Are Peripheral Biomarkers Determinants of Eating Styles in Childhood and Adolescence Obesity? A Cross-Sectional Study

Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships between several biomarkers crucially involved in obesity (ghrelin, insulin resistance, and leptin/adiponectin ratio) and eating styles in children and adolescents with obesity. Seventy participants aged between 8 and 16 (56.2% men) fulfilled the Spanish version of the Dutch Eating Behavior Questionnaire for Children to measure external, emotional, and restrained eating styles. In addition, concentrations of ghrelin, leptin, adiponectin, insulin, and glucose were obtained through a blood test. Hierarchical multiple regression analyses controlling for age and sex were computed for each eating style. Results indicated that individuals with higher ghrelin concentration levels showed lower scores in restrained eating (β = −0.61, p < 0.001). The total model explained 32% of the variance of the restrained pattern. No other relationships between obesity-related biomarkers and eating behaviors were found. This study highlights that one of the obesity-risk factors, namely lower plasma ghrelin levels, is substantially involved in a well-known maladaptive eating style, restraint eating, in childhood obesity.

Direct and Indirect Relationships Between Impaired Sleep, Obesity Risk Factors and Overweight and Obesity

PurposeThe relationship between impaired sleep and overweight/obesity may be explained by sleep-disrupting behaviour that are practised by overweight people (e.g. night-eating, insufficient physical activity [PA], electronic device use) and stress/affective distress. Thus, we evaluated whether sleep parameters predicted overweight/obesity after taking into account the behaviour and affective state.MethodsOnline questionnaires asked about sleep quality, night-eating, PA, electronic device use and stress/affective distress at T1 (baseline) and T2 (3-months later). Height, weight and waist and hip circumference were measured. PA and sleep were assessed over 24-hours on two occasions using actigraphy in 161 participants at T1 and T2.ResultsAt T1, high body mass index (BMI)/waist-to-hip ratio (WHR) and obesity category were together related to more sleep disturbances (subjective) and longer awake time (objective), after controlling covariates (e.g. watching TV) and demographics (e.g. older age, male gender). At T2, high WHR was predicted by older age and male gender after controlling T1 WHR, demographics and covariates. Mediational analyses showed that sleep disturbances mediated nocturnal indigestion (NI) to BMI, poor subjective sleep quality mediated NI to WHR and high daytime dysfunction mediated NI to obesity category relationships.ConclusionMore time spent awake during the night (experienced as more sleep disturbances) was related to overweight/obesity indices even after taking into account other obesity risk factors (e.g. night-eating, insufficient PA, affect) and demographics. Mediational results suggest that NI parsimoniously explained the impaired sleep - overweight/obesity relationship.Level of Evidence: Level III, evidence obtained from well-designed cohort.

Effects of the First 1000 Days Program, a systems-change intervention, on obesity risk factors during pregnancy

Background First 1000 Days is a systems-oriented program starting in early pregnancy lasting through the first 24 months of infancy focused on preventing obesity and related risk factors among low income, mother-infant pairs. The program was developed in partnership with stakeholders to create an infrastructure for system-wide change. It includes screening for adverse health behaviors and socio-contextual factors, patient navigation and educational materials to support behavior change and social needs, and individualized health coaching for women at highest risk of obesity and has been shown to reduce excess gestational weight gain for women who were overweight at the start of their pregnancy. The purpose of this study was to examine changes from the first to third trimester for women participating in the First 1000 Days Program. Methods We collected information through self-administered questionnaires during the first and third trimester of gestation and from electronic health records relating to obesity risk factors. Measures collected included behavior (i.e., diet, physical activity and screen time) and psychosocial (i.e., anxiety) outcomes, as well as enrollment in Women, Infant, and Children (WIC) program. We examined the extent to which participation in the program was associated with changes in behaviors and psychosocial outcomes among women during pregnancy. Results Women completed surveys at their initial and third trimester prenatal visits (n = 264). Mean age (SD) was 30.2 (5.51) years and 75% had an annual household income of <$50,000. Mean pre-pregnancy body mass index (BMI) was 27.7 kg/m2 and 64% started pregnancy with a BMI ≥ 25 kg/m2. In multivariable adjusted models, we observed decreases in intake of sugary-drinks (− 0.95 servings/day; 95% CI: − 1.86, − 0.03) and in screen time (− 0.21 h/day; 95% CI: − 0.40, − 0.01), and an increase in physical activity (0.88 days/week; 95% CI: 0.52, 1.23) from the first to third trimester. We also observed a decrease in pregnancy-related anxiety score (− 1.06 units; 95% CI: − 1.32, − 0.79) and higher odds of enrollment in Women, Infant, and Children (WIC) program (OR: 2.58; 95% CI: 1.96, 3.41). Conclusions Our findings suggest that a systems-oriented prenatal intervention may be associated with improvements in behaviors and psychosocial outcomes during pregnancy among low-income mothers. Trial registration ClinicalTrials.gov (NCT03191591; Retrospectively registered on June 19, 2017).

