Search results for: obesity awareness

Authors: Nur H. Ahmad, Silvia S. Inge, Vanessa A. Julliete, A. Veraditias, Laila F. Febinda

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Abdominal obesity is a risk factor for metabolic syndrome and mostly found in adolescents. Waist circumference is related to abdominal obesity which has a significant effect on the increase of blood pressure. Inulin is one of prebiotic, that has health benefits by offering the potential for lipid management, that can be useful to decrease the risk factor of metabolic syndrome. The aim of the research is to evaluate the effect of 10 gram inulin-substituted ice cream in waist circumference and blood pressure of abdominal obesity adolescents. Inulin had the ability to produce Short Chain Fatty Acid which can improve blood pressure and waist circumference. Systolic blood pressure was significantly decreased in the treatment group (p=0.028) with the mean of reduction 7.35 ± 11.59 mmHg. However, diastolic blood pressure and waist circumference showed no significant effect. Waist circumference, systolic blood pressure and diastolic blood pressure was decreased in control group. These results suggest that inulin-substituted ice cream used as therapeutics and prevention for the early onset of metabolic syndrome.

Keywords: blood pressure, inulin, metabolic syndrome, waist circumference

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Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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Authors: Avhasei Dorothy Rasifudi, Josephine Mandizha

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Cardiovascular risk factors continue to be the leading cause of death in the majority of developed and developing countries. In 2011, the World Health Organization reported that every year an estimated 17 million people globally die of CVD, representing 30% of all global deaths, particularly caused by heart attacks and strokes. The purpose of the study was to determine and describe the prevalence of selected cardiovascular risk factors among university of Venda staff. A cross-sectional study was conducted among 100 staff aged 20-65 years. The anthropometric measurements were conducted in accordance to and with standardized procedures advocated by the International Society for the Advanced Kinanthropometry. Weight, Height, waist circumference and hip circumference were measured for calculation of body mass index and waist-hip ratio. Blood pressure was measured using a Heine cuff and sphygmomanometer. Questionnaire was administered to gather demographic details and cardiovascular risk factors of hypertension and obesity. Data were analyzed using mean and standard deviation. The parameter t-test was applied to test significance level at p ≤ 0.05 between sexes. The statistical significance was set at p ≤ 0.05. The prevalence of hypertension was 23% with the highest prevalence amongst those aged 40 years and above. Factors found to be to be significantly associated with hypertension were gender, age, physical inactivity and family history. Prevalence of obesity was 43%, with the highest prevalence among those aged 40 years. The factors associated with obesity were diet, age and physical activity. The prevalence of hypertension and obesity in the study were high.

Keywords: cardiovascular, prevalence, risk factors, staff

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Authors: Natnicha Hasoontree

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The purposes of this research was to study the relationship of television viewers with brand awareness and brand loyalty from the perspective of customers in Bangkok. A probability random sampling of 482 television viewers was utilized. A Likert-five-scale questionnaire was designed to collect the data and small in-depth interviews were also used to obtain their opinions. The findings revealed that the majority of respondents reported a positive relationship between time of viewing television and brand awareness and brand loyalty. The more they watched the advertisement of a particular brand, the more positive the information was perceived and thereby increasing brand loyalty. Finally, the findings from the in-depth interviews with small group of television producers revealed that they are convinced that advertising exposure had a positive impact on brand awareness and brand loyalty.

Keywords: brand awareness, brand loyalty, television viewers, advertisement

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Authors: Mwenya Mubanga, Sula Mazimba

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Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

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Authors: Matei Tudor Berceanu, Hema Viswambharan, Kirti Kain, Chew Weng Cheng

