Search results for: central obesity

Authors: A. A. Adedini, B. A. Aina, P. U. Ogbo

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Child obesity is on the rise globally. According to the World Health Organization, the number of obese children would increase to 70 million by 2025 if no intervention is made. An increase in the prevalence of overweight and obesity amongst school children in Lagos State, Nigeria has been established but specific factors promoting its prevalence are unknown. This aim of this study is to identify the commonly expressed factor(s) responsible for the rise in prevalence of child overweight and obesity in Lagos, Nigeria. Five focus group discussions were conducted with different groups of stake-holders involved in child care, namely: parents, teachers and health workers. Participants were recruited using a purposive sampling method; a validated question guide was employed for the discussion sessions. The discussions were recorded, collated, analysed using Grounded theory to extract themes. Six themes emerged from the discussions as follows: Civilization and lifestyle imbalance resulting from busy work schedules of young mothers leading to adoption of westernized culture promoting preference for processed and fast food meals; insecurity and congestion of the state which discourages out-door activities; ignorance of the populace on the prevalence of child obesity in the state; inadequate educative and enlightenment programmes in schools and by the Nigerian government; myths on child care and body physique and societal perceptions of the children born into affluent homes. Some of the factors responsible for the rise in the prevalence of child obesity in Lagos, Nigeria have been identified. Preventive strategies to control the prevalence of obesity in children residing in Lagos state is considered for further studies.

Keywords: Childhood Obesity, factors, lagos state, stakeholders

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Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Dzerovych, Roksolana Povoroznyuk

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Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m² (n=129) and Group II – patients without obesity and BMI of < 30 kg/m² (n=267). The BMD of total body, lumbar spine L₁-L₄, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L₁- L₄ was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L₁-L₄, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L₁-L₄ was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L₁-L₄, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L₁-L₄ (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L₁-L₄ was also significant, though negative.

Keywords: bone mineral density, trabecular bone score, obesity, men

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Authors: Carlos Rios Llamas

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Urban health challenges, like the obesity epidemic, need to be studied from a dialogue between different disciplines and geographical conditions. Public health uses quantitative analysis and local samples, but qualitative data and multisite analysis would help to better understand how obesity has become a health problem. In the last decades, obesity rates have increased in most of the countries, especially in the Western World. Concerned about the problem, the American Medical Association has recently voted obesity as a disease. Suddenly, a ‘war on obesity’ attracted scientists from different disciplines to explore various ways to control and even reverse the trends. Medical sciences have taken the advance with quantitative methodologies focused on individual behaviors. Only a few scientist have extended their studies to the environment where obesity is produced as social risk, and less of them have taken into consideration the political and cultural aspects. This paper presents a multisite ethnography in South Bronx, USA, La Courneuve, France, and Lomas del Sur, Mexico, where obesity rates are as relevant as urban degradation. The comparative ethnography offers a possibility to unveil the mechanisms producing health risks from the urban tissue. The analysis considers three main categories: 1) built environment and access to food and physical activity, 2) biocultural construction of the healthy body, 3) urban inequalities related to health and body size. Major findings from a comparative ethnography on obesogenic environments, refer to the anthropological values related to food and body image, as well as the multidimensional oppression expressed in fat people who live in stigmatized urban zones. At the end, obesity, like many other diseases, is the result of political and cultural constructions structured in urbanization processes.

Keywords: comparative ethnography, urban health, obesogenic cities, biopolitics

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Authors: Lydia Foucan, Laurent Larifla, Emmanuelle Durand, Christine Rambhojan, Veronique Dhennin, Jean-Marc Lacorte, Philippe Froguel, Amelie Bonnefond

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In the population of Guadeloupe Island (472,124 inhabitants and 80% of subjects of African descent), overweight and obesity were estimated at 23% and 9% respectively among children. High prevalence of diabetes has been reported (~10%) in the adult population. Nevertheless, no study has investigated the contribution of gene mutations to childhood obesity in this population. We aimed to investigate rare genetic mutations in genes involved in monogenic obesity or diabetes in obese Afro-Caribbean children from Guadeloupe Island using next-generation sequencing. The present investigation included unrelated obese children, from a previous study on overweight conducted in Guadeloupe Island in 2013. We sequenced coding regions of 59 genes involved in monogenic obesity or diabetes. A total of 25 obese schoolchildren (with Z-score of body mass index [BMI]: 2.0 to 2.8) were screened for rare mutations (non-synonymous, splice-site, or insertion/deletion) in 59 genes. Mean age of the study population was 12.4 ± 1.1 years. Seventeen children (68%) had insulin-resistance (HOMA-IR > 3.16). A family history of obesity (mother or father) was observed in eight children and three of the accompanying parent presented with type 2 diabetes. None of the children had gonadotrophic abnormality or mental retardation. We detected five rare heterozygous mutations, in four genes involved in monogenic obesity, in five different obese children: MC4R p.Ile301Thr and SIM1 p.Val326Thrfs*43 mutations which were pathogenic; SIM1 p.Ser343Pro and SH2B1 p.Pro90His mutations which were likely pathogenic; and NTRK2 p.Leu140Phe that was of uncertain significance. In parallel, we identified seven carriers of mutation in ABCC8 or KCNJ11 (involved in monogenic diabetes), which were of uncertain significance (KCNJ11 p.Val13Met, KCNJ11 p.Val151Met, ABCC8 p.Lys1521Asn and ABCC8 p.Ala625Val). Rare pathogenic or likely pathogenic mutations, linked to severe obesity were detected in more than 15% of this Afro-Caribbean population at high risk of obesity and type 2 diabetes.

