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Overnutrition or undernutrition during all or part of the reproductive cycle predisposes sows to metabolic consequences and poor reproductive health which contributes to a decrease in sow longevity and an increase in perinatal mortality. This represents not only an economic problem for the pig industry but also results in poor animal welfare. To maximize profitability and increase sustainability in pig production; it is pivotal to provide researchers and practitioners with synthesized information about the repercussions of maternal obesity or malnutrition on reproductive health and perinatal outcomes; and to pinpoint currently available nutritional managements to keep sows’ body condition in an optimal range. Thus, the present review summarizes recent work on the consequences of maternal malnutrition and highlights new findings.
There is a lack of consistency in the literature that shows a relationship between chronotype, habits of eating, and obesity in Iranian adults. This cross-sectional study, was conducted on 850 individuals aged ≥ 18 years, selected from health houses of Tehran, Iran. Chronotype was assessed by Horne and Ostberg Morningness-Eveningness Questionnaire (MEQ). Specific eating habits, including breakfast skipping, intakes of fruits and vegetables, fast food, processed meats, soft drinks, coffee and tea, was assessed by dietary recalls. Weight, height, BMI, waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), visceral adiposity index (VAI), body roundness index (BRI) and body adiposity index (BAI) were based on measured values. We used logistic regression to investigate the association between chronotypes and anthropometric measures as well as eating habits. Morning- and intermediate/evening-type chronotypes accounted for 51.4% and 48.6% of the total individuals, respectively. Moreover, intermediate/evening-type chronotypes were shown to have a lower education of diploma (53%), employed (49.9%) and smokers (11.6%) compared to morning-types (both sexes). We found that intermediate/evening-type chronotypes might not be significantly related to higher anthropometric measures and following unhealthy eating habits after controlling for confounders in men and women (all P>0.05). Overall, both anthropometric measures and specific eating habits were not related to chronotype among Iranian adults. Further studies are needed to clarify these relations and to consider sleep disturbances.
Sarcopenic obesity is defined as the presence of high fat mass and low muscle mass combined with low physical function, and it is closely related with the onset of cardiovascular disease (CVD). The existing anthropometric indices, which are being utilized in clinical practice as predictors of CVD, may also be used to screen sarcopenic obesity, but their feasibility remained unknown. Using cross-sectional data of 2,031 participants aged 70-84 years (mean age, 75.9±3.9 years; 49.2% women) from the Korean Frailty and Aging Cohort Study, we analyzed the association of anthropometric indices, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and weight-adjusted waist index (WWI) with sarcopenic obesity. Body composition was measured using dual-energy X-ray absorptiometry. Higher WWI, WHtR, and WC quartiles were associated with higher risk of sarcopenic obesity; the odds ratio (OR) of sarcopenic obesity were highest in the fourth quartile of the WWI (OR: 10.99, 95% confidence interval [CI]: 4.92–24.85, P for trend < 0.001). WWI provided the best diagnostic power for sarcopenic obesity in men (area under the receiver operating characteristic curve: 0.781, 95% CI: 0.751–0.837). No anthropometric indices were significantly associated with sarcopenic obesity in women. WWI was the only index that was negatively correlated with physical function in both men and women. WWI showed the strongest association with sarcopenic obesity, defined by high fat mass and low muscle mass combined with low physical function only in older men. No anthropometric indices were associated with sarcopenic obesity in older women.
This chapter attempts to answer some specific questions: Which is the cause of obesity? How does it relate to body image? How does obesity impact on personal identity? How does the situation vary according to gender? How does this condition vary in relation to age range? How does the family dynamic affect this condition? During this excursus many other interesting facts emerge, such as the statistic that only 10% of obese or overweight people are actually dieting, whereas nearly 20% of the rest of the population are trying to lose weight, even if they do not really need to. It is one of the paradoxes of the current era and one that affects mainly industrialized countries. Specific theories, scientific studies, and clinical examples are presented.
Polycystic ovary syndrome (PCOS) is associated with a high prevalence of mental health disorders, including depression, anxiety and eating disorders. There are numerous clinic-based and population studies from around the world showing a high prevalence of both depressive symptoms and depression in reproductive-age women with PCOS compared to controls. These studies indicate that the risk of depression may be independent of obesity and associated with clinical and biochemical hyperandrogenism, with genetic data supporting closely linked biological pathways. Similarly, the risk of anxiety is significantly higher in women with PCOS as compared to a control population. Longitudinal studies depicted a persistence of both depression and anxiety symptoms in women with PCOS over time. First-line treatments for PCOS, including weight-loss interventions and use of hormonal contraceptives, may improve depression and anxiety scores. Recent publications indicate an increased risk of disordered eating and eating disorders in women with PCOS. Given that lifestyle modifications are a first-line treatment for PCOS, early screening and treatment of depression, anxiety and disordered eating are essential for comprehensive management of this population.