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Background - Obesity parameters, particularly visceral obesity as measured by the waist-to-height ratio (WHtR), correlate with insulin resistance. The metabolic microvascular changes associated with insulin resistance causes increased peripheral arteriolar resistance primarily to the lower limb vessels. We hypothesize that ankle systolic blood pressures (SBPs) are more significantly associated with visceral obesity than brachial SBPs. Methods - 1098 adults enriched in south Asians or Europeans with diabetes (T2DM) were recruited from a primary care practice in West Yorkshire. Their medical histories, including T2DM and cardiovascular disease (CVD) status, were gathered from an electronic database. The brachial, dorsalis pedis, and posterior tibial SBPs were measured using a Doppler machine. Their body mass index (BMI) and WHtR were calculated after measuring their weight, height, and waist circumference. Linear regressions were performed between the 6 SBPs and both obesity parameters, after adjusting for covariates. Results - Generally, the left posterior tibial SBP (P=4.559*10⁻¹⁵) and right posterior tibial SBP (P=1.114* 10⁻¹³ ) are the pressures most significantly associated with the BMI, as well as in south Asians (P < 0.001) and Europeans (P < 0.001) specifically. In South Asians, although the left (P=0.032) and right brachial SBP (P=0.045) were associated to the WHtR, the left posterior tibial SBP (P=0.023) showed the strongest association. Conclusion - Regardless of ethnicity, ankle SBPs are more significantly associated with generalized obesity than brachial SBPs, suggesting their screening potential for screening for early detection of T2DM and CVD. A combination of ankle SBPs with WHtR is proposed in south Asians.

Keywords: ankle blood pressures, body mass index, insulin resistance, waist-to-height-ratio

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is defined as a severe chronic disease characterized by a low-grade inflammatory state. Therefore, inflammatory markers gained utmost importance during the evaluation of obesity and metabolic syndrome (MetS), a disease characterized by central obesity, elevated blood pressure, increased fasting blood glucose and elevated triglycerides or reduced high density lipoprotein cholesterol (HDL-C) values. Some inflammatory markers based upon complete blood cell count (CBC) are available. In this study, it was questioned which inflammatory marker was the best to evaluate the differences between various obesity groups. 514 pediatric individuals were recruited. 132 children with MetS, 155 morbid obese (MO), 90 obese (OB), 38 overweight (OW) and 99 children with normal BMI (N-BMI) were included into the scope of this study. Obesity groups were constituted using age- and sex-dependent body mass index (BMI) percentiles tabulated by World Health Organization. MetS components were determined to be able to specify children with MetS. CBC were determined using automated hematology analyzer. HDL-C analysis was performed. Using CBC parameters and HDL-C values, ratio markers of inflammation, which cover neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL-C ratio (MHR) were calculated. Statistical analyses were performed. The statistical significance degree was considered as p < 0.05. There was no statistically significant difference among the groups in terms of platelet count, neutrophil count, lymphocyte count, monocyte count, and NLR. PLR differed significantly between OW and N-BMI as well as MetS. Monocyte-to HDL-C value exhibited statistical significance between MetS and N-BMI, OB, and MO groups. HDL-C value differed between MetS and N-BMI, OW, OB, MO groups. MHR was the ratio, which exhibits the best performance among the other CBC-based inflammatory markers. On the other hand, when MHR was compared to HDL-C only, it was suggested that HDL-C has given much more valuable information. Therefore, this parameter still keeps its value from the diagnostic point of view. Our results suggest that MHR can be an inflammatory marker during the evaluation of pediatric MetS, but the predictive value of this parameter was not superior to HDL-C during the evaluation of obesity.

Keywords: children, complete blood cell count, high density lipoprotein cholesterol, metabolic syndrome, obesity

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Authors: Emran M. Badghish

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Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

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Authors: Pınar Karakaya, Meral Mert, Yildiz Okuturlar, Didem Acarer, Asuman Gedikbasi, Filiz Islim, Teslime Ayaz, Ozlem Soyluk, Ozlem Harmankaya, Abdulbaki Kumbasar

