity, development of diabetes, quality of life, and harms. Results: The review included 89 publications (N = 68 882). Two randomized clinical trials (RCTs) (25 120 participants) found no significant difference between screening and control groups for all-cause or cause-specific mortality at 10 years. For harms (eg, anxiety or worry), the trials reported no significant differences between screening and control groups. For recently diagnosed (not screen-detected) diabetes, 5 RCTs (5138 participants) were included. In the UK Prospective Diabetes Study, health outcomes were improved with intensive glucose control with sulfonylureas or insulin. For example, for all-cause mortality the relative risk (RR) was 0.87 (95% CI, 0.79 to 0.96) over 20 years (10-year posttrial assessment). For overweight persons, intensive glucose control with metformin improved health outcomes at the 10-year follow-up (eg, all-cause mortality: RR, 0.64 [95% CI, 0.45 to 0.91]), and benefits were maintained longer term. Lifestyle interventions (most involving >360 minutes) for obese or overweight persons with prediabetes were associated with reductions in the incidence of diabetes (23 RCTs; pooled RR, 0.78 [95% CI, 0.69 to 0.88]). Lifestyle interventions were also associated with improved intermediate outcomes, such as reduced weight, body mass index, systolic blood pressure, and diastolic blood pressure (pooled weighted mean difference, -1.7 mm Hg [95% CI, -2.6 to -0.8] and -1.2 mm Hg [95% CI, -2.0 to -0.4], respectively). Metformin was associated with a significant reduction in diabetes incidence (pooled RR, 0.73 [95% CI, 0.64 to 0.83]) and reduction in weight and body mass index. Conclusions and Relevance: Trials of screening for diabetes found no significant mortality benefit but had insufficient data to assess other health outcomes; evidence on harms of screening was limited. For persons with recently diagnosed (not screen-detected) diabetes, interventions improved health outcomes; for obese or overweight persons with prediabetes, interventions were associated with reduced incidence of diabetes and improvement in other intermediate outcomes.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Programas de Rastreamento , Estado Pré-Diabético/diagnóstico , Adulto , Idoso , Causas de Morte , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/terapia , Feminino , Humanos , Masculino , Programas de Rastreamento/efeitos adversos , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Estado Pré-Diabético/complicações , Estado Pré-Diabético/mortalidade , Estado Pré-Diabético/terapia , Comportamento de Redução do Risco
5.
Nutrients ; 13(8)2021 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-34445049

RESUMO

Vitamin D deficiency is highly prevalent in patients with overweight/obesity and type 2 diabetes (T2DM). Herein, we investigated the relationship between vitamin D status and overweight/obesity status, insulin resistance (IR), systemic inflammation as well as oxidative stress (OS). Anthropometric and laboratory assessments of 25-hydroxyvitamin D (25(OH)D) and glycemic, pro-inflammatory and OS biomarkers were performed in a sample of 47 patients with T2DM who were divided into categories based on overweight and degree of obesity. The main findings were: the overweight/obesity status correlated negatively with the degree of serum 25(OH)D deficiency (ρ = -0.27) with a trend towards statistical significance (p = 0.069); the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly different (p = 0.024) in patients with 25(OH)D deficiency, as was total oxidant status (TOS) and oxidative stress index (OSI) in patients with severe serum 25(OH)D deficiency as compared to those with 25(OH)D over 20 ng/mL (TOS: p = 0.007, OSI: p = 0.008); and 25(OH)D had a negative indirect effect on TOS by body mass index (BMI), but BMI was not a significant mediator of the studied relationship. In a setting of overweight and increasing degree of obesity, patients with T2DM did not display decreasing values of 25(OH)D. Subjects with the lowest values of 25(OH)D presented the highest values of BMI. Patients with 25(OH)D deficiency were more insulin resistant and showed increased OS but no elevated systemic inflammation. The negative effect of 25(OH)D on TOS did not seem to involve BMI as a mediator.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Estado Nutricional/fisiologia , Obesidade/sangue , Sobrepeso/sangue , Vitamina D/análogos & derivados , Adulto , Idoso , Antropometria , Biomarcadores/sangue , Glicemia/metabolismo , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Inflamação , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Estresse Oxidativo , Prevalência , Estudos Prospectivos , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
6.
Nutrients ; 13(7)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34371815

