Search results for: obese teenagers

Authors: Yi-Ying Lin, Su-Guo, Chia-Hao, Ming-Szu Hong

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Objectives: Smoking is a common addictive behavior in teenagers. Long-term smoking is hazardous to health, causes family and social expenditure, and is an important topic that should not be overlooked by academia or the government. The aims of this study are to examine the effectiveness of these courses in terms of teenagers’ knowledge and attitudes towards the hazards of smoking and the effectiveness of their self-efficacy in rejecting smoking. Methods: This study adopted a pre-test post-test design and selected 7th, 8th, 10th, and 11th graders from two junior high schools. Total of 1073 valid questionnaires were collected. The self-completed questionnaire included background information, smoking status of relatives staying with the subject, attitudes of parents towards child smoking, knowledge and attitudes towards smoking, and anti-smoking self-efficacy. Results and clinical applications: Subjects in the experimental group underwent course interventions, which are 'smoking prevention courses,' in the semester. After course intervention, it was found that the intervention showed significant efficacy in terms of knowledge and self-efficacy in rejecting smoking in senior high school students but no efficacy in junior high school. We recommend that this course can be used in normal senior high schools. With regards to junior high schools, smoking prevention courses should be designed to be gamified, or combined with activities with both anti-smoking messages and entertainment at the same time, so that knowledge, attitudes, and self-efficacy can be subconsciously cultivated.

Keywords: adolescent students, smoking knowledge, attitudes, anti-smoking self-efficiency, smoking prevention intervention

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Authors: Seongho Jang

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Objective: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. Methods: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean ±standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. Results: The underweight or normal group’s SM, SB, and the safe margin were 1.2±0.2, 2.1±0.4, and 1.4 to 1.7 cm, respectively. The overweight group’s SM and SB were 1.4±0.2 and 2.4±0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group’s SM, SB, and the safe margin were 1.8±0.3, 2.7±0.5, and 2.1 to 2.2 cm, respectively. Conclusion: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.

Keywords: pneumothorax, rhomboid major muscle, trigger point injection, ultrasound

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Authors: Bulelani Ngamntwini, Liezel Cilliers

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South Africa has one of the highest prevalence of obese people on the African continent. Forty-six percent of the adults in South Africa are physically inactive. Fitness applications can be used to increase physical inactivity. However, the uptake of mobile fitness applications in South Africa has been found to be poor due to usability challenges with the technology. The study developed a usability framework to influence the intention to use mobile fitness applications in South Africa. The study made use of a positivistic approach to collect data. A questionnaire was used to collect quantitative data from 377 respondents that have used mobile fitness applications in the past. A response rate of 80.90% was recorded. To analyse the data, the Pearson correlation was used to determine the relationships between the various hypotheses. There are four usability factors, efficiency, effectiveness, satisfaction, and learnability, which contribute to the intention of users to make use of mobile fitness applications. The study, therefore, recommends that for a mobile fitness application to be successful, these four factors must be considered and incorporated by developers when designing the applications.

Keywords: obese, overweight, physical inactivity, mobile fitness application, usability factors

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Authors: Samuel N. Forjuoh, Marcia G. Ory, Jaewoong Won, Samuel D. Towne, Suojin Wang, Chanam Lee

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The public health burden of obesity is well established as is the influence of physical activity (PA) on the health and wellness of individuals who are obese. This study examined the influence of selected demographic, health, and socioenvironmental factors on the walking behaviors of middle-aged and older overweight and obese adults. Online and paper surveys were administered to community-dwelling overweight and obese adults aged ≥ 50 years residing in four cities in central Texas and seen by a family physician in the primary care clinic from October 2013 to June 2014. Descriptive statistics were used to characterize participants’ anthropometric and demographic data as well as their health conditions and walking, socioenvironmental, and more broadly defined PA behaviors. Then Pearson chi-square tests were used to assess differences between participants who reported walking the recommended ≥ 150 minutes for any purpose in a typical week as a proxy to meeting the U.S. Centers for Disease Control and Prevention’s PA guidelines and those who did not. Finally, logistic regression was used to predict walking the recommended ≥ 150 minutes for any purpose, controlling for covariates. The analysis was conducted in 2016. Of the total sample (n=253, survey response rate of 6.8%), the majority were non-Hispanic white (81.7%), married (74.5%), male (53.5%), and reported an annual household income of ≥ $50,000 (65.7%). Approximately, half were employed (49.6%), or had at least a college degree (51.8%). Slightly more than 1 in 5 (n=57, 22.5%) reported walking the recommended ≥150 minutes for any purpose in a typical week. The strongest predictors of walking the recommended ≥ 150 minutes for any purpose in a typical week in adjusted analysis were related to education and a high favorable perception of the neighborhood environment. Compared to those with a high school diploma or some college, participants with at least a college degree were five times as likely to walk the recommended ≥ 150 minutes for any purpose (OR=5.55, 95% CI=1.79-17.25). Walking the recommended ≥ 150 minutes for any purpose was significantly associated with participants who disagreed that there were many distracted drivers (e.g., on the cell phone while driving) in their neighborhood (OR=4.08, 95% CI=1.47-11.36) and those who agreed that there are sidewalks or protected walkways (e.g., walking trails) in their neighborhood (OR=3.55, 95% CI=1.10-11.49). Those employed were less likely to walk the recommended ≥ 150 minutes for any purpose compared to those unemployed (OR=0.31, 95% CI=0.11-0.85) as were those who reported some difficulty walking for a quarter of a mile (OR=0.19, 95% CI=0.05-0.77). Other socio-environmental factors such as having care-giver responsibilities for elders, someone to walk with, or a dog in the household as well as Walk Score™ were not significantly associated with walking the recommended ≥ 150 minutes for any purpose in a typical week. Neighborhood perception appears to be an important factor associated with the walking behaviors of middle-aged and older overweight and obese individuals. Enhancing the neighborhood environment (e.g., providing walking trails) may promote walking among these individuals.