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Objective: To evaluate the relation of mean platelet volume (MPV) levels with serum paraoxonase-1 activity and brachial artery diameter and intima media thickness in diabetic patients with respect to obesity and diabetic complications. Methods: A total of 201 diabetic patients grouped with respect to obesity [obese (n=89) and non-obese (n=112) and diabetic complications [with (n=50) or without (n=150) microvascular complications and with (n=91) or without (n=108) macrovascular complications] groups were included. Data on demographic and lifestyle characteristics of patients, anthropometric measurements, diabetes related microvascular and macrovascular complications, serum levels for MPV, bBrachial artery diameter and intima media thickness (IMT) and serum paraoxonase and arylesterase activities were recorded. Correlation of MPV values to paraoxonase and arylesterase activities as well as to brachial artery diameter and IMT was evaluated in study groups. Results: Mean(SD) paraoxonase and arylesterase values were 119.8(37.5) U/L and 149.0(39.9) U/L, respectively in the overall population with no significant difference with respect to obesity and macrovascular diabetic complications, whereas significantly lower values for paraoxonase (107.5(30.7) vs. 123.9(38.8) U/L, p=0.007) and arylesterase (132.1(30.2) vs. 154.7(41.2) U/L, p=0.001) were noted in patients with than without diabetic microvascular complications. Mean(SD) MPV values were 9.10 (0.87) fL in the overall population with no significant difference with respect to obesity and diabetic complications. No significant correlation of MPV values to paraoxonase, arylesterase activities, to brachial artery diameter and IMT was noted in the overall study population as well as in study groups. Conclusion: In conclusion, our findings revealed a significant decrease I PON-1 activity in diabetic patients with microvascular rather than macrovascular complications, whereas regardless of obesity and diabetic complications, no increase in thrombogenic activity and no relation of thrombogenic activity with PON-1 activity and brachial artery diameter and IMK.

Keywords: atherosclerosis, diabetes mellitus, microvascular complications, macrovascular complications, obesity, paraoxonase

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Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara

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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.

Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka

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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: Eric S. Parilla, Marc Edward Abadilla

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The study aims to determine the effect of awareness of business students towards cryptocurrencies and the readiness of universities and colleges to accept cryptocurrencies as a medium of exchange, considering the mediation of business students’ attitudes. The research used partial least squares structural equation modeling (PLS-SEM) and deployed a questionnaire attuned to the awareness and attitudes of business students towards cryptocurrencies and readiness and compatibility of use in universities and colleges in Ilocos Norte. The output of the investigation revealed that awareness of business students is not correlated to the readiness of universities and colleges, which means that even though students understand cryptocurrencies, it is not an assurance that universities and colleges are ready to accept them as the medium of exchange. The study proposes that training and seminars for business students and professionals should be conducted to expand understanding and acceptance of cryptocurrencies.

Keywords: cryptocurrencies, awareness, readiness, attitudes

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Authors: M. Rojo, M. Blanco, T. Lacruz, S. Solano, L. Beltran, M. Graell, A. R. Sepulveda.

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There is an association between an early accumulation of Stressful Life Events (SLE) during childhood and various physical and psychological health complications. However, there are only a few studies on this topic in children and adolescents with overweight or obesity. The general aim of the study was to evaluate the accumulation and type of SLE in 200 children from 8 to 12 years old and analyze the relationship with their emotional well-being and weight status (obesity, overweight and normal weight). The children and their families completed an interview. The evaluated variables that are included in this study are sociodemographic measures, medical/psychological history, anthropometric measures (BMI, z-BMI), and psychological variables (children's clinical interview K-SADS-PL(Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version) and battery of questionnaires). Results: Children with overweight and obesity accumulate more stressful events from an early age and have a significantly higher percentage of psychiatric diagnoses, compared to their peers with normal weight. Presenting a child psychiatric disorder is related to greater z-BMI and the total number of SLE (p < 0.001). A higher z-BMI is also related to a greater number of stressful events during childhood. There is also a positive and significant relationship between the total number of SLE and worse emotional well-being (higher levels of anxious and depressive symptoms and low self-esteem of children) (p < 0.01). Conclusion: Children with overweight and obesity grow up in a family, school, and social context where more stressors are accumulated. This is also directly associated with worse emotional well-being. It is necessary to implement multidisciplinary prevention and intervention strategies in different changes (school, family, and health). This study is included in a project funded by the Ministry of Innovation and Science (PSI2011-23127).