Obesity is commonly associated with polycystic ovarian syndrome (PCOS), featuring both elements of insulin resistance and metabolic syndrome. Understanding the causes of obesity, its impact on health and its comorbidities, as well as its regulation, are important factors in relation to the treatment of obesity and more particularly the effect of weight loss in PCOS. The various modalities of treatment include the conservative approach, utilizing lifestyle and dietary techniques, pharmacotherapy and the more invasive surgical approach, which has been shown to have better weight-loss results and less recidivism.
This study examines the individual and combined association of body mass index (BMI) and 7 waist-to-hip ratio (WHR) with cardiovascular diseases (CVD) risk using genetic scores of the 8 obesity measurements as proxies.
A 2×2 factorial analysis approach was applied, with participants divided into four groups of lifetime exposure to low BMI and WHR, high BMI, high WHR, and high BMI and WHR based on weighted genetic risk scores. The difference in CVD risk across groups was evaluated using multivariable logistic regression.
A total of 408,003 participants were included from the prospective observational UK Biobank study.
A total of 58,429 of CVD events were recorded. Compared to the low BMI and WHR genetic scores group, higher BMI or higher WHR genetic scores were associated with an increase in CVD risk (high BMI: odds ratio (OR), 1.07; 95%CI, 1.04–1.10; high WHR: OR, 1.12; 95%CI, 1.09–1.16). A weak additive effect on CVD risk was found between BMI and WHR (high BMI and WHR: OR, 1.16; 95%CI, 1.12–1.19). Subgroup analysis showed similar patterns between different sex, age (<65, ≥65 years old), smoking status, Townsend deprivation index, fasting glucose level and medication uses, but lower systolic blood pressure was associated with higher CVD risk in obese participants.
High BMI or WHR were associated with increased CVD risk, and their effects are weakly additive. Even though there were overlapping of effect, both BMI and WHR are important in assessing the CVD risk in the general population.
To evaluate the effectiveness of PASOS SALUDABLES, a culturally tailored lifestyle intervention to prevent obesity and diabetes among Latino farmworkers, when implemented at large scale in the worksite.
This study was a two-arm parallel group, cluster randomised controlled trial, where participants received either a twelve-session lifestyle intervention (intervention) or six-session leadership training (control) at their worksite. The intervention was delivered by Promotoras in Spanish. All sessions were conducted at the worksites (ranches) during meal breaks. Blinded, trained research assistants collected socio-demographic and outcome data (i.e. BMI as primary outcome and waist circumference, glycated Hb (HbA1c), cholesterol and blood pressure as secondary outcomes) at baseline and follow-up assessments (i.e. 3 months, 6 months, 1 year and 1·5 years).
Recruitment and intervention delivery occurred at twelve study ranches in Oxnard, California.
We enrolled farmworkers hired by a large berry grower company, who were ≥18 years old, spoke Spanish and were free of diabetes at screening.
A total of 344 workers were enrolled in the intervention and 271 in the control group. The intervention resulted in attenuated increase of BMI over time; however, the difference in trend between groups was not significant (β = −0·01 for slope difference, P = 0·29). No significantly different trend by group was observed in secondary outcomes (P > 0·27).
The worksite intervention, implemented during meal breaks, did not reduce BMI or other clinical indicators. Nevertheless, this study supports the feasibility of recruiting and engaging the Latino farmworker population in workplace health promotion interventions.
To quantify the change in availability of hyper-palatable foods (HPF) in the US foods system over 30 years (1988–2018).
Three datasets considered representative of the US food system were used in analyses to represent years 1988, 2001 and 2018. A standardised definition from Fazzino et al. (2019) that specifies combinations of nutrients was used to identify HPF.
Analysis of food-item level data was conducted. Differences in the prevalence of HPF were characterised by Cochran’s Q and McNemar’s tests. Generalised linear mixed models with a fixed effect for time and random intercept for food item estimated change in the likelihood that a food was classified as hyper-palatable over time.
No participant data were used.
The prevalence of HPF increased 20 % from 1988 to 2018 (from 49 % to 69 %; P < 0·0001). The most prominent difference was in the availability of HPF high in fat and Na, which evidenced a 17 % higher prevalence in 2018 compared with 1988 (P < 0·0001). Compared with 1988, the same food items were >2 times more likely to be hyper-palatable in 2001, and the same food items were >4 times more likely to be classified as hyper-palatable in 2018 compared with 1988 (P values < 0·0001).