Obesity, Lung Cancer, and The Paradox of its Association: A Narrative Review

Background: The obesity rate in Indonesia always increases every year. RISKESDAS (Indonesian National Health Research Data) 2007, 2013 and 2018 showed that obesity rate is always increasing in Indonesia. Lung cancer is the most common cancer in Indonesia which causes death. Objective: This review aims to explain various diseases which are associated with obesity, risk factors of lung cancer and the association between them. Methods: Literature search was conducted in pubmed and textbooks regarding obesity and lung cancer risk factors. The literature search on association between obesity and lung cancer was done in pubmed with the keyword "(Lung Cancer [Title]) AND (Obesity [Title])". Results: Based on the research conducted, it was found that obesity was associated with various diseases including type 2 diabetes, dyslipidemia, cancer risk, mood disorders, heart disease, hypertension, liver disease, and reproductive disorders. Furthermore, there are various risk factors for lung cancer, including gender, genetics, tobacco use, and exposure to toxic agents. The association between obesity and lung cancer is a paradoxical phenomenon that occurs, in which obese patients have a lower risk of developing lung cancer based on the meta-analysis research (RR: 0.79; 95% CI 0.73-0.85). Conclusion: Obesity can increase the risk of various diseases, and lung cancer which is one of the most common cancers in Indonesia also has various risk factors. However, current clinical research studies have shown that obesity actually reduces the risk of lung cancer. Thus we advise researchers around the world to further enhance experimental research either in clinical or laboratory about the body mechanisms that can explain this phenomenon. Regardless of this paradox association, we also suggest that the public should keep on controlling body weight because of the risk of various diseases associated with obesity.

Effects of the First 1,000 Days Systems-Change Intervention on Obesity Risk Factors During Pregnancy

Background: First 1,000 Days is a systems-oriented program starting in early pregnancy lasting through the first 24 months of infancy focused on preventing obesity and related risk factors among low income, mother-infant pairs. The program was developed in partnership with stakeholders to create an infrastructure for system-wide change. It includes screening for adverse health behaviors and socio-contextual factors, patient navigation and educational materials to support behavior change and social needs, and individualized health coaching for women at highest risk of obesity and has been shown to reduce excess gestational weight gain for women who were overweight at the start of their pregnancy. Methods: We collected information through self-administered questionnaires during the first and third trimester of gestation and from electronic health records relating to obesity risk factors. Measures collected included behavior (i.e., diet, physical activity and screen time) and psychosocial outcomes, as well as enrollment in Women, Infant, and Children (WIC) program. We examined the extent to which participation in the program was associated with changes in behaviors and psychosocial outcomes among women during pregnancy.Results: Women completed surveys at their initial and third trimester prenatal visits (n=264). Mean age (SD) was 30.2 (5.51) years and 75% had an annual household income of <$50,000. Mean pre-pregnancy body mass index (BMI) was 27.7 kg/m2 and 64% started pregnancy with a BMI ≥ 25 kg/m2. In multivariable adjusted models, we observed decreases in intake of sugary-drinks (-0.96 servings/day; 95% CI: -1.86, -0.06) and in screen time (-0.21 hours/day; 95% CI: -0.40, -0.02), and an increase in physical activity (0.87 days/week; 95% CI: 0.56, 1.17) from the first to third trimester. We also observed a decrease in pregnancy-related anxiety score (-1.06 units; 95% CI: -1.32, -0.79) and higher odds of enrollment in Women, Infant, and Children (WIC) program (OR: 2.58; 95% CI: 1.96, 3.41). Conclusions: Our findings suggest that a systems-oriented prenatal intervention is associated with improvements in behaviors and psychosocial outcomes during pregnancy among low-income mothers.Trial registration: ClinicalTrials.gov (NCT03191591; Retrospectively registered on June 19, 2017)