RESUMO

High blood pressure is a crucial risk factor for many cardiovascular diseases, and a diet rich in whole-grain foods may modulate blood pressure. This study investigated the effects of dehulled adlay consumption on blood pressure in vivo. We initially fed spontaneous hypertensive rats diets without (SHR group) or with 12 or 24% dehulled adlay (SHR + LA and SHR + HA groups), and discovered that it could limit blood pressure increases over a 12-week experimental period. Although we found no significant changes in plasma, heart, and kidney angiotensin-converting enzyme activities, both adlay-consuming groups had lower endothelin-1 and creatinine concentrations than the SHR group; the SHR + HA group also had lower aspartate aminotransferase and uric acid levels than the SHR group did. We later recruited 23 participants with overweight and obesity, and they consumed 60 g of dehulled adlay daily for a six-week experimental period. At the end of the study, we observed a significant decrease in the group's systolic blood pressure (SBP), and the change in SBP was even more evident in participants with high baseline SBP. In conclusion, our results suggested that daily intake of dehulled adlay had beneficial effects in blood-pressure management. Future studies may further clarify the possible underlying mechanisms for the consuming of dehulled adlay as a beneficial dietary approach for people at risk of hypertension.


Assuntos
Pressão Sanguínea/fisiologia , Coix , Dieta/métodos , Hipertensão/dietoterapia , Grãos Integrais , Adulto , Animais , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Hipertensão/etiologia , Masculino , Fenômenos Fisiológicos da Nutrição , Obesidade/complicações , Obesidade/dietoterapia , Obesidade/fisiopatologia , Sobrepeso/complicações , Sobrepeso/dietoterapia , Sobrepeso/fisiopatologia , Ratos , Ratos Endogâmicos SHR
7.
Nutrients ; 13(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371853

RESUMO

Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38-53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2-24.8) kg/m2). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), or obese (BMI ≥ 30 kg/m2). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0-32.9), 28.1 (27.6-28.5), and 5.5 (5.3-5.7) per 10,000 person-years in men, whereas 25.7 (25.1-26.2), 22.5 (22.0-23.0), and 4.0 (3.8-4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.


Assuntos
Índice de Massa Corporal , AVC Hemorrágico/epidemiologia , Obesidade/complicações , Sobrepeso/complicações , Magreza/complicações , Adulto , Bases de Dados Factuais , Feminino , Fatores de Risco de Doenças Cardíacas , AVC Hemorrágico/etiologia , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores Sexuais , Magreza/epidemiologia
8.
Lancet Diabetes Endocrinol ; 9(9): 595-605, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34358471

RESUMO

BACKGROUND: Visceral and ectopic fat are key drivers of adverse cardiometabolic outcomes in obesity. We aimed to evaluate the effects of injectable liraglutide 3·0 mg daily on body fat distribution in adults with overweight or obesity without type 2 diabetes at high cardiovascular disease risk. METHODS: In this randomised, double-blind, placebo-controlled, phase 4, single centre trial, we enrolled community-dwelling adults, recruited from the University of Texas Southwestern Medical Center, with BMI of at least 30 kg/m2 or BMI of at least 27 kg/m2 with metabolic syndrome but without diabetes and randomly assigned them, in a 1:1 ratio, to 40 weeks of treatment with once-daily subcutaneous liraglutide 3·0 mg or placebo, in addition to a 500 kcal deficient diet and guideline-recommended physical activity counselling. The primary endpoint was percentage reduction in visceral adipose tissue (VAT) measured with MRI. All randomly assigned participants with a follow-up imaging assessment were included in efficacy analyses and all participants who received at least one dose of study drug were included in the safety analyses. The trial is registered on ClinicalTrials.gov: NCT03038620. FINDINGS: Between July 20, 2017 and Feb 21, 2020 from 235 participants assessed for eligibility, 185 participants were randomly assigned (n=92 liraglutide, n=93 placebo) and 128 (n=73 liraglutide, n=55 placebo) were included in the final analysis (92% female participants, 37% Black participants, 24% Hispanic participants, mean age 50·2 years (SD 9·4), mean BMI 37·7 kg/m2). Mean change in VAT over median 36·2 weeks was -12·49% (SD 9·3%) with liraglutide compared with -1·63% (SD 12·3%) with placebo, estimated treatment difference -10·86% (95% CI -6·97 to -14·75, p<0·0001). Effects seemed consistent across subgroups of age, sex, race-ethnicity, BMI, and baseline prediabetes. The most frequently reported adverse events were gastrointestinal-related (43 [47%] of 92 with liraglutide and 12 [13%] of 93 with placebo) and upper respiratory tract infections (10 [11%] of 92 with liraglutide and 14 [15%] of 93 with placebo). INTERPRETATION: In adults with overweight or obesity at high cardiovascular disease risk, once-daily liraglutide 3·0 mg plus lifestyle intervention significantly lowered visceral adipose tissue over 40 weeks of treatment. Visceral fat reduction may be one mechanism to explain the benefits seen on cardiovascular outcomes in previous trials with liraglutide among patients with type 2 diabetes. FUNDING: NovoNordisk.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Gordura Intra-Abdominal/efeitos dos fármacos , Liraglutida/administração & dosagem , Obesidade/complicações , Sobrepeso/complicações , Adulto , Composição Corporal , Doenças Cardiovasculares , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Resultado do Tratamento
9.
Nutrients ; 13(6)2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34200533