Keywords: childhood obesity, MC4R, monogenic obesity, SIM1

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Authors: Lise Retat, Maria Carmen Huerta, Laura Webber, Franco Sassi

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Background: Intra-generational social mobility (ISM) can be defined as the extent to which individuals change their socio-economic position over a period of time or during their entire life course. The relationship between poor health and ISM is established. Therefore, quantifying the impact that potential health policies have on ISM now and into the future would provide evidence for how social inequality could be reduced. This paper takes the condition of overweight and obesity as an example and estimates the mean earning change per individual if the UK were to introduce policies to effectively reduce overweight and obesity. Methods: The HealthLumen individual-based model was used to estimate the impact of obesity on social mobility measures, such as earnings, occupation, and wealth. The HL tool models each individual's probability of experiencing downward ISM as a result of their overweight and obesity status. For example, one outcome of interest was the cumulative mean earning per person of implementing a policy which would reduce adult overweight and obesity by 1% each year between 2020 and 2030 in the UK. Results: Preliminary analysis showed that by reducing adult overweight and obesity by 1% each year between 2020 and 2030, the cumulative additional mean earnings would be ~1,000 Euro per adult by 2030. Additional analysis will include other social mobility indicators. Conclusions: These projections are important for illustrating the role of health in social mobility and for providing evidence for how health policy can make a difference to social mobility outcomes and, in turn, help to reduce inequality.

Keywords: modelling, social mobility, obesity, health

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Authors: Deepa Vasudevan, Thomas Northrup, Angela Stotts, Michelle Klawans

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To date, we have conducted three studies on this subject. The research done to date is through three studies. The initial study was to document that modified criteria independently identified higher numbers of overweight/obese South Asian Indians. The second study was to document physician knowledge of appropriate diagnosis of obesity among South Asian Indians. The final study was an intervention to evaluate the efficacy of a training module on improving physician diagnosis and counseling of overweight/obese Asian patients.

Keywords: South Asian Indians, obesity, physicians, BMI and waist circumference

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Authors: Alina Smalinskiene Janina Petkeviciene, Jurate Klumbiene, Vilma Kriaucioniene, Vaiva Lesauskaite

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The worldwide prevalence of obesity has been increasing dramatically in the last few decades, and Lithuania is no exception. In 2012, every fifth adult (19% of men and 20.5 % of women) was obese and every third was overweight Association studies have highlighted the influence of SNPs in obesity, with particular focus on FTO rs9939609. Thus far, no data on the possible association of this SNP to obesity in the adult Lithuanian population has been reported. Here, for the first time, we demonstrate an association between the FTO rs9939609 homozygous AA genotype and increased BMI when compared to homozygous TT. Furthermore, a positive association was determined between the FTO rs9939609 variant and risk of metabolic syndrome. Background: This study aimed to examine the associations between the fat mass and obesity associated (FTO) gene rs9939609 variant with obesity and metabolic syndrome in Lithuanian adult population. Materials and Methods: A cross-sectional health survey was carried out in randomly selected municipalities of Lithuania. The random sample was obtained from lists of 25–64 year-old inhabitants. The data from 1020 subjects were analysed. The rs9939609 SNP of the FTO gene was assessed using TaqMan assays (Applied Biosystems, Foster City, CA, USA). The Applied Biosystems 7900HT Real-Time Polymerase Chain Reaction System was used for detecting the SNPs. Results: The carriers of the AA genotype had the highest mean values of BMI and waist circumference (WC) and the highest risk of obesity. Interactions ‘genotype x age’ and ‘genotype x physical activity’ in determining BMI and WC were shown. Neither lipid and glucose levels, nor blood pressure were associated with the rs9939609 independently of BMI. In the age group of 25-44 years, association between the FTO genotypes and metabolic syndrome was found. Conclusion: The FTO rs9939609 variant was significantly associated with BMI and WC, and with the risk of obesity in Lithuanian population. The FTO polymorphism might have a greater influence on weight status in younger individuals and in subjects with a low level of physical activity.

Keywords: obesity metabolic syndrome, FTO gene, polymorphism, Lithuania

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Authors: Oladele V. Adeniyi, B. Longo-Mbenza, Daniel T. Goon

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Background: Lipids are often low or in the normal ranges and controversial in the atherogenesis among Black Africans. The effect of the severity of obesity on some traditional and novel cardiovascular disease risk factors is unclear before and after a diet and exercise maintenance programme among obese black South Africans with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to identify the risk factors to discriminate obesity classes among patients with T2DM before and after a diet and exercise programme. Methods: This interventional cohort of Black South Africans with T2DM was followed by a very – low calorie diet and exercise programme in Mthatha, between August and November 2013. Gender, age, and the levels of body mass index (BMI), blood pressure, monthly income, daily frequency of meals, blood random plasma glucose (RPG), serum creatinine, total cholesterol (TC), triglycerides (TG), LDL –C, HDL – C, Non-HDL, ratios of TC/HDL, TG/HDL, and LDL/HDL were recorded. Univariate analysis (ANOVA) and multivariate discriminant analysis were performed to separate obesity classes: normal weight (BMI = 18.5 – 24.9 kg/m2), overweight (BMI = 25 – 29.9 kg/m2), obesity Class 1 (BMI = 30 – 34.9 kg/m2), obesity Class 2 (BMI = 35 – 39.9 kg/m2), and obesity Class 3 (BMI ≥ 40 kg/m2). Results: At the baseline (1st Month September), all 327 patients were overweight/obese: 19.6% overweight, 42.8% obese class 1, 22.3% obese class 2, and 15.3% obese class 3. In discriminant analysis, only systolic blood pressure (SBP with positive association) and LDL/HDL ratio (negative association) significantly separated increasing obesity classes. At the post – evaluation (3rd Month November), out of all 327 patients, 19.9%, 19.3%, 37.6%, 15%, and 8.3% had normal weight, overweight, obesity class 1, obesity class 2, and obesity class 3, respectively. There was a significant negative association between serum creatinine and increase in BMI. In discriminant analysis, only age (positive association), SBP (U – shaped relationship), monthly income (inverted U – shaped association), daily frequency of meals (positive association), and LDL/HDL ratio (positive association) classified significantly increasing obesity classes. Conclusion: There is an epidemic of diabesity (Obesity + T2DM) in this Black South Africans with some weight loss. Further studies are needed to understand positive or negative linear correlations and paradoxical curvilinear correlations between these markers and increase in BMI among black South African T2DM patients.