Keywords: childhood obesity, emotional well-being, psychopathology, stressful life events

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Authors: Salwa Obeisat

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Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like obstructed labors, infections, and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Health care providers are not immune to obesity-related prejudice, and the literature features several examples of their negative attitudes towards obese patients. In Jordan, few studies were conducted to investigate obesity prevalence rate and its associated factors. The purposes of this study were to assess the health care providers' attitudes toward overweight and obese women during the childbirth in the North of Jordan and to investigate the relationships between health care providers' socio-demographic characteristics and their attitudes. A descriptive, cross-sectional design was utilized. A convenient sample was consisted of 95 midwives, 30 nurses and 62 obstetricians, who were working in the labor rooms. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and Arabic version of Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS). Results: The study findings revealed that the majority of Jordanian health care providers held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did obstetricians and nurses. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with health care providers’ attitudes. The Conclusion: Health care providers negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing health care providers.

Keywords: attitudes, obesity, prevalence rate, nurses, midwives, obstetrician, childbirth

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric obesity indices such as waist circumference (WC), indices derived from anthropometric measurements such as waist-to-hip ratio (WHR), and indices created from body fat mass composition such as trunk-to-leg fat ratio (TLFR) are commonly used for the evaluation of mild or severe forms of obesity. Their clinical utilities are being compared using body mass index (BMI) percentiles to classify obesity groups. The best of them is still being investigated to make a clear-cut discrimination between healthy normal individuals (N-BMI) and overweight or obese (OB) or morbid obese patients. The aim of this study is to derive a new index, which best suits the purpose for the discrimination of children with N-BMI from OB children. A total of eighty-three children participated in the study. Two groups were constituted. The first group comprised 42 children with N-BMI, and the second group was composed of 41 OB children, whose age- and sex- adjusted BMI percentile values vary between 95 and 99. The corresponding values for the first group were between 15 and 85. This classification was based upon the tables created by World Health Organization. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements were taken and recorded following a detailed physical examination. Within this context, weight, height (Ht), WC, hip C (HC), neck C (NC) values were taken. Body mass index, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. Trunk-to-leg fat ratio, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2) were calculated. Fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis of the data was performed. Significantly increased values of (WC+HC)/2, (TF+LF)/2, D2I, and FMI were observed in OB group in comparison with those of N-BMI group. Significant correlations were calculated between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I as well as FMI both in N-BMI and OB groups. The same correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I, and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I as well as FMI in N-BMI group. Same correlations were observed also with TAFR. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. From these findings, it was concluded that (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index. The only correlation valid in both groups was that exists between (WC+HC)/2 and (TF+LF)/2. This index was suggested as a link between anthropometric and fat-based indices.

Keywords: children, hip circumference, obesity, waist circumference

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Authors: Ian Phil Canlas, Mageswary Karpudewan, Joyce Magtolis, Rosario Canlas

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This study reported the development and validation of the Awareness to Disaster Risk Reduction Questionnaire for Teachers (ADRRQT). The questionnaire is a combination of Likert scale and open-ended questions that were grouped into two parts. The first part included questions relating to the general awareness on disaster risk reduction. Whereas, the second part comprised questions regarding the integration of disaster risk reduction in the teaching process. The entire process of developing and validating of the ADRRQT was described in this study. Statistical and qualitative findings revealed that the ADRRQT is significantly valid and reliable and has the potential of measuring awareness to disaster risk reduction of stakeholders in the field of teaching. Moreover, it also shows the potential to be adopted in other fields.

Keywords: awareness, development, disaster risk reduction, questionnaire, validation

