Spatiotemporal Trends of Colorectal Cancer Mortality Due to Low Physical Activity and High Body Mass Index From 1990 to 2019: A Global, Regional and National Analysis

Background: Understanding the spatiotemporal trends of colorectal cancer (CRC) deaths caused by low physical activity (LPA) and high body mass index (BMI) is essential for the prevention and control of CRC. We assessed patterns of LPA and high BMI-induced CRC deaths from 1990 to 2019 at global, regional, and national levels.Methods: Data on CRC deaths due to LPA and high BMI was downloaded from the Global Burden of Disease 2019 Study. We calculated estimated annual percentage change (EAPC) to quantify spatiotemporal trends in the CRC age-standardized mortality rate (ASMR) due to LPA and high BMI.Results: In 2019, CRC deaths due to LPA and high BMI were estimated as 58.66 thousand and 85.88 thousand, and the corresponding ASMRs were 0.77/100,000 and 1.07/100,000, with EAPCs of−0.39 [95% confidence interval (CI):−0.49,−0.29] and 0.64[95% CI: 0.57, 0.71] from 1990 to 2019 respectively. Since 1990, the ASMR of CRC attributable to LPA and high BMI has been on the rise in many geographic regions, especially in low middle and middle sociodemographic index (SDI) regions. Thirteen countries had a significant downward trend in CRC ASMR attributed to LPA, with EAPCs < −1. And, only 4 countries had a significant downward trend in CRC ASMR attributable to high BMI, with EAPCs < −1. Countries with a higher baseline burden in 1990 and a higher SDI in 2019 had a faster decline in ASMR due to high BMI and LPA.Conclusions: The burden of CRC caused by LPA and high BMI is on the rise in many countries. Countries should adopt a series of measures to control the local prevalence of obesity and LPA in order to reduce disease burden, including CRC.

Night-eating, Overweight/obesity and Sleep Quality

PurposeImpaired sleep has been reported to be a consequence of overweight/obesity. However, sleep-disrupting behaviour that tend to coexist with overweight/obesity are also independent risk factors for impaired sleep such as night-eating, alcohol use, insufficient physical activity (PA), electronic device use and stress/affective distress. Thus, it is unclear whether night-eating and measures of body fatness will still predict sleep quality once concurrent behaviour and affective state are taken into account. MethodsOnline questionnaires asked participants about sleep quality, night-eating, alcohol use, electronic device use and stress/affective distress at T1 (baseline) and T2 (3-months later). Height, weight and waist and hip circumference was measured at T1 and objective physical activity (PA) was assessed over 24-hours (using actigraphy) in 161 participants at T1 and T2. ResultsAt T1, night-eating was related to poorer subjective sleep quality, longer sleep onset latency, lower sleep efficacy, more sleep disturbances and daytime dysfunction and obesity category was related to daytime dysfunction after controlling demographics and covariates. At T2, high BMI predicted lower sleep efficacy after controlling T1 sleep components, demographics and covariates. ConclusionNight-eating and obesity category were associated with multiple impairments in sleep quality, but only high BMI predicted sleep quality at T2. Thus, night-eating and measures of body fatness predicted sleep quality components at T1 and T2 even after co-existing behaviour and emotional states were taken into account.Level of EvidenceLevel III, evidence obtained from well-designed cohort.

‘When Hunger Makes Everything Better Looking!’: The Effect of Hunger on the Aesthetic Appreciation of Human Bodies, Faces and Objects

Background: Research evidence suggests that physiological state of hunger might affect preference for female body weight, such that hungrier, compared to satiate, men prefer heavier body weight and rate as more attractive heavier female figures. Here, we seek to extend these findings by comparing the effects of fasting and snack on aesthetics judgements of the bodies and faces of conspecifics and of objects in a sample of female and male participants. Methods: Forty-four participants (women: n = 21, mean age = 23.70yrs ± 0.62) provided aesthetic liking judgments of round and slim human bodies, faces and objects, under at least 12 h of overnight fasting and immediately after having eaten a snack (i.e., bananas). An anthropometric measure of adiposity (i.e., Body Mass Index, BMI) was also collected from each observer. Results: Overall, we found that participants’ aesthetic judgements were higher for slim stimuli compared to round ones. However, after fasting, participants rated round stimuli as more attractive compared to when they had a snack. This hunger-based shift in ratings not only was apparent when stimuli depicted a human body or face, but also when they depicted an object, thus suggesting a general modification of observers’ aesthetic preference related to hunger. Importantly, this effect was modulated by participants’ BMI so that only participants with a high BMI provided higher aesthetic judgements for round stimuli after fasting than after a snack. Conclusions: Our results demonstrated that both the modification of the physiological state and the individual differences in adiposity level of the observers might affect the aesthetic appreciation of the external world.