Keywords: determinants of walking, obesity, older adults, physical activity

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Authors: V. Davaakhuu, D. Tserendagva, D. Amarsaikhan, T. Altanstetseg

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In this study we aimed to detect main risk factors for diabetes in Mongolia and obtain data we used survey modified questionnaire. Survey data were obtained from 634 valid nurses (day work nurses-317, shift work nurses-317). Participants who were pregnant, less than 20 years old and no check for fasting glucose level were excluded from the survey in order to determine the risk factors of diabetes. Our study result shows the main risk factors of diabetes were physical inactivity, overweight and obesity, alcohol and tobacco use and lack of vegetable and fruit consumption. Peripheral blood glucose level was normal in subjects with BMI 26.28 ± 0.56, but 20 % of the subjects with normal blood glucose level were obese. Blood glucose level was higher in subjects with BMI 28.63 ± 2.32 and 36 % of them were obese. According to our study results, 3.62% of the surveyed population were identified having no diabetes risk factors, 52.3% were at risk, 28.8% were in higher risk for diabetes by the WHO criteria. In general, the prevalence of blood glucose were especially higher in shift work nurses.

Keywords: day work nurses, shift work nurses, BMI, WHR

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Authors: Chan Eang Teng, Tang Mui Joo

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In the beginning of the prevalence of social media, it would be an obvious trend that the young adult age group has the highest population among the users on social media. However, apart from the age group of the users are becoming younger and younger, the elderly group has become a new force on social media, and this age group has increased rapidly. On top of that, the influence of social media towards the elderly is becoming more significant and it is even trending among them. This is because basic computer knowledge is not instilled into their life when they were young. This age group tends to be engrossed more than the young as this is something new for them, and they have the mindset that it is a new platform to approach things, and they tend to be more engrossed when they start getting in touch with the social media. Generally, most of the social media has been accepted and accessed by teenagers and young adult, but it is reasonable to believe that the social media is not really accepted among the elderly. Surprisingly, the elderlies are more addicted to the social media than the teenagers. Therefore, this study is to determine and understand the relationship between the elderly and social media, and how they employ social media in their lives. An online survey on 200 elderly aged 45-80 and an interview with a media expert are conducted to answer the main questions in the research paper. Uses and Gratification Approach is employed in theoretical framework. Finding revealed that majority of the respondents use social media to connect with family, friends, and for leisure purposes. The finding concluded that the elderly use social media differently according to their needs and wants which is in par with the highlight of Uses and Gratification theory. Considering the significantly large role social media plays in our culture and daily life today, the finding will shed some light on the effect of social media on the elderly or senior citizens who are usually relegated into a minority group in today’s age where the internet and social media are of great importance to our society and humanity in general. This may also serve to be useful in understanding behavioral patterns and preference in terms of social media usage among the elderly.

Keywords: elderly, Facebook, Malaysia, social media

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity may lead to growing serious health problems throughout the world. Vitamin D appears to play a role in cardiovascular and metabolic health. Vitamin D deficiency may add to derangements in human metabolic systems, particularly those of children. Childhood obesity is associated with an increased risk of chronic and sophisticated diseases. The aim of this study is to investigate associations as well as possible differences related to parameters affected by obesity and their relations with vitamin D status in obese (OB) and morbid obese (MO) children. This study included a total of 78 children. Of them, 41 and 37 were OB and MO, respectively. WHO BMI-for age percentiles were used for the classification of obesity. The values above 99 percentile were defined as MO. Those between 95 and 99 percentiles were included into OB group. Anthropometric measurements were recorded. Basal metabolic rates (BMRs) were measured. Vitamin D status is determined by the measurement of 25-hydroxy cholecalciferol [25- hydroxyvitamin D3, 25(OH)D] using high-performance liquid chromatography. Vitamin D status was evaluated as deficient, insufficient and sufficient. Values < 20.0 ng/ml, values between 20-30 ng/ml and values > 30.0 ng/ml were defined as vitamin D deficient, insufficient and sufficient, respectively. Optimal 25(OH)D level was defined as ≥ 30 ng/ml. SPSSx statistical package program was used for the evaluation of the data. The statistical significance degree was accepted as p < 0.05. Mean ages did not differ between the groups. Significantly increased body mass index (BMI), waist circumference (C) and neck C as well as significantly decreased fasting blood glucose (FBG) and vitamin D values were observed in MO group (p < 0.05). In OB group, 37.5% of the children were vitamin D deficient, and in MO group the corresponding value was 53.6%. No difference between the groups in terms of lipid profile, systolic blood pressure (SBP), diastolic blood pressure (DBP) and insulin values was noted. There was a severe statistical significance between FBG values of the groups (p < 0.001). Important correlations between BMI, waist C, hip C, neck C and both SBP as well as DBP were found in OB group. In MO group, correlations only with SBP were obtained. In a similar manner, in OB group, correlations were detected between SBP-BMR and DBP-BMR. However, in MO children, BMR correlated only with SBP. The associations of vitamin D with anthropometric indices as well as some lipid parameters were defined. In OB group BMI, waist C, hip C and triglycerides (TRG) were negatively correlated with vitamin D concentrations whereas none of them were detected in MO group. Vitamin D deficiency may contribute to the complications associated with childhood obesity. Loss of correlations between obesity indices-DBP, vitamin D-TRG, as well as relatively lower FBG values, observed in MO group point out that the emergence of MetS components starts during obesity state just before the transition to morbid obesity. Aside from its deficiency state, associations of vitamin D with anthropometric measurements, blood pressures and TRG should also be evaluated before the development of morbid obesity.