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Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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In recent years childhood obesity has increased to pan-epidemic proportions along with a concomitant increase in obesity-associated morbidity. Birth weight is an important determinant of later adult health, with neonates at both ends of the birth weight spectrum at risk of future health complications. Consequently, infants who are born large for gestational age (LGA) are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. Adipose tissue plays a role in linking events in fetal growth to the subsequent development of adult diseases. In addition to its role as a storage depot for fat, adipose tissue produces and secrets a number of hormones of importance in modulating metabolism and energy homeostasis. Cord blood leptin level has been positively correlated with fetal adiposity at birth. It is established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given body mass index indicating a genetic predisposition in the occurrence of obesity. To our knowledge, studies have never been conducted in Sri Lanka to determine the relationship between adipocytokine profile in cord blood and anthropometric parameters in newborns. Thus, the objective of this study is to establish the above relationship for the Sri Lankan population to implement awareness programs to minimize childhood obesity in the future. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of leptin was measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured. Pearson’s correlation was used to assess the relationship between leptin and anthropometric parameters while the Mann-Whitney U test was used to assess the differences in cord blood leptin levels between small for gestational age (SGA), appropriate for gestational age (AGA) and LGA infants. There was a significant difference (P < 0.05) between the cord blood leptin concentrations of LGA infants (12.67 ng/mL ± 2.34) and AGA infants (7.10 ng/mL ± 0.90). However, a significant difference was not observed between leptin levels of SGA infants (8.86 ng/mL ± 0.70) and AGA infants. In both male and female neonates, umbilical leptin levels showed significant positive correlations (P < 0.05) with birth weight of the newborn, pre-pregnancy maternal weight and pre pregnancy BMI between the infants of large and appropriate for gestational ages. Increased concentrations of leptin levels in the cord blood of large for gestational age infants suggest that they may be involved in regulating fetal growth. Leptin concentration of Sri Lankan population was not significantly deviated from published data of Asian populations. Fetal leptin may be an important predictor of neonatal adiposity; however, interventional studies are required to assess its impact on the possible risk of childhood obesity.

Keywords: appropriate for gestational age, childhood obesity, leptin, anthropometry

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Authors: Ojochenemi J. Onubi, Debbi Marais, Lorna Aucott, Friday Okonofua, Amudha Poobalan

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Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the development of obesity, and maternal obesity is associated with significant adverse effects in the mother and child. Nigeria is experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women. However, there is scarcity of data on maternal obesity in Nigeria and other African countries. Aims and Objectives: This project aimed at identifying crucial components of potential interventions for maternal obesity in Nigeria. The objectives were to assess the prevalence, effects, and distribution of maternal obesity; knowledge, attitude and practice (KAP) of pregnant women and maternal healthcare providers; and identify existing interventions for maternal obesity in Nigeria. Methodology: A systematic review and meta-analysis were initially conducted to appraise the existing literature on maternal obesity in Africa. Following this, a quantitative questionnaire survey of the KAP of pregnant women and a qualitative interview study of the KAP of Health Care Workers (HCW) were conducted in seven secondary and tertiary hospitals across Nigeria. Quantitative data was analysed using SPSS statistical software, while thematic analysis was conducted for qualitative data. Results: Twenty-nine studies included in the systematic review showed significant prevalence, socio-demographic associations, and adverse effects of maternal obesity on labour, maternal, and child outcomes in Africa. The questionnaire survey of 435 mothers revealed a maternal obesity prevalence of 17.9% among mothers who registered for antenatal care in the first trimester. The mothers received nutrition information from different sources and had insufficient knowledge of their own weight category or recommended Gestational Weight Gain (GWG), causes, complications, and safe ways to manage maternal obesity. However, majority of the mothers were of the opinion that excess GWG is avoided in pregnancy and some practiced weight management (diet and exercise) during pregnancy. For the qualitative study, four main themes were identified: ‘Concerns about obesity in pregnancy’, ‘Barriers to care for obese pregnant women’, ‘Practice of care for obese pregnant women’, and ‘Improving care for obese pregnant women’. HCW expressed concerns about rising levels of maternal obesity, lack of guidelines for the management of obese pregnant women and worries about unintended consequences of antenatal interventions. ‘Barriers’ included lack of contact with obese women before pregnancy, late registration for antenatal care, and perceived maternal barriers such as socio-cultural beliefs of mothers and poverty. ‘Practice’ included anticipatory care and screening for possible complications, general nutrition education during antenatal care and interdisciplinary care for mothers with complications. HCW offered suggestions on improving care for obese women including timing, type, and settings of interventions; and the need for involvement of other stake holders in caring for obese pregnant women. Conclusions: Culturally adaptable/sensitive interventions should be developed for the management of obese pregnant women in Africa. Education and training of mothers and health care workers, and provision of guidelines are some of the components of potential interventions in Nigeria.

