Gender-specific effects of early nutritional restriction on adult obesity risk: evidence from quasi-experimental studies.

PubMed

Robinson, Whitney R

2012-12-01

In countries undergoing nutrition transition and historically poor minority groups in wealthy countries, obesity tends to be more common in women than men. A potential contributor to this female excess of obesity is a mismatch between perinatal nutritional restriction and a later calorie-rich environment. Several epidemiologic and quasi-experimental studies support a gender-differential effect of early nutritional deprivation on adult obesity. The quasi-experimental studies are of particular interest because results of quasi-experimental studies are typically less vulnerable to confounding bias than observational studies. Four quasi-experimental studies-exploiting 20th century famines that occurred in Europe, Africa, and Asia-provide evidence that perinatal nutritional restriction followed by relative caloric abundance may increase adult obesity risk to a greater extent in women than men. If the findings are accurate and generalizable to contemporary food environments, they suggest that the female offspring of poor, or otherwise nutritionally restricted, women in rapidly developing and wealthy countries may be at particularly high risk of adult obesity. Research into gender-specific effects of early life nutritional deprivation and its interactions with later environmental exposures may provide insight into global gender differences in obesity prevalence.

Urbanization and obesity in The Gambia: a country in the early stages of the demographic transition.

PubMed

Siervo, M; Grey, P; Nyan, O A; Prentice, A M

2006-04-01

To investigate the distribution of overweight and obesity and its relationship with socio-economic and behavioural factors in a developing-country population undergoing rapid nutritional transition. Cross-sectional house-to-house survey in urban Gambia. Four groups of 50 subjects were sampled as follows: young men (YM, 14-25 years), young women (YW, 14-25 years), older men (OM, 35-50 years) and older women (OW, 35-50 years). Several socio-economic and behavioural factors were investigated. Composite indices for socio-economic status, education, healthy lifestyle and western influences were created. Body weight, height, waist and hip circumferences were measured and body mass index (BMI) was calculated. Body composition was assessed by leg-to-leg bioimpedance. Overweight was defined as BMI=25.0-29.9 kg/m(2) and obesity as BMI>or=30.0 kg/m(2). There were highly significant gender and age differences in overweight (YM=0%, YW=10%, OM=6% and OW=34%) and obesity (YM=0%, YW=4%, OM=6% and OW=50%). Only 16% of OW were neither overweight nor obese compared to 88% of OM. OW had a higher fat mass percent (38.4%) than other groups, while fat-free mass (kg) was significantly higher in males than females with YW having the lowest value. Young generations were more educated and more influenced by western ideals than OM and OW. Weight gain was not always associated with weight concern and many overweight/obese subjects did not perceive themselves as overweight. Social and behavioural changes are already creating a perceptible 'generational gap' among this population undergoing rapid transition. The improved education and current lean status of the younger adults offers opportunities for preventative interventions. These need to be specially targeted at women.

[Phenomenological study of infertile women with obesity].

PubMed

Arranz-Lara, Lilia; Martínez-Lemus, Hugo; Ruíz-Ornelas, Jaime; Sauceda-González, Luciano; Pimentel, Elizabeth; Anguiano, Norma; Sondón, Zoé; Cedillo, Javier; Chávez, Alvaro; Regalado, Miguel Angel; Moreno, Daniel

2010-10-01

Obesity is a condition strongly associated with polycystic ovary and other conditions that interfere with or complicate the treatment of assisted reproduction. To examine, from a phenomenological point of view, the perception of infertile women obesity problem before undergoing assisted reproduction treatment. This analysis should help to design a psychotherapeutic strategy focused on this problem. One hundred patients with infertility, with a BMI equal to or greater than 30, candidates for assisted reproductive treatments in the service of Human Reproduction, Centro Médico Nacional 20 de Noviembre, ISSSTE. The phenomenological qualitative analysis was performed in 72 women who agreed to be interviewed in depth. The phenomenon is to study obesity in infertile women candidates for assisted reproduction treatment. Obese infertile women subject to assisted reproduction treatment perceive their difficulty losing weight is closely associated with infertility. Most patients had social feelings of worthlessness, sadness, worthlessness, and family rejection. The inability to obtain a steady weight loss is regarded as a minor frustration that sterility. It is very important to perform intensive, multidisciplinary labor, which is focused on concepts associated with psychological distress, such as: management of depression by sterility, control of anxiety and stress, control of social pressures and management of the illusion of motherhood. Also rely on specialists of eating habits and exercise.

Impact of reduction mammoplasty on the quality of life of obese patients suffering from symptomatic macromastia: A descriptive cohort study.

PubMed

Hernanz, F; Fidalgo, M; Muñoz, P; Noriega, M González; Gómez-Fleitas, M

2016-08-01

Although reduction mammoplasty (RM) is an effective and efficient treatment for symptomatic macromastia, overweight and obese patients who request this treatment are frequently rejected because of selection criteria based on the body mass index. Scientific evidence is inconclusive regarding the increased postoperative complications in obese patients undergoing RM, and there is a lack of adequately designed studies examining the impact of RM on the quality of life of this group of patients. A descriptive cohort study was performed on 37 consecutive obese patients (body mass index > 30 kg/m(2)) undergoing bilateral RM for symptomatic macromastia. Short Form SF-36 quality-of-life questionnaires were completed at interviews a week before surgery and 6 and 18 months after surgery. In addition, 37 women of matching ages, who were companions of patients hospitalized at our short-stay surgery unit, were used as a control group for comparison. Significant differences between repeated measurements on a single sample were assessed using the Wilcoxon signed-rank test. To evaluate these changes, we used effect size by computing Hedges' g corrected. The preoperative SF-36 physical component score was significantly lower than the control group's score (40 vs. 53, p < 0.001). There was no significant difference in the mental component score (45 vs. 49, p = 0.210). Postoperative SF-36 scores were increased with a normalizing effect, as 18 months after surgery only the body pain domain scored lower than the control group scores. According to our results, obese women with symptomatic macromastia undergoing RM exhibited increased quality of life, and this improvement was maintained over time. Level III Evidence. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Maternal obesity in Africa: a systematic review and meta-analysis.

PubMed

Onubi, Ojochenemi J; Marais, Debbi; Aucott, Lorna; Okonofua, Friday; Poobalan, Amudha S

2016-09-01

Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a 'double burden', especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

Maternal obesity in Africa: a systematic review and meta-analysis

PubMed Central

Onubi, Ojochenemi J.; Marais, Debbi; Aucott, Lorna; Okonofua, Friday; Poobalan, Amudha S.

2016-01-01

Background Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a ‘double burden’, especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. Methods MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Results Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. Conclusions These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects. PMID:26487702

Early Pregnancy Diabetes Screening and Diagnosis: Prevalence, Rates of Abnormal Test Results, and Associated Factors.

PubMed

Mission, John F; Catov, Janet; Deihl, Tiffany E; Feghali, Maisa; Scifres, Christina

2017-11-01

To evaluate the prevalence of early diabetes screening in pregnancy, rates of abnormal diabetes test results before 24 weeks of gestation, and factors associated with early diabetes screening. This was a retrospective cohort study of all singleton deliveries from 2012 to 2014 among diverse clinical practices at a large academic medical center. We assessed rates of early (less than 24 weeks of gestation) and routine (at or beyond 24 weeks of gestation) diabetes screening, with abnormal test results defined using the Carpenter-Coustan criteria, a 50-g glucose challenge test result greater than 200 mg/dL, or a hemoglobin A1C level greater than 6.5%. Univariate and multivariate analyses were used to evaluate clinical and demographic determinants of screening and diagnosis. Overall, 1,420 of 11,331 (12.5%) women underwent early screening. Increasing body mass index (BMI) category, race, public insurance, history of gestational diabetes mellitus, a family history of diabetes, and chronic hypertension were associated with early screening. Early screening rates rose with increasing BMI category, but only 268 of 551 (48.6%) of women with class III obesity underwent early screening. Among those screened early, 2.0% of normal-weight women, 4.0% of overweight women, 4.2% of class I obese women, 3.8% of class II obese women, and 9.0% of class III obese women had abnormal early test results (P<.001). Early diabetes screening is used inconsistently, and many women with risk factors do not undergo early screening. A significant proportion of women with class III obesity will test positive for gestational diabetes mellitus before 24 weeks of gestation, and studies are urgently needed to assess the effect of early diabetes screening and diagnosis on perinatal outcomes in high-risk women.

Does obesity compromise ovarian reserve markers? A clinician's perspective.

PubMed

Malhotra, Neena; Bahadur, Anupama; Singh, Neeta; Kalaivani, Mani; Mittal, Suneeta

2013-01-01

The aim of the study was to ascertain if increasing body mass index (BMI) adversely affects ovarian reserve among infertile women of Asian origin undergoing in vitro fertilization (IVF). This prospective study on 183 women was carried out in the infertility clinic of All India Institute of Medical Sciences, New Delhi, India. Blood hormonal assay in all patients including follicle-stimulating hormone (FSH), luteinizing hormone (LH) and inhibin B was performed on day 2/3 of a spontaneous cycle. A transvaginal ultrasonographic examination on day 2-5 of the menstrual cycle was done for antral follicle count (AFC) and ovarian volume. A correlation between BMI and ovarian reserve parameters like FSH, LH, inhibin B, antral follicle count and ovarian volume was noted. Age was comparable in the three BMI groups. The mean duration of infertility was 8.38 years. Compared to the normal weight, the overweight and obese women had a statistically significantly low inhibin B (p < 0.0259). The AFC when taken together on both sides was not statistically significant between the groups; however, the overweight and obese women had a significantly low AFC (p < 0.0129) on the right side. Incorporating anti-mullerian hormone, a newer marker for ovarian reserve, may benefit these obese infertile women. Further work is required to elucidate the mechanisms underlying the effect of obesity on inhibin B as a marker of ovarian reserve in infertile women. The best marker to check the ovarian reserve is perhaps the woman's performance during an IVF cycle. However, considering the psychological and financial stress of the procedure, it may seem wise to consider counseling of obese women on their expected performance in the first cycle of IVF through such studies.

Associations Between Insulin Resistance, Free Fatty Acids, and Oocyte Quality in Polycystic Ovary Syndrome During In Vitro Fertilization

PubMed Central

Niu, Zhihong; Lin, Nan; Gu, Ruihuan; Sun, Yijuan

2014-01-01

Context: Both polycystic ovary syndrome (PCOS) and obesity are associated with specific reproductive health complications, including lower oocyte quality and clinical pregnancy rates in assisted conception cycles, which may be a result of metabolism-induced changes in the oocyte through the microenvironment of follicular fluid. Free fatty acids (FFAs) are important biomedical indicators of abnormal lipid metabolism and have pronounced effects on cells, leading to changes in metabolism, cell growth, and differentiation Objective: Our objective was to determine the effect of FFA metabolism in plasma and follicular fluid on oocyte quality in the women with PCOS undergoing in vitro fertilization. Design and Setting: Ninety-three women undergoing in vitro fertilization treatment, including 55 with PCOS and 38 age-matched controls, were recruited. PCOS patients were divided into obese and nonobese subgroups on the basis of their body mass index. Main Outcome Measures: Embryo quality was morphologically assessed, and serum sex hormone and insulin levels were measured. FFAs in plasma and follicular fluid were measured using gas chromatography-mass spectrometry. Results: PCOS was found to be associated with significantly higher LH/FSH, total T, free androgen index (FAI), and lower SHBG levels, independent of obesity(P < .05). Obese women with PCOS had a significantly higher total T level, FAI, fasting insulin, insulin resistance index as determined by homeostasis model assessment for insulin resistance, and lower SHBG levels than the nonobese women with PCOS (P < .05). The embryo fragmentation score was significantly positively correlated with the oleic acid concentration in all PCOS patients (r = 0.22, P = .04, for nonobese patients and r = 0.25, P = .03, for obese patients). Conclusions: Our findings clearly demonstrated that PCOS is associated with significantly higher FAI and insulin resistance levels and decreased plasma SHBG levels, independent of body mass index. Obese PCOS patients had higher palmitoleic acid and oleic acid levels in both the plasma and follicular fluid than did the control subject and nonobese PCOS patients. Our results indicated that developmental competence is associated with oleic and stearic acid concentrations, which may contribute to the poor pregnancy outcomes in patients with PCOS. PMID:24694334

Clomiphene citrate is associated with favorable cycle characteristics but impaired outcomes of obese women with polycystic ovarian syndrome undergoing ovarian stimulation for in vitro fertilization

PubMed Central

Jiang, Shutian; Kuang, Yanping

2017-01-01

Abstract The aim of this study was to explore the effect of clomiphene citrate (CC) on the cycle characteristics and outcomes of obese women with polycystic ovarian syndrome (PCOS) undergoing ovarian stimulation for in vitro fertilization (IVF). This is a retrospective cohort study, and it was conducted at the tertiary-care academic medical center. This study included 174 obese PCOS patients undergoing IVF. In the study group (n = 90), CC and human menopausal gonadotropin (HMG) were administered simultaneously beginning on cycle day 3, while in control group (n = 84) HMG was used only. Both of the 2 groups used medroxyprogesterone acetate (MPA) for preventing premature luteinizing hormone (LH) surges. Ovulation was cotriggered by a GnRH agonist and hCG when dominant follicles matured. The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the number of top-quality embryos, maturation rate, fertilization rate, cleavage rate, incidence of premature LH surge, and OHSS. The study group received obviously lower total HMG dose [1650 (975–4800) vs 2025 (1350–3300) IU, P = 2.038E–4] but similar HMG duration. While the antral follicle count (AFC) is higher in study group, the number of oocytes retrieved and top-quality embryos are remarkably less [5 (0–30) vs 13 (0–42), P = 6.333E–5; 2 (0–14) vs 3.5 (0–15), P = .003; respectively]. The mature oocyte rate is higher in study group (P = .036). No significant differences were detected in fertilization rate and cleavage rate between 2 groups. CC has a positive influence on cycle characteristics, but might be correlated with the impaired IVF outcomes (less oocytes retrieved and top quality embryos, lower oocyte retrieval rate) in obese PCOS patients undergoing IVF, when HMG and MPA are used simultaneously. PMID:28796038

Quantification of cefazolin in serum and adipose tissue by ultra high performance liquid chromatography-Tandem mass spectrometry (UHPLC-MS/MS): application to a pilot study of obese women undergoing cesarean delivery.

PubMed

Lillico, Ryan; Sayre, Casey L; Sitar, Daniel S; Davies, Neal M; Baron, Cynthia M; Lakowski, Ted M

2016-09-15

Higher doses of cefazolin are required in obese patients for preoperative antibiotic prophylaxis, owing to its low lipophilicity. An ultra high performance liquid chromatography-tandem mass spectrometry method was developed to quantify cefazolin in serum and adipose tissue from 6 obese patients undergoing cesarean delivery, and using stable-isotope labeled cefazolin as an internal standard. The method has a 2μg/g lower limit of quantitation. The concentration in adipose tissue was 3.4±1.6μg/mL, which is less than half of the reported minimum inhibitory concentration of 8μg/mL for cefazolin. Serum cefazolin concentrations were more than 30-fold higher than in adipose tissue. Copyright © 2016 Elsevier B.V. All rights reserved.

Racial and Ethnic Disparities in the Impact of Obesity on Breast Cancer Risk and Survival: A Global Perspective123

PubMed Central

Bandera, Elisa V; Maskarinec, Gertraud; Romieu, Isabelle; John, Esther M

2015-01-01

Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression. PMID:26567202

Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective.

PubMed

Bandera, Elisa V; Maskarinec, Gertraud; Romieu, Isabelle; John, Esther M

2015-11-01

Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression. © 2015 American Society for Nutrition.

Urodynamic characterization of obese women with urinary incontinence undergoing a weight loss program: the Program to Reduce Incontinence by Diet and Exercise (PRIDE) trial.

PubMed

Richter, Holly E; Creasman, Jennifer M; Myers, Deborah L; Wheeler, Thomas L; Burgio, Kathryn L; Subak, Leslee L

2008-12-01

The purpose of this study was to describe urodynamic characteristics of overweight or obese women with urinary incontinence and explore the relationship between urodynamic parameters, body mass index (BMI), and abdominal circumference (AC). One hundred ten women underwent a standardized cough stress test and urodynamic study. Eighty-six percent of women had urodynamic stress incontinence and 15% detrusor overactivity. Intra-abdominal pressure (Pabd) at maximum cystometric capacity (MCC) increased 0.4 cm H(2)O per kg/m(2) unit of BMI (95% confidence interval [CI] = 0.0,0.7, p = 0.04) and 0.4 cm H(2)O per 2 cm increase in AC (CI = 0.2, 0.7, p < 0.01). Intravesical pressure (Pves) at MCC increased 0.4 cm H(2)O per 2 cm increase in AC (CI = 0.0, 0.8, p = 0.05) but was not associated with BMI (p = 0.18). BMI and AC had a stronger association with Pabd than with Pves, suggesting a possible mechanism for the association between obesity and urinary incontinence.

Prolonged monitoring of ethinyl estradiol and levonorgestrel levels confirms an altered pharmacokinetic profile in obese oral contraceptives users

PubMed Central

Edelman, Alison B; Cherala, Ganesh; Munar, Myrna Y.; DuBois, Barent; McInnis, Martha; Stanczyk, Frank Z.; Jensen, Jeffrey T

2014-01-01

Background Pharmacokinetic (PK) parameters based on short sampling times (48 h or less) may contain inaccuracies due to their dependency on extrapolated values. This study was designed to measure PK parameters with greater accuracy in obese users of a low-dose oral contraceptive (OC), and to correlate drug levels with assessments of end-organ activity. Study design Obese (BMI ≥30 kg/m2), ovulatory, otherwise healthy, women (n = 32) received an OC containing 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) for two cycles. EE and LNG PK parameters were characterized for 168 h at the end of Cycle 1. During Cycle 2, biweekly outpatient visits were performed to assess cervical mucus, monitor ovarian activity with transvaginal ultrasound, and obtain serum samples to measure EE, LNG, estradiol (E2), and progesterone (P) levels. PK parameters were calculated and correlated with end-organ activity and compared against control samples obtained from normal and obese women sampled up to 48 h in a previous study. Standard determination of PK accuracy was performed; defined by the dependency on extrapolated values (‘excess’ area under the curve of 25% or less). Results The mean BMI was 39.4 kg/m2 (SD 6.6) with a range of 30–64 kg/m2. Key LNG PK parameters were as follows: clearance 0.52 L/h (SD 0.24), half-life 65 h (SD 40), AUC 232 h*ng/mL (SD 102) and time to reach steady-state 13.6 days (SD 8.4). The majority of subjects had increased ovarian activity with diameter of follicles ≥8 mm (n = 25) but only seven women had follicles ≥10 mm plus cervical mucus scores ≥5. Evidence of poor end-organ suppression did not correlate with the severity of the alterations in PK. As compared to historical normal and obese controls (48 h PK sampling), clearance, half-life, area under the curve (AUC) and time to reach steady-state were found to be significantly different (p ≤ 0.05) in obese women undergoing a longer duration of PK sampling (168 h). Longer sampling also improved PK accuracy for obese women (excess AUC 20%) as compared to both normal and obese controls undergoing shorter sampling times (48 h) with excess AUCs of 25% and 50%, respectively. Conclusions Obesity results in significant alterations in OC steroid PK parameters but the severity of these alterations did not correlate with end-organ suppression. A longer PK sampling interval (168 h vs. 48 h) improved the accuracy of PK testing. PMID:23153898

Prolonged monitoring of ethinyl estradiol and levonorgestrel levels confirms an altered pharmacokinetic profile in obese oral contraceptives users.

PubMed

Edelman, Alison B; Cherala, Ganesh; Munar, Myrna Y; Dubois, Barent; McInnis, Martha; Stanczyk, Frank Z; Jensen, Jeffrey T

2013-02-01

Pharmacokinetic (PK) parameters based on short sampling times (48 h or less) may contain inaccuracies due to their dependency on extrapolated values. This study was designed to measure PK parameters with greater accuracy in obese users of a low-dose oral contraceptive (OC) and to correlate drug levels with assessments of end-organ activity. Obese [body mass index (BMI) ≥30 kg/m2], ovulatory, otherwise healthy women (n=32) received an OC containing 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) for two cycles. EE and LNG PK parameters were characterized for 168 h at the end of Cycle 1. During cycle 2, biweekly outpatient visits were performed to assess cervical mucus, monitor ovarian activity with transvaginal ultrasound and obtain serum samples to measure EE, LNG, estradiol and progesterone levels. PK parameters were calculated and correlated with end-organ activity and compared against control samples obtained from normal and obese women sampled up to 48 h in a previous study. Standard determination of PK accuracy was performed, defined by the dependency on extrapolated values ('excess' area under the curve of 25% or less). The mean BMI was 39.4 kg/m2 (SD 6.6) with a range of 30-64 kg/m2. Key LNG PK parameters were as follows: clearance, 0.52 L/h (SD 0.24); half-life, 65 h (SD 40); area under the curve (AUC), 232 h*ng/mL (SD 102); and time to reach steady state, 13.6 days (SD 8.4). The majority of subjects had increased ovarian activity with diameter of follicles ≥8 mm (n=25), but only seven women had follicles ≥10 mm plus cervical mucus scores ≥5. Evidence of poor end-organ suppression did not correlate with the severity of the alterations in PK. As compared to historical normal and obese controls (48-h PK sampling), clearance, half-life, AUC and time to reach steady state were found to be significantly different (p≤.05) in obese women undergoing a longer duration of PK sampling (168 h). Longer sampling also improved PK accuracy for obese women (excess AUC 20%) as compared to both normal and obese controls undergoing shorter sampling times (48 h) with excess AUCs of 25% and 50%, respectively. Obesity results in significant alterations in OC steroid PK parameters, but the severity of these alterations did not correlate with end-organ suppression. A longer PK sampling interval (168 h vs. 48 h) improved the accuracy of PK testing. Copyright © 2013 Elsevier Inc. All rights reserved.

Epidemiologic Evidence That Excess Body Weight Increases Risk of Cervical Cancer by Decreased Detection of Precancer.

PubMed

Clarke, Megan A; Fetterman, Barbara; Cheung, Li C; Wentzensen, Nicolas; Gage, Julia C; Katki, Hormuzd A; Befano, Brian; Demarco, Maria; Schussler, John; Kinney, Walter K; Raine-Bennett, Tina R; Lorey, Thomas S; Poitras, Nancy E; Castle, Philip E; Schiffman, Mark

2018-04-20

Purpose Obesity has been inconsistently linked to increased cervical cancer incidence and mortality; however, the effect of obesity on cervical screening has not been explored. We investigated the hypothesis that increased body mass might decrease detection of cervical precancer and increase risk of cervical cancer even in women undergoing state-of-the-art screening. Methods We conducted a retrospective cohort study of 944,227 women age 30 to 64 years who underwent cytology and human papillomavirus DNA testing (ie, cotesting) at Kaiser Permanente Northern California (January 2003 to December 2015). Body mass index was categorized as normal/underweight (< 25 kg/m 2 ), overweight (25 to < 30 kg/m 2 ), or obese (≥ 30 kg/m 2 ). We estimated 5-year cumulative risks of cervical precancer and cancer by category of body mass index using logistic Weibull survival models. Results We observed lower risk of cervical precancer (n = 4,489) and higher risk of cervical cancer (n = 490) with increasing body mass index. Specifically, obese women had the lowest 5-year risk of precancer (0.51%; 95% CI, 0.48% to 0.54% v 0.73%; 95% CI, 0.70% to 0.76% in normal/underweight women; P trend < .001). In contrast, obese women had the highest 5-year risk of cancer (0.083%; 95% CI, 0.072% to 0.096% v 0.056%; 95% CI, 0.048% to 0.066% in normal/underweight women; P trend < .001). Results were consistent in subgroups defined by age (30 to 49 v 50 to 64 years), human papillomavirus status (positive v negative), and histologic subtype (glandular v squamous). Approximately 20% of cervical cancers could be attributed to overweight or obesity in the women in our study who underwent routine cervical screening. Conclusion In this large, screened population, overweight and obese women had an increased risk of cervical cancer, likely because of underdiagnosis of cervical precancer. Improvements in equipment and/or technique to assure adequate sampling and visualization of women with elevated body mass might reduce cervical cancer incidence.

McDonald versus Shirodkar cervical cerclage for the prevention of preterm birth: impact of body mass index.

PubMed

Figueroa, Reinaldo; Crowell, Rebecca; Martinez, Alvin; Morgan, Marielle; Wakefield, Dorothy

2018-04-30

To compare obstetrical outcomes on women undergoing a McDonald or Shirodkar cerclage and to estimate the impact of maternal body mass index (BMI) on these outcomes. We conducted a retrospective review of the medical records of all women with singleton pregnancies who underwent placement of a McDonald or Shirodkar cerclage at St. Francis Hospital from January 2008 to October 2013. The subjects were categorized based on BMI groups (normal: less than 25 kg/m 2 , overweight: 25-29 kg/m 2 , obese: 30 kg/m 2 or more). The primary outcome was gestational age at delivery. Statistical analyses included chi-square, Student's t-test, and multivariable regression analysis. Of 95 women, 47 (49.5%) received a Shirodkar, and 48 (50.5%) a McDonald cerclage. 16 women (16.8%) were categorized as normal weight, 35 (36.8%) as overweight, and 44 (46.3%) as obese. Gestational age at delivery differed significantly by group, decreasing with each categorical increase in BMI (normal: 39.0 ± 0.3 weeks; overweight: 36.6 ± 0.7 weeks; obese: 33.0 ± 1.1 weeks; p < .01). Overall, women receiving a Shirodkar cerclage had significantly longer pregnancies than women with a McDonald cerclage (36.7 ± 0.6 weeks versus 33.9 ± 1.0 weeks; p = .02). However, analysis showed a significant interaction between weight status and gestational age at delivery. Obese women had significantly longer pregnancies when they received a Shirodkar cerclage versus a McDonald cerclage (32.6 ± 1.0 weeks versus 28.8 ± 0.9 weeks; p < .01). However, there was no significant difference in gestational age at delivery between women categorized as normal/overweight (Shirodkar: 33.5 ± 0.9 weeks; McDonald: 32.9 ± 0.9 weeks; p = .63). Compared to obese women receiving a McDonald cerclage, obese women receiving a Shirodkar cerclage had significantly longer pregnancies. No significant differences in pregnancy duration were found in normal/overweight women regardless of cerclage technique. Pregnancy duration in obese women receiving a Shirodkar cerclage was similar to the pregnancy duration of normal/overweight women.

The impact of body mass index on the risk of high spinal block in parturients undergoing cesarean delivery: a retrospective cohort study.

PubMed

Lamon, Agnes M; Einhorn, Lisa M; Cooter, Mary; Habib, Ashraf S

2017-08-01

To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients. This is a retrospective study at an academic center. We searched the perioperative database for women who underwent cesarean delivery under spinal or combined spinal epidural anesthesia with hyperbaric bupivacaine ≥10.5 mg. A body mass index (BMI) ≥30 kg/m 2 was defined as obese. We categorized obesity into: obesity class I (BMI = 30-34.9 kg/m 2 ), obesity class II (BMI = 35-39.9 kg/m 2 ), obesity class III (BMI = 40-49.9 kg/m 2 ), and super obese (BMI ≥50 kg/m 2 ). The primary outcome was high spinal block defined as need to convert to general anesthesia within 20 min of spinal placement as a result of altered mental status, weakness, or respiratory distress resulting from the high block, or a recorded block height ≥T1. The analysis included 5015 women. High spinal blocks occurred in 29 patients (0.6%). The risk of high spinal was significantly different according to BMI (p = 0.025). In a multivariate model, BMI (p = 0.008) and cesarean delivery priority (p = 0.009) were associated with high blocks. BMI ≥50 kg/m 2 was associated with greater odds of high block compared to BMI <30 kg/m 2 [odds ratio (95% confidence interval): 6.3 (2.2, 18.5)]. Scheduled cesarean delivery was also associated with greater odds of high block compared with unscheduled delivery. At standard spinal doses of hyperbaric bupivacaine used in our practice (≥10.5 mg), there were greater odds of high block in those with BMI ≥50 kg/m 2 .

Robotic hysterectomy strategies in the morbidly obese patient.

PubMed

Almeida, Oscar D

2013-01-01

The purpose of this study was to present strategies for performing computer-enhanced telesurgery in the morbidly obese patient. This was a prospective, institutional review board-approved, descriptive feasibility study (Canadian Task Force classification II-2) conducted at a university-affiliated hospital. Twelve class III morbidly obese women with a body mass index of 40 kg/m(2) or greater were selected to undergo robotic-assisted total laparoscopic hysterectomy. Robotic-assisted total laparoscopic hysterectomy, classified as type IVE, with complete detachment of the cardinal-uterosacral ligament complex, unilateral or bilateral, with entry into the vagina was performed. The median estimated blood loss was 146.3 mL (range, 15-550 mL), the mean length of stay in the hospital was 25.3 hours (range, 23- 48 hours), and the complication rate was 0%. The rate of conversion to laparotomy was 8%. The median surgical time was 109.6 minutes (range, 99 -145 minutes). Robotic-assisted total laparoscopic hysterectomy can be a safe and effective method of performing hysterectomies in select morbidly obese patients, allowing them the opportunity to undergo minimally invasive surgery without increased perioperative complications.

Risk factors for psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment.

PubMed

Volgsten, Helena; Skoog Svanberg, Agneta; Ekselius, Lisa; Lundkvist, Orjan; Sundström Poromaa, Inger

2010-03-01

To identify risk factors associated with depression and anxiety in infertile women and men undergoing in vitro fertilization (IVF). Prospective study. A university hospital in Sweden during a 2-year period. 825 participants (413 women and 412 men). Primary Care Evaluation of Mental Disorders (PRIME-MD), based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), as the diagnostic tool for evaluating mood and anxiety disorders, and fertility history and outcome of IVF treatment collected from the patients' medical records. Risk factors associated with depression and anxiety disorders. A negative pregnancy test and obesity were the independent risk factors for any mood disorders in women. Among men, the only independent risk factor for depression was unexplained infertility. No IVF-related risk factors could be identified for any anxiety disorder. A negative pregnancy test is associated with an increased risk for depression in women undergoing IVF, but no risk of developing anxiety disorders is associated with the pregnancy test result after IVF. Pregnancy test results were not a risk factor for depression or anxiety among men. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Obesity as an emerging risk factor for iron deficiency.

PubMed

Aigner, Elmar; Feldman, Alexandra; Datz, Christian

2014-09-11

Iron homeostasis is affected by obesity and obesity-related insulin resistance in a many-facetted fashion. On one hand, iron deficiency and anemia are frequent findings in subjects with progressed stages of obesity. This phenomenon has been well studied in obese adolescents, women and subjects undergoing bariatric surgery. On the other hand, hyperferritinemia with normal or mildly elevated transferrin saturation is observed in approximately one-third of patients with metabolic syndrome (MetS) or nonalcoholic fatty liver disease (NAFLD). This constellation has been named the "dysmetabolic iron overload syndrome (DIOS)". Both elevated body iron stores and iron deficiency are detrimental to health and to the course of obesity-related conditions. Iron deficiency and anemia may impair mitochondrial and cellular energy homeostasis and further increase inactivity and fatigue of obese subjects. Obesity-associated inflammation is tightly linked to iron deficiency and involves impaired duodenal iron absorption associated with low expression of duodenal ferroportin (FPN) along with elevated hepcidin concentrations. This review summarizes the current understanding of the dysregulation of iron homeostasis in obesity.

Insulin resistance and polycystic ovary syndrome.

PubMed

Galluzzo, Aldo; Amato, Marco Calogero; Giordano, Carla

2008-09-01

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in humans, affecting approximately 7-8% of women of reproductive age. Despite the criteria adopted, PCOS is considered to be a predominantly hyperandrogenetic syndrome and the evaluation of metabolic parameters and insulin sensitivity is not mandatory. Most women with PCOS also exhibit features of the metabolic syndrome, including insulin resistance, obesity and dyslipidaemia. While the association with type 2 diabetes is well established, whether the incidence of cardiovascular disease is increased in women with PCOS remains unclear. Acknowledging the strong impact of insulin-resistance in the genesis of PCOS could be helpful not only to make the diagnosis more robust, but also for conferring better cardiovascular risk prevention. Several current studies support a strong recommendation that women with PCOS should undergo comprehensive evaluation for the metabolic syndrome and recognized cardiovascular risk factors, and receive appropriate treatment as needed. Lifestyle modifications remain the first-line therapy for all obese women with PCOS. However, many of these women do not lose weight easily. Insulin-sensitizing drugs are discussed as a promising and unique therapeutic option for the chronic treatment of PCOS.

High Intensity Interval Training Increases Natural Killer Cell Number and Function in Obese Breast Cancer-challenged Mice and Obese Women.

PubMed

Barra, Nicole G; Fan, Isabella Y; Gillen, Jenna B; Chew, Marianne; Marcinko, Katarina; Steinberg, Gregory R; Gibala, Martin J; Ashkar, Ali A

2017-12-01

High intensity interval training (HIIT) boosts natural killer (NK) cell number and activity in normal weight breast cancer patients; however, whether this occurs in obese individuals is not well established. The goal of this study was to determine whether HIIT effectively boosts NK cells as a therapeutic strategy against breast cancer in an obese mouse model and in overweight/obese women. Diet induced female C57Bl/6 obese mice were assigned to undergo HIIT for four weeks or remain sedentary. Female participants were subjected to a six weeks HIIT protocol. HIIT mice acclimatized to treadmill running were subsequently injected with 5 × 10 5 polyoma middle T (MT) breast cancer cells intravenously. NK cell number and activation were monitored using flow cytometry, and tumor burden or lipid content evaluated from histological lung and liver tissues, respectively. In both mice and humans, circulating NK cell number and activation (CD3-NK1.1+CD27+ and CD3-CD56+, respectively) markedly increased immediately after HIIT. HIIT obese mice had reduced lung tumor burden compared to controls following MT challenge, and had diminished hepatic lipid deposition despite minimal body weight loss. Our findings demonstrate that HIIT can benefit obese individuals by enhancing NK cell number and activity, reducing tumor burden, and enhancing metabolic health.

High Intensity Interval Training Increases Natural Killer Cell Number and Function in Obese Breast Cancer-challenged Mice and Obese Women

PubMed Central

Barra, Nicole G.; Fan, Isabella Y.; Gillen, Jenna B.; Chew, Marianne; Marcinko, Katarina; Steinberg, Gregory R.; Gibala, Martin J.; Ashkar, Ali A.

2017-01-01

High intensity interval training (HIIT) boosts natural killer (NK) cell number and activity in normal weight breast cancer patients; however, whether this occurs in obese individuals is not well established. The goal of this study was to determine whether HIIT effectively boosts NK cells as a therapeutic strategy against breast cancer in an obese mouse model and in overweight/obese women. Diet induced female C57Bl/6 obese mice were assigned to undergo HIIT for four weeks or remain sedentary. Female participants were subjected to a six weeks HIIT protocol. HIIT mice acclimatized to treadmill running were subsequently injected with 5 × 105 polyoma middle T (MT) breast cancer cells intravenously. NK cell number and activation were monitored using flow cytometry, and tumor burden or lipid content evaluated from histological lung and liver tissues, respectively. In both mice and humans, circulating NK cell number and activation (CD3−NK1.1+CD27+ and CD3−CD56+, respectively) markedly increased immediately after HIIT. HIIT obese mice had reduced lung tumor burden compared to controls following MT challenge, and had diminished hepatic lipid deposition despite minimal body weight loss. Our findings demonstrate that HIIT can benefit obese individuals by enhancing NK cell number and activity, reducing tumor burden, and enhancing metabolic health. PMID:29302585

Morbid obesity and pregnancy outcomes after single blastocyst transfer: a retrospective, North American study.

PubMed

Russo, Miguel; Ates, Senem; Shaulov, Talya; Dahan, Michael H

2017-04-01

Maternal obesity has been shown to affect reproductive function and pregnancy outcomes following in vitro fertilization. More recently, studies have demonstrated lower live birth rates after single blastocyst transfer (SBT) in patients who are overweight or obese. However, the impact of morbid obesity on pregnancy outcomes after SBT has not been well elucidated. The present study aimed to determine whether morbid obesity has a detrimental impact on pregnancy outcomes after SBT in a North American population. A retrospective, cohort study including 520 nulliparous and multiparous women undergoing top-quality SBT between August 2010 and March 2014 at a University Health Centre in North America was conducted. Primary outcomes included: miscarriage rate, clinical pregnancy rate, and live birth rate. Subjects were divided into different BMI categories (kg/m 2 ), including <20, 20-24.9, 25.0-29.9, 30-40, and 40 or more. The miscarriage rate per pregnancy for each group, respectively, was 36, 64, 59, 61, and 50% (p = 0.16); the clinical pregnancy (per patient) rate per group was 36, 52, 38, 26, and 10% (p = 0.009); and the live birth rate (per patient) per group was 35, 50, 38, 26 and 10% (p = 0.03). Morbid obesity is a strong and independent predictor of poor pregnancy outcomes in patients undergoing top-quality SBT.

Sexual satisfaction following bariatric surgery: A prospective exploratory study.

PubMed

Ferrer-Márquez, Manuel; Pomares-Callejón, María Ángeles; Fernández-Agis, Inmaculada; Belda-Lozano, Ricardo; Vidaña-Márquez, Elisabet; Soriano-Maldonado, Alberto

2017-11-01

Bariatric surgery improves sexual function in obese individuals, although the extent to which sexual satisfaction is improved following surgery is unknown. The aims of this study were 1) to describe sexual satisfaction in severely/morbidly obese men and women candidates for bariatric surgery; 2) to assess the effects of bariatric surgery on sexual satisfaction at 12-months follow-up; and 3) to assess whether weight changes at follow-up following bariatric surgery are associated with changes in sexual satisfaction. We conducted a prospective observational study from February 2011 to June 2014. A total of 44 patients with severe/morbid obesity participated in the study. Sexual satisfaction was assessed (at baseline and 12-months follow-up) through the Index of Sexual Satisfaction (ISS) questionnaire. Of 44 patients who completed the ISS at baseline (mean age 40.3 [SD=9.4] years and BMI 46.9 [SD=6.2] kg/m 2 ), 17 were lost to follow-up. The baseline ISS total scores were 32.0 (SD=20.1) in women and 24.4 (SD=16.0) in men (P>0.05). The proportion of sexually satisfied men and women at baseline was 62.5% and 46.4%, respectively (P=0.360). At follow-up, sexual satisfaction improved significantly in women (average difference 13.7 units; P=0.032) but not in men (average difference 3.6 units; P=0.717). The percentage of women with sexual satisfaction problems was reduced by 33% at follow-up (P=0.038). A relatively large percentage of severely/morbidly obese women and men present clinically significant sexual satisfaction problems before undergoing bariatric surgery. Sexual satisfaction improves significantly 12 months following bariatric surgery, particularly in women. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Obesity paradox in patients undergoing coronary intervention: A review

PubMed Central

Patel, Nirav; Elsaid, Ossama; Shenoy, Abhishek; Sharma, Abhishek; McFarlane, Samy I

2017-01-01

There is strong relationship exist between obesity and cardiovascular disease including coronary artery disease (CAD). However, better outcomes noted in obese patients undergoing percutaneous cardiovascular interventions for CAD, a phenomenon known as the obesity paradox. In this review, we performed extensive search for obesity paradox in obese patients undergoing percutaneous coronary intervention and discussed possible mechanism and disparities in different race and sex. PMID:29081905

Serum Cholinesterase Is Inversely Associated with Body Weight Change in Men Undergoing Routine Health Screening.

PubMed

Oda, Eiji

2015-01-01

The purpose of this study is to investigate the relationships between serum cholinesterase and body weight change, in addition to incident obesity defined as a body mass index (BMI) of 25 kg/m(2) or greater. A retrospective 5-year follow-up study was conducted. The crude incidence and hazard ratios (HRs) of obesity adjusted for the BMI and other confounders were calculated for cholinesterase quartiles in 1,412 men and 921 women. Partial correlation coefficients (PCCs) were calculated between cholinesterase and changes in the BMI during the 5-year follow-up period adjusted for age and other confounders and the change in the BMI were compared among cholinesterase quartiles in 1,223 men and 681 women. During the 5-year follow-up period, 149 men (10.6%) and 65 women (7.1%) developed obesity. The adjusted HRs of obesity decreased, although the crude incidence of obesity increased along the quartiles of cholinesterase in men. The adjusted HRs of obesity for the first (lowest), second and third quartiles of cholinesterase were 2.02 (p=0.006), 1.45 (p=0.122), and 1.28 (p=0.265), respectively compared with the highest quartile in men. The PCC between the baseline level of cholinesterase and change in the BMI was -0.16 (p<0.001) in men. The mean changes in BMI for 5 years were 0.31 kg/m(2), 0.17 kg/m(2), 0.01 kg/m(2) and -0.04 kg/m(2), respectively in the first, second, third and fourth quartiles of cholinesterase in men (p=0.005). Neither incident obesity nor weight gain was significantly associated with cholinesterase in women. The serum cholinesterase level was inversely associated with body weight change, as well as incident obesity, after adjusted for the BMI in men.

Effects of sex and obesity on gait biomechanics before and six months after total knee arthroplasty: A longitudinal cohort study.

PubMed

Paterson, K L; Sosdian, L; Hinman, R S; Wrigley, T V; Kasza, J; Dowsey, M; Choong, P; Bennell, K L

2018-03-01

Gait biomechanics, sex, and obesity can contribute to suboptimal outcomes from primary total knee arthroplasty. The aims of this study were to i) determine if sex and/or obesity influence the amount of change in gait biomechanics from pre-surgery to six months post-surgery and; ii) assess if gait returns to normal in men and women. Three-dimensional gait analysis was performed on 43 patients undergoing primary total knee arthroplasty for knee osteoarthritis (pre- and six months post-operative) and 40 asymptomatic controls. Mixed linear regression models were fit to assess which factors influenced change in gait biomechanics within the arthroplasty cohort, and interaction terms were included to assess if biomechanics returned to normal following surgery. Male peak knee adduction moment (p < 0.001) and impulse (p < 0.001) decreased six months following arthroplasty, whilst gait in women remained unchanged after surgery. Obesity did not influence gait changes in men or women. Gait of female arthroplasty participants did not differ from female controls after surgery except for sagittal plane knee range of motion (p = 0.003), whilst men differed from controls for peak knee adduction moment (p = 0.011), knee range of motion (p < 0.001), and peak knee flexion moment (p < 0.001). Sex, but not obesity, influenced changes in gait biomechanics after arthroplasty. Men retained abnormal gait patterns after surgery, whilst women did not. Further research should determine the long-term implications of gait abnormalities seen in men after arthroplasty. Copyright © 2018 Elsevier B.V. All rights reserved.

Prevention of diabetes and cardiovascular disease in women with PCOS: treatment with insulin sensitizers.

PubMed

Sharma, Susmeeta T; Nestler, John E

2006-06-01

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in United States, affecting 6-10% of females in the reproductive age group. Recent studies have shown that insulin resistance plays an important role in the pathogenesis of PCOS. Traditionally, management of PCOS consisted mainly of ovulation induction, treatment of acne and hirsutism, and prevention of endometrial cancer. However, with mounting evidence showing that PCOS is associated with dysmetabolic syndrome and an increased risk for developing diabetes and heart disease, this can no longer be our sole focus. Current data support a strong recommendation that women with PCOS should undergo comprehensive evaluation for diabetes and recognized cardiovascular risk factors and receive appropriate treatment as needed. Lifestyle modifications remain the first-line therapy for all obese women with PCOS. However, many obese women with PCOS find weight loss difficult to achieve and maintain, and this is not an option for lean women with PCOS. For these reasons, insulin-sensitizing drugs are proving to be a promising and unique therapeutic option for chronic treatment of PCOS.

Obesity as an Emerging Risk Factor for Iron Deficiency

PubMed Central

Aigner, Elmar; Feldman, Alexandra; Datz, Christian

2014-01-01

Iron homeostasis is affected by obesity and obesity-related insulin resistance in a many-facetted fashion. On one hand, iron deficiency and anemia are frequent findings in subjects with progressed stages of obesity. This phenomenon has been well studied in obese adolescents, women and subjects undergoing bariatric surgery. On the other hand, hyperferritinemia with normal or mildly elevated transferrin saturation is observed in approximately one-third of patients with metabolic syndrome (MetS) or nonalcoholic fatty liver disease (NAFLD). This constellation has been named the “dysmetabolic iron overload syndrome (DIOS)”. Both elevated body iron stores and iron deficiency are detrimental to health and to the course of obesity-related conditions. Iron deficiency and anemia may impair mitochondrial and cellular energy homeostasis and further increase inactivity and fatigue of obese subjects. Obesity-associated inflammation is tightly linked to iron deficiency and involves impaired duodenal iron absorption associated with low expression of duodenal ferroportin (FPN) along with elevated hepcidin concentrations. This review summarizes the current understanding of the dysregulation of iron homeostasis in obesity. PMID:25215659

Severity of coronary artery disease in obese patients undergoing coronary angiography: "obesity paradox" revisited.

PubMed

Niraj, Ashutosh; Pradhan, Jyotiranjan; Pradahan, Jyotiranjan; Fakhry, Hesham; Veeranna, Vikas; Afonso, Luis

2007-08-01

Recent studies have highlighted the existence of an 'obesity paradox' in patients undergoing coronary angiography, i.e., a high body mass Index (BMI) is associated with less severe coronary lesions. We sought to confirm the existence of this phenomenon in the US patient population. Study subjects included 770 consecutive patients (470 men, 428 African-Americans, 212 Caucasians) referred for coronary angiography to a tertiary care center. Duke myocardial jeopardy score, a prognostication tool predictive of 1-year mortality in coronary artery disease (CAD) patients, was assigned to angiographic data. Patients were classified according to their BMI (kg/m2) as normal (21-24), overweight (25-29), obesity class I (30-34), class II (35-39) and class III (40 or above). Patients in the increasing obesity class had a higher prevalence of diabetes, hypertension and dyslipidemia and were more likely to be women. A negative correlation was observed between BMI and age (R = - 0.15 p < 0.001) as well as between BMI and Duke Jeopardy score (r = - 0.07, p < 0.05) indicating that patients with higher BMI were referred for coronary angiography at a younger age, and had a lower coronary artery disease (CAD) burden. BMI was not an independent predictor of coronary lesion severity on multivariate stepwise linear regression analysis. Obese patients are referred for coronary angiography at an earlier age and have a lower CAD burden lending further credence to the existence of an apparent "obesity paradox". However, obesity per se, after adjustment for comorbidities, is not an independent predictor of severity of coronary artery disease. (c) 2007 Wiley Periodicals, Inc.

Decreased maternal hypothalamic-pituitary-adrenal axis activity in very severely obese pregnancy: Associations with birthweight and gestation at delivery.

PubMed

Stirrat, Laura I; O'Reilly, James R; Barr, Sarah M; Andrew, Ruth; Riley, Simon C; Howie, Alexander F; Bowman, Maria; Smith, Roger; Lewis, John G; Denison, Fiona C; Forbes, Shareen; Seckl, Jonathan R; Walker, Brian R; Norman, Jane E; Reynolds, Rebecca M

2016-01-01

The maternal hypothalamic-pituitary-adrenal-axis (HPAA) undergoes dramatic activation during pregnancy. Increased cortisol and corticotrophin-releasing-hormone (CRH) associate with low birthweight and preterm labor. In non-pregnant obesity, the HPAA is activated but circulating cortisol levels are normal or lower than in lean women. We hypothesized that maternal cortisol levels would be lower in obese pregnancy, and would associate with increased fetal size and length of gestation. Fasting serum cortisol was measured at 16, 28 and 36 weeks gestation and at 3-6 months postpartum in 276 severely obese and 135 lean women. In a subset of obese (n=20) and lean (n=20) we measured CRH, hormones that regulate bioavailable cortisol (corticosteroid-binding-globulin, estradiol, estriol, and progesterone). Urinary glucocorticoid metabolites were measured in pregnant (obese n=6, lean n=5) and non-pregnant (obese n=7, lean n=7) subjects. Maternal cortisol and HPAA hormones were lower in obese pregnancy. Total urinary glucocorticoid metabolites increased significantly in lean pregnancy, but not in obese. Lower maternal cortisol in obese tended to be associated with increased birthweight (r=-0.13, p=0.066). In obese, CRH at 28 weeks correlated inversely with gestational length (r=-0.49, p=0.04), and independently predicted gestational length after adjustment for confounding factors (mean decrease in CRH of -0.25 pmol/L (95% CI -0.45 to -0.043 pmol/L) per/day increase in gestation). In obese pregnancy, lower maternal cortisol without an increase in urinary glucocorticoid clearance may indicate a lesser activation of the HPAA than in lean pregnancy. This may offer a novel mechanism underlying increased birthweight and longer gestation in obese pregnancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prospective data collection of a new procedure by a specialty society: the FIBROID registry.

PubMed

Myers, Evan R; Goodwin, Scott; Landow, Wendy; Mauro, Matthew; Peterson, Eric; Pron, Gaylene; Spies, James B; Worthington-Kirsch, Robert

2005-07-01

To describe registry methods and baseline patient demographics from a national sample of women undergoing uterine artery embolization for uterine leiomyomata. Interventional radiology practices were recruited to submit data by a secure Web site on women undergoing uterine artery embolization for symptomatic leiomyomata. Baseline data included patient demographics, prior medical, surgical, and obstetrical history, uterine anatomy, and quality-of-life measures. Subsequent data collected included details of the uterine artery embolization procedure and hospital stay and outcomes at 30 days; patients were also offered the opportunity to participate in longer-term follow-up. Characteristics of white and African-American women were compared using t tests, chi(2), or Wilcoxon rank-sum tests as appropriate. As of December 31, 2002, 3,319 uterine artery embolization cases had been entered into the registry by 72 sites; number of patients entered by individual sites ranged from 1 to 514. Of these patients, 95.4% consented to participation in the short-term outcomes registry. Forty-eight percent of patients were African American, and 44.4% were white and non-Hispanic. Heavy menstrual bleeding was the single most bothersome symptom in 64.3% of patients. Compared with white non-Hispanic women, African-American women were significantly younger, more likely to be obese, had larger uteri and more numerous leiomyomata, more severe symptoms, and poorer quality-of-life scores before treatment. It is feasible to collect prospective data on new technologies. The FIBROID Registry prospectively collected data on more than 3,000 women undergoing uterine artery embolization for symptomatic leiomyomata. Baseline patient characteristics of this patient population seem to be similar to those of women undergoing other procedures for leiomyomata. III.

Wound Complication Rates After Staples or Suture for Midline Vertical Skin Closure in Obese Women: A Randomized Controlled Trial.

PubMed

Kuroki, Lindsay M; Mullen, Mary M; Massad, L Stewart; Wu, Ningying; Liu, Jingxia; Mutch, David G; Powell, Matthew A; Hagemann, Andrea R; Thaker, Premal H; McCourt, Carolyn K; Novetsky, Akiva P

2017-07-01

To compare wound complication rates after skin closure with staples and subcuticular suture in obese gynecology patients undergoing laparotomy through a midline vertical incision. In this randomized controlled trial, women with body mass indexes (BMIs) of 30 or greater undergoing surgery by a gynecologic oncologist through a midline vertical incision were randomized to skin closure with staples or subcuticular 4-0 monofilament suture. The primary outcome was the rate of wound complication, defined as the presence of a wound breakdown, or infection, within 8 weeks postoperatively. Secondary outcomes included operative time, Stony Brook scar cosmetic score, and patient satisfaction. A sample size of 162 was planned to detect a 50% reduction in wound complications. At planned interim review (n=82), there was no significant difference in primary outcome. Between 2013 and 2016, 163 women were analyzed, including 84 who received staples and 79 suture. Women who received staples were older (mean age 59 compared with 57 years), had lower mean BMI (37.3 compared with 38.9), and fewer benign indications for surgery (22 compared with 27). There were no differences in wound complication rates between staple compared with suture skin closure (28 [33%] compared with 25 [32%], relative risk 1.05, 95% confidence interval [CI] 0.68-1.64). Women with staples reported worse median cosmetic scores (four of five compared with five of five, P<.001), darker scar color (37 [49%] compared with 13 [18%], relative risk 2.69, 95% CI 1.57-4.63), and more skin marks (30 [40%] compared with three [4%], relative risk 9.47, 95% CI 3.02-29.65) compared with women with suture closure. There was no group difference regarding satisfaction with their scar. Stepwise multivariate analysis revealed BMI (odds ratio [OR] 1.13, 95% CI 1.07-1.20), maximum postoperative glucose (OR 1.01, 95% CI 1.00-1.01), and cigarette smoking (OR 4.96, 95% CI 1.32-18.71) were correlates of wound complication. Closure of midline vertical skin incisions with subcuticular suture does not reduce surgical site wound complications compared with staples in obese gynecology patients. ClinicalTrials.gov, NCT01977612.

In women with polycystic ovary syndrome and obesity, loss of intra-abdominal fat is associated with resumption of ovulation.

PubMed

Kuchenbecker, Walter K H; Groen, Henk; van Asselt, Sophie J; Bolster, Johanna H T; Zwerver, J; Slart, Riemer H J; Vd Jagt, Erik J; Muller Kobold, Anneke C; Wolffenbuttel, Bruce H R; Land, Jolande A; Hoek, Annemieke

2011-09-01

It is not clear why some anovulatory women with polycystic ovary syndrome (PCOS) and obesity resume ovulation and others remain anovulatory after weight loss. The objective of this study was to compare the changes in body fat distribution and specifically intra-abdominal fat (IAF) and subcutaneous abdominal fat (SAF) between a group of anovulatory women with PCOS and obesity who resume ovulation (RO+) to those who remain anovulatory (RO-) during a lifestyle program. In a prospective pilot cohort study, anovulatory women with PCOS underwent a 6 month lifestyle program in a tertiary fertility clinic. Body fat distribution was assessed by anthropometrics, dual-energy X-ray absorptiometry (DEXA) and single slice abdominal CT scan at intake, after 3 months and after 6 months. Baseline-corrected changes over time were analysed using generalized estimating equations longitudinal regression analysis. In 32 anovulatory women with PCOS (age, 28 ± 4 years; BMI, 37.5 ± 5.0 kg/m²), there were no significant baseline differences in anthropometrics and biochemical assessment between 14 RO+ participants and 18 RO- participants. RO+ women lost more weight (6.3 versus 3.0%) and abdominal fat on DEXA (15.0 versus 4.3%) compared with RO- women. Resumption of ovulation was associated with early and consistent loss of IAF (12.4 versus 5.0% at 3 months and 18.5 versus 8.6% at 6 months). Loss of SAF between the RO+ women and the RO- women was similar at 3 months (6.2 versus 6.1%) but did not change any further in RO- women (6.1%) as it did in RO+ women (11.4%) at 6 months. In anovulatory women with PCOS and obesity undergoing a lifestyle program, RO+ women lose more body weight and abdominal fat on DEXA than RO- women. In addition, this study shows that early and consistent loss of IAF is associated with resumption of ovulation. Future studies should address the mechanisms behind these changes and should assess interventions aimed at loss of IAF to facilitate resumption of ovulation.

Association of Patient Age at Gastric Bypass Surgery With Long-term All-Cause and Cause-Specific Mortality.

PubMed

Davidson, Lance E; Adams, Ted D; Kim, Jaewhan; Jones, Jessica L; Hashibe, Mia; Taylor, David; Mehta, Tapan; McKinlay, Rodrick; Simper, Steven C; Smith, Sherman C; Hunt, Steven C

2016-07-01

Bariatric surgery is effective in reducing all-cause and cause-specific long-term mortality. Whether the long-term mortality benefit of surgery applies to all ages at which surgery is performed is not known. To examine whether gastric bypass surgery is equally effective in reducing mortality in groups undergoing surgery at different ages. All-cause and cause-specific mortality rates and hazard ratios (HRs) were estimated from a retrospective cohort within 4 categories defined by age at surgery: younger than 35 years, 35 through 44 years, 45 through 54 years, and 55 through 74 years. Mean follow-up was 7.2 years. Patients undergoing gastric bypass surgery seen at a private surgical practice from January 1, 1984, through December 31, 2002, were studied. Data analysis was performed from June 12, 2013, to September 6, 2015. A cohort of 7925 patients undergoing gastric bypass surgery and 7925 group-matched, severely obese individuals who did not undergo surgery were identified through driver license records. Matching criteria included year of surgery to year of driver license application, sex, 5-year age groups, and 3 body mass index categories. Roux-en-Y gastric bypass surgery. All-cause and cause-specific mortality compared between those undergoing and not undergoing gastric bypass surgery using HRs. Among the 7925 patients who underwent gastric bypass surgery, the mean (SD) age at surgery was 39.5 (10.5) years, and the mean (SD) presurgical body mass index was 45.3 (7.4). Compared with 7925 matched individuals not undergoing surgery, adjusted all-cause mortality after gastric bypass surgery was significantly lower for patients 35 through 44 years old (HR, 0.54; 95% CI, 0.38-0.77), 45 through 54 years old (HR, 0.43; 95% CI, 0.30-0.62), and 55 through 74 years old (HR, 0.50; 95% CI, 0.31-0.79; P < .003 for all) but was not lower for those younger than 35 years (HR, 1.22; 95% CI, 0.82-1.81; P = .34). The lack of mortality benefit in those undergoing gastric bypass surgery at ages younger than 35 years primarily derived from a significantly higher number of externally caused deaths (HR, 2.53; 95% CI, 1.27-5.07; P = .009), particularly among women (HR, 3.08; 95% CI, 1.4-6.7; P = .005). Patients undergoing gastric bypass surgery had a significantly lower age-related increase in mortality than severely obese individuals not undergoing surgery (P = .001). Gastric bypass surgery was associated with improved long-term survival for all patients undergoing surgery at ages older than 35 years, with externally caused deaths only elevated in younger women. Gastric bypass surgery is protective against mortality even for older patients and also reduces the age-related increase in mortality observed in severely obese individuals not undergoing surgery.

Effects of obesity and diabetes on rate of bone density loss.

PubMed

Leslie, W D; Morin, S N; Majumdar, S R; Lix, L M

2018-01-01

In this large registry-based study, women with diabetes had marginally greater bone mineral density (BMD) loss at the femoral neck but not at other measurement sites, whereas obesity was not associated with greater BMD loss. Our data do not support the hypothesis that rapid BMD loss explains the increased fracture risk associated with type 2 diabetes and obesity observed in prior studies. Type 2 diabetes and obesity are associated with higher bone mineral density (BMD) which may be less protective against fracture than previously assumed. Inconsistent data suggest that rapid BMD loss may be a contributing factor. We examined the rate of BMD loss in women with diabetes and/or obesity in a population-based BMD registry for Manitoba, Canada. We identified 4960 women aged ≥ 40 years undergoing baseline and follow-up BMD assessments (mean interval 4.3 years) without confounding medication use or large weight fluctuation. We calculated annualized rate of BMD change for the lumbar spine, total hip, and femoral neck in relation to diagnosed diabetes and body mass index (BMI) category. Baseline age-adjusted BMD was greater in women with diabetes and for increasing BMI category (all P < 0.001). In women with diabetes, unadjusted BMD loss was less at the lumbar spine (P = 0.017), non-significantly greater at the femoral neck (P = 0.085), and similar at the total hip (P = 0.488). When adjusted for age and BMI, diabetes was associated with slightly greater femoral neck BMD loss (- 0.0018 g/cm 2 /year, P = 0.012) but not at the lumbar spine or total hip. There was a strong linear effect of increasing BMI on attenuated BMI loss at the lumbar spine with negligible effects on hip BMD. Diabetes was associated with slightly greater BMD loss at the femoral neck but not at other measurement sites. BMD loss at the lumbar spine was reduced in overweight and obese women but BMI did not significantly affect hip BMD loss.

Contraceptive Use Before and After Gastric Bypass: a Questionnaire Study.

PubMed

Ginstman, Charlotte; Frisk, Jessica; Ottosson, Johan; Brynhildsen, Jan

2015-11-01

At present, women are recommended to avoid pregnancy 12-18 months after bariatric surgery. Our aim in this study was to describe patterns of contraceptive use before and after gastric bypass in Sweden, and to describe the contraceptive counseling given preoperatively to women undergoing gastric bypass. In October 2012, a questionnaire was sent to 1000 Swedish women who all had undergone gastric bypass during 2010. The women had been included in the Scandinavian Obesity Surgery Register at time of surgery. The main outcome measures were patterns of use of contraception before and after bariatric surgery. The response rate was 57 %. The most commonly used contraceptive methods were intrauterine devices, 29 % preoperatively and 26 % postoperatively even though there was a postoperative switch from the copper intrauterine device to the levonorgestrel intrauterine system. Thirty percent did not use any contraceptive during the first 12 months after surgery. Sixty percent of the responders were aware of the recommendations to avoid pregnancy after surgery. Many women who undergo bariatric surgery are not using any contraceptive method despite the recommendation that they should avoid pregnancy for at least 12 months. There is a great need to improve contraceptive counseling for this growing group of women.

The impact of testosterone imbalance on depression and women's health.

PubMed

Rohr, Uwe D

2002-04-15

Women suffer more often from depression than males, indicating that hormones might be involved in the etiology of this disease. Low as well as high testosterone (T) levels are related to depression and well-being in women, T plasma levels correlate to depression in a parabolic curve: at about 0.4-0.6 ng/ml plasma free T a minimum of depression is detected. Lower levels are related to depression, osteoporosis, declining libido, dyspareunia and an increase in total body fat mass. Androgen levels in women decrease continuously to about 50% before menopause compared to a 20-year-old women. Androgen levels even decline 70% within 24 h when women undergo surgical removal of the ovaries. Conventional oral contraception or HRT cause a decline in androgens because of higher levels of SHBG. Hyperandrogenic states exist, like hirsutism, acne and polycystic ovary syndrome. Social research suggests high androgen levels cause aggressive behavior in men and women and as a consequence may cause depression. Higher androgen values are more pronounced at young ages and before and after delivery of a baby and might be responsible for the "baby blues". It was found that depression in pubertal girls correlated best with an increase in T levels in contrast to the common belief that "environmental factors" during the time of growing up might be responsible for emotional "up and downs". T replacement therapy might be useful in perimenopausal women suffering from hip obesity, also named gynoid obesity. Abdominal obesity in men and women is linked to type 2 diabetes and coronary heart diseases. Testosterone replacement therapy in hypoandrogenic postmenopausal women might not only protect against obesity but also reduce the risk of developing these diseases. Antiandrogenic progestins might be useful for women suffering from hyperandrogenic state in peri- and postmenopause. Individual dosing schemes balancing side effects and beneficial effects are absolutely necessary. Substantial interindividual variability in T plasma values exists, making it difficult to utilize them for diagnostic purposes. Therefore a "four-level-hormone classification scheme" was developed identifying when estradiol (E) and T levels are out of balance. (1) Low E-low T levels are correlated with osteoporosis, depression, and obesity; (2) high E-low T with obesity, decreased libido; (3) high T-low E levels with aggression, depression, increased libido, and substance abuse; (4) high E-high T with type II diabetes risk, breast cancer and cardiovascular risk. Testosterone delivery systems are needed where beneficial and negative effects can be balanced. Any woman diagnosed for osteoporosis should be questioned for symptoms of depression.

Gender differences in risk profile and outcome of Middle Eastern patients undergoing percutaneous coronary intervention.

PubMed

Jarrah, Mohamad I; Hammoudeh, Ayman J; Al-Natour, Dalal B; Khader, Yousef S; Tabbalat, Ramzi A; Alhaddad, Imad A; Kullab, Susan M

2017-02-01

To determine the gender differences in cardiovascular risk profile and outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods: In a prospective multicenter study of consecutive Middle Eastern patients managed with PCI from January 2013 to February 2014 in 12 tertiary care centers in Amman and Irbid, Jordan. Clinical and coronary angiographic features, and major cardiovascular events were assessed for both genders from hospital stay to 1 year. Results: Women comprised 20.6% of 2426 enrolled patients, were older (mean age 62.9 years versus 57.2 years), had higher prevalence of hypertension (81% versus 57%), diabetes (66% versus 44%), dyslipidemia (58% versus 46%), and obesity (44% versus 25%) compared with men, p less than 0.001. The PCI for ST-segment elevation myocardial infarction was indicated for fewer women than men (23% versus 33%; p=0.001). Prevalence of single or multi-vessel coronary artery disease was similar in women and men. More women than men had major bleeding during hospitalization (2.2% versus 0.6%; p=0.003) and at one year (2.5% versus 0.9%; p=0.007). There were no significant differences between women and men in mortality (3.1% versus 1.7%) or stent thrombosis (2.1% versus 1.8%) at 1 year. Conclusion: Middle Eastern women undergoing PCI had worse baseline risk profile compared with men.Except for major bleeding, no gender differences in the incidence of major adverse cardiovascular events were demonstrated.

"Syndrome in syndrome": Wernicke syndrome due to afferent loop syndrome. Case report and review of the literature.

PubMed

D'Abbicco, D; Praino, S; Amoruso, M; Notarnicola, A; Margari, A

2011-01-01

Wernicke syndrome is a rare neurological pathology due to a deficit in vitamin B1. The syndrome is common among alcohol abusers, patients with malignant tumor or gastrointestinal diseases, those who undergo hemodialysis or long-term peritoneal dialysis, pregnant women with hyperemesis, women who breast-feed, patients with hyperthyroidism or anorexia nervosa or gastric or jejunal-ileal bypass surgery for obesity, patients submitted to gastric surgery or prolonged total parenteral nutrition or prolonged intravenous therapy. We report a case of Wernicke syndrome due to afferent loop syndrome characterized by incoercible vomiting.

Waist-hip ratio and 1-year clinical outcome in patients with non-ST-elevation myocardial infarctions.

PubMed

Lee, Hye Won; Hong, Taek Jong; Hong, Ju Young; Choi, Jong Hyun; Kim, Bo Won; Ahn, Jinhee; Park, Jin Sup; Oh, Jun-Hyok; Choi, Jung Hyun; Lee, Han Cheol; Cha, Kwang Soo

2016-08-01

Obesity is a well-known cardiovascular disease risk factor. We evaluated the relationship between the waist-hip ratio (WHR), as a surrogate marker of central obesity, and clinical outcomes in patients with non-ST-segment elevation myocardial infarctions (NSTEMIs) undergoing percutaneous coronary interventions (PCIs). Between 2008 and 2010, NSTEMI patients who underwent PCI and who had available anthropometric data were divided into three groups according to their WHR tertile range. Clinical outcomes in the groups were analyzed. Increasing incidences of hypertension and diabetes mellitus were associated with increasing WHR. As the WHR increased, a disintegration of patient metabolic patterns was documented in laboratory findings. There was no difference in the 1-year mortality rates between the three groups. However, increasing 1-year major adverse cardiovascular event rates were documented as the WHR increased (13, 14.7, and 19.4% in tertile groups 1-3, respectively; P=0.005). After adjusting for confounding variables, the highest tertile group was associated with increased 1-year mortality and major adverse cardiovascular event rates compared with the lowest tertile group. These differences arose from the female subgroup, suggesting that the magnitude of the central obesity effect might be greater in female than in male patients. Central obesity, represented by WHR, was associated with poor clinical outcomes in NSTEMI patients undergoing PCI, particularly among women.

Severe Obesity in Cancer Care.

PubMed

Streu, Erin

2016-05-01

Increasing weight and body fat composition has an impact on cancer detection and staging. Obese women are less likely to engage in breast and cervical screening practices. Excessive adipose tissue makes physical assessment more difficult, and patients with a BMI greater than 35 kg/m2 may have deeper and wider pelvic structures, which make internal examinations problematic. A retrospective review of 324 primary surgical patients found that patients with a BMI greater than 40 kg/m2 are seven times less likely to undergo complete surgical staging for endometrial cancer compared with individuals with a BMI less than 40 kg/m2. In addition, healthcare provider bias against the need for screening, feelings of discomfort and embarrassment, as well as patient's fears of guilt, humiliation, and shame pose significant barriers to addressing the issue of obesity in clinical care with patients and family members. 
.

Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients.

PubMed

Whitlock, Keith G; Piponov, Hristo I; Shah, Sapan H; Wang, Olivia J; Gonzalez, Mark H

2016-12-01

Women present later than men for total knee arthroplasty (TKA) with more severe osteoarthritic disease but achieve comparable functional improvement and implant survival and also lower rates of revision. Despite these findings, there is significant underutilization of the procedure for women compared to men. We conducted a retrospective study to address the lack of information in the literature concerning the immediate and short-term perioperative outcomes between genders. The National Hospital Discharge Survey was evaluated between 2001 and 2010 for men and women undergoing primary TKA in the United States. Differences in gender, patient demographics, comorbidities, complications, length of stay, and discharge disposition were analyzed and identified. The growth in TKA was 145% for men and 131% for women over the 10-year period. Women presented with significantly higher rates of obesity, morbid obesity, postoperative transfusion rate, and length of stay. In contrast, men showed a greater proportion of diabetes, postoperative wound infections, and increased mortality rates. Males were also more likely to be discharged to home, whereas females were more likely to be discharged to rehabilitation facilities. Our findings provide important insight into the perioperative outcomes that may be influencing gender disparity in TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

The influence of tumor necrosis factor-α on the tumorigenic Wnt-signaling pathway in human mammary tissue from obese women.

PubMed

Roubert, Agathe; Gregory, Kelly; Li, Yuyang; Pfalzer, Anna C; Li, Jinchao; Schneider, Sallie S; Wood, Richard J; Liu, Zhenhua

2017-05-30

Epidemiological studies have convincingly suggested that obesity is an important risk factor for postmenopausal breast cancer, but the mechanisms responsible for this relationship are still not fully understood. We hypothesize that obesity creates a low-grade inflammatory microenvironment, which stimulates Wnt-signaling and thereby promotes the development of breast cancer. To test this hypothesis, we evaluated the correlations between expression of multiple inflammatory cytokines and Wnt pathway downstream genes in mammary tissues from women (age ≥ 50) undergoing reduction mammoplasty. Moreover, we specifically examined the role of tumor necrosis factor-α (TNF-α), an important proinflammatory cytokine associated with obesity and a possible modulator of the Wnt pathway. The regulatory effects of TNF-α on Wnt pathway targets were measured in an ex vivo culture of breast tissue treated with anti-TNF-α antibody or TNF-α recombinant protein. We found that BMI was positively associated with the secretion of inflammatory cytokines IL-1β, IL-6 and TNF-α, all of which were negatively correlated with the expression of SFRP1. The transcriptional expression of Wnt-signaling targets, AXIN2 and CYCLIN D1, were higher in mammary tissue from women with BMI ≥ 30 compared to those with BMI < 30. Our ex vivo work confirmed that TNF-α is causally linked to the up-regulation of active β-CATENIN, a key component in the Wnt pathway, and several Wnt-signaling target genes (i.e. CYCLIN D1, AXIN2, P53 and COX-2). Collectively, these findings indicate that obesity-driven inflammation elevates Wnt-signaling in mammary tissue and thereby creates a microenvironment conducive to the development of breast cancer.

Outcomes after elective abdominal aortic aneurysm repair in obese versus nonobese patients.

PubMed

Locham, Satinderjit; Rizwan, Muhammad; Dakour-Aridi, Hanaa; Faateh, Muhammad; Nejim, Besma; Malas, Mahmoud

2018-06-07

Obesity is a worldwide epidemic, particularly in Western society. It predisposes surgical patients to an increased risk of adverse outcomes. The aim of our study was to use a nationally representative vascular database and to compare in-hospital outcomes in obese vs nonobese patients undergoing elective open aortic repair (OAR) and endovascular aneurysm repair (EVAR). All patients undergoing elective abdominal aortic aneurysm repair were identified in the Vascular Quality Initiative database (2003-2017). Obesity was defined as body mass index ≥30 kg/m 2 . Univariable (Student t-test and χ 2  test) and multivariable (logistic regression) analyses were implemented to compare in-hospital mortality and any major complications (wound infection, renal failure, and cardiopulmonary failure) in obese vs nonobese patients. We identified a total of 33,082 patients undergoing elective OAR (nonobese, n = 4605 [72.4%]; obese, n = 1754 [27.6%]) and EVAR (nonobese, n = 18,338 [68.6%]; obese, n = 8385 [31.4%]). Obese patients undergoing OAR and EVAR were relatively younger compared with nonobese patients (mean age [standard deviation], 67.55 [8.26] years vs 70.27 [8.30] years and 71.06 [8.22] years vs 74.55 [8.55] years), respectively; (both P < .001). Regardless of approach, obese patients had slightly longer operative time (OAR, 259.02 [109.97] minutes vs 239.37 [99.78] minutes; EVAR, 138.27 [70.64] minutes vs 134.34 [69.98] minutes) and higher blood loss (OAR, 2030 [1823] mL vs 1619 [1642] mL; EVAR, 228 [354] mL vs 207 [312] mL; both P < .001). There was no significant difference in mortality between the two groups undergoing OAR and EVAR (OAR, 2.9% vs 3.2% [P = .50]; EVAR, 0.5% vs 0.6% [P = .76]). On multivariable analysis, obese patients undergoing OAR had 33% higher odds of renal failure (adjusted odds ratio [OR], 1.33; 95% confidence interval [CI], 1.09-1.63; P = .006) and 75% higher odds of wound infections (adjusted OR, 1.75; 95% CI, 1.11-2.76; P = .02) compared with nonobese patients. However, in patients undergoing EVAR, no association was seen between obesity and any major complications. A significant interaction was found between obesity and surgical approach in the event of renal failure, in which obese patients undergoing OAR had significantly higher odds of renal failure compared with those in the EVAR group (OR interaction , 1.36; 95% CI, 1.05-1.75; P = .02). Using a large nationally representative database, we demonstrated an increased risk of renal failure and wound infections in obese patients undergoing OAR compared with nonobese patients. On the other hand, obesity did not seem to increase the odds of major adverse outcomes in patients undergoing EVAR. Further long-term prospective studies are needed to verify the effects of obesity after abdominal aortic aneurysm repair and the implications of these findings in clinical decision-making. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Food insecurity and the metabolic syndrome among women from low income communities in Malaysia.

PubMed

Shariff, Zalilah Mohd; Sulaiman, Norhasmah; Jalil, Rohana Abdul; Yen, Wong Chee; Yaw, Yong Heng; Taib, Mohd Nasir Mohd; Kandiah, Mirnalini; Lin, Khor Geok

2014-01-01

This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/ obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.

Estradiol increases body weight loss and gut-peptide satiation after Roux-en-Y gastric bypass in ovariectomized rats.

PubMed

Asarian, Lori; Abegg, Kathrin; Geary, Nori; Schiesser, Marc; Lutz, Thomas A; Bueter, Marco

2012-08-01

Despite the fact that ∼85% of bariatric operations are performed in women, the effects of the reproductive axis function on outcome of bariatric surgery remain to be determined. Here we developed the first published model of Roux-en-Y gastric bypass (RYGB) in female rats. We show in ovariectomized rats receiving estradiol or control treatment that (1) RYGB-induced body weight loss and (2) the satiating efficacy of endogenous glucagon-like peptide-1 and cholecystokinin satiation were significantly increased in estradiol-treated rats. These data are relevant to the care of obese women, in particular perimenopausal women, undergoing bariatric surgery. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

Subgingival microbial profile of obese women with periodontal disease.

PubMed

Silva-Boghossian, Carina M; Cesário, Paola C; Leão, Anna Thereza T; Colombo, Ana Paula V

2018-02-01

This study compared the composition of subgingival microbiota between obese and non-obese women with or without periodontal disease. Full-mouth periodontal clinical assessments were carried out in 76 obese women (17 periodontally healthy and 59 with periodontal disease), and 34 non-obese women (12 periodontally healthy, 22 with periodontal disease). Subgingival biofilm samples were individually obtained from seven sites of each individual, and the prevalence and counts of 40 bacterial taxa were determined by the checkerboard method. The frequency and counts of each species were computed for each individual and across the groups. Differences among and between groups were sought by the Kruskal-Wallis and Mann-Whitney tests, respectively. Possible correlations between obesity and clinical and microbiologic parameters were tested with Spearman correlation coefficient. Streptococcus sanguinis, Streptococcus oralis, and Capnocytophaga ochracea were found in significantly higher levels in obese compared with non-obese women (P < 0.01). In patients with periodontal health, Porphyromonas gingivalis and Leptotrichia buccalis were detected in higher mean frequency and/or counts in obese women than in non-obese women, whereas in patients with periodontal disease, obese women harbored greater levels of C. ochracea than non-obese women (P < 0.01). Moreover, obese women with periodontal disease presented significantly greater mean counts of P. gingivalis and Tannerella forsythia than non-obese women with periodontal health (P < 0.01). When the conditions obesity and periodontal disease are present at the same time, significant positive correlations were detected with C. ocharcea, P. gingivalis, S. sanguinis, and T. forsythia. Few differences in the composition of the subgingival microbiota of obese and non-obese women with periodontal health or disease were found. However, a high prevalence of P. gingivalis in obese women with periodontal health was observed. © 2018 American Academy of Periodontology.

Health professionals' experiences providing breastfeeding-related care for obese women.

PubMed

Garner, Christine D; Ratcliff, Stephannie L; Devine, Carol M; Thornburg, Loralei L; Rasmussen, Kathleen M

2014-12-01

Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods. In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively. HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women. HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care.

Obese women experience multiple challenges with breastfeeding that are either unique or exacerbated by their obesity: discoveries from a longitudinal, qualitative study.

PubMed

Garner, Christine D; McKenzie, Shanice A; Devine, Carol M; Thornburg, Loralei L; Rasmussen, Kathleen M

2017-07-01

Obese women are at risk for shorter breastfeeding duration, but little is known about how obese women experience breastfeeding. The aim of this study was to understand obese women's breastfeeding experiences. We enrolled pregnant women in upstate New York, who were either obese [n = 13; body mass index (BMI) ≥30 kg/m 2 ] or normal weight (n = 9; BMI 18.5-24.9 kg/m 2 ) before conception and intended to breastfeed. A longitudinal, qualitative study was conducted from February 2013 through August 2014 with semi-structured interviews during pregnancy and at specific times post-partum through 3 months. Interviews were audio recorded, transcribed and analyzed using content analysis. Themes that emerged in analysis were compared between obese and normal-weight women. Differences were identified and described. Prenatally, obese women expressed less confidence about breastfeeding than normal-weight women. Post-partum, obese women and their infants had more health issues that affected breastfeeding, such as low infant blood glucose. Compared with normal-weight women, they also experienced more challenges with latching and positioning their infants. Breastfeeding required more time, props and pillows, which limited where obese women could breastfeed. Obese women also experienced more difficulty finding nursing bras and required more tangible social support than normal-weight women. In conclusion, obese women experienced more challenges than women of normal weight; some challenges were similar to those of normal-weight women but were experienced to a greater degree or a longer duration. Other challenges were unique. Obese women could benefit from targeted care prenatally and during the hospital stay as well as continued support post-partum to improve breastfeeding outcomes. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

Anesthetic Considerations in Patients Undergoing Bariatric Surgery: A Review Article

PubMed Central

Soleimanpour, Hassan; Safari, Saeid; Sanaie, Sarvin; Nazari, Mehdi; Alavian, Seyed Moayed

2017-01-01

Context This article discusses the anesthetic considerations in patients undergoing bariatric surgery in the preoperative, intraoperative, and postoperative phases of surgery. Evidence Acquisition This review includes studies involving obese patients undergoing bariatric surgery. Searches have been conducted in PubMed, MEDLINE, EMBASE, Google Scholar, Scopus, and Cochrane Database of Systematic Review using the terms obese, obesity, bariatric, anesthesia, perioperative, preoperative, perioperative, postoperative, and their combinations. Results Obesity is a major worldwide health problem associated with many comorbidities. Bariatric surgery has been proposed as the best alternative treatment for extreme obese patients when all other therapeutic options have failed. Conclusions Anesthetists must completely assess the patients before the surgery to identify anesthesia- related potential risk factors and prepare for management during the surgery. PMID:29430407

Health Professionals' Experiences Providing Breastfeeding-Related Care for Obese Women

PubMed Central

Ratcliff, Stephannie L.; Devine, Carol M.; Thornburg, Loralei L.; Rasmussen, Kathleen M.

2014-01-01

Abstract Background: Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods. Materials and Methods: In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively. Results: HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women. Conclusions: HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care. PMID:25347705

Obesity is Not Protective Against Fracture in Postmenopausal Women: GLOW

PubMed Central

Compston, Juliet E.; Watts, Nelson B.; Chapurlat, Roland; Cooper, Cyrus; Boonen, Steven; Greenspan, Susan; Pfeilschifter, Johannes; Silverman, Stuart; Díez-Pérez, Adolfo; Lindsay, Robert; Saag, Kenneth G.; Netelenbos, J. Coen; Gehlbach, Stephen; Hooven, Frederick H.; Flahive, Julie; Adachi, Jonathan D.; Rossini, Maurizio; LaCroix, Andrea Z.; Roux, Christian; Sambrook, Philip N.; Siris, Ethel S.

2016-01-01

OBJECTIVE To investigate the prevalence and incidence of clinical fractures in obese, postmenopausal women enrolled in the Global Longitudinal study of Osteoporosis in Women (GLOW). METHODS This was a multinational, prospective, observational, population-based study carried out by 723 physician practices at 17 sites in 10 countries. A total of 60,393 women aged ≥55 years were included. Data were collected using self-administered questionnaires that covered domains that included patient characteristics, fracture history, risk factors for fracture, and anti-osteoporosis medications. RESULTS Body mass index (BMI) and fracture history were available at baseline, 1 and 2 years in 44,534 women, 23.4% of whom were obese (BMI ≥30 kg/m2). Fracture prevalence in obese women at baseline was 222 per 1,000 and incidence at 2 years was 61.7 per 1,000, similar to rates in non-obese women (227 and 66.0 per 1,000, respectively). Fractures in obese women accounted for 23% and 22% of all previous and incident fractures, respectively. The risk of incident ankle and upper leg fractures was significantly higher in obese than in non-obese women whilst the risk of wrist fracture was significantly lower. Obese women with fracture were more likely to have experienced early menopause and to report two or more falls in the past year. Self-reported asthma, emphysema, and type 1 diabetes were all significantly more common in obese than non-obese women with incident fracture. At 2 years, 27% of obese women with incident fracture were receiving bone-protective therapy, compared with 41% of non-obese and 57% of underweight women. CONCLUSIONS Our results demonstrate that obesity is not protective against fracture in postmenopausal women and is associated with increased risk of ankle and upper leg fractures. These findings have major public health implications in view of the rapidly rising incidence of obesity. Further studies are required to establish the pathogenesis of fractures in the obese population and to develop effective preventive strategies. PMID:22017783

Risk of obstructive sleep apnea in obese and non-obese women with polycystic ovary syndrome and healthy reproductively normal women

PubMed Central

Mokhlesi, Babak; Scoccia, Bert; Mazzone, Theodore; Sam, Susan

2011-01-01

Objective To study the risk for obstructive sleep apnea (OSA) in a group of non-obese and obese PCOS and control women. Women with polycystic ovary syndrome (PCOS) are at high risk for obstructive sleep apnea (OSA). Whether this risk is independent of obesity is not clear. Design/Patients/Interventions/Main Outcome Measures In a prospective study, 44 women with PCOS and 34 control women completed the Berlin questionnaire for assessment of OSA risk. All women underwent fasting determination of androgens, glucose and insulin. Results Women with PCOS were more obese compared to control women (p=0.02). However, there were no differences in BMI once subjects were divided into non-obese (PCOS n=17 and control n=26) and obese (PCOS n=26 and control n=8) groups. Women with PCOS had higher prevalence of high risk OSA compared to control women on the Berlin questionnaire (47% vs. 15%, P<0.01). However, none of the non-obese PCOS and control women screened positive for high risk OSA. Among the obese group, the risk did not differ between groups (77% vs. 63%, P= 0.65). Conclusions Our findings indicate that even though the risk for OSA in PCOS is high, it is related to the high prevalence of severe obesity. The risk for OSA among non-obese women with PCOS is very low. However, our findings are limited by lack of polysomnographic confirmation of OSA. PMID:22264851

'Fat girls' and 'big guys': gendered meanings of weight loss surgery.

PubMed

Newhook, Julia Temple; Gregory, Deborah; Twells, Laurie

2015-06-01

Over 80% of weight loss surgery (WLS) patients are women, yet gender is overwhelmingly absent in WLS research. This article discusses the findings of 54 interviews with twenty-one women and six men waiting for WLS in Newfoundland and Labrador, Canada. We critically examine the ways that gender shapes the meaning of WLS in these narratives. We explore gendered meanings in participants' perspectives on their embodied experiences before surgery, social support as they decided to undergo the procedure, and their expectations for their lives after WLS. We draw on feminist theory to explain how these findings counter the dominant gender-neutral medical model of obesity. © 2015 Foundation for the Sociology of Health & Illness.

Twenty years of ovulation induction with metformin for PCOS; what is the best available evidence?

PubMed

Abu Hashim, Hatem

2016-01-01

The potential reproductive benefits of metformin, a drug endowed with the capacity to ameliorate insulin resistance in polycystic ovary syndrome (PCOS), has garnered much interest over the past 2 decades. In this review, randomized-controlled trials (RCT) and meta-analyses of RCT comparing metformin are critically appraised and summarized. PubMed and CENTRAL databases were consulted. Evidence is insufficient to favour the use of metformin or metformin plus clomiphene citrate instead of clomiphene citrate for ovulation induction in women with newly diagnosed PCOS. Evidence is also insufficient to recommend metformin as a primary treatment for non-obese women with PCOS. Metformin plus clomiphene citrate should be considered as an effective option in clomiphene citrate-resistant PCOS. In women with PCOS undergoing gonadotrophin ovulation induction, metformin significantly increased pregnancy and live birth rates (P < 0.0001 and P = 0.020, respectively) with reduced risk of cancelled cycles. A beneficial effect of metformin co-treatment in increasing clinical pregnancy rates and reducing the risk of OHSS in PCOS patients undergoing assisted reproduction techniques has been shown. No evidence was found of reduced risk of spontaneous abortion or increased risk of major anomalies in women with PCOS taking metformin during the first trimester. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Association of gestational weight gain and pre-pregnancy body mass index with adverse pregnancy outcome.