Keywords: children, morbid obesity, obesity, vitamin D

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Authors: Manuela Gamba, Niki Mandolesi

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Teenagers today have little knowledge about how to move or play together. The adults who are part of sports culture must find an effective way to foster this essential ability. Our research in Italy uses a 'holistic model' based on fantasy literature to explore the relationships between the game identities and self-identities of young people and the achievement of psycho-motor, emotional and social well-being in the realms of sport and education. Physical activity projects were carried out in schools and extra-curricular associations in Rome, combining outdoor activities and distance learning. This holistic and malleable game model is inspired by fantasy accounts of the journeys taken in The Lord of Rings and Harry Potter books. We know that many have a lot of resistance to the idea of using fantasy and play as a pedagogical tool, but the results obtained in this experience are surprising. Our interventions and investigations focused on promoting self-esteem, awareness, a sense of belonging, social integration, cooperation, well-being, and informed decision making: a basis for healthy and effective citizenship. For teenagers, creative thinking is the right stimulus to involve and compare the story of characters to their own journey through social and self-reflective identity analysis. We observed how important it is to engage students emotionally as well as cognitively and that enabling them to play with identity through relationships with peers. There is a need today for a multidisciplinary synthesis of analog and digital values, especially in response to recent distance-living experiences. There is a need for a global reconceptualization of free time and nature in the human experience.

Keywords: awareness, creativity, identity, play

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Authors: Mustafa Metin Donma

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Circumference measurements are important because they are easily obtained values for the identification of the weight gain without determining body fat. They may give meaningful information about the varying stages of obesity. Besides, some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements, each giving a valuable information independently, to question whether their combined power within a formula was capable of being helpful for the differential diagnosis of morbid obesity without metabolic syndrome (MetS) from MetS. One hundred and eighty seven children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University Faculty of Medicine. The parents of the participants were informed about asked to fill and sign the consent forms. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee. The study population was divided into four groups as normal-body mass index (N-BMI), obese (OB), morbid obese (MO) and MetS, which were composed of 35, 44, 75 and 33 children, respectively. Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. Body mass index values were calculated. A circumference index, advanced Donma circumference index (ADCI) was introduced as WC*HC/NC. The statistical significance degree was chosen as p value smaller than 0.05. Body mass index values were 17.7±2.8, 24.5±3.3, 28.8±5.7, 31.4±8.0 kg/m2, for N-BMI, OB, MO, MetS groups, respectively. The corresponding values for ADCI were 165±35, 240±42, 270±55, and 298±62. Significant differences were obtained between BMI values of N-BMI and OB, MO, MetS groups (p=0.001). Obese group BMI values also differed from MO group BMI values (p=0.001). However, the increase in MetS group compared to MO group was not significant (p=0.091). For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p=0.001). Obese group ADCI values also differed from MO group ADCI values (p=0.015). A significant difference between MO and MetS groups was detected (p=0.043). The correlation coefficient value and the significance check of the correlation was found between BMI and ADCI as r=0.0883 and p=0.001 upon consideration of all participants. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: anthropometry, body mass index, child, circumference, metabolic syndrome, obesity

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Authors: Anna Bak-Klimek, Emily Spencer, Siew Lee, Karen Campbell, Wendy McInally

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Background & Significance: Over half of Teenagers and Young Adults (TYAs) say that they experience psychological distress after cancer diagnosis and TYAs with cancer are at higher risk of developing distress compared to other age groups. Despite this there are no age-appropriate interventions to help TYAs manage distress and there is a lack of conceptual understanding of what causes distress in this population group. This makes it difficult to design a targeted, developmentally appropriate intervention. This review aims to identify the key determinants of distress in TYAs affected by cancer and to propose an integrative model of cancer-related distress for TYAs. Method: A literature search was performed in Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, EMBASE and PsycArticles in May-June, 2022. Quantitative literature was systematically reviewed on the relationship between psychological distress experienced by TYAs affected by cancer and a wide range of factors i.e. individual (demographic, psychological, developmental, and clinical factors) and contextual (social/environmental) factors. Evidence was synthesized and correlates were categorized using the Biopsychosocial Model. The full protocol is available from PROSPERO (CRD42022322069) Results: Thirty eligible quantitative studies met criteria for the review. A total of twenty-six studies were cross-sectional, three were longitudinal and one study was a case control study. The evidence on the relationship between the socio-demographic, illness and treatment-related factors and psychological distress is inconsistent and unclear. There is however consistent evidence on the link between psychological factors and psychological distress. For instance, the use of cognitive and defence coping, negative meta-cognitive beliefs, less optimism, a lack of sense of meaning and lower resilience levels were significantly associated with higher psychological distress. Furthermore, developmental factors such as poor self-image, identity issues and perceived conflict were strongly associated with higher distress levels. Conclusions: The current review suggests that psychological and developmental factors such as ineffective coping strategies, poor self-image and identity issues may play a key role in the development of psychological distress in TYAs affected by cancer. The review proposes a Positive Developmental Psychology Model of Distress for Teenagers and Young Adults affected by cancer. The review highlights that implementation of psychological interventions that foster optimism, improve resilience and address self-image may result in reduced distress in TYA’s with cancer.

Keywords: cancer, determinant, psychological distress, teenager and young adult, theoretical model

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Authors: Ahmed Ghachem, Denis Prud’homme, Rémi-Rabasa-Lhoret, M. Brochu

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Objective: To compare the effects of a CR on body composition, lipid profile and glucose homeostasis in obese postmenopausal women with and without MetS. Methods: Secondary analyses were performed on seventy-three inactive obese postmenopausal women (age: 57.7 ± 4.8 yrs; body mass index: 32.4 ± 4.6 kg/m2) who participated in the 6-month caloric restriction arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorized participants with MetS [n = 20, 27.39%] and without MetS [n = 53, 72.61%]. Variables of interest were: body composition (DXA), body fat distribution (CT scan), glucose homeostasis at the fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids and resting blood pressure. Results: By design, the MetS group had a worse cardiometabolic profile; while both groups were comparable for age. Fifty-five patients out of seventy-three displayed no change in MetS status after the intervention. Twelve participants out of twenty (or 60.0%) in the MetS group had no more MetS after weight loss (P= NS); while six participants out of fifty three (or 11.3%) in the other group developed the MetS after the intervention (P= NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/HDL-C ratio, which decrease significantly more in the MetS group (P ≤ 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile. Conclusion: Despite no overall significant effects on MetS, heterogeneous results were obtained in response to weight loss in the present study; with some improving the MetS while other displaying deteriorations. Further studies are needed in order to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.