The availability of HPF in the US food system increased substantially over 30 years. Existing food products in the food system may have been reformulated over time to enhance their palatability.
The study examined the association between depressive symptoms and iron status, anaemia, body weight, and pubertal status among Mexican adolescent girls.
In this cross-sectional study, depressive symptoms were assessed by the 6-item Kutcher Adolescent Depressive Scale (6-KADS), and latent class analysis (LCA) was used to identify and characterize groups of girls based on depressive symptoms. Iron status and inflammation were assessed using ferritin and soluble transferrin receptor, C-reactive protein and alpha-1-acid glycoprotein, respectively. Multiple logistic and linear regression were applied to model class membership as a function of iron status, anaemia, body weight, and pubertal status.
We collected data from 408 girls aged 12-20 years.
public schools in northern Mexico.
LCA yielded three classes of depressive symptoms; 44.4% of the adolescents were “unlikely to be depressed”, 41.5% were “likely to be depressed”, and 14.1% were “highly likely to be depressed”. Our analyses demonstrated that iron deficient girls had greater odds of being “likely depressed” (odds ratio, OR=2.01, 95% CI 1.01-3.00) or “highly likely depressed (OR=2.80, 95% CI 1.76-3.84). Linear regression analyses revealed that lower haemoglobin concentrations and higher body weight increased the probability of being “likely depressed”. There was no evidence that depressive symptoms were associated to age at menarche and years since menstruation.
This study shows that iron deficient adolescent girls are more likely to suffer from depressive symptoms, and that lower concentrations of haemoglobin and higher body weight increased the probability of experiencing depressive symptoms.
Overweight and obesity have been related to a variety of adverse health outcomes. Understanding the overweight and obesity epidemic in Bangladesh, particularly among reproductive-aged women, is critical for monitoring and designing effective control measures. The purpose of this study was to determine the prevalence of overweight and obesity in reproductive-aged women and to identify the risk factors of overweight and obesity.
A total of 70 651 women were obtained from the five most recent and successive Bangladesh Demographic and Health Surveys (BDHS). The multilevel logistic regression model was used to explore the individual- and community-level factors of overweight and obesity.
Five most recent nationally representative household surveys across all regions.
Approximately 35·2 % (95 % CI: 34·9–35·6 %) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (adjusted odds ratio (aOR) = 5·79, 95 % CI: 5·28–6·34), secondary or higher education (aOR = 1·69 [1·60–1·78]), relatively wealthiest households (aOR = 4·41 [4·10–4·74]), electronic media access (aOR = 1·32 [1·26–1·37]) and community high literacy (aOR = 1·10 [1·04–1·15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR = 0·79 [0·76–0·82]) from larger-sized households (aOR = 0·80 [0·73–0·87]) and have high community employment (aOR = 0·92 [0·88–0·97]) were negatively associated with the probability of being overweight or obese.
Individual- and community-level factors influenced the overweight and obesity of Bangladeshi reproductive-aged women. Interventions and a comprehensive public health plan aimed at identifying and addressing the growing burden of overweight and obesity should be a top focus.
This study investigated associations between types and food sources of protein with overweight/obesity and underweight in Ethiopia.
We conducted a cross-sectional dietary survey using a non-quantitative food frequency questionnaire. Linear regression models were used to assess associations between percent energy intake from total, animal, and plant protein and body mass index (BMI). Logistic regression models were used to examine associations of percent energy intake from total, animal, and plant protein and specific protein food sources with underweight and overweight/obesity.
Addis Ababa, Ethiopia.
1,624 Ethiopian adults (992 women and 632 men) aged 18-49 years in selected households sampled using multi-stage random sampling from five sub-cities of Addis Ababa, Ethiopia.
Of the surveyed adults, 31% were overweight or obese. The majority of energy intake was from carbohydrate with only 3% from animal protein. In multivariable-adjusted linear models, BMI was not associated with percent energy from total, plant or animal protein. Total and animal protein intake were both associated with lower odds of overweight/obesity (Odds Ratio [OR] per 1% energy increment of total protein 0.92; 95% CI: 0.86, 0.99; P=0.02; OR per 1% energy increment of animal protein 0.89; 95% CI: 0.82, 0.96; P=0.004) when substituted for carbohydrate and adjusted for sociodemographic covariates.