PubMed

Munim, Shama; Maheen, Humaira

2012-11-01

To determine the association between gestation weight gain (GWG) and adverse pregnancy outcome in a Pakistani population. Analytical study. The Aga Khan University, Karachi, from February 2003 to 2007. This study used secondary data of 4,735 women from a large cohort study on fetal growth. Pre-pregnancy BMI was categorized according to the recommendations from the institute of medicine (IOM, 2009) and gestation weight gain (GWG) was noted. Chi-square test was used to find the association of GWG and pre-pregnancy BMI with low birth weight (LBW), preterm delivery, large for gestational age (LGA), and caesarean section. Logistic regression analysis was performed to control for confounders like age, parity, working status and ethnicity. The prevalence of LBW decreased with increasing BMI. GWG of the population was noted as 8.5 kg. LBW was observed to have an inverse relationship with GWG. Women below the age of 19 were twice more likely to have LBW than above 35 years of age. Weight gain above the recommended range were twice more likely to have large for dates.Overweight women were 1.5 times more likely to deliver preterm whereas obese women were 1.4 times more likely to undergo caesarean section than women with normal BMI. The optimal weight gain was estimated to be 8.5 kg to prevent low birth weight in our population. Obese women are more likely to have LGA, caesarean sections and pre-term deliveries.

Distinct association between educational attainment and overweight/obesity in unmarried and married women: evidence from a population-based study in Japan.

PubMed

Murakami, Keiko; Ohkubo, Takayoshi; Hashimoto, Hideki

2017-11-25

Associations between education and obesity have been consistently reported among women in developed countries, but few studies have considered the influence of marital status and husbands' education. This study aimed to examine differences in the association between education and overweight/obesity by marital status and to determine the contribution of husbands' education to overweight/obesity among community-dwelling Japanese women. A questionnaire survey was conducted from 2010 to 2011 among residents aged 25-50 years in Japanese metropolitan areas. Of 2145 women who agreed to participate and completed the survey, 582 were unmarried and 1563 were married. Overweight/obesity was defined as body mass index ≥25 kg/m 2 . Multiple logistic regression analysis was conducted to determine whether women's or their husbands' education was associated with overweight/obesity after adjusting for age, work status, and equivalent income. The prevalence of overweight/obesity was 11.9% among unmarried women and 10.3% among married women. Women's own education was significantly associated with overweight/obesity among unmarried women but not among married women. The multivariate-adjusted odds ratio of high school education or lower compared with university education or higher was 3.21 (95% confidence interval: 1.59-6.51) among unmarried women. Among married women, husbands' education was significantly associated with overweight/obesity: women whose husbands' educational attainment was high school or lower had significantly higher odds of overweight/obesity than did those whose husbands had a university education or higher (1.67, 95% confidence interval: 1.10-2.55). Among married women whose educational attainment was college or higher, women whose husbands' educational attainment was high school or lower had a significantly higher risk for overweight/obesity when compared with women whose husbands' educational attainment was college or higher. Associations between women's own education and overweight/obesity varied by marital status, and husbands' educational level was important for married women's overweight/obesity. These findings indicate that the social influences bound to educational background affect women's overweight/obesity.

Comparison of Mammographic Density Assessed as Volumes and Areas among Women Undergoing Diagnostic Image-Guided Breast Biopsy

PubMed Central

Gierach, Gretchen L.; Geller, Berta M.; Shepherd, John A.; Patel, Deesha A.; Vacek, Pamela M.; Weaver, Donald L.; Chicoine, Rachael E.; Pfeiffer, Ruth M.; Fan, Bo; Mahmoudzadeh, Amir Pasha; Wang, Jeff; Johnson, Jason M.; Herschorn, Sally D.; Brinton, Louise A.; Sherman, Mark E.

2014-01-01

Background Mammographic density (MD), the area of non-fatty appearing tissue divided by total breast area, is a strong breast cancer risk factor. Most MD analyses have employed visual categorizations or computer-assisted quantification, which ignore breast thickness. We explored MD volume and area, using a volumetric approach previously validated as predictive of breast cancer risk, in relation to risk factors among women undergoing breast biopsy. Methods Among 413 primarily white women, ages 40–65, undergoing diagnostic breast biopsies between 2007–2010 at an academic facility in Vermont, MD volume (cm3) was quantified in cranio-caudal views of the breast contralateral to the biopsy target using a density phantom, while MD area (cm2) was measured on the same digital mammograms using thresholding software. Risk factor associations with continuous MD measurements were evaluated using linear regression. Results Percent MD volume and area were correlated (r=0.81) and strongly and inversely associated with age, body mass index (BMI), and menopause. Both measures were inversely associated with smoking and positively associated with breast biopsy history. Absolute MD measures were correlated (r=0.46) and inversely related to age and menopause. Whereas absolute dense area was inversely associated with BMI, absolute dense volume was positively associated. Conclusions Volume and area MD measures exhibit some overlap in risk factor associations, but divergence as well, particularly for BMI. Impact Findings suggest that volume and area density measures differ in subsets of women; notably, among obese women, absolute density was higher with volumetric methods, suggesting that breast cancer risk assessments may vary for these techniques. PMID:25139935

Association between chronic undernutrition and hypertension.

PubMed

Sawaya, Ana L; Sesso, Ricardo; Florêncio, Telma M de Menezes Toledo; Fernandes, Maria T B; Martins, Paula A

2005-07-01

In developing countries nutritional deficit during prenatal and continuing in post-natal life is very common. This condition leads to stunting and important metabolic changes. Over 30% of children in the world are stunted. The metabolic resultants of nutritional deficit during growth are classically known to aim at energy conservation. This review summarizes data from Brazil, a developing country undergoing the double burden of obesity and undernutrition, especially among the poor, and suggests that stunting or chronic undernutrition increases the risk of obesity and hypertension later in life. Around 60 million people are under the poverty line in Brazil. In São Paulo, the richest city of the country, 20% of the population live in slums and in Maceió, the capital of one of the poorest states, this percentage reaches 50%. Undernutrition in this population is around 20% among children, with high frequency of infections, anemia, and parasitic infestations, associated with poor sanitation. Among stunted adolescents, we found a high prevalence of hypertension (21%) that is a considerably higher estimate compared to non-stunted adolescents (less than 10%). The prevalence of hypertension in undernourished pre-school children, or in those who recovered from undernutrition, was higher than that in controls (29%, 20% and 2%, respectively, P < 0.001). Among stunted adults eating no more than 66% of the requirements (adjusted for stature), overweight/obesity was 35% in women and 25% in men. The prevalence of hypertension was 44% among stunted women and 18% among stunted men. Fifty per cent of stunted and obese women had hypertension. These data reinforce the important association between undernutrition and hypertension from childhood through adulthood. Health policies for preventing and combating childhood undernutrition should have an impact on the morbidity and mortality related to hypertension during adulthood.

The effect of pioglitazone and resistance training on body composition in older men and women undergoing hypocaloric weight loss.

PubMed

Shea, M Kyla; Nicklas, Barbara J; Marsh, Anthony P; Houston, Denise K; Miller, Gary D; Isom, Scott; Miller, Michael E; Carr, J Jeffrey; Lyles, Mary F; Harris, Tamara B; Kritchevsky, Stephen B

2011-08-01

Age-related increases in ectopic fat accumulation are associated with greater risk for metabolic and cardiovascular diseases, and physical disability. Reducing skeletal muscle fat and preserving lean tissue are associated with improved physical function in older adults. PPARγ-agonist treatment decreases abdominal visceral adipose tissue (VAT) and resistance training preserves lean tissue, but their effect on ectopic fat depots in nondiabetic overweight adults is unclear. We examined the influence of pioglitazone and resistance training on body composition in older (65-79 years) nondiabetic overweight/obese men (n = 48, BMI = 32.3 ± 3.8 kg/m(2)) and women (n = 40, BMI = 33.3 ± 4.9 kg/m(2)) during weight loss. All participants underwent a 16-week hypocaloric weight-loss program and were randomized to receive pioglitazone (30 mg/day) or no pioglitazone with or without resistance training, following a 2 × 2 factorial design. Regional body composition was measured at baseline and follow-up using computed tomography (CT). Lean mass was measured using dual X-ray absorptiometry. Men lost 6.6% and women lost 6.5% of initial body mass. The percent of fat loss varied across individual compartments. Men who were given pioglitazone lost more visceral abdominal fat than men who were not given pioglitazone (-1,160 vs. -647 cm(3), P = 0.007). Women who were given pioglitazone lost less thigh subcutaneous fat (-104 vs. -298 cm(3), P = 0.002). Pioglitazone did not affect any other outcomes. Resistance training diminished thigh muscle loss in men and women (resistance training vs. no resistance training men: -43 vs. -88 cm(3), P = 0.005; women: -34 vs. -59 cm(3), P = 0.04). In overweight/obese older men undergoing weight loss, pioglitazone increased visceral fat loss and resistance training reduced skeletal muscle loss. Additional studies are needed to clarify the observed gender differences and evaluate how these changes in body composition influence functional status.

Biphasic effect of alcohol intake on the development of fatty liver disease.

PubMed

Takahashi, Hirokazu; Ono, Masafumi; Hyogo, Hideyuki; Tsuji, Chika; Kitajima, Yoichiro; Ono, Naofumi; Eguchi, Takahisa; Fujimoto, Kazuma; Chayama, Kazuaki; Saibara, Toshiji; Anzai, Keizo; Eguchi, Yuichiro

2015-11-01

Fatty liver is an important clinical feature not only in alcoholic and non-alcoholic fatty liver diseases, but in other chronic liver diseases as well. Our aim was to elucidate the effect and relationship between habitual alcohol intake and obesity in the development of fatty liver disease. We enrolled 8,029 subjects undergoing abdominal ultrasonography with general medical examinations, and analyzed the factors associated with fatty liver based on daily alcohol intake, body mass index (BMI), and waist circumference. For fatty liver, BMI, waist circumference, total cholesterol, triglycerides, and fasting plasma glucose were significant and independent risk factors. Heavy alcohol intake (50 g/day) was a significant risk factor for fatty liver in women (odds ratio [OR], 3.35). Analysis based on the presence or absence of obesity revealed that moderate alcohol intake was a significant negative risk factor for fatty liver in both male and female obese (BMI ≥25 kg/m(2)) subjects (OR, 0.74 for non-obese and 0.39 for obese patients, respectively). Heavy alcohol intake was also a significant negative risk factor in obese males (0.62). In contrast, heavy alcohol intake was a risk factor in non-obese males (OR, 1.29) and in all females (OR, 2.22 for non-obese and 6.6 for obese patients, respectively). The influence of alcohol intake on fatty liver differed depending on the level of alcohol consumption, gender, and the presence of obesity, and showed biphasic effects.

Comparison of serum androgens and endometrial thickness in obese and non-obese postmenopausal women

PubMed Central

Arıkan, İlker İnan; Barut, Aykut; Arıkan, Deniz; Harma, Müge; Harma, Mehmet İbrahim; Bozkurt, Serpil

2010-01-01

Objective In this study, we investigated whether serum androgen levels and endometrial thickness differed in obese and non-obese women. Material and Methods Thirtytwo non-obese (BMI <30) and 48 obese (BMI ≥ 30) women were enrolled. Blood samples were analyzed for testosterone, free testosterone, androstenedione, DHEAS, and SHBG, and transvaginal ultrasonography was performed. Results Obese women had significantly higher free testosterone and endometrial thickness and significantly lower SHBG. Eight of 17 women with endometrial thickness >5 mm had significant pathology. Conclusion These results suggest that obesity may be a risk factor for endometrial carcinoma and other pathologies in post-menopausal women through an action on androgen concentrations. PMID:24591922

Obesity in Women: The Clinical Impact on Gastrointestinal and Reproductive Health and Disease Management.

PubMed

Pickett-Blakely, Octavia; Uwakwe, Laura; Rashid, Farzana

2016-06-01

Approximately 36% of adult women in the United States are obese. Although obesity affects women similarly to men in terms of prevalence, there seem to be gender-specific differences in the pathophysiology, clinical manifestations, and treatment of obesity. Obesity is linked to comorbid diseases involving multiple organ systems, including the gastrointestinal tract, like gastroesophageal reflux disease, fatty liver disease, and gallstones. This article focuses on obesity in women, specifically the impact of obesity on gastrointestinal diseases and reproductive health, as well as the treatment of obesity in women. Copyright © 2016 Elsevier Inc. All rights reserved.

Labor length among overweight and obese women undergoing induction of labor.

PubMed

Hirshberg, Adi; Levine, Lisa D; Srinivas, Sindhu

2014-11-01

Maternal weight is thought to impact labor. With rising rates of obesity and inductions, we sought to evaluate labor times among induced women by body mass index (BMI) category. Retrospective cohort study of term inductions from 2005 to 2010. BMI categories were: normal weight (NW), overweight (OW), and obese (Ob) (18.5-24.9, 25-29.9, ≥30 kg/m(2)). Kruskal-Wallis tests compared median latent labor (LL) length and active labor (AL) length. Chi-square determined associations. Multivariable logistic regression controlled for confounders. Analyses were stratified by parity. A total of 448 inductions were analyzed. For nulliparas, there was no difference in LL by BMI category (p = 0.22). However, OW nulliparas had a longer AL compared to NW and Ob nulliparas (3.2, 1.7, 2.0 h, p = 0.005). For multiparas, NW had the shortest LL (5.5 h, p = 0.025) with no difference in AL among BMI categories (p = 0.42). The overall cesarean rate was 23% with no difference by BMI category (p = 0.95). However, Ob women had a greater percentage of first stage cesareans (41%) and NW had a greater percentage of second stage cesareans (55%), p = 0.06. The association between BMI and labor length among inductions differs by phase of labor and parity. BMI also influences the stage of labor in which a cesarean occurs.

Lipocalin-2 expression and serum levels as early predictors of type 2 diabetes mellitus in obese women.

PubMed

Rashad, Nearmeen M; El-Shal, Amal S; Etewa, Rasha L; Wadea, Fady M

2017-02-01

Obesity and diabetes are increasing in epidemic proportions globally. Lipocalin-2 (LCN-2) is an inflammatory adipocytokine and obesity-related marker of low-grade inflammation. We aimed to investigate, for first time, the possible role of LCN-2 expression and serum levels in prediction of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) among obese Egyptian women. This study included 188 obese women and 180 controls. Obese women were subdivided into three subgroups according to their fasting blood glucose, normal glucose tolerance (NGT), IGT and T2DM. Circulating LCN-2 expression levels were determined by real time polymerase chain reaction. Serum LCN-2 concentrations were assessed by ELISA. Our findings revealed that LCN-2 expression and serum levels were higher in obese women compared to lean controls. They were higher in IGT and T2DM obese cases than in NGT obese women. Receiver operating characteristic analyses revealed that LCN-2 expression level was a useful biomarker discriminating IGT from NGT and T2DM from IGT obese women (AUC were 0.735 and 0.740, respectively). It was an independent predictor of IGT and T2DM among obese women. Serum LCN-2 level was a useful biomarker discriminating IGT from NGT and T2DM from IGT obese women (AUC were 0.705 and 0.728, respectively). It was independent predictor of T2DM without predicting IGT among obese women. The power of combined LCN-2 serum levels and expression in discriminating between IGT from NGT and T2DM from IGT obese women was high (AUC = 0.717 and 0.741, respectively). In conclusion, LCN-2 expression and serum levels could discriminate IGT from NGT and T2DM from IGT obese women and early predicting T2DM among obese women. While, LCN-2 expression level was the independent predictor of IGT in obese women. Combination of both LCN-2 expression and serum levels improved their diagnostic value in early detection of IGT and T2DM among obese women. © 2017 IUBMB Life, 69(2):88-97, 2017. © 2017 International Union of Biochemistry and Molecular Biology.

Association Between Obesity and Migraine in Women.

PubMed

Pavlovic, Jelena M; Vieira, Julio R; Lipton, Richard B; Bond, Dale S

2017-08-25

Migraine is a common and highly disabling condition that is particularly prevalent among women and especially women of reproductive age. The tremendous rise in adiposity in the Western world has led to an epidemic of obesity in women. The particular effects of obesity on women with migraine of various ages are the focus of this review. Conflicting findings from various studies with different approaches and populations have made challenging definitive conclusions about associations between migraine and obesity. While the association between obesity and migraine frequency has been consistently demonstrated and obesity is considered a risk factor for progression from episodic to chronic migraine, the association between obesity and migraine prevalence is still somewhat debated and appears to be dependent on gender and age, with the most consistent effects observed in women younger than 55 years of age. Association between migraine and obesity is most commonly observed in women of reproductive age. The multimodal changes associated with age and hormonal change in women likely play a role in this relationship, as obesity does not appear to be related to migraine in women over 55 years of age. Future studies focusing on the migraine-obesity relationship in women should examine the effects of age, endogenous hormonal state, and exogenous hormones on migraine and obesity.

Contraception and the obese woman

PubMed Central

Reifsnider, Elizabeth; Mendias, Nonie; Davila, Yolanda; Babendure, Jennie Bever

2016-01-01

Purpose Obesity has reached epidemic rates among U.S. women of reproductive age, many of whom want to use contraception. However, some forms of contraception can have adverse effects on an obese woman's health. This article explores risks of contraception available in the United States and provides clinical recommendations for use by obese women. Data sources Information was compiled by reviewing the scientific literature on contraception and female obesity using CINAHL, MEDLINE, PubMed search engines. Conclusions The evidence is largely supportive of combined oral contraceptive (COC) use in carefully screened obese women without known risks factors for cardiovascular disease. The efficacy of COCs may be slightly reduced in obese women because of increased body mass. Other types of hormonal contraceptives have varying safety and efficacy reports when used by obese women. Intrauterine devices do not have reduced efficacy nor increased risks for obese women but insertion may be more difficult. Obesity has no effect on efficacy of barrier methods of contraception. Implications Clinicians should conduct a careful history and physical exam with selected supporting laboratory tests when considering prescription of hormonal contraceptives for obese women. Obese women require health counseling to carefully follow directions for contraceptive use to avoid unintended pregnancy. PMID:24170564

Awareness on causes, consequences and preventive measures of obesity among urban married women in India.

PubMed

Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa

2013-10-01

In spite of the numerous chronic diseases that have been linked to obesity, studies focusing on the awareness regarding causes, consequences and strategies to prevent and control of obesity among women are lacking in the literature, especially in developing countries such as India, where obesity is culturally accepted and nurtured and women bearded the highest weight gain in the recent decade. We explored the awareness regarding causes, consequences and preventive measures of obesity among 325 ever-married aged 20-54 years women with different levels of body mass index (BMI) in the national capital territory of Delhi representing urban India. A population based follow-up survey of women systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) samples who were re-interviewed after four years in 2003. As a part of qualitative data collection, the respondents were asked to free list open-ended questions on causes, consequences and preventive measures of obesity. Responses were analyzed through Anthropac software package. Over eating was reported as the most important cause of obesity by normal and overweight women whereas obese women reported fried food consumption as the most important cause of weight gain. A few women from each group reported changing lifestyle as a cause of obesity. Also, there were lots of misconceptions about the cause of obesity among women (such as no tension in life, more tension, happiness, constipation, problem in Delhi's water etc.). In terms of the consequences of obesity, the participants were well aware of the common physical consequences. Normal and obese women reported breathlessness as the most important consequence whereas overweight women reported problem in standing and sitting. Regarding preventive measures, overweight and obese women reported 'walking' as most important preventive measure of obesity whereas normal women reported 'doing exercise'. In addition, 'dieting' was reported as the next important preventive measures of obesity by all groups of women. Our study of a fairly large, community-based sample of women has shown that women were aware of the complex nature of obesity in terms of causes, consequences and a range of potential solutions. The findings are important for public health interventions in obesity care in India. Implementation of health promotion and health education in the community should use effective school education and mass media programme to raise more awareness of the causes, consequences and preventive measures and hammer misconceptions, to combat the growing level of obesity among Indian women.

Awareness on causes, consequences and preventive measures of obesity among urban married women in India

PubMed Central

Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa

2017-01-01

Background In spite of the numerous chronic diseases that have been linked to obesity, studies focusing on the awareness regarding causes, consequences and strategies to prevent and control of obesity among women are lacking in the literature, especially in developing countries such as India, where obesity is culturally accepted and nurtured and women bearded the highest weight gain in the recent decade. Objective We explored the awareness regarding causes, consequences and preventive measures of obesity among 325 ever-married aged 20-54 years women with different levels of body mass index (BMI) in the national capital territory of Delhi representing urban India. Materials and Methods A population based follow-up survey of women systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) samples who were re-interviewed after four years in 2003. As a part of qualitative data collection, the respondents were asked to free list open-ended questions on causes, consequences and preventive measures of obesity. Responses were analyzed through Anthropac software package. Results Over eating was reported as the most important cause of obesity by normal and overweight women whereas obese women reported fried food consumption as the most important cause of weight gain. A few women from each group reported changing lifestyle as a cause of obesity. Also, there were lots of misconceptions about the cause of obesity among women (such as no tension in life, more tension, happiness, constipation, problem in Delhi’s water etc.). In terms of the consequences of obesity, the participants were well aware of the common physical consequences. Normal and obese women reported breathlessness as the most important consequence whereas overweight women reported problem in standing and sitting. Regarding preventive measures, overweight and obese women reported ‘walking’ as most important preventive measure of obesity whereas normal women reported ‘doing exercise’. In addition, ‘dieting’ was reported as the next important preventive measures of obesity by all groups of women. Conclusion Our study of a fairly large, community-based sample of women has shown that women were aware of the complex nature of obesity in terms of causes, consequences and a range of potential solutions. The findings are important for public health interventions in obesity care in India. Implementation of health promotion and health education in the community should use effective school education and mass media programme to raise more awareness of the causes, consequences and preventive measures and hammer misconceptions, to combat the growing level of obesity among Indian women. PMID:28856116

Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea.

PubMed

We, Ji-Sun; Han, Kyungdo; Kwon, Hyuk-Sang; Kil, Kicheol

2016-05-01

The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.

Prevalence of obesity among children and/or grandchildren of adult bariatric surgery patients.

PubMed

Bao, Jean J; Desai, Vikas; Christoffel, Katherine Kaufer; Smith-Ray, Patrick; Nagle, Alex P

2009-07-01

Clinical experience suggests that some adults who undergo bariatric surgery have children who are obese. Childhood obesity is associated with increased morbidity and mortality in later life. This study examined the prevalence of obesity among children and grandchildren (< or =12 years of age) of adult bariatric surgery patients. Patients in a prospective database of morbidly obese patients who underwent bariatric surgery between January 2004 and May 2007 were recruited by phone and in clinic. Patient demographics, body mass index (BMI) at surgery, and survey data were collected. The survey included questions regarding their child/grandchild's body habitus, weight, and height. Child obesity was defined as BMI percentile > or =95. Statistical significance was set at p < 0.05. One hundred twenty-two patients were enrolled in this study (77% women, mean BMI 49 kg/m(2)). One hundred thirty-four out of 233 children/grandchildren identified had complete data; 41% had a BMI percentile > or =95. Only 29% of these obese children were so identified by the adult respondents. Significantly more biological children/grandchildren were obese than nonbiological (p = 0.013), and significantly more biological children were obese than biological grandchildren (p = 0.027). This sample of bariatric surgery patients had a high proportion of obese preteen children/grandchildren. Obesity was most prevalent among biological children (vs. biological grandchildren and nonbiological children). Patients often did not recognize the degree of overweight in their children/grandchildren. Because families of bariatric surgery patients often include obese children, interventions aimed at all family members merit consideration.

Exaggerated haemodynamic and neural responses to involuntary contractions induced by whole-body vibration in normotensive obese versus lean women.

PubMed

Dipla, Konstantina; Kousoula, Dimitra; Zafeiridis, Andreas; Karatrantou, Konstantina; Nikolaidis, Michalis G; Kyparos, Antonios; Gerodimos, Vassilis; Vrabas, Ioannis S

2016-06-01

What is the central question of this study? In obesity, the exaggerated blood pressure response to voluntary exercise is linked to hypertension, yet the mechanisms are not fully elucidated. We examined whether involuntary contractions elicit greater haemodynamic responses and altered neural control of blood pressure in normotensive obese versus lean women. What is the main finding and its importance? During involuntary contractions induced by whole-body vibration, there were augmented blood pressure and spontaneous baroreflex responses in obese compared with lean women. This finding is suggestive of an overactive mechanoreflex in the exercise-induced hypertensive response in obesity. Passive contractions did not elicit differential heart rate responses in obese compared with lean women, implying other mechanisms for the blunted heart rate response reported during voluntary exercise in obesity. In obesity, the exaggerated blood pressure (BP) response to exercise is linked to hypertension, yet the mechanisms are not fully elucidated. In this study, we examined whether involuntary mechanical oscillations, induced by whole-body vibration (WBV), elicit greater haemodynamic responses and altered neural control of BP in obese versus lean women. Twenty-two normotensive, premenopausal women (12 lean and 10 obese) randomly underwent a passive WBV (25 Hz) and a control protocol (similar posture without WVB). Beat-by-beat BP, heart rate, stroke volume, systemic vascular resistance, cardiac output, parasympathetic output (evaluated by heart rate variability) and spontaneous baroreceptor sensitivity (sBRS) were assessed. We found that during WBV, obese women exhibited an augmented systolic BP response compared with lean women that was correlated with body fat percentage (r = 0.77; P < 0.05). The exaggerated BP rise was driven mainly by the greater increase in cardiac output index in obese versus lean women, associated with a greater stroke volume index in obese women. Involuntary contractions did not elicit a differential magnitude of responses in heart rate, heart rate variability indices and systemic vascular resistance in obese versus lean women; however, they did result in greater sBRS responses (P < 0.05) in obese women. In conclusion, involuntary contractions elicited an augmented BP and sBRS response in normotensive obese versus lean women. The greater elevations in circulatory haemodynamics in obese women are suggestive of an overactive mechanoreflex in the exercise-induced hypertensive response in obesity. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.

Trends in anthropometry and severity of sleep-disordered breathing over two decades of diagnostic sleep studies in an Australian adult sleep laboratory.

PubMed

Pretto, Jeffrey J; Gyulay, Stephen G; Hensley, Michael J

2010-08-16

To document trends in subject demographics, anthropometry and sleep disorder severity over 21 years of diagnostic sleep studies. A retrospective observational study of consecutive subjects undergoing initial diagnostic polysomnography for investigation of possible sleep disorders in a university-affiliated tertiary public metropolitan hospital in the Hunter New England region of New South Wales between 1987 and 2007. Body weight, body mass index (BMI) and severity of sleep-related breathing disorders (apnoea-hypopnoea index [AHI]). Between 1987 and 2007, 14 648 new diagnostic sleep studies were performed. The median age of subjects (51 years; interquartile range, 41-61 years) did not change over time and the proportion of women increased from 20% to 39%. Median body weight increased from 89 kg to 99 kg for men (11%) and from 73 kg to 85 kg for women (16%), equating to a yearly increase in median BMI of 0.15 kg/m(2) for men and 0.14 kg/m(2) for women. The proportion of subjects who were morbidly obese (BMI > or = 40) increased from 3% in 1987 to 16% in 2007. Median AHI progressively increased from 1992-1995 to 2004-2007 (from 6.5 events/h to 14.3 events/h; P < 0.001), indicating increasing disease severity. Over the same period, for every unit increase in BMI, AHI increased by 5.5 events/h for men and by 2.8 events/h for women. About 80% of the observed variance in AHI over this period was attributable to variance in BMI. There is a continuing trend towards increasing body weight and BMI in people undergoing diagnostic sleep studies. Our data do not support the hypothesis that increased accessibility to diagnostic services and increased awareness of sleep disorders are resulting in a decline in disease severity. These findings are consistent with the premise that worsening severity in sleep-disordered breathing is primarily attributable to increasing obesity.

A comperative study for short-term surgical outcomes of midurethral sling procedures in obese and non-obese women with stress urinary incontinence.

PubMed

Kokanalı, Mahmut Kuntay; Cavkaytar, Sabri; Kokanalı, Demet; Aksakal, Orhan; Doganay, Melike

2016-11-01

There is little data comparing the surgical outcomes of tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures in obese women. Therefore, we aimed to compare the surgical outcomes of TOT and TVT procedures among obese women with a diagnosis of stress urinary incontinence (SUI). One hundred and eighty-nine women who underwent TVT or TOT procedures due to pure SUI were included. Women in whom the body mass index (BMI) was ≥30 kg/m 2 were considered as obese, while <30 kg/m 2 were non-obese. And women with BMI ≥35 kg/m 2 was defined as morbidly obese. At sixth month postoperative follow-up, neither the comparison of TVT and TOT results in obese women nor the comparison of TVT or TOT results between obese and non-obese women showed any significant differences in terms of objective and subjective cure rates, quality of life improvements, or intra/postoperative complications. TVT and TOT procedures also have similar effectiveness among morbidly obese women. We have concluded that TVT and TOT operations seem to be equally effective and safe surgical treatment procedures for female SUI regardless of BMI.

Adipocytokines, neuropeptide Y and insulin resistance in overweight women with gynoid and android type of adipose tissue distribution.

PubMed

Orbetzova, Maria M; Koleva, Daniela I; Mitkov, Mitko D; Atanassova, Iliana B; Nikolova, Julia G; Atanassova, Pepa K; Genchev, Gencho D

2012-01-01

The AIM of the study was to compare the levels of certain adipose tissue hormones in women with the two main morphological types of obesity - android and gynoid obesity. The study included 2 groups of age- and weight-matched women with android (n = 32) and gynoid (n = 27) type of obesity, and a group of age-matched healthy women (n = 24) with normal weight and body constitution. Leptin, resistin, tumour necrosis factor alpha (TNFalpha), neuropeptide Y (NPY), glucose and insulin were measured. HOMA index was calculated. Leptin levels in the women with gynoid obesity did not differ significantly from those in the controls and the women with android obesity. The controls had significantly lower leptin levels compared with the android obesity women. NPY was significantly higher in the control women compared to the women with android obesity and did not differ significantly between the two groups of obese women. TNFalpha levels in all groups were very similar. Resistin did not show significant differences between all groups but tended to have the lowest levels in the controls. In the women with android obesity, insulin was significantly higher than that in the women with gynoid obesity and the controls. Insulin resistance was found in the women with android obesity only. Basal insulin and HOMA index in the women with gynoid obesity did not differ significantly from the values in the control group. The results from this study contribute to understanding the association of adipose tissue hormones and insulin resistance in obesity. When adipose tissue is predominantly distributed in the abdominal area at similar amount and percentage of body fats, leptin production is higher and insulin resistance develops. In the gynoid type of adipose tissue predisposition, overt insulin resistance is not found, leptin levels does not differ significantly from those in the control group.

Macrophage migration inhibitory factor in obese and non obese women with polycystic ovary syndrome.

PubMed

Mejia-Montilla, Jorly; Álvarez-Mon, Melchor; Reyna-Villasmil, Eduardo; Torres-Cepeda, Duly; Santos-Bolívar, Joel; Reyna-Villasmil, Nadia; Suarez-Torres, Ismael; Bravo-Henríquez, Alfonso

2015-01-01

To measure macrophage migration inhibitory factor (MIF) concentrations in obese and non-obese women diagnosed with polycystic ovary syndrome (PCOS). Women diagnosed with PCOS and age-matched healthy controls with regular menses and normal ovaries on ultrasound examination were selected and divided into 4 groups (group A, PCOS and obese; group B, PCOS and non-obese; group C, obese controls; and group D, non-obese controls) based on body mass index (obese >30 kg/m2 and non-obese <25 kg/m2). Luteinizing hormone, follicle-stimulating hormone, androstenedione, testosterone, sex hormone-binding globulin, serum glucose, insulin and MIF levels were measured. Obese and non-obese women with PCOS had higher luteinizing hormone, follicle-stimulating hormone, androstenedione, testosterone, and insulin levels as compared to the obese and non-obese control groups, respectively (P < .0001). Women with PCOS had significantly higher MIF levels (group A, 48.6 ± 9.9 mg/ml; group B, 35.2 ± 6.0 ng/ml) as compared to controls (group C, 13.5 ± 6.0 ng/ml; group D, 12.0 ± 4.3 ng/dl; P < .0001). A weak, positive and significant correlation was seen between fasting blood glucose and insulin levels in women with PCOS (P < .05). Significant differences exist in plasma MIF levels between obese and non-obese women with and without PCOS. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

Land-based versus aquatic resistance therapeutic exercises for older women with sarcopenic obesity: study protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Sarcopenic obesity is a health condition that combines excess adipose tissue and loss of muscle mass and strength. Sarcopenic obesity predisposes to more functional disabilities than obesity or sarcopenia alone. Progressive resistance exercises are recommended for older people as a potential treatment for sarcopenia and also for obesity. However, there is a lack of evidence indicating which programmes are best applied to older people, and no studies have investigated their effects on sarcopenic obese people. The aims of this protocol study are to investigate and compare the efficacy of land-based and aquatic resistance exercise programmes on improving muscle performance, functional capacity and quality of life of older women with sarcopenic obesity. Methods/Design This is a protocol study for a parallel randomised controlled clinical trial. Eligible participants are older women (≥65 years) with a body mass index ≥30 kg/m 2 and hand grip strength ≤21 kg force. A total sample of 36 participants will be randomly allocated to one of the intervention groups in blocks of three: land-based, aquatic or control. Each intervention group will undergo 2-week sessions of a 10-week therapeutic exercise programme for strength, power and endurance training of the lower-limb muscles. Participants in the control group will not participate in any strengthening activity for lower limbs and will receive telephone calls once a week. Baseline and final evaluation of outcomes will encompass muscle performance of the lower limbs assessed by an isokinetic dynamometer; functional tests of usual walking speed, maximal walking speed (shuttle walking test), stair speed and the Short Physical Performance Battery; and health-related quality of life (Medical Outcomes Study Short Form Questionnaire – SF-36). Data collectors will be blinded to randomisation and will not be in touch with participants during the interventions. Discussion This study is the first randomised controlled trial designed to evaluate resistance exercises in older patients with sarcopenic obesity. If our hypothesis proves correct, both intervention programmes will be effective, with the land-based exercises conferring better results in muscle performance. Trial registration Registro Brasileiro de Ensaios Clínicos: RBR-9p5q67 PMID:24041219

[Postmenopausal osteoporosis in obese women].

PubMed

Izmozherova, N V; Popov, A A

2008-01-01

assessment of frequency of obesity and comorbidities in women with postmenopausal osteoporosis (OP). cross-sectional study included 243 postmenopausal symptomatic women with OP diagnosed by dual energy lumbar spine absorptiometry. normal body mass was found in 74 women (30.5%), 105 persons (43.2%) had overweight and 64 patients (26.3%) were obese. Obese OP patients had significantly higherfrequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than those with normal body mass. Obese persons also had more severe menopausal symptoms than women with normal body mass. There was no difference in non-traumatic fractures between obese, overweight and slim patients. Thus, postmenopausal OP in obese women was associated with numerous comorbidities and more severe menopausal symptoms.

Short-term effects of a hypocaloric diet with low glycemic index and low glycemic load on body adiposity, metabolic variables, ghrelin, leptin, and pregnancy rate in overweight and obese infertile women: a randomized controlled trial.

PubMed

Becker, Geórgia F; Passos, Eduardo P; Moulin, Cileide C

2015-12-01

Obesity is related to hormonal disorders that affect the reproductive system. Low-glycemic index (LGI) diets seem to exert a positive effect on weight loss and on metabolic changes that result from obesity. We investigated the effects of a hypocaloric diet with an LGI and low glycemic load on anthropometric and metabolic variables, ghrelin and leptin concentrations, and the pregnancy rate in overweight and obese infertile women who were undergoing in vitro fertilization (IVF). The study was a randomized block-design controlled trial in which we analyzed 26 overweight or obese infertile women. Patients were assigned to a hypocaloric LGI-diet group or a control group and followed the protocol for 12 wk. Body weight, body mass index (BMI), percentage of body fat, glucose, insulin, homeostasis model assessment of insulin resistance, serum lipids, reproductive hormones, leptin, acylated ghrelin, number of oocytes retrieved in the IVF cycle, and pregnancy rate were determined. There were greater reductions in body mass, BMI, percentage of body fat, waist:hip ratio, and leptin in the LGI-diet group than in the control group (P < 0.05). Despite a change of 18% in mean values, there was no significant increase in acylated ghrelin concentrations in the LGI group compared with the control group (P = 0.215). The LGI-diet group had 85.4% more oocytes retrieved than did the control group (7.75 ± 1.44 and 4.18 ± 0.87, respectively; P = 0.039) in the IVF cycle. Three patients (21.4%) in the LGI group experienced a spontaneous pregnancy during the follow-up, which generated 3 live births. The hypocaloric LGI diet promoted a decrease in BMI, percentage of body fat, and leptin concentrations, which improved oocyte development and pregnancy rate. These results support the clinical recommendation to advise overweight and obese women to lose weight through a balanced diet before being submitted for treatment with assisted reproduction technologies. A hypocaloric diet combined with LGI foods seems to be beneficial for these patients, but additional studies are required before this treatment is recommended. This trial was registered at clinicaltrials.gov as NCT02416960. © 2015 American Society for Nutrition.

Ghrelin is independently associated with anti-mullerian hormone levels in obese but not non-obese women with polycystic ovary syndrome.

PubMed

Garin, Margaret C; Butts, Samantha F; Sarwer, David B; Allison, Kelly C; Senapati, Suneeta; Dokras, Anuja

2017-03-01

Ghrelin is an endogenous appetite stimulant that may have a role in ovarian function. Women with polycystic ovary syndrome have anovulation and frequently weight management issues; however the associations between ghrelin and hormonal markers in polycystic ovary syndrome have not been well studied. In order to characterize the association between total ghrelin levels and ovarian function and the possible modification of this relationship by obesity, we examined total ghrelin levels and anti-mullerian hormone, total testosterone, and insulin in obese and non-obese women with and without polycystic ovary syndrome. Total ghrelin levels were lower in obese women with polycystic ovary syndrome (n = 45) compared to obese controls (n = 33) (p = 0.005), but similar in non-obese women with polycystic ovary syndrome (n = 20) compared to non-obese controls (n = 21) (p = NS). In the obese polycystic ovary syndrome group, anti-mullerian hormone was associated with ghrelin levels independent of age, insulin, and total testosterone (p = 0.008). There was no association between total ghrelin and anti-mullerian hormone levels in non-obese women with polycystic ovary syndrome, non-obese controls, or obese controls (p = NS). Our results provide evidence for a potential relationship between ghrelin and ovarian function in obese women with polycystic ovary syndrome that was not observed in non-obese women with polycystic ovary syndrome or controls.

Metabolic profiles and lipoprotein lipid concentrations in non-obese and obese patients with polycystic ovarian disease.

PubMed

Mahabeer, S; Naidoo, C; Norman, R J; Jialal, I; Reddi, K; Joubert, S M

1990-10-01

Clinical parameters, androgen status and lipoprotein lipid profiles were assessed in 10 non-obese and 10 obese patients with polycystic ovarian disease (PCOD) and reference subjects matched for age, height and weight. Both obese and non-obese women with PCOD had significantly higher androgen levels when compared to the reference groups. When comparison of lipoprotein lipid profiles were made between groups, non-obese women with PCOD had significantly higher total cholesterol, triglycerides and LDL-cholesterol levels than non-obese reference subjects. Obese PCOD women manifested significantly higher total cholesterol, LDL-cholesterol, cholesterol/HDL, and LDL/HDL values than did obese reference subjects. Correlations between serum androgens and lipoprotein lipid concentrations in PCOD and normal women were unhelpful. Both non-obese and obese patients with PCOD had significantly higher systolic and diastolic blood pressures (BPs) than the reference groups. Thus, both non-obese and obese women with PCOD manifest hyperandrogenaemia which may result in a male pattern of lipoprotein lipid concentrations.

Does segmental body composition differ in women with Prader-Willi syndrome compared to women with essential obesity?

PubMed

Bedogni, G; Grugni, G; Tringali, G; Marazzi, N; Sartorio, A

2015-09-01

Subjects with Prader-Willi syndrome (PWS) have a higher fat mass and a lower fat-free mass compared to subjects with essential obesity. However, few data are presently available on the segmental body composition (BC) of PWS subjects. To evaluate whether women with PWS and women with essential obesity, matched for age and percent body fat, differ in segmental fat distribution and surrogate markers of cardiometabolic disease (CMD). 35 women with PWS and 50 women with essential obesity were matched for age and percent body fat using coarsened exact matching. BC was measured by dual-energy X-ray absorptiometry. Oral glucose tolerance testing and measurements of cholesterol, triglycerides, C-reactive protein, and blood pressure were performed. Comparisons between PWS and obese women were performed using generalized linear models. Trunk fat was lower in PWS than in obese women on both absolute [-7.3 (95% confidence interval -9.4 to -5.2) kg] and relative [-4.1 (-6.9 to -1.4)% of body fat] grounds. PWS and obese women had similar surrogate markers of CMD, with the exception of HDL-cholesterol, which was higher in PWS women. Trunk fat is lower in obese women with PWS than in those with essential obesity. Surrogate markers of CMD are, however, mostly similar in the two groups.

A preliminary evaluation of influence of body mass index on in vitro fertilization outcome in non-obese endometriosis patients.

PubMed

Garalejic, Eliana; Arsic, Biljana; Radakovic, Jovana; Bojovic Jovic, Dragana; Lekic, Dragana; Macanovic, Biljana; Soldatovic, Ivan; Perovic, Milan

2017-11-16

Obese and overweight women experience a lower probability for pregnancy after IVF. However, despite the increasing prevalence of obesity, the large majority of infertile women are non-obese. One of the most common indications for IVF is endometriosis. Thought-provoking inverse correlation has been established between BMI and endometriosis. Lower BMI is a risk factor for development of endometriosis and a predictive factor for severe endometriosis. Since severe endometriosis carries lower reproductive chances, even after IVF, we preliminary tested a hypothesis that higher BMI among non-obese endometriosis patients improves IVF outcomes. Preliminary retrospective observational cross-sectional study was performed in women with endometriosis as a sole infertility cause who underwent IVF. During analyzed period we performed 2782 IVF procedures. In order to achieve highly homogenous study sample and to eliminate almost all confound factors that could lead to bias, we implemented strict study criteria. The number of eligible subjects was 156 and they were divided into underweight, normal weight and overweight groups. Primary outcomes were number of retrieved oocytes, good quality oocytes, embryos, and the rates of biochemical, clinical and ongoing pregnancies. For group comparisons, we used parametric test, analysis of variance, and non-parametric tests (Kruskal-Wallis test, Chi-square test). Logistic regression and General linear model was used to assess correlation between BMI and dependent variables (outcome and stimulation duration) when adjusted for age. Endometriosis as a single infertility factor among IVF couples had prevalence of 5.61%. Underweight women accounted for 10.26%, normal weight 71.15% and overweight 18.59% of study population. Significant differences were not found in number of retrieved oocytes (p = 0.880), good quality oocytes (p = 0.476), obtained embryos (p = 0.706), and biochemical (p = 0.298), clinical (p = 0.770) and ongoing (p = 0.822) pregnancy rates between study groups. Although preliminary results do not support our hypothesis, increase in BMI did not adversely affect the outcome of IVF in non-obese endometriosis patients, which is in contrast to literature data as regards general population of infertile women undergoing IVF. Prospective studies with large number of patients with endometriosis or prospective case-control studies should address these issues and provide more comprehensive counseling of infertile endometriosis patients regarding achievement of optimal BMI prior to IVF with the intention of achievement higher pregnancy rates.

In vitro fertilization outcomes in obese women under and above 35 years of age.

PubMed

Vural, F; Vural, B; Çakiroglu, Y

2016-01-01

To explore the impact of obesity on in vitro fertilization (IVF) outcomes and comparing the results with regards to age groups. This retrospective cohort recruited 780 women that underwent IVF. Women with polycystic ovarian syndrome (PCOS) were excluded from the study. Women under and above 35 years were categorized into three groups as normal weight, overweight, and obese. The main outcome measures were ovarian response, oocyte maturity, and clinical pregnancy rates. Despite oocyte count and fertilization rate that decreased in both younger and older obese women, this difference was not statistically significant. After age matched-normal weight controls, the clinical pregnancy rates were significantly decreased in older obese women. On the other hand, poor ovarian response observed significantly in young obese women without effect on pregnancy rates. These results suggested that obesity in young and old women has different outcomes and different steps of IVF process may be affected.

Pharmacokinetics and ovarian suppression during use of a contraceptive vaginal ring in normal-weight and obese women.

PubMed

Westhoff, Carolyn L; Torgal, Anupama H; Mayeda, Elizabeth Rose; Petrie, Kelsey; Thomas, Tiffany; Dragoman, Monica; Cremers, Serge

2012-07-01

Many observational studies indicate higher oral contraceptive failure among obese women, but most clinical trials and physiologic studies do not support these differences. Limited data indicate higher failure rates among obese contraceptive patch users. Data regarding contraceptive vaginal ring performance in obese women are needed. Twenty normal weight (body mass index [BMI] 19.0-24.9; median, 21.65) and 20 obese (BMI 30.0-39.9; median, 33.7) women enrolled in a prospective study of ethinyl estradiol (EE(2)) and etonorgestrel pharmacokinetics and of ovarian follicle development, endometrial thickness, and bleeding patterns, all measured biweekly during the second cycle of contraceptive vaginal ring use. Thirty-seven women completed follow-up. Mean day 0-21 EE(2) concentrations were lower among obese vs normal weight women (15.0 vs 22.0 pg/mL, respectively, P = .004), whereas etonorgestrel concentrations were similar (1138 vs 1256 pg/mL, respectively, P = .39). Follicular development was minimal in both groups, with only 5 women achieving a maximum follicle diameter >13 mm at any time during 3 weeks follow-up (3 normal weight and 2 obese women); these women had serum progesterone levels <1.0. Obese women reported more bleeding or spotting than normal weight women (3.6 vs 1.4 days, respectively, P = .01). Although obese women had lower EE(2) levels during contraceptive vaginal ring use, they had excellent suppression of ovarian follicle development, similar to normal weight women. This predicts that contraceptive vaginal ring effectiveness will be similar in women with a BMI up to 39.9. The lower serum EE(2) levels in the obese women may explain the greater reported bleeding or spotting days. Copyright © 2012 Mosby, Inc. All rights reserved.

Pharmacokinetics and ovarian suppression during use of a contraceptive vaginal ring in normal-weight and obese women

PubMed Central

WESTHOFF, Carolyn L.; TORGAL, Anupama H.; MAYEDA, Elizabeth Rose; PETRIE, Kelsey; THOMAS, Tiffany; DRAGOMAN, Monica; CREMERS, Serge

2012-01-01

BACKGROUND Many observational studies indicate higher oral contraceptive failure among obese women, but most clinical trials and physiological studies do not support these differences. Limited data indicate higher failure rates among obese contraceptive patch users. Data regarding contraceptive vaginal ring (CVR) performance in obese women are needed. METHODS 20 normal weight (BMI 19.0–24.9, median 21.65) and 20 obese (BMI 30.0–39.9, median 33.7) women enrolled in a prospective study of ethinyl estradiol (EE) and etonorgestrel (ENG) pharmacokinetics and of ovarian follicle development, endometrial thickness, and bleeding patterns, all measured biweekly during the second cycle of CVR use. RESULTS Thirty-seven women completed follow-up. Mean day 0–21 EE concentrations were lower among obese versus normal weight women (15.0 versus 22.0 pg/mL, respectively. p = 0.004), while ENG concentrations were similar (1138 versus 1256 pg/mL, respectively. p = 0.39). Follicular development was minimal in both groups, with only five women achieving a maximum follicle diameter > 13mm at any time during 3 weeks follow-up (3 normal weight and 2 obese women); these women had serum progesterone levels < 1.0. Obese women reported more bleeding or spotting than normal weight women (3.6 versus 1.4 days, respectively. p = 0.01). CONCLUSIONS While obese women had lower EE levels during CVR use, they had excellent suppression of ovarian follicle development, similar to normal weight women. This predicts that CVR effectiveness will be similar in women with a BMI up to 39.9. The lower serum EE levels in the obese women may explain the greater reported bleeding or spotting days. PMID:22727346

Binge eating disorder and obesity: preliminary evidence for distinct cardiovascular and psychological phenotypes.

PubMed

Klatzkin, Rebecca R; Gaffney, Sierra; Cyrus, Kathryn; Bigus, Elizabeth; Brownley, Kimberly A

2015-04-01

This study investigated cardiovascular functioning, mood, and eating-related psychological factors at rest and in response to mental stress in three groups of women: 1) Obese women with binge eating disorder (BED; n=9); 2) obese non-BED women (n=15); and 3) normal weight (NW) non-BED women (n=15). Compared to both obese and NW non-BED women, obese women with BED showed heightened overall blood pressure and reported greater depression symptoms, perceived stress, and eating-related psychopathology. Additionally, obese women with BED reported greater overall negative affect and state anxiety compared to obese non-BED women. The heart rate response to stress was blunted in the obese BED group compared to the other groups, but this effect was no longer significant after controlling for baseline differences in depression. Correlational analyses revealed a positive association between stress-induced changes in hunger and cardiovascular measures only in obese women with BED. Longitudinal studies are needed to determine if stress dysregulation and stress-induced increases in hunger contribute to the onset and/or maintenance of BED. In particular, studies utilizing an additional NW BED control group are warranted in order to further examine the impact of BED above and beyond the impact of obesity on psychophysiological functioning and to inform the growing literature regarding stress-related factors that distinguish the BED and obesity phenotypes. Copyright © 2015 Elsevier Inc. All rights reserved.

Referral Bias in Defining the Phenotype and Prevalence of Obesity in Polycystic Ovary Syndrome

PubMed Central

Ezeh, Uche; Yildiz, Bulent O.

2013-01-01

Background: The described phenotype of the polycystic ovary syndrome (PCOS) has been primarily based on findings in a referred (self or otherwise) population. It is possible that the phenotype of PCOS would be different if the disorder were to be detected and studied in its natural (unbiased) state. Objective: Our objective was to compare the phenotype of PCOS detected in an unselected population with that identified in a referral population. Participants: Participants included 292 PCOS patients identified at a tertiary care outpatient facility (referral PCOS) and 64 PCOS women (unselected PCOS) identified through the screening of a population of 668 seeking a pre-employment physical. Among the women undergoing a pre-employment physical, 563 did not demonstrate features of the disorder (unselected controls). All PCOS subjects met the National Institutes of Health 1990 criteria for the disorder. Main Outcome Measures: We estimated prevalence of obesity and severity of disease burden. Results: Referral PCOS subjects had greater mean body mass index and hirsutism score and higher degrees of hyperandrogenemia, were more likely to be non-Hispanic White (83.90%), and demonstrated a more severe PCOS subphenotype than unselected PCOS or unselected controls. The prevalence of obesity and severe obesity in referral PCOS was 2.3 and 2.5 times greater than estimates of the same in unselected PCOS and 2.2 and 3.8 times greater than estimates in unselected controls, respectively. Alternatively, unselected PCOS subjects had a prevalence of obesity and severe obesity and a mean body mass index similar to those of the general population from which they were derived. Conclusion: The phenotype of PCOS, including the racial/ethnic mix, severity of presentation, and rate of obesity, is affected significantly by whether the PCOS subject arises from a referral population or through unselected screening, likely reflecting the degree of patient concern and awareness and access to healthcare. PMID:23539721

Obesity during pregnancy affects sex steroid concentrations depending on fetal gender.

PubMed

Maliqueo, M; Cruz, G; Espina, C; Contreras, I; García, M; Echiburú, B; Crisosto, N

2017-11-01

It is not clear whether maternal obesity along with fetal gender affect sex steroid metabolism during pregnancy. Therefore, we compared sex steroid concentrations and placental expression of steroidogenic enzymes between non-obese and obese pregnant women with non-pathological pregnancies, and investigated the influence of fetal gender on these parameters. In 35 normal weight (body mass index (BMI) 20-24.9 kg m - 2 ) (controls) and 36 obese women (BMI 30-36 kg m - 2 ) (obese), a fasting blood sample was obtained at first and at third trimester of gestation to measure progesterone, dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione, testosterone and estradiol by liquid chromatography-tandem mass spectrometry and estrone by radioimmunoassay. In a subset of women, placental mRNA and protein expression of steroidogenic enzymes was measured by quantitative PCR and western blot, respectively. The comparisons were primarily made between controls and obese, and then separately according to fetal gender. At first and third trimesters of gestation serum progesterone was lower whereas testosterone was higher in obese women (P<0.05, respectively). Upon analyzing according to fetal gender, lower progesterone levels were present in obese pregnant women with male fetuses at first trimester and with female fetuses at third trimester (P<0.05, respectively). Testosterone was higher in obese women with male fetuses compared to control women with male fetuses (P<0.05). The placental protein expression of P450scc was higher in obese women compared to controls (P<0.05). P450 aromatase was higher in obese women with female fetuses (P=0.009), whereas in obese women with male fetuses P450 aromatase was lower compared to control women (P=0.026). Obesity in non-pathological pregnancies alters the maternal serum progesterone and testosterone concentrations depending on fetal gender. These changes can be attributed to gender-related placental adaptations, as the expression of P450 aromatase is different in placentas from females compared to males.

Obese but not normal-weight women with polycystic ovary syndrome are characterized by metabolic and microvascular insulin resistance.

PubMed

Ketel, Iris J G; Stehouwer, Coen D A; Serné, Erik H; Korsen, Ted J M; Hompes, Peter G A; Smulders, Yvo M; de Jongh, Renate T; Homburg, Roy; Lambalk, Cornelis B

2008-09-01

Polycystic ovary syndrome (PCOS) and obesity are associated with diabetes and cardiovascular disease, but it is unclear to what extent PCOS contributes independently of obesity. The objective of the study was to investigate whether insulin sensitivity and insulin's effects on the microcirculation are impaired in normal-weight and obese women with PCOS. Thirty-five women with PCOS (19 normal weight and 16 obese) and 27 age- and body mass index-matched controls (14 normal weight and 13 obese) were included. Metabolic Insulin sensitivity (isoglycemic-hyperinsulinemic clamp) and microvascular insulin sensitivity [endothelium dependent (acetylcholine [ACh])] and endothelium-independent [sodium nitroprusside (SNP)] vasodilation with laser Doppler flowmetry was assessed at baseline and during hyperinsulinemia. Metabolic insulin sensitivity (M/I value) and the area under the response curves to ACh and SNP curves were measured to assess microcirculatory function at baseline and during insulin infusion (microvascular insulin sensitivity). Obese women were more insulin resistant than normal-weight women (P < 0.001), and obese PCOS women were more resistant than obese controls (P = 0.02). In contrast, normal-weight women with PCOS had similar insulin sensitivity, compared with normal-weight women without PCOS. Baseline responses to ACh showed no difference in the four groups. ACh responses during insulin infusion were significantly greater in normal-weight PCOS and controls than in obese PCOS and controls. PCOS per se had no significant influence on ACh responses during insulin infusion. During hyperinsulinemia, SNP-dependent vasodilatation did not significantly increase, compared with baseline in the four groups. PCOS per se was not associated with impaired metabolic insulin sensitivity in normal-weight women but aggravates impairment of metabolic insulin sensitivity in obese women. In obese but not normal-weight women, microvascular and metabolic insulin sensitivity are decreased, independent of PCOS. Therefore, obese PCOS women in particular may be at increased risk of metabolic and cardiovascular diseases.

Serum trace elements in obese women with or without diabetes

PubMed Central

Yerlikaya, F. Hümeyra; Toker, Aysun; Arıbaş, Alpay

2013-01-01

Background & objectives: Relationship of trace elements with obesity and diabetes is complex, alterations in their metabolism can be induced by the diseases and their complications. To study the role of the trace elements in diabetes and obesity, serum trace elements levels (Cr, Se, Fe, Zn, Cu and Mn) were measured in obese women with or without diabetes as well as healthy women. Further, correlation between serum trace elements levels and glucose, insulin, homeostasis model assessment (HOMA-IR), glycated haemoglobin (HbA1c), body mass index (BMI), waist circumferences, waist -to -hip ratio and high-sensitivity C-reactive protein(hsCRP) were also determined in these women. Methods: This study was performed with morbidly obese (BMI >40 kg/m2) women with diabetes (n=41), without diabetes (n=45) and 50 healthly non obese women. Anthropometric measurements were taken and levels of serum Zn, Cr, Fe Cu and Mn were determined. Biochemical parameters included serum glucose, insulin, lipids, haemoglobin, hsCRP and HbA1C. Results: The levels of Zn (P<0.001), Mn (P<0.05), Fe (P<0.05) were significantly lower and the level of Cu (P<0.001) and Cu / Zn ratio (P<0.05) were significantly higher in the diabetic obese women than those of the healthy women. Also, the levels of Zn and Fe were significantly lower and the levels of Cu were significantly higher in the non diabetic obese women than those of the healthy group. Serum Zn levels negatively and serum Cu levels positively correlated with anthropometric values in diabetic and non diabetic obese women. Further, serum Zn, Mn and Cr levels negatively correlated and serum Se levels positively correlated glycaemia control parameters in diabetic obese women. In addition, serum Zn levels negatively correlated with hsCRP in diabetic and nondiabetic obese females. Interpretation & conclusions: Our findings showed significant association between Zn and Fe deficiencies and obesity. Also, obese women with diabetes may be at a greater risk of developing imbalances and deficiencies of trace elements compared with obese women without diabetes. PMID:23563378

Obesity is not protective against fracture in postmenopausal women: GLOW.

PubMed

Compston, Juliet E; Watts, Nelson B; Chapurlat, Roland; Cooper, Cyrus; Boonen, Steven; Greenspan, Susan; Pfeilschifter, Johannes; Silverman, Stuart; Díez-Pérez, Adolfo; Lindsay, Robert; Saag, Kenneth G; Netelenbos, J Coen; Gehlbach, Stephen; Hooven, Frederick H; Flahive, Julie; Adachi, Jonathan D; Rossini, Maurizio; Lacroix, Andrea Z; Roux, Christian; Sambrook, Philip N; Siris, Ethel S

2011-11-01

To investigate the prevalence and incidence of clinical fractures in obese, postmenopausal women enrolled in the Global Longitudinal study of Osteoporosis in Women (GLOW). This was a multinational, prospective, observational, population-based study carried out by 723 physician practices at 17 sites in 10 countries. A total of 60,393 women aged ≥ 55 years were included. Data were collected using self-administered questionnaires that covered domains that included patient characteristics, fracture history, risk factors for fracture, and anti-osteoporosis medications. Body mass index (BMI) and fracture history were available at baseline and at 1 and 2 years in 44,534 women, 23.4% of whom were obese (BMI ≥ 30 kg/m(2)). Fracture prevalence in obese women at baseline was 222 per 1000 and incidence at 2 years was 61.7 per 1000, similar to rates in nonobese women (227 and 66.0 per 1000, respectively). Fractures in obese women accounted for 23% and 22% of all previous and incident fractures, respectively. The risk of incident ankle and upper leg fractures was significantly higher in obese than in nonobese women, while the risk of wrist fracture was significantly lower. Obese women with fracture were more likely to have experienced early menopause and to report 2 or more falls in the past year. Self-reported asthma, emphysema, and type 1 diabetes were all significantly more common in obese than nonobese women with incident fracture. At 2 years, 27% of obese women with incident fracture were receiving bone protective therapy, compared with 41% of nonobese and 57% of underweight women. Our results demonstrate that obesity is not protective against fracture in postmenopausal women and is associated with increased risk of ankle and upper leg fractures. Copyright © 2011 Elsevier Inc. All rights reserved.

Midwifery Management of Pregnant Women Who Are Obese.

PubMed

Reither, Margi; Germano, Elaine; DeGrazia, Michele

2018-05-19

Obesity is associated with increased risks for adverse health outcomes during and after pregnancy in both the woman with obesity and her infant. This study was designed to investigate midwifery management of pregnant women with obesity. Certified midwives and certified nurse-midwives who were members of the American College of Nurse-Midwives were sent a survey. The survey instrument was divided into 4 sections: demographic characteristics; practice guidelines and protocols; the role of the 2015 Levels of Maternal Care guidelines for referral, including transfer to a higher level of care; and factors that influence management of pregnant women with obesity. Descriptive statistics were used to analyze data. In a sample of 546 midwives, 87% of respondents reported observing an increase in perinatal complications associated with obesity. Midwives reported increasing discomfort with the care of pregnant women with obesity as body mass index (BMI) increased. For pregnant women with extreme obesity, the respondents reported less frequent use of physiologic birth guidelines only and increased use of interventions, referral to physician care, and transfer to a higher level of care. Approximately half (270, 49.5%) reported having a guideline that addressed the care of women with obesity. Of these, 145 midwives (53.7%) reported that extreme obesity was the BMI threshold for identifying an increased or high risk for perinatal complications. Sixty percent (339) of midwives who participated requested guidance for management of laboring women who are obese. This study provides a greater understanding of midwifery management practices when caring for women with obesity and opportunities to improve care. The results suggest that midwifery management alters with increased BMI, specifically in the care of women with extreme obesity. Suggestions for future study include research on management of pregnant women with obesity and extreme obesity with outcome data examining management strategies that provide safe, satisfying care. © 2018 by the American College of Nurse-Midwives.

Postpartum Care and Contraception in Obese Women.

PubMed

Maclean, Courtney C; Thompson, Ivana S

2016-03-01

Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women.

Efficacy of prophylactic antibiotic administration for breast cancer surgery in overweight or obese patients: a randomized controlled trial.

PubMed

Gulluoglu, Bahadir M; Guler, Sertac Ata; Ugurlu, M Umit; Culha, Gulcan

2013-01-01

To assess the impact of prophylactic antibiotics on the prevention of surgical site infection (SSI) and the cost-effectiveness of this prophylaxis for breast cancer surgery in overweight or obese women. SSI is higher than expected after breast surgery. Obesity was found to be one of the risk factors. The trial was designed as a phase IV randomized, controlled, parallel-group efficacy trial. It was conducted at a tertiary university hospital. Overweight or obese women with clinically early-stage breast cancer who had been assigned to undergo surgery were eligible. Patients were randomly allocated to either a prophylaxis or a control group by using a computer-generated list. The prophylaxis group received 1 g ampicillin-sulbactam intravenously at anesthesia. The control group received no intervention. Patients and observers were blinded to the assignments. The primary outcome was the comparison of SSI incidences of the 2 groups. Patients were monitored for 30 days. A total of 369 patients were included in final analysis, out of which 187 were allocated for prophylaxis and 182 were randomly assigned to the control group. Analysis was done according to the intention-to-treat principle. Prophylaxis significantly reduced the SSI rate (4.8%) in the prophylaxis group when compared with that in the control group [13.7%; relative risk (RR) 0.35; 95% CI: 0.17-0.73]. No adverse reaction was observed. The mean SSI-related cost (20.26 USD) was found to be significantly higher in the control group when compared with that (8.48 USD) in the prophylaxis group. Antibiotic prophylaxis significantly decreased SSI incidence after elective surgery and was shown to be cost-effective in obese breast cancer patients. ClinicalTrials.gov Identifier: NCT00356148.

Obesity-Associated Hypertension: the Upcoming Phenotype in African-American Women.

PubMed

Samson, Rohan; Qi, Andrea; Jaiswal, Abhishek; Le Jemtel, Thierry H; Oparil, Suzanne

2017-05-01

The present obesity epidemic particularly affects African-American women. Whether the obesity epidemic will alter the hypertension phenotype in African-American women is entertained. The prevalence of morbid obesity is steadily increasing in African-American women, who are prone to developing hypertension (HTN) even in the absence of obesity. The obesity-associated hypertension phenotype is characterized by marked sympathetic nervous system activation and resistance/refractoriness to antihypertensive therapy. Weight loss achieved through lifestyle interventions and pharmacotherapy has a modest and rarely sustained antihypertensive effect. In contrast, bariatric surgery has a sustained antihypertensive effect, as evidenced by normalization of hypertension or lessening of antihypertensive therapy. The prevalence of HTN and its obesity-associated phenotype is likely to increase in African-American women over the next decades. Obese African-American women may be increasingly referred for bariatric surgery when hypertension remains uncontrolled despite lifestyle interventions and pharmacological therapy for weight loss and blood pressure (BP) control.

Obesity and fractures in postmenopausal women.

PubMed

Compston, Juliet

2015-07-01

Although obesity was previously believed to be protective against fracture, there is now evidence that a significant proportion of fractures in postmenopausal women occur in those who are obese. In this article the epidemiology, pathophysiology and clinical management of fractures in obese postmenopausal women are discussed with particular focus on the site specificity of the effect of BMI on fracture, interactions between fat and bone and risk assessment and prevention of fractures. There is similarity in many respects between risk factors for fracture in obese and nonobese women, although falls may play a particularly important role in the obese. Treatment rates in obese postmenopausal women with fracture are currently low, and further studies are required to establish effective preventive strategies. Fractures in obese postmenopausal women contribute significantly to the overall fracture burden in this population. Further work is required to establish their pathophysiology and to develop effective preventive strategies.

Overweight, obesity and related non-communicable diseases in Asian Indian girls and women.

PubMed

Chopra, S M; Misra, A; Gulati, S; Gupta, R

2013-07-01

The prevalence of obesity is rising globally and in India. Overweight, obesity and related diseases need to be delineated in Asian Indian women. A literature search was done using key words like 'obesity', 'Asian Indian women', 'body fat distribution', 'type 2 diabetes', 'fertility', 'polycystic ovarian disease', metabolic syndrome', 'cardiovascular disease', 'non-alcoholic fatty liver disease', 'gender', 'sex' and 'prevalence' up to September 2012 in Pubmed and Google Scholar search engines. This review highlights the Asian Indian body composition with regards to obesity and provides a collated perspective of gender-specific prevalence of the co-morbidities. Recent data show that women (range of prevalence of overweight and obesity from different studies 15-61%) have higher prevalence of overweight and obesity as compared with men (range of prevalence of overweight and obesity from different studies 12-54%) in India and that obesity is increasing in the youth. The prevalence of overweight and obesity in both men and women steeply rose in a Punjabi community from Jaipur. Importantly, prevalence of abdominal obesity has been consistently higher in women than in men. The lowest prevalence (6.0%) of type 2 diabetes mellitus in women is reported from South India (rural Andhra Pradesh; 2006) and the highest (14.0%) by the National Urban Diabetes Survey (2001). Although the clustering of cardiovascular disease risk factors was generally high, it increased further in post-menopausal women. There are a number of factors that predispose Indian women to obesity; sedentary behaviour, imbalanced diets, sequential and additive postpartum weight gain and further decrease in physical activity during this period and cultural issues. In view of these data, preventive measures should be specifically targeted to Indian women.

Obesity and risk taking. A male phenomenon.

PubMed

Koritzky, Gilly; Yechiam, Eldad; Bukay, Irit; Milman, Uzi

2012-10-01

There is a growing tendency to regard overeating as an addiction, with obesity as its primary symptom. We propose that similar to other addictions, obesity is associated with excessive risk-taking in men, though not in women. To examine this suggestion we conducted two studies, one involving a sample of overweight and normal-weight students, and the other involving obese adults drawn from a dataset of health care clients, and a control sample of normal-weight adults. In both of these studies, we found that overweight and obese men took more risk in a laboratory task than normal-weight men, while overweight and obese women did not differ from normal-weight women in this respect. At the same time, obese women (but not overweight women) displayed higher impulsivity levels than normal-weight women. These findings shed light on the cognitive characteristics of obesity in men, and accent the importance of taking gender into account when developing research paradigms and treatment methods for obesity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Less activation in the left dorsolateral prefrontal cortex in the reanalysis of the response to a meal in obese than in lean women and its association with successful weight loss23

PubMed Central

Son NT Le, Duc; Pannacciulli, Nicola; Chen, Kewei; Salbe, Arline D; Hill, James O; Wing, Rena R; Reiman, Eric M; Krakoff, Jonathan

2007-01-01

Background We previously found that obese men have less activation in the left dorsolateral prefrontal cortex (LDLPFC) in response to a meal than do lean men, which indicates an association between this altered neuronal response and the pathophysiology of obesity. Objectives The objectives of the study were to extend this finding in obese women and to investigate activity in this region in women with a history of severe obesity who have successfully lost weight (ie, formerly obese women, sometimes called postobese women). Design We reanalyzed previously collected data to compare post-meal (after receiving a liquid meal) with premeal (after a 36-h fast) regional cerebral blood flow, a marker of neuronal activity, by using 15O-water positron emission tomography in 10 lean [26 ± 6% body fat (BF)], 9 obese (39 ± 3%BF) and 8 formerly obese (28 ± 4%BF) right-handed women. Data were analyzed by using a 2-level, random-effect analysis of variance. Results The regional cerebral blood flow in the LDLPFC differed in response to the meal across the 3 groups (P < 0.001, uncorrected for multiple comparisons). Post hoc group comparisons showed that obese women had significantly less activation in this area than did lean and formerly obese women. No significant difference between formerly obese and lean women was found. Conclusions These results extend our previous findings, indicating that obese women have less activation in the LDLPFC in response to a meal than do lean or formerly obese women. Neuronal activity in this region did not differ significantly between the latter 2 groups. Longitudinal studies are needed to determine whether these differences in neuronal activity change with or predict weight change. PMID:17823419

Optimal waist circumference cut-off values for predicting cardiovascular risk factors in a multi-ethnic Malaysian population.

PubMed

Cheong, Kee C; Ghazali, Sumarni M; Hock, Lim K; Yusoff, Ahmad F; Selvarajah, Sharmini; Haniff, Jamaiyah; Zainuddin, Ahmad Ali; Ying, Chan Y; Lin, Khor G; Rahman, Jamalludin A; Shahar, Suzana; Mustafa, Amal N

2014-01-01

Previous studies have proposed the lower waist circumference (WC) cutoffs be used for defining abdominal obesity in Asian populations. To determine the optimal cut-offs of waist circumference (WC) in predicting cardiovascular (CV) risk factors in the multi-ethnic Malaysian population. We analysed data from 32,703 respondents (14,980 men and 17,723 women) aged 18 years and above who participated in the Third National Health and Morbidity Survey in 2006. Gender-specific logistic regression analyses were used to examine associations between WC and three CV risk factors (diabetes mellitus, hypertension, and hypercholesterolemia). The Receiver Operating Characteristic (ROC) curves were used to determine the cut-off values of WC with optimum sensitivity and specificity for detecting these CV risk factors. The odds ratio for having diabetes mellitus, hypertension, and hypercholesterolemia, or at least one of these risks, increased significantly as the WC cut-off point increased. Optimal WC cut-off values for predicting the presence of diabetes mellitus, hypertension, hypercholesterolemia and at least one of the three CV risk factors varied from 81.4 to 85.5 cm for men and 79.8 to 80.7 cm for women. Our findings indicate that WC cut-offs of 81 cm for men and 80 cm for women are appropriate for defining abdominal obesity and for recommendation to undergo cardiovascular risk screening and weight management in the Malaysian adult population. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

An assessment of the relationship of physical activity, obesity, and chronic diseases/conditions between active/obese and sedentary/ normal weight American women in a national sample.

PubMed

Pharr, J R; Coughenour, C A; Bungum, T J

2018-03-01

Obesity and physical inactivity are associated with increased rates of chronic diseases and conditions. However, the 'fit but fat' theory posits that cardiopulmonary fitness (or physical activity) can mitigate risks to health associated with obesity. The purpose of this study was to compare chronic diseases and conditions of highly active/obese women with inactive/normal weight women. This was a cross-sectional study of the 2015 Behavioral Risk Factor Surveillance System data. Weighted descriptive statistics were performed to describe the demographic characteristics of the two groups. We calculated odds ratios and adjusted odds ratios for chronic diseases and conditions comparing highly active/obese women with inactive/normal weight women. Highly active/obese women were more likely to report risk factors (hypertension, high cholesterol, and diabetes) for coronary heart disease (CHD) and cardiovascular disease (CVD) than inactive/normal weight women; however, they did not have increased rates of CVD, CHD, or heart attack and had decreased risk for stroke. Highly active/obese women had increased risk for asthma, arthritis, and depression, but not for cancer, kidney disease, or chronic obstructive pulmonary disease. Highly active/obese women appear to be staving off the actual development of CHD and CVD; however, further research is needed to understand the long-term health benefits of physical activity among obese women. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Intake of sweet foods and counts of cariogenic microorganisms in obese and normal-weight women.

PubMed

Barkeling, B; Andersson, I; Lindroos, A K; Birkhed, D; Rössner, S

2001-10-01

To study the intake of sweet foods in obese and normal-weight women, while also taking menstrual cycle effects on eating behaviour into consideration. An objective test of the intake of sugar-containing foods was introduced by measuring salivary counts of mutans streptococci and lactobacilli. A cross-sectional comparison of the intake of sweet foods in obese and normal-weight women. The obese women were also studied longitudinally after 10 weeks in a weight reduction programme. Obese (n=72, body mass index (BMI) 42.0+/-5.2 kg/m2) and normal-weight women (n=67, BMI 22.2+/-1.6 kg/m2) participated. Mutans streptococci in saliva were higher in obese than in normal-weight women (P<0.0001), although the reported habitual daily intake of sweet foods did not differ. Of the menstruating women, 80% of the obese subjects and 62% of the normal-weight ones (P<0.05) reported periods during the menstrual cycle with an 'extra large' intake of sweet foods; these intakes were higher in obese than in normal-weight women (P<0.01). The obese women reduced their intake of sweet foods after 10 weeks of weight reduction, although these changes were not pronounced enough to significantly affect the counts of cariogenic microorganisms. In contrast to most previous cross-sectional studies, this study shows that obese women have a higher intake of sweet foods, especially pre-menstrually. This was indicated by higher salivary counts of cariogenic microorganisms. Karolinska Institute Research Funds.

Dietary patterns and the metabolic syndrome in obese and non-obese Framingham women.

PubMed

Sonnenberg, Lillian; Pencina, Michael; Kimokoti, Ruth; Quatromoni, Paula; Nam, Byung-Ho; D'Agostino, Ralph; Meigs, James B; Ordovas, Jose; Cobain, Mark; Millen, Barbara

2005-01-01

To examine the relationship between habitual dietary patterns and the metabolic syndrome (MetS) in women and to identify foci for preventive nutrition interventions. Dietary patterns, nutrient intake, cardiovascular disease (CVD), and MetS risk factors were characterized in 1615 Framingham Offspring-Spouse Study (FOS) women. Dietary pattern subgroups were compared for MetS prevalence and CVD risk factor status using logistic regression and analysis of covariance. Analyses were performed overall in women and stratified on obesity status; multivariate models controlled for age, apolipoprotein E (APOE) genotypes, and CVD risk factors. Food and nutrient profiles and overall nutritional risk of five non-overlapping habitual dietary patterns of women were identified including Heart Healthier, Lighter Eating, Wine and Moderate Eating, Higher Fat, and Empty Calories. Rates of hypertension and low high-density lipoprotein levels were high in non-obese women, but individual MetS risk factor levels were substantially increased in obese women. Overall MetS risk varied by dietary pattern and obesity status, independently of APOE and CVD risk factors. Compared with obese or non-obese women and women overall with other dietary patterns, MetS was highest in those with the Empty Calorie pattern (contrast p value: p<0.05). This research shows the independent relationship between habitual dietary patterns and MetS risk in FOS women and the influence of obesity status. High overall MetS risk and the varying prevalence of individual MetS risk factors in female subgroups emphasize the importance of preventive nutrition interventions and suggest potential benefits of targeted behavior change in both obese and non-obese women by dietary pattern.

Effect of obesity on the effectiveness of hormonal contraceptives: an individual participant data meta-analysis.

PubMed

Yamazaki, Michiyo; Dwyer, Kate; Sobhan, Mahboob; Davis, Daniel; Kim, Myong-Jin; Soule, Lisa; Willett, Gerald; Yu, Chongwoo

2015-11-01

The objective of this investigation was to assess the potential effect of obesity on the effectiveness of hormonal contraceptives (HCs). A meta-analysis was conducted using individual participant data directly from the Phase 3 clinical trials of combination oral contraceptives (COCs) rather than extracting summary data from literature. Trials selected were reviewed by the US Food and Drug Administration (FDA) between 2000 and 2012, conducted in North America, had more than six 28-day cycle equivalents of exposure, and had readily retrievable participant-level data. Contraceptive effectiveness was measured by the Pearl Index (PI: the number of pregnancies per 100 woman-years) in women aged 18-35 at risk of unintended pregnancy. The incidence rate ratio (IRR), a ratio of PIs for obese women (defined as body mass index [BMI] ≥30 kg/m(2)) compared to non-obese women (BMI <30 kg/m(2)) was calculated. A Cox proportional-hazard regression model with fixed and random-effects were used to estimate hazard ratios (HRs) for unintended pregnancy in obese women compared to non-obese women. Seven clinical trials with COCs (N=14,024: 2707 obese and 11,317 non-obese women) met the inclusion criteria for the meta-analysis. The PI for each trial varied: 2.05-5.08 for obese and 1.84-3.80 for non-obese women. The pooled PI estimated using direct weighted average method was 3.14 (95% CI: 2.33-4.22) for obese and 2.53 (95% CI: 1.88-3.41) for non-obese women. The pooled IRRs estimated using direct weighted average and Mantel-Haenszel adjustment methods were comparable: 1.37 (95% CI: 1.02-1.84) and 1.43 (95% CI: 1.07-1.92), respectively. The overall HR of 1.44 (95% CI: 1.06-1.95; p=.018) in the meta-analysis suggested a 44% higher pregnancy rate during COC use for obese women after adjusting for age and race. Obesity may increase the risk of unintended pregnancy in women using COCs; more data on obese women from ongoing and future Phase 3 clinical trials are necessary to allow further evaluation of this topic. Results of this meta-analysis suggest that obese women may have a higher pregnancy rate during COC use compared to non-obese women. Future analysis should assess differences in pharmacodynamics or compliance that could potentially account for the observed difference in unintended pregnancy rates. Published by Elsevier Inc.

Convergence in insulin resistance between very severely obese and lean women at the end of pregnancy.

PubMed

Forbes, Shareen; Barr, Sarah M; Reynolds, Rebecca M; Semple, Scott; Gray, Calum; Andrew, Ruth; Denison, Fiona C; Walker, Brian R; Norman, Jane E

2015-11-01

Disrupted intermediary metabolism may contribute to the adverse pregnancy outcomes in women with very severe obesity. Our aim was to study metabolism in such pregnancies. We recruited a longitudinal cohort of very severely obese (n = 190) and lean (n = 118) glucose-tolerant women for anthropometric and metabolic measurements at early, mid and late gestation and postpartum. In case-control studies of very severely obese and lean women we measured glucose and glycerol turnover during low- and high-dose hyperinsulinaemic-euglycaemic clamps (HEC) at early and late pregnancy and in non-pregnant women (each n = 6-9) and body fat distribution by MRI in late pregnancy (n = 10/group). Although greater glucose, insulin, NEFA and insulin resistance (HOMA-IR), and greater weight and % fat mass (FM) was observed in very severely obese vs lean participants, the degree of worsening was attenuated in the very severely obese individuals with advancing gestation, with no difference in triacylglycerol (TG) concentrations between very severely obese and lean women at term. Enhanced glycerol production was observed in early pregnancy only in very severely obese individuals, with similar intrahepatic FM in very severely obese vs lean women by late gestation. Offspring from obese mothers were heavier (p = 0.04). Pregnancies complicated by obesity demonstrate attenuation in weight gain and insulin resistance compared with pregnancies in lean women. Increased glycerol production is confined to obese women in early pregnancy and obese and lean individuals have similar intrahepatic FM by term. When targeting maternal metabolism to treat adverse pregnancy outcomes, therapeutic intervention may be most effective applied early in pregnancy.

Self-others perception in a clinical sample of obese women.

PubMed

Molinari, E; Riva, G

1995-06-01

The purpose of this research, using correspondence analysis on responses to semantic differential scores, was both to examine self-perception in a clinical sample of 120 obese women and to compare this with their attitudes toward obese, thin, and normal persons. Analyses allow us to conclude that, if obese women, as reported previously, consider obesity as a largely negative condition, they have an ambivalent attitude towards themselves. Even though they share the negative connotations socially attributed to obesity, emotionally these obese women not only tend not to recognize their "abnormality" but strongly desire it.

Excess fat in the abdomen but not general obesity is associated with poorer metabolic and cardiovascular health in premenopausal and postmenopausal Asian women.

PubMed

Goh, Victor Hng Hang; Hart, William George

2018-01-01

To examine the associations of various metabolites and hormones and hormone replacement therapy (HRT) with obesity. This is a cross-sectional study of 1326 Singaporean women. A DXA-derived percent body fat (PBF) of ≥35% and percent abdominal fat (PAbdF) of >21.8% were used, respectively, to define women with general (GOb) and abdominal (AbdOb) obesity. Higher levels of insulin and glucose, lower levels of HDL, higher levels of TC/HDL and HOMA values, and different levels of some hormones were noted only in the women with abdominal, and not general obesity. The incidence of general and abdominal obesity was higher in postmenopausal women with or without HRT, except that those who were on conjugated estradiol-only HRT had no increase in the incidence of general obesity compared with premenopausal women. Abdominal obesity is associated with insulin resistance and with higher risks of metabolic syndrome and cardiovascular diseases, whereas general obesity is not. Abdominal obesity may predispose to a higher risk of diabetes. The onset of the menopause tends to increase the incidence of general and abdominal obesity, except that postmenopausal women on conjugated estradiol HRT appear to be relatively protected from general obesity. Copyright © 2017 Elsevier B.V. All rights reserved.

Obesity among Women in Turkey.

PubMed

Santas, Fatih; Santas, Gulcan

2018-05-01

This study aimed to determine the prevalence and potential risk factors of obesity among women in Turkey. The data source was the Turkey Demographic and Health Survey (TDHS) in 1998, 2003, 2008 and 2013, conducted by Hacettepe University Institute of Population Studies. Cross-tables and binary logistic regression were used in the study. Obesity was a serious problem among women in Turkey. Obesity rate was 21.7% in 1998 and increased to 26.5% in 2013. Age, education level, the number of births, region, residence, and wealth status were included as potential risk factors. Age was an important variable affecting obesity and increased with age. There was an inverse relationship between obesity and education level. Women having no education or not completed primary school and those who were not working were higher at obesity risk. Obesity increased with the giving births of mothers. Obesity was mostly observed in the West and Central. As household welfare increased, obesity increased except for 2013 research. Preventive interventions should be announced particularly among urban women in Turkey. Women should be stimulated by physical activities and informed by realistic food policies.

Obesity in Women: Insights for the Clinician.

PubMed

Tauqeer, Zujaja; Gomez, Gricelda; Stanford, Fatima Cody

2018-04-01

As a leading cause of morbidity and mortality in the United States and worldwide, obesity is a disease that is frequently encountered in clinical practice today and requires a range of medical interventions. While obesity affects both men and women across all ages, multiple issues are particularly germane to women's health, particularly as obesity is more prevalent among women than men in the United States and obesity among women of reproductive health relates to the growing issue of childhood obesity. Discussed herein are the epidemiology and pathophysiology of obesity along with the impact of perinatal obesity on fetal programming. Guidance on screening and management of obesity through lifestyle intervention, pharmacologic therapy, and bariatric surgery, as well as avoidance of weight-promoting medications wherever possible, is elaborated. Particular attention is paid to the contribution of these modalities to weight loss as well as their impact on obesity-related comorbidities that affect a woman's overall health, such as type 2 diabetes and hypertension, and her reproductive and gynecologic health. With modest weight loss, women with obesity can achieve notable improvements in chronic medical conditions, fertility, pregnancy outcomes, and symptoms of pelvic floor disorders. Moreover, as children born to women after bariatric surgery-induced weight loss show improved metabolic outcomes, this demonstrates a role for maternal weight loss in reducing risk of development of metabolic disturbances in children. In light of the immense cost burden and mortality from obesity, it is important to emphasize the role of lifestyle intervention, pharmacologic management, and bariatric surgery for weight loss in clinical practice to mitigate the impact of obesity on women's health.

Adipokine Profiling in Adult Women With Central Obesity and Hypertension

PubMed Central

Supriya, Rashmi; Yung, Benjamin Y.; Yu, Angus P.; Lee, Paul H.; Lai, Christopher W.; Cheng, Kenneth K.; Yau, Suk Y.; Chan, Lawrence W. C.; Sheridan, Sinead; Siu, Parco M.

2018-01-01

Central obesity and hypertension are common risk factors for the metabolic syndrome, cardiovascular and renal diseases. Studies have shown that it is more difficult to control blood pressure and prevent end-organ damage in obese individuals with hypertension compared to their non-obese counterparts, especially among women. Obese females have a 6 times higher risk of developing hypertension than non-obese females while obese males are at a 1.5 times higher risk of developing hypertension, compared to their non-obese counterparts. Indeed, the inter-relationship between obesity and hypertension is unclear. Adipokines have been proposed to play a mediating role in the relationship between obesity and hypertension and are involved in the pathogenesis of metabolic diseases. Therefore, this study sought to determine the role of adipokines (adiponectin, plasminogen activator inhibitor-1, leptin, and tumor necrosis factor-α) in hypertensive Hong Kong Chinese women with central obesity. A total of 387 women aged 58 ± 11 years who were examined with a 2 × 2 factorial design for central obesity (waist circumference ≥ 80 cm) and hypertension (blood pressure ≥ 140/90 mmHg), were recruited from a pool of 1,492 Hong Kong Chinese adults who were previously screened for metabolic syndrome. Subjects with hyperglycemia, hypertriglyceridemia, and dyslipidemia were excluded to eliminate confounding effects. Our findings revealed that hypertensive women with central obesity had a lower anti-inflammatory status (adiponectin) and a higher pro-inflammatory status (TNF-α) than obese alone or hypertensive alone women. Also, women with central obesity had higher circulatory PAI-1 and leptin concentrations than their non-obese counterparts. We conclude that obesity may shift toward a more pro-inflammatory state and may become more severe in the presence of hypertension or vice versa. PMID:29636702

Urban-rural disparity of overweight/obesity distribution and its potential trend with breast cancer among Chinese women

PubMed Central

Gao, Ying; Huang, Yubei; Song, Fengju; Dai, Hongji; Wang, Peishan; Li, Haixin; Zheng, Hong; Dong, Henglei; Han, Jiali; Wang, Yaogang; Chen, Kexin

2016-01-01

Objective To evaluate the urban-rural disparity of overweight/obesity and explore its potential trend with breast cancer among Chinese women. Results The prevalence of overweight/obesity for Chinese rural women (35.2%, 29.2% for overweight and 6.0% for obesity) was significantly higher than that for Chinese urban women (33.4%, 27.7% for overweight and 5.7% for obesity) (P < 0.001). For either rural or urban women, the prevalence of overweight/obesity was highest in north region, followed by east region for rural women and north-east region for urban women. For rural women, higher prevalence of overweight/obesity was significantly positively associated with elder age, Han nationality, low level of education, no occupation, high family income, less number of family residents, insurance, and elder age at marriage. Similar positive associations were also found for urban women, except negative associations for high family income, less number of family residents, and elder age at marriage. A non-significant positive trend between overweight/obesity and breast cancer was found for rural women [odds ratio (OR): 1.06; 95% confidence interval (CI): 0.87–1.29], but a significant positive trend for urban women (OR: 1.55; 95% CI: 1.19–2.02). Materials and Methods A total of 1 210 762 participants were recruited from the Chinese National Breast Cancer Screening Program. Overweight and obesity were defined as body mass index (BMI) ranged 24.0–27.9 kg/m2 and BMI ≥ 28.0kg/m2, respectively. Conclusions There was an obvious urban-rural disparity of overweight/obesity distribution among Chinese women, which could also lead to an obvious disparity of breast cancer distribution. PMID:27489359

Urban-rural disparity of overweight/obesity distribution and its potential trend with breast cancer among Chinese women.