Keywords: menopause, obesity, physical inactivity, metabolic syndrome, caloric restriction, weight loss

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Authors: Carolina Alcântara, Ileno Costa

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This study had the objective to systemize the main psycho-social and socioeducational aspects that related with the psychic suffering of adolescents in conflict of law and freedom privation. This research wanted to verify the signals and symptoms identified trough themselves perceptions related to their condition of health/insanity. In a similar way, it was objectified to know the opinions of the ambient conditions of the institution the use of the currently available resources for Health Service and Educational Service. The methodological proposal is based on the quant-qualitative analysis of interviews half-structuralized carried through with 36 teenagers was using psychiatric medication continuously. The data had pointed the experiences of sleeplessness and nightmares, associates or not with experiences of loss of reality (hallucinations) had constituted the illness most frequent. The self-punishment behavior appeared at second place. With regard to the ambient factors, it was verified that institution had, in general way, guaranteed the physical integrity and the maintenance of the health. Amongst the current available resources of Health Service, the administration of anticonvulsivants, in association with other psychotropic drugs has been widely used. The school was viewed as important device of available in the institution. By means of the adolescent’s understanding who do not like to go to the school, they don’t disqualify the knowledge, in contrast, they wanted for knowledge, however, they were frustrated for not having their educational supplies adequately, affirming that the school is weak or they do not learn. Finally, among the possible conclusions guided for the Winnicott’s thought, it was observed that institution in analysis is a representative of the paternal function. However, to begin the self-cure process is necessary that formation of therapeutical bonds. The group of teachers is identified as the main tool of change.

Keywords: serious psychic suffering, adolescent in conflict with the law, delinquency, privation of freedom

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Authors: Preeti Nakhat

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Background: Values are essential part of one's life. They are inculcated since the early years of life and shape the personality of the individual. They play a tremendous role in decision making. Teenagers are seen perplexed about the values of their life. The challenge faced by majority of the teenage population in choosing between a positive and negative value is high. The values they adopt remain throughout their life and in every decision, hence it is a crucial topic of research. Research Methodology: This research aimed at finding out the value conflict of teenagers in relations. Hypothesis of the study are: H₀- There is no significant association between the life values and value conflict of higher secondary students; H₁– There is a significant association between the life values and value conflict of higher secondary students. For the same, the standardized tool, value conflict scale by R. L. Bhardwaj has been used. The tool consists 24 questions of different life situations with multiple choice options. Findings: There is 96% variation in value conflict due to evasion vs. fortitude, dependence vs. self-reliance, selfishness vs. probity, hate vs. love, fear vs. assertion and pragmatism vs. idealism life values. There is a positive association between all the life values and value conflict of higher secondary school students. Percentages of association are: 0.17% between value conflict and evasion vs. fortitude value, 0.16% between value conflict and dependence vs. self-reliance value, 0.17% between value conflict and selfishness vs. probity value, 0.16% between value conflict and hate vs. love value, 0.17% between value conflict and fear vs. assertion, 0.17% between value conflict and pragmatism vs. idealism value. Discussions: The dilemma faced by the students regarding value conflict is high. Bewilderment of being honest or lying, of loving or hating family and friends, being pragmatic or idealistic in life decision, being selfish or selfless is seen among the students. It is the challenge for the future. Teaching of values with a practical aspect should be added in the school curriculum.

Keywords: dilemma, conflict, school, values

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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Authors: Ramesh Bhat, Ammu Somanath, A. K. Nayanatara

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Background: The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions are hallmarks of Alzheimer’s disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. Aim: The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. Material and Methods: A total of 142 female subjects constituting women before menopause between the age group of 18–44 years and women after menopause between the age group of 45–60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The Perceived Stress Scale (PSS) the major tool was used for measuring the perception of stress. Based on the stress scale measurement each group was classified into with stress and without stress. Addenbrooke’s cognitive Examination-III was used for measuring the cognitive functions. Results: Premenopausal women with stress showed a significant (P<0.05) decrease in the cognitive parameters such as attention and orientation Fluency, language and visuospatial ability. Memory did not show any significant change in this group. Whereas, in the postmenopausal stressed women all the cognitive functions except fluency showed a significant (P<0.05) decrease after menopause stressed group. Conclusion: Stress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of Yoga, Encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the HPA axis in relation to cognition and stress.

Keywords: cognition, stress, premenopausal, body mass index

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Authors: Savitri Siddanagoudra, Shantala Herlekar, Priya Arjunwadekar

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Background: The physiological response to water drinking in healthy subjects is an integrated response with an increase in sympathetic vasoconstrictor activity with induced bradycardia. Obesity is a modern pandemic, implicated in the pathogenesis of cardiovascular disease. In autonomic failure patients, water drinking has been shown the increased high blood pressure and bradycardia. Acute effects of ice water ingestion on blood pressure (BP) in relation to body mass index (BMI) is not addressed in literature. Objectives: Objective of this study is to evaluate BP before and after ingestion of cold water in all the three groups. Methods and Material: 60 healthy subjects between the age group of 18-24 yrs were selected and assigned into 3 groups based on BMI. BMI less than and equal to 25 kg/m2 is selected as Normal BMI group ,between 25- 29 kg/m2 as Overweight and BMI more than and equal to 30 kg/m2 as Obese. Procedure: Basal and after ingestion of 250 ml of cold water (7 0C ± 0.5 0C)BP was recorded in all the 3 groups. Results: Basal and after ice water ingestion BP increased statistically in all 3 groups. Conclusion: On acute ingestion of ice water overweight, obese may have more sympathoexcitaion compared to normal subjects.

