Sample records for obese women utilizing

  1. Obesity, Healthcare Utilization and Health-Related Quality of Life after Fracture in Postmenopausal Women: Global Longitudinal Study of Osteoporosis in Women (GLOW)

    PubMed Central

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

    2013-01-01

    Fractures in obese postmenopausal women may be associated with higher morbidity than in non-obese women. We aimed to compare healthcare utilization, functional status, and health-related quality of life (HRQL) in obese, non-obese and underweight women with fractures. Information from GLOW, started in 2006, was collected at baseline and at 1, 2 and 3 years. In this subanalysis, self-reported incident clinical fractures, healthcare utilization, HRQL and functional status were recorded and examined. Women in GLOW (n = 60,393) were aged ≥55 years, from 723 physician practices at 17 sites in 10 countries. Complete data for fracture and body mass index were available for 90 underweight, 3,270 non-obese and 941 obese women with ≥1 incident clinical fracture during the 3-year follow-up. The median hospital length of stay, adjusted for age, comorbidities and fracture type, was significantly greater in obese than non-obese women (6 vs. 5 days, P = 0.017). Physical function and vitality score were significantly worse in obese than in non-obese women, both before and after fracture, but changes after fracture were similar across groups. Use of anti-osteoporosis medication was significantly lower in obese than in non-obese or underweight women. In conclusion, obese women with fracture undergo a longer period of hospitalization for treatment and have poorer functional status and HRQL than non-obese women. Whether these differences translate into higher economic costs and adverse effects on longer-term outcomes remains to be established. PMID:24077896

  2. Obesity, health-care utilization, and health-related quality of life after fracture in postmenopausal women: Global Longitudinal Study of Osteoporosis in Women (GLOW).

    PubMed

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

    2014-02-01

    Fractures may be associated with higher morbidity in obese postmenopausal women than in nonobese women. We compared health-care utilization, functional status, and health-related quality of life (HRQL) in obese, nonobese, and underweight women with fractures. Information from the GLOW study, started in 2006, was collected at baseline and at 1, 2, and 3 years. In this subanalysis, self-reported incident clinical fractures, health-care utilization, HRQL, and functional status were recorded and examined. Women in GLOW (n = 60,393) were aged ≥55 years, from 723 physician practices at 17 sites in 10 countries. Complete data for fracture and body mass index were available for 90 underweight, 3,270 nonobese, and 941 obese women with one or more incident clinical fractures during the 3-year follow-up. The median hospital length of stay, adjusted for age, comorbidities, and fracture type, was significantly greater in obese than nonobese women (6 vs. 5 days, p = 0.017). Physical function and vitality score were significantly worse in obese than in nonobese women, both before and after fracture; but changes after fracture were similar across groups. Use of antiosteoporosis medication was significantly lower in obese than in nonobese or underweight women. In conclusion, obese women with fracture undergo a longer period of hospitalization for treatment and have poorer functional status and HRQL than nonobese women. Whether these differences translate into higher economic costs and adverse effects on longer-term outcomes remains to be established.

  3. 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.

  4. Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women.

    PubMed

    Abenhaim, Haim A; Alrowaily, Nouf; Czuzoj-Shulman, Nicholas; Spence, Andrea R; Klam, Stephanie L

    2016-11-01

    Pregnancies among morbidly obese women are associated with serious adverse maternal and neonatal outcomes. Our study objective is to evaluate the effect of bariatric surgery on obstetrical outcomes. We carried out a retrospective cohort study using the healthcare cost and utilization project - Nationwide Inpatient Sample from 2003 to 2011 comparing outcome of births among women who had undergone bariatric surgery with births among women with morbid obesity. Logistic regression was used to estimate the adjusted effect of bariatric surgery on maternal and newborn outcomes. There were 8 475 831 births during the study period (221 580 (2.6%) in morbidly obese women and 9587 (0.1%) in women with bariatric surgery). Women with bariatric surgery were more likely to be Caucasian and ≥35 years old as compared with morbidly obese women. As compared with women with morbid obesity, women with bariatric surgery had lower rates of hypertensive disorders, premature rupture of membrane, chorioamnionitis, cesarean delivery, instrumental delivery, postpartum hemorrhage, and postpartum infection. Induction of labor, postpartum blood transfusions, venous thromboembolisms, and intrauterine fetal growth restriction were more common in the bariatric surgery group. There were no differences observed in preterm births, fetal deaths, or reported congenital anomalies. In general, women who undergo bariatric surgery have improved pregnancy outcomes as compared with morbidly obese women. However, the bariatric surgery group was more likely to have venous thromboembolisms, to require a blood transfusion, to have their labor induced and to experience fetal growth restriction.

  5. [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.

  6. Public opinion regarding utilization of assisted reproductive technology (ART) in obese women.

    PubMed

    Shah, Divya K; Ginsburg, Elizabeth S; Correia, Katharine F; Barton, Sara E; Missmer, Stacey A

    2013-11-01

    There have been calls to restrict access to fertility treatment in women above a certain body mass index (BMI). It is important to consider public expectations before formulating policy. The study objective was to assess public opinion regarding provision of assisted reproductive technology (ART) to obese (BMI>30 kg/m(2)) women in the United States. The study was conducted through an Internet-based survey of U.S. residents ages 18-75. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression to describe predictors of response based on demographic characteristics. Of the 1049 respondents, 60.7% support the use of ART in obese women. Adjusting for age and gender, the odds of support were over twice as high in participants with BMI>40 kg/m(2) as in normal-weight respondents (OR=2.87, 95% CI=1.28-6.44). Fifty-five percent of participants supported a BMI limit for access to ART. Both increasing education (p-value=0.02) and BMI (p-value=0.01) were inversely associated with support of a BMI limit. Individuals who had themselves used ART were also less likely (OR=0.27, 95% CI=0.07--0.99) to support a BMI limit. In an Internet-based survey, participants who are in favor of ART are likely to support its use among obese women. More than 50% of these respondents also support implementation of a BMI limit for access to these services.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. Psychological correlates of obesity in women.

