Trends of central obesity and associations with nutrients intake and daily behaviors among women of childbearing age in China

Background Obesity among women of childbearing age has becoming an important public health concern. We aimed to describe the trends of central obesity among Chinese women of childbearing age from 2004 to 2011 and to examine its associations with nutrients intake and daily behaviors. Methods Longitudinal data were derived from the China Health and Nutrition Survey. Participants consisted of 2481 women aged 15–44 years old. WC (Waist circumference) and WHtR (Waist to height ratio) were adopted as indicators of central obesity. Generalized linear mixed model was performed to analyze the associations of nutrients intake and daily behaviors with central obesity. Results From 2004 to 2011, the prevalence of central obesity among Chinese women of childbearing age increased from 21.6 to 30.7% (WC as indice) or from 22.8 to 32.6% (WHtR as indice) (both p < 0.001). Protein intake above the AMDR (Acceptable macronutrient distribution range) (OR = 1.21, 95% CI 1.05–1.39, p < 0.01) and non-participation in LTPA (Leisure time physical activity) (OR = 1.45, 95% CI 1.17–1.80, p < 0.001) were risk factors for high WC, and the latter was also associated with high WHtR (OR = 1.36, 95% CI 1.10–1.67, p < 0.01). For those women who had high WC & high WHtR, the impacts of protein intake and LTPA became stronger, especial LTPA (OR = 1.53, 95% CI 1.21–1.94, p < 0.001). Age-stratified analyses found that non-participation in LTPA was key factor for central obesity in 15–34 age group, while protein intake above the AMDR was pronounced in the 35–44 age group. Conclusions Non-participation in LTPA and protein intake above the AMDR were significant contributors of central obesity, which could be intervention targets to deal with the growing trend of central obesity among women of childbearing age.

HEPATIC STEATOSIS IN SCHOOLCHILDREN AND ADOLESCENTS WITH CENTRAL OBESITY

Introduction: Non-alcoholic hepatic steatosis is defined as the excessive accumulation of adipose tissue in the absence of alcohol consumption, being rare in the pediatric population. However, with the advent of the twentieth century pandemic, such as obesity, this pathology has increased its incidence, as well as others that belong to the metabolic syndrome. Objective: To determine the presence of hepatic steatosis in schoolchildren and adolescents with central obesity. Methods: observational, descriptive and cross-sectional research. The sample was of a census type, represented by 32 schoolchildren and adolescents who met the inclusion criteria, which are: age between 6 and 19 with central obesity - prior signing the informed consent. They underwent measurement of the waist circumference, abdominal ultrasound, measurement of the lipid profile and the determination of the level of physical activity through the application of the Pictorial Questionnaire of Infant Physical Activity. Results: 32 patients were studied, 18 (56.3%) male, adolescents 59.37%. With normal ultrasound (29/32) and with hepatic steatosis (3/32), of which 66.7% are grade II and 33.3% are grade III. Hypertriglyceridemia and borderline triglyceride levels 81.27% and hypercholesterolemia and borderline cholesterol levels 75%. Conclusion: School and adolescent patients with central obesity have borderline lipid profiles or dyslipidemia, in which, despite belonging to the pediatric population, moderate and severe cases of hepatic steatosis are evident. Keywords: fatty liver, non-alcoholic fatty liver disease, dyslipidemia, obesity.

Prevalence of thinness, overweight, obesity and central obesity in Finnish school-aged children: a comparison of national and international reference values

Introduction: The global epidemic of obesity concerns children, and monitoring the prevalence is of highest priority. Body mass index (BMI) with age- and sex-specific cut-off values determine weight status in children, although multiple reference systems exist. Our aim was to compare the prevalence for thinness, normal weight, overweight and obesity in Finnish school-aged children according to national and international reference values, as well as to determine which cut-off values for overweight agree with the criteria for central obesity. Methods: This study includes 10 646 children aged 9─12 years from the Finnish Health in Teens (Fin-HIT) cohort. Height, weight and waist circumference were measured in 2011─2014. BMI (weight [kg]/height [m]2) and waist-to-height ratio (WHtR; waist [cm]/height [cm]) were calculated. The WHtR cut-off of > 0.5 indicated central obesity. We compared the sex-specific prevalence of thinness, overweight and obesity using the International Obesity Task Force (IOTF), World Health Organization (WHO) and Finnish (FIN) BMI-for-age reference values, as well as these three against central obesity based on WHtR. Results: The prevalence of thinness, overweight and obesity were 11.0%, 12.7% and 2.6%, respectively, using IOTF; 2.6%, 15.9% and 5.2% using WHO; and 5.1%, 11.4% and 2.2% using FIN. Overweight and obesity were more common in boys than girls using WHO and FIN, while thinness more common in girls using IOTF and FIN. IOTF versus WHO exhibited moderate agreement (κ = 0.59), which improved for IOTF versus FIN (κ = 0.74). Of those classified as overweight by WHO, 37% and 47% were regarded as normal weight according to IOTF and FIN, respectively. The prevalence of central obesity was 8.7%, and it was more common in boys than girls. WHO provided the highest sensitivity: 95% of individuals with central obesity were classified with overweight or obesity. Using FIN provided the highest specificity (93%). Conclusion: Our findings show that WHO overestimates the prevalence of overweight and obesity, while IOTF overrates thinness. Thus, comparing prevalence rates between studies requires caution. The novelty of this study is the comparison of the cut-off values for overweight with central obesity. The choice of reference system affects the generalizability of the research results.