Keywords: blood pressure, body mass index, ice water, symathoexcitation

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Authors: Saad Mahmud Khan, Sarah El Hajj Chehadeh, Mehera Abdulrahman, Wael Osman, Habiba Al Safar

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Obesity is a non-communicable disease that is widely prevalent with approximately 600 million people classified as obese worldwide. Its etiology is multifactorial and involves a complex interplay between genes and the environment. Over the past few decades, obesity rates among the Emirati population have been increasing. The aim of this study was to investigate the association of candidate gene single nucleotide polymorphisms (SNPs), namely the fat mass and obesity associated (FTO) gene SNP rs9939609 and Vitamin D Receptor (VDR) gene SNP rs1544410, with obesity in the UAE population. Methods: This is a case-control study in which 414 individuals were enrolled during their routine visit to endocrinology clinics in Abu Dhabi, United Arab Emirates between the period of June 2012 and December 2013. Several biochemical tests and clinical assessments along with a lifestyle questionnaire for each participant were completed at the clinic. Genomic DNA was extracted from saliva samples of 201 obese, 114 overweight and 99 normal subjects. Genotyping for the variants was performed using TaqMan assay. Results: The mean Body Mass Index (BMI) ± SD for the obese, overweight, and normal subjects was 35.76 ± 4.54, 27.53 ± 1.45 and 22.69 ± 1.84 kg/m2, respectively. Increasing BMI values were associated with an increase in values for systolic blood pressure, diastolic blood pressure, HbA1c, and triglycerides. The SNP rs9939609 in the FTO gene was found to be significantly associated with the BMI (p=0.028), with the minor allele A having a clear additive effect on BMI values. No significant association was detected between BMI and rs1544410 of the VDR gene. Conclusions: Our study findings indicate that the minor allele A of the rs9939609 has a significant association with increasing BMI values. In addition, our findings support the fact that increasing BMI is associated with increasing risks of other comorbidities such as higher blood pressure, poorer glycemic control and higher triglycerides.

Keywords: body mass index, FTO gene, obesity, rs9939609, United Arab Emirates

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Authors: Abiodun Afolabi, Rufus Adesoji Adedoyin

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This study investigated and compared the effects of gym-based exercise programme (GEBP) and audio-visual guided home-based exercise programme (AVGHBEP) on selected Anthropometric variables (Weight (W), Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), Thigh Circumference (TC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Waist-Thigh-Ratio (WTR), Biceps Skinfold Thickness (BSFT), Triceps Skinfold Thickness (TSFT), Suprailliac Skinfold Thickness (SISFT), Subscapular Skinfold Thickness (SSSFT) and Percent Body Fat (PBF)); and Cardiovasular variables (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)) of overweight and obese students of Federal College of Education (Special), Oyo, Oyo State, Nigeria, with a view to providing information and evidence for GBEP and AVGHBEP in reducing overweight and obesity for promoting cardiovascular fitness. Eighty overweight and obese students (BMI ≥ 25 Kg/m²) were involved in this pretest-posttest quasi experimental study. Participants were randomly assigned into GBEP (n = 40) and AVGBBEP (n = 40) groups. Anthropometric and cardiovascular variables were measured using a weighing scale, height meter, tape measure, skinfold caliper and electronic sphygmomanometer following standard protocols. GBEP and AVGHBEP were implemented following a circuit training (aerobic and resistance training) pattern with a duration of 40-60 minutes, thrice weekly for twelve weeks. GBEP consisted of gymnasium supervised exercise programme while AVGHBEP is a Visual Display guided exercise programme conducted at the home setting. Data were analyzed by Descriptive and Inferential Statistics. The mean ages of the participants were 22.55 ± 2.55 and 23.65 ± 2.89 years for the GBEP group and AVGHBEP group, respectively. Findings showed that in the GBEP group, there were significant reductions in anthropometric variables and adiposity measures of Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR, and PBF at week 12 of the study. Similarly, in the AVGHBEP group, there were significant reductions in Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR and PBF at the 12th week of intervention. Comparison of the effects of GEBP and AVGHBEP on anthropometric variables and measures of adiposity showed that there was no significant difference between the two groups in weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHR, WHtR, WTR and PBF between the two groups at week 12 of the study. Furthermore, findings on the effects of exercise on programmes on cardiovascular variables revealed that significant reductions occurred in SBP in GBEP group and AVGHBEP group respectively. Comparison of the effects of GBEP and AVGHBEP on cardiovascular variables showed that there was no significant difference in SBP, DBP and HR between the two groups at week 12 of the study. It was concluded that the Audio-Visual Guided Home-based Exercise Programme was as effective as the Gym-Based Exercise Programme in causing a significant reduction in anthropometric variables and body fat among college students who are overweight and obese over a period of twelve weeks. Both Gymnasium-Based Exercise Programme and Audio-Visual Guided Home-Based Exercise Programme led to significant reduction in Systolic Blood Pressure over a period of weeks. Audio-Visual Guided Home-Based Exercise Programme can, therefore, be used as an alternative therapy in the non-pharmacological management of people who are overweight and obese.