Keywords: Africa, maternal, obesity, pregnancy

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Authors: Peter Mc Coll, Alberto Caro, Chiara Gandolfo, Montserrat Labbe, Francisca Schnaidt, Michela Palazzi

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Self-esteem and emotional intelligence are variables that are related to people's nutritional status. Self-esteem may be at low levels in people living with obesity, while emotional intelligence can play an important role in the way people living with obesity cope. The objective of the study was to measure the association between self-esteem and emotional intelligence to nutritional status in adolescent population. Methodology: A cross-sectional study was carried out with 179 adolescent schoolchildren between 13 and 19 years old from a public school. The objective was to evaluate nutritional status; weight and height were measured by calculating the body mass index and Z score. Self-esteem was evaluated using the Coopersmith Self-esteem Inventory adapted by Brinkmann and Segure. Emotional intelligence was measured using the Emotional Quotient Inventory: short, by Bar On, adapted questionnaire, translated into Spanish by López Zafra. For statistical analysis: Pearson's Chi-square test, Pearson's correlation, and odd ratio calculation were used, with a p value at a significance level < 5%. Results: The study group was composed of 71% female and 29% male. The nutritional status was distributed as eutrophic 41.9%, overweight 20.1%, and obesity 21.1%. In relation to self-esteem, 44.1% presented low and very low levels, without differences by gender. Emotional intelligence was distributed: low 3.4%, medium 81%, and high 13.4% -no differences according to gender. The association between nutritional status (overweight and obesity) with low and very low self-esteem, an odds ratio of 2.5 (95% CI 1.12 – 5.59) was obtained with a p-value = 0.02. The correlation analysis between the intrapersonal sub-dimension emotional intelligence scores and the Z score of nutritional status presented a negative correlation of r = - 0.209 with a p-value < 0.005. The correlation between emotional intelligence subdimension stress management with Z score presented a positive correlation of r = 0.0161 with a p-value < 0.05. In conclusion, the group of adolescents studied had a high prevalence of overweight and obesity, a high prevalence of low self-esteem, and a high prevalence of average emotional intelligence. Overweight and obese adolescents were 2.5 times more likely to have low self-esteem. As overweight and obesity increase, self-esteem decreases, and the ability to manage stress increases.

Keywords: self-esteem, emotional intelligence, obesity, adolescent, nutritional status

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Authors: Ssekamanya, Mastura Badzis, Khamsiah Ismail, Dayang Shuzaidah Bt Abduludin

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With rising incidents of school violence worldwide, educators and researchers are trying to understand and find ways to enhance the safety of children at school. The purpose of this study was to investigate the extent to which the demographic variables of gender, age, length of service, position, academic qualification, and school location predicted teachers’ awareness about school safety practices in Malaysian primary schools. A stratified random sample of 380 teachers was selected in the central Malaysian states of Kuala Lumpur and Selangor. Multiple regression analysis revealed that none of the factors was a good predictor of awareness about school safety training, delivery methods of school safety information, and available school safety programs. Awareness about school safety activities was significantly predicted by school location (whether the school was located in a rural or urban area). While these results may reflect a general lack of awareness about school safety among primary school teachers in the selected locations, a national study needs to be conducted for the whole country.

Keywords: school safety awareness, predictors of school safety, multiple regression analysis, malaysian primary schools

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Authors: R. Komsa-Penkova, G. Golemanov, G. Georgieva, K. Popovski, N. Slavov, P. Ivanov, K. Kovacheva, S. Rathee, E. Konova, A. Blajev

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Leptin and PAI-1 are important cytokines and may play a role in the regulation of PCOS development. PCOS is frequently associated with obesity, high BMI index and consequently with increased risk of metabolic disorders. The aim of the present study was to evaluate PAI-1 levels, genetic influence of the carriage of 675 4G/5G polymorphism in PAI-1 gene and leptin as a marker of obesity in the development of PCOS. Methods: Genotyping in 84 patients with PCOS and PCO and 100 healthy control subjects to detect single nucleotide deletion 675 G in the promoter of PAI-1 gene. The present study provides evidence that SNP 4G in the PAI-1 gene is associated with early pregnancy losses in patients with polycystosis. Further to this, there is a correlation between leptin levels, PAI-1 levels and BMI in the patients with PCOS, which confirms the role of obesity as a risk factor for PCOS.