Keywords: atherogenic dyslipidaemia, dietary interventions, obesity, south africans

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Authors: Chengliang Xie, Jinhyun Ryu, Hyun Joon Kim, Gyeong Jae Cho, Wan Sung Choi, Sang Soo Kang, Kye Man Cho, Dong Hoon Lee

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Obesity has become a global health problem and a source of major metabolic diseases like type-2 diabetes, hypertension, heart disease, nonalcoholic fatty liver and cancer. Synthetic anti-obesity drugs are effective but very costly and with undesirable side effects, so natural products such as soybean are needed as an alternative for obesity treatment. Lactobacillus Plantarum P1201is a probiotic bacterial strain reported to produce conjugated linoleic acid (CLA) and increase the ratio of aglycone-isoflavone of soybean, both of which have anti-obesity effect. In this study, the anti-obesity effect of the fermented soybean extract with P1201 (FSE) will be evaluated compared with that of the soybean extract (SE) by 3T3-L1 cells as an in vitro model of adipogenesis. 3T3-L1 cells were treated with SE and FSE during the nine days of the differentiation, lipid accumulation was evaluated by oil-red staining and triglyceride content and the mRNA expression level of adipogenic or lipogenic genes were analyzed by RT-PCR and qPCR. The results showed that formation of lipid droplets in differentiated 3T3-L1 cells was inhibited and triglyceride content was reduced by 23.1% after treated with 1000 μg/mL of FSE compared with control. For SE-treated groups, no delipidating effect was observed. The effect of FSE on adipogenesis inhibition can be attributed to the down-regulation of mRNA expressionof CCAAT/enhancer binding protein (C/EBP-α), lipoprotein lipase (LPL), adiponectin, adipocyte fatty acid-binding protein (aP2), fatty acid synthesis (FAS) and CoA carboxylase (ACC). Our results demonstrated that the anti-obesity effect of soybean can be improved by fermentation with P1201, and P1201can be used as a potential probiotic bacterial strain to produce natural anti-obesity food.

Keywords: fermentation, Lactobacillus plantarum P1201, obesity, soybean

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Authors: Randy M. Fitratullah, Afriwardi, Nurhayati

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Overweight-obesity caused by exercise. The objective of this research is to analyze the relation between exercise with the incidence of overweight-obesity of medical students of medical faculty of Andalas Univesity batch 2013. This is an analytical observational research with case-control method. This research conducted in FK Unand on September-October 2015. The population of this research is medical students batch 2013. 26 samples (13 samples were case, 13 samples were control) were taken by purposive sampling technique and analysed using statistical univariate and bivariate analysis. Exercise questionnaire was used as research instruments. Based on the interview with questionnaire, anaerobic exercise was majority in case group and aerobic exercise was majority in control group. The case and control group have a rare category in exercise. Less category was majority in exercise duration of case and enough category was majority in control group. Bivariate analysis is using chi-square test with cell combining to 2x2 table, obtained p-value=0.097 in sort of exercise, p-value=1,000 in the frequency of exercise, and p-value=0,112 in duration of exercise, which means statistically unsignificant. There is no relation between exercise with the incidence of overweight-obesity of medical students of FK Unand batch 2013. For medical students suffers overweight-obesity is suggested for increase the frequency of exercise.

Keywords: overweight-obesity, exercise, aerobic, anaerobic, frequency, duration

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Authors: Orkide Donma, Mustafa M. Donma

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Chronologic age (CA) of individuals is closely related to obesity and generally affects the magnitude of obesity parameters. On the other hand, close association between basal metabolic rate (BMR) and metabolic age (MA) is also a matter of concern. It is suggested that MA higher than CA is the indicator of the need to improve the metabolic rate. In this study, the aim was to assess some commonly used obesity parameters, such as obesity degree, visceral adiposity, BMR, BMR-to-weight ratio, in several groups with varying differences between MA and CA values. The study comprises adults, whose ages vary between 18 and 79 years. Four groups were constituted. Group 1, 2, 3 and 4 were composed of 55, 33, 76 and 47 adults, respectively. The individuals exhibiting -1, 0 and +1 for their MA-CA values were involved in Group 1, which was considered as the control group. Those, whose MA-CA values varying between -5 and -10 participated in Group 2. Those, whose MAs above their real ages were divided into two groups [Group 3 (MA-CA; from +5 to + 10) and Group 4 (MA-CA; from +11 to + 12)]. Body mass index (BMI) values were calculated. TANITA body composition monitor using bioelectrical impedance analysis technology was used to obtain values for obesity degree, visceral adiposity, BMR and BMR-to-weight ratio. The compiled data were evaluated statistically using a statistical package program; SPSS. Mean ± SD values were determined. Correlation analyses were performed. The statistical significance degree was accepted as p < 0.05. The increase in BMR was positively correlated with obesity degree. MAs and CAs of the groups were 39.9 ± 16.8 vs 39.9 ± 16.7 years for Group 1, 45.0 ± 15.3 vs 51.4 ± 15.7 years for Group 2, 47.2 ± 12.7 vs 40.0 ± 12.7 years for Group 3, and 53.6 ± 14.8 vs 42 ± 14.8 years for Group 4. BMI values of the groups were 24.3 ± 3.6 kg/m², 23.2 ± 1.7 kg/m², 30.3 ± 3.8 kg/m², and 40.1 ± 5.1 kg/m² for Group 1, 2, 3 and 4, respectively. Values obtained for BMR were 1599 ± 328 kcal in Group 1, 1463 ± 198 kcal in Group 2, 1652 ± 350 kcal in Group 3, and 1890 ± 360 kcal in Group 4. A correlation was observed between BMR and MA-CA values in Group 1. No correlation was detected in other groups. On the other hand, statistically significant correlations between MA-CA values and obesity degree, BMI as well as BMR/weight were found in Group 3 and in Group 4. It was concluded that upon consideration of these findings in terms of MA-CA values, BMR-to-weight ratio was found to be much more useful indicator of the severe increase in obesity development than BMR. Also, the lack of associations between MA and BMR as well as BMR-to-weight ratio emphasize the importance of consideration of MA-CA values rather than MA.