RESUMO

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4-8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.


Assuntos
Exercício Físico/fisiologia , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Osteoartrite/complicações , Sobrepeso/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Sarcopenia/complicações , Adulto , Idoso , Dieta , Seguimentos , Humanos , Pessoa de Meia-Idade , Força Muscular/fisiologia , Tamanho do Órgão , Osteoartrite/fisiopatologia , Sobrepeso/fisiopatologia , Viés de Publicação , Análise de Regressão , Risco , Sarcopenia/fisiopatologia , Resultado do Tratamento , Caminhada/fisiologia
10.
Nutrients ; 13(6)2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34203997

RESUMO

Diet is one of the strongest modifiable risk factors for hypertension. In this study, we described the associations between dietary factors and blood pressure; and explored how weight status moderated these associations in a sample of New Zealand male adolescents. We collected demographics information, anthropometric, blood pressure, and dietary data from 108 male adolescents (15-17 years old). Mixed effects and logistic regression models were used to estimate relationships between dietary variables, blood pressure, and hypertension. Moderation effects of overweight status on the relationship between hypertension and diet were explored through forest plots. One-third (36%) of the sample was classified as hypertensive. Fruit intake was related to significantly lower systolic (-2.4 mmHg, p = 0.005) and diastolic blood pressure (-3.9 mmHg, p = 0.001). Vegetable and milk intake was related to significantly lower diastolic blood pressure (-1.4 mmHg, p = 0.047) and (-2.2 mmHg, p = 0.003), respectively. In overweight participants, greater vegetable and milk, and lower meat intake appeared to reduce the odds of hypertension. Certain dietary factors may have more prominent effects on blood pressure depending on weight status.


Assuntos
Pressão Sanguínea , Dieta , Hipertensão/etiologia , Sobrepeso/complicações , Adolescente , Animais , Índice de Massa Corporal , Estudos Transversais , Frutas , Humanos , Masculino , Leite , Nova Zelândia , Inquéritos Nutricionais , Obesidade/complicações , Fatores de Risco , Inquéritos e Questionários , Verduras
11.
Int J Mol Sci ; 22(12)2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34205666

RESUMO

Bisphenol A (BPA) is a synthetic phenol extensively used in the manufacture of polycarbonate plastics and epoxy resins and a component of liquid and food storages. Among health disorders potentially attributed to BPA, the effects on metabolism have been especially studied. BPA represents a hazard in prenatal life because of its presence in tissues and fluids during pregnancy. Our recent study in rats fed with BPA showed a placental increase in glucose type 1 transporter (GLUT-1), suggesting a higher uptake of glucose. However, the role of BPA on GLUT transporters in pregnant women with metabolic dysfunction has not yet been investigated. In this study, placental tissue from 26 overweight (OW) women and 32 age-matched normal weight (NW) pregnant women were examined for expression of GLUT1 and GLUT4. Placental explants from OW and NW mothers were exposed to BPA 1 nM and 1 µM and tested for GLUTs expression. The data showed a different response of placental explants to BPA in GLUT1 expression with an increase in NW mothers and a decrease in OW ones. GLUT4 expression was lower in the explants from OW than NW mothers, while no difference was showed between OW and NW in placental biopsies for any of the transporters.