PubMed

Gao, Ying; Huang, Yubei; Song, Fengju; Dai, Hongji; Wang, Peishan; Li, Haixin; Zheng, Hong; Dong, Henglei; Han, Jiali; Wang, Yaogang; Chen, Kexin

2016-08-30

To evaluate the urban-rural disparity of overweight/obesity and explore its potential trend with breast cancer among Chinese women. The prevalence of overweight/obesity for Chinese rural women (35.2%, 29.2% for overweight and 6.0% for obesity) was significantly higher than that for Chinese urban women (33.4%, 27.7% for overweight and 5.7% for obesity) (P < 0.001). For either rural or urban women, the prevalence of overweight/obesity was highest in north region, followed by east region for rural women and north-east region for urban women. For rural women, higher prevalence of overweight/obesity was significantly positively associated with elder age, Han nationality, low level of education, no occupation, high family income, less number of family residents, insurance, and elder age at marriage. Similar positive associations were also found for urban women, except negative associations for high family income, less number of family residents, and elder age at marriage. A non-significant positive trend between overweight/obesity and breast cancer was found for rural women [odds ratio (OR): 1.06; 95% confidence interval (CI): 0.87-1.29], but a significant positive trend for urban women (OR: 1.55; 95% CI: 1.19-2.02). A total of 1 210 762 participants were recruited from the Chinese National Breast Cancer Screening Program. Overweight and obesity were defined as body mass index (BMI) ranged 24.0-27.9 kg/m2 and BMI ≥ 28.0kg/m2, respectively. There was an obvious urban-rural disparity of overweight/obesity distribution among Chinese women, which could also lead to an obvious disparity of breast cancer distribution.

Impact of physical activity during pregnancy on obstetric outcomes in obese women

PubMed Central

Tinius, Rachel A.; Cahill, Alison G.; Cade, W. Todd

2016-01-01

Aim Maternal obesity is associated with complications and adverse outcomes during the labor and delivery process. In pregnant women with a healthy body weight, maternal physical activity during pregnancy is associated with better obstetric outcomes; however, the effect of maternal physical activity during pregnancy on obstetric outcomes in obese women is not known. The purpose of the study was to determine the influence of self-reported physical activity levels on obstetric outcomes in pregnant obese women. Methods A retrospective chart review was performed on 48 active obese women and 48 inactive obese women (N=96) who received prenatal care and delivered at the medical center during the past five years. Obstetric and neonatal outcomes were compared between the active and inactive groups. Results Obese women who were active during pregnancy spent less total time in labor (13.4 hours vs. 19.2 hours, p=0.048) and were less likely to request an epidural (92% vs. 100%, p=0.04). When stratified by parity, active multiparous women spent significantly less total time in labor compared to inactive multiparous (6.2 hours vs. 16.7 hours, p=0.018). There were no statistical differences between groups in rates of cesarean deliveries or neonatal outcomes. Conclusion Maternal physical activity during pregnancy appears to improve obstetric outcomes in obese women, and this improvement may be more pronounced among multiparous women. Our finding is of particular importance as pregnant obese women are at higher risk for adverse and delivery outcomes. PMID:26564274

Laparoscopic colectomy in the obese, morbidly obese, and super morbidly obese: when does weight matter?

PubMed

Champagne, Bradley J; Nishtala, Madhuri; Brady, Justin T; Crawshaw, Benjamin P; Franklin, Morris E; Delaney, Conor P; Steele, Scott R

2017-10-01

Previous studies have demonstrated that obese patients (BMI >30) undergoing laparoscopic colectomy have longer operative times and increased complications when compared to non-obese cohorts. However, there is little data that specifically evaluates the outcomes of obese patients based on the degree of their obesity. The aim of this study was to evaluate the impact of increasing severity of obesity on patients undergoing laparoscopic colectomy. A retrospective review was performed of all patients undergoing laparoscopic colectomy between 1996 and 2013. Patients were classified according to their BMI as obese (BMI 30.0-39.9), morbidly obese (BMI 40.0-49.9), and super obese (BMI >50). Main outcome measures included conversion rate, operative time, estimated blood loss, post-operative complications, and length of stay. There were 923 patients who met inclusion criteria. Overall, 604 (65.4%), 257 (27.9%), and 62 (6.7%) were classified as obese (O), morbidly obese (MO), and super obese (SO), respectively. Clinicopathologic characteristics were similar among the three groups. The SO group had significantly higher conversion rates (17.7 vs. 7 vs. 4.8%; P = 0.031), longer average hospital stays (7.1 days vs. 4.9 vs. 3.4; P = 0.001), higher morbidity (40.3 vs. 16.3 vs. 12.4%; P = 0.001), and longer operative times (206 min vs. 184 vs. 163; P = 0.04) compared to the MO and O groups, respectively. The anastomotic leak rate in the SO (4.8%; P = 0.027) and MO males (4.1%; P = 0.033) was significantly higher than MO females (2.2%) and all obese patients (1.8%). Increasing severity of obesity is associated with worse perioperative outcomes following laparoscopic colectomy.

Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women

PubMed Central

Schmiegelow, Michelle D; Hedlin, Haley; Mackey, Rachel H; Martin, Lisa W; Vitolins, Mara Z; Stefanick, Marcia L; Perez, Marco V; Allison, Matthew; Hlatky, Mark A

2015-01-01

Background It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups. Methods and Results We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m2) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow-up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity. Conclusions Metabolic abnormalities appeared to convey more cardiovascular risk among black women. PMID:25994446

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis.

PubMed

Nepogodiev, Dmitri

2018-06-13

Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major post-operative complications in an international cohort and to present a meta-analysis of all available prospective data. This prospective, multi-centre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma, or formation of stoma. The primary endpoint was 30-day major complications (Clavien-Dindo grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis (IPMA) was used to analyse pooled results. This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese versus normal weight patients (13.0% versus 16.2%, respectively), but this did not reach statistical significance (p=0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. IPMA demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (odds ratio 2.10, 95% confidence interval 1.49-2.96, p<0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, p<0.001), compared to normal weight patients. In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Change in fracture risk and fracture pattern after bariatric surgery: nested case-control study.

PubMed

Rousseau, Catherine; Jean, Sonia; Gamache, Philippe; Lebel, Stéfane; Mac-Way, Fabrice; Biertho, Laurent; Michou, Laëtitia; Gagnon, Claudia

2016-07-27

 To investigate whether bariatric surgery increases the risk of fracture.  Retrospective nested case-control study.  Patients who underwent bariatric surgery in the province of Quebec, Canada, between 2001 and 2014, selected using healthcare administrative databases.  12 676 patients who underwent bariatric surgery, age and sex matched with 38 028 obese and 126 760 non-obese controls.  Incidence and sites of fracture in patients who had undergone bariatric surgery compared with obese and non-obese controls. Fracture risk was also compared before and after surgery (index date) within each group and by type of surgery from 2006 to 2014. Multivariate conditional Poisson regression models were adjusted for fracture history, number of comorbidities, sociomaterial deprivation, and area of residence.  Before surgery, patients undergoing bariatric surgery (9169 (72.3%) women; mean age 42 (SD 11) years) were more likely to fracture (1326; 10.5%) than were obese (3065; 8.1%) or non-obese (8329; 6.6%) controls. A mean of 4.4 years after surgery, bariatric patients were more susceptible to fracture (514; 4.1%) than were obese (1013; 2.7%) and non-obese (3008; 2.4%) controls. Postoperative adjusted fracture risk was higher in the bariatric group than in the obese (relative risk 1.38, 95% confidence interval 1.23 to 1.55) and non-obese (1.44, 1.29 to 1.59) groups. Before surgery, the risk of distal lower limb fracture was higher, upper limb fracture risk was lower, and risk of clinical spine, hip, femur, or pelvic fractures was similar in the bariatric and obese groups compared with the non-obese group. After surgery, risk of distal lower limb fracture decreased (relative risk 0.66, 0.56 to 0.78), whereas risk of upper limb (1.64, 1.40 to 1.93), clinical spine (1.78, 1.08 to 2.93), pelvic, hip, or femur (2.52, 1.78 to 3.59) fractures increased. The increase in risk of fracture reached significance only for biliopancreatic diversion.  Patients undergoing bariatric surgery were more likely to have fractures than were obese or non-obese controls, and this risk remained higher after surgery. Fracture risk was site specific, changing from a pattern associated with obesity to a pattern typical of osteoporosis after surgery. Only biliopancreatic diversion was clearly associated with fracture risk; however, results for Roux-en-Y gastric bypass and sleeve gastrectomy remain inconclusive. Fracture risk assessment and management should be part of bariatric care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Qualitative Study of the Maternity Care Experiences of Women with Obesity: "More than Just a Number on the Scale".

PubMed

DeJoy, Sharon Bernecki; Bittner, Krystle; Mandel, Deborah

2016-01-01

The prevalence of obesity among pregnant women in the United States is high. Obesity can have long-term health consequences for both women and their offspring, so high-quality perinatal care for women with obesity is essential. However, stigmatizing encounters with health care professionals can decrease quality and promote avoidance of care. The purpose of this study was to explore the experiences of women with obesity in the maternity care system in the United States. In-depth telephone interviews were conducted with 16 women with a body mass index of 30 or greater. The authors used an inductive analytical process to translate women's experiences into themes. Women with obesity reported diverse maternity care experiences, with some reporting appropriate and satisfactory care, while most reported at least one negative encounter over the course of perinatal care. Three major themes emerged from the analysis: personalized care, depersonalized care, and setting the tone. Interactions with providers during pregnancy had psychological and emotional effects on women with obesity and influenced the content and perceived quality of their care. Further research is required to explore this phenomenon and its implications for care of women during pregnancy and birth outcomes. In the meantime, providers may wish to consider greater sensitivity to the needs of women with obesity during the perinatal period. © 2016 by the American College of Nurse-Midwives.

Health Behaviours during Pregnancy in Women with Very Severe Obesity.

PubMed

Mohd-Shukri, Nor A; Duncan, Andrew; Denison, Fiona C; Forbes, Shareen; Walker, Brian R; Norman, Jane E; Reynolds, Rebecca M

2015-10-07

The health behaviours of pregnant women with very severe obesity are not known, though these women are at high risk of pregnancy complications. We carried out a prospective case-control study including 148 very severely obese (BMI >40 kg/m²) and 93 lean (BMI <25 kg/m²) pregnant women. Diet, physical activity, smoking, alcohol and folic acid consumption were assessed by questionnaire in early and late (16 and 28 weeks gestation) pregnancy. Circulating levels of iron, vitamin B12 and folate and other essential trace elements and minerals were measured in a subset at each time point. The findings biochemically confirmed that very severely obese women consumed diets that were energy-rich but poor in essential micronutrients. A third of all women met physical activity recommendations for pregnancy. A third of very severely obese women and two thirds of lean women took folic acid supplements prior to pregnancy. Very severely obese women were more likely to smoke but less likely to drink alcohol than lean women (all p < 0.05). Women with very severe obesity have low self-reported intakes and circulating levels of essential micronutrients in pregnancy and few follow current recommendations for pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy.

Evaluation of an FFQ to assess total energy and nutrient intakes in severely obese pregnant women.

PubMed

Mohd-Shukri, Nor A; Bolton, Jennifer L; Norman, Jane E; Walker, Brian R; Reynolds, Rebecca M

2013-08-01

FFQ are popular instruments for assessing dietary intakes in epidemiological studies but have not been validated for use in severely obese pregnancy. The aim of the present study was to compare nutrient intakes assessed by an FFQ with those obtained from a food diary among severely obese pregnant women. Comparison of an FFQ containing 170 food items and a food diary for 4 d (three weekdays and one weekend day); absolute agreement was assessed using the paired t test and relative agreement by Pearson/Spearman correlation, crossclassification into tertiles and weighted kappa values. Antenatal metabolic clinic for severely obese women. Thirty-one severely obese (BMI at booking ≥ 40.0 kg/m2) and thirty-two lean control (BMI520.0–24.9 kg/m2) pregnant women. The findings showed that nutrient intakes estimated by the FFQ were significantly higher than those from the food diary; average correlation was 0.32 in obese and 0.43 in lean women. A mean of 48.5% of obese and 47.3% of lean women were correctly classified, while 12.9% (obese) and 10.0% (lean) were grossly misclassified. Weighted k values ranged from 20.04 to 0.79 in obese women and from 0.16 to 0.78 in lean women. Overall, the relative agreement between the FFQ and food diary was lower in the obese group than in the lean group, but was comparable with earlier studies conducted in pregnant women. The validity assessments suggest that the FFQ is a useful tool for ranking severely obese pregnant women according to the levels of their dietary intake.

The educational gradient of obesity increases among Swedish pregnant women: a register-based study.

PubMed

Bjermo, Helena; Lind, Simon; Rasmussen, Finn

2015-04-01

Overweight or obesity is detrimental during pregnancy. We studied time trends in the educational gradient of overweight and obesity among pregnant women. Differences in overweight and obesity by area of residence and country of birth were also examined. The study was based on the Swedish Medical Birth Register between 1992 and 2010 and included 1,569,173 singleton pregnancies. Weight and height were registered during the first visit at the antenatal-care clinic. Data on education, country of birth, and area of residence were derived from registers with national coverage. In 2008-2010, 32% of Swedish nulliparous pregnant women were overweight or obese. The relative risk of obesity among lower educated women compared to women with higher education increased from 1.91 (95% confidence interval: 1.85-1.97) in 1992-1995 to 2.09 (95% confidence interval: 2.05-2.14) in 2008-2010. There was an inverse linear relationship between risks of overweight or obesity, and population density and type of residence municipality. An excessive gestational weight gain according to the American Institute of Medicine was observed among 57-63% of the overweight or obese women, but there were small differences by education. Pregnant women born in Africa, Middle East or Latin America had higher risks of being overweight or obese compared to women born in Sweden. The prevalence of obesity as well as the social inequalities in obesity during pregnancy increased in Sweden between 1992 and 2010. Further understanding of social inequalities and geographical differentials in health behaviours of pregnant women is needed when planning public health interventions.

Adiponectin and leptin in overweight/obese and lean women with polycystic ovary syndrome.

PubMed

Chen, Chin-I; Hsu, Ming-I; Lin, Shyh-Hsiang; Chang, Yuan-Chin I; Hsu, Chun-Sen; Tzeng, Chii-Ruey

2015-04-01

The objective of this study was to evaluate the adiponectin and leptin levels in overweight/obese and lean women with polycystic ovary syndrome (PCOS). This was a retrospective study. Of the 422 studied patients, 224 women with PCOS and 198 women without PCOS were evaluated. Insulin resistance and the metabolic components were assessed. The adiponectin and leptin levels were also evaluated. Adiponectin was negatively correlated with insulin resistance, body mass index (BMI), and total testosterone, triglyceride, and low-density lipoprotein (LDL) levels; conversely, leptin reversed the aforementioned reaction and was negatively correlated with adiponectin levels. The adiponectin to leptin ratios were significantly lower in PCOS women than in those without PCOS. Compared to women with non-PCOS, overweight/obese women with PCOS had lower serum adiponectin levels than women without PCOS, which was not the case for lean women. Conversely, lean women with PCOS had higher serum leptin levels than those without PCOS, which was not the case for overweight/obese women. Adipose tissue might play an important role in the metabolic complications in women with PCOS. To study the impact of obesity biomarkers in women with PCOS, overweight/obese and lean women should be considered separately.

Obesity literacy and culture among African American women in Florida.

PubMed

López, Ivette A; Boston, Patricia Q; Dutton, Matthew; Jones, Chauneva Glenn; Mitchell, M Miaisha; Vilme, Helene

2014-07-01

To explore causal explanations of obesity among African-American women of diverse weight across the life spectrum. In-depth interviews were conducted with adult African-American women of healthy weight (N = 10), overweight (N = 10), and obese weight (N = 20) to evaluate the relationship between causal explanations of obesity and weight. Generally overlooked dimensions of health definitions were discovered. Differences in weight definitions were detected between women of different weights. Terminology, symptoms, and solutions to obesity were detected between the women of different weights and public health recommendations. Identified causal discrepancies will help bridge the disconnection between public health recommendations and African-American women's perceptions with tailored interventions.

Obesity increases risk of declining physical activity over time in women: a prospective cohort study.

PubMed

Tucker, Jared M; Tucker, Larry A; Lecheminant, James; Bailey, Bruce

2013-12-01

Research indicates that risk of obesity increases as physical activity (PA) decreases; however, the reciprocal effect has been rarely studied. The present investigation was conducted to determine the contribution of obesity on objectively measured PA over 20 months. A prospective cohort design with 254 middle-aged women was employed. Body fat percentage (BF%) was measured using Bod Pod, and obesity was defined as BF% ≥32%. PA was assessed objectively using 7-day accelerometry at baseline and ∼20 months later at follow-up. Of the 254 subjects, 124 were obese (49%) at baseline. Mean BF% was 32.1 ± 7.8 and average age was 41.7 ± 3.1 years. Mean weekly PA was 2.79 ± 0.85 million activity counts for all participants. Over the 20-month period, PA decreased significantly more in obese women (-8.1% ± 27.1%) than in nonobese women (0.3% ± 31.7%) after adjusting for confounders (F = 5.3, P = 0.022). Moderate plus vigorous PA levels also decreased more in obese women (-28.1 ± 73.6 min/week) than in nonobese women (-5.9 ± 66.8 min/week), after adjusting for covariates (F = 7.84; P = 0.0055). It appears that obese women tend to reduce PA over time at a faster rate than nonobese women. Evidently, obesity is a risk factor for decreasing PA over time in middle-aged women. Copyright © 2013 The Obesity Society.

Sociodemographic and smoking associated with obesity in adult women in Iran: results from the National Health Survey.

PubMed

Bakhshi, Enayatollah; Eshraghian, Mohammad Reza; Mohammad, Kazem; Foroushani, Abbas Rahimi; Zeraati, Hojat; Fotouhi, Akbar; Siassi, Fraidon; Seifi, Behjat

2008-12-01

There is no study that had a sample size sufficient to study the association between sociodemographic and smoking with obesity in Iran. The goal was to investigate these associations in the Iranian women. Multivariate statistical techniques included 14 176 women between 20 and 69 years of age. Height and weight were measured rather than self-reported. In Iranian adult women, obesity OR(S) for the moderate and high education were 0.78 and 0.41, respectively, compared with basic level. Using low economy index as the reference, Obesity OR(S) for the urban women were 1.29, 1.25 and 1.28 for the lower-middle, upper-middle and high groups, respectively. Obesity OR(S) for the rural women were 1.71, 1.71 and 2.02 for the lower-middle, upper-middle and high groups, respectively. Obesity OR was 0.48 for active workforce compared with inactive group. Obesity OR was 0.70 for smokers women compared with nonsmokers. Using non-married as the reference group, Obesity OR(S) were 1.23 and 2.34 for married urban and rural women, respectively. Our results on the associations between age, smoking, education level, workforce and obesity are consistent with most studies, but between economic level and obesity are consistent with some study in developing countries.

Weight Status of Mexican Immigrant Women: A Comparison With Women in Mexico and With US-Born Mexican American Women

PubMed Central

Ritterman-Weintraub, Miranda L.; Fernald, Lia C. H.; Kaufer-Horwitz, Martha

2013-01-01

Objectives. We assessed the association between birthplace, residence, or years in the United States and actual weight (body mass index), perceived weight accuracy, or provider screens for overweight or obesity among Mexican immigrant women. Methods. We used linked data from Health and Nutrition Examination Survey waves 2001–2006 and 2006 National Mexican Health and Nutrition Survey to compare 513 immigrants with 9527 women in Mexico and 342 US-born Mexican American women. Results. Immigrants were more likely than women in Mexico to be obese and to perceive themselves as overweight or obese after adjustment for confounders. Recent immigrants had similar weight-related outcomes as women in Mexico. Immigrants were less likely to be obese than were US-born Mexican Americans. Within the overweight or obese population, reported provider screens were higher among immigrants than among women in Mexico, but lower than among US-born Mexican Americans. US residency of at least 5 years but less than 20 years and reporting insufficient provider screens elevated obesity risk. Conclusions. Mexican-origin women in the United States and Mexico are at risk for overweight and obesity. We found no evidence of a “healthy immigrant” effect. PMID:23865649

Weight status of Mexican immigrant women: a comparison with women in Mexico and with US-born Mexican American women.

PubMed

Guendelman, Sylvia D; Ritterman-Weintraub, Miranda L; Fernald, Lia C H; Kaufer-Horwitz, Martha

2013-09-01

We assessed the association between birthplace, residence, or years in the United States and actual weight (body mass index), perceived weight accuracy, or provider screens for overweight or obesity among Mexican immigrant women. We used linked data from Health and Nutrition Examination Survey waves 2001-2006 and 2006 National Mexican Health and Nutrition Survey to compare 513 immigrants with 9527 women in Mexico and 342 US-born Mexican American women. Immigrants were more likely than women in Mexico to be obese and to perceive themselves as overweight or obese after adjustment for confounders. Recent immigrants had similar weight-related outcomes as women in Mexico. Immigrants were less likely to be obese than were US-born Mexican Americans. Within the overweight or obese population, reported provider screens were higher among immigrants than among women in Mexico, but lower than among US-born Mexican Americans. US residency of at least 5 years but less than 20 years and reporting insufficient provider screens elevated obesity risk. Mexican-origin women in the United States and Mexico are at risk for overweight and obesity. We found no evidence of a "healthy immigrant" effect.

Perceived discrimination among men and women with normal weight and obesity. A population-based study from Sweden.

PubMed

Hansson, Lena M; Näslund, Erik; Rasmussen, Finn

2010-08-01

We examined whether men and women with obesity reported different types of discrimination to a greater extent than those with normal weight, and explored whether these associations were modified by socioeconomic position. National representative sample of men and women, with normal weight (n = 2,000), moderate obesity (n = 2,461) and severe obesity (n = 557). Participants were identified in a yearly population-based survey (1996-2006) and data on perceived discrimination and potential confounding factors were measured in 2008. Logistic regression models tested whether obesity was associated with perceived lifetime, workplace, healthcare and interpersonal discrimination. The overall response rate was 56%. For men, moderate obesity was associated with workplace discrimination, while severely obese women were more likely to report this sort of discrimination than normal weight women. Severely obese individuals were twice as likely to report healthcare discrimination than normal weight individuals. Women, regardless of weight status group, were in turn twice as likely to report healthcare discrimination as men. Women with severe obesity were significantly more likely to report interpersonal discrimination compared with normal weight women. Socioeconomic position modified the association between weight status and healthcare discrimination. Highly educated individuals with moderate and severe obesity were more likely to report healthcare discrimination than their normal weight counterparts, whereas low educated individuals with normal weight, moderate and severe obesity were equally likely to report discrimination. In this large, population-based study, discrimination was more likely to be reported by obese individuals compared with those of normal weight. The associations, however, varied according to gender and socioeconomic position.

Physical activity during pregnancy in obese and normal-weight women as assessed by pedometer.

PubMed

Renault, Kristina; Nørgaard, Kirsten; Andreasen, Kirsten Riis; Secher, Niels Jørgen; Nilas, Lisbeth

2010-07-01

To compare physical activity as assessed by a pedometer in obese and normal-weight pregnant women at different gestational ages. To evaluate the use of a pedometer in pregnancy. Cross-sectional study. Department of obstetrics and gynecology in a university hospital in Copenhagen. 338 pregnant women, 175 normal-weight women with body mass index (BMI) 20-25 kg/m(2) and 163 obese women with BMI > or = 30 kg/m(2). Physical activity was assessed by a pedometer (Yamax Digiwalker SW-700/701) on seven consecutive days in six different groups: normal-weight or obese at gestational ages 11-13, 18-22, and 36-38, and expressed as median number of daily steps during a whole week, working days, and weekends. Relation between BMI and physical activity during pregnancy and compliance with wearing the pedometer. Noncompliance was more frequent in obese than in normal-weight women (19 vs. 10%, p < 0.001). Physical activity was lower in obese women at all gestational ages (6,482, 7,446, 4,626 steps/day in obese vs. 7,558, 8,865, 6,289 steps/day in normal-weight, p < 0.05-0.11). The greatest difference between obese and normal-weight women was seen during weekends. The level of physical activity was higher in both groups at mid-gestation than during earlier and later gestational ages. Physical activity in pregnant women can be assessed by the pedometer and the method was well accepted by the women; however, the compliance was lower in the obese. The level of physical activity differs between different gestational groups and is lower in obese than in normal-weight women, especially during leisure time.

Obesity is associated with breast cancer in African-American women but not Hispanic women in South Los Angeles.

PubMed

Sarkissyan, Marianna; Wu, Yanyuan; Vadgama, Jaydutt V

2011-08-15

Obesity is considered a risk factor for breast cancer. Modifying life styles that reduce obesity offers the potential for prevention and improved outcomes from cancer. The effects of obesity and breast cancer among African-American women and Hispanic women have been explored in a limited number of studies. The objective of the current study was to investigate the association of obesity with breast cancer in a minority cohort. This was a cross-sectional study of 471 African-American and Hispanic women with and without breast cancer in South Los Angeles. Data regarding body mass index (BMI) and clinical factors were obtained by medical record abstraction. Data were assessed using logistic regression with multivariate analysis. Kaplan-Meier survival analysis was used to assess disease-free survival. Women with breast cancer were more likely to be obese (BMI >30 kg/m(2)) than women without breast cancer (odds ratio [OR], 2.0; P = .01). There was a significant association of being overweight or obese and breast cancer among postmenopausal women (OR, 2.3 [P = .03] and 2.9 [P < .01], respectively). The association between obesity and breast cancer was significant only among African-American women (OR, 2.70; P < .01) and was especially significant among postmenopausal African-American women (OR, 4.8; P < .01). There was a borderline significant association between obesity and later disease stage at diagnosis (P = .06). An association also was observed between higher BMI (for cutoff points of both 30 kg/m(2) and 28 kg/m(2)) and poorer disease-free survival (P = .045 and P = .019, respectively). The current data suggested an association between obesity and breast cancer, especially among postmenopausal women and most significantly in the African-American cohort. Copyright © 2011 American Cancer Society.

Fat distribution and end-expiratory lung volume in lean and obese men and women.

PubMed

Babb, Tony G; Wyrick, Brenda L; DeLorey, Darren S; Chase, Paul J; Feng, Mabel Y

2008-10-01

Although obesity significantly reduces end-expiratory lung volume (EELV), the relationship between EELV and detailed measures of fat distribution has not been studied in obese men and women. To investigate, EELV and chest wall fat distribution (ie, rib cage, anterior subcutaneous abdominal fat, posterior subcutaneous fat, and visceral fat) were measured in lean men and women (ie, < 25% body fat) and obese men and women (ie, > 30% body fat). All subjects underwent pulmonary function testing, hydrostatic weighing, and MRI scans. Data were analyzed for the men and women separately by independent t test, and the relationships between variables were determined by regression analysis. All body composition measurements were significantly different among the lean and obese men and women (p < 0.001). However, with only a few exceptions, fat distribution was similar among the lean and obese men and women (p > 0.05). The mean EELV was significantly lower in the obese men (39 +/- 6% vs 46 +/- 4% total lung capacity [TLC], respectively; p < 0.0005) and women (40 +/- 4% vs 53 +/- 4% TLC, respectively; p < 0.0001) compared with lean control subjects. Many estimates of body fat were significantly correlated with EELV for both men and women. In both men and women, the decrease in EELV with obesity appears to be related to the cumulative effect of increased chest wall fat rather than to any specific regional chest wall fat distribution. Also, with only a few exceptions, relative fat distribution is markedly similar between lean and obese subjects.

Association of intimate partner violence and health-care provider-identified obesity.

PubMed

Davies, Rhian; Lehman, Erik; Perry, Amanda; McCall-Hosenfeld, Jennifer S

2016-07-01

The association of physical and nonphysical intimate partner violence (IPV) with obesity was examined. Women (N = 1,179) were surveyed regarding demographics, obesity, and IPV exposure using humiliate-afraid-rape-kick (HARK), an IPV screening tool. A three-level lifetime IPV exposure variable measured physical, nonphysical or no IPV. Health-care provider-identified obesity was defined if participants were told by a medical provider within the past 5 years that they were obese. Bivariate analyses examined obesity by IPV and demographics. Multivariable logistic regression assessed odds of obesity by IPV type, adjusting for age, race/ethnicity, education, and marital status. Among participants, 44% reported lifetime IPV (25% physical, 19% nonphysical), and 24% reported health-care provider-identified obesity. In unadjusted analyses, obesity was more prevalent among women exposed to physical IPV (30%) and nonphysical IPV (27%), compared to women without IPV (20%, p = .002). In multivariable models, women reporting physical IPV had 1.67 times greater odds of obesity (95% confidence interval [CI] 1.20, 2.33), and women reporting nonphysical IPV had 1.46 times greater odds of obesity (95% CI 1.01, 2.10), compared to women reporting no exposure. This study extends prior data by showing, not only an association between physical IPV and obesity, but also an association between obesity and nonphysical IPV.

Contraceptive use and sexual behavior in obese women.

PubMed

Kaneshiro, Bliss

2012-12-01

Obesity and unintended pregnancy differentially affect women based on sociodemographic factors. Because of the overlap of these factors, obesity and unintended pregnancy have been described as colliding epidemics. Understanding the relationship between obesity and unintended pregnancy, contraceptive use, and sexual behavior is important in improving the reproductive health of women given the increasing weight demographic. A review of the literature reveals contraceptive use versus nonuse does not differ in women of different body weights. Obese women use oral contraceptives less than normal weight women and are more likely to use procedural methods like sterilization. No difference was noted in most types of sexual behavior for women of different body weights. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Means of transportation to work and overweight and obesity: a population-based study in southern Sweden.

PubMed

Lindström, Martin

2008-01-01

To investigate the association between means of transportation to work and overweight+obesity and obesity. The 2004 public health survey in Skåne is a cross-sectional postal questionnaire study of the population aged 18-80 with a 59% response rate including 16,705 employed participants. Forty-six percent of men and 26.6% of women were overweight (BMI 25.0-29.9); 11.6% of men and 10.3% of women were obese (BMI 30.0-); 18.2% of men and 25.9% of women bicycled and/or walked to work and 10.4% and 16.2% used public transportation, respectively. In contrast, 68.3% of men and 55.8% of women went to work by car. The odds ratios of overweight+obesity among persons who walked or bicycled were significantly lower and remained 0.62 (95% CI 0.51-0.76) among men and 0.79 (95% CI 0.67-0.94) among women in the models including all confounders compared to the car driving reference category. The odds ratios of obesity were initially significantly lower among both men and women who walked or bicycled, but in the final models only among women. The odds ratios of overweight+obesity as well as obesity were also lower among men using public transportation. Walking and bicycling to work are significantly negatively associated with overweight+obesity and, to some extent, obesity. Public transportation is significantly negatively associated with overweight+obesity and obesity among men.

Temporal trends in obesity, osteoporosis treatment, bone mineral density, and fracture rates: a population-based historical cohort study.

PubMed

Leslie, William D; Lix, Lisa M; Yogendran, Marina S; Morin, Suzanne N; Metge, Colleen J; Majumdar, Sumit R

2014-04-01

Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. We studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996-2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD). The Population Fracture Registry included women aged 50 years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment. The BMD Registry included all women aged 50 years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD. Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated. Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated. In the Fracture Registry (n=27,341), fracture rates declined 1.6% per year (95% confidence interval [CI], 1.3% to 2.0%). Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment. In the BMD Registry (n=36,587), obesity increased from 12.7% to 27.4%. Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (p<0.001). Major osteoporotic fracture rates decreased in models that did not include femoral neck BMD (fully adjusted annual change -1.8%; 95% CI, -2.9 to -0.5), but adjusting for femoral neck BMD accounted for the observed reduction (annual change -0.5%; 95% CI, -1.8 to +1.0). In summary, major osteoporotic fracture rates declined substantially and linearly from 1996 to 2006, and this was explained by improvements in BMD rather than greater rates of obesity or osteoporosis treatment. © 2014 American Society for Bone and Mineral Research.

Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities, and balance in postmenopausal women.

PubMed

Ilich, J Z; Inglis, J E; Kelly, O J; McGee, D L

2015-11-01

We determined the prevalence of osteosarcopenic obesity (loss of bone and muscle coexistent with increased adiposity) in overweight/obese postmenopausal women and compared their functionality to obese-only women. Results showed that osteosarcopenic obese women were outperformed by obese-only women in handgrip strength and walking/balance abilities indicating their higher risk for mobility impairments. Osteosarcopenic obesity (OSO) is a recently defined triad of osteopenia/osteoporosis, sarcopenia, and adiposity. We identified women with OSO in overweight/obese postmenopausal women and evaluated their functionality comparing them with obese-only (OB) women. Additionally, women with osteopenic/osteoporotic obesity (OO), but no sarcopenia, and those with sarcopenic obesity (SO), but no osteopenia/osteoporosis, were identified and compared. We hypothesized that OSO women will have the lowest scores for each of the functionality measures. Participants (n = 258; % body fat ≥35) were assessed using a Lunar iDXA instrument for bone and body composition. Sarcopenia was determined from negative residuals of linear regression modeled on appendicular lean mass, height, and body fat, using 20th percentile as a cutoff. Participants with T-scores of L1-L4 vertebrae and/or total femur <-1, but without sarcopenia, were identified as OO (n = 99) and those with normal T-scores, but with sarcopenia, as SO (n = 28). OSO (n = 32) included women with both osteopenia/osteoporosis and sarcopenia, while those with normal bone and no sarcopenia were classified as OB (n = 99). Functionality measures such as handgrip strength, normal/brisk walking speed, and right/left leg stance were evaluated and compared among groups. Women with OSO presented with the lowest handgrip scores, slowest normal and brisk walking speed, and shortest time for each leg stance, but these results were statistically significantly different only from the OB group. These findings indicate a poorer functionality in women presenting with OSO, particularly compared to OB women, increasing the risk for bone fractures and immobility from the combined decline in bone and muscle mass, and increased fat mass.

The Impact of Obesity on Postoperative Outcomes in Adults with Congenital Heart Disease Undergoing Pulmonary Valve Replacement.

PubMed

Buelow, Matthew W; Earing, Michael G; Hill, Garick D; Cohen, Scott B; Bartz, Peter J; Tweddell, James S; Ginde, Salil

2015-01-01

The impact of obesity on surgical morbidity in adults with congenital heart disease is currently unknown. The aim of our study was to investigate the impact of obesity on postoperative outcomes in adults with congenital heart disease undergoing reoperation for pulmonary valve replacement. A retrospective analysis was performed assessing the influence of obesity on surgical outcomes. Obesity was defined as a body mass index ≥30 kg/m2. The mean body mass index of the cohort was 25.9 ± 6.9 kg/m2 . The cohort included 71 patients with 17 patients (24%) being obese. There was no postoperative mortality. Obese patients had a longer hospital length of stay (6.6 vs. 4.7 days; P < .001) and increased incidence of postoperative arrhythmias (29% vs. 5.6%; P = .003) compared with nonobese patients. Multivariable analysis performed using logistic regression with backwards elimination demonstrated obesity was independently associated with hospital length of stay >5 days (odds ratio [OR] = 5.2; 95% confidence interval [CI]: 1.5-18.2, P = .01) and with increased postoperative arrhythmias (OR = 4.2; 95% CI: 1.7-40, P < .01). Obesity is associated with increased morbidity in adults with congenital heart disease undergoing pulmonary valve replacement, including longer hospitalization and higher risk for postoperative arrhythmias. © 2015 Wiley Periodicals, Inc.

Smoking and primary total hip or knee replacement due to osteoarthritis in 54,288 elderly men and women.

PubMed

Mnatzaganian, George; Ryan, Philip; Reid, Christopher M; Davidson, David C; Hiller, Janet E

2013-09-05

The reported association of smoking with risk of undergoing a total joint replacement (TJR) due to osteoarthritis (OA) is not consistent. We evaluated the independent association between smoking and primary TJR in a large cohort. The electronic records of 54,288 men and women, who were initially recruited for the Second Australian National Blood Pressure study, were linked to the Australian Orthopaedic Association National Joint Replacement Registry to detect total hip replacement (THR) or total knee replacement (TKR) due to osteoarthritis. Competing risk regressions that accounted for the competing risk of death estimated the subhazard ratios for TJR. One-way and probabilistic sensitivity analyses were undertaken to represent uncertainty in the classification of smoking exposure and socioeconomic disadvantage scores. An independent inverse association was found between smoking and risk of THR and TKR observed in both men and women. Compared to non-smokers, male and female smokers were respectively 40% and 30% less likely to undergo a TJR. This significant association persisted after controlling for age, co-morbidities, body mass index (BMI), physical exercise, and socioeconomic disadvantage. The overweight and obese were significantly more likely to undergo TJR compared to those with normal weight. A dose-response relationship between BMI and TJR was observed (P < 0.001). Socioeconomic status was not independently associated with risk of either THR or TKR. The strengths of the inverse association between smoking and TJR, the temporal relationship of the association, together with the consistency in the findings warrant further investigation about the role of smoking in the pathogenesis of osteoarthritis causing TJR.

Effects of gender, body weight, and blood glucose dynamics on the growth hormone response to the glucagon stimulation test in patients with pituitary disease.

PubMed

Wilson, Jessica R; Utz, Andrea L; Devin, Jessica K

2016-02-01

Body weight blunts the growth hormone (GH) response to provocative stimuli. The appropriate GH cut-off to confirm GH deficiency in obese and overweight patients undergoing the glucagon stimulation test (GST) has recently been questioned. We hypothesized that the peak GH would be inversely related to the nadir blood glucose (BG) after glucagon and that this may be a mechanism influencing peak GH in overweight patients. This retrospective study examined effects of gender, body weight, and BG dynamics on GH response to GST in patients evaluated in our Pituitary Center. Adult patients who underwent GST from September 2009-2014 were included. Continuous variable comparisons were analyzed using the Mann-Whitney U-test and categorical data by Fisher's Exact Test. Spearman correlation was used to determine associations between continuous variables. 42 patients (N=28, 66.7% female) had sufficient data for analysis. Obese patients (N=26) had a reduced GH response, summarized as GH area under the curve (AUC) (p=0.03 vs. non-obese patients) and higher BG during GST, summarized as AUC (p<0.01 vs. non-obese patients). Obese women (N=19), in particular, stimulated lower (p=0.03 vs. non-obese women) and had a higher nadir BG (p=0.03 vs. non-obese women). While weight correlated with extent (rs=0.35; p=0.02) and timing (rs=0.31; p=0.05) of nadir BG reached, there was no significant correlation between BG dynamics and the GH response in the total population (N=42). Ten patients (7 with pan anterior hypopituitarism, defined as 3 anterior pituitary deficiencies) had a peak GH≤0.1ng/mL during GST. When these subjects with a negligible peak GH response were excluded from the analysis, weight was associated with GH AUC (rs=-0.45; p=0.01), peak GH response (rs=-0.42; p=0.02) and nadir BG (rs=0.48; p<0.01). Furthermore, the nadir BG achieved during GST was inversely related to GH AUC (rs=-0.38; p=0.03) and peak GH (rs=-0.37; p=0.04) such that patients (N=32) with higher nadir BG had lower peak GH in response to glucagon. Obese patients, particularly women, do not respond as robustly to glucagon stimulation. These data suggest that there exists an altered BG profile during GST in obese individuals, and that a less robust hypoglycemic stimulus may contribute to an impaired GH response. We suggest measuring BG levels during glucagon stimulation testing to assist with clinical interpretation of GH dynamics. The diagnostic accuracy of the GST in patients with known disorders in glucose metabolism and those taking anti-diabetic medications deserves further study. Copyright © 2015 Elsevier Ltd. All rights reserved.

Obesity and nutrition in women throughout adulthood.

PubMed

Morin, Karen H; Stark, Mary Ann; Searing, Kimberly

2004-01-01

Nutritional challenges are particularly relevant to women. Almost 62% of women are overweight; of these women, 33% are obese. The incidence of obesity is even greater in non-Hispanic Black and Mexican American women. Women who are overweight or obese experience a greater number of adverse health outcomes, including an increased incidence of cardiovascular disease and breast and colon cancer. Dietary patterns influence health outcomes, with a heart-healthy pattern having the most positive health outcomes. Health care providers should encourage women to consume a diet high in fruits and vegetables and low in total and saturated fats.

Obesity and obesity-associated cardiometabolic risk factors in indigenous Nenets women from the rural Nenets Autonomous Area and Russian women from Arkhangelsk city.

PubMed

Petrenya, Natalia; Brustad, Magritt; Dobrodeeva, Liliya; Bichkaeva, Fatima; Lutfalieva, Gulnara; Cooper, Marie; Odland, Jon Øyvind

2014-01-01

The prevalence of obesity and obesity-related conditions varies by population groups. Indigenous women of the circumpolar north are believed to be at high risk of obesity. We studied, first the obesity prevalence in indigenous Arctic women, Nenets, compared to urban Russian women. Second, the association between obesity and cardiometabolic risk factors in the combined group of Nenets and Russian women. Third, ethnic differences in the association between obesity and cardiometabolic risk factors. Cross-sectional study performed in 2008-2009. 93 Nenets women, aged 19-77 (the indigenous village, the Nenets Autonomous Area) and 132 Russian women, aged 21-72 (Arkhangelsk city). Obesity was defined as body mass index (BMI)≥30 kg/m(2), waist circumference (WC)≥88 cm and or waist-to-hip ratio (WHR)≥0.85%. We assessed associations between obesity and cardiometabolic risk factors by linear and logistic regression models that included covariates of ethnicity, age, smoking and physical activity. We also tested for interaction between obesity measurements and ethnicity. Prevalence of obesity estimated through BMI, WC and WHR were 42.5, 45.3 and 41.9% in Nenets and 34.4, 46.4 and 29.5% in Russians, respectively, with no differences found. BMI, WC and WHR associated positively with triglycerides, fasting insulin and Homeostasis Model Assessment of Insulin Resistance index. In addition, BMI and WC correlated negatively with high-density lipoprotein cholesterol and positively with systolic blood pressure and apolipoprotein B/apoliporotein A-I ratio. WC explained significant variation in fasting glucose (FG) level. BMI predicted type 2 diabetes history. FG level associated strongly with ethnicity and was found to be higher in Russians. We found no differences in prevalence of obesity between Nenets and Russian females. Obesity was associated with cardiometabolic risk factors independently of ethnicity in the sample studied. There was no link between obesity measurements and ethnicity.

Severe Obesity in Young Women and Reproductive Health: The Danish National Birth Cohort

PubMed Central

Nohr, Ellen A.; Timpson, Nicholas J.; Andersen, Camilla S.; Davey Smith, George; Olsen, Jørn; Sørensen, Thorkild I. A.

2009-01-01

Background Little is known about reproductive health in severely obese women. In this study, we present associations between different levels of severe obesity and a wide range of health outcomes in the mother and child. Methods From the Danish National Birth Cohort, we obtained self-reported information about prepregnant body mass index (BMI) for 2451 severely obese women and 2450 randomly selected women from the remaining cohort who served as a comparison group. Information about maternal and infant outcomes was also self-reported or came from registers. Logistic regression was used to estimate the association between different levels of severe obesity and reproductive outcomes. Principal Findings Subfecundity was more frequent in severely obese women, and during pregnancy, they had an excess risk of urinary tract infections, gestational diabetes, preeclampsia and other hypertensive disorders which increased with severity of obesity. They tended to have a higher risk of both pre- and post-term birth, and risk of cesarean and instrumental deliveries increased across obesity categories. After birth, severely obese women more often failed to initiate or sustain breastfeeding. Risk of weight retention 1.5 years after birth was similar to that of other women, but after adjustment for gestational weight gain, the risk was increased, especially in women in the lowest obesity category. In infants, increasing maternal obesity was associated with decreased risk of a low birth weight and increased risk of a high birth weight. Estimates for ponderal index showed the same pattern indicating an increasing risk of neonatal fatness with severity of obesity. Infant obesity measured one year after birth was also increased in children of severely obese mothers. Conclusion Severe obesity is correlated with a substantial disease burden in reproductive health. Although the causal mechanisms remain elusive, these findings are useful for making predictions and planning health care at the individual level. PMID:20041193

Obesity and obesity-associated cardiometabolic risk factors in indigenous Nenets women from the rural Nenets Autonomous Area and Russian women from Arkhangelsk city

PubMed Central

Petrenya, Natalia; Brustad, Magritt; Dobrodeeva, Liliya; Bichkaeva, Fatima; Lutfalieva, Gulnara; Cooper, Marie; Odland, Jon Øyvind

2014-01-01

Background The prevalence of obesity and obesity-related conditions varies by population groups. Indigenous women of the circumpolar north are believed to be at high risk of obesity. Objective We studied, first the obesity prevalence in indigenous Arctic women, Nenets, compared to urban Russian women. Second, the association between obesity and cardiometabolic risk factors in the combined group of Nenets and Russian women. Third, ethnic differences in the association between obesity and cardiometabolic risk factors. Design Cross-sectional study performed in 2008–2009. Subjects: 93 Nenets women, aged 19–77 (the indigenous village, the Nenets Autonomous Area) and 132 Russian women, aged 21–72 (Arkhangelsk city). Obesity was defined as body mass index (BMI)≥30 kg/m2, waist circumference (WC)≥88 cm and or waist-to-hip ratio (WHR)≥0.85%. We assessed associations between obesity and cardiometabolic risk factors by linear and logistic regression models that included covariates of ethnicity, age, smoking and physical activity. We also tested for interaction between obesity measurements and ethnicity. Results Prevalence of obesity estimated through BMI, WC and WHR were 42.5, 45.3 and 41.9% in Nenets and 34.4, 46.4 and 29.5% in Russians, respectively, with no differences found. BMI, WC and WHR associated positively with triglycerides, fasting insulin and Homeostasis Model Assessment of Insulin Resistance index. In addition, BMI and WC correlated negatively with high-density lipoprotein cholesterol and positively with systolic blood pressure and apolipoprotein B/apoliporotein A–I ratio. WC explained significant variation in fasting glucose (FG) level. BMI predicted type 2 diabetes history. FG level associated strongly with ethnicity and was found to be higher in Russians. Conclusions We found no differences in prevalence of obesity between Nenets and Russian females. Obesity was associated with cardiometabolic risk factors independently of ethnicity in the sample studied. There was no link between obesity measurements and ethnicity. PMID:25147770

A mixed methods comparison of perceived benefits and barriers to exercise between obese and nonobese women.

PubMed

Leone, Lucia Andrea; Ward, Dianne S

2013-05-01

Obese women have lower levels of physical activity than nonobese women, but it is unclear what drives these differences. Mixed methods were used to understand why obese women have lower physical activity levels. Findings from focus groups with obese white women age 50 and older (N = 19) were used to develop psychosocial items for an online survey of white women (N = 195). After examining the relationship between weight group (obese vs. nonobese) and exercise attitudes, associated items (P < .05) were tested for potential mediation of the relationship between weight and physical activity. Obese women were less likely than nonobese women to report that they enjoy exercise (OR = 0.4, 95% CI 0.2-0.8) and were more likely to agree their weight makes exercise difficult (OR = 10.6, 95% CI 4.2-27.1), and they only exercise when trying to lose weight (OR = 3.8, 95% CI 1.6-8.9). Enjoyment and exercise for weight loss were statistically significant mediators of the relationship between weight and physical activity. Exercise interventions for obese women may be improved by focusing on exercise enjoyment and the benefits of exercise that are independent of weight loss.

Obesity and selected co-morbidities in an urban Palestinian population.

PubMed

Abdul-Rahim, H F; Abu-Rmeileh, N M; Husseini, A; Holmboe-Ottesen, G; Jervell, J; Bjertness, E

2001-11-01

To assess the prevalence of obesity and central obesity in an urban Palestinian population and their associations with selected co-morbidities, including diabetes, hypertension and dyslipidaemia. A population-based cross-sectional survey in an urban Palestinian community. Men and women aged 30-65 y residing in the urban community, excluding pregnant women. According to WHO guidelines, obesity for men and women was defined as BMI> or =30 kg x m(-2), while pre-obesity was defined as BMI 25-29.9 kg x m(-2). Central obesity was defined as a waist-to-hip ratio (WHR) of >0.90 in men and >0.85 in women. The prevalence of obesity in this population was high at 41% (49% and 30% in women and men, respectively). Central obesity was more prevalent among men (59% compared to 25% in women). After adjusting for the effects of age, sex, smoking and each other, obesity and central obesity were found to be significantly associated with diabetes, low HDL-cholesterol and elevated triglycerides in separate logistic regression analyses. Central obesity was also significantly associated with hypertension (OR 2.26, 95% CI 1.30-3.91). Obesity and central obesity are prevalent in the urban Palestinian population. Their associations with diabetes, hypertension, and dyslipidaemia point to a potential rise in cardiovascular disease (CVD). An understanding of the reasons behind the high prevalence of obesity is essential for its prevention as well as for the prevention of the morbidities to which it may lead.

The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans.

PubMed

Breland, Jessica Y; Phibbs, Ciaran S; Hoggatt, Katherine J; Washington, Donna L; Lee, Jimmy; Haskell, Sally; Uchendu, Uchenna S; Saechao, Fay S; Zephyrin, Laurie C; Frayne, Susan M

2017-04-01

Most US adults are overweight or obese. Understanding differences in obesity prevalence across subpopulations could facilitate the development and dissemination of weight management services. To inform Veterans Health Administration (VHA) weight management initiatives, we describe obesity prevalence among subpopulations of VHA patients. Cross-sectional descriptive analyses of fiscal year 2014 (FY2014) national VHA administrative and clinical data, stratified by gender. Differences ≥5% higher than the population mean were considered clinically significant. Veteran VHA primary care patients with a valid weight within ±365 days of their first FY2014 primary care visit, and a valid height (98% of primary care patients). We used VHA vital signs data to ascertain height and weight and calculate body mass index, and VHA outpatient, inpatient, and fee basis data to identify sociodemographic- and comorbidity-based subpopulations. Among nearly five million primary care patients (347,112 women, 4,567,096 men), obesity prevalence was 41% (women 44%, men 41%), and overweight prevalence was 37% (women 31%, men 38%). Across the VHA's 140 facilities, obesity prevalence ranged from 28% to 49%. Among gender-stratified subpopulations, obesity prevalence was high among veterans under age 65 (age 18-44: women 40%, men 46%; age 45-64: women 49%, men 48%). Obesity prevalence varied across racial/ethnic and comorbidity subpopulations, with high obesity prevalence among black women (51%), women with schizophrenia (56%), and women and men with diabetes (68%, 56%). Overweight and obesity are common among veterans served by the VHA. VHA's weight management initiatives have the potential to avert long-term morbidity arising from obesity-related conditions. High-risk groups-such as black women veterans, women veterans with schizophrenia, younger veterans, and Native Hawaiian/Other Pacific Islander and American Indian/Alaska Native veterans-may require particular attention to ensure that systems improvement efforts at the population level do not inadvertently increase health disparities.

The perspectives of obese women receiving antenatal care: A qualitative study of women's experiences.

PubMed

Knight-Agarwal, Catherine R; Williams, Lauren T; Davis, Deborah; Davey, Rachel; Shepherd, Rebecca; Downing, Alice; Lawson, Kathryn

2016-04-01

The prevalence of overweight and obesity is increasing amongst women of child bearing age. Maternal obesity has implications for both mother and baby including increased health risks from gestational hypertensive disorders, caesarean section and stillbirth. Despite the increasing prevalence of maternal obesity little is known of the experiences of these women within the health care system. The aim of this research was to investigate the perspectives of pregnant women with a body mass index (BMI) of ≥30kg/m(2) receiving antenatal care. A qualitative study using individual interviews was undertaken. Sixteen pregnant women with a BMI ≥30kg/m(2) participated. Interviews were audio recorded, transcribed, cross checked for consistency and then entered into a word processing document for analysis. Data was analysed using Interpretative Phenomenological Analysis. In any phenomenological study the researcher's objective is to elicit the participant's views on their lived experiences. Four major themes emerged: (1) obese during pregnancy as part of a long history of obesity; (2) lack of knowledge of the key complications of obesity for both mother and child; (3) communication about weight and gestational weight gain can be conflicting, confusing and judgmental; (4) most women are motivated to eat well during pregnancy and want help to do so. Specialist lifestyle interventions for obese women should be a priority in antenatal care. Extra support is required to assist obese women in pregnancy achieve recommended nutritional and weight goals. Health professionals should approach the issue of maternal obesity in an informative but non-judgmental way. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Association of Maternal Obesity with Child Cerebral Palsy or Death.

PubMed

McPherson, Jessica A; Smid, Marcela C; Smiley, Sarah; Stamilio, David M

2017-05-01

Objective  The primary aim of this study was to determine if there is an association between maternal obesity and cerebral palsy or death in children. Study Design  This is a retrospective cohort analysis of a randomized controlled clinical trial previously performed by the Maternal-Fetal Medicine Units Network. Women in the original trial were included if at high risk for preterm delivery. The present study included singletons enrolled in the original study with complete data. Obese and nonobese women were compared. A secondary analysis comparing class 3 obese or classes 1 to 2 obese women to nonobese women was performed. The primary outcome was a composite of cerebral palsy or perinatal death. Results  In this study, 1,261 nonobese, 339 obese, and 69 morbidly obese women were included. When adjusted for gestational age at delivery and magnesium exposure, there was no association between maternal obesity and child cerebral palsy or death. In the analysis using obesity severity categories, excess risk for adverse outcome appeared confined to the class 3 obese group. Conclusion  In women at high risk of delivering preterm, maternal obesity was not independently associated with child cerebral palsy or death. The association in unadjusted analysis appears to be mediated by preterm birth among obese patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Serum level of orexin-A, leptin, adiponectin and insulin in north Indian obese women.

PubMed

Mishra, Sameeksha; Gupta, Vani; Mishra, Supriya; Sachan, Rekha; Asthana, Akash

2017-12-01

Obesity is regulated by different metabolic factors like leptin, adiponectin insulin and neuropeptide orexin-A. The aim of this study is to assess the role of these hormones and their interrelationship with obesity in north Indian women. A total of 168 obese women with Body Mass Index (BMI)>30kg/m 2 and 150 lean women (BMI<25kg/m 2 ) as control were recruited in this study. Women with obesity were further subdivided into two groups according to their BMI, 71 overweight women with the BMI 25-29.9kg/m 2 (mean±S.D: 27.87±0.71) and the 97 obese women with BMI>30kg/m 2 (34.68±1.90). Orexin -A, leptin and adiponectin were estimated using quantitative sandwich enzyme linked immunoassay and insulin was estimated by using an immuno-radiometric assay. Orexin -A and adiponectin level were significantly lower however, leptin and inulin level were significantly higher in obese women as compared with control group. Further, the one- way group analysis showed that the orexin -A and adiponectin level were significantly lower but leptin and insulin level was significantly higher in obese women as compared to overweight and control group respectively. Result showed that the level of adiponectin, leptin, orexin-A and insulin play an important role in the regulation of energy expenditure. In obesity, the activity of these peptides is disturbed. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Employment discrimination against obese women in obesity clinic's patients perspective.

PubMed

Obara-Gołębiowska, Małgorzata

2016-01-01

The workplace is one of many areas of life where obese people are unfairly treated. According to the literature obese women are particularly susceptible to discrimination in employment. There is a lack of polish researches of this subject. The main objective of this study was to analyze personal, subjective experiences related to weight bias and discrimination against obese people in the workplace of obese Polish women. The study was carried out in a hospital clinic for obesity management. A total of 420 women with BMI>30, aged 21 to 72, participated in group interviews focused on the weight bias and discrimination against obese people in the workplace. In the group of clinically obese women, 5.3% of subjects had experienced employment discrimination and 10.5% had been victims of verbal and social abuse in the workplace. The most common psycho-physical consequences of the weight stigma were emotional problems, lack of motivation and overeating in response to stress. Weight-based discrimination in the workplace poses a problem in Poland. The weight stigma and occupational discrimination lead to psycho-physical discomfort which exacerbates overeating and obesity.

[Effect of treatment with diet on reducing levels of sex hormones in perimenopausal women with overweight and obesity].

PubMed

Łokieć, Katarzyna; Błońska, Aleksandra; Walecka-Kapica, Ewa; Stec-Michalska, Krystyna

2016-06-01

Nowadays, fight against obesity is a big challenge for the developed countries. Perimenopausal women are especially prone to becoming overweight and obese. This is due to changes in hormone levels and alterations in the sex hormones synthesis pathway. The aim of this study was to evaluate the levels of sex hormones in overweight and obese women during menopause following the three month period of reducing diet. The study involved women aged 55±4,75 years. Group I - 33 overweight women (BMI 28,06±1,00 kg/m(2)). Group II - 32 obese women (BMI 34,22±3,79 kg/m(2)). Anthropometric measurements, body composition tested with Bodystat QuadScan 4000 analyzer and levels of sex hormones in the blood was determined before and after the three-months of reducing diet in both groups. Statistical data analysis was performed. After three-months of reducing diet it was noticed that levels of BMI, body fat, FSH, DHEA-S and androstenedione were decreased in a statistically significant manner. A significant increase in estradiol levels after reduction of visceral adipose tissue in both groups, overweight and obese women, was observed. However, only in the group of obese women, a decrease in BMI correlated with a significant increase in estradiol levels. Application of appropriate reducing diet in perimenopausal overweight and obese women has positive impact on visceral adipose tissue distribution and causes an increase in sex hormones levels. Perimenopausal overweight and obese women should pursue weight reduction to improve their chances of contracting cardiovascular diseases. © 2016 MEDPRESS.

Relative contribution of obesity and menopause to the association between serum adiponectin and incident metabolic syndrome.

PubMed

Ahn, Song Vogue; Jung, Dong-Hyuk; Yadav, Dhananjay; Kim, Jang-Young; Koh, Sang-Baek

2018-02-01

Metabolic syndrome is closely linked to obesity. Menopause may play a critical role in understanding the pathophysiology of metabolic syndrome in women. We investigated the relative contribution of obesity and menopause to the association between serum adiponectin levels and the development of metabolic syndrome. A prospective cohort study was conducted in which a total of 1,219 women without metabolic syndrome were examined at baseline (2005-2008) and followed up (2008-2011). Women were divided according to tertiles of serum adiponectin levels and menopause status, and then stratified into four groups: the nonobese with high adiponectin; the nonobese with low adiponectin; the obese with high adiponectin; and the obese with low adiponectin. During an average 2.5-year follow-up, 44 premenopausal women (9.8%) and 161 postmenopausal women (20.9%) developed metabolic syndrome. The obese group with low serum adiponectin demonstrated an increased risk for developing metabolic syndrome in both premenopausal (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.24-15.66) and postmenopausal women (OR 4.22, 95% CI 2.41-7.36). However, the inverse association between serum adiponectin levels and incidence of metabolic syndrome was observed in premenopausal women with obesity (OR 0.16, 95% CI 0.03-0.81), but not in postmenopausal women with obesity (OR 0.55, 95% CI 0.27-1.14). High serum adiponectin levels showed no inverse association with metabolic syndrome in postmenopausal women with obesity. These findings may suggest a need for closer management of metabolic risk in postmenopausal women.

[Studies of diet management and insulin resistance in obese pregnant women].

PubMed

Takeda, S; Saitoh, M; Kinoshita, K; Sakamoto, S

1992-02-01

In an attempt to determine the principles of diet management in obese pregnant women, the association between maternal weight gain during pregnancy (Group I; weight reduction, Group II; +0-4 kg, Group III; +5-9 kg, Group IV; +10 kg-) and the incidence of the complications was investigated in 151 obese pregnant women. Studies on glucose tolerance and insulin binding to erythrocytes were also undertaken. 1) In Group I, the incidences of C/S, forceps delivery, prolonged labor and complication of PIH were lower than those of other groups. There were no heavy-for-dates and light-for-dates babies in Group I, differing from the other three groups. 2) Plasma levels of glucose and insulin were high in obese pregnant women on 75 g OGTT in the second trimester. The binding sites of insulin to erythrocytes were significantly decreased in obese pregnant women. In conclusion, the risks of pregnancy complicated by obesity were high. Insulin resistance was a characteristic of obese pregnant women. The results of this study suggested that the nutritional requirements for very obese pregnant women should be restricted to maintaining the same weight or losing weight during the course of pregnancy to minimize maternal and perinatal risks.

Extreme obesity reduces bone mineral density: complementary evidence from mice and women.

PubMed

Núñez, Nomelí P; Carpenter, Catherine L; Perkins, Susan N; Berrigan, David; Jaque, S Victoria; Ingles, Sue Ann; Bernstein, Leslie; Forman, Michele R; Barrett, J Carl; Hursting, Stephen D

2007-08-01

To evaluate the effects of body adiposity on bone mineral density in the presence and absence of ovarian hormones in female mice and postmenopausal women. We assessed percentage body fat, serum leptin levels, and bone mineral density in ovariectomized and non-ovariectomized C57BL/6 female mice that had been fed various calorically dense diets to induce body weight profiles ranging from lean to very obese. Additionally, we assessed percentage body fat and whole body bone mineral density in 37 overweight and extremely obese postmenopausal women from the Women's Contraceptive and Reproductive Experiences study. In mice, higher levels of body adiposity (>40% body fat) were associated with lower bone mineral density in ovariectomized C57BL/6 female mice. A similar trend was observed in a small sample of postmenopausal women. The complementary studies in mice and women suggest that extreme obesity in postmenopausal women may be associated with reduced bone mineral density. Thus, extreme obesity (BMI > 40 kg/m2) may increase the risk for osteopenia and osteoporosis. Given the obesity epidemic in the U.S. and in many other countries, and, in particular, the rising number of extremely obese adult women, increased attention should be drawn to the significant and interrelated public health issues of obesity and osteoporosis.

Prepregnancy obesity and pregnancy outcome.

PubMed

Ahmed, Salah R; Ellah, Mostafa A A; Mohamed, Osman A; Eid, Hesham M

2009-07-01

Maternal obesity has long been correlated with an increased risk of chronic hypertension and diabetes prior to pregnancy and adverse pregnancy outcomes including preeclampsia, gestational diabetes, fetal macrosomia, Cesarean deliveries, postpartum endometritis and a prolonged hospital stay To determine the effect of maternal pre-pregnancy obesity on pregnancy outcomes Methods: One hundred and twenty two women were recruited in the study. The patients were allocated into two groups, group 1 obese patients (68) BMI 30 or more and group 2 non obese patients (54) BMI between 19.8-24.9. About two - third of the study group were having mild obesity, moderate obesity comprised about 28% and about 4% only was morbidly obese. Hypertensive disorders were nine folds more among obese women (R.R 4.74). Obese pregnant women were significantly more prone to have gestational diabetes (R.R 6.35). Even anemia was significantly more amongst Obese women when compared to non obese ones (29/68, R.R 3.84). Ante partum hemorrhage had significantly more in obese women (R.R 3.14). There was no increased risk for PROM (R.R 0.71). Moreover The macrosomic babies were extremely commoner among obese (R.R 9.1). Pre-pregnancy obesity is a risk factor for gestational diabetes, preeclampsia, labor induction, cesarean section for fetal distress, and wound infection. They should be considered as high risk and counseled accordingly.

Race and ethnicity, obesity, metabolic health, and risk of cardiovascular disease in postmenopausal women.

PubMed

Schmiegelow, Michelle D; Hedlin, Haley; Mackey, Rachel H; Martin, Lisa W; Vitolins, Mara Z; Stefanick, Marcia L; Perez, Marco V; Allison, Matthew; Hlatky, Mark A

2015-05-20

It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups. We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m(2)) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow-up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity. Metabolic abnormalities appeared to convey more cardiovascular risk among black women. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Resting energy expenditure may predict the relationship between obesity and susceptibility to depression disorders.

PubMed

Ahmadi, S; Mirzaei, K; Hossein-Nezhad, A; Keshavarz, S A; Ahmadivand, Z

2013-04-01

The aim of the current research was to investigate the association between depressed mood and resting energy expenditure (REE) in a representative sample of obese women. Fasting blood sample was collected from 254 obese women to determine biochemical indicators. Body composition was measured using body composition analyzer. REE was measured by means of indirect calorimetry. Comparison between depressed group and healthy obese women demonstrated that the mean of body mass index, fat percent, fat mass, visceral fat and triglyceride were higher in women with depressed mood. The level of REE/kg was significantly low in depressed obese women compared to healthy subjects.

Salivary cortisol and binge eating disorder in obese women after surgery for morbid obesity.

PubMed

Larsen, Junilla K; van Ramshorst, Bert; van Doornen, Lorenz J P; Geenen, Rinie

2009-01-01

Binge eating episodes characterized by loss of control are hypothesized to be accompanied by changes in hypothalamic pituitary adrenal (HPA) axis functioning. Cortisol is an end product of this neuroendocrine stress system. The aim of this study was to examine the cortisol levels and the awakening cortisol response (ACR) in obese persons showing binge eating after surgery for morbid obesity. Sixteen obese women with binge eating disorder (BED) and 18 obese women without BED participated in the study. Means+/-SD: age 43 +/- 15, body mass index 40 +/- 8. Salivary cortisol, anthropometric assessments, and the eating disorder examination interview were taken. Women with BED showed a significantly lower waist-to-hip ratio and cortisol levels during the day than women without BED, whereas the ACR did not differ. Our cross-sectional study in a small sample generates the hypothesis that neuroendocrine regulation differs between obese women with and without BED after obesity surgery. This finding needs replication in future studies that should also examine the causal direction of the observed association.

Obesity and female fertility: a primary care perspective.

PubMed

Wilkes, Scott; Murdoch, Alison

2009-07-01

Infertility affects approximately one in six couples during their lifetime. Obesity affects approximately half of the general population and is thus a common problem among the fertile population. Obese women have a higher prevalence of infertility compared with their lean counterparts. The majority of women with an ovulatory disorder contributing to their infertility have polycystic ovary syndrome (PCOS) and a significant proportion of women with PCOS are obese. Ovulation disorders and obesity-associated infertility represent a group of infertile couples that are relatively simple to treat. Maternal morbidity, mortality and fetal anomalies are increased with obesity and the success of assisted reproductive technology (ART) treatments is significantly reduced for obese women. Body mass index (BMI) treatment limits for ART throughout the UK vary. The mainstay for treatment is weight loss, which improves both natural fertility and conception rates with ART. The most cost-effective treatment strategy for obese infertile women is weight reduction with a hypo-caloric diet. Assisted reproduction is preferable in women with a BMI of 30 kg/m(2) or less and weight loss strategies should be employed within primary care to achieve that goal prior to referral.

Implications for Policy to Support Healthy Weight for Women.

PubMed

Kendig, Sue

2015-01-01

Worldwide, obesity rates have more than doubled during the past three decades. Women experience twice the obesity prevalence as men, and women of color, with less education, and in lower income levels disproportionately affected. Obesity and its comorbidities result in considerable economic burdens for the individual and society. Given the widespread prevalence of obesity, the potential effect on individual and population health, and associated costs, policy solutions targeting obesity prevention and interventions must be explored. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Coping with perceived racism: a significant factor in the development of obesity in African American women?

PubMed

Mwendwa, Denee T; Gholson, Georica; Sims, Regina C; Levy, Shellie-Anne; Ali, Mana; Harrell, C Jules; Callender, Clive O; Campbell, Alfonso L

2011-07-01

African American women have the highest rates of obesity in the United States. The prevalence of obesity in this group calls for the identification of psychosocial factors that increase risk. Psychological stress has been associated with obesity in women; however, there is scant literature that has explored the impact of racism on body mass index (BMI) in African American women. The current study aimed to determine whether emotional responses and behavioral coping responses to perceived racism were associated with BMI in African American women. A sample of 110 African American women participated in a community-based study. Height and weight measurements were taken to calculate BMI and participants completed the Perceived Racism Scale and the Perceived Stress Scale. Hierarchical regression analyses demonstrated a significant relationship between BMI and behavioral coping responses to perceived racism. Findings for emotional responses to perceived racism and appraisal of one's daily life as stressful were nonsignificant. Mean comparisons of BMI groups showed that obese African American women used more behavioral coping responses to perceived racism as compared to normal-weight and overweight women in the sample. Findings suggest that behavioral coping responses better explained increased risk for obesity in African American women. A biobehavioral pathway may explain this finding with a stress-response process that includes cortisol reactivity. Maladaptive behavioral coping responses may also provide insight into obesity risk. Future research is needed to determine which behavioral coping responses place African American women at greater risk for obesity.

Circulatory Estrogen Level Protects Against Breast Cancer in Obese Women

PubMed Central

Suba, Zsuzsanna

2013-01-01

Literary data suggest apparently ambiguous interaction between menopausal status and obesity-associated breast cancer risk based on the principle of the carcinogenic capacity of estrogen. Before menopause, breast cancer incidence is relatively low and adiposity is erroneously regarded as a protective factor against this tumor conferred by the obesity associated defective estrogen-synthesis. By contrast, in postmenopausal cases, obesity presents a strong risk factor for breast cancer being mistakenly attributed to the presumed excessive estrogen-production of their adipose-tissue mass. Obesity is associated with dysmetabolism and endangers the healthy equilibrium of sexual hormone-production and regular menstrual cycles in women, which are the prerequisites not only for reproductive capacity but also for somatic health. At the same time, literary data support that anovulatory infertility is a very strong risk for breast cancer in young women either with or without obesity. In the majority of premenopausal women, obesity associated insulin resistance is moderate and may be counteracted by their preserved circulatory estrogen level. Consequently, it is not obesity but rather the still sufficient estrogen-level, which may be protective against breast cancer in young adult females. In obese older women, never using hormone replacement therapy (HRT) the breast cancer risk is high, which is associated with their continuous estrogen loss and increasing insulin-resistance. By contrast, obese postmenopausal women using HRT, have a decreased risk for breast cancer as the protective effect of estrogen-substitution may counteract to their obesity associated systemic alterations. The revealed inverse correlation between circulatory estrogen-level and breast cancer risk in obese women should advance our understanding of breast cancer etiology and promotes primary prevention measures. New patents recommend various methods for the prevention and treatment of obesity-related systemic disorders and the associated breast cancer. PMID:23061769

Global Gender Disparities in Obesity: A Review1

PubMed Central

Caballero, Benjamin

2012-01-01

There is a global obesity pandemic. However, the prevalence of overweight and obesity among men and women varies greatly within and between countries, and overall, more women are obese than men. These gender disparities in overweight and obesity are exacerbated among women in developing countries, particularly in the Middle East and North Africa. Yet, in developed countries, more men are overweight than women. Current knowledge suggests that myriad sociocultural dynamics throughout the world exacerbate gender disparities in excess weight gain. Different contextual factors drive gender differences in food consumption, and women often report consuming healthier foods, yet may consume more sugar-laden foods, than men. Acculturation, through complex sociocultural pathways, affects weight gain among both men and women. The nutrition transition taking place in many developing countries has also affected excess weight gain among both genders, but has had an even greater impact on the physical activity levels of women. Furthermore, in some countries, cultural values favor larger body size among women or men as a sign of fertility, healthfulness, or prosperity. As the global obesity pandemic continues, more research on gender disparities in overweight and obesity will improve the understanding of this pandemic. PMID:22797984

Pregnancy Intention and Contraceptive Use among Women by Class of Obesity: Results from the 2006-2010 and 2011-2013 National Survey of Family Growth.

PubMed

Nguyen, Brian T; Elia, Jennifer L; Ha, Cathrine Y; Kaneshiro, Bliss E

Conflicting research findings on the association of obesity and pregnancy intention may be due to their collective definition of obesity at a body mass index of 30 kg/m 2 or greater. However, obese women with a BMI of 40 kg/m 2 or greater may be both behaviorally and clinically different from obese women with a lower BMI. This study reexamines this relationship, stratifying by class of obesity; the study also explores variations in contraceptive use by class of obesity given their potential contribution to the incidence of unintended or unwanted pregnancy. This study combined data from the 2006 through 2010 and 2011 through 2013 US National Survey of Family Growth. Pregnancy intention (intended, mistimed, unwanted) and current contraceptive use (no method, barrier, pill/patch/ring/injection, long-acting reversible contraceptive, sterilization) were compared across body mass index categories: normal (18.5-24.9 kg/m kg/m 2 ), overweight (25.0-29.9), obese class 1 (30.0-34.9 kg/m 2 ), class 2 (35.0-39.9 kg/m 2 ), and class 3 (≥40 kg/m 2 , severe obesity). Weighted multinomial logistic regressions were refined to determine independent associations of body mass index class and pregnancy intention, as well as contraceptive method, controlling for demographic, socioeconomic, and reproductive factors. Body mass index data were available for 9,848 nonpregnant, sexually active women who reported not wanting to become pregnant. Women with class 3 obesity had significantly greater odds of mistimed (adjusted odd ratio [aOR], 1.67; 95% confidence interval [CI], 1.02-2.75) or unwanted (aOR, 1.96; 95% CI, 1.15-3.32) pregnancy compared with normal weight women. Women with class 2 or 3 obesity were more likely to not be using contraception (aOR, 1.53-1.62; 95% CI, 1.04-2.29). Although women with class 2 obesity were more likely to be using long-acting reversible contraceptive methods and sterilization over short-acting hormonal methods (aOR, 1.67; 95% CI, 1.08-2.57; aOR, 2.05; 95% CI,1.44-2.91), this association was not observed among women with class 3 obesity. Women with class 3 obesity are at greater risk of unintended pregnancy and are less likely to be using contraception than normal weight women. Whether these findings are related to patient and/or provider barriers that are not as visible among women with class 1 and class 2 obesity warrants further investigation. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Understanding the Effect of Obesity on Fertility Among Reproductive-Age Women.

PubMed

Mitchell, Allison; Fantasia, Heidi Collins

2016-01-01

Obesity is a major public health concern, and obesity among women of childbearing age can have a negative impact on fertility. The mechanism of action between obesity and infertility is complex and includes hormonal factors, alterations in ovulation, and changes in the menstrual cycle. Maternal obesity has also been linked to spontaneous abortion and poorer maternal and fetal health outcomes. Many interventions exist to help childbearing women achieve a lower body mass index. These include lifestyle modifications (diet/physical activity) and surgical and pharmacologic interventions. This article reviews the pathophysiology of the relationship between obesity and infertility and discusses evidence-based interventions for improving fertility among obese childbearing women. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Higher dietary choline intake is associated with lower risk of nonalcoholic fatty liver in normal-weight Chinese women.

PubMed

Yu, Danxia; Shu, Xiao-Ou; Xiang, Yong-Bing; Li, Honglan; Yang, Gong; Gao, Yu-Tang; Zheng, Wei; Zhang, Xianglan

2014-12-01

Choline deficiency has been shown to induce liver fat accumulation in both rodent and human studies. However, it is unclear whether dietary choline intake is related to fatty liver in the general population. We examined the association between choline intake and nonalcoholic fatty liver. Participants included 56,195 Chinese women and men, 40-75 y of age, with no or negligible alcohol consumption and with no history of hepatitis, cardiovascular disease, or cancer. All participants reported undergoing liver ultrasonography. Fatty liver was defined by self-report of a physician diagnosis. Habitual dietary intakes were assessed via validated food-frequency questionnaires. The average total choline intakes were 289 ± 85 mg/d in women and 318 ± 92 mg/d in men. Major food sources were eggs, soy foods, red meat, fish, and vegetables. A higher choline intake was associated with lower risk of fatty liver; after adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the ORs (95% CIs) for the highest vs. the lowest quintiles of choline intake were 0.68 (0.59, 0.79) in women and 0.75 (0.60, 0.93) in men (both P-trend < 0.01). The inverse association was attenuated after further adjustment for history of metabolic disease and, in particular, BMI. The corresponding ORs (95% CIs) were 0.88 (0.75, 1.03) in women (P-trend = 0.05) and 0.85 (0.68, 1.06) in men (P-trend = 0.09). Stratified analyses suggested a potential effect modification by obesity status in women; the OR (95% CI) across extreme quintiles was 0.72 (0.57, 0.91) in normal-weight women vs. 1.05 (0.84, 1.31) in overweight or obese women (P-trend = 0.007 vs. 0.99, P-interaction < 0.0001). Higher dietary choline intake may be associated with lower risk of nonalcoholic fatty liver only in normal-weight Chinese women. © 2014 American Society for Nutrition.

Higher Dietary Choline Intake Is Associated with Lower Risk of Nonalcoholic Fatty Liver in Normal-Weight Chinese Women12

PubMed Central

Yu, Danxia; Shu, Xiao-Ou; Xiang, Yong-Bing; Li, Honglan; Yang, Gong; Gao, Yu-Tang; Zheng, Wei; Zhang, Xianglan

2014-01-01

Background: Choline deficiency has been shown to induce liver fat accumulation in both rodent and human studies. However, it is unclear whether dietary choline intake is related to fatty liver in the general population. Objective: We examined the association between choline intake and nonalcoholic fatty liver. Methods: Participants included 56,195 Chinese women and men, 40–75 y of age, with no or negligible alcohol consumption and with no history of hepatitis, cardiovascular disease, or cancer. All participants reported undergoing liver ultrasonography. Fatty liver was defined by self-report of a physician diagnosis. Habitual dietary intakes were assessed via validated food-frequency questionnaires. Results: The average total choline intakes were 289 ± 85 mg/d in women and 318 ± 92 mg/d in men. Major food sources were eggs, soy foods, red meat, fish, and vegetables. A higher choline intake was associated with lower risk of fatty liver; after adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the ORs (95% CIs) for the highest vs. the lowest quintiles of choline intake were 0.68 (0.59, 0.79) in women and 0.75 (0.60, 0.93) in men (both P-trend < 0.01). The inverse association was attenuated after further adjustment for history of metabolic disease and, in particular, BMI. The corresponding ORs (95% CIs) were 0.88 (0.75, 1.03) in women (P-trend = 0.05) and 0.85 (0.68, 1.06) in men (P-trend = 0.09). Stratified analyses suggested a potential effect modification by obesity status in women; the OR (95% CI) across extreme quintiles was 0.72 (0.57, 0.91) in normal-weight women vs. 1.05 (0.84, 1.31) in overweight or obese women (P-trend = 0.007 vs. 0.99, P-interaction < 0.0001). Conclusion: Higher dietary choline intake may be associated with lower risk of nonalcoholic fatty liver only in normal-weight Chinese women. PMID:25320186

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study.

PubMed

Neves, Amanda Gonçalves; Kasawara, Karina Tamy; Godoy-Miranda, Ana Carolina; Oshika, Flávio Hideki; Chaim, Elinton Adami; Surita, Fernanda Garanhani

2017-10-01

The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age. We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals. Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity. Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.

Cortisol production rate is similarly elevated in obese women with or without the polycystic ovary syndrome.

PubMed

Roelfsema, Ferdinand; Kok, Petra; Pereira, Alberto M; Pijl, Hanno

2010-07-01

The pituitary-adrenal axis in obesity and polycystic ovary syndrome (PCOS) is marked by increased urinary excretion of cortisol and its metabolites. It is not as yet clear whether the increased cortisol production in PCOS is related to obesity per se. We investigated 15 obese PCOS women with a body mass index of 30-54 kg/m(2) and 15 healthy obese controls (body mass index 31-60 kg/m(2)) with a regular menstrual cycle. Patients and control women underwent 24-h blood sampling at 20-min intervals. Cortisol concentrations were measured with a sensitive assay. Data were analyzed with a new deconvolution program, approximate entropy, and cosinor regression. Basal, pulsatile, and total cortisol production expressed per liter distribution volume, per square meter body surface, and as absolute amount per 24 h was similar in PCOS patients and matched healthy control women. In addition, the regularity of cortisol secretion and the diurnal properties were identical. Compared with 10 lean control women, mean cortisol production per liter distribution volume was similar in the three groups, but the total 24-h cortisol production was increased in obese control women and PCOS women. This study demonstrates equally increased cortisol production in PCOS women and obese healthy control women.

The influence of weight loss on anaerobic threshold in obese women.

PubMed

Zak-Golab, Agnieszka; Zahorska-Markiewicz, Barbara; Langfort, Józef; Kocelak, Piotr; Holecki, Michal; Mizia-Stec, Katarzyna; Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

2010-01-01

Obesity is associated with decreased physical activity. The aim of the study was to assess the anaerobic threshold in obese and normal weight women and to analyse the effect of weight-reduction therapy on the determined thresholds. 42 obese women without concomitant disease (age 30.5 ± 6.9y; BMI 33.6 ± 3.7 kg·m(-2)) and 19 healthy normal weight women (age 27.6 ± 7.0y; BMI 21.2 ± 1.9 kg·m(-2)) performed cycle ergometer incremental ramp exercise test up to exhaustion. The test was repeated in 19 obese women after 12.3 ± 4.2% weight loss. The lactate threshold (LT) and the ventilatory threshold (VT) were determined. Obese women had higher lactate (expressed as oxygen consumption) and ventilator threshold than normal weight women. The lactate threshold was higher than ventilatory one both in obese and normal weight women (1.11 ± 0.21 vs 0.88 ± 0.18 L·min(-1), p < 0.001; 0.94 ± 0.15 vs 0.79 ± 0.23 L·min(- 1), p < 0.01, respectively). After weight reduction therapy neither the lactate nor the ventilatory threshold changed significantly. The results concluded that; 1. The higher lactate threshold noted in obese women may be related to the increased fat acid usage in metabolism. 2. Both in obese and normal weight women lactate threshold appears at higher oxygen consumption than ventilatory threshold. 3. The obtained weight reduction, without weight normalisation was insufficient to cause significant changes of lactate and ventilatory thresholds in obese women. Key pointsResults showed that adolescent young female gymnasts have an altered serum inflammatory markers and endothelial activation, compared to their less physically active peers.Physical activities improved immune system.Differences in these biochemical data kept significant after adjustment for body weight and height.

Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England.

PubMed

Heslehurst, Nicola; Sattar, Naveed; Rajasingam, Daghni; Wilkinson, John; Summerbell, Carolyn D; Rankin, Judith

2012-12-18

Asians are at increased risk of morbidity at a lower body mass index (BMI) than European Whites, particularly relating to metabolic risk. UK maternal obesity guidelines use general population BMI criteria to define obesity, which do not represent the risk of morbidity among Asian populations. This study compares incidence of first trimester obesity using Asian-specific and general population BMI criteria. A retrospective epidemiological study of 502,474 births between 1995 and 2007, from 34 maternity units across England. Data analyses included a comparison of trends over time between ethnic groups using Asian-specific and general population BMI criteria. Logistic regression estimated odds ratios for first trimester obesity among ethnic groups following adjustment for population demographics. Black and South Asian women have a higher incidence of first trimester obesity compared with White women. This is most pronounced for Pakistani women following adjustment for population structure (OR 2.19, 95% C.I. 2.08, 2.31). There is a twofold increase in the proportion of South Asian women classified as obese when using the Asian-specific BMI criteria rather than general population BMI criteria. The incidence of obesity among Black women is increasing at the most rapid rate over time (p=0.01). The twofold increase in maternal obesity among South Asians when using Asian-specific BMI criteria highlights inequalities among pregnant women. A large proportion of South Asian women are potentially being wrongly assigned to low risk care using current UK guidelines to classify obesity and determine care requirements. Further research is required to identify if there is any improvement in pregnancy outcomes if Asian-specific BMI criteria are utilised in the clinical management of maternal obesity to ensure the best quality of care is provided for women irrespective of ethnicity.

The risk of adverse pregnancy outcomes in women who are overweight or obese

PubMed Central

2010-01-01

Background The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. Methods A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI. Conclusion The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed. Trial Registration Current Controlled Trials ISRCTN00416244 PMID:20849609

Impact of physical activity on ovarian reserve markers in normal, overweight and obese reproductive age women.

PubMed

Surekha, T; Himabindu, Y; Sriharibabu, M; Pandey, Anil Kumar

2014-01-01

Physical inactivity is a leading risk factor for overweight and obesity in the society. Prevalence of overweight and obesity in the reproductive age group women not only affects maternal health but also the health of the off spring. Infertility is a common problem in India affecting 13-19 million people at any given time. Even though it is not life threatening, infertility causes intense mental agony and trauma that can only be best described by infertile couples themselves. Infertility is more common in overweight and obese individuals compared to normal weight individuals. Decreasing ovarian reserve is an important factor for infertility in women. This study examined the impact of physical activity on ovarian reserve markers in normal, overweight and obese reproductive age women. The observations made in this study reveal that physical activity improves ovarian reserve markers in all reproductive age women but this improvement is more distinct and statistically significant in overweight and obese women compared to normal weight women.

Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012

PubMed Central

Perez Ferrer, Carolina; McMunn, Anne; Rivera Dommarco, Juan A.; Brunner, Eric J.

2014-01-01

Background Obesity is one of the leading causes of global morbidity and mortality. Trends in educational inequalities in obesity prevalence among Mexican women have not been analysed systematically to date. Methods Data came from four nationally representative surveys (1988, 1999, 2006, and 2012) of a total of 51 220 non-pregnant women aged 20 to 49. Weight and height were measured during home visits. Education level (higher education, high school, secondary, primary or less) was self-reported. We analysed trends in relative and absolute educational inequalities in obesity prevalence separately for urban and rural areas. Results Nationally, age-standardised obesity prevalence increased from 9.3% to 33.7% over 25 years to 2012. Obesity prevalence was inversely associated with education level in urban areas at all survey waves. In rural areas, obesity prevalence increased markedly but there was no gradient with education level at any survey. The relative index of inequality in urban areas declined over the period (2.87 (95%CI: 1.94, 4.25) in 1988, 1.55 (95%CI: 1.33, 1.80) in 2012, trend p<0.001). Obesity increased 5.92 fold (95%CI: 4.03, 8.70) among urban women with higher education in the period 1988–2012 compared to 3.23 fold (95%CI: 2.88, 3.63) for urban women with primary or no education. The slope index of inequality increased in urban areas from 1988 to 2012. Over 0.5 M cases would be avoided if the obesity prevalence of women with primary or less education was the same as for women with higher education. Conclusions The expected inverse association between education and obesity was observed in urban areas of Mexico. The declining trend in relative educational inequalities in obesity was due to a greater increase in obesity prevalence among higher educated women. In rural areas there was no social gradient in the association between education level and obesity across the four surveys. PMID:24599098

Educational inequalities in obesity among Mexican women: time-trends from 1988 to 2012.