    PubMed

    van der Merwe, M-T

    2007-11-01

    Psychological comorbidity is high in patients with obesity and is associated with a variety of medical and dietary problems as well as demographic, social and cognitive risk factors. Young overweight and obese women are at particular risk for developing sustained depressive mood, which is an important gateway symptom for major depressive disorder. Increased knowledge of behavioural risk factors has enabled patients with obesity to be classified on a psychological basis and this needs to be considered as part of a patient's clinical assessment and treatment strategy. Increased awareness of abnormal eating behaviour, together with profiling of personality traits, could improve treatment selection for obese women and improve the outcome of weight-loss programmes. Individualised antiobesity drug therapy may be required depending on the patient's psychological characteristics.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. College Women's Attitudes Toward Obesity.

    ERIC Educational Resources Information Center

    Chambless, Jim R.; Anderson, Eugene R.

    This study was undertaken to determine the relationship between college women's attitudes toward obesity and their own body weight. Subjects were placed in three categories: (1) acceptable level of body fat, (2) overweight, and (3) obese. Correlational techniques were used to determine the relationship between the subjects percent of body fat and…

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Anthropometric measurements of general and central obesity and the prediction of cardiovascular disease risk in women: a cross-sectional study

    PubMed Central

    Goh, Louise G H; Dhaliwal, Satvinder S; Welborn, Timothy A; Lee, Andy H; Della, Phillip R

    2014-01-01

    Objectives It is important to ascertain which anthropometric measurements of obesity, general or central, are better predictors of cardiovascular disease (CVD) risk in women. 10-year CVD risk was calculated from the Framingham risk score model, SCORE risk chart for high-risk regions, general CVD and simplified general CVD risk score models. Increase in CVD risk associated with 1 SD increment in each anthropometric measurement above the mean was calculated, and the diagnostic utility of obesity measures in identifying participants with increased likelihood of being above the treatment threshold was assessed. Design Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. Setting Population-based survey in Australia. Participants 4487 women aged 20–69 years without heart disease, diabetes or stroke. Outcome measures Anthropometric obesity measures that demonstrated the greatest increase in CVD risk as a result of incremental change, 1 SD above the mean, and obesity measures that had the greatest diagnostic utility in identifying participants above the respective treatment thresholds of various risk score models. Results Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio had larger effects on increased CVD risk compared with body mass index (BMI). These central obesity measures also had higher sensitivity and specificity in identifying women above and below the 20% treatment threshold than BMI. Central obesity measures also recorded better correlations with CVD risk compared with general obesity measures. WC and WHR were found to be significant and independent predictors of CVD risk, as indicated by the high area under the receiver operating characteristic curves (>0.76), after controlling for BMI in the simplified general CVD risk score model. Conclusions Central obesity measures are better predictors of CVD risk compared with general obesity measures in women. It is equally important to maintain a healthy

  6. Anthropometric measurements of general and central obesity and the prediction of cardiovascular disease risk in women: a cross-sectional study.

    PubMed

    Goh, Louise G H; Dhaliwal, Satvinder S; Welborn, Timothy A; Lee, Andy H; Della, Phillip R

    2014-02-06

    It is important to ascertain which anthropometric measurements of obesity, general or central, are better predictors of cardiovascular disease (CVD) risk in women. 10-year CVD risk was calculated from the Framingham risk score model, SCORE risk chart for high-risk regions, general CVD and simplified general CVD risk score models. Increase in CVD risk associated with 1 SD increment in each anthropometric measurement above the mean was calculated, and the diagnostic utility of obesity measures in identifying participants with increased likelihood of being above the treatment threshold was assessed. Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. Population-based survey in Australia. 4487 women aged 20-69 years without heart disease, diabetes or stroke. Anthropometric obesity measures that demonstrated the greatest increase in CVD risk as a result of incremental change, 1 SD above the mean, and obesity measures that had the greatest diagnostic utility in identifying participants above the respective treatment thresholds of various risk score models. Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio had larger effects on increased CVD risk compared with body mass index (BMI). These central obesity measures also had higher sensitivity and specificity in identifying women above and below the 20% treatment threshold than BMI. Central obesity measures also recorded better correlations with CVD risk compared with general obesity measures. WC and WHR were found to be significant and independent predictors of CVD risk, as indicated by the high area under the receiver operating characteristic curves (>0.76), after controlling for BMI in the simplified general CVD risk score model. Central obesity measures are better predictors of CVD risk compared with general obesity measures in women. It is equally important to maintain a healthy weight and to prevent central obesity concurrently.

  7. 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.

  8. 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

  9. 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.

  10. Effect of obesity and insulin resistance on myocardial substrate metabolism and efficiency in young women.

    PubMed

    Peterson, Linda R; Herrero, Pilar; Schechtman, Kenneth B; Racette, Susan B; Waggoner, Alan D; Kisrieva-Ware, Zulia; Dence, Carmen; Klein, Samuel; Marsala, JoAnn; Meyer, Timothy; Gropler, Robert J

    2004-05-11

    Obesity is a risk factor for impaired cardiac performance, particularly in women. Animal studies suggest that alterations in myocardial fatty acid metabolism and efficiency in obesity can cause decreased cardiac performance. In the present study, we tested the hypothesis that myocardial fatty acid metabolism and efficiency are abnormal in obese women. We studied 31 young women (body mass index [BMI] 19 to 52 kg/m2); 19 were obese (BMI >30 kg/m2). Myocardial oxygen consumption (MVO2) and fatty acid uptake (MFAUp), utilization (MFAU), and oxidation (MFAO) were quantified by positron emission tomography. Cardiac work was measured by echocardiography, and efficiency was calculated as work/MVO2. BMI correlated with MVO2 (r=0.58, P=0.0006), MFAUp (r=0.42, P<0.05), and efficiency (r=-0.40, P<0.05). Insulin resistance, quantified by the glucose area under the curve (AUC) during an oral glucose tolerance test, correlated with MFAUp (r=0.55, P<0.005), MFAU (r=0.62, P<0.001), and MFAO (r=0.58, P<0.005). A multivariate, stepwise regression analysis showed that BMI was the only independent predictor of MVO2 and efficiency (P=0.0005 and P<0.05, respectively). Glucose AUC was the only independent predictor of MFAUp, MFAU, and MFAO (P<0.05, <0.005, and <0.005, respectively). In young women, obesity is a significant predictor of increased MVO2 and decreased efficiency, and insulin resistance is a robust predictor of MFAUp, MFAU, and MFAO. This increase in fatty acid metabolism and decrease in efficiency is concordant with observations made in experimental models of obesity. These metabolic changes may play a role in the pathogenesis of decreased cardiac performance in obese women.