Keywords: basal metabolic rate, basal metabolic rate-to-weight-ratio, chronologic age, metabolic age, obesity degree

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Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

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Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: adolescents, NCDs, overweight, obesity

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Authors: In Hee Shim, Dong Sik Bae

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Introduction: Obesity and unfavorable lipid profile may be linked to depressive disorders. This study compared the levels of obesity, lipid profiles and depression severity of patients with depressive disorders. Methods: This study included 156 patients diagnosed with a depressive disorder who were hospitalized between March 2012 and February 2016. The patients were categorized into mild to moderate and severe depressive groups, based on Hamilton Depression Rating Scale scores (Mild to moderate depression 8-23 vs. severe depression ≥ 24). The charts of the patients were reviewed to evaluate body mass index and lipid profiles, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TG), confounding factors, such as other general medical disorders (hypertension, diabetes mellitus, and dyslipidemia), except smoking status (insufficient data). Demographic and clinical characteristics, such as age, sex, comorbidities, family history of mood disorders, psychotic features, and prescription patterns were also assessed. Results: Compared to the mild to the moderate depressive group, patients with severe depression had significantly lower rate of male and comorbidity. The patients with severe depression had a significantly lower TG than patients in the mild to moderate depressive group. After adjustment for the sex and comorbidity, there were no significant differences between the two groups in terms of the obesity and lipid profiles, including TG. Conclusion: These results did not show a significant difference in the association between obesity, lipid profiles and the depression severity. The role of obesity and lipid profiles in the pathophysiology of depression remains to be clarified.

Keywords: depression, HAM-D, lipid profiles, obesity

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Authors: Kyungbae Pi, Kibeom Lee, Yongil Kim, Eun-Jung Lee

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Abnormal adipocyte growth, in terms of increased cell numbers and increased cell differentiation, is considered to be a major pathological feature of obesity. Thus, the inhibition of preadipocyte mitogenesis and differentiation could help prevent and suppress obesity. The aim of this study was to assess whether extracts from Weissella koreensis 521 cells isolated from kimchi could exert anti-adipogenic effects in 3T3-L1 cells (fat cells). Differentiating 3T3-L1 cells were treated with W. koreensis 521 cell extracts (W. koreensis 521_CE), and cell viability was assessed by MTT assays. At concentrations below 0.2 mg/ml, W. koreensis 521_CE did not exert any cytotoxic effect in 3T3-L1 cells. However, treatment with W. koreensis 521_CE significantly inhibited adipocyte differentiation, as assessed by morphological analysis and Oil Red O staining of fat. W. koreensis 521_CE treatment (0.2 mg/ml) also reduced lipid accumulation by 24% in fully differentiated 3T3-L1 adipocytes. These findings collectively indicate that Weissella koreensis 521 may help prevent obesity.

Keywords: Weissella koreensis 521, 3T3-L1 cells, adipocyte differentiation, obesity

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Authors: Maryam M. Bashir, Luai A. Ahmed, Meera R. Alshamsi, Sara Almahrooqi, Taif Alyammahi, Shooq A. Alshehhi, Waad I. Alhammadi, Fatima H. Alhammadi, Hind A. Alhosani, Rami H. Al-Rifai, Fatma Al-Maskari

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Obesity in the Middle East and North Africa (MENA) region has exponentially increased over the past five decades due to rapid urbanization and unhealthy lifestyle changes. It has been well established that overweight and obesity increase the risk of non-communicable diseases (NCDs) and are the leading cause of mortality and economic burden locally, and globally. In the United Arab Emirates (UAE), there is a growing epidemic of obesity and other chronic diseases like type 2 diabetes mellitus and cardiovascular diseases. Prevalence of overweight and obesity in UAE range up to 70% depending on the group being studied. Hence, there is a need to explore their patterns in the country for more targeted and responsive interventions. Our study aimed to explore the patterns of overweight and obesity and some self-reported chronic diseases among university students in Abu Dhabi, the capital city of UAE. A validated online self-administered questionnaire was used to collect data from UAE University (UAEU) students, 18years and above, from August to September 2021. Students’ characteristics were summarized using appropriate descriptive statistics. Overweight, obesity and self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other associated factors were also explored in relation to overweight and obesity. All analyses were conducted using STATA statistical software version 16.1 (StataCorp LLC, College Station, TX, USA). 902 students participated in the study. 79.8% were females and mean age was 21.90 ± 5.19 years. Majority of the respondents were undergraduate students (80.71%). The prevalence of self-reported chronic diseases was 22.95%. Obesity (BMI≥30kg/m2), Diabetes Mellitus, and Asthma/Allergies were the commonest diseases (12.48%, 4.21% & 3.22%, respectively). Approximately 5% of the students reported more than one chronic disease. Out of the 833 participating students who had complete weight and height data, prevalence of overweight and obesity was 34.81% (22.33% and 12.48%, respectively). More than half of the male students (54.36%) were overweight or obese. This is significantly higher than in female students (30.56%, p=0.001). Overweight/obesity when compared to normal weight is associated with increasing mean age [23.40 vs 21.01, respectively (p=0.001)]. In addition to gender and age, being married [57.63% vs 31.05% (p=0.001)], being a postgraduate student [51.59% vs 30.92% (p=0.001)] and having two or more chronic diseases [65.85% vs 33.21% (p=0.001)] were also significantly associated with overweight/obesity. Our study showed that almost a quarter of the participating university students reported at least one chronic disease. Obesity was the commonest and more than 1 in 3 students were either overweight or obese. This shows the need for intensive health promotion and screening programs on obesity and other chronic diseases to meet the health needs of these students. This study is also a basis for further research, especially qualitative, to explore the relevant risk factors and risk groups for more targeted interventions.