Assuntos
Compostos Benzidrílicos/toxicidade , Transportador de Glucose Tipo 1/metabolismo , Transportador de Glucose Tipo 4/metabolismo , Sobrepeso/complicações , Fenóis/toxicidade , Placenta/efeitos dos fármacos , Complicações na Gravidez/induzido quimicamente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Sobrepeso/metabolismo , Placenta/metabolismo , Gravidez , Complicações na Gravidez/metabolismo
12.
JSLS ; 25(2)2021.
Artigo em Inglês | MEDLINE | ID: mdl-34248330

RESUMO

Objective: To investigate outcomes and ascertain the safety and efficacy on patients having total laparoscopic hysterectomy (TLH), stratified by body mass index (BMI), focusing on high-BMI patients. Methods: This was a retrospective cohort study that reviewed 2,266 patients with benign gynecologic diagnoses, early cervical, endometrial, and ovarian carcinoma from September 1996 to October 2017. BMI was from 14.5 to 74.2 and were classified as normal or underweight (<24.9); overweight (25.0-29.9); class I obese (>30.0-34.9); class II obese (35-39.9); or class III obese (>40.0). All patients underwent TLH. Results: Patients' characteristics were similar across all BMI classes except for age, postoperative pathological diagnoses, and whether a cystoscopy was performed. Surgical duration, and estimated blood loss were similar across BMI classes. Overweight and obese class III patients had lower odds of staying >1 day compared to patients of normal BMI (OR = 0.65, P = .015). Obese class II patients had fewer complications compared to normal BMI patients (OR = 0.27, P = .013), but patients from other high BMI categories did not show any difference compared to patients with normal BMI. The rate of unplanned laparotomy was statistically, but not clinically, higher in obese class III patients (1.8% versus .7%, P = 0.011), most often due to large fibroids. The mean reoperation rate was 2.7%, with the lowest rate (.5%) among obese class II patients, and the highest rate (3.9%) among the normal BMI patients. Conclusion: TLH is feasible and safe for obese women, regardless of BMI. Obesity is not a contraindication to good outcomes from laparoscopic surgery.


Assuntos
Doenças dos Genitais Femininos/cirurgia , Histerectomia/efeitos adversos , Laparoscopia/efeitos adversos , Obesidade/complicações , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Índice de Massa Corporal , Contraindicações de Procedimentos , Estudos de Viabilidade , Feminino , Doenças dos Genitais Femininos/complicações , Humanos , Histerectomia/métodos , Laparoscopia/métodos , Laparotomia , Pessoa de Meia-Idade , Sobrepeso/complicações , Estudos Retrospectivos , Resultado do Tratamento
13.
Ann Intern Med ; 174(7): JC80, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34224258

RESUMO

SOURCE CITATION: Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989. 33567185.


Assuntos
Diabetes Mellitus , Perda de Peso , Adulto , Peptídeos Semelhantes ao Glucagon/efeitos adversos , Humanos , Obesidade/complicações , Sobrepeso/complicações
14.
Int J Obes (Lond) ; 45(9): 2028-2037, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34112941

RESUMO

BACKGROUND: Patients with obesity are at increased risk of severe COVID-19, requiring mechanical ventilation due to acute respiratory failure. However, conflicting data are obtained for intensive care unit (ICU) mortality. OBJECTIVE: To analyze the relationship between obesity and in-hospital mortality of ICU patients with COVID-19. SUBJECTS/METHODS: Patients admitted to the ICU for COVID-19 acute respiratory distress syndrome (ARDS) were included retrospectively. The following data were collected: comorbidities, body mass index (BMI), the severity of ARDS assessed with PaO2/FiO2 (P/F) ratios, disease severity measured by the Simplified Acute Physiology Score II (SAPS II), management and outcomes. RESULTS: For a total of 222 patients, there were 34 patients (15.3%) with normal BMI, 92 patients (41.4%) who were overweight, 80 patients (36%) with moderate obesity (BMI:30-39.9 kg/m2), and 16 patients (7.2%) with severe obesity (BMI ≥ 40 kg/m2). Overall in-hospital mortality was 20.3%. Patients with moderate obesity had a lower mortality rate (13.8%) than patients with normal weight, overweight or severe obesity (17.6%, 21.7%, and 50%, respectively; P = 0.011. Logistic regression showed that patients with a BMI ≤ 29 kg/m2 (odds ratio [OR] 3.64, 95% CI 1.38-9.60) and those with a BMI > 39 kg/m2 (OR 10.04, 95% CI 2.45-41.09) had a higher risk of mortality than those with a BMI from 29 to 39 kg/m2. The number of comorbidities (≥2), SAPS II score, and P/F < 100 mmHg were also independent predictors for in-hospital mortality. CONCLUSIONS: COVID-19 patients admitted to the ICU with moderate obesity had a lower risk of death than the other patients, suggesting a possible obesity paradox.