  11. 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

  12. [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.

  13. 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.

  14. 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

  15. Obesity utilization and health-related quality of life in Medicare enrollees.

    PubMed

    Malinoff, Rochelle L; Elliott, Marc N; Giordano, Laura A; Grace, Susan C; Burroughs, James N

    2013-01-01

    The obese, with disproportionate chronic disease incidence, consume a large share of health care resources and drive up per capita Medicare spending. This study examined the prevalence of obesity and its association with health status, health-related quality of life (HRQOL), function, and outpatient utilization among Medicare Advantage seniors. Results indicate that obese beneficiaries, much more than overweight beneficiaries, have poorer health, functions, and HRQOL than normal weight beneficiaries and have substantially higher outpatient utilization. While weight loss is beneficial to both the overweight and obese, the markedly worse health status and high utilization of obese beneficiaries may merit particular attention.

  16. 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.

  17. [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.

  18. 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.

  19. 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.

  20. 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).

  1. 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.

  2. 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

  3. [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.

  4. 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.

  5. 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".

  6. 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.

  7. 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

  8. Parity and Overweight/Obesity in Peruvian Women.

    PubMed

    Huayanay-Espinoza, Carlos A; Quispe, Renato; Poterico, Julio A; Carrillo-Larco, Rodrigo M; Bazo-Alvarez, Juan Carlos; Miranda, J Jaime

    2017-10-19

    The rise in noncommunicable diseases and their risk factors in developing countries may have changed or intensified the effect of parity on obesity. We aimed to assess this association in Peruvian women using data from a nationally representative survey. We used data from Peru's Demographic and Health Survey, 2012. Parity was defined as the number of children ever born to a woman. We defined overweight as having a body mass index (BMI, kg/m 2 ) of 25.0 to 29.9 and obesity as a BMI ≥30.0. Generalized linear models were used to evaluate the association between parity and BMI and BMI categories, by area of residence and age, adjusting for confounders. Data from 16,082 women were analyzed. Mean parity was 2.25 (95% confidence interval [CI], 2.17-2.33) among rural women and 1.40 (95% CI, 1.36-1.43) among urban women. Mean BMI was 26.0 (standard deviation, 4.6). We found evidence of an association between parity and BMI, particularly in younger women; BMI was up to 4 units higher in rural areas and 2 units higher in urban areas. An association between parity and BMI categories was observed in rural areas as a gradient, being highest in younger women. We found a positive association between parity and overweight/obesity. This relationship was stronger in rural areas and among younger mothers.

  9. 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

  10. 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.

  11. 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.

  12. Utilization of Military Women. (A Report of Increased Utilization of Military Women, FY-1973-1977)

    DTIC Science & Technology

    The purpose of the study was to examine the utilization of military women and to prepare contingency plans for increasing the use of women to offset...to the utilization of military women : History of women in the Armed Forces; potential supply of women for the Armed Forces; assignment policies...attrition rates; costs of military women versus men; and service plans for increasing use of military women .

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Alternative methods for measuring obesity in African American women.

    PubMed

    Clark, Ashley E; Taylor, Jacquelyn Y; Wu, Chun Yi; Smith, Jennifer A

    2013-03-01

    The use of body mass index (BMI) may not be the most appropriate measurement tool in determining obesity in diverse populations. We studied a convenience sample of 108 African American (AA) women to determine the best method for measuring obesity in this at-risk population. The purpose of this study was to determine if percent body fat (PBF) and percent body water (PBW) could be used as alternatives to BMI in predicting obesity and risk for hypertension (HTN) among AA women. After accounting for age, BMI, and the use of anti-hypertensive medication, PBF (p = 0.0125) and PBW (p = 0.0297) were significantly associated with systolic blood pressure, while BMI was not. Likewise, PBF (p = 0.0316) was significantly associated with diastolic blood pressure, while PBW and BMI were not. Thus, health care practitioners should consider alternative anthropometric measurements such as PBF when assessing obesity in AA women.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. [Association between television viewing and obesity in Peruvian women].

    PubMed

    Poterico, Julio A; Bernabé-Ortiz, Antonio; Loret de Mola, Christian; Miranda, J Jaime

    2012-08-01

    To assess the association between frequency of television viewing, overweight and obesity in a nationally representative sample of Peruvian women. Secondary analysis of the Demographic and Health Survey 2008 including women aged from 15 to 49 years old. The outcome variables were obesity (body mass index >30 kg/m²) and overweight (body mass index >25 but <30 kg/m²) whereas the exposure variable was frequency of television viewing (never, occasionally, almost every day). Logistic regression taking into account the multistage study design and adjusting for potential confounders was used. Results were presented as adjusted odds ratios (aOR) with 95% confidence intervals (95%CI). A total of 21,712 women were included in the analysis. The prevalence of overweight was 34.7% (95%CI 33.8%;35.7%), and obesity prevalence was 14.3% (95%CI 13.6%;15.1%). Compared to women who never watched television, those who reported watching television occasionally and almost daily were more likely to be obese: aOR 1.7 (95%CI 1.3;-2.3) and aOR 2.6 (95%CI 2.0;3.5), respectively. The magnitude of this association was lower for overweight: aOR 1.2 (95CI 1.3;2.3) and aOR 1.6 (95%CI 1.1;1.4), respectively. The strength of the association was greater in urban areas. Frequency of television viewing was associated with overweight and obesity in Peruvian women and the strength of this association varied by area of residence. These findings can provide input to strategies for obesity prevention in the Peruvian context.

  5. 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.

  6. 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.