Keywords: chronic disease, obesity, overweight, students, United Arab Emirates

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Authors: Orkide Donma, Mustafa M. Donma

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Morbid obesity is a health threatening condition particularly in children. Generally, it leads to the development of metabolic syndrome (MetS) characterized by central obesity, elevated fasting blood glucose (FBG), triglyceride (TRG), blood pressure values and suppressed high density lipoprotein cholesterol (HDL-C) levels. However, some ambiguities exist during the diagnosis of MetS in children below 10 years of age. Therefore, clinicians are in the need of some surrogate markers for the laboratory assessment of pediatric MetS. In this study, the aim is to develop an index, which will be more helpful during the evaluation of further risks detected in morbid obese (MO) children. A total of 235 children with normal body mass index (N-BMI), with varying degrees of obesity; overweight (OW), obese (OB), MO as well as MetS participated in this study. The study was approved by the Institutional Ethical Committee. Informed consent forms were obtained from the parents of the children. Obesity states of the children were classified using BMI percentiles adjusted for age and sex. For the purpose, tabulated data prepared by WHO were used. MetS criteria were defined. Systolic and diastolic blood pressure values were measured. Parameters related to glucose and lipid metabolisms were determined. FBG, insulin (INS), HDL-C, TRG concentrations were determined. Diagnostic Obesity Notation Model Assessment Laboratory (DONMA_LAB) Index [ln TRG/HDL-C*INS] was introduced. Commonly used insulin resistance (IR) indices such as Homeostatic Model Assessment for IR (HOMA-IR) as well as ratios such as TRG/HDL-C, TRG/HDL-C*INS, HDL-C/TRG*INS, TRG/HDL-C*INS/FBG, log, and ln versions of these ratios were calculated. Results were interpreted using statistical package program (SPSS Version 16.0) for Windows. The data were evaluated using appropriate statistical tests. The degree for statistical significance was defined as 0.05. 35 N, 20 OW, 47 OB, 97 MO children and 36 with MetS were investigated. Mean ± SD values of TRG/HDL-C were 1.27 ± 0.69, 1.86 ± 1.08, 2.15 ± 1.22, 2.48 ± 2.35 and 4.61 ± 3.92 for N, OW, OB, MO and MetS children, respectively. Corresponding values for the DONMA_LAB index were 2.17 ± 1.07, 3.01 ± 0.94, 3.41 ± 0.93, 3.43 ± 1.08 and 4.32 ± 1.00. TRG/HDL-C ratio significantly differed between N and MetS groups. On the other hand, DONMA_LAB index exhibited statistically significant differences between N and all the other groups except the OW group. This index was capable of discriminating MO children from those with MetS. Statistically significant elevations were detected in MO children with MetS (p < 0.05). Multiple parameters are commonly used during the assessment of MetS. Upon evaluation of the values obtained for N, OW, OB, MO groups and for MO children with MetS, the [ln TRG/HDL-C*INS] value was unique in discriminating children with MetS.

Keywords: children, index, laboratory, metabolic syndrome, obesity

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Authors: B. O. Diyaolu, E. A. Okebanjo

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Children in today’s world need attention and care even with their physique as obesity is also at the increased. Several factors can be responsible for obesity in children and adequate attention is paramount in other not to accommodate it into adolescent period. This study investigated perceived determinants of obesity among primary school pupils in Eti Osa Local Government area of Lagos State. Descriptive survey research design was used and population was all obese pupils in Eti Osa Local Government Area of Lagos State. 92 pupils were selected from randomly picked 12 primary schools while purposive sampling technique was used to pick primary 4-6 pupils. With the aid of body mass index (BMI) and age percentile chart the obese pupils were selected. The instrument for the study was a self-developed and structured questionnaire on perceived determinant of obesity. The questionnaire was divided into three sections. The Cronbach’s Alpha reliability coefficient of 0.74 was obtained. The hypotheses were tested at 0.05 significant levels. The completed questionnaire was collated coded and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X²). Findings of this study revealed that physical activities and parental influences were determinant of obesity. Physical activity is essential in reducing the rate of obesity in Eti Osa Local Government Area both at home and within the school environment. Primary schools need to create more playing ground for pupils to exercise themselves. Parents need to cater for their children diet ensuring not just the quantity but the quality as well.

Keywords: feeding pattern, obese pupils, parental influence, physical activities

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Authors: Sakineh Nouri Saeidlou, Fatemeh Rezaiegoyjeloo, Parvin Ayremlou, Fariba Babaie

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Introduction: Childhood overweight and obesity is a major public health problem in both developed and developing countries. Overweight and obesity in children may have severe consequences later in adolescence and adulthood. The aim of current study was to determine the prevalence trend of overweight and obesity in school-aged children from 2009 to 2011. Methods: The present study was a population-based study and conducted in three consecutive years, from 2009 to 2011. The study population included all of primary, secondary and high school children in rural and urban regions of West Azarbijan province in West-North of Iran. Body mass index (BMI), the ratio of weight to height squared [weight (kg)]/ [height (m)]2, was calculated to the nearest decimal place. Overweight and obesity were classified using CDC recommendations for age and sex: a BMI 85th–95th percentile was classified as overweight and a BMI>95th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number present cases to a given population number in a given subgroup at a given time. Results: Overall, 165740, 145146 and 146203 school children were assessed at 2009, 2010 and 2011, respectively. Prevalence of overweight in primary school children among girls were 52.83, 86.93 and 116.36 and for boys were 57.07, 53.4 and 93.55 per 1000 person in 2009, 2010 and 2011 years ,respectively. The prevalence of obesity in secondary school children for girls were 22.26, 27.75 and 28.43 and 26.52, 25.72 and 35.85 for boys per 1000 person in 2009, 2010 and 2011, respectively, The highest prevalence of overweight was 77.58, 142.4 and 126.46 per 1000 person among primary, secondary and high school children, respectively, in 2011. The lowest prevalence of obesity was 12.52, 24.1 and 21.61 per 1000 person among primary, secondary and high school children, respectively, in 2009. Conclusion: However, the rapid increase in both obesity and overweight should have a special attention. Research on prevalence trend of overweight and obesity in children is poorly reported in Iran. So that, future studies need to follow-up on the associations between overweight and obesity with health outcomes when children develop and reach adolescence and adulthood.