Keywords: gym-based exercises, audio-visual guided home-based exercises, anthropometric parameters, cardiovascular parameters, overweight students, obese students

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Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

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Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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Authors: G. S. Sumanasekara, A. Balasuriya

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Introduction: In Sri Lanka studies reveal higher trend in prevalence of diabetes. The office employees have sedentary life style and their eating patterns changed due to nutritional transition. Further overall, urban and rural pre diabetes is also increasing. Objectives - Study the general food pattern of office employees and its relation to overweight/obesity and prevalence of diabetes among them. Method: The data was collected from office employees between 30-60 years (n-400).Data analyzed using SPSS 16 version.The Study design was a descriptive cross sectional study. The study setting was Ministry of Economic Development. Anthropometric measurements and blood glucose assessed by trained nurses. Dietary pattern was studied through a food frequency questionairre thereby calculated daily nutrient intakes. Results: Mean age of office employees were 38.98 SD (7.033) CI=95%) and 245 females (61.2%) 155 males (38.8 %) ,Nationality includes Sinhala (67.5%), Tamil(20%), and Muslims (12.5%).Owerweight(7,1.8%), obese male(36,9%), obese female(66,16%)/ diabetes/obese(18,4.5%) out of 127(31.8%) who were above the normal BMI whereas 273(68.2) were within the normal. Mean BMI was 24.1593.Mean Blood sugar level was 104.646,SD(16.018).12% consume tobacco products,17.8 consumed alcohol.15.8% had nutrition training. Two main dietary patterns identified who were vegetarians and non vegetarians .Mean energy intake 1727.1, (SD 4.97), Mean protein consumption(11.33, SD 1.811), Mean fat consumption(24.07, SD 4.131),Mean CHO consumption (64.56, SD 4.54), Mean Fibre (30.05, SD 17.9), Mean cholesterol(16.85, SD 17.22), Energy intake was higher in non vegetarians and larger propotion of energy derived from proteins , and fat. Their carbohydrate and cholesterol intake was also higher. Tamils were mostly vegetarians. Mainly BMI were within normal range(18.5-23.5) whereas Muslims who had higher energy intakes showed BMI above the normal. Conclusion: Two distinct dietary patterns identified. Different ethnic groups consume different diets with different nutrient composition. Dietary pattern has a relation to overweight. Overweight related to high blood glucose levels but some overweight subjects do not show any relation.

Keywords: obesity, overweight, diabetes, dietary pattern, nutrition, BMI, non communicable disease

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Authors: Muntanavadee Maytapattana

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The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1st, 8th, and 32nd weeks after finishing the program such as child exercise behavior (F(2,97) = 3.98, p = .02) and child dietary behavior (F(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: parent training program, obesity reduction, child health behaviors, school-age children

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Authors: Richa Soni, Vibha Bhatnagar, N. K. Jain

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This study was conducted to develop a computer mediated programme for weight management and physical fitness and examining its efficacy in reducing weight and improving physical fitness in obese adults. A user friendly, computer based programme was developed to provide a simple, quick, easy and user-friendly method of assessing energy balance at individual level. The programme had four main sections viz. personal Profile, know about your weight, fitness and food exchange list. The computer programme was developed to provide facilities of creating individual profile, tracking meal and physical activities, suggesting nutritional and exercise requirements, planning calorie specific menus, keeping food diaries and revising the diet and exercise plans if needed. The programme was also providing information on obesity, underweight, physical fitness. An exhaustive food exchange list was also given in the programme to assist user to make right food choice decisions. The developed programme was evaluated by a panel of 15 experts comprising endocrinologists, nutritionists and diet counselors. Suggestions given by the experts were paned down and the entire programme was modified in light of suggestions given by the panel members and was reevaluated by the same panel of experts. For assessing the impact of the programme 22 obese subjects were selected purposively and randomly assigned to intervention group (n=12) and no information control group. (n=10). The programme group was asked to strictly follow the programme for one month. Significant reduction in the intake of energy, fat and carbohydrates was observed while intake of fruits, green leafy vegetables was increased. The programme was also found to be effective in reducing body weight, body fat percent and body fat mass whereas total body water and physical fitness scores improved significantly. There was no significant alteration observed in any parameters in the control group.

Keywords: body composition, body weight, computer programme, physical fitness

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Authors: Carmela Nardelli, Laura Iaffaldano, Valentina Capobianco, Antonietta Tafuto, Maddalena Ferrigno, Angela Capone, Giuseppe Maria Maruotti, Maddalena Raia, Rosa Di Noto, Luigi Del Vecchio, Pasquale Martinelli, Lucio Pastore, Lucia Sacchetti

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Maternal obesity and nutrient excess in utero increase the risk of future metabolic diseases in the adult life. The mechanisms underlying this process are probably based on genetic, epigenetic alterations and changes in foetal nutrient supply. In mammals, the placenta is the main interface between foetus and mother, it regulates intrauterine development, modulates adaptive responses to sub optimal in uterus conditions and it is also an important source of human amniotic mesenchymal stem cells (hA-MSCs). We previously highlighted a specific microRNA (miRNA) profiling in amnion from obese (Ob) pregnant women, here we compared the miRNA expression profile of hA-MSCs isolated from (Ob) and control (Co) women, aimed to search for any alterations in metabolic pathways that could predispose the new-born to the obese phenotype. Methods: We isolated, at delivery, hA-MSCs from amnion of 16 Ob- and 7 Co-women with pre-pregnancy body mass index (mean/SEM) 40.3/1.8 and 22.4/1.0 kg/m2, respectively. hA-MSCs were phenotyped by flow cytometry. Globally, 384 miRNAs were evaluated by the TaqMan Array Human MicroRNA Panel v 1.0 (Applied Biosystems). By the TargetScan program we selected the target genes of the miRNAs differently expressed in Ob- vs Co-hA-MSCs; further, by KEGG database, we selected the statistical significant biological pathways. Results: The immunophenotype characterization confirmed the mesenchymal origin of the isolated hA-MSCs. A large percentage of the tested miRNAs, about 61.4% (232/378), was expressed in hA-MSCs, whereas 38.6% (146/378) was not. Most of the expressed miRNAs (89.2%, 207/232) did not differ between Ob- and Co-hA-MSCs and were not further investigated. Conversely, 4.8% of miRNAs (11/232) was higher and 6.0% (14/232) was lower in Ob- vs Co-hA-MSCs. Interestingly, 7/232 miRNAs were obesity-specific, being expressed only in hA-MSCs isolated from obese women. Bioinformatics showed that these miRNAs significantly regulated (P<0.001) genes belonging to several metabolic pathways, i.e. MAPK signalling, actin cytoskeleton, focal adhesion, axon guidance, insulin signaling, etc. Conclusions: Our preliminary data highlight an altered miRNA profile in Ob- vs Co-hA-MSCs and suggest that an epigenetic miRNA-based mechanism of gene regulation could affect pathways involved in placental growth and function, thereby potentially increasing the newborn’s risk of metabolic diseases in the adult life.