  7. Abdominal obesity in older women: potential role for disrupted fatty acid reesterification in insulin resistance.

    PubMed

    Yeckel, Catherine W; Dziura, James; DiPietro, Loretta

    2008-04-01

    Excess abdominal adiposity is a primary factor for insulin resistance in older age. Our objectives were to examine the role of abdominal obesity on adipose tissue, hepatic, and peripheral insulin resistance in aging, and to examine impaired free fatty acid metabolism as a mechanism in these relations. This was a cross-sectional study. The study was performed at a General Clinical Research Center. Healthy, inactive older (>60 yr) women (n = 25) who were not on hormone replacement therapy or glucose-lowering medication were included in the study. Women with abdominal circumference values above the median (>97.5 cm) were considered abdominally obese. Whole-body peripheral glucose utilization, adipose tissue lipolysis, and hepatic glucose production were measured using in vivo techniques according to a priori hypotheses. In the simple analysis, glucose utilization at the 40 mU insulin dose (6.3 +/- 2.8 vs. 9.1 +/- 3.4; P < 0.05), the index of the insulin resistance of basal hepatic glucose production (23.6 +/- 13.0 vs. 15.1 +/- 6.0; P < 0.05), and insulin-stimulated suppression of lipolysis (35 vs. 54%; P < 0.05) were significantly different between women with and without abdominal obesity, respectively. Using the glycerol appearance rate to free fatty acid ratio as an index of fatty acid reesterification revealed markedly blunted reesterification in the women with abdominal adiposity under all conditions: basal (0.95 +/- 0.29 vs. 1.35 +/- 0.47; P < 0.02); low- (2.58 +/- 2.76 vs. 6.95 +/- 5.56; P < 0.02); and high-dose (4.46 +/- 3.70 vs. 12.22 +/- 7.13; P < 0.01) hyperinsulinemia. Importantly, fatty acid reesterification was significantly (P < 0.01) associated with abdominal circumference and hepatic and peripheral insulin resistance, regardless of total body fat. These findings support the premise of dysregulated fatty acid reesterification with abdominal obesity as a pathophysiological link to perturbed glucose metabolism across multiple tissues in aging.

  8. 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

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. Effects of a weight-gain restriction programme for obese pregnant women on sickness absence and pregnancy benefits.

    PubMed

    Sydsjö, Gunilla; Monfils, Wiktor Gustafsson; de Keyser, Nicholas; Claesson, Ing-Marie; Sydsjö, Adam; Josefsson, Ann

    2013-06-01

    To evaluate the effect of a weight-gain restriction programme for obese pregnant women on sickness absence days and pregnancy benefit days during pregnancy and postpartum. A prospective, controlled intervention study. The Swedish Social Security Agency's records were utilized to compile sickness absence and pregnancy benefit information. Antenatal care clinics in the south-east of Sweden. One hundred fifty-five obese pregnant women who participated in a weight restriction program with weekly structured motivational and behavioural talks combined with aqua-aerobics during pregnancy. A total of 193 obese pregnant women with no intervention served as controls. Sickness absence benefits and pregnancy benefits expressed as a percentage. On average women in the intervention group had 76.68 total full days of sickness absence benefit compared with 53.09 days in the control group. Total full days of pregnancy benefits were 39.66% days and 41.41% for the intervention and control groups respectively. For the women who were on sick leave there were no differences between the groups in the amount of days taken. Given the complexity of factors that have an influence on sickness absence leave, it is possible that programmes that do not address the influence of social aspects and attitudes towards sickness absence have limited effect.

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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.…

  19. 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.

  20. Sibutramine promotes amygdala activity under fasting conditions in obese women.

    PubMed

    Oltmanns, Kerstin M; Heldmann, Marcus; Daul, Susanne; Klose, Silke; Rotte, Michael; Schäfer, Michael; Heinze, Hans-Jochen; Münte, Thomas F; Lehnert, Hendrik

    2012-06-01

    Sibutramine, a centrally-acting selective monoamine reuptake inhibitor, has been used as an appetite suppressant drug in obesity. To gain insight into the central nervous actions of sibutramine, brain responses to pictures of food items after sibutramine vs placebo application were assessed by functional magnetic resonance imaging (fMRI) in obese women. In a randomized double-blind crossover design, 10 healthy obese women (BMI 31.8-39.9 kg/m(2)) received 15 mg/d of sibutramine vs placebo for 14 d. Obese participants, and a group of 10 age-matched normal weight controls, viewed pictures of food items and control objects in hungry and satiated states while lying in the MR scanner. The paradigm followed a block design. In obese participants, fMRI measurements were conducted prior and after two weeks of daily sibutramine or placebo administration, whereas control participants were scanned only at one point in time. Upon food item presentation, obese participants showed increased brain activity in areas related to emotional and reward processing, perceptual processing, and cognitive control as compared to normal weight controls. Sibutramine exerted a divergent satiety-dependent effect on amygdala activity in obese participants, increasing activity in the hungry state while decreasing it under conditions of satiation. Our results demonstrate a modulatory influence of sibutramine on amygdala activity in obese women which may underlie the appetite suppressant effects of the drug.

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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....

  8. Metabolic fuel utilization and subclinical atherosclerosis in overweight/obese subjects.

    PubMed

    Montalcini, Tiziana; Gazzaruso, Carmine; Ferro, Yvelise; Migliaccio, Valeria; Rotundo, Stefania; Castagna, Alberto; Pujia, Arturo

    2013-10-01

    The utilization of different macronutrients is relevant for the risk of obesity, diabetes, or the appearing of vascular complications. The Respiratory Quotient (RQ) is a parameter measuring the fuel utilizations; in fact, it can indicate the fat stores utilization or lipogenesis activation. Aim of this study was to investigate the link between the RQ and the subclinical carotid atherosclerosis presence in overweight/obese subjects. 132 subjects with body mass index at least 25, at conventional diet, underwent an Indirect Calorimetry for the measurement of the Resting Metabolic Rate as well as the RQ and an evaluation of carotid arteries with ultrasound. Biochemical analyses were also performed. The mean age was 48 ± 12 years. There was a positive relation between carotid intima-media thickness and RQ (p = 0.010), with the high value in the subgroup with high RQ (p = 0.045 vs. group with low RQ). The RQ, an index of fuel utilization, is positively associated to subclinical carotid atherosclerosis in overweight/obese individuals.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. Weight loss experiences of obese perimenopausal women with metabolic syndrome.