PubMed

Perez Ferrer, Carolina; McMunn, Anne; Rivera Dommarco, Juan A; Brunner, Eric J

2014-01-01

Obesity is one of the leading causes of global morbidity and mortality. Trends in educational inequalities in obesity prevalence among Mexican women have not been analysed systematically to date. Data came from four nationally representative surveys (1988, 1999, 2006, and 2012) of a total of 51 220 non-pregnant women aged 20 to 49. Weight and height were measured during home visits. Education level (higher education, high school, secondary, primary or less) was self-reported. We analysed trends in relative and absolute educational inequalities in obesity prevalence separately for urban and rural areas. Nationally, age-standardised obesity prevalence increased from 9.3% to 33.7% over 25 years to 2012. Obesity prevalence was inversely associated with education level in urban areas at all survey waves. In rural areas, obesity prevalence increased markedly but there was no gradient with education level at any survey. The relative index of inequality in urban areas declined over the period (2.87 (95%CI: 1.94, 4.25) in 1988, 1.55 (95%CI: 1.33, 1.80) in 2012, trend p<0.001). Obesity increased 5.92 fold (95%CI: 4.03, 8.70) among urban women with higher education in the period 1988-2012 compared to 3.23 fold (95%CI: 2.88, 3.63) for urban women with primary or no education. The slope index of inequality increased in urban areas from 1988 to 2012. Over 0.5 M cases would be avoided if the obesity prevalence of women with primary or less education was the same as for women with higher education. The expected inverse association between education and obesity was observed in urban areas of Mexico. The declining trend in relative educational inequalities in obesity was due to a greater increase in obesity prevalence among higher educated women. In rural areas there was no social gradient in the association between education level and obesity across the four surveys.

Comparisons of energy intake and energy expenditure in overweight and obese women with and without binge eating disorder

USDA-ARS?s Scientific Manuscript database

The purpose of this study was to determine whether there are differences in energy intake or energy expenditure that distinguish obese women with and without binge eating disorder (BED). Seventeen obese women with BED and 17 obese controls completed random 24-hour dietary recall interviews, and had ...

First national epidemiological survey on the prevalence of obesity and abdominal fat distribution in Greek adults.

PubMed

Kapantais, E; Tzotzas, T; Ioannidis, I; Mortoglou, A; Bakatselos, S; Kaklamanou, M; Lanaras, L; Kaklamanos, I

2006-01-01

To provide estimates of the prevalence of obesity, overweight and body fat distribution among the adult population of Greece. Epidemiological, cross-sectional nationwide survey providing self-reported data. A total of 17,341 men and women aged from 20 to 70 years and classified into five 10-year age groups participated. The selection was conducted by stratified sampling through household family members of Greek children attending school. The participants reported data on weight, height, waist and hip circumference. BMI and waist-to-hip ratio were calculated. Abdominal obesity was defined as waist circumference > or = 102 cm in men and > or = 88 cm in women. In the total population, the mean BMI was 26.5 kg/m2, (27.3 in men, 25.7 in women). The overall prevalence of obesity was 22.5%, (26% in men, 18.2% in women) while that of overweight was 35.2% (41.1% in men, 29.9% in women). The percentages of obesity and overweight in men were similar in almost all age groups, while in women they progressively increased with age. Abdominal obesity was more frequent among women than men (35.8 vs. 26.6%, respectively), especially after the age of 50. Excess body weight is reaching epidemic proportions in Greece and obesity rates are among the highest, if not the highest, in Western society. The problem affects particularly men, and women after menopause. Interestingly, more women than men present with abdominal obesity. Preventive and treatment strategies are urgently needed to stop the obesity epidemic in this Mediterranean European country. Copyright 2006 S. Karger AG, Basel.

Food Insecurity and Obesity: Exploring the Role of Social Support.

PubMed

Ashe, Karen M; Lapane, Kate L

2018-05-01

Women are disproportionately affected by both obesity and food insecurity. Food insecurity occurs when there is limited ability to acquire adequate foods. It is unknown whether social support can reduce the effect of food insecurity on increased obesity. This study seeks to determine whether social support modifies the relationship between food insecurity and obesity. We conducted a cross-sectional study in a nationally representative sample of 4672 women aged ≥40 years using National Health and Nutrition Examination Survey (2003-2008). Individual food insecurity was assessed based on the U.S. Department of Agriculture 18-item validated household food security scale. Women were categorized as fully food secure (0 affirmative responses) or food insecure (1-10 affirmative responses). Obesity was defined as body mass index ≥30 kg/m 2 . Outcomes were analyzed by multivariable logistic regression. Fourteen percent were food insecure. Women with food insecurity had 1.4 the odds of obesity as those who were fully food secure, adjusting for race/ethnicity and health status (95% confidence interval [CI] 1.22-1.62). Food-insecure women were 80% less likely to report strong social support than women who were fully food secure (95% CI 0.11-0.36). Social support as measured in this study did not modify the association between food insecurity and obesity. Women reporting food insecurity reported lower levels of social support and were more likely to experience obesity. Interventions to reduce obesity in women who are food insecure must consider the limited resources available to these women.

Gene polymorphisms and increased DNA damage in morbidly obese women.

PubMed

Luperini, B C O; Almeida, D C; Porto, M P; Marcondes, J P C; Prado, R P; Rasera, I; Oliveira, M R M; Salvadori, D M F

2015-06-01

Obesity is characterized by increased adipose tissue mass resulting from a chronic imbalance between energy intake and expenditure. Furthermore, there is a clearly defined relationship among fat mass expansion, chronic low-grade systemic inflammation and reactive oxygen species (ROS) generation; leading to ROS-related pathological events. In the past years, genome-wide association studies have generated convincing evidence associating genetic variation at multiple regions of the genome with traits that reflect obesity. Therefore, the present study aimed to evaluate the relationships among the gene polymorphisms ghrelin (GHRL-rs26802), ghrelin receptor (GHSR-rs572169), leptin (LEP-rs7799039), leptin receptor (LEPR-rs1137101) and fat mass and obesity-associated (FTO-rs9939609) and obesity. The relationships among these gene variants and the amount of DNA damage were also investigated. Three hundred Caucasian morbidly obese and 300 eutrophic (controls) women were recruited. In summary, the results demonstrated that the frequencies of the GHRL, GHSR, LEP and LEPR polymorphisms were not different between Brazilian white morbidly obese and eutrophic women. Exceptions were the AA-FTO genotype and allele A, which were significantly more frequent in obese women than in the controls (0.23% vs. 0.10%; 0.46 vs. 0.36, respectively), and the TT-FTO genotype and the T allele, which were less frequent in morbidly obese women (p<0.01). Furthermore, significant differences in the amount of genetic lesions associated with FTO variants were observed only in obese women. In conclusion, this study demonstrated that the analyzed SNPs were not closely associated with morbid obesity, suggesting they are not the major contributors to obesity. Therefore, our data indicated that these gene variants are not good biomarkers for predicting risk susceptibility for obesity, whereas ROS generated by the inflammatory status might be one of the causes of DNA damage in obese women, favoring genetically related diseases as obesity comorbidities. Copyright © 2015 Elsevier B.V. All rights reserved.

Obesity as a protective factor for postmenopausal osteoporosis.

PubMed

Albala, C; Yáñez, M; Devoto, E; Sostin, C; Zeballos, L; Santos, J L

1996-11-01

Obesity is considered a protective factor for osteoporosis improving bone mass and maintaining higher levels of estrogen during menopause. To determine the association of obesity with bone mineral density (BMD), and its relationship with sex hormone levels. A case-control study in Caucasian obese and non obese postmenopausal women. 113 obese and 50 non-obese postmenopausal women. BMD (dual-photon X-ray absorptiometry) at cervical femur. Ward's triangle, proximal radius and lumbar spine. Plasma levels of glucose, insulin, total estrogen, follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHA-S) and testosterone. Mean BMD at femoral sites were significantly higher in obese women (femoral neck: 0.849 +/- 0.124 g/cm2 vs 0.753 +/- 0.095 g/cm2, P < 0.001; Ward's triangle: 0.634 +/- 0.134 g/cm2 vs. 0.553 +/- 0.100 g/cm2, P < 0.001). Mean BMD at lumbar spine was 0.906 +/- 0.138 g/cm2 in obese women and 0.849 +/- 0.137 g/cm2 in non obese, P < 0.017. A decreased risk of osteopenia in femoral neck (Age adjusted OR = 0.36, 95%CI 0.17-0.75) and in lumbar spine (Age adjusted OR = 0.43, 95%CI 0.20-0.91) in obese women was observed. Although total estrogen were similar in both groups, in obese women, SHBG was lower (68.6 +/- 26.84 nmol/l vs. 85.1 +/- 31.18 nmol/l, P < 0.001), and postglucose load insulin levels were higher, than in non obese (77.2 +/- 50.4 Ul/ml vs. 49.4 +/- 24.1 Ul/ml, P < 0.0005). The findings confirm a higher BMD in obese women and suggest that obesity exerts protection due to a decreased SHBG thus increasing free sex steroids. Besides, hyperinsulinemia may produce a decline in the production of IGFBG-1, leading to an increase of IGF-1, that may stimulate the proliferation of osteoblasts.

Emotional Experiences of Obese Women with Adequate Gestational Weight Variation: A Qualitative Study

PubMed Central

Faria-Schützer, Débora Bicudo; Surita, Fernanda Garanhani de Castro; Alves, Vera Lucia Pereira; Vieira, Carla Maria; Turato, Egberto Ribeiro

2015-01-01

Background As a result of the growth of the obese population, the number of obese women of fertile age has increased in the last few years. Obesity in pregnancy is related to greater levels of anxiety, depression and physical harm. However, pregnancy is an opportune moment for the intervention of health care professionals to address obesity. The objective of this study was to describe how obese pregnant women emotionally experience success in adequate weight control. Methods and Findings Using a qualitative design that seeks to understand content in the field of health, the sample of subjects was deliberated, with thirteen obese pregnant women selected to participate in an individual interview. Data was analysed by inductive content analysis and includes complete transcription of the interviews, re-readings using suspended attention, categorization in discussion topics and the qualitative and inductive analysis of the content. The analysis revealed four categories, three of which show the trajectory of body care that obese women experience during pregnancy: 1) The obese pregnant woman starts to think about her body;2) The challenge of the diet for the obese pregnant woman; 3) The relation of the obese pregnant woman with the team of antenatal professionals. The fourth category reveals the origin of the motivation for the change: 4) The potentializing factors for change: the motivation of the obese woman while pregnant. Conclusions During pregnancy, obese women are more in touch with themselves and with their emotional conflicts. Through the transformations of their bodies, women can start a more refined self-care process and experience of the body-mind unit. The fear for their own and their baby's life, due to the risks posed by obesity, appears to be a great potentializing factor for change. The relationship with the professionals of the health care team plays an important role in the motivational support of the obese pregnant woman. PMID:26529600

Association between ethnicity and obesity with high-density lipoprotein (HDL) function and subclass distribution.

PubMed

Woudberg, Nicholas J; Goedecke, Julia H; Blackhurst, Dee; Frias, Miguel; James, Richard; Opie, Lionel H; Lecour, Sandrine

2016-05-11

Obesity and low high-density lipoprotein-cholesterol (HDL-C) levels are associated with cardiovascular risk. Surprisingly, despite a greater prevalence of obesity and lower HDL concentrations than white women, black South African women are relatively protected against ischaemic heart disease. We investigated whether this apparent discrepancy may be related to different HDL function and subclass distribution in black and white, normal-weight and obese South African women (n = 40). HDL functionality was assessed by measuring paraoxonase (PON) activity, platelet activating factor acetylhydrolase (PAF-AH) activity, Oxygen Radical Absorbance Capacity (ORAC) and quantification of the expression of vascular cell adhesion molecule in endothelial cells. PON-1 and PAF-AH expression was determined in isolated HDL and serum using Western blotting. Levels of large, intermediate and small HDL subclasses were measured using the Lipoprint® system. PON activity was lower in white compared to black women (0.49 ± 0.09 U/L vs 0.78 ± 0.10 U/L, p < 0.05), regardless of PON-1 protein levels. Obese black women had lower PAF-AH activity (9.34 ± 1.15 U/L vs 13.89 ± 1.21 U/L, p <0.05) and HDL-associated PAF-AH expression compared to obese white women. Compared to normal-weight women, obese women had lower large HDL, greater intermediate and small HDL; an effect that was more pronounced in white women than black women. There were no differences in antioxidant capacity or anti-inflammatory function across groups. Our data show that both obesity and ethnicity are associated with differences in HDL functionality, while obesity was associated with decreases in large HDL subclass distribution. Measuring HDL functionality and subclass may, therefore, be important factors to consider when assessing cardiovascular risk.

Food insecurity with hunger is associated with obesity among HIV-infected and at risk women in Bronx, NY.

PubMed

Sirotin, Nicole; Hoover, Donald R; Shi, Qiuhu; Anastos, Kathryn; Weiser, Sheri D

2014-01-01

Food insecurity, insufficient quality and quantity of nutritionally adequate food, affects millions of people in the United States (US) yearly, with over 18 million Americans reporting hunger. Food insecurity is associated with obesity in the general population. Due to the increasing prevalence of obesity and risk factors for cardiovascular disease among HIV-infected women, we sought to determine the relationship between food insecurity and obesity in this cohort of urban, HIV-infected and -uninfected but at risk women. Using a cross-sectional design, we collected data on food insecurity, body mass index and demographic and clinical data from 231 HIV-infected and 119 HIV-negative women enrolled in Bronx site of the Women's Interagency HIV Study (WIHS). We used multivariate logistic regression to identify factors associated with obesity. Food insecurity was highly prevalent, with almost one third of women (110/350, 31%) reporting food insecurity over the previous six months and over 13% of women reported food insecurity with hunger. Over half the women were obese with a Body Mass Index (BMI) of ≥ 30. In multivariate analyses, women who were food insecure with hunger had higher odds of obesity (Adjusted odds ratio [aOR] =  2.56, 95% Confidence Interval [CI]  =  1.27, 5.20) after adjusting for HIV status, age, race, household status, income, drug and alcohol use. Food insecurity with hunger was associated with obesity in this population of HIV-infected and -uninfected, urban women. Both food insecurity and obesity are independent markers for increased mortality; further research is needed to understand this relationship and their role in adverse health outcomes.

Low predictability of anthropometric indicators of obesity in metabolic syndrome (MS) risks among elderly women.

PubMed

Chu, Fu-Ling; Hsu, Chung-Huei; Jeng, Chii

2012-01-01

While diagnostic criteria for MS may vary depending on ethnicity, obesity remains a key risk factor in its development. In Taiwan, the incidence of obesity and MS among women has been increasing; however cut-off values for defining obesity for the diagnosis of MS among different groups of women have not been clearly established. The goal of this research was to examine the suitability of various anthropometric indicators of obesity in predicting the presence of MS criteria and to determine appropriate cut-off values of these indicators for women of different age and menstrual status. The sample was derived from the 2002 "Taiwan Three High Prevalence Survey" database. Women were divided into three groups based on age and menstrual status. Receiver-operating characteristic (ROC) curves was applied to the anthropometric indicators of obesity including, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), to ascertain its value in predicting MS. 2848 cases were included. It was found that most MS component values were worse with age and following menopause. Obesity indicators showed poor predictability for MS risks in post-menopausal women over 65 years, but good predictability in women under 65 years; our study revealed the following as ideal cut-off values for non-menopausal female: WHtR<0.49, WC<78 cm, WHR<0.79, BMI<24 kg/m(2); for menopausal women, WHtR<0.54, WC<83 cm, WHR<0.84, BMI<24.4 kg/m(2). It was concluded that obesity alone is not a reliable predictor of MS risks in women over the age of 65, and cut-off values for obesity indicators need to be further reduced in non-menopausal women. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Health Behaviors and Breast Cancer: Experiences of Urban African American Women

ERIC Educational Resources Information Center

Stolley, Melinda R.; Sharp, Lisa K.; Wells, Anita M.; Simon, Nolanna; Schiffer, Linda

2006-01-01

Breast-cancer survival rates are lower among African American women compared to White women. Obesity may contribute to this disparity. More than 77% of African American women are overweight or obese. Adopting health behaviors that promote a healthy weight status may be beneficial because obesity increases risk for recurrence. Studies among White…

The effect of maternal obesity on pregnancy outcomes of women with gestational diabetes controlled with diet only, glyburide, or insulin.

PubMed

Joy, Saju; Roman, Ashley; Istwan, Niki; Rhea, Debbie; Desch, Cheryl; Stanziano, Gary; Saltzman, Daniel

2012-09-01

To examine the effect of obesity on maternal and neonatal outcomes in women diagnosed with gestational diabetes mellitus (GDM) and managed with diet only, glyburide, or insulin. Women with singleton gestations enrolled for outpatient services diagnosed with GDM and without history of pregnancy-related hypertension at enrollment or in a prior pregnancy were identified in a database. Women with GDM controlled by diet only (n = 3918), glyburide (n = 873), or insulin without prior exposure to oral hypoglycemic agents (n = 2229) were included. Pregnancy outcomes were compared for obese versus nonobese women within each treatment group and also compared across treatment groups within the obese and nonobese populations. Within each treatment group, obesity was associated with higher rates of cesarean delivery, pregnancy-related hypertension, macrosomia, and hyperbilirubinemia (all p < 0.05). Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in women receiving glyburide. Obesity adversely affects pregnancy outcome in women with GDM. Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in pregnant women receiving glyburide. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sexual abuse, sexual orientation, and obesity in women.

PubMed

Smith, Helen A; Markovic, Nina; Danielson, Michelle E; Matthews, Alicia; Youk, Ada; Talbott, Evelyn O; Larkby, Cynthia; Hughes, Tonda

2010-08-01

Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. Obesity was defined as body mass index (BMI) > or =30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age > or =18. Data were analyzed using chi-square tests and logistic regression models. Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA--regardless of sexual orientation--may play a role in the development of obesity.

Mediation of the bidirectional relations between obesity and depression among women.

PubMed

Vittengl, Jeffrey R

2018-06-01

Past research established that obesity increases risk for development of depression, and depression increases risk for development of obesity. The current study tested physical impairment (difficulty with instrumental activities of daily living), social dysfunction (low social support and high social strain), and emotional eating (using food to cope with stress) as mediators of the bidirectional, longitudinal relations between depression and obesity. A national sample of mid-life adults in the United States (N = 7108) was assessed at three time points over 18 years. Depression predicted increases in obesity, and obesity predicted increases in depression, for women but not for men. Among women, path analyses revealed that physical impairment, social dysfunction, and emotional eating mediated development of obesity from depression, and that physical impairment and emotional eating mediated development of depression from obesity. These results suggest that prevention or treatment of obesity-linked depression and depression-linked obesity in women may need to address multiple connections between these disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

Antenatal exercise in overweight and obese women and its effects on offspring and maternal health: design and rationale of the IMPROVE (Improving Maternal and Progeny Obesity Via Exercise) randomised controlled trial.

PubMed

Seneviratne, Sumudu N; Parry, Graham K; McCowan, Lesley Me; Ekeroma, Alec; Jiang, Yannan; Gusso, Silmara; Peres, Geovana; Rodrigues, Raquel O; Craigie, Susan; Cutfield, Wayne S; Hofman, Paul L

2014-04-26

Obesity during pregnancy is associated with adverse outcomes for the offspring and mother. Lifestyle interventions in pregnancy such as antenatal exercise, are proposed to improve both short- and long-term health of mother and child. We hypothesise that regular moderate-intensity exercise during the second half of pregnancy will result in improved maternal and offspring outcomes, including a reduction in birth weight and adiposity in the offspring, which may be protective against obesity in later life. The IMPROVE (Improving Maternal and Progeny Risks of Obesity Via Exercise) study is a two-arm parallel randomised controlled clinical trial being conducted in Auckland, New Zealand. Overweight and obese women (BMI ≥25 kg/m2) aged 18-40 years, with a singleton pregnancy of <20 weeks of gestation, from the Auckland region, are eligible for the trial. Exclusion criteria are ongoing smoking or medical contra-indications to antenatal exercise.Participants are randomised with 1:1 allocation ratio to either intervention or control group, using computer-generated randomisation sequences in variable block sizes, stratified on ethnicity and parity, after completion of baseline assessments. The intervention consists of a 16-week structured home-based moderate-intensity exercise programme utilising stationary cycles and heart rate monitors, commencing at 20 weeks of gestation. The control group do not receive any exercise intervention. Both groups undergo regular fetal ultrasonography and receive standard antenatal care. Due to the nature of the intervention, participants are un-blinded to group assignment during the trial.The primary outcome is offspring birth weight. Secondary offspring outcomes include fetal and neonatal body composition and anthropometry, neonatal complications and cord blood metabolic markers. Maternal outcomes include weight gain, pregnancy and delivery complications, aerobic fitness, quality of life, metabolic markers and post-partum body composition. The results of this trial will provide valuable insights on the effects of antenatal exercise on health outcomes in overweight and obese mothers and their offspring. Australian New Zealand Clinical Trials Registry ACTRN12612000932864.

Somatotype characteristics of normal-weight and obese women among different metabolic subtypes.

PubMed

Galić, Biljana Srdić; Pavlica, Tatjana; Udicki, Mirjana; Stokić, Edita; Mikalački, Milena; Korovljev, Darinka; Čokorilo, Nebojša; Drvendžija, Zorka; Adamović, Dragan

2016-02-01

Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to 'at risk' obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.

The influence of gestational weight gain on the development of gestational hypertension in obese women.

PubMed

Barton, John R; Joy, Saju D; Rhea, Debbie J; Sibai, Amanda J; Sibai, Baha M

2015-06-01

The objective of this study was to examine the influence of gestational weight gain on the development of gestational hypertension/preeclampsia (GHTN/PE) in women with an obese prepregnancy body mass index (BMI). Obese women with a singleton pregnancy enrolled at < 20 weeks were studied. Data were classified according to reported gestational weight gain (losing weight, under-gaining, within target, and over-gaining) from the recommended range of 11 to 9.7 kg and by obesity class (class 1 = BMI 30-34.9 kg/m(2), class 2 = 35-39.9 kg/m(2), class 3 = 40-49.9 kg/m(2), and class 4 ≥ 50 kg/m(2)). Rates of GHTN/PE were compared by weight gain group overall and within obesity class using Pearson chi-square statistics. For the 27,898 obese women studied, rates of GHTN/PE increased with increasing class of obesity (15.2% for class 1 and 32.0% for class 4). The incidence of GHTN/PE in obese women was not modified with weight loss or weight gain below recommended levels. Overall for obese women, over-gaining weight was associated with higher rates of GHTN/PE compared with those with a target rate for obesity classes 1 to 3 (each p < 0.001). Below recommended gestational weight gain did not reduce the risk for GHTN/PE in women with an obese prepregnancy BMI. These data support a gestational weight gain goal ≤ 9.7 kg in obese gravidas. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Co-occurring obesity and smoking among U.S. women of reproductive age: Associations with educational attainment and health biomarkers and outcomes.

PubMed

Vurbic, Drina; Harder, Valerie S; Redner, Ryan R; Lopez, Alexa A; Phillips, Julie K; Higgins, Stephen T

2015-11-01

Obesity and smoking are independently associated with socioeconomic disadvantage and adverse health effects in women of reproductive age and their children, but little is known about co-occurring obesity and smoking. The purpose of this study was to investigate relationships between co-occurring obesity and smoking, socioeconomic status, and health biomarkers and outcomes in a nationally representative sample. Data from non-pregnant women of reproductive age were obtained from the U.S. National Health and Nutrition Examination Surveys reported between 2007 and 2010. Linear and logistic regressions were used to examine associations between obesity and smoking alone and in combination with educational attainment and a range of health biomarkers and outcomes. Prevalence of co-occurring obesity and smoking was 8.1% (~4.1 million U.S. women of reproductive age) and increased as an inverse function of educational attainment, with the least educated women being 11.6 times more likely to be obese smokers than the most educated. Compared to women with neither condition, obese smokers had significantly poorer cardiovascular and glycemic biomarker profiles, and higher rates of menstrual irregularity, hysterectomy, oophorectomy, physical limitations, and depression. Obese smokers also had significantly worse high-density lipoprotein (HDL) cholesterol levels, physical mobility, and depression scores than those with obesity or smoking alone. Co-occurring obesity and smoking is highly associated with low educational attainment, a marker of socioeconomic disadvantage, and a broad range of adverse health biomarkers and outcomes. Interventions specifically targeting co-occurring obesity and smoking are likely necessary in efforts to reduce health disparities among disadvantaged women and their children. Copyright © 2015 Elsevier Inc. All rights reserved.

Sexual dysfunction in obese women is more affected by psychological domains than that of non-obese.

PubMed

Carrilho, Paulo José Faria; Vivacqua, Carla Almeida; Godoy, Eudes Paiva de; Bruno, Selma Sousa; Brígido, Alexandra Régia Dantas; Barros, Felipe Chaves Duarte; Sousa, Maria Bernardete Cordeiro de

2015-12-01

To compare differences in the occurrence and changed domains of sexual dysfunction in obese and non-obese Brazilian women. Female Sexual Function Index, based on six domains, to investigate 31 sexual dysfunction incidence for obese compared to 32 non-obese women, was used. Statistical analysis using ANOVA and MANOVA were performed to compare total scores of Female Sexual Function Index among groups and to identify the differences among domains, Student t -test was used. Statistical significant level was established for all tests for p<0.05. No difference in female sexual dysfunction frequency between obese (25.8%) and non-obese women (22.5%) was found. However, an important distinction in which aspects of sexual life were affected was found. While the obese group was impaired in three domains of sexual life (desire, orgasm, and arousal), in the control group five aspects were dysfunctional (desire, orgasm, arousal, pain and lubrication). Future research exploring psychological outcomes in obese females, such as body image and measures of positive and negative effect, might better characterize the female sexual dysfunction in this group. Obesity does not appear to be an independent factor for allow quality of female sexual life. However, disturbance associated to obesity indicates a low frequency of disorder in physical domains, suggesting that psychological factors seem to be mainly involved in the sexual dysfunction in obese women.

Prevalence of overweight, obesity, abdominal-obesity and short stature of adult population of Rosario, Argentina.

PubMed

Zapata, María Elisa; Bibiloni, María Del Mar; Tur, Josep A

2016-09-20

The aim of this work was to assess the prevalence of overweight, obesity, abdominal-obesity and short stature among Rosario (Argentina) adult population. A cross-sectional nutritional survey was carried out in Rosario (2012-2013). A random sample (n = 1194) of adult population (18-70 years old) was interviewed. Anthropometric measurements and a general questionnaire incorporating questions related to socio-demographic and lifestyle characteristics, education level and physical activity were used. The current study detected a high prevalence of overweight and obesity among adult population in Rosario. The prevalence of overweight was 32.7% (43.9% in men and 27.6% in women, p < 0.001), of obesity was 23.5% (21.6% in men and 24.3% in women), and of abdominal obesity was 57.5% (63.5% in men vs.54.8% in women, p < 0.005). Multivariate analysis showed that the prevalence of overweight/obesity and abdominal obesity increased according the age and abdominal obesity decreased with high physical activity in men. In women prevalence of overweight/obesity, and abdominal obesity increased with age, marital status (married or coupled), presence of at least one child at home and low educational level. The prevalence of short stature was higher in women (16.4% vs. 8.4%, p < 0.001) and was related with age, overweight and abdominal obesity.

The impact of first time mother’s body mass index or excessive weight gain in pregnancy on genital tract trauma at birth

PubMed Central

Gallagher, Kelly; Migliaccio, Laura; Rogers, Rebecca G; Leeman, Lawrence; Hervey, Elizabeth; Qualls, Clifford

2013-01-01

Objective To explore the impact of body mass index BMI or pregnancy weight gain on the presence, site and severity of genital tract trauma at childbirth in nulliparous women. Methods The present study is a sub-analysis of a prospective cohort of healthy nulliparous women recruited during pregnancy and followed through birth. Weight gain during pregnancy and pre-pregnancy BMI were recorded. At birth, women underwent detailed mapping of genital tract trauma. For analyses, women were dichotomized into obese(BMI ≥30) versus non obese(BMI <30) at baseline as well as into those who gained weight as recommended by the Institute of Medicine (IOM) and those who gained more than the recommended amount to determine the impact of obesity or excessive weight gain on rates of genital tract trauma. Results Data from 445 women were available for analysis. Presence and severity of genital tract trauma did not vary between obese and non-obese women (P = NS). Likewise women who gained more than the IOM recommended weight did not have a higher incidence of perineal lacerations (53% vs 51% with perineal lacerations, P= .61). Obese women were more likely to gain in excess of the IOM guidelines during pregnancy (75% vs 50% excessive weight gain, obese vs non-obese women, P<0.001). Conclusion A woman’s BMI or excessive weight gain in pregnancy did not influence her risk of genital tract trauma at birth. PMID:24588877

Oxidative Stress and Periodontal Disease in Obesity.

PubMed

Dursun, Erhan; Akalin, Ferda Alev; Genc, Tolga; Cinar, Nese; Erel, Ozcan; Yildiz, Bulent Okan

2016-03-01

Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women.Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated.Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P < 0.05 for all). GCF TOS was higher in the obese women (P < 0.05), whereas there was a nonsignificant trend for higher serum TOS in obese women (P = 0.074). GCF TAOC values showed a negative correlation with body mass index, whereas GCF OSI was positively correlated with fasting insulin and low-density lipoprotein-cholesterol levels (P < 0.05 for all). Clinical periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status markers.Our results suggest that young obese, otherwise healthy, women show findings of early periodontal disease (gingival inflammation) compared with age-matched healthy lean women, and that local/periodontal oxidative stress generated by obesity seems to be associated with periodontal disease.

Oxidative Stress and Periodontal Disease in Obesity

PubMed Central

Dursun, Erhan; Akalın, Ferda Alev; Genc, Tolga; Cinar, Nese; Erel, Ozcan; Yildiz, Bulent Okan

2016-01-01

Abstract Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women. Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated. Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P < 0.05 for all). GCF TOS was higher in the obese women (P < 0.05), whereas there was a nonsignificant trend for higher serum TOS in obese women (P = 0.074). GCF TAOC values showed a negative correlation with body mass index, whereas GCF OSI was positively correlated with fasting insulin and low-density lipoprotein-cholesterol levels (P < 0.05 for all). Clinical periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status markers. Our results suggest that young obese, otherwise healthy, women show findings of early periodontal disease (gingival inflammation) compared with age-matched healthy lean women, and that local/periodontal oxidative stress generated by obesity seems to be associated with periodontal disease. PMID:27015191

Maternal obesity and its effect on labour duration in nulliparous women: a retrospective observational cohort study.

PubMed

Ellekjaer, Karen Louise; Bergholt, Thomas; Løkkegaard, Ellen

2017-07-12

Obesity is increasing among primipara women. We aimed to describe the association between body mass index (BMI) during early-pregnancy and duration of labour in nulliparous women. Retrospective observational cohort study of 1885 nulliparous women with a single cephalic presentation from 37 0/7 to 42 6/7 weeks of completed gestation and spontaneous or induced labour at Nordsjællands Hospital, University of Copenhagen, Denmark, in 2011 and 2012. Total duration of labour and the first and second stages of labour were compared between early-pregnancy normal-weight (BMI <25 kg/m 2 ), overweight (BMI 25-29.9 kg/m 2 ), and obese (BMI ≥30 kg/m 2 ) women. Proportional hazards and multiple logistic regression models were applied. Early pregnancy BMI classified 1246 (66.1%) women as normal weight, 350 (18.6%) as overweight and 203 (10.8%) as obese. No difference in the duration of total or first stage of active labour was found for overweight (adjusted HR = 1.01, 95% CI 0.88-1.16) or obese (adjusted HR = 1.07, 95% CI 0.90-1.28) compared to normal weight women. Median active labour duration was 5.83 h for normal weight, 6.08 h for overweight and 5.90 h for obese women. The risk of caesarean delivery increased significantly for overweight and obese compared to normal weight women (odds ratios (OR) 1.62; 95%CI 1.18-2.22 and 1.76; 95%CI 1.20-2.58, respectively). Caesarean deliveries were performed earlier in labour in obese than normal-weight women (HR = 1.80, 95%CI 1.28-2.54). BMI had no significant effect on total duration of active labour. Risk of caesarean delivery increased with increasing BMI. Caesarean deliveries are undertaken earlier in obese women compared to normal weight women following the onset of active labour, shortening the total duration of active labour.

Obesity and Association with Area of Residence, Gender and Socio-Economic Factors in Algerian and Tunisian Adults

PubMed Central

Atek, Madjid; Traissac, Pierre; El Ati, Jalila; Laid, Youcef; Aounallah-Skhiri, Hajer; Eymard-Duvernay, Sabrina; Mézimèche, Nadia; Bougatef, Souha; Béji, Chiraz; Boutekdjiret, Leila; Martin-Prével, Yves; Lebcir, Hassiba; Gartner, Agnès; Kolsteren, Patrick; Delpeuch, Francis; Romdhane, Habiba Ben; Maire, Bernard

2013-01-01

Introduction The epidemiological transition has resulted in a major increase in the prevalence of obesity in North Africa. This study investigated differences in obesity and its association with area of residence, gender and socio-economic position among adults in Algeria and Tunisia, two countries with socio-economic and socio-cultural similarities. Methods Cross-sectional studies used stratified, three-level, clustered samples of 35–70 year old adults in Algeria, (women n = 2741, men n = 2004) and Tunisia (women n = 2964, men n = 2379). Thinness was defined as Body Mass Index (BMI) = weight/height <18.5 kg/m2, obesity as BMI ≥30, and abdominal obesity as waist circumference/height ≥0.6. Associations with area of residence, gender, age, education, profession and household welfare were assessed. Results Prevalence of thinness was very low except among men in Algeria (7.3% C.I.[5.9–8.7]). Prevalence of obesity among women was high in Algeria (30.1% C.I.[27.8–32.4]) and Tunisia (37.0% C.I.[34.4–39.6]). It was less so among men (9.1% C.I.[7.1–11.0] and 13.3% C.I.[11.2–15.4]).The results were similar for abdominal obesity. In both countries women were much more obesity-prone than men: the women versus men obesity Odds-Ratio was 4.3 C.I.[3.4–5.5] in Algeria and 3.8 C.I.[3.1–4.7] in Tunisia. Obesity was more prevalent in urban versus rural areas in Tunisia, but not in Algeria (e.g. for women, urban versus rural Odds-Ratio was 2.4 C.I.[1.9–3.1] in Tunisia and only 1.2 C.I.[1.0–5.5] in Algeria). Obesity increased with household welfare, but more markedly in Tunisia, especially among women. Nevertheless, in both countries, even in the lowest quintile of welfare, a fifth of the women were obese. Conclusion The prevention of obesity, especially in women, is a public health issue in both countries, but there were differences in the patterning of obesity according to area of residence and socio-economic position. These specificities must be taken into account in the management of obesity inequalities. PMID:24116063

Activity Behaviours in Lean and Morbidly Obese Pregnant Women.

PubMed

Fazzi, Caterina; Mohd-Shukri, Nor; Denison, Fiona C; Saunders, David H; Norman, Jane E; Reynolds, Rebecca M

2018-05-17

Interventions to increase physical activity in pregnancy are challenging for morbidly obese women. Targeting sedentary behaviours may be a suitable alternative to increase energy expenditure. We aimed to determine total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. We administered the Pregnancy Physical Activity Questionnaire PPAQ (non-objective) and the Actical accelerometer (objective) to morbidly obese (BMI≥40kg/m²) and lean (BMI≤25Kg/M²) pregnant women recruited in early (<24 weeks), and late (≥24 weeks) gestation. Data are mean (SD). Morbidly obese pregnant women reported expending significantly more energy per day in early (n=140 vs 109; 3198.4 (1847.1) vs 1972.3 (10284.8) Kcal/day, p<0.0001) and late (n=104 vs 64; 3078.2 (1356.5) vs 1947.5 (652.0) Kcal/day, p<0.0001) pregnancy, and expended significantly more energy in sedentary activities, in early (816.1 (423.5) vs 540.1 (244.9) Kcal/day, p<0.0001) and late (881.6 (455.4) vs 581.1 (248.5) Kcal/day, p<0.0001) pregnancy, than lean pregnant women. No differences were observed in the proportion of energy expended sedentary between lean and morbidly obese pregnant women. The greater total energy expenditure in morbidly obese pregnant women was corroborated by Actical accelerometer in early (n=14 per group, obese 1167.7 (313.6) Kcal; lean 781.1 (210.1) Kcal, p<0.05), and in late (n=14 per group, obese 1223.6 (351.5) Kcal; lean 893.7 (175.9) Kcal, p<0.05) pregnancy. In conclusion, non-objective and objective measures showed morbidly obese pregnant women expended more energy per day than lean pregnant. Further studies are needed to determine whether sedentary behaviours are a suitable target for intervention in morbidly obese pregnancy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A comparison of antenatal classifications of 'overweight' and 'obesity' prevalence between white British, Indian, Pakistani and Bangladeshi pregnant women in England; analysis of retrospective data.

PubMed

Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch

2017-04-11

Maternal obesity increases women's risk of poor birth outcomes, and statistics show that Pakistani and Bangladeshi women (who are born or settled) in the UK experience higher rates of perinatal mortality and congenital anomalies than white British or white Other women. This study compares the prevalence of maternal obesity in Indian, Pakistani, Bangladeshi and white British women using standard and Asian-specific BMI metrics. Retrospective cross-sectional analysis using routinely recorded secondary data in Ciconia Maternity information System (CMiS), between 2008 and 2013. Mothers (n = 15,205) whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian. Adjusted standardised residuals and Pearson Chi-square. Percentage of mothers stratified by ethnicity (Indian, Pakistani, Bangladeshi and white British) who are classified as overweight or obese using standard and revised World Health Organisation BMI thresholds. Compared to standard BMI thresholds, using the revised BMI threshold resulted in a higher prevalence of obesity: 22.8% of Indian and 24.3% of Bangladeshi and 32.3% of Pakistani women. Pearson Chi-square confirmed that significantly more Pakistani women were classified as 'obese' compared with white British, Indian or Bangladeshi women (χ 2  = 499,88 df = 9, p < 0.001). There are differences in the prevalence of obese and overweight women stratified by maternal ethnicity of white British, Indian, Pakistani and Bangladeshi. Using revised anthropometric measures in Indian, Pakistani and Bangladeshi women has clinical implications for identifying risks associated with obesity and increased complications in pregnancy.

Tranexamic acid reduces intraoperative occult blood loss and tourniquet time in obese knee osteoarthritis patients undergoing total knee arthroplasty: a prospective cohort study.

PubMed

Meng, Yutong; Li, Zhirui; Gong, Ke; An, Xiao; Dong, Jiyuan; Tang, Peifu

2018-01-01

Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight. A total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately. Of the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (both P < 0.05). Tourniquet time was shorter in the tranexamic acid group ( P < 0.05). In subgroup analysis, tranexamic acid was shown to reduce theoretical and actual blood loss in both the obese and non-obese groups ( P < 0.05). Tranexamic acid reduced occult blood loss and tourniquet time in the obese group ( P < 0.05), while no such effects were observed in the non-obese group ( P > 0.05). Tranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid.

Tranexamic acid reduces intraoperative occult blood loss and tourniquet time in obese knee osteoarthritis patients undergoing total knee arthroplasty: a prospective cohort study

PubMed Central

Gong, Ke; An, Xiao; Dong, Jiyuan; Tang, Peifu

2018-01-01

Purpose Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight. Patients and methods A total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately. Results Of the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (both P < 0.05). Tourniquet time was shorter in the tranexamic acid group (P < 0.05). In subgroup analysis, tranexamic acid was shown to reduce theoretical and actual blood loss in both the obese and non-obese groups (P < 0.05). Tranexamic acid reduced occult blood loss and tourniquet time in the obese group (P < 0.05), while no such effects were observed in the non-obese group (P > 0.05). Conclusion Tranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid. PMID:29695912

Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia - a decomposition analysis approach.

PubMed

Pujilestari, Cahya Utamie; Nyström, Lennarth; Norberg, Margareta; Weinehall, Lars; Hakimi, Mohammad; Ng, Nawi

2017-12-12

Obesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, hence requiring different focal points to design public health policies in the latter contexts. We examined socioeconomic inequalities in abdominal obesity in Purworejo District, Central Java, Indonesia and identified factors contributing to the inequalities. We utilised data from the WHO-INDEPTH Study on global AGEing and adult health (WHO-INDEPTH SAGE) conducted in the Purworejo Health and Demographic Surveillance System (HDSS) in Purworejo District, Indonesia in 2010. The study included 14,235 individuals aged 50 years and older. Inequalities in abdominal obesity across wealth groups were assessed separately for men and women using concentration indexes. Decomposition analysis was conducted to assess the determinants of socioeconomic inequalities in abdominal obesity. Abdominal obesity was five-fold more prevalent among women than in men (30% vs. 6.1%; p < 0.001). The concentration index (CI) analysis showed that socioeconomic inequalities in abdominal obesity were less prominent among women (CI = 0.26, SE = 0.02, p < 0.001) compared to men (CI = 0.49, SE = 0.04, p < 0.001). Decomposition analysis showed that physical labour was the major determinant of socioeconomic inequalities in abdominal obesity among men, explaining 47% of the inequalities, followed by poor socioeconomic status (31%), ≤ 6 years of education (15%) and current smoking (11%). The three major determinants of socioeconomic inequalities in abdominal obesity among women were poor socio-economic status (48%), physical labour (17%) and no formal education (16%). Abdominal obesity was more prevalent among older women in a rural Indonesian setting. Socioeconomic inequality in abdominal obesity exists and concentrates more among the rich population in both sexes. The inequality gap is less prominent among women, indicating a trend towards obesity being more common in poor women. Policies to address social determinants of health need to be developed to address the socioeconomic inequality gaps in obesity, with particular focus on addressing the existing burden of obesity among the better-off population group, while preventing the imminent burden of obesity among the worst-off group, particularly among women.

Association between obesity and suicide in woman, but not in man: a population-based study of young adults.

PubMed

Branco, Jerônimo Costa; Motta, Janaína; Wiener, Carolina; Oses, Jean Pierre; Pedrotti Moreira, Fernanda; Spessato, Barbara; Dias, Luciano; da Silva, Ricardo

2017-03-01

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk.

The Use of Lifestyle and Behavioral Modification Approaches in Obesity Interventions for Black Women: A Literature Review

ERIC Educational Resources Information Center

Walker, Renee E.; Gordon, Melanie

2014-01-01

The alarming obesity prevalence in Black women is well documented yet poorly understood. Obesity interventions for Black women have failed to produce long-term reductions in weight. Recommendations to incorporate a lifestyle and behavioral modification approach have been made to address obesity in this population. The purpose of this article was…

Insulin-induced capillary recruitment is impaired in both lean and obese women with PCOS.

PubMed

Ketel, I J G; Serné, E H; Ijzerman, R G; Korsen, T J M; Twisk, J W; Hompes, P G A; Smulders, Y M; Homburg, R; Vorstermans, L; Stehouwer, C D A; Lambalk, C B

2011-11-01

Insulin resistance, i.e. impaired insulin-mediated glucose uptake (IMGU), is a major risk factor for type 2 diabetes in women with polycystic ovary syndrome (PCOS). Insulin-induced capillary recruitment (IICR) is considered a significant determinant of IMGU. We investigated whether IICR is a determinant IMGU in obese and lean women with and without PCOS. The study included 36 women with PCOS (20 lean, BMI 21.9 ± 2.3 kg/m(2) and 16 obese, BMI 35.9 ± 6.0 kg/m(2)) and 27 age-matched healthy controls (14 lean, BMI 22.2 ± 1.8 kg/m(2) and 13 obese, BMI 40.5 ± 7.0 kg/m(2)). IICR was evaluated by capillary microscopy during an isoglycemic-hyperinsulinemic clamp. IMGU was expressed as M/I value. The M/I value was significantly lower in obese PCOS women compared with obese controls [0.5 (0.2-1.1) versus 0.8 (0.3-1.4) (mg kg(-1) min(-1) pmol l(-1)) × 100, P < 0.01], whereas the small difference between lean PCOS and lean control women was non-significant [1.5 (0.5-2.6) versus 1.7 (1.0-3.7) (mg kg(-1) min(-1) pmol l(-1)) × 100, P = 0.17]. Hyperinsulinemia increased capillary recruitment in lean controls (53.5 ± 20.3 versus 64.9 ± 27.4 n/mm(2), P < 0.05), but not in either PCOS group nor in obese controls. IICR and androgens were a determinant of M/I value only in lean women with or without PCOS. PCOS per se is associated with impaired IICR. Obese women with PCOS, in part independent of obesity, demonstrated a profound insulin resistance, whereas the difference between lean PCOS women and healthy controls was small and statistically non-significant. IICR was a determinant of IMGU in lean, but not in obese, women regardless of the presence of PCOS.

Impact of obesity on the pharmacokinetics of levonorgestrel-based emergency contraception: single and double dosing.

PubMed

Edelman, Alison B; Cherala, Ganesh; Blue, Steven W; Erikson, David W; Jensen, Jeffrey T

2016-07-01

To determine if differences exist in the pharmacokinetics (PK) of levonorgestrel-based emergency contraception (LNG-EC) in obese and normal body mass index (BMI) users and test whether doubling the dose of LNG-EC in obese women increases total and free (active) LNG serum concentrations. Healthy, reproductive-age women with obese and normal BMIs received 1.5mg LNG orally (ECx1) and then in a subsequent menstrual cycle, the obese group also received 3mg LNG (ECx2). Dosing occurred during the follicular phase. Total and free LNG PK parameters were obtained via serum samples through an indwelling catheter at 0, 0.5, 1, 1.5, 2, and 2.5h. The primary outcome was the difference in total and free LNG concentration maximum (Cmax) between ECx1 and ECx2 in the obese group. A total of 10 women enrolled and completed the study (normal BMI=5, median 22.8kg/m(2), range 20.8-23.7; obese BMI=5, 39.5kg/m(2), range 35.9-46.7). The total LNG Cmax for obese subjects following ECx1 (5.57±2.48ng/mL) was significantly lower than the level observed in normal BMI women (10.30±2.47, p=.027). Notably, ECx2 increased the Cmax significantly (10.52±2.76, p=.002); approximating the level in normal BMI subjects receiving ECx1. Free LNG Cmax followed a similar pattern. Obesity adversely impacts both the total and free Cmax levels of LNG EC and this likely explains its lack of efficacy in obese women. Doubling the dose appears to correct the obesity-related PK changes but additional research is needed to determine if this also improves EC effectiveness in obese women. This study demonstrates that obesity interferes with the pharmacokinetics of LNG EC, and that doubling the dose may be an effective strategy to improve its efficacy in obese women. Copyright © 2016 Elsevier Inc. All rights reserved.

[Obesity in Brazilian women: association with parity and socioeconomic status].

PubMed

Ferreira, Regicely Aline Brandão; Benicio, Maria Helena D'Aquino

2015-05-01

To determine the influence of reproductive history on the prevalence of obesity in Brazilian women and the possible modifying effect of socioeconomic variables on the association between parity and excess weight. A retrospective analysis of complex sample data collected as part of the 2006 Brazilian National Survey on Demography and Health, which included a group representative of women of childbearing age in Brazil was conducted. The study included 11 961 women aged 20 to 49 years. The association between the study factor (parity) and the outcome of interest (obesity) was tested using logistic regression analysis. The adjusted effect of parity on obesity was assessed in a multiple regression model containing control variables: age, family purchasing power, as defined by the Brazilian Association of Research Enterprises (ABEP), schooling, and health care. Significance level was set at below 0.05. The prevalence of obesity in the study population was 18.6%. The effect of parity on obesity was significant (P for trend < 0.001). Unadjusted analysis showed a positive association of obesity with parity and age. Family purchase power had a significant odds ratio for obesity only in the unadjusted analysis. In the adjusted model, this variable did not explain obesity. The present findings suggest that parity has an influence on obesity in Brazilian women of childbearing age, with higher prevalence in women vs. without children.

Influence of pre-pregnancy obesity on the development of macrosomia and large for gestational age in women with or without gestational diabetes mellitus in Chinese population.

PubMed

Wang, L-F; Wang, H-J; Ao, D; Liu, Z; Wang, Y; Yang, H-X

2015-12-01

To determine the effects of gestational diabetes mellitus (GDM) and pre-pregnancy obesity on macrosomia and large for gestational age (LGA). We conducted a prospective cohort study of 587 GDM women and 478 non-GDM women from 2012 to 2013. We collected their data of the pre-pregnancy weight, sociodemographic data, medical histories, clinical treatment, and followed-up the outcomes of delivery including birth weight. Multiple logistic regression models were used to test associations between pre-pregnant obesity and macrosomia/LGA and between GDM and macrosomia/LGA. Of 1065 women we studied, obese women had 4.17 times and 2.27 times increased risk of developing macrosomia (95% CI: 2.52 to 6.91) and LGA (95% CI: 1.60 to 3.21), respectively, than non-obese women after adjustment for maternal age, gestational weeks and GDM. We did not find GDM is a risk factor for macrosomia or LGA after GDM treatment. Pre-pregnancy obesity accounts for a high prevalence of macrosomia. Interventions that focus on pre-pregnancy obesity have the potential to reach far more women at risk of macrosomia.

A cross-sectional study on obesity and related risk factors among women of the central market of Lusonga in Lubumbashi, Democratic Republic of Congo.

PubMed

Mawaw, Paul; Yav, Thierry; Lukanka, Olivier; Mukuku, Olivier; Kakisingi, Christian; Kakoma, Jean-Baptiste; Luboya, Oscar Numbi

2017-01-01

Obesity is known as one of adjuvant factors for increase in non-communiable diseases (NCDs). The aim of this study was to describe the prevalence of obesity and identify its risk factors among women of the central market of Lusonga in Lubumbashi, Democratic Republic of Congo. In October 2014, we interviewed a total of 430 women selling in the central market of Lusonga in Lubumbashi. Data on sociodemographic characteristics, health-related habits and behaviors, diet, physical activity, chronic diseases, blood pressure and anthropometric measurements were collected. A multivariate logistic regression model was fitted. Prevalence of overweight and obesity was 16.51% and 13.26% respectively. The logistic regression did not show any significant association between age and obesity. Risk of obesity was lower in married women (adjusted odds ratio (aOR) = 0.23 (0.08-0.63)). Women with low educational profile (primary school or less) were more likely to be obese than those with higher education (secondary or high school) (aOR = 2.50 (1.12-5.63)). Risk of obesity increased with living in urban area (aOR = 2.52 (1.00-6.36)), use of oral birth control pills (aOR = 11.07 (3.52-34.83)) and low consumption of fruit (aOR = 5.47 (1.88-15.92)) and vegetable (aOR = 2.42 (1.05-5.56)). Obese women were more likely to be hypertensive than non-obese (aOR = 7.15 (2.46-20.75)) and diabetics (aOR = 3.62 (1.62-8.11)). This study has reported a prevalence of 13.26% of obesity among women selling at Lusonga's market. Marital status, education level, residence, use of oral birth control pills and consumption of fruit and vegetables had a significant association with the prevalence of obesity in this category of women.

Obesity and the association with maternal mental health symptoms.

PubMed

Ruhstaller, Kelly E; Elovitz, Michal A; Stringer, Marilyn; Epperson, C Neill; Durnwald, Celeste P

2017-08-01

To evaluate the association between maternal obesity and mood disorders including depression, anxiety, stress, and pregnancy-specific stress during pregnancy. This was a planned secondary analysis of a prospective cohort study investigating factors associated with preterm delivery. The cohort included women who initiated prenatal care before 20 weeks with a singleton pregnancy. Maternal mental health was assessed using four standard psychosocial behavioral measures to screen for depression, pregnancy-specific stress, anxiety, and stress. Screen positive scores for each tool were established based on previously published "high" scores. Of the 1010 women included in the cohort, 355 (35.1%) were obese. There was no significant difference in the number of obese women with stress (64.2% versus 68.4%, p = 0.18), pregnancy-specific stress (26.2% versus 22.1%, p = 0.15), or anxiety (38.6% versus 41.2%, p = 0.42); however, a greater number of obese women did report symptoms consistent with major depression when compared to women with BMIs <30 (30.4% versus 21.2%, p < 0.01). Obese women had higher rates of depression in early pregnancy compared to nonobese women. As many of the health behavior interventions for obese women during pregnancy have proven ineffective, incorporating depression screening and treatment into prenatal care may improve perinatal outcomes.

Contribution of overweight and obesity to adverse pregnancy outcomes among immigrant and non-immigrant women in Berlin, Germany.

PubMed

Reiss, Katharina; Breckenkamp, Jürgen; Borde, Theda; Brenne, Silke; David, Matthias; Razum, Oliver

2015-10-01

Maternal excessive weight and smoking are associated with an increased risk of pregnancy complications and adverse pregnancy outcomes. In Germany, immigrant women have a higher prevalence of pre-pregnancy overweight/obesity compared with autochthonous women. We compared the contribution of pre-pregnancy overweight/obesity to adverse pregnancy outcomes among immigrant and autochthonous women in Berlin/Germany. Data from 2586 immigrant women (from Turkey, Lebanon, other countries of origin) and 2676 autochthonous women delivering in three maternity hospitals of Berlin within 12 months (2011/2012) was used. Cox regression models were applied to estimate the association between overweight/obesity and smoking with the outcomes large-for-gestational-age (LGA), small-for-gestational-age (SGA), preterm birth (PTB) and extreme preterm-birth (E-PTB). Population attributive fractions (PAF) were calculated to quantify the proportion of the outcomes attributable to overweight/obesity and smoking, respectively. Prevalence of overweight and obesity was 33.4% among autochthonous and 53.6% among Turkish women. Prevalence risk ratios of excessive weight were highest for LGA infants among immigrant and autochthonous women. The PAFs were -11.8% (SGA), +16.3% (LGA), +3.6% (PTB) and +16.5% (E-PTB) for the total study population. Overweight/obesity is strongly associated with an increased risk of delivering an LGA infant among both immigrant and autochthonous women. Compared with autochthonous women, the contribution of excessive weight to LGA is even higher among immigrant women, in whom PAFs of overweight/obesity even exceed those of smoking for some outcomes. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Pharmacokinetics of a combined oral contraceptive in obese and normal weight women

PubMed Central

Westhoff, Carolyn L.; Torgal, Anupama H.; Mayeda, Elizabeth R.; Pike, Malcolm C.; Stanczyk, Frank Z.

2010-01-01

Background This study was conducted to compare oral contraceptive (OC) pharmacokinetics (PK) in normal weight (BMI 19.0-24.9) and obese (BMI 30.0-39.9) women. Study Design During the third week of the third cycle of OC use, we admitted 15 normal weight and 15 obese women for collection of 12 venous specimens over 24 h. Using RIA techniques, we measured levels of ethinyl estradiol (EE) and levonorgestrel (LNG). During the same cycle, women underwent twice-weekly sonography to assess ovarian follicular development and blood draws to measure endogenous estradiol (E2) and progesterone levels. Results Obese women had a lower area under the curve (AUC; 1077.2 pg*h/mL vs 1413.7 pg*h/mL) and lower maximum values (85.7 pg/mL vs 129.5 pg/mL) for EE than normal weight women (p = 0.04 and 0.01, respectively); EE trough levels were similar between BMI groups. The similar, but smaller, differences in their LNG levels for AUC and maximum values (Cmax) were not statistically significant. While peak values differed somewhat, the LNG trough levels were similar for obese and normal weight women (2.6 ng/mL and 2.5 ng/mL, respectively). Women with greater EE AUC had smaller follicular diameters (p = 0.05) and lower E2 levels (p = 0.04). While follicular diameters tended to be larger among obese women, these differences were not statistically significant. Conclusion OC hormone peak levels are lower among obese women compared to normal weight women, but their trough levels are similar. In this small study, the observed PK differences did not translate into more ovarian follicular activity among obese OC users. PMID:20472113

Metabolic profiling of gestational diabetes in obese women during pregnancy.

PubMed

White, Sara L; Pasupathy, Dharmintra; Sattar, Naveed; Nelson, Scott M; Lawlor, Debbie A; Briley, Annette L; Seed, Paul T; Welsh, Paul; Poston, Lucilla

2017-10-01

Antenatal obesity and associated gestational diabetes (GDM) are increasing worldwide. While pre-existing insulin resistance is implicated in GDM in obese women, the responsible metabolic pathways remain poorly described. Our aim was to compare metabolic profiles in blood of obese pregnant women with and without GDM 10 weeks prior to and at the time of diagnosis by OGTT. We investigated 646 women, of whom 198 developed GDM, in this prospective cohort study, a secondary analysis of UK Pregnancies Better Eating and Activity Trial (UPBEAT), a multicentre randomised controlled trial of a complex lifestyle intervention in obese pregnant women. Multivariate regression analyses adjusted for multiple testing, and accounting for appropriate confounders including study intervention, were performed to compare obese women with GDM with obese non-GDM women. We measured 163 analytes in serum, plasma or whole blood, including 147 from a targeted NMR metabolome, at time point 1 (mean gestational age 17 weeks 0 days) and time point 2 (mean gestational age 27 weeks 5 days, at time of OGTT) and compared them between groups. Multiple significant differences were observed in women who developed GDM compared with women without GDM (false discovery rate corrected p values <0.05). Most were evident prior to diagnosis. Women with GDM demonstrated raised lipids and lipoprotein constituents in VLDL subclasses, greater triacylglycerol enrichment across lipoprotein particles, higher branched-chain and aromatic amino acids and different fatty acid, ketone body, adipokine, liver and inflammatory marker profiles compared with those without GDM. Among obese pregnant women, differences in metabolic profile, including exaggerated dyslipidaemia, are evident at least 10 weeks prior to a diagnosis of GDM in the late second trimester.

Obesity and reproductive function: a review of the evidence.

PubMed

Klenov, Violet E; Jungheim, Emily S

2014-12-01

Over the last decade, the evidence linking obesity to impaired reproductive function has grown. In this article, we review this evidence and discuss the underlying pathophysiology. Obese women are less likely than normal-weight women to achieve pregnancy. Female obesity adversely affects reproductive function through alterations in the hypothalamic-pituitary-ovarian axis, oocyte quality, and endometrial receptivity. It is unclear which mechanism contributes the most to subfecundity, and it is likely a cumulative process. Emerging data highlight the contribution of male obesity to impaired reproductive function and that couple obesity has synergistic adverse effects. Once pregnant, obese women are at higher risk for adverse pregnancy outcomes. Weight loss improves reproductive potential in obese patients. As obese women surpass 35 years of age, age may be more important than body mass index in determining reproductive potential. Obstetrician gynecologists need to be aware of the negative impact of obesity on reproductive function so that they appropriately counsel their patients. Further work is needed to clarify the underlying pathophysiology responsible for adverse effects of obesity on reproduction so that novel treatment approaches may be developed.

Kidney Transplant Outcomes in the Super Obese: A National Study From the UNOS Dataset.

PubMed

Kanthawar, Pooja; Mei, Xiaonan; Daily, Michael F; Chandarana, Jyotin; Shah, Malay; Berger, Jonathan; Castellanos, Ana Lia; Marti, Francesc; Gedaly, Roberto

2016-11-01

We evaluated outcomes of super-obese patients (BMI > 50) undergoing kidney transplantation in the US. We performed a review of 190 super-obese patients undergoing kidney transplantation from 1988 through 2013 using the UNOS dataset. Super-obese patients had a mean age of 45.7 years (21-75 years) and 111 (58.4 %) were female. The mean BMI of the super-obese group was 56 (range 50.0-74.2). A subgroup analysis demonstrated that patients with BMI > 50 had worse survival compared to any other BMI class. The 30-day perioperative mortality and length of stay was 3.7 % and 10.09 days compared to 0.8 % and 7.34 days in nonsuper-obese group. On multivariable analysis, BMI > 50 was an independent predictor of 30-day mortality, with a 4.6-fold increased risk of perioperative death. BMI > 50 increased the risk of delayed graft function and the length of stay by twofold. The multivariable analysis of survival showed a 78 % increased risk of death in this group. Overall patient survival for super-obese transplant recipients at 1, 3, and 5 years was 88, 82, and 76 %, compared to 96, 91, 86 % on patients transplanted with BMI < 50. A propensity score adjusted analysis further demonstrates significant worse survival rates in super-obese patients undergoing kidney transplantation. Super-obese patients had prolonged LOS and worse DGF rates. Perioperative mortality was increased 4.6-fold compared to patients with BMI < 50. In a subgroup analysis, super-obese patients who underwent kidney transplantation had significantly worse graft and patient survival compared to underweight, normal weight, and obesity class I, II, and III (BMI 40-50) patients.

African American Women and Obesity through the Prism of Race

ERIC Educational Resources Information Center

Knox-Kazimierczuk, Francoise; Geller, Karly; Sellers, Sherrill; Taliaferro Baszile, Denise; Smith-Shockley, Meredith

2018-01-01

Background: There are minimal studies focusing on African American women and obesity, and there are even fewer studies examining obesity through a critical race theoretical framework. African American obesity research has largely focused on individual and community interventions, which have not been sufficient to reverse the obesity epidemic.…

Overweight and abdominal obesity in women of childbearing age of Russian, Somali and Kurdish origin and the general Finnish population.

PubMed

Kinnunen, Tarja I; Skogberg, Natalia; Härkänen, Tommi; Lundqvist, Annamari; Laatikainen, Tiina; Koponen, Päivikki

2017-05-15

Migrant background and higher parity may increase the risk of being overweight. We compared the prevalence of overweight (body mass index ≥25 kg/m2) and abdominal obesity (waist-to-height ratio ≥0.5) between non-pregnant migrant and Finnish women aged 18-45 years. The participants were 165 Russian, 164 Somali and 179 Kurdish origin women from the cross-sectional Migrant Health and Wellbeing study. The reference group included 388 women from the general Finnish population. Body anthropometrics were measured. The main statistical methods were logistic regression adjusted for sociodemographic and reproductive variables. The unadjusted prevalence of overweight and obesity, respectively, were higher among Somali (32.9%, 30.9%, P < 0.001) and Kurdish women (41.1%, 19.5%, P < 0.001) than among Finnish women (19.9%, 9.8%). The adjusted odds ratios (95% CI) for overweight (including obesity) were 0.54 (0.33; 0.89) for Russian, 2.89 (1.66; 5.03) for Somali and 2.56 (1.64; 4.00) for Kurdish women compared with Finnish women. Kurdish women had 2.96-fold (1.75; 5.00) adjusted odds ratio for abdominal obesity compared with Finnish women. Being parous was associated with overweight and abdominal obesity among Kurdish women. Overweight and obesity were very common among Somali and Kurdish origin women. Information on diet and physical activity in these groups is needed. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Pregnancy outcome of patients following bariatric surgery as compared with obese women: a population-based study.

PubMed

Shai, Daniel; Shoham-Vardi, Ilana; Amsalem, Doron; Silverberg, Daniel; Levi, Isaac; Sheiner, Eyal

2014-02-01

To evaluate pregnancy outcome and rates of anemia in patients following bariatric operation in comparison with obese pregnant women. A retrospective population-based study comparing pregnancy outcome of patients following bariatric with the obese population was conducted. Multivariate logistic regression models were constructed to control for confounders. To evaluate the change in hemoglobin levels, we included women who had one pregnancy before the bariatric surgery and one following the surgery or two pregnancies for women with obesity. This study included 326 women who had one pregnancy before and after a bariatric surgery and 1612 obese women who had at least two consecutive deliveries. Using a multivariable logistic regression model, controlling for confounders such as maternal age, patients following bariatric surgery had lower rates of gestational diabetes mellitus (OR 0.7; 95% CI 0.5-0.9; p = 0.49) and macrosomia (OR 0.3; 95% CI 0.2-0.5; p < 0.001) as compared with obese parturients. Women post bariatric surgery were more likely to be anemic (hemoglobin <10 g/dL) as compared to obese parturients (48% versus 37%; OR, 1.5; 95% CI, 1.2-1.9; p < 0.001). A significant decline in hemoglobin level was noted in patients following bariatric surgery (a decline of 0.33 g/dL versus 0.18 g/dL between two consecutive pregnancies of obese women). Using another multivariable model with anemia as the outcome variable, bariatric was noted as a risk factor for anemia (adjusted OR = 1.45, 95%CI 1.13-1.86, p = 0.004). Women following bariatric surgery have lower risk for gestational diabetes mellitus and fetal macrosomia as compared with obese parturients. Nevertheless, bariatric surgery is a risk factor for anemia.

The Psychosocial Factors Related to Obesity: A Study Among Overweight, Obese, and Morbidly Obese Women in India

PubMed Central

Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa

2015-01-01

Psychosocial factors among overweight, obese, and morbidly obese women in Delhi, India were examined. A follow-up survey was conducted of 325 ever-married women aged 20–54 years, systematically selected from 1998–99 National Family Health Survey samples, who were re-interviewed after 4 years in 2003. Information on day-to-day problems, body image dissatisfaction, sexual dissatisfaction, and stigma and discrimination were collected and anthropometric measurements were obtained from women to compute their current body mass index. Three out of four overweight women (BMI between 25 and 29.9 kg/m2) were not happy with their body image, compared to four out of five obese women (BMI of 30 kg/m2 or greater), and almost all (95 percent) morbidly obese women (BMI of 35 kg/m2 or greater) (p < .0001). It was found that morbidly obese and obese women were five times (adjusted odds ratio [aOR] 5.29, 95% confidence interval [CI] 2.02–13.81, p < .001) and two times (aOR 2.30, 95% CI 1.20–4.42, p < .001), respectively, as likely to report day-to-day problems; twelve times (aOR 11.88, 95% CI 2.62–53.87, p < .001) and three times, respectively, as likely (aOR 2.92, 95% CI 1.45–5.88, p = .001) to report dissatisfaction with body image; and nine times (aOR 9.41, 95% CI 2.96–29.94, p < .001) and three times (aOR 2.93, 95% CI 1.03–8.37, p = .001), respectively, as likely to report stigma and discrimination as overweight women. PMID:25905678

Decreased Emotional Perception in Obesity.

PubMed

Giel, Katrin Elisabeth; Hartmann, Armin; Zeeck, Almut; Jux, Anna; Vuck, Alexander; Gierthmuehlen, Petra C Guess; Wetzler-Burmeister, Edda; Sandholz, Angelika; Marjanovic, Goran; Joos, Andreas

2016-07-01

There is hardly any empirical evidence on emotion processing by controlled studies in obesity. Participants rated their emotions in response to visual emotional stimuli from the International Affective Picture System. Study 1 compared obese women with normal-weight controls and women with eating disorders. Study 2 compared obese men with normal-weight controls. Obese women had reduced emotional intensity scores for all basic emotions and the mixed emotion sadness-fear. Obese men had reduced scores for all emotions except happiness and disgust; anger showed a trend towards significance. The results were mainly based on ratings from non-depressed obese individuals. Obese men and women scored significantly lower on most basic and mixed emotions. Non-depressed obese subjects seem particularly affected. These new findings must be validated by further study, and longitudinal evaluation after weight loss, e.g. by bariatric surgery, will be of interest. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Maternal obesity is the new challenge; a qualitative study of health professionals' views towards suitable care for pregnant women with a Body Mass Index (BMI) ≥ 30 kg/m².

PubMed

Smith, Debbie M; Cooke, Alison; Lavender, Tina

2012-12-19

An increase in the number of women with maternal obesity (Body Mass Index [BMI] ≥30 kg/m2) has had a huge impact on the delivery of maternity services. As part of a programme of feasibility work to design an antenatal lifestyle programme for women with a BMI ≥30 kg/m2, the current study explored health professionals' experiences of caring for women with a BMI ≥30 kg/m2 and their views of the proposed lifestyle programme. Semi-structured interviews with 30 health professionals (including midwives, sonographers, anaesthetists and obstetricians) were conducted and analysed using thematic analysis. Recruitment occurred in two areas in the North West of England in early 2011. Three themes were evident. Firstly, obesity was seen as a conversation stopper; obesity can be a challenge to discuss. Secondly, obesity was seen as a maternity issue; obesity has a direct impact on maternity care and therefore intervention is needed. Finally, the long-term impact of maternal obesity intervention; lifestyle advice in pregnancy has the potential to break the cyclic obesity relationship. The health professionals believed that antenatal lifestyle advice can play a key role in addressing the public health issue of obesity as pregnancy is a time of increased motivation for women with a BMI ≥30 kg/m2. Maternal obesity is a challenge and details of the training content required for health professionals to feel confident to approach the issue of maternal obesity with women are presented. Support for the antenatal lifestyle programme for women with a BMI ≥30 kg/m2 highlights the need for further exploration of the impact of interventions on health promotion.

Obesity and fractures in postmenopausal women.

PubMed

Premaor, Melissa Orlandin; Pilbrow, Lesley; Tonkin, Carol; Parker, Richard A; Compston, Juliet

2010-02-01

Low body mass index (BMI) is a recognized risk factor for fragility fracture, whereas obesity is widely believed to be protective. As part of a clinical audit of guidance from the National Institute of Health and Clinical Excellence (NICE), we have documented the prevalence of obesity and morbid obesity in postmenopausal women younger than 75 years of age presenting to our Fracture Liaison Service (FLS). Between January 2006 and December 2007, 1005 postmenopausal women aged less than 75 years with a low-trauma fracture were seen in the FLS. Of these women, 805 (80%) underwent assessment of bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA), and values for BMI were available in 799. The prevalence of obesity (BMI 30 to 34.9 kg/m(2)) and morbid obesity (BMI > or = 35 kg/m(2)) in this cohort was 19.3% and 8.4%, respectively. Normal BMD was reported in 59.1% of obese and 73.1% of morbidly obese women, and only 11.7% and 4.5%, respectively, had osteoporosis (p < .0001). Multiple regression analysis revealed significant negative associations between hip T-score and age (p < .0001) and significant positive associations with BMI (p < .0001) and previous fracture (p = .001). Our results demonstrate a surprisingly high prevalence of obesity in postmenopausal women presenting to the FLS with low-trauma fracture. Most of these women had normal BMD, as measured by DXA. Our findings have important public heath implications in view of the rapidly rising increase in obesity in many populations and emphasize the need for further studies to establish the pathogenesis of fractures in obese individuals and to determine appropriate preventive strategies. Copyright 2010 American Society for Bone and Mineral Research.

Evaluation of the association of vitamin D deficiency with gonadotropins and sex hormone in obese and non-obese women with polycystic ovary syndrome.

PubMed

Velija-Ašimi, Zelija

2014-02-01

To evaluate the association of vitamin D (VD) deficiency with gonadotropins and sex hormone in obese and non-obese women with polycystic ovary syndrome (PCOS). Of the total of 140 women, thirty obese and thirty nonobese, aged 20-40 years, were included in the study. Inclusion criteria were the women with normal level of thyroid-stimulating hormone (TSH), prolactin (PRL), parathyroid hormone (PTH), and calcium, and those who had not received any medication or VD supplementation within the last 6 months. Serum 25- hydroxyvitamin D (25(OH)D), C-reactive protein (CRP), lipid profile, fasting serum glucose, basal insulin, homeostasis model analysis of insulin resistance (HOMA-IR) index, follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestrogen, total testosterone, dehidroepiandrostendion-sulphat (DHEA-S), androstendione, and sex hormone binding globulin (SHBG) were determined at follicular phase. Body mass index (BMI), weight, waist, lipids, and CRP were significantly higher in obese than in non-obese PCOS women (p=0.000). Meanwhile, insulin and HOMA-IR were also higher in the obese PCOS (p less than 0.000), and so was the fasting glucose (p=0.004). Furthermore, obese PCOS showed significantly higher level of LH (p=0.012), but lower level of progesterone (p=0.001) and androstendione (p=0.006) than in non-obese PCOS. In total 68% of PCOS women had VD deficiency but without significant difference among groups according to BMI. There was no association of VD deficiency with gonadotropins and sex hormones except SHBG. Insulin resistance was a better independent risk factor for the presence of vitamin D deficiency than SHBG. The insulin resistance and vitamin D deficiency significantly predicted the obesity risk in PCOS women.

The effect of palm oil, lard, and puff-pastry margarine on postprandial lipid and hormone responses in normal-weight and obese young women.

PubMed

Jensen, J; Bysted, A; Dawids, S; Hermansen, K; Hølmer, G

1999-12-01

Only a few studies have been published on the postprandial effects of different fatty acids in obese subjects. Therefore, the present study investigated the effects of three test meals containing palm oil (PO), lard (LD), or puff-pastry margarine (PPM), all normal dietary ingredients, on postprandial lipid and hormone responses in normal-weight and obese young women. The study was performed as a randomized, crossover design. The fats differed in the content of palmitic acid, stearic acid, and trans monounsaturated fatty acids allowing a dietary comparison of different 'solid' fatty acids. The obese women had significantly higher fasting concentrations and postprandial responses of plasma total triacylglycerol (TAG), chylomicron-TAG, and insulin compared with the normal-weight women but there was no significant difference in the postprandial responses between the three test meals. The obese women had fasting concentrations of leptin four times greater than the normal-weight women. There were no postprandial changes in the concentrations of leptin. The fasting concentrations of HDL-cholesterol were significantly lower in the obese women than in the normal-weight women, whereas there was no significant difference between the two groups in the concentrations of total cholesterol or LDL-cholesterol. These results provide evidence that obese women have exaggerated lipid and hormone responses compared with normal-weight women but the different contents of saturated and trans monounsaturated fatty acids provided by PO, LD, and PPM have no effect in either group.

Ovarian activity in obese and nonobese women treated with three transdermal contraceptive patches delivering three different doses of ethinyl estradiol and levonorgestrel.

PubMed

Foegh, Marie; Archer, David F; Stanczyk, Frank Z; Rubin, Arkady; Mishell, Daniel R

2013-02-01

The effect of obesity on ovarian follicular suppression in women using low-estrogen dose contraceptive patches has not been determined. A Phase II, parallel-group, multicenter, three-cycle study evaluated three patches containing different ethinyl estradiol (EE) and levonorgestrel (LNG) doses. Serum levels of EE, LNG, sex hormone-binding globulin and progesterone were compared in 41 obese [body mass index (BMI) ≥30] and 75 nonobese (BMI <30) women. Suppression of ovulation during the luteal phase was dose dependent, with the highest dose (AG200-15) preventing progesterone increases in all women (cycles 2-3). In the follicular phase, the lowest-dose patch had the highest rate of increased progesterone in nonobese subjects. Progesterone levels ≥3.0 ng/mL in the follicular phase were more common in obese than nonobese women. AG200-15 suppresses ovulation in obese and nonobese women. All three patches found increased progesterone in the follicular phase, albeit more in obese versus nonobese women. Copyright © 2013 Elsevier Inc. All rights reserved.

Assessment of female sexual function in a group of uncircumcised obese Egyptian women.

PubMed

Elnashar, A R M; Ibrahim, N H; Ahmed, H-Eh; Hassanin, A M; Elgawady, M A

2015-01-01

The aim of the present study was to assess female sexual function in an obese group (250 women) and to compare it with a control group (100 women), among 25-35-year-old uncircumcised Egyptian women, using female sexual function index (FSFI) score. FSFI total score of ⩽ 26.55 was considered diagnostic of Female Sexual Dysfunction (FSD). The percentage of FSD in the obese group was 73.6% while it was 71% in the control group, which was statistically insignificant (P > 0.05). The difference between both groups regarding the total (FSFI) score was insignificant (P > 0.05), but arousal and satisfaction domains scores were significantly lower in the obese group. In the obese group, a strong negative correlation between body mass index and arousal, orgasm and the total FSFI score was found. Women with excessive obesity had the lowest total FSFI score. In the obese group, college graduates had the highest total scores and all domain scores of FSFI followed by high school graduates while the least educated women had the lowest scores and when these subgroups were compared, significant differences were found among them. We conclude that in uncircumcised 25-35-year-old Egyptian women, obesity is not a major detrimental factor for FSD, but it may affect some sexual domains such as arousal and satisfaction, although excessive obesity is associated with FSD. Also, educational and cultural factors may have an impact on perception of sex and pleasure.

Sociodemographic Differences in the Association Between Obesity and Stress: A Propensity Score-Matched Analysis from the Korean National Health and Nutrition Examination Survey (KNHANES).

PubMed

Mak, Kwok-Kei; Kim, Dae-Hwan; Leigh, J Paul

2015-01-01

Few population-based studies have used an econometric approach to understand the association between two cancer risk factors, obesity and stress. This study investigated sociodemographic differences in the association between obesity and stress among Korean adults (6,546 men and 8,473 women). Data were drawn from the Korean National Health and Nutrition Examination Survey for 2008, 2009, and 2010. Ordered logistic regression models and propensity score matching methods were used to examine the associations between obesity and stress, stratified by gender and age groups. In women, the stress level of the obese group was found to be 27.6% higher than the nonobese group in the ordered logistic regression; the obesity effect on stress was statistically significant in the propensity score-matched analysis. Corresponding evidence for the effect of obesity on stress was lacking among men. Participants who were young, well-educated, and working were more likely to report stress. In Korea, obesity causes stress in women but not in men. Young women are susceptible to a disproportionate level of stress. More cancer prevention programs targeting young and obese women are encouraged in developed Asian countries.

77 FR 51806 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... Control and Prevention (CDC). In March 2010, HHS made 44 CPPW awards for community-based obesity and...: 28 are funded only for obesity- related initiatives; 11 are funded for both obesity and tobacco... conduct two cycles of information collection in the 39 target communities that are addressing obesity: the...

Changes in hormones and biomarkers in polycystic ovarian syndrome treated with gastric bypass.

PubMed

Eid, George M; McCloskey, Carol; Titchner, Rebecca; Korytkowski, Mary; Gross, Debra; Grabowski, Cynthia; Wilson, Mark

2014-01-01

Small retrospective studies have demonstrated reduction in weight and co-morbid hirsutism and diabetes in women with polycystic ovary syndrome (PCOS) treated with Roux-en-Y gastric bypass. The objective of this study was to prospectively determine clinical improvements in obese women with PCOS treated with gastric bypass and identify postoperative biomarker changes. Data were collected on obese women with PCOS undergoing Roux-en-Y gastric bypass over 1 year. Testosterone, follicle stimulating hormone, lutenizing hormone, insulin, fasting glucose, and lipid levels were obtained preoperatively at baseline, and 6 and 12 months after surgery. Testosterone was used as the primary hormonal biomarker. A physical examination for body mass index (BMI) and hirsutism, and information on menstrual pattern were collected at baseline and 3, 6, and 12 months after surgery. Data were available for 14 women. Mean BMI decreased from 44.8±5.9 kg/m(2) at baseline to 29.2±5.9 kg/m(2) at 12 months postoperatively. Significant improvements were seen in testosterone, fasting glucose, insulin, cholesterol, and triglyceride at 12 months (P<.05). At baseline, irregular menses were reported in 10 patients; all patients were experiencing regular menses 6 and 12 months after surgery. Hirsutism was present in 11 patients at baseline and only 7 patients at 12 months. Improvements in biomarkers, menstrual cycling, and hirsutism was not correlated with degree of weight change. Gastric bypass achieved significant reductions in BMI, testosterone, and markers of glucose and lipid metabolism. These data confirm reports of previous retrospective studies showing weight reduction and health improvement in women with PCOS treated with gastric bypass. Published by Elsevier Inc.

Roles of Sedentary Behaviors and Unhealthy Foods in Increasing the Obesity Risk in Adult Men and Women: A Cross-Sectional National Study.

PubMed

Nurwanti, Esti; Uddin, Mohy; Chang, Jung-Su; Hadi, Hamam; Syed-Abdul, Shabbir; Su, Emily Chia-Yu; Nursetyo, Aldilas Achmad; Masud, Jakir Hossain Bhuiyan; Bai, Chyi-Huey

2018-05-31

Sedentary behaviors and dietary intake are independently associated with obesity risk. In the literature, only a few studies have investigated gender differences for such associations. The present study aims to assess the association of sedentary behaviors and unhealthy foods intake with obesity in men and women in a comparative manner. The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2013/RISKESDAS 2013). In total, 222,650 men and 248,590 women aged 19⁻55 years were enrolled. A validated questionnaire, physical activity card, and food card were used for the assessments. The results showed that the prevalence of obesity (body mass index of ≥27.5 kg/m²) was higher in women (18.71%) than in men (8.67%). The mean body mass index in women tended to be higher than in men. After adjusting for age and education, the gender effect on obesity persisted in women and was more significant than in men. There was also a positive and significant effect on obesity of sedentary behaviors and unhealthy foods intake. Moreover, fatty and fried foods displayed a positive multiplicative interaction, increasing obesity risk in women more than in men and indicating a possible dietary risk in in women in relation to obesity. The study suggests that the implementation of educational programs on nutrition and physical activity is particularly important for promoting a healthy body weight among Indonesian women.

Effects of women's body mass index on in vitro fertilization success: a retrospective cohort study.

PubMed

Haghighi, Zahra; Rezaei, Zahra; Es-Haghi Ashtiani, Somayyeh

2012-07-01

The purpose of this study is to evaluate the influence of body mass index (BMI) on the reproductive outcomes and clinical pregnancy rate after in vitro fertilization (IVF). This retrospective study was performed on 230 women undergoing first cycle of standard IVF between October 2008 and February 2010. The patients were classified into three groups according to their BMI (BMI < 20 kg/m², 20 kg/m² < BMI < 27.9 kg/m² and BMI > 28 kg/m²). Information regarding clinical pregnancy was compared within these three groups. There was no significant relation between BMI and age, the number of aspirated follicles, transferred embryos, mature oocytes, days of taking human menopausal gonadotropin (HMG) ampules and the total number of HMG ampules among three BMI studied groups. Statistically significant difference was detected between BMI and endometrial thickness. BMI has no effect on IVF outcomes and clinical pregnancy after IVF. However, losing weight in obese women seems reasonable to prevent possible obstetrics complications.

Free flap lower extremity reconstruction in the obese population: does weight matter?

PubMed

Cleveland, Emily C; Fischer, John P; Nelson, Jonas A; Wink, Jason D; Levin, L Scott; Kovach, Stephen J

2014-05-01

The obesity epidemic continues to grow, and we have observed greater numbers of obese individuals among patients seeking lower extremity reconstruction at our institution. These patients may present a greater reconstructive challenge, thus we sought to identify risk factors and differences in outcomes among patients undergoing lower extremity reconstruction.In this study we have performed a retrospective cohort analysis of patients undergoing lower extremity reconstruction with free tissue transfer at our institution from 2005 to 2012. Patients were classified using the World Health Organization criteria for obesity. Records were reviewed for patient characteristics, mechanism of injury, indications for reconstruction, and surgical technique, with a focus on intraoperative and early postoperative complications and outcomes.A total of 43 out of the 119 patients undergoing lower extremity reconstruction were obese (body mass index ≥ 30). Mechanism of injury, wound location, and the indications for reconstruction were similar in both cohorts. No significant differences were found in operative characteristics and techniques, including the type of flap utilized, operative time, or thrombotic events. No significant differences were seen in complication rates overall, however, obese patients more frequently needed second flaps (11.6 vs. 0%, p=0.005).This study concludes that successful lower extremity reconstruction can be performed in the obese population, with few differences in complication rates and outcomes relative to healthy weight patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Physical activity and sedentary behavior in metabolically healthy obese young women

USDA-ARS?s Scientific Manuscript database

Studies of physical activity (PA) and sedentary behavior (SB) in metabolically healthy obese (MHO) have been limited to postmenopausal white women. We sought to determine whether PA and SB differ between MHO and metabolically abnormal obese (MAO), in young black and white women....

Generalised and abdominal adiposity are important risk factors for chronic disease in older people: results from a nationally representative survey.

PubMed

Hirani, V

2011-06-01

To look at the trends in prevalence of generalised (body mass index (BMI) ≥ 25 kg/m2) and abdominal obesity (waist circumference (WC) >102 cm, men; > 88 cm, women) among older people from 1993 to 2008, prevalence of chronic disease by overweight/obesity and WC categories in England 2005 and evaluate the association of these measures with chronic diseases. Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE). Non-institutionalised men and women aged ≥ 65 years (in HSE 2005, 1512 men and 1747 women). Height, weight, waist circumference, blood pressure measurements were taken according to standardised HSE protocols. Information collected on socio-demographic, health behaviour and doctor diagnosed health conditions. Generalised obesity and abdominal obesity increased among men and women from 1993 to 2008. In 2005, the HSE 2005 focussed on older people. 72% of men and 68% of women aged over 65 were either overweight or obese. Prevalence of raised WC was higher in women (58%) than in men (46%). The prevalence of diabetes and arthritis was higher in people with generalised obesity in both sexes. Men were more likely to have had a joint replacement and had a higher prevalence of stroke if they were overweight only but women were more likely to have had a joint replacement only if they were obese (13%) and had a higher risk of falls with generalised obesity. The pattern was similar for the prevalence of chronic diseases by raised WC. Multivariate analysis showed that generalised and abdominal obesity was independently associated with risk of hypertension, diabetes and arthritis in both men and women. In women only, there was an association between generalised obesity and having a fall in the last year (OR: 1.5), and between abdominal obesity and having a joint replacement (OR: 1.9, p=0.01). Complications of obesity such as diabetes, hypertension and arthritis, are more common in men and women aged over 65 who are overweight or obese, as well as in those with a raised WC. These conditions impact on morbidity, mortality and have cost implications for the health service and are known to improve with weight loss even in old age. Treatment strategies to address these conditions such as weight management and prevention of overweight and obesity are important even in older people. There is a need to ensure that older people are given appropriate advice about keeping physically active and eating sensibly.

Maternal and neonatal outcomes among obese women with weight gain below the new Institute of Medicine recommendations.