Influence of low, medium and high BMI on hand grip strength among community dwelling elderly population

ABSTRACT: - Aim of the study is to find out the influence of low, medium and high body mass index on hand grip strength among community dwelling elderly population. Methodology: - This was an observational cross-sectional study performed on 30 community dwelling elderly population with age groups 60 and above 60. Out of total 30 participants 8 were having low BMI, 9 were having medium BMI and 13 were having high BMI. BMI was calculated by taking weight (in kg) by using weighing machine and height in (meters). Hand grip strength was measured by using hand held (JAMER) dynamometer. Result: - Data has summarized by using descriptive statistic of mean and standard deviation. Then Pearson correlation test was used to measure relation between hand grip strength and BMI.ANOVA technique was used for multiple group comparison by using graph pad software. By using Pearson corelation we got the result that there is positive corelation between High BMI with HGS and negative corelation between HGS with low and medium BMI. By using one-way ANOVA test we got (p value>0.05) which is non-significant. One way ANOVA shows comparison of hand grip strength of low, medium and high BMI and it is like H>M>L for both dominant and non-dominant. CONCLUSION: - Our study concludes from the above result that there is corelation between Hand grip strength and body mass index.

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

BackgroundBody mass index (BMI) is an inadequate marker of obesity, and cannot distinguish between fat mass, fat free mass and distribution of adipose tissue. The purpose of this study was twofold. First, to assess cross-sectional relationship of BMI with fat mass index (FMI), fat free mass index (FFMI) and ratio of fat mass to fat free mass (FM/FFM). Second, to study the association of FMI, FFMI and FM/FFM with physical function including sarcopenia, and cognition in pre-frail older adults.MethodsCross-sectional study of 191 pre-frail participants ≥ 65 years, 57.1% females. Data was collected on demographics, cognition [Montreal Cognitive Assessment (MoCA)], function, frailty, calf circumference, handgrip strength (HGS), short physical performance battery (SPPB) and gait speed. Body composition was measured using InBody S10. FMI, FFMI and FM/FFM were classified into tertiles (T1, T2, T3) with T1 classified as lowest and T3 highest tertile respectively and stratified by BMI.ResultsHigher FFMI and lower FM/FFM in the high BMI group were associated with better functional outcomes. Prevalence of low muscle mass was higher in the normal BMI group. FMI and FM/FFM were significantly higher in females and FFMI in males with significant gender differences except for FFMI in ≥ 80 years old. Small calf circumference was significantly less prevalent in the highest tertile of FMI, FM/FMI and FFMI. Prevalence of sarcopenic obesity and low physical function (HGS, gait speed and SPPB scores) were significantly higher in the highest FMI and FM/FFM tertile. Highest FFMI tertile group had higher physical function, higher MoCA scores, lower prevalence of sarcopenic obesity and sarcopenia, After adjustment, highest tertile of FFMI was associated with lower odds of sarcopenia especially in the high BMI group. Highest tertile of FM/FFM was associated with higher odds of sarcopenia. Higher BMI was associated with lower odds of sarcopenia.ConclusionFFMI and FM/FFM may be a better predictor of functional outcomes in pre-frail older adults than BMI. Cut-off values for healthy BMI values and role of calf circumference as a screening tool for sarcopenia need to be validated in larger population. Health promotion intervention should focus on FFMI increment.

Clotting of Hemodialysis Access in Patients with COVID-19 in an Inner-City Hospital

<b><i>Background:</i></b> An increased incidence of thrombotic complications in patients with coronavirus disease 2019 (COVID-19) has been reported. Severe acute kidney injury (AKI) is one of the major clinical manifestations of COVID-19 with the need for renal replacement therapy. It was observed that hemodialysis (HD) accesses tended to thrombose more often in the COVID-19 population than in non-COVID-19 patients. We hypothesize that the hypercoagulable state of COVID-19 is associated with higher incidence of access clotting. <b><i>Method:</i></b> In this retrospective single-centered study at Kings County Hospital in New York City, 1,075 patients with COVID-19 were screened, and 174 patients who received HD from January 3, 2021 to May 15, 2020 were enrolled to examine the risk factors of dialysis access clotting in patients with COVID-19. <b><i>Results:</i></b> Of the 174 patients, 109 (63%) were COVID-19 positive. 39 (22.6%) patients had dialysis access clotting at least once during their hospitalization, and they had significantly higher body mass index (BMI) (<i>p</i> = 0.001), higher rates of COVID-19 (<i>p</i> = 0.015), AKI (<i>p</i> &#x3c; 0.001), higher platelet counts (<i>p</i> = 0.029), higher lactate dehydrogenase levels (<i>p</i> = 0.009), and lower albumin levels (<i>p</i> = 0.001) than those without access malfunctions. Low albumin levels (<i>p</i> = 0.008), AKI (<i>p</i> = 0.008), and high BMI (<i>p</i> = 0.018) were risk factors associated with HD access clotting among COVID-19 patients. <b><i>Conclusion:</i></b> Patients with COVID-19 who receive HD for AKI with high BMI are at a higher risk of clotting their HD access.