    PubMed

    Su, Mei-Chen; Lin, Hung-Ru; Chu, Nain-Feng; Huang, Chih-Hsung; Tsao, Lee-Ing

    2015-07-01

    To develop a descriptive theory for the weight loss experiences of obese perimenopausal women with metabolic syndrome. Obesity and metabolic syndrome both pose a threat to the health of perimenopausal women; therefore, understanding perimenopausal women's subjective feelings and experiences is beneficial to establishing effective prevention strategies. However, studies have rarely explored these relevant experiences. A qualitative study using the grounded theory method to establish a descriptive theory. Eighteen obese perimenopausal women with metabolic syndrome aged 45-60 years participated in comprehensive interviews. 'Crossing the gaps to making life modifications' was the core category, and 'the awareness of weight gain and health alarm' was the antecedent condition. In the weight loss experience, the following three interaction categories were identified: (1) 'experiencing bad feelings,' (2) 'encountering obstacles' and (3) 'making efforts to transition to a new life.' Some women adhered to new life habits through perceiving social support and by using self-incentives. Finally, women enjoyed and mastered self-monitoring of their health in their new life, and practiced new changes as part of their life. However, some participants felt that making changes to their life was too time-consuming. Therefore, these women chose to live with their abnormal health without making changes. Obese perimenopausal women with metabolic syndrome experienced various gaps in their weight loss process. Although they struggled with many obstacles, these women were able to learn from their experiences and face their health challenges. These findings can guide healthcare professionals to provide appropriate interventions to understand the hidden health problems of this particular group of women. Healthcare professionals should develop a set of plans by which women receive a complete weight loss program and support from professionals and family. © 2015 John Wiley & Sons Ltd.

  16. Coffee Consumption and the Risk of Obesity in Korean Women.

    PubMed

    Lee, Jeonghee; Kim, Hye Young; Kim, Jeongseon

    2017-12-08

    Instant coffee mixes that contain sugar and non-dairy creamer account for 80-90% of the total coffee market in Korea. The objective of this study was to investigate the relationship between coffee consumption and obesity in Korean women. We included 5995 women who participated in a health screening examination at the Korean National Cancer Center between 2007 and 2016. Daily coffee consumption and the use of sugar and creamer in coffee was evaluated using a 106-item food frequency questionnaire. Obesity was assessed by body mass index (BMI), and abdominal obesity was assessed by waist circumference (WC). A multiple logistic regression model was used to calculate the odds ratio (OR) of obesity according to coffee consumption. After multivariate adjustment, high coffee consumption was positively associated with obesity as measured by BMI (≥3 cups vs. no drinks, OR = 2.52; 95% confidence interval (CI) = 1.91-3.34; p for the trend < 0.001) and abdominal obesity as measured by WC (≥3 cups vs. no drinks, OR = 2.11; 95% CI = 1.59-2.79; p for the trend < 0.001). The positive association between daily coffee consumption and obesity prevalence was not altered by menopause. The amount of coffee with additives consumed per day by Korean women was positively correlated with the prevalence of obesity, but causation cannot be determined due to the cross-sectional nature of the study design. The mechanism underlying the observed relationship is yet to be elucidated.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Effects of a weight-gain restriction programme for obese pregnant women on sickness absence and pregnancy benefits

    PubMed Central

    2013-01-01

    Abstract Objective To evaluate the effect of a weight-gain restriction programme for obese pregnant women on sickness absence days and pregnancy benefit days during pregnancy and postpartum. Design A prospective, controlled intervention study. The Swedish Social Security Agency's records were utilized to compile sickness absence and pregnancy benefit information. Setting Antenatal care clinics in the south-east of Sweden. Subjects One hundred fifty-five obese pregnant women who participated in a weight restriction program with weekly structured motivational and behavioural talks combined with aqua-aerobics during pregnancy. A total of 193 obese pregnant women with no intervention served as controls. Main outcome measures Sickness absence benefits and pregnancy benefits expressed as a percentage. Results On average women in the intervention group had 76.68 total full days of sickness absence benefit compared with 53.09days in the control group. Total full days of pregnancy benefits were 39.66% days and 41.41% for the intervention and control groups respectively. For the women who were on sick leave there were no differences between the groups in the amount of days taken. Conclusions Given the complexity of factors that have an influence on sickness absence leave, it is possible that programmes that do not address the influence of social aspects and attitudes towards sickness absence have limited effect. PMID:23301596

  2. 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

  3. 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

  4. Socio-cultural, environmental and behavioural determinants of obesity in black South African women

    PubMed Central

    Micklesfield, Lisa K; Lambert, Estelle V; Hume, David John; Chantler, Sarah; Pienaar, Paula R; Dickie, Kasha; Goedecke, Julia H; Puoane, Thandi

    2013-01-01

    Summary Abstract South Africa (SA) is undergoing a rapid epidemiological transition and has the highest prevalence of obesity in sub-Saharan Africa (SSA), with black women being the most affected (obesity prevalence 31.8%). Although genetic factors are important, socio-cultural, environmental and behavioural factors, as well as the influence of socio-economic status, more likely explain the high prevalence of obesity in black SA women. This review examines these determinants in black SA women, and compares them to their white counterparts, black SA men, and where appropriate, to women from SSA. Specifically this review focuses on environmental factors influencing obesity, the influence of urbanisation, as well as the interaction with socio-cultural and socio-economic factors. In addition, the role of maternal and early life factors and cultural aspects relating to body image are discussed. This information can be used to guide public health interventions aimed at reducing obesity in black SA women. PMID:24051701

  5. Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women.

    PubMed

    Newby, P K; Tucker, Katherine L; Wolk, Alicja

    2005-06-01

    Observational studies suggest that a plant-based diet is inversely related to body mass index (BMI), overweight, and obesity. Our objective was to examine the BMI (kg/m(2)) and risk of overweight and obesity of self-defined semivegetarian, lactovegetarian, and vegan women. Data analyzed in this cross-sectional study were from 55459 healthy women participating in the Swedish Mammography Cohort. Women were asked whether they considered themselves to be omnivores (n = 54257), semivegetarians (n = 960), lactovegetarians (n = 159), or vegans (n = 83), and this question was the main exposure variable in this study. In secondary analyses, we reclassified women as lactovegetarians on the basis of food intakes reported on the food-frequency questionnaire. The prevalence of overweight or obesity (BMI >/= 25) was 40% among omnivores, 29% among both semivegetarians and vegans, and 25% among lactovegetarians. In multivariate, adjusted logistic regression analyses, self-identified vegans had a significantly lower risk of overweight or obesity [odds ratio (OR) = 0.35; 95% CI: 0.18, 0.69] than did omnivores, as did lactovegetarians (OR = 0.54; 95% CI: 0.35, 0.85) and semivegetarians (OR = 0.52; 95% CI: 0.43, 0.62). Risk of overweight or obesity remained significantly lower among lactovegetarians classified on the basis of the food-frequency questionnaire (OR = 0.48; 95% CI: 0.30, 0.78). Even if vegetarians consume some animal products, our results suggest that self-identified semivegetarian, lactovegetarian, and vegan women have a lower risk of overweight and obesity than do omnivorous women. The advice to consume more plant foods and less animal products may help individuals control their weight.