Keywords: overweight, obesity, school children, prevalence trend, Iran

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Authors: Jesus David Argueta Moreno, Justa Rufina Martel, Edith Gabriela Carrasco

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The Central American Coffee small, medium, and large corporations search for excellence, sustainability, and continuous improvement, triggers in a still unknown scale the Local expansion, crusading, and franchising strategies towards a more suitable commercial opportunity, where the dynamics of the Central American business displacement can be explained through the markets permeability traits. By considering the previously mentioned, the present study aims to evaluate the franchising potentialities offered by Central American Coffee business scenario, in order to explain dynamics of the business demography phenomena and its relevance on the Central American competitiveness landscape.

Keywords: competitiveness, franchising, business demography, Central American Coffee

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure, and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity is the most severe clinical form of obesity, and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate morbid obese children with (MOMetS+) and without (MOMetS-) MetS. Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. A recently introduced anthropometric obesity index, waist circumference + hip circumference/2 ((WC+HC)/2), was confirmed to differ OB children from those with N-BMI, however it has not been tested whether it will find clinical usage for the differential diagnosis of MOMetS+ and MOMetS-. This study was designed to find out the availability of (WC+HC)/2 for the purpose and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. Forty-five MOMetS+ and forty-five MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. Body mass index (BMI), waist-to-hip circumference (W/H), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data was analyzed statistically, and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for W/H, TLFR, TAFR, D2I, and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r=0.961; p<0.001) and MOMetS+ (r=0.936; p<0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r=0.726; p<0.001 in MOMetS- group and r=0.932; p<0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as W/H, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: children, hip circumference, metabolic syndrome, morbid obesity, waist circumference

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Authors: Saeid Doaei

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Background: Obesity in adolescence is a primary risk factor for obesity in adulthood. The objective of this study was the assessment of the effect of a comprehensive lifestyle intervention on different anthropometric indices in 12 to 16 years old boy adolescents. Methods: 96 adolescent boys of two schools of District 5 of Tehran have participated in this study. The schools were randomly assigned as intervention school (n=53) and control school (n=43). The height and weight of students were measured with a calibrated tape line and digital scale respectively and their BMI were calculated. The amounts of body fat percent (BF) and body muscle (BM) percent were determined by Bio Impedance Analyzer (BIA) considering the age, gender and height of students at baseline and after intervention. The intervention was implemented in the intervention school, according to the Ottawa charter principles. Results: 12 weeks of intervention decreased body fat percent in the intervention group in comparison with the control group (decreased by 1.81 % in the intervention group and increased by .39 % in the control group, P < .01). However, weight, BMI and BM did not change significantly. Conclusion: The result of this study showed that the implementation of comprehensive intervention in obese adolescents may improve the body composition, although these changes may not be reflected in BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.

Keywords: obesity, childhood, BMI, nutrition

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Authors: Irina M. Kolesnikova, Andrey M. Gaponov, Sergey A. Roumiantsev, Tatiana V. Grigoryeva, Alexander V. Laikov, Alexander V. Shestopalov

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Background. Neuropathy is a common complication of obesity. In this regard, the content of neurotrophins in such patients is of particular interest. Neurotrophins are the proteins that regulate neuron survival and neuroplasticity and include brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). However, the risk of complications depends on the metabolic type of obesity. Metabolically unhealthy obesity (MUHO) is associated with a high risk of complications, while this is not the case with metabolically healthy obesity (MHO). Therefore, the aim of our work was to study the effect of the obesity metabolic type on serum neurotrophins levels. Patients, materials, methods. The study included 134 healthy donors and 104 obese patients. Depending on the metabolic type of obesity, the obese patients were divided into subgroups with MHO (n=40) and MUHO (n=55). In the blood serum, the concentration of BDNF and NGF was determined. In addition, the content of adipokines (leptin, asprosin, resistin, adiponectin), myokines (irisin, myostatin, osteocrin), indicators of carbohydrate, and lipid metabolism were measured. Correlation analysis revealed the relationship between the studied parameters. Results. We found that serum BDNF concentration was not different between obese patients and healthy donors, regardless of obesity metabolic type. At the same time, in obese patients, there was a decrease in serum NGF level versus control. A similar trend was characteristic of both MHO and MUHO. However, MUHO patients had a higher NGF level than MHO patients. The literature indicates that obesity is associated with an increase in the plasma concentration of NGF. It can be assumed that in obesity, there is a violation of NGF storage in platelets, which accelerates neurotrophin degradation. We found that BDNF concentration correlated with irisin levels in MUHO patients. Healthy donors had a weak association between NGF and VEGF levels. No such association was found in obese patients, but there was an association between NGF and leptin concentrations. In MHO, the concentration of NHF correlated with the content of leptin, irisin, osteocrin, insulin, and the HOMA-IR index. But in MUHO patients, we found only the relationship between NGF and adipokines (leptin, asprosin). It can be assumed that in patients with MHO, the replenishment of serum NGF occurs under the influence of muscle and adipose tissue. In the MUHO patients only the effect of adipose tissue on NGF was observed. Conclusion. Obesity, regardless of metabolic type, is associated with a decrease in serum NGF concentration. We showed that muscle and adipose tissues make a significant contribution to the serum NGF pool in the MHO patients. In MUHO there is no effect of muscle on the NGF level, but the effect of adipose tissue remains.