Predictive hematological and immunological parameters associated with postpartum progressed Covid-19 disease

Background: In pregnancy, Coronavirus disease-2019 (COVID-19) infection disease may be more severe due to existingphysiological changes. Similarly, changes during and after birth can make the patient more subceptible. Objective: To investigate possible laboratory findings that was related to postpartum progression of COVID-19 disease. Methods: Pregnant women who are pregnant at 28 weeks or more and who are COVID-19 positive at the time of delivery were investigated in this study. Progressed post- delivery and non-progressed COVID-19 positive pregnants’ laboratory findings were analyzed. Hematological and immunological parameters associated with postpartum progressed COVID-19 disease were evaluated. Results: Totally 151 individuals were conducted to the study. In the prenatal analysis, higher BMI and lower albumin levels were detected in the progressed group (p<0.05). In the postpartum analysis; White Blood Cell, lymphocyte and albumin were increased, while neutrophil, NLR, LDH, CK, D-DIMER, Ferritin, CRP and IL-6 were decreased in the non-progressed group as opposite of the progressed group (p<005). Conclusion: We observed that prenatal low albumin and high BMI may be related to progression of the COVID-19 disease after delivery. In progressed group, inflammatory markers were increased after delivery while in non-progressed group they were improved. These markers may be warning for the postpartum progression of COVID-19 disease. Keywords: COVID-19; delivery; albumin; neutrophil-lymphocyte ratio; pregnancy.

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.

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

Bariatric and metabolic surgery is currently the most effective procedure of achieving and maintaining weight loss. In the case under discussion, a 48-year-old male patient with heart insufficiency and an implanted left-ventricular assist device (LVAD) wanted to reduce his high BMI (48.6 kg/m²), so as to qualify for the heart transplant waiting list. According to the guidelines, he underwent all the required preoperative testing, which included psychosomatic clarifications, determination of endocrinological causes, and a nutritional consultation. During laparoscopic sleeve gastrectomy, a cardiac technician was present to support the anesthetist. After inserting 3 trocars with no complications, the greater curvature was mobilized using Medtronic’s bipolar electrothermal vessel-sealing instrument, LigaSure™. The resection was performed with an Ethicon™ endostapler. Postoperative monitoring showed no signs of hemorrhage. The patient’s BMI on the day of surgery was 46.8 kg/m² and consecutively fell to 26.7 kg/m² 1 year after the procedure. Follow-up appointments revealed that the patient was fit and in good health. Thus, the patient’s aim of being listed on the transplant list was fulfilled, and at the time of this writing, he is ready to be matched with an organ donor. Because high-BMI patients with inserted LVADs are less likely to receive a donor graft and must remain longer on transplant waiting lists than normal-weight patients, bariatric and metabolic weight loss surgery may lead to a speedier resolution for these high-risk patients.

Ultra-processed food consumption in adults across Europe

Purpose The purpose of this study is to describe ultra-processed food and drinks (UPFDs) consumption, and associations with intake of total sugar and dietary fibre, and high BMI in adults across Europe. Methods Using food consumption data collected by food records or 24-h dietary recalls available from the European Food Safety Authority (EFSA) Comprehensive European Food Consumption Database, the foods consumed were classified by the level of processing using the NOVA classification. Diet quality was assessed by data linkage to the Dutch food composition tables (NEVO) and years lived with disability for high BMI from the Global Burden of Disease Study 2019. Bivariate groupings were carried out to explore associations of UPFDs consumption with population intake of sugar and dietary fibre, and BMI burden, visualised by scatterplots. Results The energy share from UPFDs varied markedly across the 22 European countries included, ranging from 14 to 44%, being the lowest in Italy and Romania, while the highest in the UK and Sweden. An overall modest decrease (2–15%) in UPFDs consumption is observed over time, except for Finland, Spain and the UK reporting increases (3–9%). Fine bakery wares and soft drinks were most frequently ranked as the main contributor. Countries with a higher sugar intake reported also a higher energy share from UPFDs, as most clearly observed for UPF (r = 0.57, p value = 0.032 for men; and r = 0.53, p value = 0.061 for women). No associations with fibre intake or high BMI were observed. Conclusion Population-level UPFDs consumption substantially varied across Europe, although main contributors are similar. UPFDs consumption was not observed to be associated with country-level burden of high BMI, despite being related to a higher total sugar intake.