  6. Glucose, insulin and C-peptide secretion in obese and non obese women with polycystic ovarian disease.

    PubMed

    Mahabeer, S; Naidoo, C; Joubert, S M

    1990-06-01

    Plasma glucose, immunoreactive insulin (IRI) and C-peptide responses during oral glucose tolerance testing (OGTT) were evaluated in 10 non obese women with polycystic ovarian disease (NOB-PCOD) and 10 obese women with polycystic ovarian disease (OB-PCOD). Mean plasma glucose response at 120 minutes in OB-PCOD showed impaired glucose tolerance. Also in this group, 1 patient had frank diabetes mellitus, whilst 3 other patients had impaired glucose tolerance 1 NOB-PCOD patient had impaired glucose tolerance. Mean plasma glucose levels and mean incremental glucose areas were higher in the OB-PCOD at all time intervals and reached statistical significance at 60 and 90 minutes. Mean plasma IRI levels were also higher in OB-PCOD at all time intervals, and reached statistically significant higher levels at 0, 60 and 90 minutes. Mean serum C-peptide valves were also higher at all time intervals in OB-PCOD. The relationship between acanthosis nigricans, obesity and PCOD was also analysed. It is evident from this study that obesity has a significant negative impact on the overall carbohydrate status in women with PCOD.

  7. 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

  8. 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

  9. 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

  10. Obesity, metabolic profile, and inhibition failure: Young women under scrutiny.

    PubMed

    Catoira, N P; Tapajóz, F; Allegri, R F; Lajfer, J; Rodríguez Cámara, M J; Iturry, M L; Castaño, G O

    2016-04-01

    The prevalence of obesity, as well as evidence about this pathology as a risk factor for cognitive decline and dementia in the elderly, is increasing worldwide. Executive functions have been found to be compromised in most studies, although the specific results are dissimilar. Obese young women constitute an interesting study and intervention group, having been found to be unaffected by age and hormonal negative effects on cognition and considering that their health problems affect not only themselves but their families and offspring. The objective of the present study was to compare the executive performance of obese young women with that of a healthy control group. A cross-sectional study was done among premenopausal women from a public hospital in Buenos Aires. The sample comprised 113 participants (32 healthy controls and 81 obese women), who were evaluated for depressive and anxiety symptoms (Beck Depression Inventory-II and State-Trait Anxiety Inventory) and executive functioning (Trail-Making Test B, Stroop Color and Word Test, Wisconsin Card Sorting Test, and verbal fluency test). Statistical analysis was done by using the SPSS version 20.0 software. Among executive functions, a significant difference was found between groups in inhibition (p<0.01). No correlation was found between psychopathologic measures and Stroop Test Interference results. We found slight correlations between Stroop Test Interference results, waist circumference, fat mass and HDL-cholesterol. In obese group, there was a negative slightly correlation between this cognitive test and 2h post-load glucose level. Inhibition was decreased in our obese young women group, and glucose/lipid metabolism may be involved in this association. The cognitive impairment is comparable with that described in addictive conditions. Our conclusions support the concept of multidisciplinary management of obese patients from the time of diagnosis. Detecting and understanding cognitive dysfunction in this

  11. 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

  12. 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.

  13. 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.

  14. Physical activity patterns in morbidly obese and normal-weight women.

    PubMed

    Kwon, Soyang; Mohammad, Jamal; Samuel, Isaac

    2011-01-01

    To compare physical activity patterns between morbidly obese and normal-weight women. Daily physical activity of 18 morbidly obese and 7 normal-weight women aged 30-58 years was measured for 2 days using the Intelligent Device for Energy Expenditure and Activity (IDEEA) device. The obese group spent about 2 hr/day less standing and 30 min/day less walking than did the normal-weight group. Time spent standing (standing time) was positively associated with time spent walking (walking time). Age- and walking time-adjusted standing time did not differ according to weight status. Promoting standing may be a strategy to increase walking.

  15. 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.

  16. Influence of obesity on bone density in postmenopausal women.

    PubMed

    Silva, Henyse G Valente da; Mendonça, Laura M C; Conceição, Flávia L; Zahar, Silvia E V; Farias, Maria Lucia F

    2007-08-01

    To evaluate the influence of obesity, age, and years since menopause on bone density. A retrospective analysis of bone mineral density (BMD) obtained from 588 women, 41 to 60 years, previously menopaused (1-10 years before). Positive influence of obesity was confirmed by the significant differences in BMD at lumbar spine, femoral neck (FN), and trochanter (TR) between the groups (p < 0.01). Age and years since menopause (YSM) were negatively correlated with BMD at all sites (p = 0.000). Comparing patients within 1 to < 6 YSM versus 6 to 10 YSM, BMD was higher in the former at LS and FN (p < 0.005), despite the higher BMI in the older group (p = 0.01). Obese patients had a lower prevalence of osteoporosis at LS and FN (p = 0.009). Regression analysis identified BMI as the strongest determinant of FN and TR BMD, while YSM was the strongest determinant of LS BMD. The protective effect of obesity is overtaken by age and estradiol deficiency. We recommend that even obese postmenopausal women should be screened for osteoporosis.

  17. Ghrelin level negatively predicts quality of life in obese women.

    PubMed

    Lu, P H; Song, Y L; Hsu, C H

    2017-02-01

    A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m 2 (3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m 2 , respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = -0.18, p = 0.001), MCS-12 level (β = -0.14, p = 0.009), WHOQOL-BREF scores: physical (β = -0.13, p = 0.03), psychological (β = -0.16, p = 0.007), social (β = -0.21, p =  < 0.001), and environmental (β = -0.22, p =  <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women.