Dietary Imbalance between Natural and Added Nutrient Sources Is Associated with Higher Fat Mass in Young Non-Obese Individuals

Increased energy intake from carbohydrates and sugars has been associated with overweight and obesity, risk factors for type 2 diabetes. However, such an association is higher with westernised diets with higher amounts of processed foods. Our aim was to correlate the dietary intake of sugars and lipids from naturally present and added sources with fat mass in young individuals. We performed an observational study in 80 young non-obese individuals, who completed food frequency and nutritional knowledge (NK) questionnaires, as well as an anthropometric evaluation. Foods were divided into naturally or added sources of sugars and lipids, and the intake from both sources was calculated separately. Individuals with a higher fat mass percentage had lower NK and lower consumption of lipids and sugars from naturally present sources. Moreover, consumption of lipids and sugars from naturally present sources was negatively correlated with nutritional knowledge and anthropometric markers of overweight, especially body weight and waist circumference. In non-obese young adults, lower consumption of sugars and lipids from naturally present sources instead of added ones is higher in individuals with excessive fat mass percentage and correlated with anthropometric markers of fat mass. Such dietary imbalance is associated with lower nutritional knowledge, suggesting that it could be a strategy to strengthen the prevention of obesity and associated pathologies later in life.

RELATION BETWEEN OBESITY AND THYROID STATUS IN GERIATRIC INDIVIDUALS OF AHMEDABAD CITY

Background: Hypothyroidism is a significant possibility factor for cardiovascular diseases. And autoimmune thyroiditis (AIT) is the prominent reason of hypothyroidism. Recent studies exhibited that even AIT patients with euthyroidism still had an increased number of premature atherosclerotic lesions. However, the specific procedure is not yet established. This study aimed to investigate the relation of thyroid status and obesity risk factors in geriatric individuals. Methods: The present study was carried out at a tertiary care centre in Ahmedabad. A total of 1000 geriatric individuals (aged more than 60 years) were included, which were randomly selected from the O.P.D. and indoor patients. Results: The geriatric patients were found to have significantly lower FT3 and FT4 levels with higher TSH and antithyroid peroxidase antibodies (Anti TPO) levels. Obesity was found to have a positive correlation with TSH and Anti TPO levels. Regression analysis also demonstrated that the Anti TPO level was one of the influencing factors for Obesity and Cholesterol. Conclusion: The Anti TPO level is positively associated with Obesity.

A Pilot Study for Metabolic Profiling of Obesity-Associated Microbial Gut Dysbiosis in Male Wistar Rats

Obesity is one of the most incident and concerning disease worldwide. Definite strategies to prevent obesity and related complications remain elusive. Among the risk factors of the onset of obesity, gut microbiota might play an important role in the pathogenesis of the disease, and it has received extensive attention because it affects the host metabolism. In this study, we aimed to define a metabolic profile of the segregated obesity-associated gut dysbiosis risk factor. The study of the metabolome, in an obesity-associated gut dysbiosis model, provides a relevant way for the discrimination on the different biomarkers in the obesity onset. Thus, we developed a model of this obesity risk factors through the transference of gut microbiota from obese to non-obese male Wistar rats and performed a subsequent metabolic analysis in the receptor rats. Our results showed alterations in the lipid metabolism in plasma and in the phenylalanine metabolism in urine. In consequence, we have identified metabolic changes characterized by: (1) an increase in DG:34:2 in plasma, a decrease in hippurate, (2) an increase in 3-HPPA, and (3) an increase in o-coumaric acid. Hereby, we propose these metabolites as a metabolic profile associated to a segregated dysbiosis state related to obesity disease.