Keywords: carriage of 675 4G/5G polymorphism, PCOS, early pregnancy losses, PAI-1 gene

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Authors: C. Ah Gang Getrude, Iqbal Hashmi Shazia, Mohd Nawi Nurul Hudani

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This study examined the effectiveness of a Traffic Psychology Workshop in enhancing positive attitudes towards road safety awareness among youths. We predicted that youths’ attitudes towards road safety would be more positive after they participated in the one-day workshop. We examined their attitudes towards road safety awareness before and after they attended a one-day workshop. There were 21 participants who completed the pre and post-studies (9 males & 12 females, mean age 22.86, SD=2.03). A Wilcoxon signed-ranks test showed that the mean for post-test ranks for students’ attitudes towards road safety awareness was higher than the mean pre-test ranks, z =-3.16, p = .00. The study showed that the Traffic Psychology Module which focuses on the three elements: i) personality & emotion; Sensation, perception and visual; and mental workload could have positive effects on youths’ attitudes towards road safety awareness. We believe that the Traffic Psychology Module could be used as a guide by relevant authorities, such as the Sabah Road Safety Department, in implementing road safety awareness workshops and programs for the public, particularly road-users.

Keywords: attitude, road safety, traffic psychology, youth

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Authors: Stefan Bauer, Josef Frysak

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According to the scientific information management literature, the improper use of information technology (e.g. personal computers) by employees are one main cause for operational and information security loss events. Therefore, organizations implement information security awareness programs to increase employees’ awareness to further prevention of loss events. However, in many cases these information security awareness programs consist of conventional delivery methods like posters, leaflets, or internal messages to make employees aware of information security policies. We assume that a viral information security awareness video might be more effective medium than conventional methods commonly used by organizations. The purpose of this research is to develop a viral video artifact to improve employee security behavior concerning information technology.

Keywords: information security awareness, delivery methods, viral videos, employee security behavior

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Authors: Mohammad Najmuddin Khan, Mohamad Khaleel Albalwi

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The prevalence of obesity has risen dramatically in past several decades. Hormonal and genetic factors are rarely the cause of childhood obesity. Because obese adult may suffer life-long physical and emotional consequences, it is imperative to discuss prevention with parents during well-child examinations. Purpose of the study was to compare the serum lipid profile of obese and non-obese males. Twenty two male students were selected from Al-Jouf University. Their age ranged from 19 to 29. They were divided into groups. One group (N=15) having more than 20% fat was considered as obese group, another group (N=7) was considered as non-obese group. Fasting blood samples were analysed for blood cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C). Independent test was applied to compare mean difference. In obese group, significantly higher cholesterol and triglycerides were observed. On the contrary, obese group had significantly lower HDL-C concentration than the non-obese group. The adult obese has relatively larger changes in serum lipids at any given level of obesity. On the average, higher amount of fat makes it more likely for an individual to be dyslipidemic and to express elements of the metabolic syndrome. Increased triglycerides level in obese impaired lipolysis which reduced the HDL-C concentrations.

Keywords: obesity, serum lipid profile, Al-Jouf, HDL, LDL

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Authors: Sushma Ghildyal, Sanjay Kumar Singh