  18. Pregnancy-associated obesity in black women in New York City.

    PubMed

    Lederman, Sally Ann; Alfasi, Goldie; Deckelbaum, Richard J

    2002-03-01

    To determine weight gain during pregnancy and weight changes postpartum in first-time mothers delivering at or near term. At about 2 weeks after delivery, 47 adult, Black and Hispanic women provided information on their prepregnancy weight and height and maximum pregnancy weight. Women reinterviewed at 2 and 6 months after delivery reported their most recent weight measurement and the date of that measurement. This information was used to compute each woman's prepregnancy body mass index, pregnancy weight gain, and weight loss postpartum. Information on infant feeding was also collected at each postpartum visit. About 2/3 of the women and 100% of the overweight and obese women gained excessive weight during pregnancy. Weight gain was most marked in women who started pregnancy overweight or obese. At 2 months postpartum, women were on average almost 18 lb above their prepregnancy weight. No additional maternal weight was lost by 6 months postpartum. Most infants were started on formula by 2 weeks of age. At 2 months of age, 85% were fed formula only and 91% of the infants were on WIC. Our results demonstrate a need for interventions to help women avoid obesity by regulating their pregnancy weight gain, losing weight for a longer period postpartum, and initiating and maintaining exclusive breast-feeding.

  19. 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

  20. The utility of childhood and adolescent obesity assessment in relation to adult health

    PubMed Central

    Goldhaber-Fiebert, Jeremy D.; Rubinfeld, Rachel E.; Bhattacharya, Jay; Robinson, Thomas N.; Wise, Paul H.

    2014-01-01

    The high prevalence of childhood obesity has raised concerns regarding long-term patterns of adult health and has generated calls for obesity screening of young children. This study examined patterns of obesity and the predictive utility of obesity screening for children of different ages in terms of adult health outcomes. Using the National Longitudinal Survey of Youth, the Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys, we estimated the sensitivity, specificity and predictive value of childhood BMI to identify 2, 5, 10, or 15 year-olds who will become obese adults. We constructed models assessing the relationship of childhood BMI to obesity-related diseases through middle age stratified by sex and race/ethnicity. 12% of 18 year-olds were obese. While 50% of these adolescents would not have been identified by screening at age 5, 9% would have been missed at age 15. Approximately 70% of obese children at age 5 became non-obese at age 18. The predictive utility of obesity screening below the age of 10 was low, even when maternal obesity was also included. The elevated risk of diabetes, obesity, and hypertension in middle age predicted by obesity at age 15 was significantly higher than at age 5 (e.g., the RR of diabetes for obese white male 15 year-olds was 4.5; for 5 year-olds, it was 1.6). Early childhood obesity assessment adds limited predictive utility to strategies that also include later childhood assessment. Targeted approaches in later childhood or universal strategies to prevent unhealthy weight gain should be considered. PMID:22647830

  1. Robot-assisted total laparoscopic hysterectomy in obese and morbidly obese women.

    PubMed

    Rebeles, Sonia A; Muntz, Howard G; Wieneke-Broghammer, Carrie; Vason, Emily S; McGonigle, Kathryn F

    2009-10-01

    Total laparoscopic hysterectomy (TLH) in obese patients is challenging. We sought to evaluate whether total laparoscopic hysterectomies using the da Vinci robotic system in obese patients, in comparison with non-obese patients, is a reasonable surgical approach. One-hundred consecutive robot-assisted TLHs were performed over a 17-month period. Obesity was not a contraindication to robotic surgery, assuming adequate respiratory function to tolerate Trendelenburg position and, for cancer cases, a small enough uterus to allow vaginal extraction without morcellation. Data were prospectively collected on patient characteristics, total operative time, hysterectomy time, estimated blood loss, length of stay, and complications. Outcomes with non-obese and obese women were compared. The median age, weight, and BMI of the 100 patients who underwent robot-assisted TLH was 57.6 years (30.0-90.6), 82.1 kg (51.9-159.6), and 30.2 kg/m(2) (19.3-60.2), respectively. Fifty (50%) patients were obese (BMI ≥ 30); 22 patients were morbidly obese (BMI ≥ 40). There was no increase in complications (p = 0.56) or blood loss (p = 0.44) with increasing BMI. While increased BMI was associated with longer operative times (p = 0.05), median time increased by only 36 min when comparing non-obese and morbidly obese patients. Median length of stay was one day for all weight categories (p = 0.42). Robot-assisted TLH is feasible and can be safely performed in obese patients. More data are needed to compare robot-assisted TLH with other hysterectomy techniques in obese patients. Nonetheless, our results are encouraging. Robot-assisted total laparoscopic hysterectomy may be the preferred technique for appropriately selected obese patients.

  2. 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.

  3. 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.

  4. Lifestyle modification intervention among infertile overweight and obese women with polycystic ovary syndrome.

    PubMed

    Mahoney, Diane

    2014-06-01

    To implement an evidence-based lifestyle modification intervention, guided by motivational interviewing, among a sample of infertile overweight and obese women with polycystic ovary syndrome to increase chances of conception while improving overall health. A prospective quantitative design was utilized (n = 12). Infertile overweight and obese women with polycystic ovary syndrome at an infertility practice completed questionnaires to assess diet and exercise practices at study onset and completion. Body mass index and weight measurements were obtained on participants at study onset and completion of intervention. Menstrual history was assessed by interview. There was a mean weight loss (p = .005) of 7(±5) pounds although a 5% weight reduction did not occur. Mean daily calorie (p = .005), fat (p = .006), and carbohydrate intake (p = .014) were significantly reduced. Frequency in brisk walking exercise significantly increased (p = .024). Frequency in home or gym exercise increased (p = .050). Menstrual cyclicity improved by 50% among prior amenorrheic subjects. An evidence-based lifestyle modification guideline could prove to be a cost effective intervention for infertile women with polycystic ovary syndrome (PCOS) who desire pregnancy. This intervention could be integrated into the primary care and reproductive medicine visits as sole therapy or in conjunction with infertility treatment. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. Impaired associative learning with food rewards in obese women.