PubMed

Blomberg, Marie

2011-05-01

To estimate whether weight loss or low gestational weight gain in class I-III obese women is associated with adverse maternal and neonatal outcomes compared with gestational weight gain within the new Institute of Medicine recommendations. This was a population-based cohort study, which included 32,991 obesity class I, 10,068 obesity class II, and 3,536 obesity class III women who were divided into four gestational weight gain categories. Women with low (0-4.9 kg) or no gestational weight gain were compared with women gaining the recommended 5-9 kg concerning obstetric and neonatal outcome after suitable adjustments. Women in obesity class III who lost weight during pregnancy had a decreased risk of cesarean delivery (24.4%; odds ratio [OR] 0.77, 95% confidence interval [CI] 0.60-0.99), large-for-gestational-age births (11.2%, OR 0.64, 95% CI 0.46-0.90), and no significantly increased risk for pre-eclampsia, excessive bleeding during delivery, instrumental delivery, low Apgar score, or fetal distress compared with obese (class III) women gaining within the Institute of Medicine recommendations. There was an increased risk for small for gestational age, 3.7% (OR 2.34, 95% CI 1.15-4.76) among women in obesity class III losing weight, but there was no significantly increased risk of small for gestational age in the same group with low weight gain. Obese women (class II and III) who lose weight during pregnancy seem to have a decreased or unaffected risk for cesarean delivery, large for gestational age, pre-eclampsia, excessive postpartum bleeding, instrumental delivery, low Apgar score, and fetal distress. The twofold increased risk of small for gestational age in obesity class III and weight loss (3.7%) is slightly above the overall prevalence of small-for-gestational-age births in Sweden (3.6%).

Effect of sex and age on the association between suicidal behaviour and obesity in Korean adults: a cross-sectional nationwide study.

PubMed

Kim, Dae-Kwon; Song, Hyun Jin; Lee, Eui-Kyung; Kwon, Jin-Won

2016-06-02

To examine the hypothesis that the relationship between obesity and the risk of suicidal behaviour would differ according to sex and age. Data from the 2007-2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used. 36 211 adults with body mass index (BMI) data were included and the mean age was 49.6 years. BMI. Suicide ideation and attempts. A cross-sectional study was performed. Multiple logistic regressions after controlling for socioeconomic variables and concomitant diseases were applied to see the relationship between obesity level and suicidal ideation or attempt. Women with severe obesity had the highest prevalence of suicide attempts and ideation, whereas among males, underweight men had the highest prevalence. After adjustment, obese men had a lower OR for suicide ideation (OR=0.87, 95% CI 0.76 to 1.00). Among women, the ORs of severely obese and underweight women were 1.27 (95% CI 1.06 to 1.52) and 1.24 (95% CI 1.06 to 1.45), respectively. When grouped by age category, the ORs for suicide ideation in severely obese women aged 18 to <30 years or attempts in severely obese women aged 30 to <50 years were 2.30 (95% CI 1.36 to 3.89) and 3.07 (95% CI 1.50 to 6.31), respectively. However, overweight and obese women aged more than 50 years exhibited significantly less ORs of suicide ideation, when compared with counterparts of normal weight. The association between obesity and suicidal behaviour exhibited a different pattern by sex and age in South Korea. In particular, severely obese young women had a substantial risk of suicidal behaviour. Our study results highlighted the importance of obesity management in the prevention of suicide among young women, and may be helpful for the drafting of the health agenda in Asian countries with an obesity prevalence and culture similar to those in Korea. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effect of sex and age on the association between suicidal behaviour and obesity in Korean adults: a cross-sectional nationwide study

PubMed Central

Kim, Dae-Kwon; Song, Hyun Jin; Lee, Eui-Kyung; Kwon, Jin-Won

2016-01-01

Objectives To examine the hypothesis that the relationship between obesity and the risk of suicidal behaviour would differ according to sex and age. Setting Data from the 2007–2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used. Participants 36 211 adults with body mass index (BMI) data were included and the mean age was 49.6 years. Independent variable BMI. Primary and secondary outcome measures Suicide ideation and attempts. Design and analysis A cross-sectional study was performed. Multiple logistic regressions after controlling for socioeconomic variables and concomitant diseases were applied to see the relationship between obesity level and suicidal ideation or attempt. Results Women with severe obesity had the highest prevalence of suicide attempts and ideation, whereas among males, underweight men had the highest prevalence. After adjustment, obese men had a lower OR for suicide ideation (OR=0.87, 95% CI 0.76 to 1.00). Among women, the ORs of severely obese and underweight women were 1.27 (95% CI 1.06 to 1.52) and 1.24 (95% CI 1.06 to 1.45), respectively. When grouped by age category, the ORs for suicide ideation in severely obese women aged 18 to <30 years or attempts in severely obese women aged 30 to <50 years were 2.30 (95% CI 1.36 to 3.89) and 3.07 (95% CI 1.50 to 6.31), respectively. However, overweight and obese women aged more than 50 years exhibited significantly less ORs of suicide ideation, when compared with counterparts of normal weight. Conclusions The association between obesity and suicidal behaviour exhibited a different pattern by sex and age in South Korea. In particular, severely obese young women had a substantial risk of suicidal behaviour. Our study results highlighted the importance of obesity management in the prevention of suicide among young women, and may be helpful for the drafting of the health agenda in Asian countries with an obesity prevalence and culture similar to those in Korea. PMID:27256086

Physical activity level of postmenopausal women in Nigeria: Association with self-rated health status, overall obesity, and abdominal obesity.

PubMed

Ogwumike, Omoyemi O; Adeniyi, Ade F; Orogbemi, Oluwakemi O

2016-07-01

Regular physical activity (PA) has been shown to have many health benefits in various populations, including postmenopausal women (n = 310). Self-rated health has been positively associated with PA. This cross-sectional survey of postmenopausal women in Nigeria was conducted from April to September 2012 to investigate associations among PA level, self-rated health, overall obesity (body mass index [BMI]), and abdominal obesity (waist-height ratio, waist-hip ratio, and waist circumference). The International Physical Activity Questionnaire was used to classify PA. Chi-square and logistic regression were used for analyses with level of significance set at .05. Participants were aged 53.0 ± 4.2 years; moderate to vigorous PA was reported by 188 (60.0%), while 26 (8.4%) self-rated their health as poor/fair, and 242 (78.1%) were either predominantly overweight or obese when classified according to BMI. Participants with fair/poor self-rated health had less odds of involvement in moderate to vigorous PA. Obese postmenopausal women had greater odds of reporting lower PA. PA was positively related to self-rated health, which was negatively associated with overall obesity but not abdominal obesity. Measures to control obesity among postmenopausal women are essential in view of its direct association with poor self-rated health and low PA in this group of women.

Narcissism as a moderator of satisfaction with body image in young women with extreme underweight and obesity.

PubMed

Lipowska, Małgorzata; Lipowski, Mariusz

2015-01-01

Body weight and age constitute main determinants of body image in women. We analyzed the role of narcissism as a moderator of body image in young women representing various extremes of body weight. The study included 325 women between 18 and 35 years, qualified into three BMI categories: obese women (BMI > 30.0, n = 72), severely underweight women who did not satisfy the remaining criteria of anorexia (BMI < 17.5, n = 85), and women with normal body weight (21.7 < "ideal BMI" > 22.7, n = 168). Satisfaction with body image was determined with Multidimensional Body-Self Relations Questionnaire and Body Esteem Scale, while narcissism was measured with Narcissistic Personality Inventory. We revealed that narcissism has significant impact on the body image of women who are extremely underweight or obese. Vanity and Leadership were narcissism dimensions which played significant role in slim women, as compared to Vanity and Self-Sufficiency in obese women. The role of narcissism as a modulator of self-satisfaction with one's body varies depending on BMI level: extremely underweight women and obese individuals constitute groups in which narcissism has the strongest impact on the self-satisfaction with body.

Similarities in food cravings and mood states between obese women and women who smoke tobacco.

PubMed

Pepino, M Yanina; Finkbeiner, Susana; Mennella, Julie A

2009-06-01

The present study assessed food cravings in a cohort of 229 women who differed in smoking history (i.e., never smoker, former smoker, and current smoker) and body weight (i.e., normal weight, overweight, and obese). Each subject completed the Food Craving Inventory (FCI), which measures cravings for sweets, high fats, carbohydrates/starches, and fast-food fats, and the Profile of Mood States (POMS), which measures psychological distress. Smoking and obesity were independently associated with specific food cravings and mood states. Current smokers craved high fats more frequently than former and never smokers. They also craved starches more frequently and felt more depressed and angry than never smokers, but not former smokers. Whereas cravings for starchy foods and some mood states may be characteristic of women who are likely to smoke, more frequent cravings for fat among smokers is related to smoking per se. Similarly, obese women craved high fats more frequently than nonobese women and depression symptoms were intensified with increasing body weights. We hypothesize that the overlapping neuroendocrine alterations associated with obesity and smoking and the remarkable similarities in food cravings and mood states between women who smoke and women who are obese suggest that common biological mechanisms modulate cravings for fat in these women.

Characterization of 24-h cortisol release in obese and non-obese hyperandrogenic women.

PubMed

Miller, J E; Bray, M A; Faiman, C; Reyes, F I

1994-12-01

Excessive androgen output is a well-recognized feature of adrenocortical oversecretion in women with ovarian hyperandrogenism, or polycystic ovary disease (PCOD). However, evidence of a concomitant alteration of cortisol secretion is lacking even though obesity per se, a common clinical feature of PCOD, has been shown to be associated with cortisol oversecretion. To clarify whether a subtle alteration in cortisol secretion exists, a study of 24-h episodic cortisol release and post-prandial cortisol responses was undertaken in eight women with PCOD and eight normal women comprising equal numbers of obese and non-obese subjects. All four groups showed normal biphasic 24-h cortisol secretion profiles but cortisol pulse frequency was increased in the PCOD groups. Independently, both hyperandrogenism and obesity were associated with an accelerated cortisol clearance rate. These changes, together with normal or only slightly elevated 24-h cortisol integrated area under the curve, suggest an increased compensatory cortisol production in women with PCOD. Furthermore, subjects with PCOD and subjects with obesity showed different post-prandial cortisol responses to normal non-obese women. In conclusion, these subtle cortisol abnormalities may be a manifestation of altered central regulation of the hypothalamic-pituitary-adrenal axis and peripheral metabolic abnormalities, and may be linked to the pathophysiology of PCOD.

Association between Myeloperoxidase Levels and Risk of Insulin Resistance in Egyptian Obese Women

PubMed Central

Zaki, Moushira; Basha, Walaa; Reyad, Hanaa; Mohamed, Ramy; Hassan, Naglaa; Kholousi, Shams

2018-01-01

BACKGROUND: Myeloperoxidase (MPO) is an enzyme involved in the pathogenesis of several diseases. AIM: The current study aimed to investigate serum MPO levels in obese Egyptian women and assess its relation with insulin resistance (IR) and other biochemical risk parameters. METHODS: The study included 80 obese women and 50 age-and-sex-matched healthy controls. Insulin resistance (IR) was evaluated by the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Serum MPO, fasting glucose, insulin and blood lipids and anthropometry were measured. Obese cases were divided into three groups based on MPO tertiles. ROC analysis was performed to obtain the optimal cut-off values of MPO to predicate IR in obese women. RESULTS: The mean serum MPO was significantly higher in obese cases than controls. Cases in the highest MPO tertile had higher HOMA-IR, blood lipids and pressure levels compared with those in the lower tertile. The cutoff point of MPO was > 87.8 (ng/mL) and area under curves was 0.82 (p < 0.01) for diagnosis of IR. MPO levels were higher in obese Egyptian women than healthy controls. CONCLUSION: Elevation of MPO was associated with abnormal metabolic parameters. MPO might be used as an earlier biomarker for IR and metabolic disturbance in obese women. PMID:29731928

Preconception Care of the Obese Woman.

PubMed

Delcore, Laura; Lacoursiere, D Yvette

2016-03-01

One third of obese women report obtaining preconception care. Only one third of those women state that weight issues were discussed at their visit. Obese women should be educated about the risks of pregnancy so they can make informed choices as to whether and when to conceive. Women should be encouraged to mitigate risk by losing weight and exercising before conception and understand complications of pregnancy within specific pregravid body mass index strata. This manuscript describes the risks and provides guidance on topics to include in the preconception visit of an obese woman.

[Pathogenic mechanisms of proatherogenic changes in pregnant women with concomitant obesity].

PubMed

Tarasenko, K V; Mamontova, T V

2013-12-01

The concentration of insulin, high sensitivity C-reactive protein (CRP) and indices of lipid metabolism (concentrations of triacylglycerols, total cholesterol, cholesterol of low density lipoproteins and cholesterol of very low density lipoproteins) in women with concomitant obesity in the second trimester of pregnancy were studied. Changes of the lipid profile in the pregnant women with concomitant obesity indicate development of type IV hyperlipoproteinemia. Concentrations of insulin and CRP in the blood serum of the pregnant women with obesity were respectively 92.1% and 62.5% higher than in the control group. On the basis of literature data and our own research it was concluded that the complex of the metabolic changes (insulin resistance, dislipidemia, endothelial dysfunction, systemic inflammation) in pregnant women with obesity promotes development of proatherogenic changes.

Origins in the Womb: Potential Role of the Physical Therapist in Modulating the Deleterious Effects of Obesity on Maternal and Offspring Health Through Movement Promotion and Prescription During Pregnancy.

PubMed

Tinius, Rachel A; Cahill, Alison G; Cade, W Todd

2017-01-01

Maternal obesity and associated metabolic disease contribute to adverse outcomes in women and their offspring, and many of these outcomes have significant acute and chronic implications for both mother and neonate. Targeted movement (ie, physical activity or exercise training) during pregnancy has been shown to be safe and effective for improving many of these outcomes in women at a healthy weight and women who are obese. However, movement prescription and advice during pregnancy are often not addressed by health care providers; this situation creates a unique opportunity for physical therapists to use their expertise in movement with patients who are pregnant. The objective of this article is to briefly review the adverse maternal and neonatal outcomes associated with maternal obesity, the benefits of intentional maternal movement during pregnancy for women who are obese, the evidence-based guidelines for prescribing intentional movement during pregnancy for women who are obese, and the potential for physical therapists to become the driving force behind a necessary increase in movement levels in women who are pregnant. Physical therapists can play a significant role in encouraging movement in women who are healthy and women who have metabolic challenges during pregnancy and thus assist in combating the vicious cycle of obesity by improving maternal and offspring health. © 2017 American Physical Therapy Association.

Sex differences in obesity related cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC-49).

PubMed

Schrijnders, Dennis; Hendriks, Steven H; Kleefstra, Nanne; Vissers, Pauline A J; Johnson, Jeffrey A; de Bock, Geertruida H; Bilo, Henk J G; Landman, Gijs W D

2018-01-01

Diabetes and obesity seem to be partly overlapping risk factors for the development of obesity-related cancer (mainly breast, prostate and colorectal cancer) in patients with type 2 diabetes (T2DM). In the general population, women have a lower risk for obesity-related cancer compared to men. Previous studies involving cardiovascular disease have shown that T2DM eliminates a female advantage of lower CVD risk in the general population compared to men. It is unclear whether the same could be true for obesity-related cancer. This study aimed to this investigate obesity-related cancer incidence in women and men known with T2DM as compared to the Dutch general population. This study included 69,583 patients with T2DM selected from a prospective primary care cohort, which was linked to the Dutch National Cancer Registry to obtain cancer specific data. Obesity-related cancers included liver, kidney, colorectal, gallbladder, pancreas, ovarian, endometrial, advanced prostate cancer, post-menopausal breast cancer and oesophageal adenocarcinoma. Primary outcome was sex-stratified, age and year of cancer diagnosis adjusted standardized incidence ratios (SIRs) for three time periods: 5 years before, the year after diagnosis and the next 4 years after T2DM diagnosis. The Dutch general population was used as reference group. Women with T2DM were at an increased risk for obesity-related cancer compared to women in the general population already 5 years before diabetes diagnosis (SIR 1.77; 95%CI: 1.63-1.91). In both men and women, there was a peak in obesity-related cancer incidence following diabetes diagnosis (SIR: 1.38; 95%CI 1.11-1.64 and SIR: 2.21; 95%CI 1.94-2.30, respectively). From the second to the fifth year after diabetes diagnosis the obesity-related cancer incidence was higher in women compared to women in the general population (SIR: 2.12; 95%CI 1.94-2.30). Women with T2DM seem to have a substantially higher obesity-related cancer risk. As opposed to men, in women this risk was already increased years before diabetes diagnosis. These results could imply that a relative advantage of women in the general population with regard to cancer risk is lost in women with T2DM.

Sex differences in obesity related cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC-49)

PubMed Central

Hendriks, Steven H.; Kleefstra, Nanne; Vissers, Pauline A. J.; de Bock, Geertruida H.; Bilo, Henk J. G.; Landman, Gijs W. D.

2018-01-01

Background Diabetes and obesity seem to be partly overlapping risk factors for the development of obesity-related cancer (mainly breast, prostate and colorectal cancer) in patients with type 2 diabetes (T2DM). In the general population, women have a lower risk for obesity-related cancer compared to men. Previous studies involving cardiovascular disease have shown that T2DM eliminates a female advantage of lower CVD risk in the general population compared to men. It is unclear whether the same could be true for obesity-related cancer. This study aimed to this investigate obesity-related cancer incidence in women and men known with T2DM as compared to the Dutch general population. Methods This study included 69,583 patients with T2DM selected from a prospective primary care cohort, which was linked to the Dutch National Cancer Registry to obtain cancer specific data. Obesity-related cancers included liver, kidney, colorectal, gallbladder, pancreas, ovarian, endometrial, advanced prostate cancer, post-menopausal breast cancer and oesophageal adenocarcinoma. Primary outcome was sex-stratified, age and year of cancer diagnosis adjusted standardized incidence ratios (SIRs) for three time periods: 5 years before, the year after diagnosis and the next 4 years after T2DM diagnosis. The Dutch general population was used as reference group. Results Women with T2DM were at an increased risk for obesity-related cancer compared to women in the general population already 5 years before diabetes diagnosis (SIR 1.77; 95%CI: 1.63–1.91). In both men and women, there was a peak in obesity-related cancer incidence following diabetes diagnosis (SIR: 1.38; 95%CI 1.11–1.64 and SIR: 2.21; 95%CI 1.94–2.30, respectively). From the second to the fifth year after diabetes diagnosis the obesity-related cancer incidence was higher in women compared to women in the general population (SIR: 2.12; 95%CI 1.94–2.30). Conclusions Women with T2DM seem to have a substantially higher obesity-related cancer risk. As opposed to men, in women this risk was already increased years before diabetes diagnosis. These results could imply that a relative advantage of women in the general population with regard to cancer risk is lost in women with T2DM. PMID:29370205

The impact of maternal obesity and race/ethnicity on perinatal outcomes: independent and joint effects

PubMed Central

Snowden, Jonathan M; Mission, John F; Marshall, Nicole E; Quigley, Brian; Main, Elliott; Gilbert, William M; Chung, Judith H; Caughey, Aaron B

2016-01-01

Objective We characterized independent and joint impacts of maternal race/ethnicity and obesity on adverse birth outcomes, including preeclampsia, low birthweight (LBW), and macrosomia. Methods Retrospective cohort study of all 2007 California births using vital records and claims data. Maternal race/ethnicity and maternal BMI were the key exposures; we analyzed their independent and joint impact on outcomes using regression models. Results Racial/ethnic minority women of normal weight generally had higher risk as compared to white women of normal weight (e.g., African-American women, preeclampsia aOR, 1.60, 95% CI: 1.48 – 1.74, versus white women). However, elevated BMI did not usually confer additional risk (e.g., preeclampsia aOR comparing African-American women with morbid obesity to white women with morbid obesity; 1.17, 95% CI: 0.89 – 1.54). Obesity was a risk factor for LBW only among white women (morbid obesity aOR, 95% CI: 1.24, 1.04 – 1.49, versus white women of normal weight), and not among racial/ethnic minority women (e.g., African-American women, 0.95, 0.83 – 1.08). Conclusions These findings add nuance to our understanding of the interplay between maternal race/ethnicity, BMI, and perinatal outcomes. While the BMI/adverse outcome gradient appears weaker in racial/ethnic minority women, this reflects the overall risk increase in racial/ethnic minority women of all body sizes. PMID:27222008

Can Religion Help Prevent Obesity?: Religious Messages and the Prevalence of Being Overweight or Obese among Korean Women in California

PubMed Central

Ayers, John W.; Irvin, Veronica L.; Park, Hae-Ryun; Hovell, Melbourne F.; Hofstetter, Richard C.; Song, Yoonju; Paik, Hee-Yong

2010-01-01

This research examines the influence of messages from religious leaders and congregants on whether Korean women are overweight or obese. Data were drawn from telephone interviews with a probability sample (N=591) of women of Korean descent living in California. Overweight or obese prevalence was measured using World Health Organization standards for Asians (BMI>23). Respondents reported the frequency of messages discouraging “excessive eating” or encouraging “exercise” from religious leaders and congregants during a typical month. When conditioned on leaders’ messages, the frequency of congregants’ messages was associated with a significantly lower probability of being overweight or obese, although messages from either in the absence of the other were unassociated with being overweight or obese. At least for Korean women, religion may help prevent obesity via religious-based social mechanisms. PMID:20886700

Induction of the 72 kDa heat shock protein by glucose ingestion in black pregnant women.

PubMed

Jaffe, Shirlee; Doulaveris, Georgios; Orfanelli, Theofano; Arantes, Mariana; Damasceno, Débora; Calderon, Iracema; Rudge, Marilza V C; Witkin, Steven S

2013-07-01

Obese Black women are at increased risk for development of gestational diabetes mellitus and have worse perinatal outcomes than do obese women of other ethnicities. Since hsp72 has been associated with the regulation of obesity-induced insulin resistance, we evaluated associations between glucose ingestion, hsp72 release and insulin production in Black pregnant women. Specifically, the effect of a 50-g glucose challenge test (GCT) on heat shock protein and insulin levels in the circulation 1 h later was evaluated. Hsp27 and hsp60 levels remained unchanged. In contrast, serum levels of hsp72 markedly increased after glucose ingestion (p = 0.0054). Further analysis revealed that this increase was limited to women who were not obese (body mass index <30). Insulin levels pre-GCT were positively correlated with body mass index (p = 0.0189). Median insulin concentrations also increased post GCT in non-obese women but remained almost unchanged in obese women. Post-GCT serum hsp72 concentrations were inversely correlated with post GCT insulin concentrations (p = 0.0111). These observations suggest that glucose intake during gestation in Black women rapidly leads to an elevation in circulating hsp72 only in non-obese Black women. The release of hsp72 may regulate the extent of insulin production in response to a glucose challenge and, thereby, protect the mother and/or fetus from development of hyperglycemia, hyperinsulinemia, and/or immune system alterations.

Obese But Fit: The Relationship of Fitness to Metabolically Healthy But Obese Status among Sexual Minority Women.

PubMed

McElroy, Jane A; Gilbert, Tess; Hair, Elizabeth C; Mathews, Katherine J; Redman, Sarah Davis; Williams, Amy

2016-07-07

The purpose of this study was to describe fitness characteristics of metabolically healthy sexual minority women who are obese. As part of the Healthy Weight in Lesbian and Bisexual Women Initiative funded by the U.S. Office on Women's Health, one site enrolled self-identified lesbian or bisexual women age 40 and older in a randomized controlled trial that evaluated interventions to improve health. Women with waist-to-height ratio of 0.5 or greater were classified as obese. Women without diabetes or cardiovascular disease and with normal range fasting blood level measurements of glucose, triglycerides, high-density cholesterol, and blood pressure were classified as metabolically healthy but obese (MHO). Otherwise, women were classified as metabolically unhealthy obese (MUHO). Fitness measurements included predicted VO2 maximum, 1-minute heart rate recovery, and strength (single maximal leg lift and chest press). Self-reported demographic and physical activity level data were obtained by standardized questionnaires. Of the 53 participants who completed the eligibility screener in Columbia, Missouri, 47 were enrolled in the study (89% participation proportion) with 45 categorized as obese. Approximately one-third (38%) were MHO. The majority of MHO and MUHO participants ranked poor or very poor on a composite fitness score that included measures of strength, flexibility, and aerobic fitness (75.0% and 77.8%, respectively). In the logistic regression models, better 1-minute heart rate recovery after peak exercise performance was significantly associated with MHO individuals (odds ratio, 2.92; 95% CI, 1.13-9.10) compared with MUHO. No other fitness measure was significantly different between the two groups. Consistent with other studies, we identified more than one-third of our obese sexual minority women as MHO. Fitness measures may be potential predictors of MHO status because one measure, heart rate recovery, was significantly associated with MHO status. With the population prevalence of obesity high and even higher among lesbian or bisexual women, sexual minority women are an ideal population for a longitudinal study to better understand MHO characteristics. Copyright © 2015 Jacobs Institute of Women's Health. All rights reserved.

Determinants of overweight or obesity among ever-married adult women in Bangladesh.

PubMed

Sarma, Haribondhu; Saquib, Nazmus; Hasan, Md Mehedi; Saquib, Juliann; Rahman, Ahmed Shafiqur; Khan, Jahidur Rahman; Uddin, Md Jasim; Cullen, Mark R; Ahmed, Tahmeed

2016-01-01

The prevalence of overweight and obesity is increasing in Bangladesh. It is higher among Bangladeshi women than among men. This study was conducted to assess a host of demographic and socioeconomic correlates of overweight and obesity, separately for the urban and rural women of Bangladesh. We used data from the Bangladesh Demographic and Health Survey (BDHS) 2011. The BDHS provides cross-sectional data on a wide range of indicators relating to population, health, and nutrition. We analyzed nutrition-related data to identify the factors associated with being overweight or obese among ever-married women aged 18-49 years. Of 16,493 women, about 18 % (95 % CI 17 · 80-18 · 99) were overweight or obese. Unemployed urban women were at 1 · 44 (95 % CI 1 · 18-1 · 76, p < 0 · 001) times higher risk of being overweight or obese than those women who were involved in manual-labored work. Watching television at least once a week was another significant predictor among urban women (OR 1 · 49; 95 % CI 1 · 24-1 · 80; p < 0 · 001) and rural women (OR 1 · 31; 95 % CI 1 · 14-1 · 51; p < 0 · 001). Household wealth index and food security were also strongly associated with overweight or obesity of both rural and urban women. The findings of the study indicate that a large number of women in Bangladesh are suffering from being overweight or obese, and multiple factors are responsible for this including, older age, being from wealthy households, higher education, being from food-secured households, watching TV at least once a week, and being an unemployed urban woman. Given the anticipated long-term effects, the factors that are associated with being overweight or obese should be considered while formulating an effective intervention for the women of Bangladesh.

Early Breastfeeding Problems Mediate the Negative Association between Maternal Obesity and Exclusive Breastfeeding at 1 and 2 Months Postpartum1–3

PubMed Central

O’Sullivan, Elizabeth J; Perrine, Cria G; Rasmussen, Kathleen M

2015-01-01

Background Compared with normal-weight women, women with obesity experience poorer breastfeeding outcomes. Successful breastfeeding among women with obesity is important for achieving national breastfeeding goals. Objectives The objectives were to determine whether the negative association between obesity and any or exclusive breastfeeding at 1 and 2 mo postpartum is mediated through breastfeeding problems that occur in the first 2 wk postpartum and if this association differs by parity. Methods Mothers (1151 normal-weight and 580 obese) in the Infant Feeding Practices Study II provided information on sociodemographic and psychosocial characteristics, body mass index, and breastfeeding outcomes. At 1 mo postpartum, participants reported the breastfeeding problems they experienced in the first 2 wk postpartum from a predefined list of 17 options. We used factor analysis to condense these problems into 4 explanatory variables; continuous factor scores were computed for use in further analyses. We used maximum likelihood logistic regression to assess mediation of the association between obesity and breastfeeding outcomes through early breastfeeding problems. Results No significant effect of obesity was found on any breastfeeding at 1 or 2 mo. At 1 mo postpartum, for both primiparous and multiparous women, there was a significant direct effect of obesity on exclusive breastfeeding and a significant indirect effect of obesity through early breastfeeding problems related to the explanatory mediating variable “Insufficient Milk” (throughout the remainder of the Abstract, this factor will be denoted by upper case notation). At 2 mo postpartum both the direct effect of obesity and the indirect effect through Insufficient Milk were significant in primiparous women but only the indirect effect remained significant in multiparous women. Conclusions Early problems related to Insufficient Milk may partially explain the association between obesity and poor exclusive breastfeeding outcomes. Women who are obese, particularly those reporting breastfeeding problems that grouped in the Insufficient Milk factor in the early postpartum period, may benefit from additional breastfeeding support. PMID:26290005

Obesity in French Inmates: Gender Differences and Relationship with Mood, Eating Behavior and Physical Activity.

PubMed

Lagarrigue, Aude; Ajana, Soufiane; Capuron, Lucile; Féart, Catherine; Moisan, Marie-Pierre

2017-01-01

Inmates, notably women, are at greater risk for obesity and metabolic complications than the general population according to several studies from high income countries. Data regarding French correctional institutions are lacking so far. To fill this gap, we have assessed in a sample from a French prison (33 females and 18 males) the gender-specific effect of incarceration on weight and body mass index (BMI) and examined their current metabolic status. Furthermore, to reveal the possible determinants of increased obesity, we analyzed emotional vulnerability, eating behavior and physical activity using self-reported questionnaires. In this sample, obesity (BMI≥30 kg/m2) was already frequent in women (18.2%) but rather scarce for men (11%) at prison entry. Incarceration worsened the rate of obesity in both genders (21.2% and 16.7% respectively). At the time of study, abdominal obesity estimated through waist circumference was particularly prevalent in women (69.7%) versus men (27.8%) and metabolic syndrome was detected in 33% of female against none in male inmates. Abdominal obesity was associated with female sex (p<0.03), low physical activity (p<0.05) and eating disorder (p = 0.07) in univariate analyses. Low physical activity remained significant as an explanatory factor of higher abdominal obesity in multivariate analysis. A marked difference between genders was found for practice of physical activity with a higher proportion of women compared to men being inactive (37.9% vs. 11.8%) and fewer women being very active (17.2% vs. 41.2%). This study revealed that a significant proportion of women of this correctional institution combined established obesity, a metabolic syndrome and very little practice of physical activity which put them at high risk of cardiovascular disease. Thus, obesity should be better surveyed and treated in prison, especially for female inmates. Increased physical activity, adapted to obese women, would be the first mean to decrease obesity and gender differences.

Stratified probabilistic bias analysis for BMI-related exposure misclassification in postmenopausal women.

PubMed

Banack, Hailey R; Stokes, Andrew; Fox, Matthew P; Hovey, Kathleen M; Cespedes-Feliciano, Elizabeth M; LeBlanc, Erin; Bird, Chloe; Caan, Bette J; Kroenke, Candyce H; Allison, Matthew A; Going, Scott B; Snetslaar, Linda; Cheng, Ting-Yuan David; Chlebowski, Rowan T; Stefanick, Marcia L; LaMonte, Michael J; Wactawski-Wende, Jean

2018-06-01

There is widespread concern about the use of body mass index (BMI) to define obesity status in postmenopausal women because it may not accurately represent an individual's true obesity status. The objective of the present study is to examine and adjust for exposure misclassification bias from using an indirect measure of obesity (BMI) compared with a direct measure of obesity (percent body fat). We used data from postmenopausal non-Hispanic black and non-Hispanic white women in the Women's Health Initiative (WHI; n=126,459). Within the WHI, a sample of 11,018 women were invited to participate in a sub-study involving dual-energy x-ray absorptiometry (DXA) scans. We examined indices of validity comparing BMI-defined obesity (≥30kg/m) with obesity defined by percent body fat. We then used probabilistic bias analysis models stratified by age and race to explore the effect of exposure misclassification on the obesity-mortality relationship. Validation analyses highlight that using a BMI cutpoint of 30 kg/m to define obesity in postmenopausal women is associated with poor validity. There were notable differences in sensitivity by age and race. Results from the stratified bias analysis demonstrated that failing to adjust for exposure misclassification bias results in attenuated estimates of the obesity-mortality relationship. For example, in non-Hispanic white women age 50-59, the conventional risk difference was 0.017 (95% CI 0.01, 0.023) and the bias-adjusted risk difference was 0.035 (95% SI 0.028, 0.043). These results demonstrate the importance of using quantitative bias analysis techniques to account for non-differential exposure misclassification of BMI-defined obesity.

Acyl-CoA synthetase long-chain 5 genotype is associated with body composition changes in response to lifestyle interventions in postmenopausal women with overweight and obesity: a genetic association study on cohorts Montréal-Ottawa New Emerging Team, and Complications Associated with Obesity.

PubMed

Rajkumar, Abishankari; Lamothe, Gilles; Bolongo, Pierrette; Harper, Mary-Ellen; Adamo, Kristi; Doucet, Éric; Rabasa-Lhoret, Remi; Prud'homme, Denis; Tesson, Frédérique

2016-08-11

Genetic studies on Acyl-CoA Synthetase Long-Chain 5 (ACSL5) demonstrate an association between rs2419621 genotype and rate of weight loss in women with obesity in response to caloric restriction. Our objectives were to (1) confirm results in two different populations of women with overweight and obesity (2) study rs2419621's influence on body composition parameters of women with overweight and obesity following lifestyle interventions. rs2419621 genotype was determined in women with overweight and obesity who participated in the Montréal-Ottawa New Emerging Team (MONET n = 137) and Complications Associated with Obesity (CAO n = 37) studies. Genotyping was done using TaqMan MGB probe-based assay. Multiple linear regression analyses were used to test for associations. When studying women with overweight and obesity, rs2419621 [T] allele carriers had a significantly greater decrease in visceral fat, absolute and percent fat mass and a greater increase in percent lean mass in response to lifestyle intervention in comparison to non-carriers. Studying only individuals with obesity showed similar results with rs2419621 [T] allele carriers also displaying a significantly greater decrease in body mass index following the lifestyle intervention in comparison to non-carriers. Women with overweight and obesity carrying the ACSL5 rs2419621 [T] allele are more responsive to lifestyle interventions in comparison to non-carriers. Conducting such genetic association studies can aid in individualized treatments/interventions catered towards an individual's genotype.

Synergistic effect of maternal obesity and periodontitis on preterm birth in women with pre-eclampsia: a prospective study.

PubMed

Lee, Hyo-Jin; Ha, Jung-Eun; Bae, Kwang-Hak

2016-08-01

The aim of this study was to investigate if pregnant women with both obesity and periodontitis are more likely to experience preterm birth (PTB) in women with pre-eclampsia (PE) than pregnant women with only obesity or only periodontitis. The study examined a total of 328 pregnant women at 21-24 weeks of gestation. Overweight and obesity was defined based on criteria proposed by the WHO Expert Consultation. Periodontal conditions were assessed by measuring periodontal clinical attachment loss. PTB was defined as delivery at <37 weeks, and PE was defined as blood pressure higher than 140/90 mmHg on two separate occasions with at least 1+ proteinuria on a random urine screen after the 20th week of pregnancy. After adjusting for other important cofactors, pregnant women with periodontitis were 5.56 times [95% confidence interval (CI) = 1.22-25.39] more likely to have PTB with PE than women without periodontitis. The association was much stronger (odds ratio = 15.94, 95% CI = 3.31-76.71) in women with both obesity and periodontitis. Our results of this study indicate that pregnant women with both pre-pregnancy obesity and periodontitis are significantly more likely to have PTB with PE than pregnant women with only periodontitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

'Not waving but drowning': a study of the experiences and concerns of midwives and other health professionals caring for obese childbearing women.

PubMed

Schmied, Virginia A; Duff, Margie; Dahlen, Hannah G; Mills, Annie E; Kolt, Gregory S

2011-08-01

to explore the experiences and concerns of health professionals who care for childbearing women who are obese. obesity is increasing nationally and internationally and has been described as an epidemic. A number of studies have highlighted the risks associated with obesity during childbirth, yet few studies have investigated the experiences and concerns of midwives and other health professionals in providing care to these women. a descriptive qualitative study using focus groups and face-to-face interviews to collect data. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. three maternity units in New South Wales, Australia. participants included 34 midwives and three other health professionals. three major themes emerged from the data analysis: 'a creeping normality', 'feeling in the dark' and 'the runaway train'. The findings highlight a number of tensions or contradictions experienced by health professionals when caring for childbearing women who are obese. These include, on the one hand, an increasing acceptance of obesity ('a creeping normality'), and on the other, the continuing stigma associated with obesity; the challenges of how to communicate effectively with pregnant women about their weight and the lack of resources, equipment and facilities ('feeling in the dark') to adequately care for obese childbearing women. Participants expressed concerns about how quickly the obesity epidemic appears to have impacted on maternity services ('the runaway train') and how services to meet the needs of these women are limited or generally not available. it was clear in this study that participants felt that they were 'not waving but drowning'. There was concern over the fact that the issue of obesity had moved faster than the health response to it. There were also concerns about how to communicate with obese women without altering the relationship. Continuity of care, training and skills development for health professionals, and expansion of limited services and facilities for these women are urgently needed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Physical activity and psychological well-being in obese pregnant and postpartum women attending a weight-gain restriction programme.

PubMed

Claesson, Ing-Marie; Klein, Sofia; Sydsjö, Gunilla; Josefsson, Ann

2014-01-01

the objective of the study was to compare the differences in psychological well-being and quality of life during pregnancy and post partum of obese physically active women and obese physically inactive women enroled in a weight gain restriction programme. We also wanted to explore whether physical activity influences weight change or health status during pregnancy. a prospective intervention study. antenatal care clinic. a total of 74 obese pregnant women in a physically active group and 79 obese women in a physically inactive group. the women kept diaries of their physical activity during pregnancy and answered the Beck Anxiety Inventory, the Edinburgh Postnatal Depression Scale and Medical Study Short-Form Health Survey in gestational weeks 15 and 35 and 11 weeks post partum. Physical activity was measured in metabolic equivalents. the physically active women experienced fewer depressive symptoms and estimated an improved quality of life during their pregnancies as measured by physical functioning, bodily pain, social functioning, role limitations due to emotional problems and general mental health as compared with the physically inactive women. There were no differences between the groups in gestational weight gain or weight change from early pregnancy to post partum or in prevalence of complications. physical activity among obese pregnant women provides better psychological well-being and improved quality of life, but does not prevent weight change. staff at Antenatal Care Clinics that face obese pregnant women, should encourage and emphasise the benefits of being physically active throughout pregnancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

Obesity in Pregnancy: A Qualitative Approach to Inform an Intervention for Patients and Providers.

PubMed

Kominiarek, Michelle A; Gay, Franklin; Peacock, Nadine

2015-08-01

To investigate perceptions of minority pregnant women and providers about obesity and gestational weight gain (GWG), and to explore strategies to improve management of obesity in pregnancy with an emphasis on group prenatal care. Sixteen primarily non-Hispanic black pregnant women with a body mass index ≥ 30 kg/m(2) and 19 prenatal care providers participated in focus groups. Discussion topics included GWG goals, body image, health behaviors, and group prenatal care with additional emphasis on provider training needs. Women frequently stated a GWG goal >20 lbs. Women described a body image not in line with clinical recommendations ("200 pounds is not that big."). They avoided the term "obese". They were interested in learning about nutrition and culturally-acceptable healthy cooking. Women would enjoy massage and exercise in group settings, though definitions of "exercise" varied. Family members could help, but generational differences posed challenges. Most had to "encourage myself" and "do this for me and the baby". Providers expressed discomfort discussing GWG and difficulty finding the right words for obesity, which was partially attributed to their own weight. They noted the challenges they faced during prenatal care including time constraints, cultural myths, and system issues. Providers considered a group setting with social support an ideal environment to address health behaviors in obese women. Culturally-tailored programs that use acceptable terms for obesity, provide education regarding healthy eating and safe exercise, and encourage support from social networks may be effective in addressing GWG in obese minority women. Provider training in communication skills is necessary to address obesity in pregnancy.

Does mammogram attendance influence participation in cervical and colorectal cancer screening? A prospective study among 1856 French women.

PubMed

Bertaut, Aurélie; Coudert, Julien; Bengrine, Leila; Dancourt, Vincent; Binquet, Christine; Douvier, Serge

2018-01-01

We aimed to determine participation rates and factors associated with participation in colorectal (fecal occul blood test) and cervical cancer (Pap-smear) screening among a population of women participating in breast cancer screening. From August to October 2015, a self-administered questionnaire was sent by post to 2 900 women aged 50-65, living in Côte-d'Or, France, and who were up to date with mammogram screening. Polytomic logistic regression was used to identify correlates of participation in both cervical and colorectal cancer screenings. Participation in all 3 screenings was chosen as the reference. Study participation rate was 66.3% (n = 1856). Besides being compliant with mammogram, respectively 78.3% and 56.6% of respondents were up to date for cervical and colorectal cancer screenings, while 46.2% were compliant with the 3 screenings. Consultation with a gynecologist in the past year was associated with higher chance of undergoing the 3 screenings or female cancer screenings (p<10-4), when consultation with a GP was associated with higher chance of undergoing the 3 screenings or organized cancer screenings (p<0.05). Unemployment, obesity, age>59 and yearly flu vaccine were associated with a lower involvement in cervical cancer screening. Women from high socio-economic classes were more likely to attend only female cancer screenings (p = 0.009). Finally, a low level of physical activity and tobacco use were associated with higher risk of no additional screening participation (p<10-3 and p = 0.027). Among women participating in breast screening, colorectal and cervical cancer screening rates could be improved. Including communication about these 2 cancer screenings in the mammogram invitation could be worth to explore.

Impact of obesity on the pharmacokinetics of levonorgestrel-based emergency contraception: single and double dosing

PubMed Central

Edelman, Alison B; Cherala, Ganesh; Blue, Steven W; Erikson, David W; Jensen, Jeffrey T

2016-01-01

Objective To determine if differences exist in the pharmacokinetics (PK) of levonorgestrel-based emergency contraception (LNG-EC) in obese and normal body mass index (BMI) users and test whether doubling the dose of LNG-EC in obese women increases total and free (active) LNG serum concentrations. Study design Healthy, reproductive-age women with obese and normal BMIs received 1.5 mg LNG orally (ECx1) and then in a subsequent menstrual cycle, the obese group also received 3mg LNG (ECx2). Dosing occurred during the follicular phase. Total and free LNG PK parameters were obtained via serum samples through an indwelling catheter at 0, 0.5, 1, 1.5, 2, and 2.5 hours. The primary outcome was the difference in total and free LNG concentration maximum (Cmax) between ECx1 and ECx2 in the obese group. Results A total of 10 women enrolled and completed the study (normal BMI = 5, median 22.8 kg/m2, range 20.8–23.7; obese BMI = 5, 39.5 kg/m2, range 35.9–46.7). The total LNG Cmax for obese subjects following ECx1 (5.57±2.48 ng/mL) was significantly lower than the level observed in normal BMI women (10.30±2.47, p=0.027). Notably, ECx2 increased the Cmax significantly (10.52±2.76, p=0.002); approximating the level in normal BMI subjects receiving ECx1. Free LNG Cmax followed a similar pattern. Conclusion Obesity adversely impacts both the total and free Cmax levels of LNG EC and this likely explains its lack of efficacy in obese women. Doubling the dose appears to correct the obesity-related PK changes but additional research is needed to determine if this also improves EC effectiveness in obese women. Implications This study demonstrates that obesity interferes with the pharmacokinetics of LNG EC, and that doubling the dose may be an effective strategy to improve its efficacy in obese women. PMID:27000996

Decreased circulating T regulatory lymphocytes in obese patients undergoing bariatric surgery.

PubMed

Agabiti-Rosei, Claudia; Trapletti, Valentina; Piantoni, Silvia; Airò, Paolo; Tincani, Angela; De Ciuceis, Carolina; Rossini, Claudia; Mittempergher, Francesco; Titi, Amin; Portolani, Nazario; Caletti, Stefano; Coschignano, Maria Antonietta; Porteri, Enzo; Tiberio, Guido A M; Pileri, Paola; Solaini, Leonardo; Kumar, Rajesh; Ministrini, Silvia; Agabiti Rosei, Enrico; Rizzoni, Damiano

2018-01-01

It has been previously demonstrated that T lymphocytes may be involved in the development of hypertension and microvascular remodeling, and that circulating T effector lymphocytes may be increased in hypertension. In particular, Th1 and Th 17 lymphocytes may contribute to the progression of hypertension and microvascular damage while T-regulatory (Treg) lymphocytes seem to be protective in this regard. However, no data is available about patients with severe obesity, in which pronounced microvascular alterations were observed. We have investigated 32 severely obese patients undergoing bariatric surgery, as well as 24 normotensive lean subjects and 12 hypertensive lean subjects undergoing an elective surgical intervention. A peripheral blood sample was obtained before surgery for assessment of CD4+ T lymphocyte subpopulations. Lymphocyte phenotype was evaluated by flow cytometry in order to assess T-effector and Treg lymphocytes. A marked reduction of several Treg subpopulations was observed in obese patients compared with controls, together with an increased in CD4+ effector memory T-effector cells. In severely obese patients, Treg lymphocytes are clearly reduced and CD4+ effector memory cells are increased. It may be hypothesized that they might contribute to the development of marked microvascular alterations previously observed in these patients.

Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth.

PubMed

Harmon, Kristin A; Gerard, Lori; Jensen, Dalan R; Kealey, Elizabeth H; Hernandez, Teri L; Reece, Melanie S; Barbour, Linda A; Bessesen, Daniel H

2011-10-01

We sought to define 24-h glycemia in normal-weight and obese pregnant women using continuous glucose monitoring (CGM) while they consumed a habitual and controlled diet both early and late in pregnancy. Glycemia was prospectively measured in early (15.7 ± 2.0 weeks' gestation) and late (27.7 ± 1.7 weeks' gestation) pregnancy in normal-weight (n = 22) and obese (n = 16) pregnant women on an ad libitum and controlled diet. Fasting glucose, triglycerides (early pregnancy only), nonesterified fatty acids (FFAs), and insulin also were measured. The 24-h glucose area under the curve was higher in obese women than in normal-weight women both early and late in pregnancy despite controlled diets. Nearly all fasting and postprandial glycemic parameters were higher in the obese women later in pregnancy, as were fasting insulin, triglycerides, and FFAs. Infants born to obese mothers had greater adiposity. Maternal BMI (r = 0.54, P = 0.01), late average daytime glucose (r = 0.48, P < 0.05), and late fasting insulin (r = 0.49, P < 0.05) correlated with infant percentage body fat. However, early fasting triglycerides (r = 0.67, P < 0.001) and late fasting FFAs (r = 0.54, P < 0.01) were even stronger correlates. This is the first study to demonstrate that obese women without diabetes have higher daytime and nocturnal glucose profiles than normal-weight women despite a controlled diet both early and late in gestation. Body fat in infants, not birth weight, was related to maternal BMI, glucose, insulin, and FFAs, but triglycerides were the strongest predictor. These metabolic findings may explain higher rates of infant macrosomia in obese women, which might be targeted in trials to prevent excess fetal growth.

The impact of obesity in the kinematic parameters of gait in young women

PubMed Central

da Silva-Hamu, Tânia Cristina Dias; Formiga, Cibelle Kayenne Martins Roberto; Gervásio, Flávia Martins; Ribeiro, Darlan Martins; Christofoletti, Gustavo; de França Barros, Jônatas

2013-01-01

Background The prevalence of obesity is increasing in the population, particularly in women. Obesity has an impact on the musculoskeletal system, leading to knee and ankle overexertion, difficulty with balance, and functional disability. The aim of this study was to identify changes in kinematic parameters of gait in obese young women. Methods A case-control study with 24 obese women (mean age 35.20 ± 9.9 years and mean body mass index of 31.85 ± 2.94 kg/m2) and 24 eutrophic women (mean age of 36.33 ± 11.14 and mean body mass index of 21.82 ± 1.58 kg/m2). The gait of women was evaluated by the system Vicon Motus® 9.2. The linear parameters of speed, cadence, right and left step, and stride lengths were studied, as well as the angular parameters of knee and ankle. Results There was a decrease in linear gait parameters (P < 0.001), speed, cadence, right and left step, and stride lengths. In regard to the angular parameters of the knee and ankle, there were also differences between the analyses (P < 0.001). At the knee joint, obese women have delayed onset of the second wave of flexion, exacerbating such movement in order to compensate. In regard to the ankle, both groups showed curves of normal plantar flexion and dorsiflexion, but there was a delay in the path graph in the ankle of obese women indicating a reduced range of motion and possible over-exertion of the pretibial muscles and soleus muscles simultaneously. Conclusion The results of this study revealed that obesity is a factor that negatively influences the kinematic parameters of gait of young women. PMID:23837005

Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of northeast china: the CHPSNE study

PubMed Central

2012-01-01

Background Obesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults. Methods A representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, weight and waist circumference (WC) were taken from 2009–2010. Definitions of overweight and obesity by the World Health Organization (WHO) were used. Results The overall prevalence rates of general obesity and overweight classified by BMI were 15.0% (15.7% for men and 14.3% for women, p<0.01) and 19.2% (20.8% for men and 17.7% for women, p<0.01), respectively, and the overall prevalence rate of abdominal obesity was 37.6% (31.1% for men and women 43.9% for women, p<0.01). Multivariable logistic regression showed that the elderly and those who had a history of parental obesity, alcohol drinking, or former cigarette smoking were at high risk of obesity classified by BMI or WC, whereas those with a higher level of education, higher family income, or a healthy and balanced diet were at low risk of obesity. Analysis stratified by gender showed that men with a higher level education level, a white-collar job, a cadre job, or higher family income were the high risk group, and women with a higher level of education or higher family income were the low risk group. Conclusions Obesity and overweight have become epidemic in urban populations in China; associations of risk factors with obesity differ between men and women. PMID:23146089

Obesity and depressive symptoms among Chinese people aged 45 and over

PubMed Central

Qian, Jiahui; Li, Ningxiu; Ren, Xiaohui

2017-01-01

We examined the controversial relationship between obesity and depression among Chinese people aged 45 and over using data from the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were measured using the CES-D 10; overweight and obesity were defined using WHO, Asian and Chinese criteria. The proportion of depressive symptoms was 19.9% and 33.2% in men and women, respectively. Depressive symptoms decreased as BMI increased in both men and women (P < 0.05). Obese women were less likely to suffer from depressive symptoms than normal weight women according to WHO, Asian and Chinese criteria (P < 0.05). Obese men were less likely to suffer from depressive symptoms than normal weight men under the Chinese criteria (P < 0.05). The results indicate that there is an inverse association between obesity and depressive symptoms among Chinese men and women, supporting the “jolly fat” hypothesis in China, and suggest that individuals and medical providers should pay attention to underweight as well as obesity. In addition, our study illustrates the importance of establishing appropriate obesity cut-off points for individual countries. PMID:28378748

Obesity classification in military personnel: a comparison of body fat, waist circumference, and body mass index measurements.

PubMed

Heinrich, Katie M; Jitnarin, Nattinee; Suminski, Richard R; Berkel, LaVerne; Hunter, Christine M; Alvarez, Lisa; Brundige, Antionette R; Peterson, Alan L; Foreyt, John P; Haddock, C Keith; Poston, Walker S C

2008-01-01

The purpose of this study was to evaluate obesity classifications from body fat percentage (BF%), body mass index (BMI), and waist circumference (WC). A total of 451 overweight/obese active duty military personnel completed all three assessments. Most were obese (men, 81%; women, 98%) using National Institutes of Health (NIH) BF% standards (men, >25%; women, >30%). Using the higher World Health Organization (WHO) BF >35% standard, 86% of women were obese. BMI (55.5% and 51.4%) and WC (21.4% and 31.9%) obesity rates were substantially lower for men and women, respectively (p < 0.05). BMI/WC were accurate discriminators for BF% obesity (theta for all comparisons >0.75, p < 0.001). Optimal cutoff points were lower than NIH/WHO standards; WC = 100 cm and BMI = 29 maximized sensitivity and specificity for men, and WC = 79 cm and BMI = 25.5 (NIH) or WC = 83 cm and BMI = 26 (WHO) maximized sensitivity and specificity for women. Both WC and BMI measures had high rates of false negatives compared to BF%. However, at a population level, WC/BMI are useful obesity measures, demonstrating fair-to-high discriminatory power.

Disparities in Risk Factors Associated with Obesity between Zanzibar and Tanzania Mainland among Women of Reproductive Age Based on the 2010 TDHS

PubMed Central

Mtumwa, Abdalla H.; Ntwenya, Julius Edward; Vuai, Said A. H.

2016-01-01

The occurrence of overweight and obesity has serious health implications. The 2010 Tanzania Demographic and Health Survey data set was reanalysed to compare the prevalences of overweight and obesity between Mainland Tanzania and Zanzibar and to determine how demographic factors can predict overweight and obesity across the United Republic of Tanzania. About 7.92% of the Tanzanian women of reproductive age were obese, 15% were overweight, and 11.5% were underweight. Women from Mainland Tanzania (6.56%) were significantly less likely (AOR = 0.66, 95% CI: 0.53–0.82) to be affected by obesity as compared to women from Zanzibar (12.19%). The common predictors of obesity in Mainland Tanzania and Zanzibar were wealth index, marital status, and age. Whereas the place of residence and education level emerged as predictors of obesity in the Mainland Tanzania alone, the number of meals per day did so in Zanzibar. Most importantly, Zanzibar had a greater prevalence of obesity compared to Mainland Tanzania. PMID:27721990

Simulating the Impact of Crime on African American Women's Physical Activity and Obesity.

PubMed

Powell-Wiley, Tiffany M; Wong, Michelle S; Adu-Brimpong, Joel; Brown, Shawn T; Hertenstein, Daniel L; Zenkov, Eli; Ferguson, Marie C; Thomas, Samantha; Sampson, Dana; Ahuja, Chaarushi; Rivers, Joshua; Lee, Bruce Y

2017-12-01

The objective of this study was to quantify the impact of crime on physical activity location accessibility, leisure-time physical activity (LTPA), and obesity among African American women. An agent-based model was developed in 2016 to represent resource-limited Washington, DC, communities and their populations to simulate the impact of crime on LTPA and obesity among African American women under different circumstances. Data analysis conducted between 2016 and 2017 found that in the baseline scenario, African American women had a 25% probability of exercising. Reducing crime so more physical activity locations were accessible (increasing from 10% to 50%) decreased the annual rise in obesity prevalence by 2.69%. Increasing the probability of African American women to exercise to 37.5% further increased the impact of reducing crime on obesity (2.91% annual decrease in obesity prevalence). These simulations showed that crime may serve as a barrier to LTPA. Reducing crime and increasing propensity to exercise through multilevel interventions (i.e., economic development initiatives to increase time available for physical activity and subsidized health care) may promote greater than linear declines in obesity prevalence. Crime prevention strategies alone can help prevent obesity, but combining such efforts with other ways to encourage physical activity can yield even greater benefits. © 2017 The Obesity Society.

Trends in obesity and abdominal obesity in the older adult population of Spain (2000-2010).

PubMed

Gutiérrez-Fisac, Juan Luis; León-Muñoz, Luz M; Regidor, Enrique; Banegas, Josér; Rodríguez-Artalejo, Fernando

2013-01-01

This work examines the trend in obesity and abdominal obesity in the Spanish population aged 60 years and over during the first decade of the 21st century. We analyze data from a representative study of the Spanish population aged 60 years and older conducted in 2000-2001 and from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) conducted in 2008-2010. In men, the distribution of BMI did not vary in the period 2000-2010. In contrast, in women there was a reduction in both mean BMI--from 29.3 to 28.8 kg/m2--and the prevalence of obesity--from 40.8 to 36.3%. This decline was greatest in women aged 60-69 years. In men, no significant changes were observed in mean waist circumference (WC) or in the prevalence of abdominal obesity. In contrast, WC decreased by 3.6 cm and abdominal obesity prevalence by 12.7% in women. The decline was greatest in women aged 60-69 years, in whom mean WC decreased by 5.1 cm and abdominal obesity prevalence by 18.6%. These findings show that the frequency of obesity has begun to decline in Spanish women aged 60 and over. The causes of this decline are unclear.

Greater physical activity levels during pregnancy are associated with lower inflammation and insulin resistance in obese women

USDA-ARS?s Scientific Manuscript database

Compared to lean pregnant women, obese women develop greater insulin resistance and systemic inflammation during pregnancy. Identifying lifestyle factors that can reduce the metabolic effect of obesity during pregnancy is critical to protect both the mother and the fetus from insulin resistance and ...

Effect of obesity on cardiovascular disease risk factors in African American women.

PubMed

Henry-Okafor, Queen; Cowan, Patricia A; Wicks, Mona N; Rice, Muriel; Husch, Donna S; Khoo, Michelle S C

2012-04-01

Obesity is a growing health care concern with implications for cardiovascular disease (CVD). Obesity and CVD morbidity and mortality are highly prevalent among African American women. This pilot study examined the association between obesity and the traditional and emerging CVD risk factors in a sample of African American women. Participants comprised 48 women (27 obese, 21 normal weight) aged 18-45. with no known history of CVD. The women completed demographic and 7-day physical activity recall questionnaires. Height and weight were used to determine body mass index (BMI). Hypertension risk was assessed using the average of two resting blood pressure (BP) measurements. Lipid profile, blood glucose, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitor-1 (PAI-1), soluble intercellular adhesion molecule-1 (sICAM-1), and E-selectin (eSel) levels were assessed using fasting blood samples. Laboratory findings were interpreted using the American Diabetes Association (ADA) and Adult Treatment Panel (ATP) III reference guidelines as well as manufacturers' reference ranges for the novel CVD risk factors. The most common traditional risk factors were physical inactivity (72.9%), positive family history of CVD (58.3%), and obesity (56.3%). Obese individuals had elevated systolic BP (p = .0002), diastolic BP (p = .0007) and HDL-cholesterol (p = .01), triglyceride (p = .02), hs-CRP (p = .002), and fibrinogen (p = .01), when compared with normal-weight women. The findings suggest an association between obesity and higher prevalence of both traditional and emerging CVD risk factors in young African American women.

Behavior of respiratory muscle strength in morbidly obese women by using different predictive equations.

PubMed

Pazzianotto-Forti, Eli M; Peixoto-Souza, Fabiana S; Piconi-Mendes, Camila; Rasera-Junior, Irineu; Barbalho-Moulim, Marcela

2012-01-01

Studies on the behavior of respiratory muscle strength (RMS) in morbidly obese patients have found conflicting results. To evaluate RMS in morbidly obese women and to compare the results by using different predictive equations. This is a cross-sectional study that recruited 30 morbidly obese women and a control group of 30 normal-weight women. The subjects underwent anthropometric and maximal respiratory pressure measurement. Visual inspection of the Bland-Altman plots was performed to evaluate the correlation between the different equations, with a p value lower than 0.05 considered as statistically significant. The obese women showed a significant increase in maximal inspiratory pressure (MIP) values (-87.83±21.40 cmH(2)O) compared with normal-weight women (-72±15.23 cmH(2)O) and a significant reduction of MIP (-87.83±21.40 cmH(2)O) according to the values predicted by the EHarik equation (-130.71±11.98 cmH(2)O). Regarding the obtained maximal expiratory pressure (MEP), there were no between-group differences (p>0.05), and no agreeement was observed between obtained and predicted values of MEP and the ENeder and ECosta equations. Inspiratory muscle strength was greater in the morbidly obese subjects. The most appropriate equation for calculating the predicted MIP values for the morbidly obese seems to be Harik-Khan equation. There seem to be similarities between the respiratory muscle strength behavior of morbidly obese and normal-weight women, however, these findings are still inconclusive.

Obesity and risk of breast cancer mortality in Hispanic and Non-Hispanic white women: the New Mexico Women's Health Study.

PubMed

Connor, Avonne E; Baumgartner, Richard N; Pinkston, Christina; Baumgartner, Kathy B

2013-04-01

Obesity is reported to be associated with poorer survival in women with breast cancer, regardless of menopausal status. Our purpose was to determine if the associations of obesity with breast cancer-specific, all-cause, and non-breast cancer mortality differ between Hispanic and non-Hispanic white (NHW) women with breast cancer. Data on lifestyle and medical history were collected for incident primary breast cancer cases (298 NHW, 279 Hispanic) in the New Mexico Women's Health Study. Mortality was ascertained through the National Death Index and New Mexico Tumor Registry over 13 years of follow-up. Adjusted Cox regression models indicated a trend towards increased risk for breast cancer-specific mortality in obese NHW women (hazard ratio [HR] 2.07; 95% confidence interval [CI] 0.98-4.35) but not in Hispanic women (HR 1.32; 95% CI 0.64-2.74). Obese NHW women had a statistically significant increased risk for all-cause mortality (HR 2.12; 95% CI 1.15-3.90) while Hispanic women did not (HR 1.23; 95% CI 0.71-2.12). Results were similar for non-breast cancer mortality: NHW (HR 2.65; 95% CI 0.90-7.81); Hispanic (HR 2.18; 95% CI 0.77-6.10). Our results suggest that obesity is associated with increased risk for breast cancer-specific mortality in NHW women; however, this association is attenuated in Hispanic women.

Titration of Intravenous Oxytocin Infusion for Postdates Induction of Labor Across Body Mass Index Groups.

PubMed

Maeder, Angela B; Vonderheid, Susan C; Park, Chang G; Bell, Aleeca F; McFarlin, Barbara L; Vincent, Catherine; Carter, C Sue

To evaluate whether oxytocin titration for postdates labor induction differs among women who are normal weight, overweight, and obese and whether length of labor and birth method differ by oxytocin titration and body mass index (BMI). Retrospective cohort study. U.S. university-affiliated hospital. Of 280 eligible women, 21 were normal weight, 134 were overweight, and 125 were obese at labor admission. Data on women who received oxytocin for postdates induction between January 1, 2013 and June 30, 2013 were extracted from medical records. Oxytocin administration and labor outcomes were compared across BMI groups, controlling for potential confounders. Data were analyzed using χ 2 , analysis of variance, analysis of covariance, and multiple linear and logistic regression models. Women who were obese received more oxytocin than women who were overweight in the unadjusted analysis of variance (7.50 units compared with 5.92 units, p = .031). Women who were overweight had more minutes between rate changes from initiation to maximum than women who were obese (98.19 minutes compared with 83.39 minutes, p = .038). Length of labor increased with BMI (p = .018), with a mean length of labor for the normal weight group of 13.96 hours (standard deviation = 8.10); for the overweight group, 16.00 hours (standard deviation = 7.54); and for the obese group, 18.30 hours (standard deviation = 8.65). Cesarean rate increased with BMI (p = .001), with 4.8% of normal weight, 33.6% of overweight, and 42.4% of obese women having cesarean births. Women who were obese and experienced postdates labor induction received more oxytocin than women who were non-obese and had longer length of labor and greater cesarean rates. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Effect of BCHE single nucleotide polymorphisms on lipid metabolism markers in women.

PubMed

Oliveira, Jéssica de; Tureck, Luciane Viater; Santos, Willian Dos; Saliba, Louise Farah; Schenknecht, Caroline Schovanz; Scaraboto, Débora; Souza, Ricardo Lehtonen R; Furtado-Alle, Lupe

2017-01-01

Butyrylcholinesterase (BChE) activity and polymorphisms in its encoding gene had previously been associated with metabolic traits of obesity. This study investigated the association of three single nucleotide polymorphisms (SNPs) in the BCHE gene: -116G > A (rs1126680), 1615GA (rs1803274), 1914A < G (rs3495), with obesity and lipid metabolism markers, body mass index (BMI), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) levels, and BChE enzymatic activity in obese (BMI≥30/n = 226) and non-obese women (BMI < 25/n = 81). BCHE SNPs genotyping was obtained by TaqMan allelic discrimination assay and by RFLP-PCR. Plasmatic BChE activity was measured using propionylthiocholine as substrate. Similar allele frequencies were found in obese and non-obese women for the three studied SNPs (p > 0.05). The dominant and recessive models were tested, and different effects were found. The -116A allele showed a dominant effect in BChE activity reduction in both non-obese and obese women (p = 0.045 and p < 0.001, respectively). The 1914A > G and 1615GA SNPs influenced the TG levels only in obese women. The 1914G and the 1615A alleles were associated with decreased plasma levels of TG. Thus, our results suggest that the obesity condition, characterized by loss of energy homeostasis, is modulated by BCHE polymorphisms.

Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses.

PubMed

McDonald, Sarah D; Han, Zhen; Mulla, Sohail; Beyene, Joseph

2010-07-20

To determine the relation between overweight and obesity in mothers and preterm birth and low birth weight in singleton pregnancies in developed and developing countries. Systematic review and meta-analyses. Medline and Embase from their inceptions, and reference lists of identified articles. Studies including a reference group of women with normal body mass index that assessed the effect of overweight and obesity on two primary outcomes: preterm birth (before 37 weeks) and low birth weight (<2500 g). Two assessors independently reviewed titles, abstracts, and full articles, extracted data using a piloted data collection form, and assessed quality. 84 studies (64 cohort and 20 case-control) were included, totalling 1 095 834 women. Although the overall risk of preterm birth was similar in overweight and obese women and women of normal weight, the risk of induced preterm birth was increased in overweight and obese women (relative risk 1.30, 95% confidence interval 1.23 to 1.37). Although overall the risk of having an infant of low birth weight was decreased in overweight and obese women (0.84, 0.75 to 0.95), the decrease was greater in developing countries than in developed countries (0.58, 0.47 to 0.71 v 0.90, 0.79 to 1.01). After accounting for publication bias, the apparent protective effect of overweight and obesity on low birth weight disappeared with the addition of imputed "missing" studies (0.95, 0.85 to 1.07), whereas the risk of preterm birth appeared significantly higher in overweight and obese women (1.24, 1.13 to 1.37). Overweight and obese women have increased risks of preterm birth and induced preterm birth and, after accounting for publication bias, appeared to have increased risks of preterm birth overall. The beneficial effects of maternal overweight and obesity on low birth weight were greater in developing countries and disappeared after accounting for publication bias.

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys

PubMed Central

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N.

2018-01-01

Background Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected. PMID:29657257

Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010.

PubMed

Ladabaum, Uri; Mannalithara, Ajitha; Myer, Parvathi A; Singh, Gurkirpal

2014-08-01

Obesity and abdominal obesity are associated independently with morbidity and mortality. Physical activity attenuates these risks. We examined trends in obesity, abdominal obesity, physical activity, and caloric intake in US adults from 1988 to 2010. Univariate and multivariate analyses were performed using National Health and Nutrition Examination Survey data. Average body mass index (BMI) increased by 0.37% (95% confidence interval [CI], 0.30-0.44) per year in both women and men. Average waist circumference increased by 0.37% (95% CI, 0.30-0.43) and 0.27% (95% CI, 0.22-0.32) per year in women and men, respectively. The prevalence of obesity and abdominal obesity increased substantially, as did the prevalence of abdominal obesity among overweight adults. Younger women experienced the greatest increases. The proportion of adults who reported no leisure-time physical activity increased from 19.1% (95% CI, 17.3-21.0) to 51.7% (95% CI, 48.9-54.5) in women, and from 11.4% (95% CI, 10.0-12.8) to 43.5% (95% CI, 40.7-46.3) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level but not caloric intake. The associated changes in adjusted BMIs were 8.3% (95% CI, 6.9-9.6) higher among women and 1.7% (95% CI, 0.68-2.8) higher among men with no leisure-time physical activity compared with those with an ideal level of leisure-time physical activity. Our analyses highlight important dimensions of the public health problem of obesity, including trends in younger women and in abdominal obesity, and lend support to the emphasis placed on physical activity by the Institute of Medicine. Copyright © 2014 Elsevier Inc. All rights reserved.

Obesity, Abdominal Obesity, Physical Activity, and Caloric Intake in U.S. Adults: 1988-2010

PubMed Central

Ladabaum, Uri; Mannalithara, Ajitha; Myer, Parvathi A.; Singh, Gurkirpal

2014-01-01

Background Obesity and abdominal obesity are independently associated with morbidity and mortality. Physical activity attenuates these risks. We examined trends in obesity, abdominal obesity, physical activity, and caloric intake in U.S. adults from 1988 to 2010. Methods Univariate and multivariate analyses were performed using National Health and Nutrition Examination Survey (NHANES) data. Results Average body-mass index (BMI) increased by 0.37% (95% CI, 0.30-0.44%) per year in both women and men. Average waist circumference increased by 0.37% (95% CI, 0.30-0.43%) and 0.27% (95% CI, 0.22-0.32%) per year in women and men, respectively. The prevalence of obesity and abdominal obesity increased substantially, as did the prevalence of abdominal obesity among overweight adults. Younger women experienced the greatest increases. The proportion of adults who reported no leisure-time physical activity increased from 19.1% (95% CI, 17.3-21.0%) to 51.7% (95% CI, 48.9-54.5%) in women, and from 11.4% (95% CI, 10.0-12.8%) to 43.5% (95% CI, 40.7-46.3%) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level, but not caloric intake. The associated changes in adjusted BMIs were 8.3% (95% CI, 6.9-9.6%) higher among women and 1.7% (95% CI, 0.68-2.8%) higher among men with no leisure-time physical activity compared to those with an ideal level of leisure-time physical activity. Conclusions Our analyses highlight important dimensions of the public health problem of obesity, including trends in younger women and in abdominal obesity, and lend support to the emphasis placed on physical activity by the Institute of Medicine. PMID:24631411

Effect of moderate-intensity exercise on oxidative stress indices in metabolically healthy obese and metabolically unhealthy obese phenotypes in postmenopausal women: a pilot study.

PubMed

Lwow, Felicja; Dunajska, Katarzyna; Milewicz, Andrzej; Jedrzejuk, Diana; Kik, Krzysztof; Szmigiero, Leszek

2011-06-01

The aim of this work was to determine whether the level of oxidative stress induced by moderate-intensity exercise depends on obesity phenotypes: metabolically healthy but obese (MHO) and non-metabolically healthy obese (at-risk obesity; non-MHO). We performed the study on 161 postmenopausal women aged 50 to 60 years. A metabolically healthy nonobese (MH-NO) group (n = 73), an MHO group (n = 27), and a non-MHO group (n = 61) exercised on a cycloergometer for 30 minutes at 50% of their peak oxygen consumption and were evaluated for oxidative status by determination of thiobarbituric acid-reactive substances (TBARS) and serum antioxidant activity (AS). No difference was found in AS between the MH-NO group and the MHO group. The AS of the non-MHO group was significantly lower than that of the MH-NO group (P < 0.05) and that of the MHO group (P = 0.011). The insulin resistance index homeostasis model assessment was the only biochemical parameter that correlated with AS. After exercise, a significant increase in the TBARS concentration in all tested groups of women was observed, but differences in the increment of TBARS level between groups were not found. Antioxidant status in obese postmenopausal women depends on obesity phenotypes and is higher for women with the MHO than those with the non-MHO phenotype. Independently of obesity phenotype, obese postmenopausal women exposed to moderate-intensity exercise seem to be at similar risk for oxidative stress compared with their nonobese counterparts. We suggest that homeostasis model assessment be taken into account when planning physical exercise for obese people.

Higher education and more physical activity limit the development of obesity in a Swedish rural population. The Skaraborg Project.

PubMed

Nyholm, M; Gullberg, B; Haglund, B; Råstam, L; Lindblad, U

2008-03-01

To investigate the prevalence and the secular trends of obesity in a rural Swedish community with emphasis on the association with socioeconomic status and lifestyle. The Skaraborg Project cross-sectional population surveys were conducted in Vara, a rural community in the southwest of Sweden, every fifth year between 1977 and 2002. A total of 3365 residents (1634 men and 1731 women) aged 30-60 years. Obesity was defined as body mass index> or =30 kg m(-2). Information on ethnicity, marital status, socioeconomic status and lifestyle was collected by a questionnaire. In 1977-1982, the average prevalence of obesity was 14% in both men and women, and in 2002, the prevalence of obesity was 19% in men and 21% in women. The age-adjusted odds ratio (OR) of obesity in 2002 was 1.48 (1.00, 2.20) in men and 1.41 (0.97, 2.05) in women. Without the simultaneous increase in the level of education and leisure-time physical activity (LTPA), the risk of developing obesity could have been considerably higher; in men OR=3.08 (1.88, 5.03) and in women OR=2.72 (1.66, 4.44). In multivariate models, higher levels of education and LTPA were associated with protective effects on obesity in both men (OR=0.60 (0.43, 0.83) and OR=0.50 (0.45, 0.79)) and women (OR=0.73 (0.54, 0.98) and OR=0.57 (0.42, 0.78)), respectively. This study revealed an upward secular trend in the prevalence of obesity in a rural community in Sweden. Increasing levels of education and LTPA limit this ongoing development of obesity. Public health strategies for the prevention of obesity should consider the special condition in rural environments.

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys.

PubMed

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N

2018-06-05

Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization's Asian body mass index cut-off points of ≥23.0 kg/m 2 and ≥27.5 kg/m 2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

Links between Childhood and Adult Social Circumstances and Obesity and Hypertension in the Mexican Population

PubMed Central

Beltrán-Sánchez, Hiram; Crimmins, Eileen M.; Teruel, Graciela M.; Thomas, Duncan

2011-01-01

Objectives This study examines links between early life circumstances and adult socioeconomic status and obesity and hypertension in the adult Mexican population. Methods We use data from the Mexican Family Life Survey (MxFLS) collected in 2002 for people aged 20 or older (N=14, 280). Results We found that men with low education and women with more education have significantly lower obesity. Women with higher education also have significantly less hypertension. Obesity triples the likelihood of hypertension among both men and women. Better childhood experiences are associated with less hypertension among women, but more hypertension among men in rural areas. Discussion Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults. PMID:21948773

Preconceptional and maternal obesity: epidemiology and health consequences.

PubMed

Poston, Lucilla; Caleyachetty, Rishi; Cnattingius, Sven; Corvalán, Camila; Uauy, Ricardo; Herring, Sharron; Gillman, Matthew W

2016-12-01

Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth. Late pregnancy complications include gestational diabetes and pre-eclampsia, both of which are associated with long-term morbidities post partum. Women with obesity can also experience difficulties during labour and delivery, and are more at risk of post-partum haemorrhage. Long-term health risks are associated with weight retention after delivery, and inherent complications for the next pregnancy. The wellbeing of the next generation is also compromised. All these health issues could be avoided by prevention of obesity among women of reproductive age, which should be viewed as a global public health priority. For women who are already obese, renewed efforts should be made towards improved management during pregnancy, especially of blood glucose, and increased attention to post-partum weight management. Effective interventions, tailored to ethnicity and culture, are needed at each of these stages to improve the health of women and their children in the context of the global obesity epidemic. Copyright © 2016 Elsevier Ltd. All rights reserved.

The positive association between number of children and obesity in Iranian women and men: results from the National Health Survey.

PubMed

Bakhshi, Enayatollah; Eshraghian, Mohammad Reza; Mohammad, Kazem; Foroushani, Abbas Rahimi; Zeraati, Hojat; Fotouhi, Akbar; Siassi, Fraidon; Seifi, Behjat

2008-06-15

To date, few studies have assessed the association between the number of children and obesity in couples. We aimed to investigate this association in men and women aged 20-75 years. Data from the National Health Survey were considered in this investigation. It included 2728 women and men (1364 couples) aged 20-75 years. Height and weight were actually measured rather than self-reported. A generalized estimating equation model was used to estimate the odds of obesity (body mass index (BMI > or = 30)) as a function of the number of children adjusted for age, sex, education, economic index, workforce, smoking and place of residence. We infer that each additional child has at least 5% and at most 34% increase in the odds of obesity in men and at least 4% and at most 29% increase in the odds of obesity in women. Our test of interaction by sex showed that the association between the number of children and obesity was not different among men and women. Among women, factors that increased obesity included age, low education, having more children, being inactive workforce and being nonsmoker. Among men, these factors included high economic index, low education, having more children, and being nonsmoker. Our results show an association between the number of children and obesity among men. We would recommend interventions to reduce the number of children to prevent obesity in men.

Association between sleep duration and obesity is modified by dietary macronutrients intake in Korean.

PubMed

Doo, Miae; Kim, Yangha

2016-01-01

Short sleep duration has been reported to be inversely associated with risk of obesity. The effects of sleep duration on obesity-related variables and the interaction of sleep duration and dietary macronutrients consumption on risk of obesity were analysed in 14,111 subjects aged 20-79 from the Korean National Health and Nutrition Examination Survey. Sleep restriction to less than 7h per day resulted in higher body mass index, plasma triglyceride level, and obesity prevalence for women, but not for men. Protein intake was significantly lower in subjects with lower sleep duration for both men and women. The subjects with short sleep duration were significantly higher fat consumption for men, whereas carbohydrate consumption for women. Among subjects whose carbohydrate consumption was above the median, subjects with sleep duration of less than 7h per day increased their odds of being obese (OR=1.255, 95% CI: 1.073-1.476, P<0.001) compared to subjects with sleep duration more than 7h per day for women. Our results showed that sleep duration positively correlated with protein consumption, but negatively correlated with carbohydrate consumption, which might lead to high risk of obesity for women. Also, our findings support a significant association between sleep duration and obesity-related variables and this association has been potentially modified by dietary macronutrients consumption in women subjects. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child.

PubMed

Catalano, Patrick M; Shankar, Kartik

2017-02-08

Obesity is the most common medical condition in women of reproductive age. Obesity during pregnancy has short term and long term adverse consequences for both mother and child. Obesity causes problems with infertility, and in early gestation it causes spontaneous pregnancy loss and congenital anomalies. Metabolically, obese women have increased insulin resistance in early pregnancy, which becomes manifest clinically in late gestation as glucose intolerance and fetal overgrowth. At term, the risk of cesarean delivery and wound complications is increased. Postpartum, obese women have an increased risk of venous thromboembolism, depression, and difficulty with breast feeding. Because 50-60% of overweight or obese women gain more than recommended by Institute of Medicine gestational weight guidelines, postpartum weight retention increases future cardiometabolic risks and prepregnancy obesity in subsequent pregnancies. Neonates of obese women have increased body fat at birth, which increases the risk of childhood obesity. Although there is no unifying mechanism responsible for the adverse perinatal outcomes associated with maternal obesity, on the basis of the available data, increased prepregnancy maternal insulin resistance and accompanying hyperinsulinemia, inflammation, and oxidative stress seem to contribute to early placental and fetal dysfunction. We will review the pathophysiology underlying these data and try to shed light on the specific underlying mechanisms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Obesity or Underweight-What is Worse in Pregnancy?

PubMed

Agrawal, Sumi; Singh, Abha

2016-12-01

This study was conducted to compare underweight and obese women and their weight gain during pregnancy on fetomaternal outcome. This is a prospective, non-interventional, observational study on 1000 women (BMI between 20 and 30 were excluded). Women attending ANC OPD with singleton pregnancy at or before 16 weeks were included and BMI calculated in early pregnancy. Their weight gain during pregnancy was noted. Any complications in the mother or perinate were noted. Incidence of obesity in our institute was 17 % and that of underweight was 18 %. Pre-eclampsia, gestational hypertensions, gestational DM, antepartum hemorrhage, all were more common among obese women, while anemia was more common in the underweight. Post-dated pregnancy, induction of labor, cesarean delivery, and postpartum complications were more common in obese women. Fetal complications were also higher in obese patients. Lower as well as higher prepregnancy BMI is an independent risk factor that is associated with increased morbidity and mortality in both the mother and the fetus.

Obesity in Neurosurgery: A Narrative Review of the Literature.

PubMed

Castle-Kirszbaum, Mendel D; Tee, Jin W; Chan, Patrick; Hunn, Martin K

2017-10-01

Obesity is an important consideration in neurosurgical practice. Of Australian adults, 28.3% are obese and it is estimated that more than two thirds of Australia's population will be overweight or obese by 2025. This review of the effects of obesity on neurosurgical procedures shows that, in patients undergoing spinal surgery, an increased body mass index is a significant risk factor for surgical site infection, venous thromboembolism, major medical complications, prolonged length of surgery, and increased financial cost. Although outcome scores and levels of patient satisfaction are generally lower after spinal surgery in obese patients, obesity is not a barrier to deriving benefit from surgery and, when the natural history of conservative management is taken into account, the long-term benefits of surgery may be equivalent or even greater in obese patients than in nonobese patients. In cranial surgery, the impact of obesity on outcome and complication rates is generally lower. Specific exceptions are higher rates of distal catheter migration after shunt surgery and cerebrospinal fluid leak after posterior fossa surgery. Minimally invasive approaches show promise in mitigating some of the adverse effects of obesity in patients undergoing spine surgery but further studies are needed to develop strategies to reduce obesity-related surgical complications. Copyright © 2017 Elsevier Inc. All rights reserved.

Prediction of successful weight reduction after laparoscopic adjustable gastric banding.

PubMed

Lee, Yi-Chih; Liew, Phui-Ly; Lee, Wei-Jei; Lin, Yang-Chu; Lee, Chia Ko; Huangs, Ming-Te; Wang, Weu; Lin, Steven C H

2009-01-01

Compared with conventional pharmacological therapies, bariatric surgery has been shown to cause greater and- sustained weight loss. It was aimed to evaluate weight loss in obese patients after laparoscopic adjustable gastric banding surgery using information typically available during the initial evaluation studied before bariatric surgery and genes. 74 patients undergoing laparoscopic adjustable gastric banding (LAGB) were enrolled. Artificial Neural Network technology was used to predict weight loss. We studied 74 patients consisting of 22 men and 52 women 2 years after operation. Mean age was 31.7 +/- 9.1 years. 27 (36.5%) patients had successful weight reduction (excess weight loss >50%) while 47 (63.5%) did not. ANN provided predicted factors on gender, insulin, albumin and two genes: re4684846_r, rs660339_r which were associated with success. Artificial neural network is a better modeling technique and the predictive accuracy is higher on the basis of multiple variables related to laboratory tests. Our finding gave demonstrated result that obese patients of successful weight reduction after laparoscopic adjustable gastric banding surgery were women, having little lower insulin and albumin, and carrying GG genotype on rs4684846 and with at least one T allele on rs660339. In these cases, weight loss will give better results.

Efficacious Cefazolin Prophylactic Dose for Morbidly Obese Women Undergoing Bariatric Surgery Based on Evidence from Subcutaneous Microdialysis and Populational Pharmacokinetic Modeling.

PubMed

Palma, Eduardo Celia; Meinhardt, Nelson Guardiola; Stein, Airton Tetelbom; Heineck, Isabela; Fischer, Maria Isabel; de Araújo, BibianaVerlindo; Dalla Costa, Teresa

2018-04-11

To determine the efficacious cefazolin prophylactic dose for bariatric surgery using free subcutaneous concentrations accessed by microdialysis after 2 g or 3 g i.v. bolus dosing to morbidly obese women and POPPK modeling. A POPPK model with variable plasma and subcutaneous tissue protein binding was developed to simultaneously describe plasma and tissue data sets. The outcomes was predicted for common surgical site infection (SSI) bacteria over 3, 4, 5 and 6 h periods postdose, as probability of target attainment (PTA) using Monte Carlo simulation. CFZ 2 g warrant up to 5 h SSI prophylaxis for bacteria with MICs ≤1 mg/L such as Escherichia coli and Staphylococcus aureus. For species such as Klebsiella pneumoniae, which present MIC distribution frequency of 2 mg/L, the maintenance of PTA ≥ 90% occurs with a 3 g dose for surgeries lasting up to 5 h, and 2 g dose provide an adequate response up to 4 h (PTA of 89%). Effectiveness of CFZ 2 g is similar to 3 g against bacteria with a MIC up to 2 mg/L, especially if the surgery does not last for more than 4 h.

Obesity during pregnancy alters maternal oxidant balance and micronutrient status

USDA-ARS?s Scientific Manuscript database

Objective: Little is known about the effect of obesity on inflammatory status in pregnant women. The objective of this study was to determine the effect of obesity on markers of inflammation, oxidative stress and micronutrient status in obese pregnant women compared to their lean counterparts. St...

Obesity increases oesophageal acid exposure

PubMed Central

El‐Serag, Hashem B; Ergun, Gulchin A; Pandolfino, John; Fitzgerald, Stephanie; Tran, Thomas; Kramer, Jennifer R

2007-01-01

Background Obesity has been associated with gastro‐oesophageal reflux disease (GERD); however, the mechanism by which obesity may cause GERD is unclear. Aim To examine the association between oesophageal acid exposure and total body or abdominal anthropometric measures. Methods A cross‐sectional study of consecutive patients undergoing 24 h pH‐metry was conducted. Standardised measurements of body weight and height as well as waist and hip circumference were obtained. The association between several parameters of oesophageal acid exposures and anthropometric measures were examined in univariate and multivariate analyses. Results 206 patients (63% women) with a mean age of 51.4 years who were not on acid‐suppressing drugs were enrolled. A body mass index (BMI) of >30 kg/m2 (compared with BMI<25 kg/m2) was associated with a significant increase in acid reflux episodes, long reflux episodes (>5 min), time with pH<4, and a calculated summary score. These significant associations have affected total, postprandial, upright and supine pH measurements. Waist circumference was also associated with oesophageal acid exposure, but was not as significant or consistent as BMI. When adjusted for waist circumference by including it in the same model, the association between BMI>30 kg/m2 and measures of oesophageal acid exposure became attenuated for all, and not significant for some, thus indicating that waist circumference may mediate a large part of the effect of obesity on oesophageal acid exposure. Conclusions Obesity increases the risk of GERD, at least partly, by increasing oesophageal acid exposure. Waist circumference partly explains the association between obesity and oesophageal acid exposure. PMID:17127706

Narcissism as a Moderator of Satisfaction with Body Image in Young Women with Extreme Underweight and Obesity

PubMed Central

Lipowska, Małgorzata; Lipowski, Mariusz

2015-01-01

Objective Body weight and age constitute main determinants of body image in women. We analyzed the role of narcissism as a moderator of body image in young women representing various extremes of body weight. Methods The study included 325 women between 18 and 35 years, qualified into three BMI categories: obese women (BMI > 30.0, n = 72), severely underweight women who did not satisfy the remaining criteria of anorexia (BMI < 17.5, n = 85), and women with normal body weight (21.7 < “ideal BMI” > 22.7, n = 168). Satisfaction with body image was determined with Multidimensional Body-Self Relations Questionnaire and Body Esteem Scale, while narcissism was measured with Narcissistic Personality Inventory. Principal Findings We revealed that narcissism has significant impact on the body image of women who are extremely underweight or obese. Vanity and Leadership were narcissism dimensions which played significant role in slim women, as compared to Vanity and Self-Sufficiency in obese women. Conclusion The role of narcissism as a modulator of self-satisfaction with one’s body varies depending on BMI level: extremely underweight women and obese individuals constitute groups in which narcissism has the strongest impact on the self-satisfaction with body. PMID:25961302

Higher Rate of Iron Deficiency in Obese Pregnant Sudanese Women.