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The present study was undertaken with the purpose to understand the relationship of lifestyle and Socio-Economic status with child obesity among 1000 boys aged from 16 to 18 years of Varanasi District of Uttar Pradesh State in India. The study was conducted in both urban and rural area of the District. Ten schools i.e. five from urban area and five from rural area were selected by using purposive sampling. Healthy boys of class 10th, 11th and 12th were taken as subjects for the study. Prior consent was obtained from school authority. Anthropometric measurements were taken from each subject. Anthropometric measurements were Standing Height, Weight, Biceps skin folds, Triceps skin folds, Sub-scapular skin folds and Supra-iliac skin folds taken by Lange’s skin fold caliper. Lifestyle and Socio-Economic Status were obtained by questionnaires. In order to assess the BMI, Body fat %, Lifestyle and Socio-Economic Status; descriptive analyses were done. To find out the significant association of obesity with lifestyle and Socio-Economic Status Chi-square test was used. To find out significant difference between obesity of Urban and Rural children t-test was applied. Level of significance was set at 0.05 level. The conclusions drawn were: (1) The result showed that in urban area Varanasi District of Uttar Pradesh 0.6% children were in very high level adaptive lifestyle, 6.2% were in high level adaptive lifestyle, 25.4% above average level adaptive lifestyle, 47.8% moderately adaptive lifestyle, 3.6% and 0.4% low and very low level adaptive lifestyle. (2) In rural area Varanasi District of Uttar Pradesh 0.00% children were in very high level adaptive lifestyle, 9.4% were in high level adaptive lifestyle, 24.8% average level adaptive lifestyle, 47.0% moderately adaptive lifestyle, 15.2% below average and 3.0% very low level adaptive lifestyle.(3) In urban area 12.8% were in upper class Socio-Economic Status, 56.6% in upper middle class Socio-Economic Status, 30.2% in middle class Socio-Economic Status and 0.2% in lower middle class Socio-Economic Status. (4) In rural area 1.4% were in upper class Socio-Economic Status, 15.2% in upper middle class Socio-Economic Status, 51.6% in middle class Socio-Economic Status and 0.8% in lower middle class Socio-Economic Status. (5) In urban area 21.2% children of 16-18 years were obese. (6) In rural area 0.2% children of 16-18 years were obese. (7) In overall Varanasi District of Uttar Pradesh 10.7% children of 16-18 years were obese. (8) There was no significant relationship of obesity with Lifestyle of urban area children of 16-18 years. (9) There was significant relationship of obesity with Socio-Economic Status of urban area children of 16-18 years (10) There was no significant relationship of obesity with Lifestyle of rural area children of 16-18 years of Varanasi District Uttar Pradesh. (11) There was significant relationship of obesity with Socio-Economic Status of rural area children of 16-18 years. (12) Results showed significant difference between urban and rural area children of 16-18 years in respect to obesity of Varanasi District of Uttar Pradesh.

Keywords: lifestyle, obesity, rural area, socio-economic status, urban area

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Authors: Orkide Donma, M. Metin Donma, Burcin Nalbantoglu, Birol Topcu, Feti Tulubas, Murat Aydin, Tuba Gokkus, Ahmet Gurel

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Increasing prevalence of childhood obesity has increased the interest in early and late indicators of gaining weight. Cell blood counts may be indicators of proinflammatory states. The aim was to evaluate associations of hematological parameters, including Hematocrit (HTC), hemoglobin, blood cell counts, and their indices with the degree of obesity in pediatric population. A total of 249; -139 morbidly obese (MO), 82 healthy Normal Weight (NW) and 28 Overweight (OW) children were included into the scope of the study. WHO BMI-for age percentiles were used to form age- and sex-matched groups. Informed consent forms and the Ethics Committee approval were obtained. Anthropometric measurements were performed. Hematological parameters were determined. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. Significant differences (p=0.000) between waist-to-hip ratios and head-to-neck ratios (hnrs) of MO and NW children were detected. A significant difference between hnrs of OW and MO children (p=0.000) was observed. Red cell Distribution Width (RDW) was higher in OW children than NW group (p=0.030). Such finding couldn’t be detected between MO and NW groups. Increased RDW was prominent in OW children. The decrease in Mean Corpuscular Hemoglobin Concentration (MCHC) values in MO children was sharper than the values in OW children (p=0.006 vs p=0.042) compared to those in NW group. Statistically higher HTC levels were observed between MO-NW (p=0.014), but none between OW-NW. Though the cause-effect relationship between obesity and erythrocyte indices still needs further investigation, alterations in RDW, HTC, MCHC during obesity may be of significance in the early life.

Keywords: anthropometry, children, erythrocytes, obesity

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Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

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Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

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Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

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Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

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Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

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Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site-specific. The aim of this study was to evaluate the Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in the obese Ukrainian women. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group a included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of < 30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur 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 our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body, and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non-obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50-59, 60-69, and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non-obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

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

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