LOW WEIGHT GAIN, BETTER GLYCAEMIA AND NO CENTRAL OBESITY ACHIEVED THROUGH A HIGH-PROTEIN DIET

A compendium of metabolic diseases associated with unhealthy habits plague the modern world today. Weight gain, hyperglycemia and excess adiposity are some of the metabolic diseases plaguing our modern society. Unhealthy dietary habits coupled with a sedentary lifestyle are recognized as important factors for the development of some metabolic illnesses. Cardiovascular diseases, diabetes mellitus, hypertension, and dyslipidemia were recognized as stemming from metabolic dysregulation due to the consumption of excess calories from certain macronutrients. Our objective in this study is to find out which diet most affects circulating blood glucose levels, body weight, and visceral fat tissue deposition. 35 male Sprague - Dawley rats were separated into five groups and were given five distinct diets for the duration of 8 weeks. The five diets are normal rat feed, high-fat, high-protein, high-sugar, and high-starch. The feeding provided was ad libitum with tap water given as drinking water. Every week, each rat was weighed, and blood were sampled for glucose. Post-sacrifice, mesenteric fat was harvested, fixed, and stained for histological analysis. The results revealed a high-protein diet significantly reduces body weight gain, improved blood sugar with no development of central obesity. At the same time, a high-fat diet was shown to be a promoter of mesenteric fat tissue hypertrophy. It was concluded that the consumption of a high-protein diet was found to achieve low weight gain, better glycaemia with no central obesity.

Correlations of Anthropometric and Calculation-Modified Anthropometric Measurements with Cardiometabolic Risk Factors in Korean Adults: A National Survey-Based Study

Background and Aims: There are studies that show NC measurements are associated with central obesity and upper body fat distribution and are strongly associated with metabolic markers. Recently, studies have been conducted regarding neck circumference (NC) as a novel index to screen for obesity and cardiometabolic risk factors. Here, we investigated various anthropometric measurements and their correlations with cardiometabolic risk factors, pulmonary function test (PFT) results and metabolic syndrome among the adult Korean population. Methods: This study was based on data acquired from the 8th edition (2019) of the Korea National Health and Nutrition Examination Survey (KNHANES), consisting of survey data on smoking and alcohol consumption, cardiometabolic risk factors, PFT results, metabolic syndrome profile and baseline characteristics such as age, gender and blood pressure. Continuous variables were analyzed by independent t-test, while categorical variables were analyzed using the Rao-Scott chi-square test Precision-recall (PR) plots were used to assess the diagnostic value of anthropometric measurements for cardiometabolic risk profiles such as insulin resistance, impaired glucose tolerance, dyslipidemia, hypertension, central obesity and PFT results. Area under the curve (AUC) was used to evaluate the predictive ability of the anthropometric measurements and calculation-modified anthropometric measurements (CMAMs) such as NC(neck circumference) devided by BMI(body mass index) and WC(waist circumference) and BMI devided by WC at different preset thresholds. Calculation was used to distinguish each anthropometric measurements aside from common features they may share. Results: A total of 3525study subjects aged over 40 years were included in the study the mean age for male and female were 56.8 and 58.5 respectively, percentage of male and female was 42% and 58% respectively. PR plots of anthropometric measurements and the metabolic syndrome profile indicated that in the presence of 3 metabolic syndrome criteria, waist circumference (WC) and body mass index (BMI) had the highest AUCs 0.62 and 0.587 respectively, in the presence of 4 metabolic syndrome criteria, waist circumference (WC) and body mass index (BMI) had the highest AUCs 0.342 and 0.317 respectively whereas in the presence of more than 5 metabolic syndrome criteria, NC and WC had the highest AUCs 0.09 and 0.083 respectively.Conclusion: This study showed that NC is correlated with metabolic syndrome. Additionally, each anthropometric measurement was uniquely correlated with specific cardiometabolic risk factor and differed according to sex. In such cases, applications in smartphones could be used to calculate for cardiometabolic risk assessments. Also it may be necessary to screen for metabolic syndrome in people whose NC is over 39.9cm for males and 34.5cm for females.