PubMed

Abbas, Wisal; Adam, Ishag; Rayis, Duria A; Hassan, Nada G; Lutfi, Mohamed F

2017-06-15

To assess the association between obesity and iron deficiency (ID). Pregnant women were recruited from Saad Abualila Hospital, Khartoum, Sudan, during January-April 2015. Medical history (age, parity, gestational age) was gathered using questionnaire. Weight and height were measured, and body mass index (BMI) was calculated. Women were sub-grouped based on BMI into underweight (< 18.5 kg/m^2), normal weight (18.5-24.9 kg/m^2), overweight (25-29.9 kg/m^2) and obese (≥ 30 kg/m^2). Serum ferritin and red blood indices were measured in all studied women. Two (0.5%), 126 (29.8%), 224 (53.0%) and 71 (16.8%) out of the 423 women were underweight, normal weight, overweight and obese, respectively. Anemia (Hb <11 g/dl), ID (ferritin <15µg/l) and iron deficiency anemia (IDA) were prevalent in 57.7%, 21.3% and 12.1%, respectively. Compared with the women with normal BMI, significantly fewer obese women were anemic [25 (35.2%) vs. 108 (85.7%), P < 0.001] and significantly higher number of obese women [25 (35.2) vs. 22 (17.5, P = 0.015] had iron deficiency. Linear regression analysis demonstrated a significant negative association between serum ferritin and BMI (- 0.010 µg/, P= 0.006). It is evident from the current findings that prevalence of anaemia and ID showed different trends about BMI of pregnant women.

Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery.

PubMed

Maia, Lígia de Albuquerque; Silva, Pedro Leme; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

2017-06-01

The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes. Expert commentary: Before determining the ideal intraoperative ventilation strategy, it is important to analyze the pathophysiology and comorbidities of each obese patient. Protective ventilation with low tidal volume, driving pressure, energy, and mechanical power should be employed during surgery; however, further studies are required to clarify the most effective ventilation strategies, such as the optimal positive end-expiratory pressure and whether recruitment maneuvers minimize lung injury. In this context, an ongoing trial of intraoperative ventilation in obese patients (PROBESE) should help determine the mechanical ventilation strategy that best improves clinical outcome in patients with body mass index≥35kg/m 2 .

Applying a social disparities lens to obesity in pregnancy to inform efforts to intervene.

PubMed

Sutherland, Georgina; Brown, Stephanie; Yelland, Jane

2013-04-01

to examine the social correlates of pre-pregnancy overweight and obesity in an Australian population-based sample and consider implications for intervention effectiveness during pregnancy. population-based survey distributed by hospitals to women 6 months after birth. two states of Australia. women who gave birth in Victoria and South Australia in September/October 2007. surveys were completed by 4,366 women. Pre-pregnancy body mass index (BMI) was calculated from women's self-reported weight in kilograms/(height in metres)(2). Results showed high rates of overweight (22%) and obesity (14%) among Australian women entering pregnancy. After adjusting for other factors in the model, pre-pregnancy obesity was significantly associated with lower household income levels, less education, the experience of financial stress in pregnancy and increasing parity. to date, there is little evidence to support the efficacy of interventions to manage problematic weight in pregnancy. Applying a social disparities lens to obesity in pregnancy challenges us to consider social factors that may seem distal to obesity but are highly relevant to efficacious intervention. pregnancy care offers an opportunity to address social issues on the pathway to obesity. Current clinical care guidelines on maternal overweight and obesity in pregnancy rarely consider social contexts that place some women at risk and are a likely impediment to efficacious intervention. Copyright © 2012 Elsevier Ltd. All rights reserved.

Proinsulin, adiponectin and hsCRP in reproductive age women with polycystic ovary syndrome (PCOS)--the effect of metformin treatment.

PubMed

Kruszyńska, Aleksandra; Słowińska-Srzednicka, Jadwiga; Jeske, Wojciech; Zgliczyński, Wojciech

2014-01-01

Women with polycystic ovary syndrome (PCOS) often suffer from obesity and insulin resistance. The role of proinsulin, which is known to be an indicator of fertility outcomes in PCOS women, and that of adiponectin, in the pathogenesis of PCOS is not well elucidated. Our objective was to determine proinsulin, adiponectin, hsCRP and other hormonal and metabolic parameters in PCOS women before and after metformin treatment. Two PCOS groups of patients of reproductive age (90 lean and 88 obese or overweight) with two control groups, adjusted for body mass index (BMI), were compared at baseline. 32 PCOS women were studied at baseline, after three and six months of metformin (1,000 mg/day) treatment. Clinical, anthropometric, biochemical and hormonal parameters were assessed. Proinsulin and hsCRP levels were the highest in obese PCOS women and were statistically different than in lean PCOS women (proinsulin: 11.4 v. 6.9 pmol/L; hsCRP 2.46 v. 0.47 mg/L, p < 0.01) and than in obese controls. Levels of adiponectin were dependant on BMI. Plasma proinsulin and androstenedione levels decreased after metformin treatment only in obese PCOS women. PCOS, when accompanied by obesity, is associated with elevated proinsulin concentrations, which correlates with higher hsCRP and increased FAI. Proinsulin level decreases due to metformin treatment. Our results suggest that obese or overweight PCOS and lean PCOS are characterised by different hormonal and metabolic parameters and have a different response to metformin treatment.

Adipocyte resistin mRNA levels are down-regulated by laparoscopic ovarian electrocautery in both obese and lean women with polycystic ovary syndrome.

PubMed

Seow, Kok-Min; Juan, Chi-Chang; Ho, Low-Tone; Hsu, Yung-Pei; Lin, Yu-Hung; Huang, Lee-Wen; Hwang, Jiann-Loung

2007-04-01

The aim of this study was to investigate serum and adipocyte mRNA expression of resistin in lean and obese women with polycystic ovary syndrome (PCOS) before and 3 months after laparoscopic ovarian electrocauterization (LOE). Adipose tissue obtained from 12 women with PCOS (six obese and six lean, body mass index > 27 kg m(-1) as threshold point) before and after LOE was analysed. Gene expression of resistin was measured by semi-quantitative RT-PCR. Ten lean, age-matched healthy women served as controls. Both lean and obese women with PCOS had significantly higher fasting and 2 h insulin and homeostasis model insulin resistance index (HOMA(IR)) values and lower fasting glucose-to-insulin ratios (G(0)/I(0)) than did the controls. The serum levels of glucose and insulin and HOMA(IR) were significantly decreased, and the G(0)/I(0) ratio was significantly increased 3 months after LOE. No difference was found in serum resistin levels between controls and either obese or lean women with PCOS before LOE, nor between PCOS patients before and after LOE. However, resistin mRNA expression levels in both lean and obese women with PCOS before LOE were significantly higher than that in controls and were decreased significantly after LOE back to control levels. Local resistin activity may be actively involved in the pathogenesis of PCOS. LOE reduces insulin resistance and down-regulates resistin mRNA expression in lean and obese women with PCOS.

Body fat distribution, in particular visceral fat, is associated with cardiometabolic risk factors in obese women.

PubMed

Elffers, Theodora W; de Mutsert, Renée; Lamb, Hildo J; de Roos, Albert; Willems van Dijk, Ko; Rosendaal, Frits R; Jukema, J Wouter; Trompet, Stella

2017-01-01

Body fat distribution is, next to overall obesity, an important risk factor for cardiometabolic outcomes in the general population. In particular, visceral adipose tissue (VAT) is strongly associated with cardiometabolic risk factors. Since it is unclear whether body fat distribution is also important in men and women with obesity we investigated the associations between measures of body fat distribution and cardiometabolic risk factors in men and women with obesity. In this cross-sectional analysis of obese men and women (BMI≥30 kg/m2) included in the Netherlands Epidemiology of Obesity Study, waist:hip ratio(WHR), waist circumference, and MRI-based abdominal subcutaneous adipose tissue (aSAT) and VAT were determined. Associations between measures of body fat distribution and presence of ≥1 risk factor, such as hypertension or hypertriglyceridemia, were examined using logistic regression analyses; stratified by sex and adjusted for age, ethnicity, education, tobacco smoking, alcohol consumption, physical activity and depending on the association additionally for total body fat or VAT. We included 2,983 obese individuals (57% women) with a mean age of 56 and standard deviation (SD) of 6 and mean BMI of 34.0 kg/m2 (4.0), after exclusion of individuals with missing values of cardiometabolic risk factors (n = 33). 241 individuals were obese without other cardiometabolic risk factors. In obese women, all measures of body fat distribution except aSAT (OR per SD:0.76, 95%CI: 0.53, 1.10) were associated with having ≥1 cardiometabolic risk factor, of which VAT most strongly associated (5.77; 3.02, 11.01). In obese men, associations of body fat distribution and the presence of cardiometabolic risk factors were attenuated. (e.g. VAT:1.42; 0.84, 2.41). In obese women, but less so in men, measures of body fat distribution, of which VAT most strongly, are associated with cardiometabolic risk factors.

The Sleeping Remnant. Effect of Roux-En-Y Gastric Bypass on Plasma Levels of Gastric Biomarkers in Morbidly Obese Women: A Prospective Longitudinal Study.

PubMed

Marchesi, Federico; Tartamella, Francesco; De Sario, Giuseppina; Forlini, Clarissa; Caleffi, Alberta; Riccò, Matteo; Di Mario, Francesco

2017-07-01

Morpho-functional modifications of the gastric remnant after Roux-en-Y gastric bypass (RYGB) have not been completely defined, due to its inaccessibility for bioptic mapping. The aim of the study is to evaluate such modifications using Gastropanel®, a non-invasive blood test cross-checking four gastric biomarkers, able to provide a snapshot of mucosa conditions. Twenty-four women undergoing RYGB were prospectively enrolled. Gastropanel® parameters (pepsinogens, Gastrin-17 and immunoglobulins against Helicobacter pylori), biometrical/clinical data were collected preoperatively and at 6-months follow-up. All parameters showed significant reduction (p < 0.05). Pepsinogen I reduction correlated with BMI percent decrease. The exclusion of food transit is responsible for significant drop in gastric output, hardly representing a risk factor in the remnant carcinogenesis, being unexposed to alimentary carcinogenic agents.

Modification of claims-based measures improves identification of comorbidities in non-elderly women undergoing mastectomy for breast cancer: a retrospective cohort study.

PubMed

Nickel, Katelin B; Wallace, Anna E; Warren, David K; Ball, Kelly E; Mines, Daniel; Fraser, Victoria J; Olsen, Margaret A

2016-08-16

Accurate identification of underlying health conditions is important to fully adjust for confounders in studies using insurer claims data. Our objective was to evaluate the ability of four modifications to a standard claims-based measure to estimate the prevalence of select comorbid conditions compared with national prevalence estimates. In a cohort of 11,973 privately insured women aged 18-64 years with mastectomy from 1/04-12/11 in the HealthCore Integrated Research Database, we identified diabetes, hypertension, deficiency anemia, smoking, and obesity from inpatient and outpatient claims for the year prior to surgery using four different algorithms. The standard comorbidity measure was compared to revised algorithms which included outpatient medications for diabetes, hypertension and smoking; an expanded timeframe encompassing the mastectomy admission; and an adjusted time interval and number of required outpatient claims. A χ2 test of proportions was used to compare prevalence estimates for 5 conditions in the mastectomy population to national health survey datasets (Behavioral Risk Factor Surveillance System and the National Health and Nutrition Examination Survey). Medical record review was conducted for a sample of women to validate the identification of smoking and obesity. Compared to the standard claims algorithm, use of the modified algorithms increased prevalence from 4.79 to 6.79 % for diabetes, 14.75 to 24.87 % for hypertension, 4.23 to 6.65 % for deficiency anemia, 1.78 to 12.87 % for smoking, and 1.14 to 6.31 % for obesity. The revised estimates were more similar, but not statistically equivalent, to nationally reported prevalence estimates. Medical record review revealed low sensitivity (17.86 %) to capture obesity in the claims, moderate negative predictive value (NPV, 71.78 %) and high specificity (99.15 %) and positive predictive value (PPV, 90.91 %); the claims algorithm for current smoking had relatively low sensitivity (62.50 %) and PPV (50.00 %), but high specificity (92.19 %) and NPV (95.16 %). Modifications to a standard comorbidity measure resulted in prevalence estimates that were closer to expected estimates for non-elderly women than the standard measure. Adjustment of the standard claims algorithm to identify underlying comorbid conditions should be considered depending on the specific conditions and the patient population studied.

Food intake does not differ between obese women who are metabolically healthy or abnormal.

PubMed

Kimokoti, Ruth W; Judd, Suzanne E; Shikany, James M; Newby, P K

2014-12-01

Metabolically healthy obesity may confer lower risk of adverse health outcomes compared with abnormal obesity. Diet and race are postulated to influence the phenotype, but their roles and their interrelations on healthy obesity are unclear. We evaluated food intakes of metabolically healthy obese women in comparison to intakes of their metabolically healthy normal-weight and metabolically abnormal obese counterparts. This was a cross-sectional study in 6964 women of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Participants were aged 45-98 y with a body mass index (BMI; kg/m(2)) ≥18.5 and free of cardiovascular diseases, diabetes, and cancer. Food intake was collected by using a food-frequency questionnaire. BMI phenotypes were defined by using metabolic syndrome (MetS) and homeostasis model assessment of insulin resistance (HOMA-IR) criteria. Mean differences in food intakes among BMI phenotypes were compared by using ANCOVA. Approximately one-half of obese women (white: 45%; black: 55%) as defined by MetS criteria and approximately one-quarter of obese women (white: 28%; black: 24%) defined on the basis of HOMA-IR values were metabolically healthy. In age-adjusted analyses, healthy obesity and normal weight as defined by both criteria were associated with lower intakes of sugar-sweetened beverages compared with abnormal obesity among both white and black women (P < 0.05). HOMA-IR-defined healthy obesity and normal weight were also associated with higher fruit and low-fat dairy intakes compared with abnormal obesity in white women (P < 0.05). Results were attenuated and became nonsignificant in multivariable-adjusted models that additionally adjusted for BMI, marital status, residential region, education, annual income, alcohol intake, multivitamin use, cigarette smoking status, physical activity, television viewing, high-sensitivity C-reactive protein, menopausal status, hormone therapy, and food intakes. Healthy obesity was not associated with a healthier diet. Prospective studies on relations of dietary patterns, which may be a better indicator of usual diet, with the phenotype would be beneficial. © 2014 American Society for Nutrition.

Food Intake Does Not Differ between Obese Women Who Are Metabolically Healthy or Abnormal1234

PubMed Central

Kimokoti, Ruth W; Judd, Suzanne E; Shikany, James M; Newby, PK

2014-01-01

Background: Metabolically healthy obesity may confer lower risk of adverse health outcomes compared with abnormal obesity. Diet and race are postulated to influence the phenotype, but their roles and their interrelations on healthy obesity are unclear. Objective: We evaluated food intakes of metabolically healthy obese women in comparison to intakes of their metabolically healthy normal-weight and metabolically abnormal obese counterparts. Methods: This was a cross-sectional study in 6964 women of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Participants were aged 45–98 y with a body mass index (BMI; kg/m2) ≥18.5 and free of cardiovascular diseases, diabetes, and cancer. Food intake was collected by using a food-frequency questionnaire. BMI phenotypes were defined by using metabolic syndrome (MetS) and homeostasis model assessment of insulin resistance (HOMA-IR) criteria. Mean differences in food intakes among BMI phenotypes were compared by using ANCOVA. Results: Approximately one-half of obese women (white: 45%; black: 55%) as defined by MetS criteria and approximately one-quarter of obese women (white: 28%; black: 24%) defined on the basis of HOMA-IR values were metabolically healthy. In age-adjusted analyses, healthy obesity and normal weight as defined by both criteria were associated with lower intakes of sugar-sweetened beverages compared with abnormal obesity among both white and black women (P < 0.05). HOMA-IR–defined healthy obesity and normal weight were also associated with higher fruit and low-fat dairy intakes compared with abnormal obesity in white women (P < 0.05). Results were attenuated and became nonsignificant in multivariable-adjusted models that additionally adjusted for BMI, marital status, residential region, education, annual income, alcohol intake, multivitamin use, cigarette smoking status, physical activity, television viewing, high-sensitivity C-reactive protein, menopausal status, hormone therapy, and food intakes. Conclusions: Healthy obesity was not associated with a healthier diet. Prospective studies on relations of dietary patterns, which may be a better indicator of usual diet, with the phenotype would be beneficial. PMID:25411036

Prevalence of Overweight and Obesity and Their Associations with Socioeconomic Status in a Rural Han Chinese Adult Population

PubMed Central

Jin, Ming-Juan; Chen, Bing-Bing; Mao, Ying-Ying; Zhu, Yi-Min; Yu, Yun-Xian; Wu, Yin-Yin; Zhang, Ming-Wu; Zhu, Shan-Kuan; Chen, Kun

2013-01-01

Background The purpose of this study is to describe the prevalence of overweight, general obesity, and abdominal obesity and examine their associations with socioeconomic status in a rural Chinese adult population. Methods This cross-sectional study was performed on 15,236 participants ≥ 35 years of age (6,313 men [41.4%] and 8,923 women [58.6%]). Each participant’s weight, height, waist circumference (WC), and hipline circumference (HC) were measured, and demographic and socioeconomic data were collected using questionnaires. Results The mean body mass index (BMI) values were 23.31 ± 2.96 and 23.89 ± 3.23 kg m-2 and the mean WC values were 79.13 ± 8.43 and 79.54 ± 8.27 cm for men and women, respectively. The age-standardized prevalence rates of overweight (BMI ≥ 24.0 kg m-2), general obesity (BMI ≥ 28.0 kg m-2), and abdominal obesity (WC ≥ 85 cm for men and ≥ 80 cm for women) were 32.0%, 6.7%, and 27.0% for men and 35.1%, 9.7%, and 48.3% for women, respectively. All gender differences were statistically significant (p < 0.001). In addition, the age-specific prevalence rates of general and abdominal obesity slowly decreased among men but sharply increased among women as age increased (p < 0.001). In subsequent logistic regression analysis, educational level was negatively associated with both general obesity and abdominal obesity among women but positively associated with abdominal obesity among men. No significant correlation was found between obesity and income. Conclusions These results suggest a high prevalence of obesity which might differ by gender and age, and an inverse association among women and a mixed association among men noted between education and obesity in our locality. Preventive and therapeutic programs are warranted to control this serious public health problem. The gender-specific characteristics of populations at high-risk of developing obesity should be taken into consideration when designing interventional programs. PMID:24224024

[Distribution of waist circumference and waist-to-height ratio by categories of body mass index in patients attended in endocrinology and nutrition units].

PubMed

López De La Torre, Martín; Bellido Guerrero, Diego; Vidal Cortada, Josep; Soto González, Alfonso; García Malpartida, Katherinne; Hernandez-Mijares, Antonio

2010-12-01

Waist circumference (WC) and the waist-to-height ratio (WHtR) are anthropometric measures widely used in clinical practice to evaluate visceral fat and the consequent cardiovascular risk. However, risk thresholds should be standardized according to body mass index (BMI). To determine the distribution of WC and WHtR according to the BMI cut-points currently used to describe overweight and obesity. WC, WHtR and BMI were measured in 3521 adult patients (>18 years) attended in Endocrinology and Nutrition units. A total of 20.8% (734 patients) were diabetic. Obesity was found in 82.1% of diabetic patients and in 75% of non-diabetic patients. The WC thresholds proposed by the National Institute of Health (102 cm in men, 88 cm in women), Bray (100 cm in men, 90 cm in women) and the International Diabetes Federation (94 cm in men, 80 cm in women) were exceeded by 92.9%, 94.8% and 98.4% of obese men, 96.8%, 95.5% and 99.7% of obese women, 79.1%, 83.1% and 90% of diabetic men and 95.5%, 81.5% and 97.4% of diabetic women, respectively. Thresholds adapted to the degree of obesity (90, 100, 110 and 125 cm in men and 80, 90, 105 and 115cm in women for normal BMI, overweight, obesity I and obesity greater than I) were exceeded by 58.4% of obese men, 54.2% of obese women, 57.5% of diabetic men and 60.7% of diabetic women. WC was higher in men, and BMI and the WHtR were higher in women. The WC of diabetic women equalled that of men, and WC, WHtR and BMI were higher in diabetic than in non-diabetic women (p<0.001). WC (p<0.005), WHtR (p<0.001) and BMI (p<0.5) were also higher in diabetic than in non-diabetic men. WC and WHtR thresholds by BMI discriminated diabetic and obese patients better than single thresholds, and can be represented graphically by the distribution of percentile ranks of WC and WHtR by BMI.ik. Copyright © 2009 SEEN. Published by Elsevier Espana. All rights reserved.

Relation with HOMA-IR and thyroid hormones in obese Turkish women with metabolic syndrome.

PubMed

Topsakal, S; Yerlikaya, E; Akin, F; Kaptanoglu, B; Erürker, T

2012-03-01

The aim of this study was to investigate the relationship between insulin resistance and thyroid function in obese pre- and postmenopausal women with or without metabolic syndrome (MetS). 141 obese women were divided into two groups, HOMA-IR<2.7 and HOMA-IR>2.7, to evaluate relation with HOMA-IR and fatness, hormone and blood parameters. They were then divided into four groups as pre- and postmenopausal with or without MetS. Various fatness, hormone and blood parameters were examined. Statistically significant difference was found in weight, body mass index (BMI), waist circumference, fat%, fasting insulin, TSH, FT3, FT4, FSH, Anti-microsomal antibody (ANTIM) and triglycerides levels in HOMA-IR<2.7 and HOMA-IR>2.7 obese Turkish women. This study showed that age, weight, BMI, waist circumference, fat%, fasting insulin, FT3, ANTIM, FSH, LH, total cholesterol, triglycerides, HDL, HOMA-IR, systolic and diastolic blood pressure levels were related in preand post menopausal status in obese women with or without MetS. Obesity may influence the levels of thyroid hormones and increases the risk of MetS in women. Postmenopausal status with MetS is associated with an increased TSH, FT3 and FT4 levels and HOMA-IR in obese women. Strong relation was observed with MetS and TSH and FT3 levels.

Comparison of psychosocial status in treatment-seeking women with class III vs. class I-II obesity.

PubMed

Wadden, Thomas A; Butryn, Meghan L; Sarwer, David B; Fabricatore, Anthony N; Crerand, Canice E; Lipschutz, Patti E; Faulconbridge, Lucy; Raper, Steven; Williams, Noel N

2006-01-01

This study compared the psychosocial status and weight loss expectations of women with extreme (class III) obesity who sought bariatric surgery with those of women with class I-II obesity who enrolled in a research study on behavioral weight control. Before treatment, all participants completed the Beck Depression Inventory-II and the Weight and Lifestyle Inventory. This latter questionnaire assesses several domains including symptoms of depression and low self-esteem, history of psychiatric complications, current stressors, and weight loss expectations. Women with class III obesity, as compared with class I-II, reported significantly more symptoms of depression. Fully 25% of women in the former group appeared to have a significant mood disorder that would benefit from treatment. As compared with women with class I-II obesity, significantly more women with class III obesity also reported a history of psychiatric complications, which included physical and sexual abuse and greater stress related to their physical health and financial/legal matters. Both groups of women had unrealistic weight loss expectations. Those who sought surgery expected to lose 47.6 +/- 9.3% of initial weight, compared with 24.8 +/- 8.7% for those who enrolled in behavioral weight control. These findings suggest that women with extreme obesity who seek bariatric surgery should be screened for psychosocial complications. Those determined to have significant psychiatric distress should be referred for behavioral or pharmacological treatment to alleviate their suffering. Long-term studies are needed to provide definitive guidance concerning the relationship between preoperative psychopathology and the outcome of bariatric surgery.

Assessing the association between 25-OH vitamin D levels and ROMA score in a population of obese women.

PubMed

Anastasi, E; Capoccia, D; Granato, T; Viggiani, V; Tartaglione, S; Manganaro, L; Angeloni, A; Leonetti, F

2016-01-01

The “Risk of Malignancy Algorithm” (ROMA) combines the diagnostic power of the CA125 and HE4 markers with menopausal status to predict the risk for developing epithelial ovarian cancer (EOC). The aim of this study was to evaluate the association between 25-OH vitamin D levels and ROMA score in obese women. One hundred and eighteen patients with a Body Mass Index (BMI) > 30 kg/m2 (Group 1) and 80 women with a BMI less than 25 kg / m² (Group 2) were studied. The 25-OH vitamin D was quantified with LUMIPULSE® G 1200. As a threshold value, identified by ROC curve analysis, 20.2 ng/ mL (sensitivity 73.3%, specificity 84%) was chosen corresponding to the limit between sufficient and insufficient 25-OH vitamin D according to the World Health Organization (WHO). Low 25-OH vitamin D levels were observed in 64% of obese women and in 11% of normal-weight women (p less than 0.001). ROMA score above 13% was detected only in obese women (19%). An association between low levels of 25-OH vitamin D and ROMA score was observed. Indeed, 64% of obese women with ROMA score >13% had concomitant insufficient levels of 25-OH vitamin D, while only 36% of obese women with ROMA score >13% had sufficient 25-OH vitamin D levels (p less than 0.0001). This study suggests that the deficiency of 25- OH vitamin D in obese women has a possible correlation with high ROMA score.

Obesity and Fractures in Postmenopausal Women: A Primary-care Cross-Sectional Study at Santa Maria, Brazil.

PubMed

Copês, Rafaela Martinez; Comim, Fabio Vasconcellos; Langer, Felipe Welter; Codevilla, Antonio Aurelio da Silveira; Sartori, Giovani Ruviaro; de Oliveira, Cristina; Cocco, Aline Rubin; de Almeida, Adriana Maria; de Almeida, Luciana Leiria; Dal Osto, Léo Canterle; Compston, Juliet Elizabeth; Premaor, Melissa Orlandin

2015-01-01

Obesity and osteoporosis are chronic disorders with increasing prevalence worldwide. The aim of this study was to investigate the association between obesity and fracture in postmenopausal women from Santa Maria, Brazil. A cross-sectional study was carried out at Santa Maria (parallel 29° south), Brazil. Postmenopausal women aged ≥55 yr who had at least 1 appointment at the primary care in the 2 years before the study were recruited from March 1, 2013 to August 31, 2013. The Global Longitudinal Study of Osteoporosis in Women study questionnaire was applied with permission of The Center for Outcomes Research, University of Massachusetts Medical School. Height and weight were measured according to the World Health Organization protocol. Bone fractures (excluding hand, feet, and head) that occurred after the age of 45 yr were considered as the outcome. Overall, 1057 women completed the study, of whom 984 had body mass index measured. The mean (standard deviation) age and body mass index of the women included in the study were 67.1 (7.6) yr and 29.2 (5.5) kg/m(2), respectively. The prevalence of fractures in obese and nonobese women was similar (17.3% vs 16.0%); 41.4% of all fractures occurred in obese women. Obese postmenopausal women make a substantial contribution to the overall burden of prevalent fractures in this population. Our results provide further evidence in support of the concept that obesity is not protective against fracture. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

The relationship between food insecurity and overweight/obesity differs by birthplace and length of US residence.

PubMed

Ryan-Ibarra, Suzanne; Sanchez-Vaznaugh, Emma V; Leung, Cindy; Induni, Marta

2017-03-01

To examine whether the cross-sectional association between food insecurity and overweight/obesity varied according to birthplace and length of residence in the USA among California women. Using cross-sectional, population-based data from the California Women's Health Survey (CWHS) 2009-2012, we examined whether the association between food insecurity and overweight or obesity varied by birthplace-length of US residence. California, USA. Women (n 16 008) aged 18 years or older. Among US-born women, very low food security (prevalence ratio (PR)=1·21; 95 % CI 1·11, 1·31) and low food security (PR=1·19; 95 % CI 1·10, 1·28) were significantly associated with higher prevalence of overweight/obesity, after controlling for age, marital status, race/ethnicity, poverty and education. Among immigrant women who lived in the USA for 10 years or longer, very low food security was significantly associated with higher prevalence of overweight/obesity, after controlling for covariates (PR=1·16; 95 % CI 1·07, 1·27). Among immigrant women who had lived in the USA for less than 10 years, low and very low food security were not significantly associated with overweight/obesity, after controlling for covariates. Food insecurity may be an important pathway through which weight may increase with longer US residence among immigrant women. Public health programmes and policies should focus on increasing food security for all women, including immigrant women, as one strategy to reduce the prevalence of overweight/obesity.

A U-Shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study

PubMed Central

Ju, Hong; Jones, Mark; Mishra, Gita D.

2015-01-01

Background Both obesity and dysmenorrhea are prevalent among women. Few population-based longitudinal studies investigate the association between body mass index (BMI) and dysmenorrhea yielding mixed results, especially for obesity. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods 9,688 women from a prospective population-based cohort study were followed for 13 years. Data were collected through self-reported questionnaires. The longitudinal association between dysmenorrhea and BMI or BMI change was investigated by logistic regression analysis using generalized estimating equations to account for the repeated measures. Results When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.15, 1.57) and obese (OR 1.22, 95% CI 1.11, 1.35). Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.33, 95% CI 1.20, 1.48), were underweight despite weight gain (OR 1.33, 95% CI 1.12, 1.58), became underweight (OR 1.28, 95% CI 1.02, 1.61). However the higher risk among obese women disappeared when they lost weight (OR 1.06, 95% CI 0.85, 1.32). Conclusions A U-shaped association was revealed between dysmenorrhea and BMI, revealing a higher risk of dysmenorrhea for both underweight and obese women. Maintaining a healthy weight over time may be important for women to have pain-free periods. PMID:26218569

A U-Shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study.

PubMed

Ju, Hong; Jones, Mark; Mishra, Gita D

2015-01-01

Both obesity and dysmenorrhea are prevalent among women. Few population-based longitudinal studies investigate the association between body mass index (BMI) and dysmenorrhea yielding mixed results, especially for obesity. This study aims to investigate the long-term association between BMI and dysmenorrhea. 9,688 women from a prospective population-based cohort study were followed for 13 years. Data were collected through self-reported questionnaires. The longitudinal association between dysmenorrhea and BMI or BMI change was investigated by logistic regression analysis using generalized estimating equations to account for the repeated measures. When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.15, 1.57) and obese (OR 1.22, 95% CI 1.11, 1.35). Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.33, 95% CI 1.20, 1.48), were underweight despite weight gain (OR 1.33, 95% CI 1.12, 1.58), became underweight (OR 1.28, 95% CI 1.02, 1.61). However the higher risk among obese women disappeared when they lost weight (OR 1.06, 95% CI 0.85, 1.32). A U-shaped association was revealed between dysmenorrhea and BMI, revealing a higher risk of dysmenorrhea for both underweight and obese women. Maintaining a healthy weight over time may be important for women to have pain-free periods.

Obesity in minority women: calories, commerce, and culture.

PubMed

Phelan, Sharon T

2009-06-01

Obesity is increasing at epidemic rates in all women, but especially in minority women and children. Factors that contribute to this include changes in caloric intake and expenditure (calories), cost and ease of acquiring food along with pressures from the marketplace and media (commerce) and the community response to the increasing prevalence of obesity and sedentary lifestyle (culture).

Gender and obesity interaction in quality of life in adults assisted by family doctor program in Niterói, Brazil.

PubMed

Torres, Karla Dala Paula; Rosa, Maria Luiza Garcia; Moscavitch, Samuel Datum

2016-05-01

Obesity impacts the quality of life (HRQL). Studies about the effects of a possible interaction between gender and body mass are rare. The objective of the present paper is to estimate the biological interaction between gender and obesity on HRQL. This was a cross-sectional study based on data from CAMELIA study with population assisted by the Family Doctor Program of Niteroi visited between June 2006 and December 2007. HRQL was assessed by the SF-36. The exposure categories were: obese women, non-obese women, obese men and non-obese men, the reference category. Obese women showed higher percentages of low overall, physical and mental quality of life with the largest associations in the physical component. The excess risk due to interaction was statistically significant in physical dimension: RERI = 1.97 (0.40-3.52) and RERIa = 1,97 (0.40-1.7). Among the Brazilian population aged 20-64 years, obesity was independently associated with low HRQL. This association differed by gender, being significant for women. The possibility of the combined effect takes greater importance in the context of increasing incidence of obesity globally. Healthcare professionals in primary care settings should pay attention to gender differences in the impact of obesity on HRQL.

BODY MASS INDEX AND SELF-EMPLOYMENT IN SOUTH KOREA.

PubMed

Han, Euna; Kim, Tae Hyun

2017-07-01

This study assesses differential labour performance by body mass index (BMI), focusing on heterogeneity across three distinct employment statuses: unemployed, self-employed and salaried. Data were drawn from the Korean Labor and Income Panel Study. The final sample included 15,180 person-year observations (9645 men and 5535 women) between 20 and 65 years of age. The findings show that (i) overweight/obese women are less likely to have salaried jobs than underweight/normal weight women, whereas overweight/obese men are more likely to be employed in both the salaried and self-employed sectors than underweight/normal men, (ii) overweight/obese women have lower wages only in permanent salaried jobs than underweight/normal weight women, whereas overweight/obese men earn higher wages only in salaried temporary jobs than underweight/normal weight women, (iii) overweight/obese women earn lower wages only in service, sales, semi-professional and blue-collar jobs in the salaried sector than underweight/normal weight women, whereas overweight/obese men have lower wages only in sales jobs in the self-employed sector than underweight/normal weight women. The statistically significant BMI penalty in labour market outcomes, which occurs only in the salaried sector for women, implies that there is an employers' distaste for workers with a high BMI status and that it is a plausible mechanism for job market penalty related to BMI status. Thus, heterogeneous job characteristics across and within salaried versus self-employed sectors need to be accounted for when assessing the impact of BMI status on labour market outcomes.

Obesity in pregnancy: risks and management

PubMed Central

Fitzsimons, Kate J; Modder, Jo; Greer, Ian A

2009-01-01

Maternal obesity is now considered one of the most commonly occurring risk factors seen in obstetric practice. Compared with women with a healthy pre-pregnancy weight, women with obesity are at increased risk of miscarriage, gestational diabetes, preeclampsia, venous thromboembolism, induced labour, caesarean section, anaesthetic complications and wound infections, and they are less likely to initiate or maintain breastfeeding. Babies of obese mothers are at increased risk of stillbirth, congenital anomalies, prematurity, macrosomia and neonatal death. Intrauterine exposure to obesity is also associated with an increased risk of developing obesity and metabolic disorders in childhood. This article reviews the prevalence of obesity in pregnancy and the associated maternal and fetal complications. Recommendations and suggestions for pre-conception, antenatal and postnatal care of women with obesity are presented, and current research in the UK and future research priorities are considered. PMID:27582812

Trends in nutritional status and nutrient intakes and correlates of overweight/obesity among rural adult women (≥18-60 years) in India: National Nutrition Monitoring Bureau (NNMB) national surveys.

PubMed

Meshram, I I; Balakrishna, N; Sreeramakrishna, K; Rao, K Mallikharjun; Kumar, R Hari; Arlappa, N; Manohar, G; Reddy, Ch Gal; Ravindranath, M; Kumar, S Sharad; Brahmam, G N V; Laxmaiah, A

2016-04-01

To assess trends in nutrient intakes and nutritional status of rural adult women (≥18-60 years) and the association of sociodemographic characteristics with overweight/obesity. Community-based cross-sectional studies carried out during 1975-79 to 2011-12 by the National Nutrition Monitoring Bureau (NNMB) were used. Anthropometric measurements such as height, weight and waist circumference, carried out during the surveys, were used. Association and logistic regression analyses between sociodemographic characteristics and overweight/obesity and abdominal obesity were conducted using a complex samples procedure. Ten NNMB states of India. Non-pregnant and non-lactating rural women aged ≥18-60 years covered during the above periods from ten states in India. The prevalence of chronic energy deficiency has declined from 52 % during 1975-79 to 34 % during 2011-12, while that of overweight/obesity has increased from 7 % to 24 % during the same period. Median intakes of most of the nutrients have increased over the same period, although they were below recommended levels. The chance of overweight/obesity and abdominal obesity was significantly (P<0·01) higher among women aged 40-60 years, those belonging to Christian religion and other backward communities, women living in pucca houses, literate women, women engaged in service and business, and those having higher per capita income. Prevalence of chronic energy deficiency has declined significantly; however, overweight/obesity has increased during the same period. This increase in overweight/obesity may be attributed to increased consumption of fatty foods, sedentary lifestyle and improved socio-economic status. There is a need to educate the community about regular physical exercise, low intakes of fats and oils, and a balanced diet.

Bioavailable Insulin-Like Growth Factor-I as Mediator of Racial Disparity in Obesity-Relevant Breast and Colorectal Cancer Risk among Postmenopausal Women

PubMed Central

Jung, Su Yon; Barrington, Wendy E.; Lane, Dorothy S.; Chen, Chu; Chlebowski, Rowan; Corbie-Smith, Giselle; Hou, Lifang; Zhang, Zuo-Feng; Paek, Min-So; Crandall, Carolyn J.

2016-01-01

Objectives Bioavailable insulin-like growth factor (IGF)-I interacts with obesity and exogenous estrogen in a racial disparity in obesity-related cancer risk, yet their interconnected pathways are not fully characterized. We investigated whether circulating bioavailable IGF-I acted as a mediator of the racial disparity in obesity-related cancers such as breast and colorectal (CR) cancers and how obesity and estrogen use regulate this relationship. Methods A total of 2,425 white and 164 African American (AA) postmenopausal women from the Women's Health Initiative Observational Study were followed from October 1, 1993, through August 29, 2014. To assess bioactive IGF-I as a mediator of race–cancer relationship, we used the Baron-Kenny method and quantitative estimation of the mediation effect. Results Compared with white women, AA women had higher IGF-I levels; their higher risk of CR cancer, after accounting for IGF-I, was no longer significant. IGF-I was associated with breast and CR cancers even after controlling for race. Among viscerally obese (waist/hip ratio >0.85) and overall non-obese women (body mass index <30), IGF-I was a strong mediator, reducing the racial disparity in both cancers by 30% and 60%, respectively. In estrogen-only users and nonusers, IGF-I explained the racial disparity in CR cancer only modestly. Conclusions Bioavailable IGF-I is potentially important in racial disparities in obesity-related breast and CR cancer risk between postmenopausal AA and white women. Body fat distribution and estrogen use may be part of the interconnected hormonal pathways related to racial difference in IGF-I levels and obesity-related cancer risk. PMID:27749737

Clinical, hormonal and metabolic characteristics of polycystic ovary syndrome among obese and nonobese women in the Croatian population.

PubMed

Baldani, Dinka Pavicić; Skrgatić, Lana; Goldstajn, Marina Sprem; Vrcić, Hrvoje; Canić, Tomislav; Strelec, Mihajlo

2013-06-01

Obesity has a deteriorating impact on women with PCOS, although prevalence and the impact of specific traits of PCOS remain inconstant in different populations. Therefore, the aim of this study was to explore the differences in clinical, hormonal and metabolic features between obese and nonobese Croatian women diagnosed as having PCOS according to Rotterdam consensus criteria. The study included 74 obese and 208 nonobese women with PCOS. Clinical, biochemical and metabolic variables were compared among those PCOS subgroups. Obese subjects with PCOS had a higher risk of developing oligo-amenorrhea (OR 3.7; 95% CI, 1.1-12.5) and lower risk for developing hirsutism and acne (OR 0.2; 95% CI, 0.1-0.3 and OR 0.8; 95% CI 0.5-1.4, respectively). Obese PCOS subjects also had a higher risk of developing hyperandrogenemia (OR 2.5; CI 95% 0.9-6.7), insulin resistance (OR 4.5; CI 95%, 2.6-7.9), hypercholesterolemia (OR 5.0, CI 95% 2.5-10.2), hypertriglyceridemia (OR 5.2; 95% CI, 2.9-9.2) as well as elevated serum CRP levels (OR 4.1; 95% CI 1.4-12.2) compared to nonobese PCOS women. In conclusion, nonobese Croatian women with PCOS are more inclined to cosmetic problems associated with PCOS then metabolic ones. This is the first study to report the impact of obesity on acne and irregular menses as a study outcome. Obesity deteriorates menstrual regularity, insulin sensitivity and lipid profile in Croatian women with PCOS; therefore one of the fundamental treatment strategies of PCOS should be obesity prevention.

Association of TLR2 S450S and ICAM1 K469E polymorphisms with polycystic ovary syndrome (PCOS) and obesity.

PubMed

Ojeda-Ojeda, Miriam; Martínez-García, M Ángeles; Alpañés, Macarena; Luque-Ramírez, Manuel; Escobar-Morreale, Héctor F

2016-02-01

Toll-like receptors (TLRs) are activated by inflammatory stimuli and influence endothelial functions, contributing to the pathogenesis of atherosclerosis. We investigate the influence of polymorphisms in the genes encoding toll-like receptor 2 (TLR2) and 4 (TLR4) and endothelial adhesion molecules on polycystic ovary syndrome (PCOS) and its interaction with obesity. Ten single nucleotide polymorphisms were genotyped in 305 women with PCOS and 166 non-hyperandrogenic control women. In obese women, TLR2 S450S and ICAM1 K469E polymorphisms differently influenced metabolic variables and PCOS, respectively. Irrespective of PCOS, variant alleles of TLR2 S450S increased triglycerides, fasting insulin levels, and insulin resistance in obese women. TLR2 S450S interacted with obesity and PCOS on androstenedione levels, mutant alleles were associated with increased androstenedione concentrations in all women, with the exception of obese patients with PCOS (P=0.034). Regarding ICAM1 K469E, homozygosis for K469 alleles was more frequent in PCOS, but only in obese women (P=0.014). K469 alleles were also related to increased body mass index (P=0.017) and diastolic blood pressure (P=0.034). Moreover, ICAM1 K469E interacted with obesity and PCOS on serum triglyceride levels (P=0.019) and with PCOS on serum sex hormone-binding globulin concentrations (P=0.006). In conclusion, TLR2 S450S and ICAM1 K469E polymorphisms may be associated with PCOS and metabolic comorbidities in obese women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Overweight and obesity among low-income women in rural West Virginia and urban Los Angeles County.

PubMed

Robles, Brenda; Frost, Stephanie; Moore, Lucas; Harris, Carole V; Bradlyn, Andrew S; Kuo, Tony

2014-10-01

We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult women recruited from public-sector clinics serving low-income populations. All participants answered survey questions regarding socio-demographics and diets. In both jurisdictions, we assessed obesity using objectively measured height and weight (calculated BMI). As part of each community case study, we performed multivariable regression analyses to describe the relationships between overweight and obesity and selected covariates (e.g., dietary behaviors). Overweight and obesity were prevalent among low-income women from WV (73%, combined) and LA County (67%, combined). In both communities, race and ethnicity appeared to predict the two conditions; however, the associations were not robust. In LA County, for example, African American and Hispanic women were 1.4 times (95% CI=1.12, 1.81) more likely than white women to be overweight and obese. Collectively, these subpopulation health data served as an important guide for further planning of obesity prevention efforts in both communities. These efforts became a part of the subsequent Community Transformation Grants portfolio. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors associated with health-related quality of life among overweight and obese Korean women.

PubMed

Choo, Jina; Turk, Melanie T; Jae, Sae Young; Choo, Il Han

2015-01-01

Health-related quality of life (HRQOL) tends to be lower among individuals who are overweight and obese than those of normal weight, and women may be more vulnerable to lower HRQOL associated with obesity than men. Identifying factors associated with HRQOL may be crucial for improving HRQOL for overweight/obese women. We aimed to determine the factors associated with obesity-specific HRQOL among overweight/obese Korean women. A cross-sectional study was conducted with 125 women aged 20-64 years, who comprised a baseline sample in the Community-based Heart and Weight Management Trial. The data were collected from September 2010 to November 2011. The Weight Efficacy Lifestyle, Beck Depression Inventory-II, Interpersonal Social Evaluation List, and Impact of Weight on Quality of Life (IWQOL)-Lite scales were used to measure self-efficacy for weight control, depressive symptoms, social support, and HRQOL, respectively. Increased body mass index, lower self-efficacy for weight control, and higher levels of depressive symptoms were significantly associated with greater impairment in total IWQOL in the regression models. However, social support was not significantly associated with IWQOL. Along with weight loss strategies, other strategies for improving self-efficacy and alleviating depressive symptoms may be essential for improving HRQOL among overweight and obese women.

[Contribution of leptin in the development of insulin resistance in pregnant women with obesity].

PubMed

Tarasenko, K

2014-03-01

The aim of the present study was to investigate contribution of leptin in the development of insulin resistance in obese pregnant women depending on the obesity class as well as its effect on the progression of pregnancy. 36 pregnant women of I and II obesity classes and 21 pregnant women with normal body mass participated in the study. Concentrations of insulin, leptin and C-reactive protein in blood serum were measured with immunoenzymatic assays. Insulin resistance (IR) was determined with the Caro index. Contribution of leptin to development of IR was assessed with the ratio "leptin/Caro index". An increase of leptin concentration in blood serum was found in pregnant women with obesity compared to healthy controls. Moreover, the ratio "leptin/Caro index" increased with IR progression and reached maximum in the group with obesity class II, where it was 5.8 times higher than in the control group. An increased frequency of gestoses and placentary dysfunction were manifestations of weakening of adaptive mechanisms of the organism associated with the IR progression and increased role of leptin in its development. Therefore, activation of adipocyte function through the increased leptin secretion and increased ratio "leptin/Caro index" reflects the important role of leptin in pathogenesis of IR in pregnant women with obesity.

The Relationship Between Time of Day of Physical Activity and Obesity in Older Women.

PubMed

Chomistek, Andrea K; Shiroma, Eric J; Lee, I-Min

2016-04-01

Physical activity is important for maintaining healthy weight. The time of day when exercise is performed-a highly discretionary aspect of behavior-may impact weight control, but evidence is limited. Thus, we examined the association between the timing of physical activity and obesity risk in women. A cross-sectional analysis was conducted among 7157 Women's Health Study participants who participated in an ancillary study begun in 2011 that is measuring physical activity using accelerometers. The exposure was percentage of total accelerometer counts accumulated before 12:00 noon and the outcome was obesity. Mean (±SD) BMI among participants was 26.1 (±4.9) kg/m2 and 1322 women were obese. The mean activity counts per day was 203,870 (±95,811) of which a mean 47.1% (±11.5%) were recorded in the morning. In multivariable-adjusted models, women who recorded < 39% (lowest quartile) of accelerometer counts before 12:00 noon had a 26% higher odds of being obese, compared with those recording ≥ 54% (highest quartile) of counts before noon (Ptrend = 0.02). These study findings-that women who are less active during morning hours may be at higher risk of obesity-if confirmed can provide a novel strategy to help combat the important health problem of obesity.

Interaction between Education and Household Wealth on the Risk of Obesity in Women in Egypt

PubMed Central

Aitsi-Selmi, Amina; Chandola, Tarani; Friel, Sharon; Nouraei, Reza; Shipley, Martin J.; Marmot, Michael G.

2012-01-01

Background Obesity is a growing problem in lower income countries particularly among women. There are few studies exploring individual socioeconomic status indicators in depth. This study examines the interaction of education and wealth in relation to obesity, hypothesising that education protects against the obesogenic effect of wealth. Methods Four datasets of women of reproductive age from the Egyptian Demographic and Health Surveys spanning the period 1992–2008 are used to examine two distinct time periods: 1992/95 (N = 11097) and 2005/08 (N = 23178). The association in the two time periods between education level and household wealth in relation to the odds of being obese is examined, and the interaction between the two socioeconomic indicators investigated. Estimates are adjusted for age group and area of residence. Results An interaction was found between the association of education and wealth with obesity in both time periods (P-value for interaction <0.001). For women with the lowest education level, moving up one wealth quintile was associated with a 78% increase in the odds of obesity in 1992/95 (OR; 95%CI: 1.78; 1.65,1.91) and a 33% increase in 2005/08 (OR; 95%CI: 1.33; 1.26,1.39). For women with the highest level of education, there was little evidence of an association between wealth and obesity (OR; 95%CI: 0.82; 0.57,1.16 in 1992/95 and 0.95; 0.84,1.08 in 2005/08). Obesity levels increased most in women who were in the no/primary education, poorest wealth quintile and rural groups (absolute difference in prevalence percentage points between the two time periods: 20.2, 20.1, and 21.3 respectively). Conclusion In the present study, wealth appears to be a risk factor for obesity in women with lower education levels, while women with higher education are protected. The findings also suggest that a reversal in the social distribution of obesity risk is occurring which can be explained by the large increase in obesity levels in lower socioeconomic groups between the two time periods. PMID:22761807

Physical health-related quality of life in relation to metabolic health and obesity among men and women in Germany.

PubMed

Truthmann, Julia; Mensink, Gert B M; Bosy-Westphal, Anja; Hapke, Ulfert; Scheidt-Nave, Christa; Schienkiewitz, Anja

2017-06-10

This study examined sex-specific differences in physical health-related quality of life (HRQoL) across subgroups of metabolic health and obesity. We specifically asked whether (1) obesity is related to lower HRQoL independent of metabolic health status and potential confounders, and (2) whether associations are similar in men and women. We used cross-sectional data from the German Health Interview and Examination Survey 2008-11. Physical HRQoL was measured using the Short Form-36 version 2 physical component summary (PCS) score. Based on harmonized ATPIII criteria for the definition of the metabolic health and a body mass index ≥ 30 kg/m 2 to define obesity, individuals were classified as metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Sex-specific analyses including multivariable linear regression analyses were based on PCS as the dependent variable, metabolic health and obesity category as the independent variable with three categories and MHNO as the reference, and age, education, lifestyle and comorbidities as confounders. This study included 6860 participants (3298 men, 3562 women). Compared to MHNO, all other metabolic health and obesity categories had significantly lower PCS in both sexes. As reflected by the beta coefficients [95% confidence interval] from bivariable linear regression models, a significant inverse association with PCS was strongest for MUO (men: -7.0 [-8.2; -5.8]; women: -9.0 [-10.2; -7.9]), intermediate for MUNO (men: -4.2 [-5.3; -3.1]; women: -5.6 [-6.8; -4.4]) and least pronounced for MHO (men: -2.2 [-3.6; -0.8]; women -3.9 [-5.4; -2.5]). Differences in relation to MHNO remained statistically significant for all groups after adjusting for confounders, but decreased in particular for MUNO (men:-1.3 [-2.3; -0.3]; women: -1.5 [-2.7; -0.3]. Obesity was significantly related to lower physical HRQoL, independent of metabolic health status. Potential confounders including age, educational status, health-related behaviors, and comorbidities explained parts of the inverse relationship. Associations were evident in both sexes and consistently more pronounced among women than men.

Interaction between education and household wealth on the risk of obesity in women in Egypt.

PubMed

Aitsi-Selmi, Amina; Chandola, Tarani; Friel, Sharon; Nouraei, Reza; Shipley, Martin J; Marmot, Michael G

2012-01-01

Obesity is a growing problem in lower income countries particularly among women. There are few studies exploring individual socioeconomic status indicators in depth. This study examines the interaction of education and wealth in relation to obesity, hypothesising that education protects against the obesogenic effect of wealth. Four datasets of women of reproductive age from the Egyptian Demographic and Health Surveys spanning the period 1992-2008 are used to examine two distinct time periods: 1992/95 (N = 11097) and 2005/08 (N = 23178). The association in the two time periods between education level and household wealth in relation to the odds of being obese is examined, and the interaction between the two socioeconomic indicators investigated. Estimates are adjusted for age group and area of residence. An interaction was found between the association of education and wealth with obesity in both time periods (P-value for interaction <0.001). For women with the lowest education level, moving up one wealth quintile was associated with a 78% increase in the odds of obesity in 1992/95 (OR; 95%CI: 1.78; 1.65,1.91) and a 33% increase in 2005/08 (OR; 95%CI: 1.33; 1.26,1.39). For women with the highest level of education, there was little evidence of an association between wealth and obesity (OR; 95%CI: 0.82; 0.57,1.16 in 1992/95 and 0.95; 0.84,1.08 in 2005/08). Obesity levels increased most in women who were in the no/primary education, poorest wealth quintile and rural groups (absolute difference in prevalence percentage points between the two time periods: 20.2, 20.1, and 21.3 respectively). In the present study, wealth appears to be a risk factor for obesity in women with lower education levels, while women with higher education are protected. The findings also suggest that a reversal in the social distribution of obesity risk is occurring which can be explained by the large increase in obesity levels in lower socioeconomic groups between the two time periods.

77 FR 2730 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-19

...-Evaluation Assessments of Nutrition, Physical Activity and Obesity Programs and Policies--New--National... Prevention (CDC). Background and Brief Description The causes of obesity in the United States are complex and... jurisdictions funded through CDC's Nutrition, Physical Activity and Obesity (NPAO) cooperative agreement program...

Influence of physical activity on psychosomatic health in obese women.

PubMed

Menzyk, K; Cajdler, A; Pokorski, M

2008-12-01

It is unclear to what extent the known psychosomatic benefits of exercise hold true for the obese. In the present study, we investigated the hypothesis that the psychosomatic health and components of general intelligence, such as the capacity for logical-deductive tasks, would be better in regularly exercising than non-exercising obese women. We addressed the issue in a self-reported survey study, comprising two groups of middle-aged obese women (age 30-50 years, BMI >30 kg/m(2)) of 25 persons each. The criterion for the group division was regular exercise, minimum twice a week, for at least 2 months. The following psychometric tools were used: Physical Fitness and Exercise Scale, Patient Health Questionnaire-9 for depression, Life Satisfaction Scale, General Health Inventory-28, Raven's Matrices Test for intelligence, and a test for selfcontentment with one's body figure shape. The exercising obese women scored significantly better in Life Satisfaction Scale (17.1 +/- 1.2 vs.12.0 +/- 0.9), had a lower level of depression (8.1 +/- 0.6 vs. 13.4 +/- 0.7), and a better assessment of the health status (24.6 +/- 1.6 vs. 36.4 +/- 2.2) (reversed score) compared with non-exercising ones (P<0.05). The exercising obese women also appreciably better assessed their bodily looks. Interestingly, if depression was present in exercising women, it had more detrimental health effects than in physically inactive ones. The study failed to substantiate appreciable changes in general intelligence between active and non-active obese women. In conclusion, physical activity is of benefit for the psychosomatic health in obese women, which should be considered in behavioral counseling.

Obese women less likely to have low serum ferritin, Nicaragua

PubMed Central

Wendt, Amanda S; Jefferds, Maria E; Perrine, Cria G; Halleslevens, Patricia; Sullivan, Kevin M

2015-01-01

Objective To examine the association between overweight and obesity and serum ferritin among women of reproductive age (15–49 years) in Nicaragua, considering the effect of α1-acid glycoprotein (AGP), a marker of inflammation. Design We analysed data from the 2004–05 Nicaraguan Integrated Surveillance System for Nutrition Interventions. Three logistic regression models were analysed with low serum ferritin (<15 μg/l) as the dependent variable: (i) overweight or obese status and covariates; (ii) model 1 plus AGP; and (iii) model 1 restricted to only women with normal AGP levels (≤1·0 g/l). Setting Nicaragua. Subjects Included in this analysis were 832 non-pregnant mother/caregivers (15–49 years) surveyed in 2004–2005. Results In the sample, prevalence of overweight and obesity was 31·8 % and 19·2 %, respectively, and 27·6 % had low serum ferritin. In model 1, the adjusted OR of low serum ferritin was 0·74 (95 % CI 0·52, 1·05) for overweight women and 0·42 (95 % CI 0·26, 0·65) for obese women. In model 2, AGP was significantly independently associated with low serum ferritin (adjusted OR=0·56, 95 % CI 0·34, 0·92) while the adjusted OR for overweight and obesity were largely unchanged. Excluding women with elevated AGP did not appreciably affect the relationship between overweight or obesity and low serum ferritin (model 3). Conclusions Overall, in this population of reproductive-age women, obese women were less likely to have low serum ferritin levels, and this was independent of inflammation as measured by AGP. PMID:24848519

Increased follistatin levels after oral contraceptive treatment in obese and non-obese women with polycystic ovary syndrome.

PubMed

Chen, Mei-Jou; Yang, Wei-Shiung; Chen, Hsin-Fu; Kuo, Jahn-Jahn; Ho, Hong-Nerng; Yang, Yu-Shih; Chen, Shee-Uan

2010-03-01

Follistatin levels have recently been considered as a marker for inflammation. Our objective was to evaluate the level of circulating follistatin and high-sensitivity C-reactive protein (hsCRP) in women with polycystic ovary syndrome (PCOS) after oral contraceptive (OC) treatment. A total of 56 Taiwanese women with PCOS were enrolled in this prospective observational study in which they were treated for 3 months with OCs (ethinyl estradiol-cyproterone acetate). Blood samples were taken at baseline after treatment during the withdrawal bleed. Body mass index (BMI), lipid profiles, plasma follistatin, hsCRP, fasting glucose, insulin for the homeostasis model assessment of insulin resistance (HOMA-IR) and hormone profiles were measured and analyzed. Total testosterone, free androgen index (FAI), dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels were significantly lower, but total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, circulating follistatin and hsCRP were significantly higher than baseline in women with PCOS after treatment with OCs. An elevation of fasting insulin, HOMA-IR and hsCRP after OC treatment was more evident in non-obese than obese women, whereas the elevation of follistatin was significant in both obese and non-obese women. Follistatin and hsCRP levels all showed significant correlations with each other at baseline and after treatment. The differences in follistatin and hsCRP levels from baseline to after OC treatment were significantly associated with the difference in triglyceride levels. Both hsCRP and follistatin levels increase after OC treatment in women with PCOS. Follistatin seems more sensitive than hsCRP alone to represent the aggravated low-grade inflammatory status after OC treatment in obese and non-obese women with PCOS.

Plasma interleukin-6 levels, glutathione peroxidase and isoprostane in obese women before and after weight loss. Association with cardiovascular risk factors.

PubMed

Bougoulia, Maria; Triantos, Athanassios; Koliakos, George

2006-01-01

To evaluate the levels of Interleukin-6 (IL-6), glutathione peroxidase and isoprostane in obese women and their association with markers of cardiovascular risk factors before and after weight loss. 36 healthy obese women of reproductive age (group A: age (mean+/-SD) 35.4+/-9.2 years, Body Mass Index (BMI) 38.5+/-7 kg/m2) and 30 healthy, normal weight women (group B: age mean+/-SD 34.9+/-7.4 y., BMI 24+/-1.1 kg/m2) were included in the study. Glucose tolerance was normal in all participating women. Il-6, glutathione peroxidase and isoprostane, C-Reactive Protein (CRP), insulin, fasting plasma glucose, HOMA-IR as well as the lipid profile were evaluated. Body weight, BMI, Waist to Hip ratio (W/H) ratio, Waist Circumference (WC), %free fat mass and the %fat mass were also measured. A hypo-caloric diet was prescribed for the obese women and all participants were re-examined after six months. In obese women after weight loss, anthropometric obesity markers (BMI, W/H ratio), %fat, lipid profile, insulin levels and inflammation indices such as IL-6 and CRP, the oxidative stress index isoprostane, as well as glutathione peroxidase were significantly ameliorated. The levels of serum glutathione peroxidase activity were negatively correlated with IL-6 levels and were significantly increased after weight reduction. In obese women there was an association between IL-6 levels and the values of %fat, %free fat mass, insulin and HOMA-IR before and after weight loss. Weight loss is related to reduction of oxidative stress and inflammation; this beneficial effect could possibly be translated into reduction of cardiovascular risk in obese individuals.

Dyspnea on exertion in obese women: association with an increased oxygen cost of breathing.

PubMed

Babb, Tony G; Ranasinghe, Kamalini G; Comeau, Laurie A; Semon, Trisha L; Schwartz, Belinda

2008-07-15

Although exertional dyspnea in obesity is an important and prolific clinical concern, the underlying mechanism remains unclear. To investigate whether dyspnea on exertion in otherwise healthy obese women was associated with an increase in the oxygen cost of breathing or cardiovascular deconditioning. Obese women with and without dyspnea on exertion participated in two independent experiments (n = 16 and n = 14). All participants underwent pulmonary function testing, hydrostatic weighing, ratings of perceived breathlessness during cycling at 60 W, and determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea at 40 and 60 L/min. Cardiovascular exercise capacity, fat distribution, and respiratory mechanics were determined in 14 women in experiment 2. Data were analyzed between groups by independent t test, and the relationship between the variables was determined by regression analysis. In both experiments, breathlessness during 60 W cycling was markedly increased in over 37% of the obese women (P < 0.01). Age, height, weight, lung function, and %body fat were not different between the groups in either experiment. In contrast, the oxygen cost of breathing was significantly (P < 0.01) and markedly (38-70%) greater in the obese women with dyspnea on exertion. The oxygen cost of breathing was significantly (P < 0.001) correlated with the rating of perceived breathlessness obtained during the 60 W exercise in experiment 1 (r(2) = 0.57) and experiment 2 (r(2) = 0.72). Peak cardiovascular exercise capacity, fat distribution, and respiratory mechanics were not different between groups in experiment 2. Dyspnea on exertion is prevalent in otherwise healthy obese women, which seems to be strongly associated with an increased oxygen cost of breathing. Exercise capacity is not reduced in obese women with dyspnea on exertion.

Cardiovascular Risk Factors in Bulgarian Patients with Polycystic Ovary Syndrome and/or Obesity

PubMed Central

Gateva, Antoaneta; Kamenov, Zdravko

2012-01-01

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disturbances in women of reproductive age. Besides its well-known effects on reproductive health, it is also linked to increased cardiovascular risk in later life. The aim of this study is to investigate some classical cardiovascular risk factors in a crossectional study of Bulgarian women with PCOS and/or obesity. We performed a retrospective medical chart review of 375 women from an university endocrine clinic. We found significant differences in the indices of carbohydrate metabolism, blood pressure, lipid profile, rate of liver steatosis, and the levels liver enzymes and hematological results between the lean and obese PCOS women. Obese women without PCOS did not show significantly different results in their OGGT form obese PCOS women. Waist-to-stature-ratio (WSR) correlated better with the baseline IRI levels and lipid profile than waist-to-hip-ratio (WHR) that makes it a better marker for unfavorable metabolic profile. PMID:22262974

Maternal Obesity and its Short- and Long-Term Maternal and Infantile Effects

PubMed Central

Korkmaz, Levent; Baştuğ, Osman; Kurtoğlu, Selim

2016-01-01

Obesity, in childhood or in adulthood, remains to be a global health problem. The worldwide prevalence of obesity has increased in the last few decades, and consequently, the women of our time suffer more gestational problems than women in the past. The prevalence of obesity is greater in older women than in younger ones and in women with low educational level than in their counterparts with a higher level of education. Maternal obesity during pregnancy may increase congenital malformations and neonatal morbidity and mortality. Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. We discuss the current epidemiological evidence for the association of maternal obesity with congenital structural neural tube and cardiac defects, fetal macrosomia that predisposes infants to birth injuries and to problems with physiological and metabolic transition, as well as potential for long-term complications secondary to prenatal and neonatal programming effects compounded by a reduction in sustained breastfeeding. PMID:26758575

Maternal Obesity and its Short- and Long-Term Maternal and Infantile Effects.

PubMed

Korkmaz, Levent; Baştuğ, Osman; Kurtoğlu, Selim

2016-06-05

Obesity, in childhood or in adulthood, remains to be a global health problem. The worldwide prevalence of obesity has increased in the last few decades, and consequently, the women of our time suffer more gestational problems than women in the past. The prevalence of obesity is greater in older women than in younger ones and in women with low educational level than in their counterparts with a higher level of education. Maternal obesity during pregnancy may increase congenital malformations and neonatal morbidity and mortality. Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. We discuss the current epidemiological evidence for the association of maternal obesity with congenital structural neural tube and cardiac defects, fetal macrosomia that predisposes infants to birth injuries and to problems with physiological and metabolic transition, as well as potential for long-term complications secondary to prenatal and neonatal programming effects compounded by a reduction in sustained breastfeeding.

[Frequency of diagnosis of postmenopausal osteoporosis of the spine, distant radius and extravertebral fractures in women with normal body mass, overweight and obesity].

PubMed

Popov, A A; Izmozherova, N V; Fominykh, M I; Tagil'tseva, N V; Kozulina, E V; Gavrilova, E I

2008-01-01

To assess features and peculiarities of postmenopausal osteoporosis (OP) in women with normal body mass, overweight and obesity. Dual energy X-ray absorptiometry of the lumbal spine (Lunar DPX) and distal radius X-ray absorptiometry (DTX 200) were performed during cross-section study of 730 symptomatic postmenopausal women. OP was diagnosed in 253 (34.7%) women, 30.5% of them had normal body mass, 43.2% had overweight and 26.3% were obese. Among them 227 had atraumatic fractures at the age over 50 years. Obese OP patients had significantly higher frequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than osteoporotic patients with normal body mass. Fracture frequency did not differ between groups with normal body mass, overweight and obesity. Excessive body mass did not decrease fracture risk in women with postmenopausal OP.

Both obesity and lack of physical activity are associated with a less favorable health-related quality of life in Hong Kong Chinese.

PubMed

Ko, Gary T C

2006-01-01

To investigate the relationships among obesity, physical activity and quality of life (QOL) in Hong Kong Chinese adults. A cross-sectional study involving 876 subjects (32.9% men and 67.1% women, mean age: 34.8 +/- 7.9 years) from a nonmanual working population. The Medical Outcome Study Short Form 36 (SF-36, Chinese version) was used for health-related QOL. Level of physical activity was assessed with self-reported questionnaire. Obesity was defined as body mass index > or = 25 kg/m2. 31% of men and 9% of women were obese (overall 16.0%). Obese subjects had lower scores on some of the SF-36 subscales. As the level of physical activity decreased, mean scores on most SF-36 subscales also progressively decreased. Obese women who had no regular physical activity had lower scores on some QOL subscales than obese women who had some regular physical activity. Among this Hong Kong Chinese sample, both obesity and lack of physical activity are associated with lower scores on QOL.

Overweight and obesity and its socio-demographic correlates among urban Ethiopian women: evidence from the 2011 EDHS.

PubMed

Abrha, Solomon; Shiferaw, Solomon; Ahmed, Kedir Y

2016-07-26

Evidences show that the burden of overweight and obesity is increasing in developing countries, particularly among urban women. Despite this worrying trend and the recognition of the emerging problem of chronic diseases in the recently launched Health Sector Transformation Plan of Ethiopia, little efforts are being made to address overweight and obesity. The present study aimed at assessing the prevalence and socio-demographic correlates of overweight and obesity among urban women. This study was based on the 2011 Ethiopian Demographic Health Survey (EDHS) that used a two-stage stratified cluster sampling technique. A total of 3602 non-pregnant urban reproductive age women were included in the analysis. Simple descriptive, bivariate and multiple logistic regression analysis were employed as appropriate. The prevalence of overweight and obesity among urban Ethiopian women was found to be 435 (12.1 %) and 99 (2.8 %), respectively. Urban women in the age groups from 20-29 years [Adjusted Odds Ratio (AOR) = 2.3 95 % CI: 1.4, 3.9], 30-39 years (AOR = 5.0 95 % CI: 2.9, 8.8) and 40-49 years (AOR = 9.8 95 % CI: 5.1, 13.8) were significantly more likely to have overweight and obesity compared to the youngest age group (15 to 19 years). The odds of being overweight and obese was significantly higher among women in the richest quintile (AOR = 1.8 95 % CI: 1.1, 2.5), those with secondary and above education (AOR = 2.0 95 % CI: (1.3, 3.1) and married women (AOR = 2.0 95 % CI: (1.2, 3.3). The prevalence of overweight and obesity was found to be higher in urban women compared to the national average. Being married, older, belonging to the richest quintile, living in the three metropolises (Addis Ababa, Harari and Dire Dawa), and with secondary and above educational level are independent predictors of overweight and obesity. Programs that target on older, educated and well to do women, and those living in the big cities are expected to cope with this substantial public health concern.

Contraction frequency after administration of misoprostol in obese versus nonobese women.

PubMed

Stefely, Erin; Warshak, Carri R

2018-04-30

To examine impact of obesity on contraction frequency following misoprostol. Our hypothesis is that an increased volume of distribution reduces the bioavailability of misoprostol and may be an explanation for reduced efficacy. We examined the contraction frequency as a surrogate marker for bioavailability of misoprostol. We compared the rate of contractions at five time intervals in 313 subjects: prior to administration, and at four intervals post administration. We compared number of contractions in obese versus nonobese. As a planned secondary analysis, we then compared the rate of change in contractions per hour at four time intervals: a repeated measures analysis to compare the rate of change in contractions per hour over the 5-hour window controlling for race (White versus non-White) and parity (primiparous versus multiparous). General linear model and repeated measures analysis were conducted to report the parameter estimates, least square means, difference of least square means, and p values. Nonobese women presented with more contractions at baseline, 7 ± 5 versus 4 ± 5 c/h, p < .001. At all four time intervals after misoprostol administration obese women had fewer contractions per hour. The rate of change in contraction frequency after administration found obese women had a lower rate of increase in contraction frequency over the course of all four hours. We found a least squares means estimate (c/h): first hour (-0.87), p = .08, second hour (-2.43), p = .01, third hour (-1.80), p = .96, and fourth hour (-2.98), p = .007. Obese women have a lower rate of contractions per hour at baseline and at four intervals after misoprostol administration. In addition, the rate of change in the increase in contractions/hour also was reduced in obese women versus nonobese women. This suggests a lower bioavailability of misoprostol in women with a larger volume of distribution which would likely impact the efficacy of misoprostol in obese women when given the same dose of misoprostol. It is unknown if higher misoprostol dosing would increase efficacy of misoprostol in obese women.

Prevalence and correlates of obesity and overweight among asian immigrant women in Korea.

PubMed

Yang, Sook Ja; Choi, Hye Young; Chee, Yeon Kyung; Kim, Jung A

2012-07-01

This study examines the prevalence of obesity and overweight as well as associations between obesity and overweight and demographic, sociocultural, and lifestyle factors among Asian immigrant women in Korea. Data were collected from physical measurements and standardized questionnaires from 287 adult women from China, Vietnam, the Philippines, and other Asian countries. The mean BMI (body mass index) was 22.0 kg/m(2); 15.0% of the sample were obese (BMI ≥ 25.0), and 17.1% were overweight (23.0 ≤ BMI < 25.0). The highest obesity proportion was found in Filipino (22.0%) and the lowest in Vietnamese women (7.8%). Adjusted for demographic, sociocultural, and lifestyle variables, individuals with greater length of residence (5+ years; odds ratio = 3.22, P = .010) were more likely to be obese or overweight. For prevention of excess body weight, public health efforts need to be targeted to immigrants starting at arrival in Korea.

The impact of hyperandrogenism in female obesity and cardiometabolic diseases associated with polycystic ovary syndrome.

PubMed

Barber, Thomas M; Vojtechova, Petra; Franks, Stephen

2013-09-01

Polycystic ovary syndrome (PCOS) is a common condition characterized by reproductive and hyperandrogenic features and is often associated with obesity and metabolic dysfunction. Overall, women with PCOS have a substantially greater prevalence of metabolic syndrome than women from the general population. Furthermore, PCOS per se (independent of its frequent association with obesity) often confers cardiometabolic risk (including insulin resistance), and its concurrence with obesity often represents a metabolic "double-whammy" from the adverse effects of PCOS and obesity. The introduction of the Rotterdam diagnostic criteria for PCOS in 2003 has broadened the scope of this condition. The Rotterdam diagnostic criteria have also introduced two new phenotypic subgroups (including normoandrogenemic women with PCOS) that have provided novel insights into a potential role for hyperandrogenism in the development of adverse cardiometabolic risk in women with PCOS. Based on evidence from cross-sectional and interventional studies, hyperandrogenism, obesity, and cardiometabolic risk in women appear to be linked through complex and multidirectional pathways. Furthermore, data from obese women without a formal diagnosis of PCOS also suggest that these interrelationships often exist in female obesity per se (in milder forms than occurs in PCOS). Data from female-to-male transsexuals are particularly informative because these show direct effects of hyperandrogenism (induced through exogenous use of androgenic therapies) on fat distribution and cardiometabolic risk in women. A challenge for the future will be to disentangle and improve our understanding of this complex pathogenic web, thereby facilitating novel and targeted therapies for the hyperandrogenic and adverse cardiometabolic manifestations of PCOS.

Maternal obesity and gestational weight gain are risk factors for infant death.

PubMed

Bodnar, Lisa M; Siminerio, Lara L; Himes, Katherine P; Hutcheon, Jennifer A; Lash, Timothy L; Parisi, Sara M; Abrams, Barbara

2016-02-01

Assessment of the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality was performed. This study used Pennsylvania linked birth-infant death records (2003-2011) from infants without anomalies born to mothers with prepregnancy BMI categorized as underweight (n = 58,973), normal weight (n = 610,118), overweight (n = 296,630), grade 1 obesity (n = 147,608), grade 2 obesity (n = 71,740), and grade 3 obesity (n = 47,277). Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z scores of gestational weight gain and infant death after confounder adjustment. Infant mortality risk was lowest among normal-weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grades 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal-weight women. Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. © 2015 The Obesity Society.

The Association between Socioeconomic Status and Obesity in Peruvian Women

PubMed Central

Poterico, J.A.; Stanojevic, S.; Ruiz, P.; Bernabe-Ortiz, A.; Miranda, J. J.

2012-01-01

Historically in developing countries, the prevalence of obesity has been greater in more advantaged socioeconomic groups. However, in recent years the association between socioeconomic status (SES) and obesity has changed and varies depending on the country’s development stage. This study examines the relationship between SES and obesity using two indicators of SES: education or possession assets. Using the cross-sectional 2008 National Demographic and Family Health Survey of Peru (ENDES 2008) we investigated this relationship in women aged 15 to 49 years living in rural and urban settings. Descriptive, linear and logistic regressions analyses were conducted accounting for the multi-staged nature of the sampling design. The overall prevalence of obesity in this study was 14.1% (95%CI: 13.3–14.8); 8.4% (95%CI: 7.5–9.3) in rural areas and 16.2% (95%CI: 15.2–17-2) in urban areas. Wealthier women were more likely to be obese, and this association was stronger in rural areas. Conversely, more educated women were less likely to be obese, especially in urban areas. The distribution of obesity in Peruvian women is strongly related to socioeconomic position, and differs whether measured as possession assets or by level of education. These findings could have important implications for policy development in Peru. PMID:21959344

Maternal obesity and gestational weight gain are risk factors for infant death

PubMed Central

Bodnar, Lisa M.; Siminerio, Lara L.; Himes, Katherine P.; Hutcheon, Jennifer A.; Lash, Timothy L.; Parisi, Sara M.; Abrams, Barbara

2015-01-01

Objective To assess the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality. Methods We used Pennsylvania linked birth-infant death records (2003–2011) from infants without anomalies to underweight (n=58,973), normal weight (n=610,118), overweight (n=296,630), grade 1 obese (n=147,608), grade 2 obese (n=71,740), and grade 3 obese (n=47,277) mothers. Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z-scores of gestational weight gain and infant death after confounder adjustment. Results Infant mortality risk was lowest among normal weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grade 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal weight women. Conclusions Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. PMID:26572932

Obesity in pregnancy: implications for the mother and lifelong health of the child. A consensus statement.

PubMed

Poston, Lucilla; Harthoorn, Lucien F; Van Der Beek, Eline M

2011-02-01

Obesity among pregnant women is becoming one of the most important women's health issues. Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects all occur more frequently than in women with a normal BMI. Evidence shows that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that early life adversities may extend into adulthood. In September 2009, ILSI Europe convened a workshop with multidisciplinary expertise to review practices and science base of health and nutrition of obese pregnant women, with focus on the long-term health of the child. The consensus viewpoint of the workshop identified gaps and gave recommendations for future research on gestational weight gain, gestational diabetes, and research methodologies. The evidence available on short- and long-term health impact for mother and child currently favors actions directed at controlling prepregnancy weight and preventing obesity in women of reproductive ages. More randomized controlled trials are needed to evaluate the effects of nutritional and behavioral interventions in pregnancy outcomes. Moreover, suggestions that maternal obesity may transfer obesity risk to child through non-Mendelian (e.g. epigenetic) mechanisms require more long-term investigation.

Obesity and Associated Factors — Kingdom of Saudi Arabia, 2013

PubMed Central

El Bcheraoui, Charbel; Tuffaha, Marwa; Robinson, Margaret; Daoud, Farah; Jaber, Sara; Mikhitarian, Sarah; Al Saeedi, Mohammed; AlMazroa, Mohammad A.; Mokdad, Ali H.; Al Rabeeah, Abdullah A.

2014-01-01

Introduction Data on obesity from the Kingdom of Saudi Arabia (KSA) are nonexistent, making it impossible to determine whether the efforts of the Saudi Ministry of Health are having an effect on obesity trends. To determine obesity prevalence and associated factors in the KSA, we conducted a national survey on chronic diseases and their risk factors. Methods We interviewed 10,735 Saudis aged 15 years or older (51.1% women) through a multistage survey. Data on sociodemographic characteristics, health-related habits and behaviors, diet, physical activity, chronic diseases, access to and use of health care, and anthropometric measurements were collected through computer-assisted personal interviews. We first compared sociodemographic factors and body mass index between men and women. Next, we conducted a sex-specific analysis for obesity and its associated factors using backward elimination multivariate logistic regression models. We used SAS 9.3 for the statistical analyses and to account for the complex sampling design. Results Of the 10,735 participants evaluated, 28.7% were obese (body mass index ≥30 kg/m2). Prevalence of obesity was higher among women (33.5% vs 24.1%). Among men, obesity was associated with marital status, diet, physical activity, diagnoses of diabetes and hypercholesterolemia, and hypertension. Among women, obesity was associated with marital status, education, history of chronic conditions, and hypertension. Conclusion Obesity remains strongly associated with diabetes, hypercholesterolemia, and hypertension in the KSA, although the epidemic’s characteristics differ between men and women. PMID:25299980

Bariatric Surgery Reduces Serum Anti-mullerian Hormone Levels in Obese Women With and Without Polycystic Ovarian Syndrome.

PubMed

Chiofalo, Francesco; Ciuoli, Cristina; Formichi, Caterina; Selmi, Federico; Forleo, Raffaella; Neri, Ornella; Vuolo, Giuseppe; Paffetti, Patrizia; Pacini, Furio

2017-07-01

Obesity in fertile women has negative effect on fertility. Anti-mullerian hormone (AMH) represents a good index of fertility, and it is considered a marker of ovarian reserve and of polycystic ovarian syndrome (PCOS) gravity. Previous studies evaluated the relationship between obesity and AMH with contradictory results. The aim of the study was to investigate the relationship between obesity and AMH and the changes of AMH in obese women in reproductive age submitted to bariatric surgery. Fifty-five obese patients between 18 and 39 years with (29 patients) and without PCOS (26 patients) were compared with a control group of normal weight women with (24 patients) and without PCOS (19 patients). Fourteen obese women with PCOS and 18 without PCOS underwent to bariatric surgery. Serum AMH, testosterone, androstenedione, and DHEAS were performed in all patients before and 1 year after surgical intervention. AMH was significantly higher in the PCOS groups (p < 0.001), both in obese (5.84 ± 3.94 ng/ml) and non-obese women (7.35 ± 4.39 ng/ml). AMH was positively related to testosterone (p < 0.0001), androstenedione (p = 0.0005), and DHEAS (p = 0.003). After bariatric surgery, AMH levels were reduced in the both PCOS (p = 0.02) and non-PCOS group (p = 0.04). AMH levels are elevated in PCOS patients regardless of the body weight. Bariatric surgery is effective in the normalization of AMH levels (a possible indirect marker of better fertility) only in obese patients with PCOS.

The relationship between body mass index and periodontitis among postmenopausal women.

PubMed

Al Habashneh, Rola; Azar, Wesam; Shaweesh, Ashraf; Khader, Yousef

2016-01-01

Periodontitis and overweight/obesity prevalence are both increasing worldwide. Overweight/obesity has been suggested as a risk factor for developing periodontitis. The aim of this study was to determine the association between obesity and periodontitis among postmenopausal Jordanian women. Cross-sectional associations between obesity and periodontitis were examined in 400 postmenopausal women aged 50-79 years. All women completed a questionnaire, had a clinical periodontal examination and had their weight and height recorded. Multivariable analysis was carried out using logistic regression with adjustment for possible confounders. Based on body mass index (BMI), 23.5% of the women were considered overweight and 70% were obese. Obese participants with BMI≥25 had decreased odds (OR) for having periodontitis compared to participants with normal weight (OR: 0.54; 95% confidence interval [CI]: 0.27-0.87). The obese patients showed significantly higher loss of clinical attachment (CAL), calculus, as well as plaque and gingival index and as compared to normal and overweight (p<0.01). The extent of periodontal disease was also significantly higher in obese women as measured by average percent of sites with the deepest CAL≥5 mm (p=0.025). There was no significant difference in mean and percentage of sites with alveolar crestal bone loss (ACH) among different categories of obesity. In conclusion, BMI may be inversely associated with prevalence of periodontitis but positively related to the severity of periodontitis assessed by several periodontal parameters such as CAL, recession, plaque, and calculus. Additional prospective studies to further quantify, or understand the mechanisms, of this association are merited. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Food insecurity and adult overweight/obesity: Gender and race/ethnic disparities.

PubMed

Hernandez, Daphne C; Reesor, Layton M; Murillo, Rosenda

2017-10-01

The majority of the food insecurity-obesity research has indicated a positive association among women, especially minority women. Less research has been conducted on men, and the findings are inconsistent. The aim was to assess whether gender and race/ethnic disparities exists between the food insecurity and overweight/obesity relationship among adults ages 18-59. We used the cross-sectional 2011 and 2012 National Health Interview Survey data (N = 19,990). Three or more affirmative responses on the 10-item USDA Food Security Scale indicated food insecure experiences. Self-reported height and weight were used to calculate body mass index according to the Centers for Disease Control and Prevention. Multivariate logistic regression models were stratified by gender and race/ethnicity to estimate the association between food insecurity and overweight/obesity controlling for several demographic characteristics. Adults on average were 36 years of age (51% female; 56% white, 27% Hispanic, and 17% black), 27% were food insecure, and 65% were overweight/obese. Food insecurity was most prevalent among blacks and Hispanics, regardless of gender. A greater percentage of food insecure women were overweight/obese compared to food secure women among all race/ethnicity groups; while similar proportions of white, black, and Hispanic men were overweight/obese irrespective of their food security status. In covariate-adjusted models, food insecurity was associated with a 41% and 29% higher odds of being overweight/obese among white and Hispanic women, respectively. Food insecurity was not related to overweight/obesity among black women nor among white, black, and Hispanic men. The complex relationship between food insecurity and obesity suggests a need to investigate potential behavioral and physiological mechanisms, and moderators of this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

Global differences between women and men in the prevalence of obesity: is there an association with gender inequality?

PubMed

Garawi, F; Devries, K; Thorogood, N; Uauy, R

2014-10-01

In most populations the prevalence of obesity is greater in women than in men; however, the magnitude of the difference between the sexes varies significantly by country. We considered the role of gender inequality in explaining these disparities. We undertook an ecological analysis of internationally comparable obesity prevalence data to examine the association between indicators of gender inequality and the differences between men and women in obesity prevalence. Gender inequality was assessed using three measures: the Gender Inequality Index, the Global Gender Gap Index and the Social Institutions and Gender Index. We fitted multiple regression models to examine the association. We found that the prevalence of obesity across countries shows gendered patterning with greater prevalence and greater heterogeneity in women than in men (P<0.001). We also found that two of three measures of gender inequality were significantly associated with the sex differences in obesity prevalence across countries. The patterning of obesity across countries is gendered. However, the association between global measures of gender inequality and the sex gap in obesity is dependent on the measure used. Further research is needed to investigate the mechanisms that underpin the gendered nature of obesity prevalence.

Antepartum Care of Women Who Are Obese During Pregnancy: Systematic Review of the Current Evidence.

PubMed

Carlson, Nicole S; Leslie, Sharon Lynn; Dunn, Alexis

2018-05-14

Nearly 40% of US women of childbearing age are obese. Obesity during pregnancy is associated with multiple risks for both the woman and fetus, yet clinicians often feel unprepared to provide optimal antepartum care for this group of women. We collected and reviewed current evidence concerning antepartum care of women who are obese during pregnancy. We conducted a systematic review using PRISMA guidelines. Current evidence relating to the pregnancy care of women with a prepregnancy body mass index of 30kg/m 2 or higher was identified using MEDLINE databases via PubMed, Embase, and Web of Science Core Collection between January 2012 and February 2018. A total of 354 records were located after database searches, of which 63 met inclusion criteria. Topic areas for of included studies were: pregnancy risk and outcomes related to obesity, communication between women and health care providers, gestational weight gain and activity/diet, diabetic disorders, hypertensive disorders, obstructive sleep apnea, mental health, pregnancy imaging and measurement, late antepartum care, and preparation for labor and birth. Midwives and other health care providers can provide better antepartum care to women who are obese during pregnancy by incorporating evidence from the most current clinical investigations. © 2018 by the American College of Nurse-Midwives.

Overweight and obese midlife women in Israel: cultural differences in perceived weight status.

PubMed

Elran-Barak, Roni; Blumstein, Tzvia; Boyko, Valentina; Hadar, Dana; Farhi, Adel; Lerner-Geva, Liat; Benyamini, Yael

2015-10-26

To examine cultural differences in Weight status misperception (WSMP) and identify associations between weight perception and weight control efforts among overweight/obese midlife women in Israel. Data from the nationally representative Women's-Health-in-Midlife-National-Study were used. Participants included overweight (25 ≤ BMI < 30) and obese (BMI ≥ 30) midlife women (45-64 years) from three cultural groups: Long-Term Jewish Residents (LTJR), Immigrants from the former USSR, and Arabs. Interviews included measures of BMI, weight perception, lifestyle, and socio-demographics. Most overweight/obese women (88 %) perceived their weight status correctly. No significant differences were found in overall WSMP rates across cultural groups. Overweight women of Arab origin were significantly more likely (p < 0.001) to perceive their weight as "about right" relative to LTJR and Immigrants. WSMP was associated with several unhealthy eating patterns [eating red meat (OR = 2.1, 95 % CI = 1.13-3.97), white bread (OR = 2.4, 95 % CI = 1.26-4.58)] and with more perceived barriers to exercising (OR = 1.8, 95 % CI = 1.00-3.42). Health care providers are encouraged to pay attention to overweight/obese women who misperceive their weight status. These women are more likely to consume unhealthy foods and to be at higher risks of suffering from medical complications associated with obesity.

Weight and Body Composition Changes During Oral Contraceptive Use in Obese and Normal Weight Women

PubMed Central

Torgal, Anupama H.; Westhoff, Carolyn L.