Keywords: neurotrophins, nerve growth factor, NGF, brain-derived neurotrophic factor, BDNF, obesity, metabolically healthy obesity, metabolically unhealthy obesity

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Authors: Abdul Soofi, Katherine Wolf, Egon Ranghini, Gregory Dressler

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Obesity and its associated complications, such as insulin resistance and non-alcoholic fatty liver disease, are reaching epidemic proportions. In mice, the TGF-β superfamily is implicated in the regulation of white and brown adipose tissues differentiation. The Kielin/Chordin-like Protein (KCP) is a secreted regulator of the TGF-β superfamily pathways that can inhibit both TGF-β and Activin signals while enhancing the Bone Morphogenetic protein (BMP) signaling. However, the effects of KCP on metabolism and obesity have not been studied in animal models. Thus, we examined the effects of KCP loss or gain of function in mice that were maintained on either a regular or a high fat diet. Loss of KCP sensitized mice to obesity and associated complications such as hepatic steatosis and glucose intolerance. In contrast, transgenic mice that expressed KCP in the kidney, liver and adipose tissues were resistant to developing high fat diet induced obesity and had significantly reduced white adipose tissue. KCP over-expression was able to shift the pattern of Smad signaling in vivo, to increase the levels of P-Smad1 and decrease P-Smad3, resulting in resistance to high fat diet induced hepatic steatosis and glucose intolerance. In aging mice, loss of KCP promoted liver pathology even when mice were fed a normal diet. The data demonstrate that shifting the TGF-β superfamily signaling with a secreted inhibitor or enhancer can alter the physiology of adipose tissue to reduce obesity and can inhibit the initiation and progression of hepatic steatosis to significantly reduce the effects of high fat diet induced metabolic disease.

Keywords: adipose tissue, KCP, obesity, TGF-β, BMP, hepatic steatosis, metabolic syndrome

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Authors: Yudia Mailani Putri, Martalena Purba, B. J. Istiti Kandarina

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Background: Obesity has been recognized as a global health problem. Individuals classified as overweight and obese are increasing at an alarming rate. This condition is associated with psychological and physiological problems. as a person reaches adulthood, somatic growth ceases. At this stage, the human body has developed fully, to a stable state. As the capital of Riau Province in Indonesia, Pekanbaru is dominated by Malay ethnic population habitually consuming cholesterol-rich fatty foods as a daily menu, a trigger to the onset of obesity resulting in high prevalence of degenerative diseases. Research objectives: The aim of this study is elaborating the relationship between high-fat consumption pattern, stress level, physical activity and the incidence of obesity in adult women in Pekanbaru city. Research Methods: Among the combined research methods applied in this study, the first stage is quantitative observational, analytical cross-sectional research design with adult women aged 20-40 living in Pekanbaru city. The sample consists of 200 women with BMI≥25. Sample data is processed with univariate, bivariate (correlation and simple linear regression) and multivariate (multiple linear regression) analysis. The second phase is qualitative descriptive study purposive sampling by in-depth interviews. six participants withdrew from the study. Results: According to the results of the bivariate analysis, there are relationships between the incidence of obesity and the pattern of high fat foods consumption (energy intake (p≤0.000; r = 0.536), protein intake (p≤0.000; r=0.307), fat intake (p≤0.000; r=0.416), carbohydrate intake (p≤0.000; r=0.430), frequency of fatty food consumption (p≤0.000; r=0.506) and frequency of viscera foods consumption (p≤0.000; r=0.535). There is a relationship between physical activity and incidence of obesity (p≤0.000; r=-0.631). However, there is no relationship between the level of stress (p=0.741; r=0.019-) and the incidence of obesity. Physical activity is a predominant factor in the incidence of obesity in adult women in Pekanbaru city. Conclusion: There are relationships between high-fat food consumption pattern, physical activity and the incidence of obesity in Pekanbaru city whereas physical activity is a predominant factor in the occurrence of obesity, supported by the unchangeable pattern of high-fat foods consumption.

Keywords: obesity, adult, high in fat, stress, physical activity, consumption pattern

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Authors: Seham Alsaif, Susan Wray

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Obesity is a worldwide disorder influencing women’s health and childbearing. There is a close relation between obesity and pregnancy related complications. Dyslipidemia and adipokine dysregulation are core environmental changes that may mechanistically link these complications with obesity in pregnant women. We have previously found that visfatin has a relaxant effect on mouse, rat and human myometrial contractility. We hypothesised that visfatin inhibits mouse myometrial contractility through the NAD+ pathway. This study was designed to examine the mechanism of action of visfatin on myometrial contractility. To examine the NAD+ pathway, FK866 which is a potent inhibitor of NAD+ biosynthesis was used. Methods: Myometrial strips from term pregnant mice were dissected, superfused with physiological saline and the effects of visfatin (10nM) on oxytocin-induced contractions (0.5nM) alone and after the infusion of FK866 (10uM) were studied. After regular contractions were established, contractility was examined for control (100%) and test response at 37 °C for 10 min each. Results: FK866 was found to inhibit the effect of visfatin on myometrial contractility (the AUC increased from 89±2% of control, P=0.0009 for visfatin alone to 97±4% of control, P>0.05 for visfatin combined with FK866, n=8). In conclusion, NAD+ pathway appears to be involved in the mechanism of action of visfatin on mouse myometrium. This could have a role in making new targets to prevent obesity-related complications.

Keywords: myometrium, obesity, oxytocin, pregnancy, visfatin

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Authors: Chih-Hung Liang, Jung-Jung Chen, Shen-Shih Chiang

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Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health, which are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Cordyceps militaris (CM) is a well-known traditional medicine in Asian countries and a rich source of biologically active components. Black rice (Oryza sativa L.) is a special cultivar of rice that contains rich anthocyanins and regarded as a health-promoting food in China and other Eastern. The aim of this study was to investigate the anti-obesity effect of Cordyceps militaris fermented black rice (CB) on HFD-induced BALB/c mice model. The results indicated that administration of low and high dosage of CB powder significantly reduced the body weights (7.38% and 7.78%), body fat ratio (2.37% and 2.78%), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared to the HF group (p<0.05). Histopathological analysis showed that the score of fatty liver in HF group (5.0) was significantly higher than CB groups (2.1 and 3.6) (p<0.05). In conclusion, Cordyceps militaris fermented black rice can reduce the body weight via inhibition of the fat accumulation in liver and body and possess the anti-obesity potency.