U-Shaped Association between Waist-to-Hip Ratio and All-Cause Mortality in Stage 3–5 Chronic Kidney Disease Patients with Body Mass Index Paradox

The obesity paradox, referring to the association of high body mass index (BMI) with low all-cause mortality risk, is found in patients with chronic kidney disease (CKD). Central obesity is associated with metabolic syndrome and may have better prognostic value than BMI for all-cause mortality. Whether central obesity is associated with all-cause mortality in cases of obesity paradox in CKD patients remains unknown. We included 3262 patients with stage 3–5 CKD, grouped into five quintiles (Q1–5) by waist-to-hip ratio (WHR). Low WHR and BMI were associated with malnutrition and inflammation. In Cox regression, high BMI was not associated with all-cause mortality, but BMI < 22.5 kg/m2 increased the mortality risk. A U-shaped association between central obesity and all-cause mortality was found: WHR Q1, Q4, and Q5 had higher risk for all-cause mortality. The hazard ratio (95% confidence interval) of WHR Q5 and Q1 for all-cause mortality was 1.39 (1.03–1.87) and 1.53 (1.13–2.05) in male and 1.42 (1.02–1.99) and 1.28 (0.88–1.85) in female, respectively. Waist-to-height ratio and conicity index showed similar results. Low WHR or low BMI and high WHR, but not high BMI, are associated with all-cause mortality in advanced CKD.

Association of Obesity and Hypertension: A Cohort Study in China

The prevalence of general and central obesity has increased rapidly in China for decades, while little is known on obesity-normal weight-central obesity (NWCO) in China. In this study, we aim to depict the trend of the three kinds of obesity and to explore their associations with hypertension in a cohort study in China. We used data from eight waves of the China Health and Nutrition Survey (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009, 2011, and 2015 for analysis. The Cochran–Armitage test was used for trend of the three kinds of obesity or hypertension. Mixed logistic regression was used to explore their relationship. In this study, we found the prevalence of general obesity increased from 20.81% in 1993 to 50.57% in 2015 in China, which was from 19.23% to 56.15% for central obesity and from 27.20% to 49.07% for NWCO, respectively. Males had the highest increase among all the subgroups. The RR for hypertension and general obesity was 3.71 (95%CI: 3.26–4.22), 3.62 (95%CI 3.19–4.12) for central obesity, and 1.60 (95%CI 1.23–2.06) for NWCO after adjusted for age, sex, education, smoking, alcohol drinking, marriage status, urbanicity and income. Both prevalence of obesity and hypertension have increased significantly in China for the two decades. The general obesity was most likely to develop hypertension compared to central or NOCWO in this study.

NPPA promoter hypomethylation predicts central obesity development: a prospective longitudinal study in Chinese adults

Introduction: Atrial natriuretic peptide (ANP) plays a potential role in obesity with unclear molecular mechanisms. The objective of this study was to examine the association between its coding gene (NPPA) methylation and obesity. Methods: Peripheral blood DNA methylation of NPPA promoter was quantified at baseline by targeted bisulfite sequencing for 2,497 community members (mean aged 53 years, 38% men) in the Gusu cohort. Obesity was repeatedly assessed by body mass index (BMI) and waist circumference (WC) at baseline and follow-up examinations. The cross-sectional, longitudinal, and prospective associations between NPPA promoter methylation and obesity were examined. Results: Of the 9 CpG loci assayed, DNA methylation levels at 6 CpGs were significantly lower in participants with central obesity than those without (all P<0.05 for permutation test). These CpG methylation levels at baseline were also inversely associated with dynamic changes in BMI or WC during follow-up (all P<0.05 for permutation test). After an average 4 years of follow-up, hypermethylation at the 6 CpGs (CpG2 located at Chr1: 11908348, CpG3 located at Chr1:11908299, CpG4 located at Chr1:11908200, CpG5 located at Chr1:11908182, CpG6 located at Chr1:11908178, and CpG8 located at Chr1:11908165) were significantly associated with a lower risk of incident central obesity (all P<0.05 for permutation test). Conclusions: Hypomethylation at NPPA promoter was associated with increased future risk of central obesity in Chinese adults. Aberrant DNA methylation of the NPPA gene may participate in the mechanisms of central obesity.

Late-Life Obesity Associated with Tau Pathology in Cognitively Normal Individuals: The CABLE Study

Background: Existed evidence suggests that midlife obesity increases the risk of Alzheimer’s disease (AD), while there is an inverse association between AD and obesity in late life. However, the underlying metabolic changes of AD pathological proteins attributed to obesity in two life stages were not clear. Objective: To investigate the associations of obesity types and obesity indices with AD biomarkers in cerebrospinal fluid (CSF) in different life stages. Methods: We recruited 1,051 cognitively normal individuals (61.94±10.29 years, 59.66%male) from the Chinese Alzheimer’s Biomarker and LifestylE (CABLE) study with CSF detections for amyloid-β 42 (Aβ 42), total-tau (T-tau), and phosphorylated tau (P-tau). We utilized body mass index, waist circumference, waist-to-height ratio, and metabolic risk factors to determine human obesity types. Multiple linear models and interaction analyses were run to assess the impacts of obesity on AD biomarkers. Results: The metabolically unhealthy obesity or healthy obesity might exert a reduced tau pathology burden (p < 0.05). Individuals with overweight, general obesity, and central obesity presented lower levels of tau-related proteins in CSF than normal controls (p < 0.05). Specially, for late-life individuals, higher levels of obesity indices were associated with a lower load of tau pathology as measured by CSF T-tau and T-tau/Aβ 42 (p < 0.05). No similar significant associations were observed in midlife. Conclusion: Collectively, late-life general and central obesity seems to be associated with the reduced load of tau pathology, which further consolidates the favorable influence of obesity in specific life courses for AD prevention.