Keywords: hA-MSCs, obesity, miRNA, biosystem

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Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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Authors: Husham Bayazed

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Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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Authors: Mustafa Metin Donma, Orkide Donma

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Vitamin deficiencies are common in obese individuals. Particularly, the status of vitamin B12 and its association with vitamin B9 (folate) and vitamin D is under investigation in recent time. Vitamin B12 is closely related to many vital processes in the body. In clinical studies, its involvement in fat metabolism draws attention from the obesity point of view. Obesity, in its advanced stages and in combination with metabolic syndrome (MetS) findings, may be a life-threatening health problem. Pediatric obesity is particularly important because it may be a predictor of severe chronic diseases during the adulthood period of the child. Due to its role in fat metabolism, vitamin B12 deficiency may disrupt metabolic pathways of the lipid and energy metabolisms in the body. The association of low B12 levels with obesity degree may be an interesting topic to be investigated. Obesity indices may be helpful at this point. Weight- and fat-based indices are available. Of them, body mass index (BMI) is in the first group. Fat mass index (FMI), fat-free mass index (FFMI) and diagnostic obesity notation model assessment-II (D2I) index lie in the latter group. The aim of this study is to clarify possible associations between vitamin B12 status and obesity indices in the pediatric population. The study comprises a total of one hundred and twenty-two children. Thirty-two children were included in the normal body mass index (N-BMI) group. Forty-six and forty-four children constitute groups with morbid obese children without MetS and with MetS, respectively. Informed consent forms and the approval of the institutional ethics committee were obtained. Tables prepared for obesity classification by World Health Organization were used. Metabolic syndrome criteria were defined. Anthropometric and blood pressure measurements were taken. Body mass index, FMI, FFMI, D2I were calculated. Routine laboratory tests were performed. Vitamin B9, B12, D concentrations were determined. Statistical evaluation of the study data was performed. Vitamin B9 and vitamin D levels were reduced in MetS group compared to children with N-BMI (p>0.05). Significantly lower values were observed in vitamin B12 concentrations of MetS group (p<0.01). Upon evaluation of blood pressure as well as triglyceride levels, there exist significant increases in morbid obese children. Significantly decreased concentrations of high density lipoprotein cholesterol were observed. All of the obesity indices and insulin resistance index exhibit increasing tendency with the severity of obesity. Inverse correlations were calculated between vitamin D and insulin resistance index as well as vitamin B12 and D2I in morbid obese groups. In conclusion, a fat-based index, D2I, was the most prominent body index, which shows a strong correlation with vitamin B12 concentrations in the late stage of obesity in children. A negative correlation between these two parameters was a confirmative finding related to the association between vitamin B12 and obesity degree.

Keywords: body mass index, children, D2I index, fat mass index, obesity

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Authors: Mustafa M. Donma, Orkide Donma

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Spexin, expressed in central nervous system, has attracted much interest in feeding behavior, obesity, diabetes, energy metabolism and cardiovascular functions. Fetuin A is known as negative acute phase reactant synthesized in the liver. So far, it has become a major concern of many studies in numerous clinical states. The relationship between the concentrations of spexin as well as fetuin A and the risk for cardiovascular diseases (CVDs) were also investigated. Eosinophils, suggested to be associated with the development of CVDs, are introduced as early indicators of cardiometabolic complications. Patients with elevated platelet count, associated with hypercoagulable state in the body, are also more liable to CVDs. In this study, the aim is to examine the profiles of spexin and fetuin A concomitant with the course of variations detected in eosinophil as well as platelet counts in morbid obese children. Thirty-four children with normal-body mass index (N-BMI) and fifty-one morbid obese (MO) children participated in the study. Written-informed consent forms were obtained prior to the study. Institutional ethics committee approved the study protocol. Age- and sex-adjusted BMI percentile tables prepared by World Health Organization were used to classify healthy and obese children. Mean age ± SEM of the children were 9.3 ± 0.6 years and 10.7 ± 0.5 years in N-BMI and MO groups, respectively. Anthropometric measurements of the children were taken. Body mass index values were calculated from weight and height values. Blood samples were obtained after an overnight fasting. Routine hematologic and biochemical tests were performed. Within this context, fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein-cholesterol (HDL-C) concentrations were measured. Homeostatic model assessment for insulin resistance (HOMA-IR) values were calculated. Spexin and fetuin A levels were determined by enzyme-linked immunosorbent assay. Data were evaluated from the statistical point of view. Statistically significant differences were found between groups in terms of BMI, fat mass index, INS, HOMA-IR and HDL-C. In MO group, all parameters increased as HDL-C decreased. Elevated concentrations in MO group were detected in eosinophils (p<0.05) and platelets (p>0.05). Fetuin A levels decreased in MO group (p>0.05). However, decrease was statistically significant in spexin levels for this group (p<0.05). In conclusion, these results have suggested that increases in eosinophils and platelets exhibit behavior as cardiovascular risk factors. Decreased fetuin A behaved as a risk factor suitable to increased risk for cardiovascular problems associated with the severity of obesity. Along with increased eosinophils, increased platelets and decreased fetuin A, decreased spexin was the parameter, which reflects best its possible participation in the early development of CVD risk in MO children.