Assuntos
COVID-19/mortalidade , Obesidade/complicações , Insuficiência Respiratória/mortalidade , Adolescente , Adulto , Idoso , Índice de Massa Corporal , COVID-19/complicações , Estado Terminal , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações , Insuficiência Respiratória/complicações , Estudos Retrospectivos , Adulto Jovem
15.
Breast Cancer Res Treat ; 189(1): 145-154, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34089422

RESUMO

PURPOSE: Obesity increases the risk of cancer recurrence and death in survivors of breast cancer. This study tested the hypothesis that exercise alone, diet alone, and the combination of exercise plus diet reduce body weight and improve body composition in survivors of breast cancer. METHODS: In this 2 × 2 factorial trial, 351 survivors of breast cancer with overweight or obesity were randomized to one of four treatment groups for 52 weeks: control, exercise alone, diet alone, or exercise plus diet. Endpoints included body weight and body composition measured by dual-energy x-ray absorptiometry. RESULTS: After 52 weeks, compared with control, diet alone [- 5.39 kg (95% CI - 7.24, - 3.55);- 6.0% (95% CI - 8.0, - 3.9)] and exercise plus diet [- 6.68 kg (95% CI - 8.46, - 4.90);- 7.4% (95% CI - 9.4, - 5.4)] reduced body weight; exercise alone did not change body weight. Compared with control, diet alone [- 3.59 kg (95% CI - 5.00, - 2.17)] and exercise plus diet [- 4.28 kg (95% CI - 5.71, - 2.84)] reduced fat mass; exercise alone did not change fat mass. Compared with control, diet alone [- 0.82 kg (95% CI - 1.50, - 0.15)] and exercise plus diet [- 1.24 kg (95% CI - 1.92, - 0.56)] reduced lean mass; exercise alone did not change lean mass. Compared with control, exercise alone, diet alone, and exercise plus diet did not change bone mineral density. CONCLUSION: In survivors of breast cancer with overweight or obesity, diet alone or diet plus exercise produced clinically meaningful weight loss at week 52. The majority of weight loss was fat mass.


Assuntos
Neoplasias da Mama , Composição Corporal , Índice de Massa Corporal , Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Dieta , Feminino , Humanos , Recidiva Local de Neoplasia , Obesidade/complicações , Obesidade/terapia , Sobrepeso/complicações , Sobrepeso/terapia , Sobreviventes
16.
Saudi Med J ; 42(6): 666-672, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34078730

RESUMO

OBJECTIVES: To evaluate direct cost of in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle and reproductive outcomes among infertile women with different body mass index (BMI). METHODS: A retrospective study of 826 subfertility patients who had IVF or IVF-ICSI in 2017 to 2018 were reviewed. The patients were divided into 4 groups bestowing to BMI to normal weight (18.5-24.9 kg/m2), underweight (<18.5 kg/m2), overweight(25-29.9 kg/m2), and obese(≥30 kg/m2). Data on treatment costs of IVF/ICSI and reproductive outcomes were collected and analyzed. A total of 338 patients (40.9%) were overweight, and 300 (36.3%) patients were obese. A bottom-up methodology was used to measure the resource utilization. The capital inputs needed for individual procedures were defined and calculated by consulting with appropriate clinicians and priced using market prices for 2017-2018. RESULTS: There was no statistical significant difference for live birth rate (LBR) among the BMI groups, with the occurrence of LBR in 23 women with normal BMI (13.1%), in 48 (14.2%) women who were overweight, in 48 (16%) in women who were obese (p=0.7). The median cost for IVF/ICSI treatment cycle did not differ across BMI groups; the cost was 10,380 SAR for women of normal weight, 10,440 SAR for women who are overweight and obese (p=0.6). CONCLUSION: Our results suggest that costs of IVF/IVF-ICSI is not significantly affected in women who are overweight or obese.