Increasing proportion of energy intake from total protein or animal protein in place of carbohydrate could be a strategy to address overweight and obesity in Addis Ababa; longitudinal studies are needed to further examine this potential association.
People who are overweight and obese suffer from significant health impacts that have increased globally. Concurrently, usage of information and communication devices such as television and mobile phones have also been growing, affecting people’s weight. This study examined the association between watching television and owning a mobile phone with overweight and obesity among reproductive-aged women in low- and lower-middle-income countries (LLMICs). Data of 21 LLMICs reported between 2015 and 2020 were collected from the Demographic and Health Surveys. Multivariate logistic regression was performed to determine the association into three pooled segments: a group of 21 countries, the World Bank income classification and the regional categorisation of the countries. The all-inclusive prevalence of overweight or obesity was found at 27.1% among 175,370 reproductive-aged women, and this prevalence varied among countries. Overall, the odds of being overweight or obese were 1.20 (adjusted odds ratio [AOR]=1.20, 95% confidence interval [CI]: 1.15–1.24), 1.40 (AOR=1.40, 95% CI: 1.35–1.44) and 1.18 (AOR=1.18, 95% CI: 1.03–1.35) times higher among those who watched television less than once a week, at least once a week and almost every day, respectively, compared with those who did not watch television. Besides, women’s mobile phone ownership is more likely to experience overweight or obesity (AOR=1.72, 95% CI: 1.67–1.77). Consistent results were found for the countries categorised according to the World Bank income and regional classification. Focus on sedentary behaviour, such as television watching and mobile phone use, of women and regional or country-specific innovative strategies and programs are of great immediate importance to decrease the prevalence of overweight and obesity.
The aim of this study was to assess the changes in the prevalence of overweight, obesity and high adiposity in children and adolescents from Krakow (Poland), between the years 2010 and 2020. Two cross-sectional series of anthropometric measurements were carried out in 2010 and 2020. Analysed characteristics included: body height and weight, BMI (Body Mass Index), body adiposity (%BF). The subjects were categorised according to their BMI (underweight, normal weight, overweight, obesity), as well as %BF (low, normal, high body fat).The research was conducted in randomly selected primary schools in Krakow (Poland). Studied cohorts (8-15 years of age), which represented four of the traditional residential districts: Śródmieście, Podgórze, Krowodrza and Nowa Huta. Among the girls, there was a negative secular trend regarding the prevalence of underweight and obesity. On the other hand, there also was a positive trend concerning the prevalence of overweight and low and high body fat. In boys, there was a negative secular trend regarding the prevalence of underweight and low adiposity. There was also a generally positive secular trend regarding the prevalence of overweight, obesity as well as high adiposity in boys. The findings of this study are particularly significant because detailed knowledge of the prevalence of overweight/obesity in childhood and adolescence is crucial for the future health of entire populations. Further studies should also take into account the levels of physical fitness and activity of the examined population.
American Indian and Alaska Native peoples (AI/AN) have a disproportionately high rate of obesity, but little is known about the social determinants of obesity among older AI/AN. Thus, our study assessed social determinants of obesity in AI/AN aged ≥ 50 years.
We conducted a cross-sectional analysis using multivariate generalised linear mixed models to identify social determinants associated with the risk of being classified as obese (BMI ≥ 30·0 kg/m2). Analyses were conducted for the total study population and stratified by median county poverty level.
Indian Health Service (IHS) data for AI/AN who used IHS services in FY2013.
Totally, 27 696 AI/AN aged ≥ 50 years without diabetes.
Mean BMI was 29·8 ± 6·6 with 43 % classified as obese. Women were more likely to be obese than men, and younger ages were associated with higher obesity risk. While having Medicaid coverage was associated with lower odds of obesity, private health insurance was associated with higher odds. Living in areas with lower rates of educational attainment and longer drive times to primary care services were associated with higher odds of obesity. Those who lived in a county where a larger percentage of people had low access to a grocery store were significantly less likely to be obese.
Our findings contribute to the understanding of social determinants of obesity among older AI/AN and highlight the need to investigate AI/AN obesity, including longitudinal studies with a life course perspective to further examine social determinants of obesity in older AI/AN.