2014-01-01

Abstract Background: Oral contraceptive (OC) use seems to have little effect on weight change in normal weight women. Most previous studies have excluded obese women, so the effect of OC use on weight change in obese women is unknown. Methods: This analysis evaluates weight and body composition change with OC use among obese (body mass index [BMI] 30.0–39.9) and normal weight (BMI 19.0–24.9) women who were randomly assigned to two OC doses: 20 μg ethinyl estradiol (EE) and 100 μg levonorgestrel (LNG) OCs or 30 μg EE and 150 μg LNG OCs. Follow-up occurred after three to four OC cycles. Weight and body composition were measured at baseline and at follow-up using a bioelectrical impedance analyzer. Results: Among 150 women (54 obese and 96 normal weight) who used OCs for 3 to 4 months, there were no clinically or statistically significant weight or body composition changes in the overall group or by BMI or OC formulation group. Conclusions: These findings add to evidence that EE/LNG OCs are not associated with short term weight or body composition change for normal weight women and suggest that OCs are also are not associated with short term weight or body composition change in obese women. PMID:24156617

Differences in Psychosocial Predictors of Obesity Among LGBT Subgroups.

PubMed

Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

2016-08-01

The purpose of the current study was to examine the overall presence of and differences in rates of overweight/obesity among a large, nationally diverse sample of lesbian, gay, bisexual, transgender (LGBT)-identified individuals (i.e., cisgender lesbians, cisgender gay men, cisgender bisexual women, cisgender bisexual men, transgender women, and transgender men) and to identify specific psychosocial predictors of obesity within each of the six LGBT subgroups. A total of 2702 LGBT-identified participants participated in the online study. Participants completed a series of demographic questions (including weight and height) and the Depression Anxiety Stress Scale 21. The percentage of participants who were overweight/obese did not differ significantly across LGBT subgroups, with 61.1% of the total sample being overweight/obese. However, the percentage of participants who self-reported body mass indexes in the obese range differed significantly across the six LGBT subgroups, with the highest prevalence in transgender men (46.0%). In addition, the predictors of obesity varied by subgroup, with age a significant predictor for cisgender lesbians, cisgender gay men, and cisgender bisexual women, relationship status for cisgender bisexual women, employment status for both cisgender gay men and cisgender bisexual women, education level for cisgender lesbians, and depression, anxiety, and stress for cisgender gay men. None of the examined psychosocial factors emerged as predictors of obesity for cisgender bisexual men, transgender women, or transgender men. These findings suggest that there are substantial variations in the presence and predictors of obesity across LGBT subgroups that support the need for culturally tailored healthy weight promotion efforts within the LGBT community.

Educational differences in obesity in the United States: a closer look at the trends.

PubMed

Yu, Yan

2012-04-01

Both body weight and educational attainment have risen in the United States. Empirical evidence regarding educational differences in obesity (BMI ≥30) is inconsistent. According to some widely cited claims, these differences have declined since the 1970s, and the most educated have experienced the greatest gain in obesity. Prior research was limited in grouping college graduates with nongraduates, combining men and women in the same analysis, and using self-reported rather than measured anthropometric information. Using the National Health and Nutrition Examination Surveys (NHANES), we address these issues and examine changing educational differences in obesity from 1971-1980 to 1999-2006 for non-Hispanic whites and blacks in two separate age groups (25-44 vs. 45-64 years). We find that (i) obesity differentials by education have remained largely stable, (ii) compared with college graduates, less educated whites and younger black women continue to be more likely to be obese, (iii) but the differentials are larger for women than men, and weak or nonexistent among black men and older black women. There are exceptions to the overall trend. The obesity gap has widened between the two groups of college-educated younger women, but disappeared between the least and most educated younger white men. Thus, the increase in obesity was similar for most educational groups, but significantly greater for younger women with some college and smaller for younger white men without a high-school degree. Lumping together the two distinct college groups has biased previous estimates of educational differences in obesity.

Trends of Obesity in Iranian Adults from 1990s to late 2000s; a Systematic Review and Meta-analysis

PubMed Central

Mirzazadeh, Ali; Salimzadeh, Hamideh; Arabi, Minoo; Navadeh, Soodabeh; Hajarizadeh, Behzad; Haghdoost, Ali Akbar

2013-01-01

BACKGROUND Obesity is currently emerging as a global epidemic, affecting 10% of adult population worldwide. The primary objective of the current systematic review is to describe the trend of overall prevalence of obesity in Iranian women and menthrough a meta-analysis. METHODS We searched the medical literature published from 1990 to 2007 in Medline (PubMed), EMBASE database, and the Iranian digital library. All published reports of research projects, papers in relevant congresses, unpublished crude data analysis, proceedings, books and dissertations were reviewed. Data from eligible papers that fulfilled the qualification criteria entered meta-analysis (Random Model). RESULTS Data from 209,166 individuals were analyzed. The overall prevalence of obesity in adults was 18.5% (95%CI: 15.1-21.8), respectively. The prevalence of obesity in men and women was 12.9% (95%CI: 10.9-14.9) and 26.2% (95%CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders; women had almost a constantly higher risk of obesity than men during the recent two decades. CONCLUSION Data from 209,166 individuals were analyzed. The overall prevalence of obesity in adults was 18.5% (95%CI: 15.1-21.8), respectively. The prevalence of obesity in men and women was 12.9% (95%CI: 10.9-14.9) and 26.2% (95%CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders; women had almost a constantly higher risk of obesity than men during the recent two decades. PMID:24829686

Telescoping the origins of obesity to women's bodies: how gender inequalities are being squeezed out of Barker's hypothesis.

PubMed

Warin, Megan; Moore, Vivienne; Zivkovic, Tanya; Davies, Michael

2011-07-01

This paper traces the genealogy of the Barker hypothesis and its intersections with popular representations of scientific discourses about pregnancy and maternal obesity. Drawing on Foucault's genealogical method, this study examines the historical 'descent' of the developmental origins of adult disease and its initial grounding in structural factors of gender inequality and low socioeconomic status. In the more recent reproductive medicine literature, Barker's hypothesis has been used to understand the causes and consequences of foetal over-nutrition and has shifted its focus from social determinants to individual, gendered bodies. The print media has gainfully employed this conceptualization of obesity and, in doing so, placed women, and mothers in particular, as causal agents in the reproduction of obesity across generations. Such a 'common sense' understanding of obesity production and reproduction means that both the scientific literature and the public understanding of science has inadvertently assisted in putting women forward as the transmitters of obesity across generations. This powerful telescoping of the origins of obesity to women's bodies and their appetites is in stark contrast to earlier foci on gender inequalities and changing women's circumstances.

Stress Management-Augmented Behavioral Weight Loss Intervention for African American Women: A Pilot, Randomized Controlled Trial

ERIC Educational Resources Information Center

Cox, Tiffany L.; Krukowski, Rebecca; Love, ShaRhonda J.; Eddings, Kenya; DiCarlo, Marisha; Chang, Jason Y.; Prewitt, T. Elaine; West, Delia Smith

2013-01-01

The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week…

Maternal obesity and congenital heart defects: a population-based study123

PubMed Central

Mills, James L; Troendle, James; Conley, Mary R; Carter, Tonia; Druschel, Charlotte M

2010-01-01

Background: Obesity affects almost one-third of pregnant women and causes many complications, including neural tube defects. It is not clear whether the risk of congenital heart defects, the most common malformations, is also increased. Objective: This study was conducted to determine whether obesity is associated with an increased risk of congenital heart defects. Design: A population-based, nested, case-control study was conducted in infants born with congenital heart defects and unaffected controls from the cohort of all births (n = 1,536,828) between 1993 and 2003 in New York State, excluding New York City. The type of congenital heart defect, maternal body mass index (BMI; in kg/m2), and other risk factors were obtained from the Congenital Malformations Registry and vital records. Mothers of 7392 congenital heart defect cases and 56,304 unaffected controls were studied. Results: All obese women (BMI ≥ 30) were significantly more likely than normal-weight women (BMI: 19–24.9) to have children with a congenital heart defect [odds ratio (OR): 1.15; 95% CI: 1.07, 1.23; P < 0.0001]. Overweight women were not at increased risk (OR: 1.00; 95% CI: 0.94, 1.06). The risk in morbidly obese women (BMI ≥ 40) was higher (OR: 1.33; 95% CI: 1.15, 1.54; P = 0.0001) than that in obese women with a BMI of 30–39.9 (OR: 1.11; 95% CI: 1.04, 1.20; P = 0.004). There was a highly significant trend of increasing OR for congenital heart defects with increasing maternal obesity (P < 0.0001). The offspring of obese women had significantly higher ORs for atrial septal defects, hypoplastic left heart syndrome, aortic stenosis, pulmonic stenosis, and tetralogy of Fallot. Conclusions: Obese, but not overweight, women are at significantly increased risk of bearing children with a range of congenital heart defects, and the risk increases with increasing BMI. Weight reduction as a way to reduce risk should be investigated. PMID:20375192

The overlap of overweight and anaemia among women in three countries undergoing the nutrition transition.

PubMed

Eckhardt, C L; Torheim, L E; Monterrubio, E; Barquera, S; Ruel, M T

2008-02-01

To compare the odds of anaemia in overweight and obese (OVWT) (body mass index (BMI) > or =25) versus non-overweight (non-OVWT) (BMI<25) women in three countries at different stages of the nutrition transition. Analysis of cross-sectional data. Nationally representative data from Mexico (1998 National Nutrition Survey), Peru and Egypt (2000 Demographic and Health Surveys) were analyzed. Data from non-pregnant women ages 18-49 years were used. Logistic regression was used to test whether the odds of anaemia differed by BMI category, controlling for sociodemographic factors. More than half of the women were OVWT in all three countries and the prevalence of OVWT reached 77% in Egypt. Anaemia prevalence was similar across countries (28, 31 and 23% in Egypt, Peru and Mexico respectively). In Egypt, OVWT women had significantly lower odds of anaemia than non-OVWT women (OR=0.78, 95% CI: 0.68, 0.90). Similar results were found in Peru, but the difference was smaller in magnitude (OR=0.83, 95% CI: 0.71, 0.96). In Mexico, there were no differences in the odds of anaemia by BMI group. These findings show that the iron needs of OVWT women in developing countries are not necessarily being met. The intakes of other micronutrients might also be insufficient. Diet quality remains an important issue even among women with sufficient energy intakes.

Iron status in obese women.

PubMed

Stankowiak-Kulpa, Hanna; Kargulewicz, Angelika; Styszyński, Arkadiusz; Swora-Cwynar, Ewelina; Grzymisławski, Marian

2017-12-23

A decreased concentration of iron, and consecutively haemoglobin, ferritin and decreased level of saturated transferrin, were observed in obese individuals more often than in healthy subjects. The purpose of this study was to determine whether iron, ferritin, transferrin saturation are significantly diminished in obese female patients compared to non-obese counterparts, and whether excess adiposity and inflammation were associated with depleted iron. Female patients (n=48) diagnosed with obesity (BMI > 30 kg/m²), aged 18-40 were accepted for the study. A control group (n=30) encompassed normal weight women, aged 18-30. All obese women obtained an individually adjusted dietary plan with an energy content of 1,500 kcal. Blood glucose, insulin, lipids, ferritin, TIBC and iron concentrations were assayed in serum twice, initially and after 8 weeks of dieting. The obese women at the initial evaluation, in comparison to non-obese control women, were characterized by a significantly lower mean red blood cell volume (MCV; 84.2±12.4 vs. 91.3±9.3 fL; p<0.0001), serum iron level (92.6±42.4 vs. 119.8±44.0 μg/dL; p<0.01), and transferrin saturation (TSAT; 25.9±12.7 vs. 38.8±15.7%; p<0.01), but by higher plasma level of the C-reactive protein (CRP; 7.0±6.7 vs. 1.2±1.3 mg/L; p<0.01). The obese women after 8 weeks of diet decreased their mean total body weight from 104.1±21.3 to 99.2±20.7 kg (p<0.0001). CRP level decreased slightly but significantly from 6.9±7.1 to 6.2±7.5 (p<0.05). Obese women exhibit an increased level of CRP which may affect iron homeostasis. Weight loss leads to decrease in the CRP level, but it does not change haematologic parameters in the period of 8 weeks.

Effect of dietary macronutrients on postprandial incretin hormone release and satiety in obese and normal-weight women.

PubMed

Wikarek, Tomasz; Chudek, Jerzy; Owczarek, Aleksander; Olszanecka-Glinianowicz, Magdalena

2014-01-28

The aim of the present study was to assess the effect of dietary macronutrients on postprandial incretin responses and satiety and hunger sensation in obese and normal-weight women. A total of eleven obese and nine normal-weight women were recruited for the assessment of plasma concentrations of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and insulin and the sensation of satiety and hunger using a visual analogue scale before and during a 6 h period after administration of three different macronutrient test meals. The AUCtotal GLP-1 and AUCtotal GIP values were decreased in obese women after the consumption of a fatty meal and all the test meals, respectively. However, the AUCtotal insulin value after a carbohydrate meal was greater in the obese group. The AUCtotal satiety value was decreased only after the intake of the protein meal in obese women when compared with normal-weight women. After the consumption of the fatty meal, a significant positive correlation between maximum satiety sensation and the AUCtotal GLP-1 value in the obese group and that between minimum hunger sensation and the AUCtotal GLP-1 value in the normal-weight group were observed. In conclusion, the findings of the present study suggest that: (1) satiety sensation after consumption of carbohydrate and protein meals in the obese group is related to the postprandial insulin response, while after consumption of a fatty meal, it is related to the postprandial GLP-1 release; (2) the postprandial GIP response does not influence the sensation of satiety and hunger; (3) the reduced GLP-1 release after the intake of a fatty meal in obese individuals may explain impaired satiety sensation; (4) the impaired postprandial GIP response is not related to the consumption of macronutrients and may be the early indicator of incretin axis dysfunction in obese women.

Associations of menstrual cycle irregularities with age, obesity and phenotype in patients with polycystic ovary syndrome.

PubMed

Panidis, Dimitrios; Tziomalos, Konstantinos; Papadakis, Efstathios; Chatzis, Panagiotis; Kandaraki, Eleni A; Tsourdi, Elena A; Macut, Djuro; Bjekic-Macut, Jelica; Marthopoulos, Apostolos; Katsikis, Ilias

2015-01-01

Limited data suggest that menstrual cycle abnormalities are more pronounced in younger and more obese patients with polycystic ovary syndrome (PCOS). We aimed to evaluate the association between menstrual cycle pattern and age, obesity and PCOS phenotype in a large population of women with PCOS. We studied 1,297 women with PCOS and divided them according to: a) age in ≤ 20, 21-30 and > 30 years old, b) body mass index in normal weight, overweight and obese and c) PCOS phenotype in phenotype 1 (anovulation, hyperandrogenemia and polycystic ovaries), 2 (anovulation and hyperandrogenemia without polycystic ovaries), 3 (hyperandrogenemia and polycystic ovaries without anovulation) and 4 (anovulation and polycystic ovaries without hyperandrogenemia). The proportion of women with regular menstrual cycles progressively increased in the older age groups, being 8.1, 10.5 and 12.7% in women ≤ 20, 21-30 and > 30 years old, respectively (p = 0.037). The proportion of women with regular menstrual cycles did not differ between normal weight and obese women but was higher in overweight women (9.3, 9.4 and 13%, respectively; p = 0.020). The proportion of women with regular cycles alternating with irregular cycles was highest in women with phenotype 4, intermediate in women with phenotype 2 and lowest in women with phenotype 1 (74.3, 69.4 and 61.7%, respectively; p = 0.027). Menstrual cycle pattern is more irregular in women with the "classic" PCOS phenotypes than in phenotype 4 but appears to normalize with ageing. On the other hand, obesity does not appear to have an important effect on menstrual cycle pattern in PCOS.

Higher Rate of Iron Deficiency in Obese Pregnant Sudanese Women

PubMed Central

Abbas, Wisal; Adam, Ishag; Rayis, Duria A.; Hassan, Nada G.; Lutfi, Mohamed F.

2017-01-01

AIM: To assess the association between obesity and iron deficiency (ID). MATERIAL AND METHODS: Pregnant women were recruited from Saad Abualila Hospital, Khartoum, Sudan, during January–April 2015. Medical history (age, parity, gestational age) was gathered using questionnaire. Weight and height were measured, and body mass index (BMI) was calculated. Women were sub-grouped based on BMI into underweight (< 18.5 kg/m^2), normal weight (18.5–24.9 kg/m^2), overweight (25–29.9 kg/m^2) and obese (≥ 30 kg/m^2). Serum ferritin and red blood indices were measured in all studied women. RESULTS: Two (0.5%), 126 (29.8%), 224 (53.0%) and 71 (16.8%) out of the 423 women were underweight, normal weight, overweight and obese, respectively. Anemia (Hb <11 g/dl), ID (ferritin <15µg/l) and iron deficiency anemia (IDA) were prevalent in 57.7%, 21.3% and 12.1%, respectively. Compared with the women with normal BMI, significantly fewer obese women were anemic [25 (35.2%) vs. 108 (85.7%), P < 0.001] and significantly higher number of obese women [25 (35.2) vs. 22 (17.5, P = 0.015] had iron deficiency. Linear regression analysis demonstrated a significant negative association between serum ferritin and BMI (– 0.010 µg/, P= 0.006). CONCLUSION: It is evident from the current findings that prevalence of anaemia and ID showed different trends about BMI of pregnant women PMID:28698743

Suppressed cytokine production in whole blood cultures is related to iron status and is partially corrected following weight reduction in morbidly obese pre-menopausal women

USDA-ARS?s Scientific Manuscript database

Assess ex vivo whole-blood cytokine production and its association with iron status in obese versus non-obese women. Determine the change in ex vivo whole-blood cytokine production six months after restrictive bariatric surgery in the obese group. Subjects were 17 obese (BMI: 46.6 ±7.9 kg/m2) and 1...

Effects of the weight management program based self-efficacy for body composition, blood lipid profile, weight self-efficacy lifestyles, depression in middle-aged obese women.

PubMed

Park, Nam Hee; An, Hye Gyung

2006-12-01

This study was done to determine the effects of weight management program using self-efficacy in middle-aged obese women. The study also attempted to measure the effects of the program on the weight efficacy lifestyle, body composition, and depression. The research design of this study was a nonequivalent control group pretest-posttest design. The experimental group consisted of 21 middle-aged obese women and another 21 middle-aged obese women in the control group. The women in the experimental group participated in the weight management program for 12 weeks using self-efficacy. The weight management program using self-efficacy included education on effects of exercise for weight control, aerobic exercise program, muscle training and counseling through the telephone. After 12 weeks of participation in the program, BMI (p<.0001), body fat % (p<.0001), abdominal fat (p<.0001), in the experimental group were significantly decreased compared to the control group. Weight self-efficacy lifestyle (p<.0001) and depression (p=.006) in the experimental group were significantly improved after the program compared to the control group. According to these findings, weight management program self-efficacy for middle-aged obese women could increase weight efficacy lifestyle, and decrease depression, BMI, body fat, and abdominal fat. The result also suggested that the increasing weight efficacy and lifestyle help the obese women to perform and continue exercise. This program could be used in the community such as public health center for weight care and mental health promotion of middle-aged obese women.

Obesity-associated Breast Cancer: Analysis of risk factors.

PubMed

Engin, Atilla

2017-01-01

Several studies show that a significantly stronger association is obvious between increased body mass index (BMI) and higher breast cancer incidence. Furthermore, obese women are at higher risk of all-cause and breast cancer specific mortality when compared to non-obese women with breast cancer. In this context, increased levels of estrogens due to excessive aromatization activity of the adipose tissue, overexpression of pro-inflammatory cytokines, insulin resistance, hyperactivation of insulin-like growth factors (IGFs) pathways, adipocyte-derived adipokines, hypercholesterolemia and excessive oxidative stress contribute to the development of breast cancer in obese women. While higher breast cancer risk with hormone replacement therapy is particularly evident among lean women, in postmenopausal women who are not taking exogenous hormones, general obesity is a significant predictor for breast cancer. Moreover, increased plasma cholesterol leads to accelerated tumor formation and exacerbates their aggressiveness. In contrast to postmenopausal women, premenopausal women with high BMI are inversely associated with breast cancer risk. Nevertheless, life-style of women for breast cancer risk is regulated by avoiding the overweight and a high-fat diet. Estrogen-plus-progestin hormone therapy users for more than 5 years have elevated risks of both invasive ductal and lobular breast cancer. Additionally, these cases are more commonly node-positive and have a higher cancer-related mortality. Collectively, in this chapter, the impacts of obesity-related estrogen, cholesterol, saturated fatty acid, leptin and adiponectin concentrations, aromatase activity, leptin and insulin resistance on breast cancer patients are evaluated. Obesity-related prognostic factors of breast cancer also are discussed at molecular basis.

The relationship of food insecurity and overweight/obesity differs by birthplace and length of US residence

PubMed Central

Ryan-Ibarra, Suzanne; Sanchez-Vaznaugh, Emma V; Leung, Cindy; Induni, Marta

2017-01-01

Objective To examine whether the cross-sectional association between food insecurity and overweight/obesity varied according to birthplace and length of residence in the US among California women. Design Using cross-sectional, population-based data from the California Women’s Health Survey (CWHS) 2009–2012, we examined whether the association between food insecurity and overweight or obesity varied by birthplace-US length of residence. Setting California, US Subjects Women (n=16,259) 18 years and older Results Among US-born women, very low food security (PR 1.21, 95% CI 1.11–1.31) and low food security (PR 1.19, 95% CI 1.10–1.28) were significantly associated with higher prevalence of overweight/obesity, after controlling for age, marital status, race/ethnicity, poverty, and education. Among immigrant women who lived in the US for 10 years or longer, very low food security was significantly associated with higher prevalence of overweight/obesity, after controlling for covariates (PR 1.16, 95% CI 1.07–1.27). Among immigrant women who had lived in the US for less than 10 years, low and very low food security were not significantly associated with obesity, after controlling for covariates. Conclusions Food insecurity may be an important pathway through which weight may increase with longer US residence among immigrant women. Public health programs and policies should focus on increasing food security for all women, including immigrant women, as one strategy to reduce the prevalence of overweight/obesity. PMID:27890021

Obesity-related metabolite profiles of black women spanning the epidemiologic transition.

PubMed

Dugas, Lara R; Chorell, Elin; Plange-Rhule, Jacob; Lambert, Estelle V; Cao, Guichan; Cooper, Richard S; Layden, Brian T; Scholten, Denise; Olsson, Tommy; Luke, Amy; Goedecke, Julia H

2016-03-01

In developed countries, specific metabolites have been associated with obesity and metabolic diseases, e.g. type 2 diabetes. It is unknown whether a similar profile persists across populations of African-origin, at increased risk for obesity and related diseases. In a cross-sectional study of normal-weight and obese black women (33.3 ± 6.3 years) from the US ( N = 69, 65 % obese), South Africa (SA, N = 97, 49 % obese) and Ghana ( N = 82, 33 % obese) serum metabolite profiles were characterized via gas chromatography-time of flight/mass spectrometry. In US and SA women, BMI correlated with branched-chain and aromatic amino acids, as well as dopamine and aminoadipic acid. The relationship between BMI and lipid metabolites differed by site; BMI correlated positively with palmitoleic acid (16:1) in the US; negatively with stearic acid (18:0) in SA, and positively with arachidonic acid (20:4) in Ghana. BMI was also positively associated with sugar-related metabolites in the US; i.e. uric acid, and mannitol, and with glucosamine, glucoronic acid and mannitol in SA. While we identified a common amino acid metabolite profile associated with obesity in black women from the US and SA, we also found site-specific obesity-related metabolites suggesting that the local environment is a key moderator of obesity.

Obesity-related metabolite profiles of black women spanning the epidemiologic transition

PubMed Central

Plange-Rhule, Jacob; Lambert, Estelle V.; Cao, Guichan; Cooper, Richard S.; Layden, Brian T.; Scholten, Denise; Olsson, Tommy; Luke, Amy; Goedecke, Julia H.

2016-01-01

In developed countries, specific metabolites have been associated with obesity and metabolic diseases, e.g. type 2 diabetes. It is unknown whether a similar profile persists across populations of African-origin, at increased risk for obesity and related diseases. In a cross-sectional study of normal-weight and obese black women (33.3 ± 6.3 years) from the US (N = 69, 65 % obese), South Africa (SA, N = 97, 49 % obese) and Ghana (N = 82, 33 % obese) serum metabolite profiles were characterized via gas chromatography-time of flight/mass spectrometry. In US and SA women, BMI correlated with branched-chain and aromatic amino acids, as well as dopamine and aminoadipic acid. The relationship between BMI and lipid metabolites differed by site; BMI correlated positively with palmitoleic acid (16:1) in the US; negatively with stearic acid (18:0) in SA, and positively with arachidonic acid (20:4) in Ghana. BMI was also positively associated with sugar-related metabolites in the US; i.e. uric acid, and mannitol, and with glucosamine, glucoronic acid and mannitol in SA. While we identified a common amino acid metabolite profile associated with obesity in black women from the US and SA, we also found site-specific obesity-related metabolites suggesting that the local environment is a key moderator of obesity. PMID:27346989

The role of obesity in the development of polycystic ovary syndrome.

PubMed

Motta, Alicia Beatriz

2012-01-01

Polycystic Ovary Syndrome (PCOS) is one of the common endocrine diseases that affects women in their reproductive age. PCOS has diverse clinical implications that include reproductive (infertility, hyperandrogenism, hirsutism), metabolic (insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, cardiovascular diseases) and psychological features (increased anxiety, depression and worsened quality of life). The exact patho-physiology of PCOS is complex and remains largely unclear. The prevalence of PCOS is estimated at 4-18%, depending on diverse factors discussed ahead. The phenotype varies widely depending on life stage, genotype, ethnicity and environmental factors including lifestyle and body weight. During the last decades, obesity and excess weight are major chronic diseases all around the word. Obesity increases some features of PCOS such as hyperandrogenism, hirsutism, infertility and pregnancy complications. Both obesity and insulin resistance increase diabetes mellitus type 2 and cardiovascular diseases. Moreover, obesity impairs insulin resistance and exacerbates reproductive and metabolic features of PCOS. It is well known that obesity is associated with anovulation, pregnancy loss and late pregnancy complications (pre-eclampsia, gestational diabetes). Obesity in PCOS is also linked to failure or delayed response to the various treatments including clomiphene citrate, gonadotropins and laparoscopic ovarian diathermy. It has been reported that, after losing as little as 5 % of initial body weight obese women with PCOS improved spontaneous ovulation rates and spontaneous pregnancy. Therefore, the weight loss prior to conception improves live birth rate in obese women with or without PCOS. The treatment of obesity may include lifestyle therapy (diet and exercise), pharmacological treatment and bariatric surgery. In summary, weight loss is considered the first-line therapy in obese women with PCOS. In the present review, the consequence and treatment of obesity in women with PCOS are discussed.

Prevalence, Distributions and Determinants of Obesity and Central Obesity in the Southern Cone of America

PubMed Central

Bazzano, Lydia; Rubinstein, Adolfo; Calandrelli, Matias; Chen, Chung-Shiuan; Elorriaga, Natalia; Gutierrez, Laura; Manfredi, Jose A.; Seron, Pamela; Mores, Nora; Poggio, Rosana; Ponzo, Jacqueline; Olivera, Hector; He, Jiang; Irazola, Vilma E.

2016-01-01

Background Obesity is a major determinant of cardiovascular disease in South America. However, population-based data are limited. Methods A total of 7,524 women and men, aged 35 to 74 years old, were randomly selected from 4 cities in the Southern Cone of Latin America between February 2010 and December 2011. Obesity clinical measurements and cardiovascular risk factors were measured using standard methodology. Results The prevalence of obesity and central obesity were 35.7% and 52.9%, respectively. The prevalence of obesity and central obesity were higher in women, and even higher in women with lower education compared with women with higher education. In men and women obesity was associated with a higher prevalence of diabetes, odds ratio (OR) 2.38 (95% Confidence Interval [CI]: 1.86 to 3.05) and 3.01 (95%CI 2.42 to 3.74) respectively, hypertension (OR 2.79 (95%CI 2.32 to 3.36) and 2.40 (95%CI 2.05 to 2.80) respectively, dyslipidemia (OR 1.83 (95%CI 1.50 to 2.24) and 1.69 (95%CI 1.45 to 1.98), respectively, low physical activity (OR 1.38(95%CI 1.14 to 1.68) and 1.38 (95%CI 1.18 to 1.62) respectively and a lower prevalence of smoking (OR, 0.65 (95%CI 0.53 to 0.80) and 0.58(95%CI 0.48 to 0.70) respectively. Conclusions Obesity and central obesity are highly prevalent in the general population in the Southern Cone of Latin America and are strongly associated with cardiovascular risk factor prevalence. These data suggest that efforts toward prevention, treatment, and control of obesity should be a public health priority in the Southern Cone of Latin America. PMID:27741247

Prevalence, Distributions and Determinants of Obesity and Central Obesity in the Southern Cone of America.

PubMed

Lanas, Fernando; Bazzano, Lydia; Rubinstein, Adolfo; Calandrelli, Matias; Chen, Chung-Shiuan; Elorriaga, Natalia; Gutierrez, Laura; Manfredi, Jose A; Seron, Pamela; Mores, Nora; Poggio, Rosana; Ponzo, Jacqueline; Olivera, Hector; He, Jiang; Irazola, Vilma E

2016-01-01

Obesity is a major determinant of cardiovascular disease in South America. However, population-based data are limited. A total of 7,524 women and men, aged 35 to 74 years old, were randomly selected from 4 cities in the Southern Cone of Latin America between February 2010 and December 2011. Obesity clinical measurements and cardiovascular risk factors were measured using standard methodology. The prevalence of obesity and central obesity were 35.7% and 52.9%, respectively. The prevalence of obesity and central obesity were higher in women, and even higher in women with lower education compared with women with higher education. In men and women obesity was associated with a higher prevalence of diabetes, odds ratio (OR) 2.38 (95% Confidence Interval [CI]: 1.86 to 3.05) and 3.01 (95%CI 2.42 to 3.74) respectively, hypertension (OR 2.79 (95%CI 2.32 to 3.36) and 2.40 (95%CI 2.05 to 2.80) respectively, dyslipidemia (OR 1.83 (95%CI 1.50 to 2.24) and 1.69 (95%CI 1.45 to 1.98), respectively, low physical activity (OR 1.38(95%CI 1.14 to 1.68) and 1.38 (95%CI 1.18 to 1.62) respectively and a lower prevalence of smoking (OR, 0.65 (95%CI 0.53 to 0.80) and 0.58(95%CI 0.48 to 0.70) respectively. Obesity and central obesity are highly prevalent in the general population in the Southern Cone of Latin America and are strongly associated with cardiovascular risk factor prevalence. These data suggest that efforts toward prevention, treatment, and control of obesity should be a public health priority in the Southern Cone of Latin America.

Estimating Disability Prevalence Among Adults by Body Mass Index: 2003–2009 National Health Interview Survey

PubMed Central

Courtney-Long, Elizabeth; Campbell, Vincent A.; Wethington, Holly R.

2012-01-01

Introduction Obesity is associated with adverse health outcomes in people with and without disabilities; however, little is known about disability prevalence among people who are obese. The purpose of this study was to determine the prevalence and type of disability among obese adults in the United States. Methods We analyzed pooled data from sample adult modules of the 2003–2009 National Health Interview Survey (NHIS) to obtain national prevalence estimates of disability, disability type, and obesity by using 30 questions that screened for activity limitations, vision and hearing impairment, and cognitive, movement, and emotional difficulties. We stratified disability prevalence by category of body mass index (BMI, measured as kg/m2): underweight, less than 18.5; normal weight, 18.5 to 24.9; overweight, 25.0 to 29.9; and obese, 30.0 or higher. Results Among the 25.3% of adult men and 24.6% of women in our pooled sample who were obese, 35.2% and 46.9%, respectively, reported a disability. In contrast, 26.7% of men and 26.8% women of normal weight reported a disability. Disability was much higher among obese women than among obese men (46.9% vs 35.2%, P < .001). Movement difficulties were the most common disabilities among obese men and women, affecting 25.3% of men and 37.9% of women. Conclusion This research contributes to the literature on obesity by including disability as a demographic in characterizing people by body mass index. Because of the high prevalence of disability among those who are obese, public health programs should consider the needs of those with disabilities when designing obesity prevention and treatment programs. PMID:23270667

Dietary patterns and their associations with general obesity and abdominal obesity among young Chinese women.

PubMed

Zhang, J G; Wang, Z H; Wang, H J; Du, W W; Su, C; Zhang, J; Jiang, H R; Zhai, F Y; Zhang, B

2015-09-01

Dietary patterns represent the combined effects of foods and efficaciously illustrate the impact of diet on health outcomes. This study identified the dietary patterns and determined their relationships with obesity among young Chinese women. In 2011, the China Health and Nutrition Survey included 2363 young women aged 18-44 years. Factor analysis of data from three consecutive 24-h dietary recalls identified the dietary patterns. Weight, height and waist circumstance (WC) were measured, and body mass index (BMI) was calculated. General obesity was defined as BMI ⩾28 kg/m(2) and abdominal obesity as WC ⩾85 cm. Four dietary patterns were identified: traditional south; traditional north; snack; and high protein. After adjusting for confounders and energy intake, women in the highest-score quintiles of the traditional south pattern were less likely to have general obesity (odds ratio (OR)=0.48; 95% confidence interval (CI) 0.29-0.78) and abdominal obesity (OR=0.64; 95% CI 0.46-0.90). Subjects in the highest-score quintiles of the traditional north pattern had significantly greater risk of general obesity (OR=2.28; 95% CI 1.38-3.74) and of abdominal obesity (OR=2.32; 95% CI 1.66-3.24). The traditional south pattern of rice as the major staple food with pork and vegetable dishes is associated with lower risk of general and abdominal obesity. The traditional north pattern of high intake of wheat, other cereals and tubers is positively associated with general and abdominal obesity. This provides important information for interventions and policies addressing obesity prevention among young Chinese women.

The relationship between child abuse and adult obesity among california women.

PubMed

Alvarez, Jennifer; Pavao, Joanne; Baumrind, Nikki; Kimerling, Rachel

2007-07-01

Despite clinical studies suggesting that child abuse is associated with adult obesity, very few studies have been conducted with large community or state-based samples. This study examines the relationship between child abuse and adult obesity, relative to other risk factors such as demographics, food insecurity, inadequate fruit and vegetable consumption, and physical inactivity, in a representative sample of California women. Data are from the California Women's Health Survey, a state-based, random-digit-dial annual probability survey of California women. Participants included 11,115 nonpregnant women aged 18 or older, who provided complete data for all study variables. The telephone interview included assessment of child abuse (abstracted from the Traumatic Stress Schedule), food insecurity, perceived stress, physical activity, fruit and vegetable consumption, height, and weight. Data were collected in 2002, 2003, and 2004, and analyzed in 2006. Obese (body mass index [BMI] of 30 or higher) women were significantly more likely to report exposure to child abuse (odds ratio [OR]=1.32, 95% confidence interval [CI]=1.23-1.42). In a multivariate model adjusted for age, race/ethnicity, education, food insecurity, inadequate fruit and vegetable consumption, physical inactivity, and perceived stress, women exposed to child abuse remained significantly more likely to be obese than unexposed women (adjusted OR=1.27, 95% CI=1.13-1.40). The population-attributable fraction of obesity associated with any type of abuse was 4.5% (95% CI=2.28-6.55). Exposure to child abuse is associated with adult obesity among California women, even accounting for other relevant variables. This supports the notion that child abuse and its sequelae may be important targets for public health intervention, particularly in subpopulations where the prevalence of child abuse is known to be high.

Developing a complex intervention for diet and activity behaviour change in obese pregnant women (the UPBEAT trial); assessment of behavioural change and process evaluation in a pilot randomised controlled trial.

PubMed

Poston, Lucilla; Briley, Annette L; Barr, Suzanne; Bell, Ruth; Croker, Helen; Coxon, Kirstie; Essex, Holly N; Hunt, Claire; Hayes, Louise; Howard, Louise M; Khazaezadeh, Nina; Kinnunen, Tarja; Nelson, Scott M; Oteng-Ntim, Eugene; Robson, Stephen C; Sattar, Naveed; Seed, Paul T; Wardle, Jane; Sanders, Thomas A B; Sandall, Jane

2013-07-15

Complex interventions in obese pregnant women should be theoretically based, feasible and shown to demonstrate anticipated behavioural change prior to inception of large randomised controlled trials (RCTs). The aim was to determine if a) a complex intervention in obese pregnant women leads to anticipated changes in diet and physical activity behaviours, and b) to refine the intervention protocol through process evaluation of intervention fidelity. We undertook a pilot RCT of a complex intervention in obese pregnant women, comparing routine antenatal care with an intervention to reduce dietary glycaemic load and saturated fat intake, and increase physical activity. Subjects included 183 obese pregnant women (mean BMI 36.3 kg/m2). Compared to women in the control arm, women in the intervention arm had a significant reduction in dietary glycaemic load (33 points, 95% CI -47 to -20), (p < 0.001) and saturated fat intake (-1.6% energy, 95% CI -2.8 to -0. 3) at 28 weeks' gestation. Objectively measured physical activity did not change. Physical discomfort and sustained barriers to physical activity were common at 28 weeks' gestation. Process evaluation identified barriers to recruitment, group attendance and compliance, leading to modification of intervention delivery. This pilot trial of a complex intervention in obese pregnant women suggests greater potential for change in dietary intake than for change in physical activity, and through process evaluation illustrates the considerable advantage of performing an exploratory trial of a complex intervention in obese pregnant women before undertaking a large RCT. ISRCTN89971375.

Prevalence and predictors of osteopenia and osteoporosis in postmenopausal Chinese women with type 2 diabetes.

PubMed

Zhou, Yijun; Li, Yan; Zhang, Dan; Wang, Jiahe; Yang, Hongwu

2010-12-01

To determine the prevalence and biochemical/hormonal determinants of osteopenia/osteoporosis in postmenopausal Chinese women with type 2 diabetes. This cross-sectional study was carried out in 890 postmenopausal women with type 2 diabetes and 689 age-matched non-diabetic women. Of the total subjects included in both groups were classified as obese (BMI ≥ 25 kg/m²) and non-obese (BMI< 25 kg/m²). Bone mineral density (BMD) at the sites (lumbar spine, femoral neck, and hip), obtained by dual X-ray absorptiometry and some other relevant clinical and laboratory indices of bone mineral metabolism were investigated. The prevalence of osteopenia and that of osteoporosis were evaluated. BMDs, T- and Z-scores at the total hip, femoral neck and ward's triangle were significantly lower in non-obese diabetic women than those in BMI-matched control subjects (P < 0.038). Obese diabetic patients and control subjects had similar BMDs and T- and Z-scores at various skeletal regions. Osteopenia/osteoporosis was more common at the hip and femoral neck in non-obese diabetic women than in obese diabetic women and control subjects (P = 0.026). On multiple linear regression analysis, which was adjusted for the sex hormone concentration, BMI, fasting insulin level, and serum osteocalcin were positively associated with BMDs at the hip and lumbar spine. Age, mean HbA₁(c) levels, and NTx/Cr showed negative correlation (P < 0.0284) with BMD at the lumbar spine and femoral neck. Postmenopausal non-obese women with type 2 diabetes have lower BMD levels and higher osteopenia/osteoporosis rate than BMI-matched control subjects. Impaired bone formation may occur in Chinese postmenopausal women with type 2 diabetes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Caloric restriction and aerobic exercise in sarcopenic and non-sarcopenic obese women: an observational and retrospective study.

PubMed

Barbat-Artigas, Sébastien; Garnier, Sophie; Joffroy, Sandra; Riesco, Éléonor; Sanguignol, Frédéric; Vellas, Bruno; Rolland, Yves; Andrieu, Sandrine; Aubertin-Leheudre, Mylène; Mauriège, Pascale

2016-06-01

Sarcopenic obese (SO) individuals are a unique subset of subjects that combines obesity and sarcopenia. Traditional weight loss programmes including aerobic exercises may worsen their condition by further reducing their lean mass. The objective of this observational and retrospective study was to verify the effect of a mixed weight loss programme combining caloric restriction and exercise on body composition, and lipid-lipoprotein profile of obese women according to their sarcopenic status. One hundred and forty-six obese women (body mass index ≥ 30 kg/m(2) and fat mass ≥ 40%) participated to the 3 week usual and institutionalized weight-reducing programme combining a dietary plan (1400 ± 200 kcal/day) and aerobic exercise (1 h/day, 6 days/week) of a specialized medical institution. The lean body mass index (LMI; lean mass/height(2)) was calculated, and women in the lowest tertile of LMI were considered SO. At baseline, SO women were older, and their body weight and LMI were lower than non-sarcopenic obese (N-SO) women (p < 0.05). N-SO and SO women similarly lost fat mass and improved their lipid-lipoprotein profile (p < 0.05), while differences in LMI between groups persisted at the end of the weight-reducing programme. Indeed, N-SO women lost lean mass (p < 0.05) while SO did not. These findings suggest that a short weight loss programme combining caloric restriction and aerobic exercise may significantly reduce fat mass and improve lipid-lipoprotein profile in obese women, independently of their sarcopenic status. Such programmes may have deleterious effects on lean mass in N-SO subjects, only.

Impact of obesity on perinatal outcomes among asthmatic women

PubMed Central

Thuot, Meggie; Coursol, Marc-André; Nguyen, Sonia; Lacasse-Guay, Vanessa; Beauchesne, Marie-France; Fillion, Anne; Forget, Amélie; Kettani, Fatima-Zohra; Blais, Lucie

2013-01-01

BACKGROUND: Only one study has investigated the combined effect of maternal asthma and obesity on perinatal outcomes; however, it did not consider small-for-gestational age and large-for-gestational age infants. OBJECTIVES: To examine the impact of obesity on perinatal outcomes among asthmatic women. METHODS: A cohort of 1386 pregnancies from asthmatic women was reconstructed using three of Quebec’s administrative databases and a questionnaire. Women were categorized using their prepregnancy body mass index. Underweight, overweight and obese women were compared with normal weight women. The primary outcome was the birth of a small-for-gestational-age infant, defined as a birth weight below the 10th percentile for gestational age and sex. Secondary outcomes were large-for-gestational-age infants (birth weight >90th percentile for gestational age) and preterm birth (<37 weeks’ gestation). Logistic regression models were used to obtain the ORs of having small-for-gestational-age infants, large-for-gestational-age infants and preterm birth as a function of body mass index. RESULTS: The proportions of underweight, normal weight, overweight and obese women were 10.8%, 53.3%, 19.7% and 16.2%, respectively. Obese asthmatic women were not found to be significantly more at risk for giving birth to small-for-gestational-age infants (OR 0.6 [95% CI 0.4 to 1.1]), large-for-gestational-age infants (OR 1.2 [95% CI 0.7 to 2.2]) or having a preterm delivery (OR 0.7 [95% CI 0.4 to 1.3]) than normal-weight asthmatic women. CONCLUSIONS: No significant negative interaction between maternal asthma and obesity on adverse perinatal outcomes was observed. PMID:23951559

Endothelial function in young women with polycystic ovary syndrome (PCOS): Implications of body mass index (BMI) and insulin resistance.

PubMed

El-Kannishy, Ghada; Kamal, Shaheer; Mousa, Amany; Saleh, Omayma; Badrawy, Adel El; Farahaty, Reham El; Shokeir, Tarek

2010-01-01

Evidence regarding endothelial function in both obese and nonobese women with PCOS is contradictory. It is unknown whether obese women with PCOS carry an increased risk related to body mass index (BMI). To identify endothelial function and investigate its relationship to body mass index and insulin resistance in young women with PCOS. Twenty-two obese women with PCOS (BMI 35.2 ± 3.2) as well as fourteen lean women (BMI 22.8 ± 2.1)with PCOS were included in the study. Fasting serum insulin, blood glucose were estimated and HOMA and Quicki index were calculated. All patients were subjected to ultrasound recording of brachial artery diameter at rest and after reactive hyperemia (FMD) for assessment of endothelial function. Ten age matched healthy females with normal BMI were chosen as a control group. There were higher basal insulin levels with lower Quicki index and higher HOMA index in women with PCOS than normal group, but the differences were significant only between obese PCOS subgroup and control. On the other hand, FMD was significantly and equally decreased in both groups of women with PCOS, compared with control subjects (3.7 ± 3.2% in the nonobese subgroup and 3.5 ± 2.8% in the obese one vs. 10.6 ± 4.1% in control subjects, P, 0.001). FMD was not correlated with BMI nor insulin resistance indices. Endothelial dysfunction is already present in young women with PCOS. In this patient group, it cannot be attributed to insulin resistance or obesity. © 2010 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

The Impact of Maternal Obesity and Gestational Weight Gain on Early and Mid-Pregnancy Lipid Profiles

PubMed Central

Scifres, Christina M.; Catov, Janet M.; Simhan, Hyagriv N.

2015-01-01

Objective We evaluated the impact of maternal overweight/obesity and excessive weight gain on maternal serum lipids in the first and second trimester of pregnancy. Design and Methods Prospective data were collected for 225 women. Maternal serum lipids and fatty acids were measured at <13 weeks and between 24–28 weeks. Analyses were stratified by normal weight versus overweight/obese status and excessive vs. non-excessive weight gain. Results Overweight/obese women had higher baseline cholesterol (161.3±29.6 vs 149.4±26.8 mg/dL, p<0.01), LDL (80.0±19.9 vs 72.9 ±18.8 mg/dL, p<0.01) and triglycerides ( 81.7±47.2 vs 69.7±40.3 mg/dL, p=0.05) when compared to normal weight women, while HDL (43.6 ±10.4 47.6±11.5 mg/dL, p<0.01) was lower. However, cholesterol and LDL increased at a higher weekly rate in normal weight women, resulting in higher total cholesterol in normal weight women (184.1±28.1 vs. 176.0 ±32.1 mg/dL, p=0.05) at 24–28 weeks. Excessive weight gain did not affect the rate of change in lipid profiles in either group. Overweight/obese women had higher levels of arachidonic acid at both time points. Conclusions Overweight/obese women have significantly more atherogenic lipid profiles than normal weight women during the period of early pregnancy, delineating one physiologic pathway that could explain differences in pregnancy outcomes between normal weight and overweight/obese women. PMID:23853155

The Gut Microbiome, Obesity, and Weight Control in Women's Reproductive Health.

PubMed

Greathouse, K Leigh; Faucher, Mary Ann; Hastings-Tolsma, Marie

2017-08-01

The microbes residing in the human gut, referred to as the microbiome, are intricately linked to energy homeostasis and subsequently obesity. Integral to the origins of obesity, the microbiome is believed to affect not only health of the human gut but also overall health. This microbiome-obesity association is mediated through the process of energy extraction, metabolism, and cross talk between the brain and the gut microbiome. Host exposures, including diet, that potentially modify genetic predisposition to obesity and affect weight management are reviewed. The higher prevalence of obesity among women and recent evidence linking obesity during pregnancy with offspring health make this topic particularly relevant. Current limitations in microbiome research to address obesity and future advances in this field are described. Applications of this science with respect to applied nursing and overall health care in general are included, with emphasis on the reproductive health of women and their offspring.

Association between obesity and depressive symptoms among U.S. Military active duty service personnel, 2002.

PubMed

Kress, Amii M; Peterson, Michael R; Hartzell, Michael C

2006-03-01

The association between obesity and depression remains equivocal. The purpose of this study was to describe the prevalence and association of obesity and depressive symptoms among military personnel. A cross-sectional analysis was performed using data (N=10,040) from the U.S. Department of Defense (DoD) Survey of Health-Related Behaviors. Prevalence odds ratios were calculated to describe the association between obesity and depressive symptoms. Approximately 10% of active duty men and 4% of active duty women were obese. The prevalence of depressive symptoms ranged from approximately 16% of overweight men to 49% of obese women. Obese men and women and underweight men had increased odds of depressive symptoms as compared with normal-weight individuals. The DoD should emphasize prevention and regular screening for obesity and depressive symptoms to improve readiness and reduce health care costs and disease burden in this cohort.

Anaesthetic management of obese parturients: what is the evidence supporting practice guidelines?

PubMed

Eley, V A; van Zundert, A A J; Lipman, J; Callaway, L K

2016-09-01

Increasing rates of obesity in western populations present management difficulties for clinicians caring for obese pregnant women. Various governing bodies have published clinical guidelines for the care of obese parturients. These guidelines refer to two components of anaesthetic care: anaesthetic consultation in the antenatal period for women with a body mass index (BMI) ≥ 40 kg/m 2 and the provision of early epidural analgesia in labour. These recommendations are based on the increased incidence of obstetric complications and the predicted risks and difficulties in providing anaesthetic care. The concept behind early epidural analgesia is logical-site the epidural early, use it for surgical anaesthesia and avoid general anaesthesia if surgery is required. Experts support this recommendation, but there is weak supporting evidence. It is known that the management of labour epidurals in obese women is complicated and that women with extreme obesity require higher rates of general anaesthesia. Anecdotally, anaesthetists view and apply the early epidural recommendation inconsistently and the acceptability of early epidural analgesia to pregnant women is variable. In this topic review, we critically appraise these two practice recommendations. The elements required for effective implementation in multidisciplinary maternity care are considered. We identify gaps in the current literature and suggest areas for future research. While prospective cohort studies addressing epidural extension ('top-up') in obese parturients would help inform practice, audit of local practice may better answer the question "is early epidural analgesia beneficial to obese women in my practice?".

Obesity and sleepiness in women with fibromyalgia.

PubMed

de Araújo, Tânia Aparecida; Mota, Maria Carliana; Crispim, Cibele Aparecida

2015-02-01

Fibromyalgia (FM) is associated with a number of comorbidities, including chronic widespread pain, fatigue and non-restorative sleep. Evidence has shown that FM is closely associated with overweight and obesity. The objective of the present study was to investigate the relationship between obesity and sleepiness in women with FM. A total of 100 adult female patients with a prior medical diagnosis of FM participated in the study. Body mass, height and waist circumference were measured, and body mass index (BMI) was calculated. The diet quality was evaluated by the Healthy Eating Index. Subjective analyses of daytime sleepiness [Epworth Sleepiness Scale (ESS)] and sleep quality (Pittsburgh Sleep Quality) were performed. An obesity rate of 41 % was found in all women (56.1 % were sleepy and 43.9 % were not, p = 0.04). Obese women showed a greater level of sleepiness when compared with non-obese (10.2 and 7.0, respectively, p = 0.004). Sleepy women showed a greater weight gain after the diagnosis of FM when compared with non-sleepy women (11.7 and 6.4 kg, respectively, p = 0.04). A positive and significant correlation between BMI and sleepiness (r = 0.35, p = 0.02) was also found. In multivariate logistic regression, moderate or severe sleepiness (ESS >12) was associated with obesity (odds ratio 3.44, 95 % CI 1.31-9.01, p = 0.04). These results demonstrate an important association between sleepiness and FM, suggesting that the occurrence of obesity may be involved with sleepiness in these patients.

Obesity and Survival Among Black Women and White Women 35 to 64 Years of Age at Diagnosis With Invasive Breast Cancer

PubMed Central

Lu, Yani; Ma, Huiyan; Malone, Kathleen E.; Norman, Sandra A.; Sullivan-Halley, Jane; Strom, Brian L.; Marchbanks, Polly A.; Spirtas, Robert; Burkman, Ronald T.; Deapen, Dennis; Folger, Suzanne G.; Simon, Michael S.; Press, Michael F.; McDonald, Jill A.; Bernstein, Leslie

2011-01-01

Purpose To evaluate the effect of obesity on survival among black women and white women with invasive breast cancer and to determine whether obesity explains the poorer survival of black women relative to white women. Patients and Methods We observed 4,538 (1,604 black, 2,934 white) women who were 35 to 64 years of age when diagnosed with incident invasive breast cancer between 1994 and 1998. Multivariate Cox regression models were used to examine the effect of body mass index (BMI, in kilograms per square meter) 5 years before diagnosis on risk of death from any cause and from breast cancer. Results During a median of 8.6 years of follow-up, 1,053 women died (519 black, 534 white), 828 as a result of breast cancer (412 black, 416 white). Black women were more likely to die than white women (multivariate-adjusted relative risk [RR], 1.33; 95% CI, 1.16 to 1.53). Compared with women with BMI of 20 to 24.9 kg/m2, those who were obese (BMI ≥ 30 kg/m2) had a greater risk of all-cause mortality (RR, 1.23; 95% CI, 1.04 to 1.47) and breast cancer–specific mortality (RR, 1.20; 95% CI, 0.99 to 1.46). These associations were observed among white women (all-cause RR, 1.54; 95% CI, 1.21 to 1.96; breast cancer RR, 1.46; 95% CI, 1.11 to 1.92), but not among black women (all-cause RR, 1.03; 95% CI, 0.81 to 1.29; breast cancer RR, 1.02; 95% CI, 0.79 to 1.33). Conclusion Obesity may play an important role in mortality among white but not black patients with breast cancer. It is unlikely that differences in obesity distributions between black women and white women account for the poorer survival of black women. PMID:21788570

Interleukin-20 circulating levels in obese women: effect of weight loss.

PubMed

Maiorino, M I; Schisano, B; Di Palo, C; Vietri, M T; Cioffi, M; Giugliano, G; Giugliano, D; Esposito, K

2010-03-01

Obesity is associated with an increased risk of developing atherosclerosis. Interleukin-20 (IL-20) is a pleiotropic cytokine thought to be involved in the onset and progression of atherosclerosis. The aim of this study was to determine whether circulating levels of IL-20 are elevated in obese women and whether they could be affected by a substantial decrease in body weight. Fifty obese and 50 age-matched, normal weight, premenopausal women participated in the study. Obese women entered into a medically supervised weight loss program aimed at reducing body weight to 90% of baseline. We measured anthropometric, glucose and lipid parameters, and IL-20, C-Reactive Protein (CRP) and interleukin-10 (IL-10) circulating levels. Circulating IL-20 and CRP levels were significantly higher in obese than control women (P=0.01), while IL-10 levels were significantly lower; IL-20 levels were positively associated with body weight (r=0.35; P=0.02) and visceral fat (waist-hip ratio; r=0.32; P=0.025). Caloric restriction-induced weight loss (>10% of original weight) over 6 months reduced IL-20 levels from 152 (112/184) to 134 (125/153)pg/ml (median and 25%/75%; P=0.03), and it was positively associated with changes in body mass index and waist-hip ratio. In premenopausal obese women, IL-20 levels are higher than matched normal weight control women, are associated with body weight and waist-hip ratio, and are reduced by weight loss. (c) 2009 Elsevier B.V. All rights reserved.

Adequacy of usual dietary intake and nutritional status among pregnant women in the context of nutrition transition: the DEPOSIT Study.

PubMed

Abu-Saad, Kathleen; Shahar, Danit R; Fraser, Drora; Vardi, Hillel; Friger, Michael; Bolotin, Arkardy; Freedman, Laurence S

2012-11-28

Bedouin Arabs in southern Israel are a traditionally semi-nomadic population undergoing the nutrition transition in a context of urbanisation. The effect of these changes on the nutritional status of pregnant women is unknown. The Dietary Exposures and Pregnancy Outcomes in a Society In Transition (DEPOSIT) study evaluated the adequacy of pregnant Bedouin women's usual dietary intake and their nutritional status. Dietary intake was assessed in a cross-sectional study design using repeat 24 h recall (24HR) questionnaires. The National Cancer Institute method was used to estimate the usual intake of selected nutrients. The Estimated Average Requirement (EAR) was used to evaluate nutrient intake adequacy. Measured weight and height data were used to calculate the participants' BMI. A total of 1109 24HR were obtained from 683 participants, of which 8 % contained no animal-source protein and an additional 43 % contained no haeme-Fe. Animal-source protein intake reached less than half of the EAR for most participants (71 %). Over 90 % had inadequate intakes of Ca, Fe, animal-source Zn, vitamin A and folate. The probability of consuming haeme-source Fe was higher among urban than rural participants (OR 1·68, 95 % CI 1·17, 2·41), and among those with employed v. unemployed husbands (OR 1·81, 95 % CI 1·27, 2·58). Only 14 % reported consuming home-produced animal products. According to pre-pregnancy BMI, 42 % were overweight or obese. The DEPOSIT study findings suggest that Bedouin Arab women are in need of interventions that address the co-existing problems of inadequate nutrient intakes and increased risk of obesity.

Bidirectional Association between Depression and Obesity in Middle-aged and Older Women

PubMed Central

Pan, An; Sun, Qi; Czernichow, Sébastien; Kivimaki, Mika; Okereke, Olivia I.; Lucas, Michel; Manson, JoAnn E.; Ascherio, Alberto; Hu, Frank B.

2011-01-01

Objective Although it has been hypothesized that the depression-obesity relation is bidirectional, few studies have addressed this hypothesis in a prospective setting. We aimed to examine the bidirectional relationship in middle-aged and elderly women. Subjects A total of 65,955 women aged 54–79 years in the Nurses’ Health Study were prospective followed from 1996 to 2006 with updated information on body weight, depression status and various covariates every two years. Depression was defined as self-report of physician-diagnosed depression and/or antidepressant use. Obesity was defined as a body mass index ≥30.0 kg/m2. The first three waves (1996–2000) were used as the baseline period, and the last three waves (2002–2006) were used as the follow-up period. Results After adjusting for baseline age, physical activity, comorbidities, body mass index (BMI) and other covariates, depression at the baseline period was associated with an increased risk of obesity at the follow-up period in all women (multivariate-adjusted odds ratio [OR], 1.38; 95% CI, 1.24–1.53) and baseline non-obese women (OR, 1.51; 95% CI, 1.36–1.67). In the opposite direction, after adjusting for baseline age, physical activity, comorbidities, depression status and other covariates, obese women at baseline had a moderately increased risk of depression at the follow-up period compared with normal weight women (OR, 1.11; 95% CI, 1.03–1.18); and this association was similar for new onset of depression (OR for obese vs. normal weight women, 1.10; 95% CI, 1.02–1.20). Conclusions Our results suggest a bidirectional association between depression and obesity in middle-aged and elderly women. Future studies are needed to confirm our findings in different populations, and investigate the potential mechanisms underlying this association. Our results underscore the importance of early detection and proper behavioral modifications to lower the burden of both conditions. PMID:21654630

Metabolic profile and quality of life in class I sarcopenic overweight and obese postmenopausal women: a MONET study.

PubMed

Messier, Virginie; Karelis, Antony D; Lavoie, Marie-Eve; Brochu, Martin; Faraj, May; Strychar, Irene; Rabasa-Lhoret, Remi

2009-02-01

Sarcopenia is believed to be associated with disability and metabolic complications. The objective of this study was to examine the metabolic and quality-of-life profile of sarcopenic overweight and obese postmenopausal women. In this cross-sectional study of 136 healthy overweight and obese postmenopausal women, 9 class I sarcopenic women were identified. Class I sarcopenia was defined as an appendicular lean body mass index (ALBMI)

Adiposity and metabolic dysfunction in polycystic ovary syndrome.

PubMed

Sam, Susan

2015-02-01

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among reproductive-age women and is associated with a high risk for metabolic disorders. Adiposity and insulin resistance are two prevalent conditions in PCOS and the likely culprits for the heightened metabolic risk. Up to 60% of women with PCOS are considered to be overweight or obese, and even among non-obese women with PCOS there is an increased accumulation of adipose tissue in abdominal depots. Insulin resistance in PCOS is unique and independent of obesity, as even non-obese women with this condition are frequently insulin resistant. However, obesity substantially aggravates the insulin resistance and the metabolic and reproductive abnormalities in women with PCOS. Recently, it has been shown that many aspects of adipose tissue function in PCOS are abnormal, and these abnormalities likely predispose to development of insulin resistance even in the absence of obesity. This review provides an overview of these abnormalities and their impact on development of metabolic disorders. At the end, an overview of the therapeutic options for management of adiposity and its complications in PCOS are discussed.

[Body image among obese women: consequences and degree of body dissatisfaction, relationship with low self-esteem and coping strategies].

PubMed

Brytek-Matera, Anna

2010-01-01

Definition of factors influencing negative body image among obese women and analysis of the relationship between body dissatisfaction and personality variables. 63 patients participated in this study. The mean age of the obese subjects was 41.90 years (SD +/- 12.23) and the mean body mass index (BMI) was 37.09 kg/m2 (SD +/- 8.09). The control group consisted of 60 women with normal body weight. The Body Dissatisfaction Scale of EDI (Garner et al., 1984), the Self-Esteem Inventory (Coopersmith, 1983) and the Brief COPE (Carver, 1997) were used in the study. In the clinical sample of women suffering from obesity, we have found a correlation between body dissatisfaction and behavioural disengagement, four dimensions of self-esteem (general, social, family and professional) and coping strategies focused on planning and positive reinterpretation. The regression analysis revealed that use of emotional support, planning and general self-esteem were predictive factors for the body dissatisfaction in obesity. Body dissatisfaction seriously influences the social, professional and emotional obese women's self.

75 FR 16128 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

... Project Evaluation of Childhood Obesity Prevention and Control Initiative: New York City Health Bucks... Disease Control and Prevention (CDC). Background and Brief Description Childhood obesity is a major public health concern. One out of every five children is affected by overweight or obesity in the United States...

Metabolic Concomitants of Obese and Nonobese Women With Features of Polycystic Ovarian Syndrome

PubMed Central

Boumosleh, Jocelyne Matar; Grundy, Scott M.; Phan, Jennifer; Neeland, Ian J.; Chang, Alice

2017-01-01

Context: Polycystic ovarian syndrome (PCOS) is often associated with obesity and diabetes. Objective: The present study measured body fat distribution and metabolic risk factors in women with features of PCOS. Design: Cross-sectional, multiethnic study of cardiovascular risks. Setting: General community. Study Participants: 145 PCOS and 344 non-PCOS women. Exposure Measures: Body composition by dual x-ray absorptiometry; abdominal fat masses measured by magnetic resonance imaging and hepatic triglyceride by magnetic resonance spectroscopy. Outcomes Measures: Body composition, liver fat content, homeostatic model assessment for insulin resistance (HOMA-IR), revised, and metabolic syndrome components. Results: PCOS women had a higher free androgen index compared with the non-PCOS women. Nonobese PCOS and non-PCOS women had a similar body fat content and distribution, HOMA-IR, and hepatic triglyceride content. Obese PCOS women had a similar total body fat percentage compared with their non-PCOS counterparts (41.4% and 41.4% respectively). Both obese groups had similar intraperitoneal fat (1.4% of total body mass in PCOS vs 1.4% in non-PCOS). However, obese PCOS women had a greater ratio of truncal/lower body fat (1.42 vs 1.27; P < 0.016). They also had greater insulin resistance (HOMA-IR: PCOS, 2.24% vs non-PCOS, 1.91%; P < 0.016), higher liver triglyceride content (6.96% in PCOS vs 4.44% in non-PCOS; P < 0.016), and a greater incidence of hypertension (33% vs 24%; P < 0.05). No differences were observed in other metabolic risk factors. Conclusions: Both obese and nonobese women with PCOS features had a greater free androgen index compared with non-PCOS women, but neither had greater intraperitoneal fat or abnormal lipid levels. Obese, but not nonobese, women with PCOS had a greater truncal/lower extremity fat ratio, HOMA-IR, and liver triglyceride content. PMID:29264465

Childhood family structure and women's adult overweight risk: A longitudinal study.

PubMed

Chaparro, M Pia; de Luna, Xavier; Häggström, Jenny; Ivarsson, Anneli; Lindgren, Urban; Nilsson, Karina; Koupil, Ilona

2017-07-01

The aim of this study was to investigate whether women's adult overweight and obesity risk was associated with their childhood family structure, measured as their mothers' marital status history, during the women's first 18 years of life. Using linked register data, we analyzed 30,584 primiparous women born in Sweden in 1975 who were between 19-35 years of age when their height and pre-pregnancy weight was recorded. The outcomes were women's overweight/obesity (body mass index (BMI) ≥ 25 kg/m 2 ) and obesity (BMI ≥ 30 kg/m 2 ) and the predictor was mothers' marital status history, which was summarized using sequence analysis. We carried out nested logistic regression models adjusting for women's age and maternal sociodemographic characteristics. Mothers' marital status history was summarized into six clusters: stable marriage, stable cohabitation, married then divorcing, cohabiting then separating, varied transitions, and not with father. In fully adjusted models and compared with women whose mothers belonged to the stable marriage cluster: (1) women whose mothers belonged to the other marital status clusters had higher odds of overweight/obesity (odds ratio (OR) ranging 1.15-1.19; p < 0.05); and (2) women whose mothers belonged to the stable cohabitation (OR = 1.31; 95% confidence interval (CI) = 1.14-1.52), cohabiting then separating (OR = 1.23; 95% CI = 1.01-1.49), varied transitions (OR = 1.24; 95% CI = 1.11-1.39), and not with father (OR = 1.24; 95% CI = 1.00-1.54) clusters had higher odds of obesity. Women whose mothers were not in stable marriage relationships had higher odds of being overweight or obese in adulthood. The finding that even women raised in the context of stable cohabitation had higher odds of being overweight or obese is intriguing as these relationships are socially accepted in Sweden.

The social patterning of relative body weight and obesity in Denmark and Finland.

PubMed

Sarlio-Lähteenkorva, Sirpa; Lissau, Inge; Lahelma, Eero

2006-02-01

Relative body weight is typically inversely associated with social status in affluent societies but studies comparing the social patterning of relative body weight and obesity in different countries have only seldom been conducted. The aim of this study was to analyse and compare the social patterning of relative weight and obesity by occupational status, educational attainment and marital status between Danish and Finnish women and men. Data from the Finnish Survey on Living Conditions and the Danish Health and Morbidity Survey, both collected in 1994, were compared. Relative weight was studied by using body mass index (BMI), and those with BMI > or =30 kg/m(2) were regarded as obese. Logistic regression analysis was used to examine the social patterning of obesity in the pooled dataset. Two-variable interaction effects were tested separately. Compared with their Danish counterparts, Finnish women and men had higher average relative weight and they were more often obese. There were no country differences in the socio-economic patterning of obesity by educational attainment, but a stronger patterning of obesity by occupational status was found among Danish women. Moreover, non-married women in Denmark were more likely to be obese than their married counterparts. Finns have higher relative weight and they are more often obese than Danes. The social patterning of obesity was similar in both studied countries but stronger in Denmark.

Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses

PubMed Central

Han, Zhen; Mulla, Sohail; Beyene, Joseph

2010-01-01

Objective To determine the relation between overweight and obesity in mothers and preterm birth and low birth weight in singleton pregnancies in developed and developing countries. Design Systematic review and meta-analyses. Data sources Medline and Embase from their inceptions, and reference lists of identified articles. Study selection Studies including a reference group of women with normal body mass index that assessed the effect of overweight and obesity on two primary outcomes: preterm birth (before 37 weeks) and low birth weight (<2500 g). Data extraction Two assessors independently reviewed titles, abstracts, and full articles, extracted data using a piloted data collection form, and assessed quality. Data synthesis 84 studies (64 cohort and 20 case-control) were included, totalling 1 095 834 women. Although the overall risk of preterm birth was similar in overweight and obese women and women of normal weight, the risk of induced preterm birth was increased in overweight and obese women (relative risk 1.30, 95% confidence interval 1.23 to 1.37). Although overall the risk of having an infant of low birth weight was decreased in overweight and obese women (0.84, 0.75 to 0.95), the decrease was greater in developing countries than in developed countries (0.58, 0.47 to 0.71 v 0.90, 0.79 to 1.01). After accounting for publication bias, the apparent protective effect of overweight and obesity on low birth weight disappeared with the addition of imputed “missing” studies (0.95, 0.85 to 1.07), whereas the risk of preterm birth appeared significantly higher in overweight and obese women (1.24, 1.13 to 1.37). Conclusions Overweight and obese women have increased risks of preterm birth and induced preterm birth and, after accounting for publication bias, appeared to have increased risks of preterm birth overall. The beneficial effects of maternal overweight and obesity on low birth weight were greater in developing countries and disappeared after accounting for publication bias. PMID:20647282

Prevalence of Underweight, Overweight, and Obesity Among Reproductive-Age Women and Adolescent Girls in Rural China

PubMed Central

He, Yuan; Pan, An; Yang, Ying; Wang, Yuanyuan; Xu, Jihong; Zhang, Ya; Liu, Dujia; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Yan, Donghai; Peng, Zuoqi; Hu, Frank B.

2016-01-01

Objectives. To provide prevalence and trends of underweight, overweight, and obesity among reproductive-age women and adolescent girls in rural China. Methods. We measured weight and height in 16 742 344 women aged 20 to 49 years and 178 556 girls aged 15 to 19 years from the National Free Preconception Health Examination Project between 2010 and 2014. Results. Among women, the prevalence of underweight was 7.8% (95% confidence interval [CI] = 7.7%, 7.9%), and overweight or obesity was 16.5% (95% CI = 16.4%, 16.6%; World Health Organization criteria). Among adolescents, prevalence of underweight was 6.0% (95% CI = 5.7%, 6.2%; Centers for Disease Control and Prevention criteria) and overweight or obesity was 8.3% (95% CI = 7.9% to 8.8%; International Obesity Task Force criteria). According to Chinese criteria, overweight and obesity prevalence was 24.8% (95% CI = 24.7%, 24.9%) for women and 17.2% (95% CI = 16.6%, 17.8%) for adolescents, and underweight prevalence was 2.9% (95% CI = 2.8%, 3.1%) for adolescents. Considerable disparities existed in prevalence and trends within subpopulations (age groups, parity, region, education levels, and socioeconomic status). Conclusions. Our results reveal coexisting underweight and overweight or obesity among rural women and adolescents of reproductive age, which requires public health attention. PMID:27831775

Television exposure and overweight/obesity among women in Ghana.

PubMed

Tuoyire, Derek Anamaale

2018-01-01

Although the public health importance of the association between television (TV) viewing and obesity and/or related outcomes have been demonstrated in both cross-sectional and prospective studies elsewhere, similar studies are lacking within the African region. With the view to fill this gap in the literature, the current study explored the association between TV exposure and overweight/obesity among Ghanaian women. Based on a sample of 4158 women, descriptive statistics and binary logistic regression were applied to data on TV ownership, TV viewing frequency, and body mass index (BMI) measures from the 2014 Ghana Demographic and Health Survey (GDHS) to explore the association between TV exposure and overweight/obesity among Ghanaian women. Despite controlling for other factors (age educational level, marital status, wealth quintile, occupation, type of locality, and parity), the results show that women with TV in their households, and with high TV exposure were significantly ( P  < 0.05) more likely (OR = 1.39, 95% CI = 1.002, 1.923) to be overweight/obese compared to those with no TV in their households, and no TV exposure. The study demonstrates that increased TV exposure is significantly associated with overweight/obesity among women in Ghana even after adjusting for other factors. Interventions aimed at tackling obesity in Ghana should focus on encouraging the uptake of more physically demanding pastime activities in place of TV "sit time".

Bone mineral density in postmenopausal Mexican-Mestizo women with normal body mass index, overweight, or obesity.

PubMed

Méndez, Juan Pablo; Rojano-Mejía, David; Pedraza, Javier; Coral-Vázquez, Ramón Mauricio; Soriano, Ruth; García-García, Eduardo; Aguirre-García, María Del Carmen; Coronel, Agustín; Canto, Patricia

2013-05-01

Obesity and osteoporosis are two important public health problems that greatly impact mortality and morbidity. Several similarities between these complex diseases have been identified. The aim of this study was to analyze if different body mass indexes (BMIs) are associated with variations in bone mineral density (BMD) among postmenopausal Mexican-Mestizo women with normal weight, overweight, or different degrees of obesity. We studied 813 postmenopausal Mexican-Mestizo women. A structured questionnaire for risk factors was applied. Height and weight were used to calculate BMI, whereas BMD in the lumbar spine (LS) and total hip (TH) was measured by dual-energy x-ray absorptiometry. We used ANCOVA to examine the relationship between BMI and BMDs of the LS, TH, and femoral neck (FN), adjusting for confounding factors. Based on World Health Organization criteria, 15.13% of women had normal BMI, 39.11% were overweight, 25.96% had grade 1 obesity, 11.81% had grade 2 obesity, and 7.99% had grade 3 obesity. The higher the BMI, the higher was the BMD at the LS, TH, and FN. The greatest differences in size variations in BMD at these three sites were observed when comparing women with normal BMI versus women with grade 3 obesity. A higher BMI is associated significantly and positively with a higher BMD at the LS, TH, and FN.

Prevalence of Underweight, Overweight, and Obesity Among Reproductive-Age Women and Adolescent Girls in Rural China.

PubMed

He, Yuan; Pan, An; Yang, Ying; Wang, Yuanyuan; Xu, Jihong; Zhang, Ya; Liu, Dujia; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Yan, Donghai; Peng, Zuoqi; Hu, Frank B; Ma, Xu

2016-12-01

To provide prevalence and trends of underweight, overweight, and obesity among reproductive-age women and adolescent girls in rural China. We measured weight and height in 16 742 344 women aged 20 to 49 years and 178 556 girls aged 15 to 19 years from the National Free Preconception Health Examination Project between 2010 and 2014. Among women, the prevalence of underweight was 7.8% (95% confidence interval [CI] = 7.7%, 7.9%), and overweight or obesity was 16.5% (95% CI = 16.4%, 16.6%; World Health Organization criteria). Among adolescents, prevalence of underweight was 6.0% (95% CI = 5.7%, 6.2%; Centers for Disease Control and Prevention criteria) and overweight or obesity was 8.3% (95% CI = 7.9% to 8.8%; International Obesity Task Force criteria). According to Chinese criteria, overweight and obesity prevalence was 24.8% (95% CI = 24.7%, 24.9%) for women and 17.2% (95% CI = 16.6%, 17.8%) for adolescents, and underweight prevalence was 2.9% (95% CI = 2.8%, 3.1%) for adolescents. Considerable disparities existed in prevalence and trends within subpopulations (age groups, parity, region, education levels, and socioeconomic status). Our results reveal coexisting underweight and overweight or obesity among rural women and adolescents of reproductive age, which requires public health attention.

Associations of components of sarcopenic obesity with bone health and balance in older adults.

PubMed

Scott, David; Shore-Lorenti, Catherine; McMillan, Lachlan; Mesinovic, Jakub; Clark, Ross A; Hayes, Alan; Sanders, Kerrie M; Duque, Gustavo; Ebeling, Peter R

To determine characteristics of sarcopenic obesity that are independently associated with bone health and balance in older adults. Cross-sectional study of 168 community-dwelling older adults (mean age 67.7 ± 8.4 years; 55% women). Appendicular lean mass (ALM), whole-body areal BMD (aBMD) and body fat percentage were assessed by dual-energy X-ray absorptiometry. Peripheral quantitative computed tomography assessed muscle density and cortical volumetric BMD (vBMD), area, thickness, and strength-strain index (SSI) at 66% tibial length. Hand grip strength (dynamometry) and balance path length (computerised posturography) were assessed. Obesity was defined as high body fat percentage. Greater lower-leg muscle density was associated with lower balance path length in men (r = -0.36; P < .01) and women (r = -0.40; P = < .01). Obese participants by body fat percentage did not differ to non-obese on bone indices, although a trend towards lower cortical vBMD was observed in obese compared with non-obese men (1041.4 ± 39.8 vs 1058.8 ± 36.1 mg/cm 3 ; P = .051). In multivariable models, ALM was positively associated with all bone parameters in obese women, and with whole-body aBMD, proximal tibial cortical area and SSI in non-obese women, and both non-obese and obese men (all P < .05). Lower-leg muscle density was also positively associated with cortical vBMD (B = 2.91; 95% CI 0.02, 5.80) and area (2.70; 0.06, 5.33) in obese women. Amongst components of sarcopenic obesity, higher ALM is a consistent independent predictor of better bone health. Low muscle density may also compromise bone health and balance. Interventions which improve muscle mass and composition may lower fracture risk in sarcopenic obesity. Copyright © 2017 Elsevier B.V. All rights reserved.

Alarming weight gain in women of a post-transitional country.

PubMed

Garmendia, Maria L; Alonso, Faustino T; Kain, Juliana; Uauy, Ricardo; Corvalan, Camila

2014-03-01

In post-transitional countries, obesity disproportionally affects women. Longitudinal studies can detect high-risk groups in whom to target actions. We investigated the magnitude and velocity of BMI changes in Chilean women of reproductive age and evaluated whether these trends vary in specific groups. Longitudinal study. We measured weight and height in 2007 (baseline) and again in 2010 (follow-up); we estimated change in BMI (weight/height2) within the 3-year period and assessed its relationship with age, years of education and parity, collected at baseline and follow-up using a questionnaire. Population-based cohort of low- to middle-income Chilean women. Seven hundred and sixty-one women of reproductive age (mean 32·0 (sd 7·0) years), mothers of children who participate in the Growth and Obesity Cohort Study (GOCS). At baseline, 61 % of women had BMI ≥ 25·0 kg/m2. After 3 years, women gained on average 2·6 kg and obesity (BMI ≥ 30·0 kg/m2) increased by 23 % (12 % new obesity cases). Women with normal nutritional status gained more BMI than obese women (1·4 v. 0·6 kg/m2, P < 0·001). An increase in parity was positively associated with BMI change, independently of age, nutritional status and education (P < 0·05). Age and education were not associated with BMI change after controlling for other factors (P > 0·05). In Chile, a post-transitional country, we observed an alarming increase in obesity among women of reproductive age. Our results indicate that in this population actions need to be targeted at all women irrespective of their nutritional status. A key component of these policies should be avoiding excessive weight gain during pregnancy.

The influence of sex, body composition, and nonesterified fatty acids on serum adipokine concentrations.

PubMed

Plaisance, Eric P; Grandjean, Peter W; Judd, Robert L; Jones, Kathy W; Taylor, J Kyle

2009-11-01

Serum adiponectin concentrations are higher in women than men. The sexual dimorphism for adiponectin has been attributed to the direct effects of testosterone on adipose tissue adiponectin secretion. However, serum testosterone and adiponectin concentrations are generally lower in obese men than lean men, suggesting that sex steroids may not be the only factor that contributes to sex differences in serum adiponectin. The primary objective of this study was to examine the influence of sex, body composition, and nonesterified fatty acids (NEFAs) on serum adiponectin concentrations. Women and men between the ages of 18 and 35 years were consecutively accrued into the study. Sixty-one participants were partitioned into normal-weight (15 female and 16 male) or obese (14 female and 16 male) groups. Blood samples were obtained after a 12-hour fast. Differences between groups were determined by analysis of variance with Tukey-Kramer post hoc testing. Serum adiponectin was 26% higher in women compared with men. Body mass index was associated with total serum adiponectin in men (r = -0.63, P < .05) but not women. Adiponectin was correlated with the homeostasis model assessment index in women (r = -0.56, P < .05) and men (r = -0.58, P < .05) and with NEFAs (r = -0.68, P < .05) in men only. After partitioning men and women into normal-weight and obese groups, serum adiponectin was lower and NEFAs were higher in obese men only. Homeostasis model assessment was similar between obese women and men despite higher NEFAs in the obese men. Leptin and plasminogen activator inhibitor-1 were higher in obese participants but were not associated with serum NEFAs. These results suggest that serum NEFAs may reduce adiponectin concentrations independent of their effects on insulin sensitivity in obese young men.

Bioavailable insulin-like growth factor-I as mediator of racial disparity in obesity-relevant breast and colorectal cancer risk among postmenopausal women.

PubMed

Jung, Su Yon; Barrington, Wendy E; Lane, Dorothy S; Chen, Chu; Chlebowski, Rowan; Corbie-Smith, Giselle; Hou, Lifang; Zhang, Zuo-Feng; Paek, Min-So; Crandall, Carolyn J

2017-03-01

Bioavailable insulin-like growth factor-I (IGF-I) interacts with obesity and exogenous estrogen (E) in a racial disparity in obesity-related cancer risk, yet their interconnected pathways are not fully characterized. We investigated whether circulating bioavailable IGF-I acted as a mediator of the racial disparity in obesity-related cancers such as breast and colorectal (CR) cancers and how obesity and E use regulate this relationship. A total of 2,425 white and 164 African American (AA) postmenopausal women from the Women's Health Initiative Observational Study were followed from October 1, 1993 through August 29, 2014. To assess bioactive IGF-I as a mediator of race-cancer relationship, we used the Baron-Kenny method and quantitative estimation of the mediation effect. Compared with white women, AA women had higher IGF-I levels; their higher risk of CR cancer, after accounting for IGF-I, was no longer significant. IGF-I was associated with breast and CR cancers even after controlling for race. Among viscerally obese (waist/hip ratio >0.85) and overall nonobese women (body mass index <30), IGF-I was a strong mediator, reducing the racial disparity in both cancers by 30% and 60%, respectively. In E-only users and nonusers, IGF-I explained the racial disparity in CR cancer only modestly. Bioavailable IGF-I is potentially important in racial disparities in obesity-related breast and CR cancer risk between postmenopausal AA and white women. Body fat distribution and E use may be part of the interconnected hormonal pathways related to racial difference in IGF-I levels and obesity-related cancer risk.

[Yogurt consumption and reduced risk of overweight and obesity in adults].

PubMed

Martinchik, A N; Baturin, A K; Peskova, E V; Keshabyants, E E; Mikhaylov, N A

2016-01-01

Fermented dairy products comprise a large food group in Russia and are an important source of dietary nutrients like protein, calcium, fat. Obesity is a rising public health issue in Russia. Observing the role of fermented dairy in the maintenance of healthy weights is important. Current study objective was to explore the association between obesity/overweight prevalence and yogurt consumption in Russian adults. Data from RLMS-HSE 1994-2012 was used. Primary materials are available on http://www.cpc.unc.edu/projects/rlms-hse, http://www. hse.ru/org/hse/rlms. Data collected included dietary intake by single 24h recalls and anthropometric measures for 72.400 adults (≥ 19 y.o.). Logistic regression models were used to explore the relationships between yogurt consumption and obesity prevalence (BMI > 30.0 compared with. 18.5-25.0), controlling for age and gender. Daily average intake (g/day) of yogurt significantly increased from 1994 to 2012. Yogurt consumption decreased over 40 y.o. in both gender. Women yogurt consumption is inversely correlated with the magnitude of the BMI: the consumption of yogurt in women with normal BMI values (> 18.5-25.0) was significantly higher than in women who are overweight and/or obese (BMI > 25.0; or > 30.0). The mean values of BMI in women who ate yogurt, were significantly lower than in women not consuming yogurt. In men, the relationship between consumption of yogurt and BMI is not revealed. Thus, among women, a significant inverse association was observed between yogurt consumption and obesity (OR 0.582, CI 95% 0.497, 0.680; p < 0.001). The observed association between yogurt intake and prevalence of obesity is dependent on gender: yogurt is associated with lower obesity prevalence only in women.

Increasing prevalence of overweight and obesity in Bangladeshi women of reproductive age: Findings from 2004 to 2014.

PubMed

Biswas, Tuhin; Uddin, Md Jasim; Mamun, Abdullah Al; Pervin, Sonia; P Garnett, Sarah

2017-01-01

Overweight and obesity are a particular concern for women of reproductive age. They not only increase the risk of chronic diseases but they are also associated with adverse perinatal, neonatal, infant and child outcomes. The objective of this study was to examine the trend of overweight and obesity among Bangladeshi women of reproductive age between 2004 and 2014. This is a secondary data analysis of the 2004, 2007, 2011 and 2014 Bangladesh Demographic and Health Surveys (BDHS). We determined the age standardized prevalence of overweight and obesity of women aged 15-49 years, who had their weight and height measured. Overweight and obesity were determined using the Asian specific BMI cut-offs criteria. The prevalence of overweight increased from 11.4% [95% CI: 10.4to 12.5] in 2004 to 25.2% [95% CI: 24.0 to 26.4] in 2014. The prevalence of obesity increased from 3.5% [95% CI: 3.0to4.2] to 11.2% [95% CI: 10.1to12.5%] over the same period of time. This was seen in all age groups. However, the greatest increase was observed in women aged 35 to 49 years. The highest prevalence of overweight and obesity were observed in those women with the highest education level and wealth, larger family size, living in urban areas and not being in paid employment. The prevalence of overweight and obesity among women of reproductive age in Bangladesh is high and increasing. We speculate that this has the potential to jeopardize the improvements that have been made in maternal and infant health over the last two decades. Evidence based prevention strategies are required to address this serious public health issue.

Leptin production during early starvation in lean and obese women.

PubMed

Klein, S; Horowitz, J F; Landt, M; Goodrick, S J; Mohamed-Ali, V; Coppack, S W

2000-02-01

We evaluated abdominal adipose tissue leptin production during short-term fasting in nine lean [body mass index (BMI) 21 +/- 1 kg/m(2)] and nine upper body obese (BMI 36 +/- 1 kg/m(2)) women. Leptin kinetics were determined by arteriovenous balance across abdominal subcutaneous adipose tissue at 14 and 22 h of fasting. At 14 h of fasting, net leptin release from abdominal adipose tissue in obese subjects (10.9 +/- 1.9 ng x 100 g tissue x (-1) x min(-1)) was not significantly greater than the values observed in the lean group (7.6 +/- 2.1 ng x 100 g(-1) x min(-1)). Estimated whole body leptin production was approximately fivefold greater in obese (6.97 +/- 1.18 microg/min) than lean subjects (1.25 +/- 0.28 microg/min) (P < 0.005). At 22 h of fasting, leptin production rates decreased in both lean and obese groups (to 3.10 +/- 1.31 and 10.5 +/- 2.3 ng x 100 g adipose tissue(-1) x min(-1), respectively). However, the relative declines in both arterial leptin concentration and local leptin production in obese women (arterial concentration 13.8 +/- 4.4%, local production 10.0 +/- 12.3%) were less (P < 0.05 for both) than the relative decline in lean women (arterial concentration 39.0 +/- 5.5%, local production 56.9 +/- 13.0%). This study demonstrates that decreased leptin production accounts for the decline in plasma leptin concentration observed after fasting. However, compared with lean women, the fasting-induced decline in leptin production is blunted in women with upper body obesity. Differences in leptin production during fasting may be responsible for differences in the neuroendocrine response to fasting previously observed in lean and obese women.