Keywords: cardiovascular diseases , eosinophils , fetuin A , pediatric morbid obesity , platelets , spexin

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Authors: Mustafa M. Donma, Orkide Donma

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Iron is physiologically essential. However, it also participates in the catalysis of free radical formation reactions. Its deficiency is associated with amplified health risks. This trace element establishes some links with another physiological process related to cell death, apoptosis. Both iron deficiency and iron overload are closely associated with apoptosis. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) has the ability to trigger apoptosis and plays a dual role in the physiological versus pathological inflammatory responses of tissues. The aim of this study was to investigate the status of these parameters as well as the associations among them in children with obesity, a low-grade inflammatory state. The study was performed on groups of children with normal body mass index (N-BMI) and obesity. Forty-three children were included in each group. Based upon age- and sex-adjusted BMI percentile tables prepared by World Health Organization, children whose values varied between 85 and 15 were included in N-BMI group. Children whose BMI percentile values were between 99 and 95 comprised obese (OB) group. Institutional ethical committee approval and informed consent forms were taken prior to the study. Anthropometric measurements (weight, height, waist circumference, hip circumference, head circumference, neck circumference) and blood pressure values (systolic blood pressure and diastolic blood pressure) were recorded. Routine biochemical analysis including serum iron, total iron binding capacity (TIBC), transferrin saturation percent (Tf Sat %), and ferritin were performed. Soluble tumor necrosis factor-like weak inducer of apoptosis levels were determined by enzyme-linked immunosorbent assay. Study data was evaluated using appropriate statistical tests performed by the statistical program SPSS. Serum iron levels were 91±34 mcrg/dl and 75±31 mcrg/dl in N-BMI and OB children, respectively. The corresponding values for TIBC, Tf Sat %, ferritin were 265 mcrg/dl vs 299 mcrg/dl, 37.2±19.1 % vs 26.7±14.6 %, and 41±25 ng/ml vs 44±26 ng/ml. in N-BMI and OB groups, sTWEAK concentrations were measured as 351 ng/L and 325 ng/L, respectively (p>0.05). Correlation analysis revealed significant associations between sTWEAK levels and iron related parameters (p<0.05) except ferritin. In conclusion, iron contributes to apoptosis. Children with iron deficiency have decreased apoptosis rate in comparison with that of healthy children. sTWEAK is inducer of apoptosis. Obese children had lower levels of both iron and sTWEAK. Low levels of sTWEAK are associated with several types of cancers and poor survival. Although iron deficiency state was not observed in this study, the correlations detected between decreased sTWEAK and decreased iron as well as Tf Sat % values were valuable findings, which point out decreased apoptosis. This may induce a proinflammatory state, potentially leading to malignancies in the future lives of obese children.

Keywords: apoptosis, children, iron-related parameters, obesity, soluble tumor necrosis factor-like weak inducer of apoptosis

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Authors: Maja Ruzic-Baf, Vedrana Keteles, Andrea Debeljuh

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Younger and younger children are now using a smartphone, a device which has become ‘a must have’ and the life of children would be almost ‘unthinkable’ without one. Devices are becoming lighter and lighter but offering an array of options and applications as well as the unavoidable access to the Internet, without which it would be almost unusable. Numerous features such as taking of photographs, listening to music, information search on the Internet, access to social networks, usage of some of the chatting and messaging services, are only some of the numerous features offered by ‘smart’ devices. They have replaced the alarm clock, home phone, camera, tablet and other devices. Their use and possession have become a part of the everyday image of young people. Apart from the positive aspects, the use of smartphones has also some downsides. For instance, free time was usually spent in nature, playing, doing sports or other activities enabling children an adequate psychophysiological growth and development. The greater usage of smartphones during classes to check statuses on social networks, message your friends, play online games, are just some of the possible negative aspects of their application. Considering that the age of the population using smartphones is decreasing and that smartphones are no longer ‘foreign’ to children of pre-school age (smartphones are used at home or in coffee shops or shopping centers while waiting for their parents, playing video games often inappropriate to their age), particular attention must be paid to a very sensitive group, the teenagers who almost never separate from their ‘pets’. This paper is divided into two sections, theoretical and empirical ones. The theoretical section gives an overview of the pros and cons of the usage of smartphones, while the empirical section presents the results of a research conducted in three elementary schools regarding the usage of smartphones and, specifically, their usage during classes, during breaks and to search information on the Internet, check status updates and 'likes’ on the Facebook social network.

Keywords: education, smartphone, social networks, teenagers

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Authors: Abeer Ahmed Abdelhameed

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The aim of this study was to investigate the effect of aerobic exercises on LV parameters, lipid profile, and anthropometric measurements in hypertensive middle aged male subjects. Thirty obese patients were recruited for the study from the outpatient clinic of National Heart Institute, Egypt. Their ages ranges from 40 to 60 years. All participants underwent an aerobic training program including regular aerobic sub-maximal exercises in the form of treadmill walking and abdominal exercises 3/week for four months, the exercise were individually tailored for each participant depending on the result of cardiopulmonary exercise test. The result showed no significant difference observed in both LVPWT and LVSWT data from pre-test values to post-test values in all subjects after 4 months, with a significant reduction in WHR, systolic blood pressure, TAG and LDL records. Result also revealed a significant increase in HDL, Eƒ, LVEDD and FS records for all participants. The significant improvement in ventricular functions in form of ejection fraction of electrical group more than exercise group after 4 months at the end of the study may be due to the beneficial effect of faradic stimulation in lipolysis of storage adipose tissues, stimulation of lean body mass and muscles and/or thermal effect that improves vascularization.

Keywords: left ventricular parameters, aerobic training, electrical stimulation, lipid profile

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