Keywords: Cordyceps militaris, black rice, obesity, HFD-induced mice

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Authors: N. M. Aborehab, M. Helmy, N. E. Waly

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Resistin was identified as an adipocyte hormone that participates in regulation of glucose metabolism. Elevated levels of Resistin are postulated to cause insulin resistance. This may link obesity, and increased fat mass to type II diabetes and insulin resistance. We hypothesized that tomato and broccoli extract treatment regulates glucose homeostasis via modulation of resistin levels in high fat diet induced obesity rats (HFD). 63 male albino rats were divided into 8 groups as follows: control, HFD, stop fat diet (SD), Tomato 200 mg/kg (T200), Tomato 400mg/kg (T400), Broccoli 200 mg/kg (B200), Broccoli 400 mg/kg (B400), Chromax (CX). Treatment continued for 1 month. Serum levels of resistin, leptin, adiponectin, glucose and insulin were measured using ELISA, and spectrophotometry. Serum level of resistin was significantly reduced in T 200, T 400, B 200, B 400 and CX groups to: 4.13 ± 0.22 ng/ml, 1.51 ± 0.04 ng/ml, 4.13 ± 0.22 ng/ml, 2.32 ± 0.15 ng/ml and 1.37 ± 0.03 ng/ml respectively compared to HFD group and SD group (P value < 0.0001). Non-significant difference was found between T 400, B 400 and CX groups. Mean serum level of leptin was significantly reduced in T 400 (22.7 ± 0.84 Pg/ml) group compared to B 400 (41 ± 2.45 Pg/ml) and CX groups (45.7 ± 2.91 Pg/ml), P value < 0.001.The mean serum level of adiponectin was significantly increased in T 400 group (131 ± 3.84 Pg/ml) compared to CX group (112 ± 4.77 Pg/ml), P value was < 0.01. Our results demonstrate that tomato and broccoli extract treatment regulates glucose homeostasis via reduction of serum resistin and may be a useful non-pharmacological therapy for obesity. Further studies are required to assess the potential use of these extract as a treatment for type II diabetes and obesity.

Keywords: broccoli, obesity, resistin, tomato

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Authors: Mustafa M. Donma, Orkide Donma

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A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.

Keywords: children, C-reactive protein, systemic immune-inflammation index, obesity

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Authors: Cristian Baldini

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‘Diabesity’ is a term for diabetes occurring in the context of obesity. The positive effect of LCHF diets (low-carb, high-fat diets) is well documented: LCHF diets are at least as effective as other dietary strategies for reducing body weight, improving glycaemic control, and reducing both hyperinsulinaemia and blood glucose (reduction of HbA1c) in type 2 diabetes and have unique positive effects on blood lipid concentrations and cardiovascular risk factors. Also, in obese insulin-resistant women, food fried in extra-virgin olive oil significantly reduced both insulin and C-peptide responses after a meal. This case study shows that if combined, both dietary strategies produce a strong effect on blood glucose, resulting in a “forced” reduction of exogenous insulin injection to avoid the problem of hypoglycaemia. Blood tests after three months of this dietary treatment show how HbA1c, triglycerides, and blood lipid profile (LDL, HDL, Total Cholesterol) are improved despite the reduction of exogenous insulin injection of 80% with a parallel body weight decrease of 15%. For continuous glucose monitoring (CGM), the patient used FreeStyle Libre before and after the dietary treatment. In order to check general body functions and glycosuria, the patient used the urine test Multistix 10 SG Siemens.

Keywords: diabetes, obesity, diabesity, fat, fried foods

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Authors: Madhur Verma, Meena Rajput, Kamal Kishore

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Background: The general view that obesity is a problem of prosperous Western countries has been repealed with substantial evidence showing that middle-income countries like India are now at the heart of a fat explosion. Neck circumference has evolved as a promising index to measure obesity, because of the convenience of its use, even in culture sensitive population. Objectives: To determine whether neck circumference (NC) was associated with overweight and obesity and contributed to the prediction like other classical anthropometric indices. Methodology: Cross-sectional study consisting of 1080 adults (> 19 years) selected through Multi-stage random sampling between August 2013 and September 2014 using the pretested semi-structured questionnaire. After recruitment, the demographic and anthropometric parameters [BMI, Waist & Hip Circumference (WC, HC), Waist to hip ratio (WHR), waist to height ratio (WHtR), body fat percentage (BF %), neck circumference (NC)] were recorded & calculated as per standard procedures. Analysis was done using appropriate statistical tests. (SPSS, version 21.) Results: Mean age of study participants was 44.55+15.65 years. Overall prevalence of overweight & obesity as per modified criteria for Asian Indians (BMI ≥ 23 kg/m2) was 49.62% (Females-51.48%; Males-47.77%). Also, number of participants having high WHR, WHtR, BF%, WC & NC was 827(76.57%), 530(49.07%), 513(47.5%), 537(49.72%) & 376(34.81%) respectively. Variation of NC, BMI & BF% with age was non- significant. In both the genders, as per the Pearson’s correlational analysis, neck circumference was positively correlated with BMI (men, r=0.670 {p < 0.05}; women, r=0.564 {p < 0.05}), BF% (men, r=0.407 {p < 0.05}; women, r= 0.283 {p < 0.05}), WC (men, r=0.598{p < 0.05}; women, r=0.615 {p < 0.05}), HC (men, r=0.512{p < 0.05}; women, r=0.523{p < 0.05}), WHR (men, r= 0.380{p > 0.05}; women, r=0.022{p > 0.05}) & WHtR (men, r=0.318 {p < 0.05}; women, r=0.396{p < 0.05}). On ROC analysis, NC showed good discriminatory power to identify obesity with AUC (AUC for males: 0.822 & females: 0.873; p- value < 0.001) with maximum sensitivity and specificity at a cut-off value of 36.55 cms for males & 34.05cms for females. Conclusion: NC has fair validity as a community-based screener for overweight and obese individuals in the study context and has also correlated well with other classical indices.

Keywords: neck circumference, obesity, anthropometric indices, body fat percentage

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