The prevalence and factors associated with obesity among adult women in Selangor, Malaysia

PubMed Central

Sidik, Sherina Mohd; Rampal, Lekhraj

2009-01-01

Introduction The prevalence of obesity in developing countries especially among women is on the rise. This matter should be taken seriously because it can burden the health care systems and lower the quality of life. Aim The purpose of this study was to determine the prevalence of obesity among adult women in Selangor and to determine factors associated with obesity among these women. Methods This community based cross sectional study was conducted in Selangor in January 2004. Multi stage stratified proportionate to size sampling method was used. Women aged 20–59 years old were included in this study. Data was collected using a questionnaire-guided interview method. The questionnaire consisted of questions on socio-demographic (age, ethnicity, religion, education level, occupation, monthly income, marital status), Obstetric & Gynaecology history, body mass index (BMI), and the Patient Health Questionnaire (PHQ-9). Results Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age was 37.91 ± 10.91. The prevalence of obesity among the respondents was 16.7% (mean = 1.83 ± 0.373). Obesity was found to be significantly associated with age (p = 0.013), ethnicity (p = 0.001), religion (p = 0.002), schooling (p = 0.020), educational level (p = 0.016), marital status (p = 0.001) and the history of suffering a miscarriage within the past 6 months (p = 0.023). Conclusion The prevalence of obesity among adult women in this study was high. This problem needs to be emphasized as the prevalence of obesity keeps increasing, and will continue to worsen unless appropriate preventive measures are taken. PMID:19358728

Differential effects of daily snack food intake on the reinforcing value of food in obese and nonobese women123

PubMed Central

Bulkley, Alison M; Badawy, Rebecca L; Krause, Nicole; McCann, Sarah; Epstein, Leonard H

2009-01-01

Background: Food reinforcement, ie, motivation to obtain food, is associated with energy intake and obesity. Finding ways to decrease the reinforcing value of unhealthy foods may help with adherence to diets and maintenance of weight loss. Our previous study in nonobese adults showed that daily consumption of the same snack food (food consumed apart from meals) for 14 d significantly decreased its reinforcing value. Objectives: The aims of this study were to replicate and extend these findings to obese individuals and to examine the effects of different portion sizes of snack foods on food reinforcement. Design: Food reinforcement and liking were tested in 31 obese and 27 nonobese women at baseline and after 2 wk of daily consumption of 0, 100, or 300 kcal/d of the same snack food. Results: We found a significant interaction of phase, portion size, and body mass index on the pattern of operant responding for food. Obese women had a significant increase in food reinforcement after consuming the 300-kcal portion of food for 2 wk, whereas nonobese women had the opposite response. No significant differences were found on the reinforcing value with the 0- and 100-kcal portion-size conditions. Women in the 300-kcal group (obese and nonobese) reported a significant decrease in snack food liking from baseline to after daily intake. Conclusions: These findings suggest that obese and nonobese women respond differently to the daily intake of a snack food and that this may not be a viable mechanism for reducing food reinforcement in obese women. This trial was registered at www.clinicaltrials.gov as NCT00837694. PMID:19458018

Increasing prevalence of overweight and obesity in Bangladeshi women of reproductive age: Findings from 2004 to 2014

PubMed Central

Uddin, Md. Jasim; Mamun, Abdullah Al; Pervin, Sonia; P Garnett, Sarah

2017-01-01

Background Overweight and obesity are a particular concern for women of reproductive age. They not only increase the risk of chronic diseases but they are also associated with adverse perinatal, neonatal, infant and child outcomes. The objective of this study was to examine the trend of overweight and obesity among Bangladeshi women of reproductive age between 2004 and 2014. Method This is a secondary data analysis of the 2004, 2007, 2011 and 2014 Bangladesh Demographic and Health Surveys (BDHS). We determined the age standardized prevalence of overweight and obesity of women aged 15–49 years, who had their weight and height measured. Overweight and obesity were determined using the Asian specific BMI cut-offs criteria. Result The prevalence of overweight increased from 11.4% [95% CI: 10.4to 12.5] in 2004 to 25.2% [95% CI: 24.0 to 26.4] in 2014. The prevalence of obesity increased from 3.5% [95% CI: 3.0to4.2] to 11.2% [95% CI: 10.1to12.5%] over the same period of time. This was seen in all age groups. However, the greatest increase was observed in women aged 35 to 49 years. The highest prevalence of overweight and obesity were observed in those women with the highest education level and wealth, larger family size, living in urban areas and not being in paid employment. Conclusion The prevalence of overweight and obesity among women of reproductive age in Bangladesh is high and increasing. We speculate that this has the potential to jeopardize the improvements that have been made in maternal and infant health over the last two decades. Evidence based prevention strategies are required to address this serious public health issue. PMID:28753680

Obesity Among HIV-Infected Adults Receiving Medical Care in the United States: Data From the Cross-Sectional Medical Monitoring Project and National Health and Nutrition Examination Survey.

PubMed

Thompson-Paul, Angela M; Wei, Stanley C; Mattson, Christine L; Robertson, McKaylee; Hernandez-Romieu, Alfonso C; Bell, Tanvir K; Skarbinski, Jacek

2015-07-01

Our objective was to compare obesity prevalence among human immunodeficiency virus (HIV)-infected adults receiving care and the U.S. general population and identify obesity correlates among HIV-infected men and women.Cross-sectional data was collected in 2009 to 2010 from 2 nationally representative surveys: Medical Monitoring Project (MMP) and National Health and Nutrition Examination Survey (NHANES).Weighted prevalence estimates of obesity, defined as body mass index ≥30.0 kg/m, were compared using prevalence ratios (PR, 95% confidence interval [CI]). Correlates of obesity in HIV-infected adults were examined using multivariable logistic regression.Demographic characteristics of the 4006 HIV-infected adults in MMP differed from the 5657 adults from the general U.S. population in NHANES, including more men (73.2% in MMP versus 49.4% in NHANES, respectively), black or African Americans (41.5% versus 11.6%), persons with annual incomes <$20,000 (64.5% versus 21.9%), and homosexuals or bisexuals (50.9% versus 3.9%). HIV-infected men were less likely to be obese (PR 0.5, CI 0.5-0.6) and HIV-infected women were more likely to be obese (PR1.2, CI 1.1-1.3) compared with men and women in the general population, respectively. Among HIV-infected women, younger age was associated with obesity (<40 versus >60 years). Among HIV-infected men, correlates of obesity included black or African American race/ethnicity, annual income >$20,000 and <$50,000, heterosexual orientation, and geometric mean CD4+ T-lymphocyte cell count >200 cells/μL.Obesity is common, affecting 2 in 5 HIV-infected women and 1 in 5 HIV-infected men. Correlates of obesity differ for HIV-infected men and women; therefore, different strategies may be needed for the prevention and treatment.

Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities: A Mediation Analysis of a French Nationwide Survey.

PubMed

Audureau, Etienne; Pouchot, Jacques; Coste, Joël

2016-05-01

Negative effects of obesity on health-related quality of life (HRQoL) have been reported, especially in women, but the relative contribution of cardiometabolic and other obesity-related comorbidities to such effects remains unclear. Our objective was to model the association by sex between body mass index and HRQoL and to precisely quantify the indirect effects mediated by obesity-related comorbidities. Data were drawn from the latest French Decennial Health Survey, a nationwide cross-sectional study conducted in 2003 (21 239 adults aged 25-64 years analyzed). HRQoL was measured by the 36-item short-form health survey questionnaire. A mediation analysis based on the counterfactual framework was performed to quantify the proportion of obesity effects on HRQoL mediated by related comorbidities, including cardiometabolic risk factors (diabetes mellitus, hypertension, dyslipidemia) and diseases (ischemic heart disease, cerebrovascular, and peripheral vascular disease), musculoskeletal disorders, and asthma. After multiple linear regression, inverse associations were found between increasing body mass index category and physically oriented and most mentally oriented 36-item short-form health survey dimensions, with evidence of greater effects in women. Mediation analysis revealed that obesity effects were significantly mediated by several comorbidities, more apparently in men (eg, proportion of obesity class II total effect mediated via cardiometabolic factors: general health 27.0% [men] versus 13.6% [women]; proportion of obesity class II total effect mediated via total count of comorbidities: physical functioning 17.8% [men] versus 7.7% [women] and general health 37.1% [men] versus 20.3% [women]). Women have a greater overall impact of obesity on HRQoL, but with proportionally lower effects mediated by cardiometabolic and other obesity-related conditions, suggesting the possible role of other specific psychosocial processes. © 2016 American Heart Association, Inc.

No evidence of increased cortisol stress response in obese women with binge eating disorder.

PubMed

Schulz, S; Laessle, R; Hellhammer, D

2011-09-01

Increased cortisol levels after stress have been associated with excessive food intake during binges in obese women with binge eating disorder (BED). The present study tried to replicate these findings in a sample of obese women with BED compared to obese women without BED. Twenty women with a mean BMI of 37.75 kg/m² were studied. Salivary cortisol was sampled before and after a socially evaluated cold pressure test at 8 time points. Both comparison groups showed the expected cortisol increase after the stressor (p<0.03), but no significant differences between groups emerged (p=0.96). These results do not support an increased stress reactivity of HPA in BED. Instead they would favour psychological explanations of binges, focusing on diminished perception of satiety.

Multiparity is associated with High Motivation to Change Diet among Overweight and Obese Postpartum Women

PubMed Central

Bastian, Lori A.; Pathiraja, Varanga C.; Krause, Katrina; Namenek Brouwer, Rebecca J.; Swamy, Geeta K.; Lovelady, Cheryl A.; Østbye, Truls

2010-01-01

Background Pregnancy is associated with weight gain and obesity. The aim of this study is to identify the effect of parity and other factors on motivation to change diet to lose weight in a cohort of overweight and obese postpartum women. Study Design Active Mothers Postpartum (AMP) is a randomized controlled trial aimed at postpartum weight reduction. At baseline, we measured motivation to change diet to lose weight among 491 overweight/obese postpartum women. Logistic regression was used to model the effect of parity on motivation to change diet at baseline while adjusting for potential confounders including age, race, education, BMI category, and breastfeeding status. Results Approximately two thirds (68%) of participants were highly motivated to change their diet to lose weight. In the multivariable model, women with three or more children had 2.5 times the odds of high motivation compared to primigravid women, and women not breastfeeding had 1.6 times the odds of high motivation compared to any breastfeeding. Conclusion Although risk for obesity is incurred starting with a woman’s first pregnancy, women in this study were more motivated to change their diet to lose weight after their third pregnancy. Further research is needed to understand how to best capitalize on the high motivation in women with several children and also how to improve motivation for primigravid women and women who are breastfeeding. PMID:20149971

Is BMI a valid measure of obesity in postmenopausal women?

PubMed

Banack, Hailey R; Wactawski-Wende, Jean; Hovey, Kathleen M; Stokes, Andrew

2018-03-01

Body mass index (BMI) is a widely used indicator of obesity status in clinical settings and population health research. However, there are concerns about the validity of BMI as a measure of obesity in postmenopausal women. Unlike BMI, which is an indirect measure of obesity and does not distinguish lean from fat mass, dual-energy x-ray absorptiometry (DXA) provides a direct measure of body fat and is considered a gold standard of adiposity measurement. The goal of this study is to examine the validity of using BMI to identify obesity in postmenopausal women relative to total body fat percent measured by DXA scan. Data from 1,329 postmenopausal women participating in the Buffalo OsteoPerio Study were used in this analysis. At baseline, women ranged in age from 53 to 85 years. Obesity was defined as BMI ≥ 30 kg/m and body fat percent (BF%) greater than 35%, 38%, or 40%. We calculated sensitivity, specificity, positive predictive value, and negative predictive value to evaluate the validity of BMI-defined obesity relative BF%. We further explored the validity of BMI relative to BF% using graphical tools, such as scatterplots and receiver-operating characteristic curves. Youden's J index was used to determine the empirical optimal BMI cut-point for each level of BF% defined obesity. The sensitivity of BMI-defined obesity was 32.4% for 35% body fat, 44.6% for 38% body fat, and 55.2% for 40% body fat. Corresponding specificity values were 99.3%, 97.1%, and 94.6%, respectively. The empirical optimal BMI cut-point to define obesity is 24.9 kg/m for 35% BF, 26.49 kg/m for 38% BF, and 27.05 kg/m for 40% BF according to the Youden's index. Results demonstrate that a BMI cut-point of 30 kg/m does not appear to be an appropriate indicator of true obesity status in postmenopausal women. Empirical estimates of the validity of BMI from this study may be used by other investigators to account for BMI-related misclassification in older women.

Socioeconomic inequality and obesity prevalence trends in Luxembourg, 1995-2007.

PubMed

Tchicaya, Anastase; Lorentz, Nathalie

2012-08-29

Overweight and obesity are becoming increasingly critical problems in most developed countries. Approximately 20% of adults in most European countries are obese. This study examines the prevalence of overweight and obesity in Luxembourg and their association with different demographic, socioeconomic (SES), and behavioural factors. The data used in this study were taken from 2 surveys on household income and living conditions conducted in 1995 and 2007. The target population was household residents aged 16 years and older, and body mass index (BMI) data were self-reported. Average BMI, overweight, and obesity prevalence rates were calculated according to each demographic (gender, nationality, marital status), SES (educational level, profession, and place of residence), and behavioural (physical activity and diet) factors. A multivariate logistic regression analysis was conducted to measure the relationship between obesity and demographic, SES, and behavioural factors. All analyses were conducted according to gender, and data used were weighted. Between 1995 and 2007, the average BMI remained nearly constant among men and women in the entire study population. Obesity prevalence increased by 24.5% through the study period (14.3% in 1995 to 17.8% in 2007). Obesity prevalence increased by 18.5% for men (15.1% in 1995 to 17.9% in 2007) and by 30% for women (13.6% in 1995 to 17.7% in 2007). Between 1995 and 2007, obesity increased sharply by 48.2% (from 11% to 16.3%) in Portuguese men, 76.7% (from 13.3% to 23.5%) in Portuguese women, 79.7% (from 17.2% to 30.9%) in widowed men, and 84.3% (from 12.1% to 22.3%) in divorced women. Multivariate logistic regression analysis showed that the relationship between the educational level and obesity was not statistically significant for men, but was significant for women. The prevalence of overweight and obesity is high in Luxembourg and has changed slightly in recent years. SES inequalities in obesity exist and are most compelling among women. The fight against obesity should focus on education, with emphasis on the socially disadvantaged segment of the population.

Trends of Obesity in Iranian Adults from 1990s to late 2000s; a Systematic Review and Meta-analysis.

PubMed

Mirzazadeh, Ali; Salimzadeh, Hamideh; Arabi, Minoo; Navadeh, Soodabeh; Hajarizadeh, Behzad; Haghdoost, Ali Akbar

2013-07-01

Obesity is currently emerging as a global epidemic, affecting 10% of adultpopulation worldwide. The primary objective of the current systematic reviewis to describe the trend of overall prevalence of obesity in Iranian women andmenthrough a meta-analysis. We searched the medical literature published from 1990 to 2007 in Medline(PubMed), EMBASE database, and the Iranian digital library. All publishedreports of research projects, papers in relevant congresses, unpublished crudedata analysis, proceedings, books and dissertations were reviewed. Data fromeligible papers that fulfilled the qualification criteria entered meta-analysis(Random Model). Data from 209,166 individuals were analyzed. The overall prevalence ofobesity in adults was 18.5% (95%CI: 15.1-21.8), respectively. The prevalenceof obesity in men and women was 12.9% (95%CI: 10.9-14.9) and 26.2%(95%CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders;women had almost a constantly higher risk of obesity than men duringthe recent two decades. Data from 209,166 individuals were analyzed. The overall prevalence ofobesity in adults was 18.5% (95%CI: 15.1-21.8), respectively. The prevalenceof obesity in men and women was 12.9% (95%CI: 10.9-14.9) and 26.2%(95%CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders;women had almost a constantly higher risk of obesity than men duringthe recent two decades.

Obesity in Bahraini adults.

PubMed

al-Mannai, A; Dickerson, J W; Morgan, J B; Khalfan, H

1996-02-01

In this study the prevalence of obesity and the demographic factors associated with it were analysed on 290 adult Bahraini individuals, of whom 137 were males and 153 were females. The overweight and obesity prevalence rates, using the Body Mass Index (BMI) as a criterion, were 26% and 16% in males and 29% and 31% in females, respectively. The prevalence of underweight (BMI < 20) was 16.8% and 11.8% in the males and females respectively. The mean body fat percentage of females, calculated from the skinfold measurements, was 35%; the fat percentage of males was 18.6%. Bahraini women had greater fat deposition in the subscapular region than the amount reported for American women. Females and males living in urban areas had a greater tendency to be obese than those residing in rural areas. Marriage, ownership of a car as well as a large family ( > 7 members) were positively associated with obesity; unmarried women were more likely to be underweight than married women. The educational level was not associated with obesity in either the males or females. The age of adult females was not found to be associated with obesity, whereas in males the incidence of obesity was more frequent among those who were 50 years of age and above than under 50 years of age. Family monthly income was not associated with the incidence of obesity. The high prevalence of overweight and obesity in the women reported in this study and the difference in the distribution of body fat suggest that genetics may be a determinant factor of this disorder in Bahrainis but certainly social factors are also important.

Childhood Sexual Abuse Moderates the Relationship Between Obesity and Mental Health in Low-Income Women.

PubMed

Ramirez, Jennifer C; Milan, Stephanie

2016-02-01

We examined whether a history of self-reported childhood sexual abuse (CSA) moderates the relationship between obesity and mental health symptoms (depression, anxiety, and posttraumatic stress disorder) in an ethnically diverse sample of low-income women. A community sample of 186 women completed self-report measures and had their weight and height measured. Body mass index and CSA had an interactive effect on all mental health measures, such that obese women with a CSA history reported substantially higher levels of all symptoms. These results give greater specificity to the obesity-mental health link reported in previous studies and provide possible directions for targeted intervention. © The Author(s) 2015.

Factors associated with nutritional status among adult women in urban India, 1998-2006.

PubMed

Rai, Rajesh Kumar

2015-03-01

This study attempts to understand the factors associated with chronic energy deficiency (CED) and overweight/obesity together with change in CED and overweight/obesity among urban Indian women during 1998-2006. Both National Family Health Survey (NFHS) 1998-1999 and NFHS 2005-2006 data sets were used. The standard cutoff points for both CED (BMI < 18.5 kg/m(2)) and overweight/obesity (BMI ≥ 23 kg/m(2)) were considered. The Phi and Cramer's V tests and predicted probabilities were used to fulfill the study objective. Results indicate an almost 3% reduction in CED and a 6% increase in overweight/obesity during 1998-2006. The probability of CED has reduced among nonliterate women and women belonging to the poorest wealth quintile; on the other hand, the likelihood of being overweight/obese has increased among women with high school education and above and women belonging to the richest wealth quintile. Interventions to promote physical activities and nutritional awareness programs, which are effective in addressing nutritional problems, have been proposed. © 2012 APJPH.

Cultural constructions of "obesity": understanding body size, social class and gender in Morocco.

PubMed

Batnitzky, Adina K

2011-01-01

This article presents data from an in-depth qualitative study of overweight and diabetic women in Morocco, a North African country experiencing a rapid increase in obesity according to national statistics. This case study explores the heterogeneous relationship among health, culture and religion in Morocco by highlighting the relationship between the intricacies of women's everyday lives and their body sizes. My findings suggest that although the Body Mass Index (BMI) of adult women has been documented to have increased in Morocco along with other macroeconomic changes (i.e., increases in urbanization, etc.), "obesity" has yet to be universally medicalized in the Moroccan context. As such women do not generally utilize a medicalized concept of obesity in reference to their larger body sizes. Rather, cultural constructions of "obesity" are understood through cultural understandings of a larger body size, religious beliefs about health and illness, and the nature of women's religious participation. This stands in contrast to dominant accounts about the region that promote an overall veneration of a larger body size for women. Copyright © 2010 Elsevier Ltd. All rights reserved.

Childhood maltreatment and pre-pregnancy obesity: a comparison of obese, overweight, and normal weight pregnant women.

PubMed

Nagl, Michaela; Steinig, Jana; Klinitzke, Grit; Stepan, Holger; Kersting, Anette

2016-04-01

Pre-pregnancy overweight and obesity is associated with poor health outcomes for the mother and the child. General population studies suggest that childhood maltreatment is associated with obesity in adulthood. The aim of our study was to examine the association between pre-pregnancy overweight and obesity and a history of childhood abuse or neglect including different stages of severity of abuse and neglect. Three hundred twenty-six normal weight, overweight, or obese pregnant women reported demographic data, height and weight, and general psychological distress at 18-22 weeks of gestation. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Associations were examined using logistic regression analyses and a reference group of normal weight women. Fifty percent reported a history of abuse or neglect. After adjusting for age, education, income, marital status, and the number of previous children, pre-pregnancy overweight and obesity were strongly associated with severe physical abuse (overweight: OR = 8.33, 95% CI 1.48-47.03; obesity: OR = 6.31, 95% CI 1.06-37.60). Women with severe physical neglect (OR = 4.25, 95% CI 1.23-14.74) were at increased risk of pregnancy overweight. We found a dose-response relationship between physical abuse and pre-pregnancy overweight and obesity. Whereas other studies report an association between childhood maltreatment and pre-pregnancy obesity, this is the first study that found an association between childhood maltreatment and pre-pregnancy overweight. Considering the severe health risks of pre-pregnancy overweight and obesity and the long-term consequences of childhood maltreatment, affected women constitute a subgroup with special needs in prenatal care. Further research is needed to improve the understanding of the underlying mechanisms.

Association between obesity and depressive symptoms in Mexican population.

PubMed

Zavala, Gerardo A; Kolovos, Spyros; Chiarotto, Alessandro; Bosmans, Judith E; Campos-Ponce, Maiza; Rosado, Jorge L; Garcia, Olga P

2018-06-01

Obesity and depression are among the leading causes of disability in Mexico, but their association has not been explored yet. The aim of the current study was to investigate the association between obesity and depression in Mexican population. We used data from the health and nutrition survey (ENSANUT 2012), which is representative of the Mexican population. Obesity was determined using the body mass index (BMI) and abdominal obesity by measuring waist circumference. Depressive symptoms were reported using the Center for Epidemiological Studies Depression Scale Short-Form (CES-D-SF, scale 0-21). Regression analyses were performed between obesity and depression, adjusting for gender, age, living with a partner, education, and diabetes history. Obese women had 1.28 (95% CI 1.07-1.53) times the odds of having depression in comparison with normal-weight women, whereas no association was found for men (OR 0.94; 95% CI 0.74-1.19). A significant association between BMI and depressive symptoms score (β = 0.05, 95% CI 0.02-0.07) was present in women, but no association was found for men (β = - 0.02, 95% CI - 0.05 to 0.00). There was a statistically significant association between waist circumference and depression scores again for women (β = 0.03, 95% CI 0.01-0.04) but not for men (β = 0.00, 95% CI - 0.01 to 0.01). No associations were found between abdominal obesity and depression for both genders. No association was found between different obesity severity levels and depression for both genders. Obesity was associated with depression in Mexican women, whereas no association was found between obesity and depression in men.

Doubling over ten years of central obesity in Hong Kong Chinese working men.

PubMed

Ko, Tin-choi Gary; Chan, Juliana; Chan, Amy; Wong, Patrick; Hui, Stanley; Chow, Ferrie; Tong, Spencer; Chan, Cecilia

2007-07-05

Obesity is now an epidemic in most parts of the world. In this cross sectional study, we report the most recent data on obesity in Hong Kong Chinese working population and compare the changes over 10 years. Between July 2000 and March 2002, 5882 adult subjects from the working class in Hong Kong were recruited (2716 men (46.2%) and 3166 women (53.8%)). They were randomly selected using computer generated codes according to the distribution of occupational groups. Results of this study were compared with the data collected from a prevalence survey for cardiovascular risk factors in a Hong Kong Chinese working population conducted in 1990 (1513 subjects, 910 men (60.1%) and 603 women (39.9%)). Standardized percentages of overweight, obesity, and central obesity, in Hong Kong Chinese working population were 59.7%, 35.0%, 26.7% in men and 32.0%, 21.7%, 26.7% in women. Compared to the data collected in 1990, the percentage of obesity increased by 5% in men and reduced by 6% in women. The percentage of central obesity doubled in men (from 12.2% to 26.7%) but remained stable in women. There is a doubling of the percentage of central obesity in Hong Kong Chinese working men over previous decade. Education and proper lifestyle modification program to tackle this social health issue are urgently indicated.

Biomarkers of metabolic syndrome and its relationship with the zinc nutritional status in obese women.

PubMed

Ennes Dourado Ferro, F; de Sousa Lima, V B; Mello Soares, N R; Franciscato Cozzolino, S Ma; do Nascimento Marreiro, D

2011-01-01

Obesity is a chronic disease that induces risk factors for metabolic syndrome and, is associated with disturbances in the metabolism of the zinc. Therefore, the aim of this study was to investigate the existence of relationship between the biomarkers of metabolic syndrome and the zinc nutricional status in obese women. Seventy-three premenopausal women, aged between 20 and 50 years, were divided into two groups: case group, composed of obese (n = 37) and control group, composed of no obese (n = 36). The assessment of the body mass index and waist circumference were carried out using anthropometric measurements. The plasmatic and erythrocytary zinc were analyzed by method atomic absorption spectrophotometry (λ = 213.9 nm). In the study, body mass index and waist circumference were higher in obese women than control group (p < 0.05). The mean plasmatic zinc was 72.2 ± 9.0 μg/dl in obese women and 73.4 ± 8.5 μg/dl in control group (p > 0.05). The mean erythrocytary zinc was 36.4 ± 15.0 μg/gHb and 45.4 ± 14.3 μg/gHb in the obese and controls, respectively (p < 0.05). Regression analysis showed that the body mass index (t =-2.85) and waist circumference (t = -2.37) have a negative relationship only with the erythrocytary zinc (R² = 0.32, p < 0.05). The study shows that there are alterations in biochemical parameters of zinc in obese women, with low zinc concentrations in erythrocytes. Regression analysis demonstrates that the erythrocytary zinc is influenced by biomarkers of the metabolic syndrome, presenting an inverse relationship with the waist circumference and body mass index.

Prevalence of Overweight and Obesity and Weight Loss Practice among Beijing Adults, 2011

PubMed Central

Cai, Li; Han, Xiaoyan; Qi, Zhi; Li, Zhe; Zhang, Yumei; Wang, Peiyu; Liu, Aiping

2014-01-01

Objective This study aims to determine the up-to-date prevalence of overweight and obesity, the distributions of body weight perception and weight loss practice in Beijing adults. Methods A cross-sectional study was conducted in 2011. A total of 2563 men and 4088 women aged 18–79 years from the general population were included. Data were obtained from questionnaire and physical examination. Results The prevalence of overweight (BMI 24–27.9 kg/m2) and obesity (BMI≥28 kg/m2) was 42.1% and 20.3% in men and 35.6% and 17.1% in women, respectively. Age was inversely associated with overweight in both sexes, and obesity in women. Education level was negatively associated with overweight and obesity in women but not in men. Only 49.1% men and 58.3% women had a correct perception of their body weight. Underestimation of body weight was more common than overestimation, especially in men, the older people, and those with low education level. The percentage of taking action to lose weight was inversely associated with men and old age, and positively associated with higher education level, higher BMI, and self-perception as “fat” (OR = 3.78 in men, OR = 2.91 in women). Only 26.1% of overweight/obese individuals took action to lose weight. The top two weight loss practices were to reduce the amount of food intake and exercise. Conclusion Overweight and obesity were highly prevalent with high incorrect body weight perceptions in the general adult population in Beijing. Weight loss practice was poor in overweight and obese individuals. Actions at multiple levels are needed to slow or control this overweight and obesity epidemic. PMID:25225884

Maternal super-obesity and perinatal outcomes in Australia: a national population-based cohort study.

PubMed

Sullivan, Elizabeth A; Dickinson, Jan E; Vaughan, Geraldine A; Peek, Michael J; Ellwood, David; Homer, Caroline S E; Knight, Marian; McLintock, Claire; Wang, Alex; Pollock, Wendy; Jackson Pulver, Lisa; Li, Zhuoyang; Javid, Nasrin; Denney-Wilson, Elizabeth; Callaway, Leonie

2015-12-02

Super-obesity is associated with significantly elevated rates of obstetric complications, adverse perinatal outcomes and interventions. The purpose of this study was to determine the prevalence, risk factors, management and perinatal outcomes of super-obese women giving birth in Australia. A national population-based cohort study. Super-obese pregnant women (body mass index (BMI) >50 kg/m(2) or weight >140 kg) who gave birth between January 1 and October 31, 2010 and a comparison cohort were identified using the Australasian Maternity Outcomes Surveillance System (AMOSS). Outcomes included maternal and perinatal morbidity and mortality. Prevalence estimates calculated with 95% confidence intervals (CIs). Adjusted odds ratios (ORs) were calculated using multivariable logistic regression. 370 super-obese women with a median BMI of 52.8 kg/m(2) (range 40.9-79.9 kg/m(2)) and prevalence of 2.1 per 1 000 women giving birth (95% CI: 1.96-2.40). Super-obese women were significantly more likely to be public patients (96.2%), smoke (23.8%) and be socio-economically disadvantaged (36.2%). Compared with other women, super-obese women had a significantly higher risk for obstetric (adjusted odds ratio (AOR) 2.42, 95% CI: 1.77-3.29) and medical (AOR: 2.89, 95% CI: 2.64-4.11) complications during pregnancy, birth by caesarean section (51.6%) and admission to special care (HDU/ICU) (6.2%). The 372 babies born to 365 super-obese women with outcomes known had significantly higher rates of birthweight ≥ 4500 g (AOR 19.94, 95 % CI: 6.81-58.36), hospital transfer (AOR 3.81, 95 % CI: 1.93-7.55) and admission to Neonatal Intensive Care Unit (NICU) (AOR 1.83, 95% CI: 1.27-2.65) compared to babies of the comparison group, but not prematurity (10.5% versus 9.2%) or perinatal mortality (11.0 (95% CI: 4.3-28.0) versus 6.6 (95% CI: 2.6- 16.8) per 1 000 singleton births). Super-obesity in pregnancy in Australia is associated with increased rates of pregnancy and birth complications, and with social disadvantage. There is an urgent need to further address risk factors leading to super-obesity among pregnant women and for maternity services to better address pre-pregnancy and pregnancy care to reduce associated inequalities in perinatal outcomes.

Marital status and educational level associated to obesity in Greek adults: data from the National Epidemiological Survey.

PubMed

Tzotzas, Themistoklis; Vlahavas, George; Papadopoulou, Sousana K; Kapantais, Efthymios; Kaklamanou, Daphne; Hassapidou, Maria

2010-11-26

Obesity is an important public health issue and its prevalence is reaching epidemic proportions in both developed and developing countries. The aim of the present study was to determine associations of overweight (OW), obesity (OB) and abdominal obesity (AO) with marital status and educational level in Greek adults of both genders based on data from the National Epidemiological Survey on the prevalence of obesity. The selection was conducted by stratified sampling through household family members of Greek children attending school during 2003. A total of 17,341 Greek men and women aged from 20 to 70 years participated in the survey and had anthropometric measurements (height, weight, and waist circumference) for the calculation of prevalence of OW, OB and AO. WHO cut-offs were used to define overweight and obesity categories. Waist circumference of more than 102 cm in men and 88 cm in women defined AO. Marital status and educational level were recorded using a specially designed questionnaire and were classified into 4 categories. The overall prevalence of OB was 22.3% (25.8% in men, 18.4% in women), that of OW 35.2% (41.0% in men, 29.8% in women) and that of AO 26.4% in men and 35.9% in women. A higher risk of OB was found in married men (OR: 2.28; 95% CI: 1.85-2.81) and married women (OR: 2.31; 95% CI: 1.73-3.10) than in the respective unmarried ones. Also, a higher risk of AO was found in married men (OR: 3.40; 95% CI: 2.86-4.03) and in married women (OR: 2.40; 95% CI 2.00-2.88) compared to unmarried ones. The risk for being obese was lower among educated women (primary school, OR: 0.76; 95% CI: 0.60-0.96, high school, OR: 0.58; 95% CI: 0.46-0.74 and University, OR: 0.64; 95% CI: 0.49-0.81) than among illiterates. No significant differences were found among men. In Greek adults, marital status was significantly associated with obesity and abdominal obesity status in both genders while educational level was inversely associated with obesity status only in women.

An increase level of acylation stimulating protein is correlated with metabolic risk markers in North Indian obese women.

PubMed

Mishra, Supriya; Gupta, Vani; Mishra, Sameeksha; Gupta, Vandana; Mahdi, Abbas Ali; Sachan, Rekha

2017-12-01

The present study was to investigate the association between serum acylation stimulating protein (ASP) level with metabolic risk factors in North Indian obese women. This is a case control study, total n=322 women aged between 20 and 45 years (n=162 with metabolic syndrome & n=160 without metabolic syndrome) were recruited for the study according to National Cholesterol Education Program Treatment Panel (NCEPATP) guidelines. Serum ASP level were determined by enzyme linked immunosorbent assay. Results indicated that circulating ASP and other metabolic risk factors (waist circumference, triglycerides, fasting plasma glucose etc) were significantly higher in women with metabolic syndrome (WmetS) than in women without syndrome (WometS) (p<0.001). Furthermore circulating ASP was significantly higher possitively correlated with waist circumference (r=0.51, p<0.001), triglyceride (r=0.56, p<0.001), glucose (r=0.70, p<0.001), and negatively correlated with high density lipoprotein(r=-0.56, p<0.001) in women with metabolic syndrome. Conclusively circulating ASP was found to be significantly associated with hyperlipidemia, obesity and obesity related disorders in North Indian obese women. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes.

PubMed

Persson, Martina; Cnattingius, Sven; Wikström, Anna-Karin; Johansson, Stefan

2016-10-01

Women with type 1 or type 2 diabetes are at increased risk of pre-eclampsia. Overweight and obesity are associated with an increased risk of pre-eclampsia in women without diabetes. The aim of the study was to investigate the impact of maternal overweight and obesity on the risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes. In a population-based cohort study including singleton births in Sweden, we estimated the risk of pre-eclampsia among women with type 1 diabetes (n = 7062) and type 2 diabetes (n = 886), and investigated whether maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI ≥30.0 kg/m(2)) modified the risk. Logistic regression analyses were used to estimate crude and adjusted ORs with 95% CIs, using women without diabetes as the reference group (n = 1,509,525). Compared with women without diabetes, the adjusted ORs for pre-eclampsia in women with type 1 and type 2 diabetes were 5.74 (95% CI 5.31, 6.20) and 2.11 (95% CI 1.65, 2.70), respectively. The corresponding risks of pre-eclampsia combined with preterm birth were even higher. Risks of pre-eclampsia increased with maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI ≥30.0 kg/m(2)), foremost in women without diabetes, to a lesser extent in women with type 1 diabetes but not in women with type 2 diabetes. Maternal overweight and obesity increased risks of pre-eclampsia in women with type 1 diabetes but not in women with type 2 diabetes. Even so, considering associations between maternal BMI and overall maternal and offspring risk, all women (with and without diabetes) should aim for a normal weight before pregnancy.

Food choice, eating behavior, and food liking differs between lean/normal and overweight/obese, low-income women.

PubMed

Dressler, Heidi; Smith, Chery

2013-06-01

The higher rate of obesity among low-income women has widely been attributed to environmental barriers; however, many low-income women are still able to maintain a healthy weight despite obesogenic environments. To better understand personal and behavioral attributes related to food choice and weight, overweight/obese women and lean/normal weight women living in similar low-income environments, participated in focus groups, and taste testing sessions to investigate food liking (n=83). During focus groups, lean/normal weight participants reported that health was influential in food choice, while overweight/obese participants expressed cost as being more of a factor. Both BMI (kg/m(2)) groups reported that taste was of greatest importance. Personal factors, like emotional eating, and overeating were also discussed with differences noted between BMI (kg/m(2)) groups. Quantitative data also showed cost to be more important for overweight/obese women. Taste testing results revealed that overweight/obese participants had a higher overall liking for both healthy and less healthy foods, as well as other food categories. Additionally, these women had a higher liking of fat in the context of spreadable fats. Our results show that a variety of complex factors interact to influence eating behavior and present weight status of women living in similarly impoverished environments. However, findings from this exploratory study should be confirmed through further research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Obesity is associated with a higher prevalence of musculoskeletal pain in middle-aged women.

PubMed

Blümel, Juan Enrique; Arteaga, Eugenio; Mezones-Holguín, Edward; Zúñiga, María Cristina; Witis, Silvina; Vallejo, María Soledad; Tserotas, Konstantino; Sánchez, Hugo; Onatra, William; Ojeda, Eliana; Mostajo, Desiree; Monterrosa, Alvaro; Lima, Selva; Martino, Mabel; Hernández-Bueno, Jose Alberto; Gómez, Gustavo; Espinoza, María Teresa; Flores, Daniel; Chedraui, Peter; Calle, Andrés; Bravo, Luz María; Benítez, Zully; Bencosme, Ascanio; Barón, Germán

2017-05-01

Musculoskeletal pain (MSP) has been recently linked with high plasma leptin levels. Our objective was to study if obese women, who have higher leptin levels, could have a higher frequency of MSP. We studied 6079 Latin-American women, 40-59 years old. Their epidemiological data were recorded and the Menopause Rating Scale (MRS), Golberg Anxiety and Depression Scale and Insomnia Scale were applied. MSP was defined as a score ≥2 on MRS11. Women with MSP were slightly older, had fewer years of schooling and were more sedentary. They also complained of more severe menopausal symptoms (29.2% versus. 4.4%, p < 0.0001). Furthermore, they had a higher abdominal perimeter (87.2 ± 12.0 cm versus 84.6 ± 11.6 cm, p < 0.0001) and a higher prevalence of obesity (23.1% versus 15.2%, p < 0.0001). Compared to normal weight women, those with low body weight (IMC <18.5) showed a lower risk of MSP (OR 0.71; 95%CI, 0.42-1.17), overweight women had a higher risk (OR 1.64; 95%CI, 1.44-1.87) and obese women the highest risk (OR 2.06; 95%CI, 1.76-2.40). Logistic regression analysis showed that obesity is independently associated to MSP (OR 1.34; 95%CI, 1.16-1.55). We conclude that obesity is one identifiable risk factor for MSP in middle-aged women.

Association between sleep and overweight/obesity among women of childbearing age in Canada

USDA-ARS?s Scientific Manuscript database

Tests of the relationship between sleep and overweight/obesity (OW/OB) among women have been inconsistent. Few studies reporting such associations have focused on women of childbearing age. This paper investigates this association among Canadian women of childbearing age. Data were from the Canadian...

75 FR 58394 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... obesity, and even childhood leukemia and sudden infant death syndrome (SIDS). However, the groups that are at higher risk for diabetes, obesity, and poor health overall persistently have the lowest...

Physical activity and the incidence of obesity in young African-American women.

PubMed

Rosenberg, Lynn; Kipping-Ruane, Kristen L; Boggs, Deborah A; Palmer, Julie R

2013-09-01

Obesity occurs more commonly among African-American women than among other racial/ethnic groups, and most weight gain occurs before middle age. The study prospectively investigated the relationship of vigorous exercise and brisk walking to the incidence of obesity (BMI ≥ 30) among African-American women aged <40 years. During 1995-2009 in the Black Women's Health Study, the current authors followed 20,259 African-American women who were aged <40 years and not obese at baseline. BMI, exercise, and walking were assessed at baseline and on biennial follow-up questionnaires. Data for BMI were collected through 2009. Data for exercise and walking were collected through 2007. Validation and reproducibility data indicated that reporting was more accurate for vigorous exercise than for brisk walking. Cox proportional hazards models estimated incidence rate ratios (IRRs) and 95% CIs of incident obesity for hours/week of vigorous exercise and walking relative to "little or no exercise" (<1 hour/week of vigorous exercise and <1 hour/week of brisk walking). The analyses were conducted in 2012. The incidence of obesity decreased with increasing vigorous exercise; the IRR was 0.77 (95% CI=0.69, 0.85) for ≥ 7 hours/week relative to little or no exercise; the IRRs were reduced both among women with a healthy weight (BMI <25) at baseline and among women who were overweight (BMI 25-<30) at baseline. The IRRs for brisk walking for exercise and walking for transport were <1.0 for most levels of walking, but without clear trends of decreasing risk with increasing time spent walking. The results suggest that vigorous exercise may reduce the incidence of obesity among young African-American women. Results for brisk walking were inconclusive. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Social support modifies the negative effects of acculturation on obesity and central obesity in Mexican men.

PubMed

Yoshida, Yilin; Broyles, Stephanie; Scribner, Richard; Chen, Liwei; Phillippi, Stephen; Jackson-Thompson, Jeanette; Simoes, Eduardo J; Tseng, Tung-Sung

2018-06-26

This study examined the moderating role of social support in the acculturation-obesity/central obesity relationship in Mexican American (MA) men and women. Data from NHANES 1999-2008 were used. Acculturation derived from language use, country of birth and length of residence in the U.S. Social support assessed emotional and financial support. BMI (≥30) and waist circumference (≥88 cm for women; ≥102 cm for men) measured obesity and central obesity, respectively. Weighted multivariate logistic regression models were used to describe associations. Compared to less acculturation, more acculturation was associated with higher odds of obesity (ORs 2.48; 95% CI 1.06-5.83) and central obesity (2.90; 1.39-6.08) among MA men with low/no social support, but not among MA men reporting high social support. The modifying effects was not observed among women. Higher amounts of social support appeared to attenuate the risk of obesity/central obesity associated with acculturation. Interventions enhancing social support maybe effective among acculturated MAs, particularly among men.

Does body image influence the relationship between body weight and breastfeeding maintenance in new mothers?

PubMed

Swanson, Vivien; Keely, Alice; Denison, Fiona C

2017-09-01

Obese women have lower breastfeeding initiation and maintenance rates than healthy weight women. Research generally focuses on biomedical explanations for this. Psychosocial factors including body image and well-being after childbirth are less well understood as predictors of breastfeeding. In obese and healthy weight women, we investigated changes in body image between 72 hrs post-delivery and 6-8 weeks post-natal, studying how women's body image related to breastfeeding initiation and maintenance. We also investigated how psychological distress was related to body image. Longitudinal semi-structured questionnaire survey. Body image and psychological distress were assessed within 72 hrs of birth and by postal questionnaire at 6-8 weeks, for 70 obese and 70 healthy weight women initiating exclusive (breastmilk only) breastfeeding or mixed feeding (with formula milk) in hospital. Breastfeeding was re-assessed at 6-8 weeks. Obese women were less likely to exclusively breastfeed in hospital and maintain breastfeeding to 6-8 weeks. Better body image was related to maintaining breastfeeding and to lower post-natal psychological distress for all women, but education level was the most significant predictor of maintenance in multivariate regression including body image and weight status. Body image mediated, but did not moderate the relationship between weight and breastfeeding maintenance. Body image was lower overall in obese women, but all women had low body image satisfaction around childbirth, reducing further at 6-8 weeks. Health professionals should consider women's body image when discussing breastfeeding. A focus on breast function over form may support breastfeeding for all women. Statement of contribution What is already known on this subject? Obesity can negatively affect breastfeeding initiation and maintenance, but there is little information about how psychosocial factors affect this relationship. Body image may be an important factor, but has not been studied in relation to breastfeeding maintenance. What does this study add This article examines the influence of body image on obese and healthy-weight women's breastfeeding maintenance at 6-8 weeks. Different aspects of body image mediated but did not moderate the relationship between weight status and breastfeeding maintenance, but in multivariate regression, maternal education level was the most significant predictor. Obese women had poorer body image and were less likely to maintain breastfeeding; however, for all women, body image became more negative in this postpartum period. Interventions should normalize positive aspects of women's postnatal bodies, including function rather than form. Addressing body concerns could encourage new mothers to maintain breastfeeding, irrespective of weight status. © 2017 The British Psychological Society.

Obesity Risk Knowledge, Weight Misperception, and Diet and Health-Related Attitudes among Women Intending to Become Pregnant.

PubMed

Berenson, Abbey B; Pohlmeier, Ali M; Laz, Tabassum H; Rahman, Mahbubur; Saade, George

2016-01-01

Our aim was to evaluate obesity risk knowledge, weight misperception, and diet and health-related attitudes among women intending to become pregnant compared to those not intending to become pregnant. We conducted a cross-sectional survey of health behaviors, including obesity risk knowledge, weight misperception, and diet and health-related attitudes among women (aged 16 to 40 years) attending reproductive health clinics in southeast Texas. Data were collected through self-administered questionnaires and chart review. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and obesity risk knowledge, weight misperception, and health-related attitudes after adjusting for age, race, income, and gravidity. Overall, 1,726 women completed the survey, of which 1,420 responded to a question on pregnancy intention. Of these, 126 stated they were intending to become pregnant. Obesity risk knowledge (adjusted odds ratio=1.14; 95% confidence interval [CI] 0.74 to 1.77) and weight misperception (adjusted odds ratio=1.17; 95% CI 0.75 to 1.83) did not differ between women intending and not intending to become pregnant. In addition, diet and health-related attitudes did not differ between these two groups (P>0.05 for all). Among women intending to become pregnant, 51% had low obesity risk knowledge and 31% misperceived their body weight. Further, 76% of these women felt confused about what constitutes a healthy diet, although 47% believed that their current diet was healthy and saw no reason to change their current eating patterns. While weight misperception did not differ significantly between the two groups, overweight women intending to become pregnant were more likely to misperceive their weight than obese women intending to become pregnant (71% vs 10%; P<0.001). There is a need for improved preconception counseling, especially for women intending to become pregnant, regarding the risks associated with being overweight or obese, misperception of body weight, and negative diet and health-related attitudes. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Labor Intervention and Outcomes in Women Who Are Nulliparous and Obese: Comparison of Nurse-Midwife to Obstetrician Intrapartum Care

PubMed Central

Carlson, Nicole S.; Corwin, Elizabeth J.; Lowe, Nancy K.

2017-01-01

Background Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. Methods This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index 30 kg/m2). Labors were managed by either a certified nurse-midwife (CNM) or an obstetrician at one hospital from 2005 through 2012. Comparisons were made on a range of labor processes and outcomes. Results Women who were obese and cared for in labor by CNMs were 87.0% less likely to have operative vaginal birth (adjusted odds ratio [aOR], 0.15; 95% confidence interval [CI], 0.06–0.41) and 76.3% less likely to have third- or fourth-degree perineal lacerations (aOR, 0.31; 95% CI, 0.13–0.79) compared to a matched group of women who were obese and had similarly sized neonates but who were cared for by obstetricians. The rates of unplanned cesarean birth, postpartum hemorrhage, maternal intrapartum fever, and neonatal intensive care unit admission were similar between groups. CNM patients were significantly less likely than patients of obstetricians to have labor anesthesia, synthetic oxytocin augmentation, or intrauterine pressure catheters. By contrast, CNM patients were significantly more likely than patients of obstetricians to use physiologic labor interventions, including intermittent fetal monitoring, ambulation, and hydrotherapy. Discussion In women with spontaneous labor onset who were healthy, obese, and nulliparous, watchful waiting and use of physiologic labor interventions, characterizing CNM intrapartum care, were associated with outcomes that were similar to, or better than, those of women who were obese and exposed to more high-technology interventions characterizing intrapartum care by obstetricians. In women who were obese, physiologic labor interventions were safe for both mothers and neonates. PMID:28099786

Labor Intervention and Outcomes in Women Who Are Nulliparous and Obese: Comparison of Nurse-Midwife to Obstetrician Intrapartum Care.

PubMed

Carlson, Nicole S; Corwin, Elizabeth J; Lowe, Nancy K

2017-01-01

Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m 2 ). Labors were managed by either a certified nurse-midwife (CNM) or an obstetrician at one hospital from 2005 through 2012. Comparisons were made on a range of labor processes and outcomes. Women who were obese and cared for in labor by CNMs were 87.0% less likely to have operative vaginal birth (adjusted odds ratio [aOR], 0.15; 95% confidence interval [CI], 0.06-0.41) and 76.3% less likely to have third- or fourth-degree perineal lacerations (aOR, 0.31; 95% CI, 0.13-0.79) compared to a matched group of women who were obese and had similarly sized neonates but who were cared for by obstetricians. The rates of unplanned cesarean birth, postpartum hemorrhage, maternal intrapartum fever, and neonatal intensive care unit admission were similar between groups. CNM patients were significantly less likely than patients of obstetricians to have labor anesthesia, synthetic oxytocin augmentation, or intrauterine pressure catheters. By contrast, CNM patients were significantly more likely than patients of obstetricians to use physiologic labor interventions, including intermittent fetal monitoring, ambulation, and hydrotherapy. In women with spontaneous labor onset who were healthy, obese, and nulliparous, watchful waiting and use of physiologic labor interventions, characterizing CNM intrapartum care, were associated with outcomes that were similar to, or better than, those of women who were obese and exposed to more high-technology interventions characterizing intrapartum care by obstetricians. In women who were obese, physiologic labor interventions were safe for both mothers and neonates. © 2017 by the American College of Nurse-Midwives.

Behavioral and body size correlates of energy intake underreporting by obese and normal-weight women.

PubMed

Kretsch, M J; Fong, A K; Green, M W

1999-03-01

To examine behavioral and body size influences on the underreporting of energy intake by obese and normal-weight women. Seven-day estimated food records were kept by subjects before they participated in a 49-day residential study. Self-reported energy intake was compared with energy intake required to maintain a stable body weight during the residential study (reference standard). Energy intake bias and its relationship to various body size and behavioral measures were examined. Twenty-two, healthy, normal-weight (mean body mass index [BMI] = 21.3) and obese (mean BMI = 34.2) women aged 22 to 42 years were studied. Analysis of variance, paired t test, simple linear regression, and Pearson correlation analyses were conducted. Mean energy intake from self-reported food records was underreported by normal-weight (-9.7%) and obese (-19.4%) women. BMI correlated inversely with the energy intake difference for normal-weight women (r = -.67, P = .02), whereas the Beck Depression Inventory correlated positively with the energy intake difference for obese women (r = .73, P < .01). CONCLUSION/APPLICATIONS: Results suggest that body size and behavioral traits play a role in the ability of women to accurately self-report energy intake. BMI appears to be predictive of underreporting of energy intake by normal-weight women, whereas emotional factors related to depression appear to be more determinant of underreporting for obese women. Understanding causative factors of the underreporting phenomenon will help practicing dietitians to devise appropriate and realistic diet intervention plans that clients can follow to achieve meaningful change.

Reasons, Motivational Factors, and Perceived Personal Barriers to Engagement in Physical Activity During Pregnancy Vary Within the BMI Classes: The Prenatal Prevention Project Germany.

PubMed

Bauer, Carina; Graf, Christine; Platschek, Anna M; Strüder, Heiko K; Ferrari, Nina

2018-03-01

International data indicate that approximately only 20.0% of pregnant women reach physical activity recommendations (≥150 min/wk). To find ways for increasing physical activity, the reasons for exercising, motivational factors, and barriers need to be determined. The aim of this pilot study was to identify these factors in respect to body mass index classification in German pregnant women. A total of 61 women [age: 32.7 (4.8) y; 13.3 (3.4) wk of gestation] participated in this study. Before pregnancy, 10.0% of women were underweight, 58.3% were normal weight, 18.3% were overweight, and 13.4% were obese. Standardized questionnaires were used to evaluate the abovementioned factors. "Fun" was one of the main reasons for being active in underweight/normal weight compared with overweight/obese women (53.7% vs 10.5%; P = .002), whereas "burning fat" was more important in overweight/obese women (9.8% vs 36.8%; P = .027). According to motivational factors, differences occurred in "calorie burning" (7.3% underweight/normal weight vs 31.6% overweight/obese; P = .025) and "fat burning" (7.3% underweight/normal weight vs 47.4% overweight/obese; P = .001). Regarding barriers for being active, "tiredness" was more often a barrier in overweight/obese (63.2%) compared with normal weight/underweight women (31.7%; P = .022). Pregnant women should be given tailored advice/motivation according to prepregnancy body mass index. However, larger studies are necessary to evaluate these factors on pregnant women's physical activity level.

Associations between poor sleep quality and psychosocial stress with obesity in reproductive-age women of lower socioeconomic status.

PubMed

Tom, Sarah E; Berenson, Abbey B

2013-01-01

Prior studies have not examined the role of psychosocial stress in the relationship between poor sleep quality and obesity among women of lower socioeconomic status (SES). We tested the following hypotheses in a sample of reproductive-age women of lower SES: 1) Poor sleep quality is related to increased risk of obesity, and 2) psychosocial stress confounds this association between poor sleep quality and obesity. A total of 927 women age 16 to 40 years attending public health clinics in Southeastern Texas provided information on the Pittsburgh Sleep Quality Index and sociodemographic and health characteristics, including the Perceived Stress Scale. Height, weight, and waist circumference (WC) were measured in clinic. A series of models examined the associations between sleep disturbance, perceived stress, and weight outcomes, accounting for potential confounding factors. Nearly 30% of women were overweight, and 35% were obese. Half of women had a WC of greater than 35 inches. Most women had poor sleep quality and high levels of stress. Sleep quality and perceived stress were not related to body mass index category or WC in models that adjusted for age and race/ethnicity. Adjusting for potential confounding factors did not alter results. Perceived stress did not modify the association between sleep quality and weight outcomes. Poor sleep quality and psychosocial stress were not related to weight in reproductive-aged women of lower SES. However, poor sleep quality, high stress, overweight, and obesity were common in this group. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Overweight and Obesity among Women by Economic Stratum in Urban India

PubMed Central

Prusty, Ranjan Kumar

2014-01-01

Using data of the third round of the National Family Health Survey (NFHS) 2005-2006, this study examined the prevalence of overweight and obesity among women from different economic strata in urban India. The study used a separate wealth index for urban India constructed using principal components analysis (PCA). The result shows that prevalence of overweight and obesity is very high in urban areas, more noticeably among the non-poor households. Furthermore, overweight and obesity increase with age, education, and parity of women. The results of multinomial logistic regression show that non-poor women are about 2 and 3 times more at risk of being overweight and obese respectively. Marital status and media exposure are the other covariates associated positively with overweight and obesity. Thus, the growing demand which now appears before the Government or urban health planners is to address this rising urban epidemic with equal importance as given to other issues in the past. PMID:24847596

Nitrogen loss in normal and obese subjects during total fast.

PubMed

Göschke, H; Stahl, M; Thölen, H

1975-07-01

Healthy volunteers of ideal weight (12 men and 12 women) were fasted for 6 days, and obese but otherwise healthy subjects (20 men, 28 women) for 6--28 days. In all groups studied a significant increase in urinary nitrogen loss from day 1 to day 3 of fasting was followed by a steady decrease. The early rise in urinary nitrogen excretion coincided with a rise in plasma glucagon levels, suggesting a relation of the latter to increased gluconeogenesis from amino acids. At equal weight greater nitrogen losses were found in men than in women, in both normal and obese subjects. In spite of much higher weight and larger energy expenditure and nitrogen loss in obese subjects however was not higher than in normal ones. Mean daily nitrogen losses varied from 14.5 g (normal and obese men early in starvation) to 3.0 g (obese women after a 4-weeks fast). Calculating the amount of calories derived from body protien (urinary nitrogen X 6.25 X 4.1)and taking total energy expenditure from tabular metabolic values, the contribution of protein to total calorie output was found to vary from 15% (normal men 6 day fast) to 5(obese women, 4th week of fasting). The clinical significance of nitrogen loss during therapeutic fasting is discussed.

Food Insecurity, Not Stress is Associated with Three Measures of Obesity in Low-Income, Mexican-American Women in South Texas.

PubMed

Salinas, Jennifer J; Shropshire, William; Nino, Ana; Parra-Medina, Deborah

2016-01-01

To determine the relationship between obesity, food insecurity and perceived stress in very low income Mexican American women. Cross-sectional baseline data analysis of a randomized clinical trial. Texas-Mexico border region of South Texas. Very Low Income Mexican American Women. The relationship between obesity and food insecurity in a sample of very low income Hispanic women living in South Texas depends on the measure of obesity and the dimension of food insecurity. The only measure of food insecurity associated with all measures of obesity was often not having enough money to afford to eat balanced meals. Waist circumference was associated with the most dimensions of food insecurity, while BMI had the least associations. Finally, perceived stress was not significantly associated with BMI, waist circumference or percent body fat when adjusted for other covariates. We have found a strong and significant relationship between food insecurity related to having enough resources to eat a balanced diet and BMI, waist circumference, and percent body fat in low-income Mexican American women. While behavioural change is an important strategy for reducing obesity, consideration may need to be made as to how food access with high nutritional value, may be in and of itself a contributing factor in obesity in low income populations.

The incretin effect and secretion in obese and lean women with polycystic ovary syndrome: a pilot study.

PubMed

Pontikis, Charalambos; Yavropoulou, Maria P; Toulis, Konstantinos A; Kotsa, Kalliopi; Kazakos, Kyriakos; Papazisi, Aleka; Gotzamani-Psarakou, Anna; Yovos, John G

2011-06-01

Insulin resistance is considered to play an important role in the pathogenesis of polycystic ovary syndrome (PCOS) and in the progression to type 2 diabetes. Recent reports concentrate on a possible relationship between incretin secretion and beta-cell function in PCOS. The aim of the present study is to investigate the incretin effect in obese and lean women with PCOS. Twenty women with PCOS and ten age-matched healthy women were recruited in the study. The oral glucose tolerance test (OGTT) and isoglycemic test were carried out on each participant after an overnight fast at 2-weeks interval. Plasma levels of insulin, glucose, C-peptide, glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1) were assayed. Obese women with PCOS demonstrated lower GIP concentrations (area under the curve [AUC]) in response to OGTT compared to the control group. The incretin effect was found significantly augmented in the obese women with PCOS compared to controls. This finding remained robust in the subgroup analysis including only body mass index (BMI)-matched healthy women. Increased insulinotropic effect could counteract the blunted GIP response to OGTT in obese women with PCOS. It is suggested that the pathology of PCOS may also include impaired activity of the enteroinsular axis.

[Prevalence of obesity, hypertension and dyslipidemia in rural aboriginal groups in Chile].

PubMed

Pérez, F; Carrasco, E; Santos, J L; Calvillán, M; Albala, C

1999-10-01

Chilean aboriginal ethnic groups (mapuche and aymaras) have a very low prevalence rate of type 2 diabetes. The investigation of a possible relationship between this low prevalence of diabetes and obesity, hypertension and serum lipid profiles in both groups is worthwhile. To study the prevalence of obesity, hypertension and lipid profile in two Chilean aboriginal communities. The prevalence of obesity, hypertension, fasting serum total cholesterol, HDL cholesterol, triglycerides, glucose, insulin, leptin and oral glucose tolerance test were measured in 345 mapuche (106 male) and 247 aymara (100 male) individuals. Sixty three percent of mapuche women, 37.9% of mapuche men, 39.7% of the aymara women and 27.0% of aymara men had a body mass index over 27 kg/m2. Twenty percent of mapuche men, 18.0% of mapuche women, 9.0% of aymara men and 4.8% of the aymara women had high blood pressure values. Serum HDL cholesterol was below 35 mg/dl in 16% of mapuche women, 14% of mapuche men, 25% of the aymara women and 27% of aymara men. No differences in total cholesterol levels were observed between mapuches and aymaras. Mapuche women have higher prevalence of obesity and high blood pressure than aymara women. Low serum HDL cholesterol has a higher prevalence among aymara individuals.

Association Between Obesity During Pregnancy and the Adequacy of Prenatal Care.

PubMed

Zozzaro-Smith, Paula E; Bacak, Stephen; Conway, Ciara; Park, Jennifer; Glantz, J Christopher; Thornburg, Loralei L

2016-01-01

In the United States, more than a third of women are obese [body mass index (BMI) ≥ 30]. Although obese populations utilize health care at increased rates and have higher health care costs than non-obese patients, the adequacy of prenatal care in this population is not well established and assumed to be suboptimal. We therefore evaluated adequacy of prenatal care among obese women. We utilized an electronic database including 7094 deliveries with pre-pregnancy BMI ≥ 18.5 from January 2009 through December 2011. Subjects were categorized as normal weight 18.5-24.9 kg/m2, overweight 25-29.9 kg/m2, and obese ≥30 kg/m2 (class I-II-III). Adequacy of prenatal care (PNC) was evaluated using the Kotelchuck Index (KI), corrected for gestational age at delivery. Adequate care was defined as KI "adequate" or "adequate plus," and non-adequate as "intermediate" or "inadequate." Chi square and logistic regression were used for comparisons. When compared to non-obese women, obese women were more likely to have adequate PNC (74.1 vs. 68.7%; OR 1.30, 95% CI 1.15-1.47). After adjusting for age, race, education, diabetes, hypertension, and practice type, obesity remained a significant predictor of adequate prenatal care (OR 1.29, 95% CI 1.14-1.46). While age and hypertension were not significant independent predictors of adequate PNC, college education, Caucasian, diabetes, and resident or MFM care had positive associations. Maternal obesity is associated with increased adequacy of prenatal care. Although some comorbidities associated with obesity increase utilization of prenatal services, this did not explain the improvement in PNC adequacy associated with obesity. Overweight and obese women are at a higher risk of pregnancy complications with obesity contributing to increased morbidity and mortality of the mother. Several studies have evaluated barriers to routine health care services, with obese parturients perceiving their weight to be a barrier to obtaining appropriate care. There is limited data available assessing the adequacy of prenatal care in this population. Our study demonstrated that obesity was actually associated with an increased adequacy of prenatal care. The presence of comorbidities did not explain this improvement in prenatal care.

Treatment-Associated Changes in Body Composition, Health Behaviors, and Mood as Predictors of Change in Body Satisfaction in Obese Women: Effects of Age and Race/Ethnicity

ERIC Educational Resources Information Center

Annesi, James J.; Tennant, Gisèle A.; Mareno, Nicole

2014-01-01

A lack of satisfaction with one's body is common among women with obesity, often prompting unhealthy "dieting." Beyond typically slow improvements in weight and body composition, behavioral factors might also affect change in body satisfaction. Age and race/ethnicity (African American vs. White) might moderate such change. Obese women (N…

Prevalence of 'obesity-associated gonadal dysfunction' in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis.

PubMed

Escobar-Morreale, Hector F; Santacruz, Elisa; Luque-Ramírez, Manuel; Botella Carretero, José I

2017-07-01

Sexual dimorphism manifests noticeably in obesity-associated gonadal dysfunction. In women, obesity is associated with androgen excess disorders, mostly the polycystic ovary syndrome (PCOS), whereas androgen deficiency is frequently present in obese men in what has been termed as male obesity-associated secondary hypogonadism (MOSH). Obesity-associated gonadal dysfunction, consisting of PCOS in women and MOSH in men, is a frequent finding in patients with severe obesity and it may be ameliorated or even resolve with marked weight loss, especially after bariatric surgery. We aimed to obtain an estimation of the prevalence of obesity-associated gonadal dysfunction among women and men presenting with severe obesity and to evaluate the response to bariatric surgery in terms of resolution and/or improvement of this condition and changes in circulating sex hormone concentrations. We searched PubMed and EMBASE for articles published up to June 2016. After deleting duplicates, the abstract of 757 articles were analyzed. We subsequently excluded 712 articles leaving 45 studies for full-text assessment of eligibility. Of these, 16 articles were excluded. Hence, 29 studies were included in the quantitative synthesis and in the different meta-analyses. Quality of the studies was assessed using the Quality index for prevalence studies and the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group available from the National Heart, Lung and Blood Institute. For meta-analyses including more than 10 studies, we used funnel and Doi plots to estimate publication bias. In severely obese patients submitted to bariatric surgery, obesity-associated gonadal dysfunction was very prevalent: PCOS was present in 36% (95CI 22-50) of women and MOSH was present in 64% (95CI 50-77) of men. After bariatric surgery, resolution of PCOS was found in 96% (95CI 89-100) of affected women and resolution of MOSH occurred in 87% (95CI 76-95) of affected men. Sex hormone-binding globulin concentrations increased after bariatric surgery in women (22 pmol/l, 95CI 2-47) and in men (22 pmol/l, 95CI 19-26) and serum estradiol concentrations decreased in women (-104 pmol/l, 95CI -171 to -39) and to a lesser extent in men (-22 pmol/l, 95CI -38 to -7). On the contrary, sex-specific changes were observed in serum androgen concentrations: for example, total testosterone concentration increased in men (8.1 nmol/l, 95CI 6-11) but decreased in women (-0.7 nmol/l, 95CI -0.9 to -0.5). The latter was accompanied by resolution of hirsutism in 53% (95CI 29-76), and of menstrual dysfunction in 96% (95CI 88-100), of women showing these symptoms before surgery. Obesity-associated gonadal dysfunction is among the most prevalent comorbidities in patients with severe obesity and should be ruled out routinely during their initial diagnostic workup. Considering the excellent response regarding both PCOS and MOSH, bariatric surgery should be offered to severely obese patients presenting with obesity-associated gonadal dysfunction. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Neighborhood-Level Poverty at Menarche and Prepregnancy Obesity in African-American Women

PubMed Central

Peters, Rosalind M.; Burmeister, Charlotte; Bielak, Lawrence F.; Johnson, Dayna A.

2016-01-01

Introduction. Menarche is a critical time point in a woman's reproductive system development; exposures at menarche may influence maternal health. Living in a poorer neighborhood is associated with adult obesity; however, little is known if neighborhood factors at menarche are associated with prepregnancy obesity. Methods. We examined the association of neighborhood-level poverty at menarche with prepregnancy body mass index category in 144 pregnant African-American women. Address at menarche was geocoded to census tract (closest to year of menarche); neighborhood-level poverty was defined as the proportion of residents living under the federal poverty level. Cumulative logistic regression was used to examine the association of neighborhood-level poverty at menarche, in quartiles, with categorical prepregnancy BMI. Results. Before pregnancy, 59 (41%) women were obese. Compared to women in the lowest neighborhood-level poverty quartile, women in the highest quartile had 2.9 [1.2, 6.9] times higher odds of prepregnancy obesity; this was slightly attenuated after adjusting for age, marital status, education, and parity (odds ratio: 2.3 [0.9, 6.3]). Conclusions. Living in a higher poverty neighborhood at menarche is associated with prepregnancy obesity in African-American women. Future studies are needed to better understand the role of exposures in menarche on health in pregnancy. PMID:27418977

Neighborhood-Level Poverty at Menarche and Prepregnancy Obesity in African-American Women.

PubMed

Cassidy-Bushrow, Andrea E; Peters, Rosalind M; Burmeister, Charlotte; Bielak, Lawrence F; Johnson, Dayna A

2016-01-01

Introduction. Menarche is a critical time point in a woman's reproductive system development; exposures at menarche may influence maternal health. Living in a poorer neighborhood is associated with adult obesity; however, little is known if neighborhood factors at menarche are associated with prepregnancy obesity. Methods. We examined the association of neighborhood-level poverty at menarche with prepregnancy body mass index category in 144 pregnant African-American women. Address at menarche was geocoded to census tract (closest to year of menarche); neighborhood-level poverty was defined as the proportion of residents living under the federal poverty level. Cumulative logistic regression was used to examine the association of neighborhood-level poverty at menarche, in quartiles, with categorical prepregnancy BMI. Results. Before pregnancy, 59 (41%) women were obese. Compared to women in the lowest neighborhood-level poverty quartile, women in the highest quartile had 2.9 [1.2, 6.9] times higher odds of prepregnancy obesity; this was slightly attenuated after adjusting for age, marital status, education, and parity (odds ratio: 2.3 [0.9, 6.3]). Conclusions. Living in a higher poverty neighborhood at menarche is associated with prepregnancy obesity in African-American women. Future studies are needed to better understand the role of exposures in menarche on health in pregnancy.

Effects of Age at First Childbirth and Other Factors on Central Obesity in Postmenopausal Women: The 2013–2015 Korean National Health and Nutrition Examination Survey

PubMed Central

Lee, Wang Jin; Lee, Joo Ha; Kwag, Byoung Gyu; Chang, Shin Hae; Choi, Yu Jin

2018-01-01

Background Waist circumference is one of the key components of metabolic syndrome. Recent studies demonstrated that the reproductive profile was associated with metabolic syndrome in postmenopausal women. This study focused on the association between central obesity and age at first childbirth. It also considered other factors associated with central obesity in postmenopausal women. Methods This study was based on the 2013–2015 Korean National Health and Nutrition Examination Survey and involved 3,143 naturally postmenopausal women. These women were divided into three groups according to their age at first childbirth: 19 years or younger (n=252), 20–29 years (n=2,695), and 30 years or older (n=196). Multivariate analysis using logistic regression was performed to evaluate the effects of various reproductive factors, including other confounding factors. Results During adjustment for confounding factors, in the early age at first childbirth group, odds ratios (95% confidence intervals) for central obesity decreased. In the final model, younger age at first childbirth was not significantly related to central obesity (waist circumference more than 85 cm) in naturally postmenopausal women after adjusting for other confounding factors. Conclusion Younger age at first childbirth was not significantly associated with central obesity after adjustment for confounding factors. PMID:29788703

Relation of body mass and sex steroid hormone levels to hot flushes in a sample of mid-life women.

PubMed

Schilling, C; Gallicchio, L; Miller, S R; Langenberg, P; Zacur, H; Flaws, J A

2007-02-01

Previous studies indicate that obesity is associated with a higher risk of experiencing hot flushes in mid-life women. The reasons for this association are unknown, although altered hormone levels have been associated with both hot flushes and obesity. Thus, this current study tested the hypothesis that obesity is associated with hot flushes in mid-life women through a mechanism involving levels of total and free androgen, free estrogen, progesterone, and sex hormone binding globulin (SHBG). Women aged 45-54 years were recruited from Baltimore and its surrounding counties. Each participant (n=628) was weighed, measured, completed a questionnaire, and provided a blood sample that was used to measure estradiol, estrone, testosterone, androstenedione, dehydroepiandrosterone sulfate, progesterone, and SHBG. Obese mid-life women (body mass index (BMI)>or=30.0 kg/m2) had significantly higher testosterone, and lower estradiol, estrone, progesterone, and SHBG levels than normal-weight mid-life women (BMI

Restaurant foods, sugar-sweetened soft drinks, and obesity risk among young African American women.

PubMed

Boggs, Deborah A; Rosenberg, Lynn; Coogan, Patricia F; Makambi, Kepher H; Adams-Campbell, Lucile L; Palmer, Julie R

2013-01-01

The prevalence of obesity is disproportionately high in African American women, and consumption of fast foods and sugar-sweetened soft drinks is also especially high among African Americans. We investigated the relation of intakes of sugar-sweetened soft drinks and specific types of restaurant foods to obesity in the Black Women's Health Study. In this prospective cohort study, 19,479 non-obese women aged 21-39 years at baseline were followed for 14 years (1995-2009). Dietary intake was assessed by validated food frequency questionnaire in 1995 and 2001. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of intakes of restaurant foods and sugar-sweetened soft drinks with incident obesity. Higher intakes of burgers from restaurants and sugar-sweetened soft drinks were associated with greater risk of becoming obese. The associations were present in models that included both factors and adjusted for overall dietary pattern. The HR of obesity in relation to restaurant burger consumption of > or = 2 times/week compared with < 5 times/year was 1.26 (95% CI: 1.14-1.40; P-trend<.001). For sugar-sweetened soft drink intake, the HR was 1.10 (95% CI: .99-1.23; P-trend = .14) for > or = 2 drinks/day compared with < 1 drink/month. The associations were stronger among women younger than age 30 with normal weight at baseline. Frequent consumption of burgers from restaurants and sugar-sweetened soft drinks contribute to obesity among young African American women.

Epidural extension failure in obese women is comparable to that of non-obese women.

PubMed

Eley, V A; Chin, A; Tham, I; Poh, J; Aujla, P; Glasgow, E; Brown, H; Steele, K; Webb, L; van Zundert, A

2018-07-01

Management of labor epidurals in obese women is difficult and extension to surgical anesthesia is not always successful. Our previous retrospective pilot study found epidural extension was more likely to fail in obese women. This study used a prospective cohort to compare the failure rate of epidural extension in obese and non-obese women and to identify risk factors for extension failure. One hundred obese participants (Group O, body mass index ≥ 40 kg/m 2 ) were prospectively identified and allocated two sequential controls (Group C, body mass index ≤ 30 kg/m 2 ). All subjects utilized epidural labor analgesia and subsequently required anesthesia for cesarean section. The primary outcome measure was failure of the labor epidural to be used as the primary anesthetic technique. Risk factors for extension failure were identified using Chi-squared and logistic regression. The odds ratio (OR) of extension failure was 1.69 in Group O (20% vs. 13%; 95% CI: 0.88-3.21, P = 0.11). Risk factors for failure in obese women included ineffective labor analgesia requiring anesthesiologist intervention, (OR 3.94, 95% CI: 1.16-13.45, P = 0.028) and BMI > 50 kg/m 2 (OR 3.42, 95% CI: 1.07-10.96, P = 0.038). The failure rate of epidural extension did not differ significantly between the groups. Further research is needed to determine the influence of body mass index > 50 kg/m 2 on epidural extension for cesarean section. © 2018 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Long working hours and overweight and obesity in working adults.

PubMed

Kim, Byung-Mi; Lee, Bo-Eun; Park, Hye-Sook; Kim, Young-Ju; Suh, Young-Ju; Kim, Jeong-Youn; Shin, Ji-Young; Ha, Eun-Hee

2016-01-01

Previous studies have identified a link between gender and the various risk factors associated with obesity. We examined obesity risk factors in working adults to identify the effects of differences in body mass index (BMI) and percentage body fat (PBF) between women and men. A total of 1,120 adults agreed to participate in the study. Data from 711 participants, including 411 women and 300 men, were analyzed. Multiple logistic regression analysis was used to estimate the effects of risk factors on obesity and being overweight. In addition, the least-squares (LS) means of both BMI and PBF were estimated by analysis of covariance (ANCOVA) in a generalized linear model. Increases in BMI and PBF were significantly related to an age > 50 years and long working hours in women after compensating for confounding factors. Using the PBF criterion, the odds ratio (OR) of being overweight or obese in women > 50 years of age who worked for > 9 h a day was 3.9 (95% confidence interval [CI], 1.05-11.00). For BMI, women who were > 50 years of age and worked for > 9 h a day were 3.82 times (95% CI, 1.31-11.14) more likely to be overweight or obese than those who were < 50 years of age and worked for < 9 h a day. Obesity in working adults was associated with > 50 years of age and long working hours in women. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implications for the prevention and management of excess weight and obesity.

Sex Differences in Obesity Prevalence and Cardiometabolic Factors among Western Alaska Native People

PubMed Central

Hopkins, SE; Austin, MA; Metzger, JS; Koller, KR; Umans, JG; Kaufmann, C; Wolfe, AW; Howard, BV; Boyer, BB

2014-01-01

Background and Aims Obesity is associated with increased risks of cardiovascular disease, type 2 diabetes, and other chronic diseases. Prevalence estimates for metabolic disorders are well documented in many populations, but Alaska Native groups are understudied. The Western Alaska Tribal Collaborative for Health Study combines data from three Alaska Native study cohorts to assess differences in obesity prevalence and associations with cardiometabolic risk factors by sex. Methods and Results Analyses were based upon a sample of 3985 adult Yup’ik and Inupiat participants with a mean age of 40 years. Prevalence of obesity and metabolic risk factors was assessed according to nationally recognized guidelines. Regression analysis was used to evaluate the association between obesity and cardiometabolic risk factors, including lipids, blood pressure and glucose. The prevalence of obesity (BMI ≥ 30) was significantly higher in women (40%) than men (20%). Only 18.6% of men had a waist circumference (WC) >102cm, while 58% of women had a WC >88cm (p<0.001). Women had higher mean HDL-C and triglyceride levels compared to men, while systolic and diastolic blood pressure, LDL-C, and glucose means were higher in men than in women. In multivariate analyses, BMI and WC were significantly associated with all of the cardiometabolic risk factors, although these associations were more pronounced in men than women. Conclusion The high prevalence of obesity and central adiposity among AN women is an important public health concern. Differences in associations between obesity and cardiometabolic risk factors by sex warrants further investigation to develop effective intervention programs. PMID:25467216

Multiparity is associated with high motivation to change diet among overweight and obese postpartum women.

PubMed

Bastian, Lori A; Pathiraja, Viranga C; Krause, Katrina; Namenek Brouwer, Rebecca J; Swamy, Geeta K; Lovelady, Cheryl A; Østbye, Truls

2010-01-01

Pregnancy is associated with weight gain and obesity. The aim of this study was to identify the effect of parity and other factors on motivation to change diet to lose weight in a cohort of overweight and obese postpartum women. Active Mothers Postpartum is a randomized, controlled trial aimed at postpartum weight reduction. At baseline, we measured motivation to change diet to lose weight among 491 overweight/obese postpartum women. Logistic regression was used to model the effect of parity on motivation to change diet at baseline while adjusting for potential confounders including age, race, education, body mass index category, and breastfeeding status. Approximately two thirds (68%) of participants were highly motivated to change their diet to lose weight. In the multivariable model, women with three or more children had 2.5 times the odds of high motivation compared with primigravid women, and women not breastfeeding had 1.6 times the odds of high motivation compared with any breastfeeding. Although risk for obesity is incurred starting with a woman's first pregnancy, women in this study were more motivated to change their diet to lose weight after their third pregnancy. Further research is needed to understand how to best capitalize on the high motivation in women with several children as well as how to improve motivation for primigravid women and women who are breastfeeding. Copyright 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis.

PubMed

Lindsay, Ana Cristina; Greaney, Mary L; Wallington, Sherrie F; Wright, Julie A; Hunt, Anne T

2017-08-02

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15-44). Participants ( n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers' Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m²), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24-6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02-1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when designing interventions targeting Latina immigrants.

Antenatal and postnatal depression in women with obesity: a systematic review.

PubMed

Steinig, Jana; Nagl, Michaela; Linde, Katja; Zietlow, Grit; Kersting, Anette

2017-08-01

Obesity and depression are prevalent complications during pregnancy and associated with severe health risks for the mother and the child. The co-occurrence of both conditions may lead to a particular high-risk group. This review provides a systematic overview of the association between pre-pregnancy obesity and antenatal or postnatal depression. We conducted a systematic electronic literature search for English language articles published between January 1990 and March 2017. Inclusion criteria were (a) adult pregnant women, (b) women with pre-pregnancy obesity and normal weight controls, (c) definition of obesity according to the IOM 1990/2009 criteria, (d) established depression measure, and (e) report on the association between pre-pregnancy obesity and antenatal or postnatal depression. Fourteen (eight prospective (PS), six cross-sectional (CS)) studies were included. One study reported data from a large community-based sample, and one reported cross-national data. Of 13 studies examining pre-pregnancy obesity and antenatal depression, 9 found a higher risk or higher levels of antenatal depression among women with obesity relative to normal weight (6 PS, 3 CS), while 4 studies found no association (2 PS, 2 CS). Of four studies examining pre-pregnancy obesity and postnatal depression, two studies found a positive association (two PS), one study (CS) reported different findings for different obesity classes, and one study found none (PS). The findings suggest that women with obesity are especially vulnerable to antenatal depression. There is a need to develop appropriate screening routines and targeted interventions to mitigate negative health consequences for the mother and the child. Research addressing the association between obesity and postnatal depression is too limited to draw solid conclusions. Results are mainly based on selective samples, and there is a need for further high-quality prospective studies examining the association between pre-pregnancy obesity and antenatal and postnatal depression.

Altered intragenic DNA methylation of HOOK2 gene in adipose tissue from individuals with obesity and type 2 diabetes

PubMed Central

Fernández-Bayón, Gustavo; Morales-Sánchez, Paula; Sanz, Lourdes; Turienzo, Estrella; González, Juan José; Martinez-Faedo, Ceferino; Suarez-Gutiérrez, Lorena; Ares, Jessica; Díaz-Naya, Lucia; Martin-Nieto, Alicia; Fernández-Morera, Juan L.; Fraga, Mario F.

2017-01-01

Aims/Hypothesis Failure in glucose response to insulin is a common pathology associated with obesity. In this study, we analyzed the genome wide DNA methylation profile of visceral adipose tissue (VAT) samples in a population of individuals with obesity and assessed whether differential methylation profiles are associated with the presence of type 2 diabetes (T2D). Methods More than 485,000 CpG genome sites from VAT samples from women with obesity undergoing gastric bypass (n = 18), and classified as suffering from type 2 diabetes (T2D) or not (no type 2 diabetes, NT2D), were analyzed using DNA methylation arrays. Results We found significant differential methylation between T2D and NT2D samples in 24 CpGs that map with sixteen genes, one of which, HOOK2, demonstrated a significant correlation between differentially hypermethylated regions on the gene body and the presence of type 2 diabetes. This was validated by pyrosequencing in a population of 91 samples from both males and females with obesity. Furthermore, when these results were analyzed by gender, female T2D samples were found hypermethylated at the cg04657146-region and the cg 11738485-region of HOOK2 gene, whilst, interestingly, male samples were found hypomethylated in this latter region. Conclusion The differential methylation profile of the HOOK2 gene in individuals with T2D and obesity might be related to the attendant T2D, but further studies are required to identify the potential role of HOOK2 gene in T2D disease. The finding of gender differences in T2D methylation of HOOK2 also warrants further investigation. PMID:29228058

Sitting Time and Obesity or Abdominal Obesity in Older South Koreans: Korean National Health and Nutrition Examination Survey 2013.

PubMed

Sohn, Minsung; Cho, Kyung-Hwan; Han, Kyung-Do; Choi, Mankyu; Kim, Yang-Hyun

2017-01-01

We examined relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status in elderly people. We analyzed data from the Korean National Health and Nutrition Examination Survey 2013, and 1565 participants were included in the study. Multivariate logistic regression analysis was used to examine relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status. Sitting time was positively correlated with body mass index in men and women and waist circumference in men. When considering socioeconomic factors, men who sat for 5 hours or longer and fell within the lowest income were more likely to have obesity and abdominal obesity relative to men who sat for 5 hours or shorter and earned higher incomes (odds ratio [95% confidence interval] = 1.80 [1.14-2.84] and 1.63 [1.02-2.61] respectively), and women who sat for 5 hours or longer and fell within the lowest educational level were more likely to have obesity relative to women who sat for 5 hours or less and were educated to a higher level (1.24 [1.01-1.85]). Strategies to reduce sedentary behavior would help to prevent obesity in older men who earn low incomes and women with lower levels of educational attainment.

[Prevalence of overweight and obesity in children from Monterrey, Nuevo León].

PubMed

Hernández-Herrera, Ricardo Jorge; Mathiew-Quirós, Álvaro; Díaz-Sánchez, Oscar; Reyes-Treviño, Norma Orelia; Álvarez-Álvarez, Criselda; Villanueva-Montemayor, Daniel; de la Garza-Salinas, Laura Hermila; González-Guajardo, Eduardo

2014-01-01

Pediatric obesity is a major health problem around the globe. It has increased in the last decades up to 30 % (in 2010). The aim of this study was to establish the prevalence of overweight and obesity in children from zero to 14 years from three family medicine units and one school. A prospective study of prevalence, which included children of both sexes who assisted to three family medicine units and a junior high school. We assessed the somatometry and compared it in accordance to the World Health Organization 2006-2007 references and standards. The overall overweight and obesity prevalence in 1624 children was 45.5 % (15.5 % of overweight and 29.9 % of obesity, respectively). A total of 354 of 840 women (42.1 %) and 385 of 784 men (49 %) had overweight and obesity (p < 0.05). In both sexes, we did not observed a difference in overweight (15.7, women; 15.4, men). However, with regards to obesity, women showed 26.4 versus 33.6 of men (p < 0.05). We observed only one family unit with major obesity prevalence, which probably had an initial overestimation. We found one of the highest prevalences of overweight and obesity in children at a national level: up to 45 % in a state of Mexican northwestern. Obesity doubled overweight, and it was almost 10 % higher in men than in women.

Obesity and Endometrial Cancer: A Lack of Knowledge but Opportunity for Intervention.

PubMed

Haggerty, Ashley F; Sarwer, David B; Schmitz, Kathryn H; Ko, Emily M; Allison, Kelly C; Chu, Christina S

2017-10-01

The causal link between obesity and endometrial cancer is well established; however obese women's knowledge of this relationship is unknown. Our objective was to explore patients' understanding of this relationship and assess the acceptability of a technology-based weight loss intervention. Obese women with Type I endometrial cancer/hyperplasia were surveyed about their assessment of their body mass, knowledge of the relationship of obesity and endometrial cancer, and eating and activity habits. Interest in participation in an intervention also was assessed. Eighty-one women with early stage (71.6% stage I) and grade (41.7% grade 1) disease completed the survey. The median BMI was 35.4 kg/m 2 (IQR 32.2-43.5 kg/m 2 ) and the average age was 59.3 (SD 11.1) yr. 76.25% of women were unable to categorize their BMI correctly and 86.9% of those incorrectly underestimated their BMI category. One-third (35.9%) were unaware of any association between obesity and endometrial cancer and 33.3% responded that obesity decreased or did not significantly increase the risk of endometrial cancer. 59% expressed interest in a weight loss intervention. Endometrial cancer survivors with obesity underestimated their obesity and lacked knowledge regarding the link between obesity and endometrial cancer. However, the majority expressed interest in electronically delivered weight loss interventions.

Factors That Influence the Decision to Undergo Labiaplasty: Media, Relationships, and Psychological Well-Being.

PubMed

Sharp, Gemma; Tiggemann, Marika; Mattiske, Julie

2016-04-01

An increasing number of women are undergoing labiaplasty procedures; however, very little is known about the psychological factors that motivate women to seek out this procedure. To investigate the factors that influence women's decisions to undergo labiaplasty. Women seeking to undergo labiaplasty (n = 35) were compared with women who were not (n = 30). Standardized measures were employed to assess the patients' media exposure (television, the Internet, advertising, pornography), relationship quality, and psychological well-being. Women's motivations for deciding to undergo a labiaplasty procedure were characterized as "appearance," "functional," "sexual," or "psychological" motivations, with concerns about the labia's appearance being the most commonly reported motivation. Correspondingly, women seeking labiaplasty were significantly less satisfied with the appearance of their genitals than the comparison group (P < .001). These women had also experienced greater exposure to images of female genitalia on the Internet (P = .004) and in advertisements (P = .021), and had internalized these images to a greater extent (P = .010). There were no differences between the two groups on the measures of relationship quality. However, significantly fewer of the women seeking to undergo a labiaplasty procedure were involved in a romantic relationship at the time of the study (P = .039). There were also no differences between the two groups on the measures of psychological well-being, except that women seeking to undergo labiaplasty were less satisfied with their lives overall (P = .027). The findings identified media exposure and relationship status as important factors that influence women's decisions to undergo labiaplasty. 3 Risk. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.