Assuntos
Infertilidade Feminina , Índice de Massa Corporal , Feminino , Fertilização In Vitro , Humanos , Infertilidade Feminina/terapia , Obesidade/complicações , Sobrepeso/complicações , Estudos Retrospectivos
17.
Nutrients ; 13(5)2021 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-34063439

RESUMO

Excess body weight is a major global health concern, particularly due to its associated increased health risks. Several strategies have been proposed to prevent overweight and obesity onset. In the past decade, it has been suggested that eating speed/rate and eating frequency might be related to obesity. The main aim of this narrative review was to summarize existing evidence regarding the impact of eating speed/rate and eating frequency on adiposity, metabolic syndrome (MetS), or diet quality (DQ). For this purpose, a literature search of observational and interventional trials was conducted between June and September 2020 in PubMed and Web of Sciences databases, without any data filters and no limitations for publication date. Results suggest that children and adults with a faster eating speed/rate may be associated with a higher risk of developing adiposity, MetS or its components. Furthermore, a higher eating frequency could be associated with diet quality improvement, lower adiposity, and lower risk of developing MetS or its components. Further interventional trials are warranted to clarify the mechanism by which these eating behaviors might have a potential impact on health.


Assuntos
Adiposidade/fisiologia , Dieta , Ingestão de Alimentos/fisiologia , Comportamento Alimentar/fisiologia , Síndrome Metabólica/complicações , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Bases de Dados Factuais , Ingestão de Energia , Humanos , Obesidade/complicações , Sobrepeso/complicações
18.
Clin Pediatr (Phila) ; 60(8): 370-375, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34100658

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is common in overweight adolescents, and screening with serum alanine transaminase (ALT) levels is recommended by the American Academy of Pediatrics. We sought to determine if ALT is an accurate adolescent screening measure for NAFLD in a nationally representative sample of overweight adolescents. Diagnosis of NAFLD was determined using vibration-controlled transient elastography. Analyses were performed to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and Youden's index at various serum ALT cutoff levels. Receiver operating curves were generated in order to determine ALT's discrimination capability. Males and females were analyzed separately. While average measures (mean and median) of ALT were higher in subjects with NAFLD, ALT provided only minimal discrimination with AUROC (area under the receiver operating characteristic) values of .66 in males and .67 in females. In a nationally representative sample of overweight and obese adolescents, serum ALT level functioned inadequately as a screening test to detect NAFLD.


Assuntos
Alanina Transaminase/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Inquéritos Nutricionais/métodos , Sobrepeso/complicações , Adolescente , Adulto , Biomarcadores/sangue , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/complicações , Inquéritos Nutricionais/estatística & dados numéricos , Sobrepeso/sangue , Reprodutibilidade dos Testes , Adulto Jovem
20.
Int J Clin Pract ; 75(9): e14431, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34080258

RESUMO

BACKGROUND: Weight loss and consumption of nuts may both improve plasma lipids and lipoproteins. However, their effects in patients with coronary artery disease (CAD) who are under treatment with statins remain unclear. This study was conducted to determine plasma lipid and lipoprotein responses to a low-calorie (25% of energy deficit) nuts containing diet (NELCD) compared with a nut-free energy-restricted diet (NFLCD) in stable CAD patients who were overweight or obese (n = 67). METHODS: Plasma lipids and lipoproteins and ATP-binding cassette (ABC) A1 and ABCG1 mRNA expressions in peripheral blood mononuclear cells (PBMCs) isolated from patients were assessed at baseline and after 8 weeks. RESULTS: Plasma high-density lipoprotein (HDL) cholesterol and apoA1 increased significantly in the NELCD group at the end of Week 8 compared with those in NFLCD group (in NELCD group, mean change and 95% confidence interval (CI) were 1.17 [-1.31, 3.66] mg/dL, P = 0.012, and 2.55 [-2.10, 7.20] mg/dL, P = 0.011, for HDL cholesterol and apoA1, respectively). In both groups, the concentrations of total cholesterol, low-density lipoprotein cholesterol and triglyceride reduced significantly at Week 8 compared with those in baseline with no significant difference between the two groups. ABCA1 and ABCG1 mRNA expressions non-significantly decreased in both groups. CONCLUSION: This study indicates that inclusion of nuts as part of a calorie-restricted diet improves the concentrations of HDL cholesterol and apoA-1 in patients with stable, established CHD receiving statins.


Assuntos
Doença da Artéria Coronariana , Nozes , HDL-Colesterol , Dieta , Humanos , Leucócitos Mononucleares , Obesidade , Sobrepeso/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...