Obesity and undernutrition are manifestations of malnutrition that affect many people worldwide. A lack of access to food may explain the association of food insecurity (FI) with both undernutrition and obesity, but there are other factors that are specifically related to obesity. Studies have also found that FI is related to both overweight and obesity among women but not among men. The present study aimed to evaluate the association between FI and weight status among adults from a nationally representative sample of Brazil and to consider the impacts of sex. Data from the 2017–2018 Household Budget Survey (n 28 112), a national cross-sectional study, were analysed using the Brazilian Household FI Scale (EBIA) and BMI (measured in kg/m2) by individual self-reported weight and height. Associations were estimated by OR with 95 % CI considering a multinomial logistic regression model. Women with severe FI were more than twice (OR = 2·36) as likely to be underweight and had a higher frequency of obesity (OR = 1·39). Among men, severe FI status was a protective factor for overweight (OR = 0·58) and obesity (OR = 0·61). In conclusion, FI was a risk factor for underweight and obesity among women but not among men.
Portion sizes of many foods have increased over time. However, the size of effect that reducing food portion sizes has on daily energy intake and body weight is less clear. We used systematic review methodology to identify eligible articles that used an experimental design to manipulate portion size served to human participants and measured energy intake for a minimum of one day. Searches were conducted in September 2020 and again in October 2021. Fourteen eligible studies contributing 85 effects were included in the primary meta-analysis. There was a moderate-to-large reduction in daily energy intake when comparing smaller vs. larger portions (SMD = -.709 [95% CI: -.956 to -.461], ∼235kcal). Larger reductions to portion size resulted in larger decreases in daily energy intake. There was evidence of a curvilinear relationship between portion size and daily energy intake; reductions to daily energy intake were markedly smaller when reducing portion size from very large portions. In a subset of studies that measured body weight (4 studies contributing 5 comparisons), being served smaller vs. larger portions was associated with less weight gain (0.58kg). Reducing food portion sizes may be an effective population level strategy to prevent weight gain.
Persecutory fears build on feelings of vulnerability that arise from negative views of the self. Body image concerns have the potential to be a powerful driver of feelings of vulnerability. Body image concerns are likely raised in patients with psychosis given the frequent weight gain. We examined for the first-time body esteem – the self-evaluation of appearance – in relation to symptom and psychological correlates in patients with current persecutory delusions.
One-hundred and fifteen patients with persecutory delusions in the context of non-affective psychosis completed assessments of body image, self-esteem, body mass index (BMI), psychiatric symptoms and well-being. Body esteem was also assessed in 200 individuals from the general population.
Levels of body esteem were much lower in patients with psychosis than non-clinical controls (d = 1.2, p < 0.001). In patients, body esteem was lower in women than men, and in the overweight or obese BMI categories than the normal weight range. Body image concerns were associated with higher levels of depression (r = −0.55, p < 0.001), negative self-beliefs (r = −0.52, p < 0.001), paranoia (r = −0.25, p = 0.006) and hallucinations (r = −0.21, p = 0.025). Body image concerns were associated with lower levels of psychological wellbeing (r = 0.41, p < 0.001), positive self-beliefs (r = 0.40, p < 0.001), quality of life (r = 0.23, p = 0.015) and overall health (r = 0.31, p = 0.001).
Patients with current persecutory delusions have low body esteem. Body image concerns are associated with poorer physical and mental health, including more severe psychotic experiences. Improving body image for patients with psychosis is a plausible target of intervention, with the potential to result in a wide range of benefits.
To examine associations of household food insecurity with health and obesogenic behaviours among pregnant women enrolled in an obesity prevention programme in the greater Boston area.
Cross-sectional evaluation. Data were collected from structured questionnaires that included a validated two-item screener to assess household food insecurity. We used separate multivariable linear and logistic regression models to quantify the association between household food insecurity and maternal health behaviours (daily consumption of fruits and vegetables, sugar-sweetened beverages and fast food, physical activity, screen time, and sleep), mental health outcomes (depression and stress), hyperglycaemia status and gestational weight gain.
Three community health centres that primarily serve low-income and racial/ethnic minority patients in Revere, Chelsea and Dorchester, Massachusetts.
Totally, 858 pregnant women participating in the First 1,000 Days program, a quasi-experimental trial.
Approximately 21 % of women reported household food insecurity. In adjusted analysis, household food insecurity was associated with low fruit and vegetable intake (β = −0·31 daily servings; 95 % CI −0·52, −0·10), more screen time (β = 0·32 daily hours; 95 % CI 0·04, 0·61), less sleep (β = −0·32 daily hours; 95 % CI −0·63, −0·01), and greater odds of current (adjusted odds ratio (AOR) 4·42; 95 % CI 2·33, 8·35) or past depression (AOR 3·01; 95 % CI 2·08, 4·35), and high stress (AOR 2·91; 95 % CI 1·98, 4·28).
In our sample of mostly low-income, racial/ethnic minority pregnant women, household food insecurity was associated with mental health and behaviours known to increase the likelihood of obesity.