    PubMed

    Zhang, Zhihao; Manson, Kirk F; Schiller, Daniela; Levy, Ifat

    2014-08-04

    Obesity is a major epidemic in many parts of the world. One of the main factors contributing to obesity is overconsumption of high-fat and high-calorie food, which is driven by the rewarding properties of these types of food. Previous studies have suggested that dysfunction in reward circuits may be associated with overeating and obesity. The nature of this dysfunction, however, is still unknown. Here, we demonstrate impairment in reward-based associative learning specific to food in obese women. Normal-weight and obese participants performed an appetitive reversal learning task in which they had to learn and modify cue-reward associations. To test whether any learning deficits were specific to food reward or were more general, we used a between-subject design in which half of the participants received food reward and the other half received money reward. Our results reveal a marked difference in associative learning between normal-weight and obese women when food was used as reward. Importantly, no learning deficits were observed with money reward. Multiple regression analyses also established a robust negative association between body mass index and learning performance in the food domain in female participants. Interestingly, such impairment was not observed in obese men. These findings suggest that obesity may be linked to impaired reward-based associative learning and that this impairment may be specific to the food domain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. 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.

  12. The Use of Stress-Management Training for Obese Women.

    ERIC Educational Resources Information Center

    Sternberg, Daniel; Del Porto, Delbert

    Stress management training contributes to weight loss, maintenance of weight loss and improved social and occupational functioning in obese women. Data from the Beck Depression Inventory and the Assertiveness Questionnaire indicate that obese persons have poor self-concepts which result in depression which is inversely related to assertiveness.…

  13. 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.

  14. 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.

  15. 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.

  16. Obesity and Body Size Preferences of Jordanian Women

    ERIC Educational Resources Information Center

    Madanat, Hala; Hawks, Steven R.; Angeles, Heidi N.

    2011-01-01

    The nutrition transition is associated with increased obesity rates and increased desire to be thin. This study evaluates the relationship between actual body size and desired body size among a representative sample of 800 Jordanian women. Using Stunkard's body silhouettes, women were asked to identify their current and ideal body sizes, healthy…

  17. African American Women and Obesity Through the Prism of Race.

    PubMed

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

    2018-06-01

    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. The purpose of this study was to examine the relationship between race and body mass index (BMI) for African American women. Previously collected data from the National Survey of American Life Self-Administered Questionnaire, 2001-2003 (NSAL-SAQ) was analyzed for this study. The NSAL-SAQ dedicated a section to the exploration of group and personal identity, along with having anthropometric data and health habit questions to be able to conduct analyses for associations between the racial identity dimensions and obesity. Multiple linear regression was used to examine the constructs of racial identity on BMI comparing standardized coefficients (β) and R 2 adj values. Results indicated participants ascribing more to the stereotype of "Blacks giving up easily" (β = 0.527, p = .000) showed an increased BMI. Additionally, the negative stereotype of "Blacks being violent" (β = 0.663, p = .000) and "Blacks being lazy" (β = 0.506, p = .001) was associated with an increased BMI. Based on these finds high negative racial regard is associated with increased weight. This study contributes uniquely to the scientific literature, focusing on the construct of racial identity and obesity in African American women.

  18. Obesity as a public health problem among adult women in rural Tanzania

    PubMed Central

    Keding, Gudrun B; Msuya, John M; Maass, Brigitte L; Krawinkel, Michael B

    2013-01-01

    ABSTRACT Background: For many developing countries, obesity and its sequelae have become a challenge of a magnitude similar to hunger and undernutrition. The main objective of this study was, therefore, to investigate the weight status of women in rural Tanzania with reference to season as well as the link between women's weight, food consumption, and attitudes toward obesity. Methods: Three cross-sectional surveys in 3 different seasons within 1 year interviewed the same 210 women, ages 17–45 years, from 3 rural districts of northeastern and central Tanzania. These surveys assessed body mass index (BMI), food intake, and dietary diversity through 24-hour recalls, women's attitudes toward obesity, vegetable production, and socioeconomic status. Results: Although 71% of the women had a normal BMI, 7% were underweight, 16% overweight, and 6% obese. The BMI was correlated with the Dietary Diversity Score (DDS), the Food Variety Score (FVS), with the consumption of foods from the food groups “bread/cakes,” “sugar,” and “tea,” and with the production of exotic vegetables. In a multiple regression model, FVS was directly associated with BMI. When asked to describe the typical characteristics of an obese person, women mentioned more negative than positive characteristics. Conclusion: The prevalence of overweight and obesity was 3 times higher than that of underweight. Apparently, even in rural areas of Tanzania, a nutrition transition is underway. No direct association was identified between vegetable consumption and BMI. Although this study did not assess behavioral factors, such behavioral factors as activity levels as well as attitudes need to be considered, even in rural settings, to address all facets of malnutrition. PMID:25276549

  19. 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

  20. 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

  1. The Curves Exercise Suppresses Endotoxemia in Korean Women with Obesity.

    PubMed

    Jin, Seon Ah; Kim, Sun Kyeong; Seo, Hee Jung; Kim, Mijoo; Ahn, Kye Taek; Kim, Jun Hyung; Park, Jae Hyeong; Lee, Jae Hwan; Choi, Si Wan; Jeong, Jin Ok

    2017-02-01

    Obesity and metabolic syndrome is a worldwide pandemic and associated with high cardiovascular risk. Metabolic endotoxemia (ME) is thought to be an underlying molecular mechanism. It triggers toll-like receptor 4-mediated inflammatory adipokines and causes a chronic low grade inflammatory status, which results in cardiovascular risk increase. Exercise is the best nonpharmacological treatment to improve prognosis. In this study, we examined the circulating endotoxin level in Korean obese women and investigated effects of exercise on it. Women over body mass index (BMI) 25 kg/m² participated in a resistance training exercise, Curves. At baseline and after 12 weeks exercise, tests including blood samples were taken. In Korean obese women, the fasting endotoxin was 1.45 ± 0.11 EU/mL. Ingestion of a high calorie meal led to a peak level after 2 hours (postprandial 2 hours [PP2]) and a significant rise over the 4 hours (postprandial 4 hours [PP4]) in it (1.78 ± 0.15 and 1.75 ± 0.14 EU/mL for PP2 and PP4, P < 0.05 vs. fasting). After exercise, BMI and hip circumference were reduced significantly. The total cholesterol (TC) at fasting, PP2 and PP4 were decreased significantly. All levels of circulating endotoxin at fasting, PP2 and PP4 showed reduction. But, the peak change was only significant (baseline vs. 12 weeks for PP2; 1.78 ± 0.15 vs. 1.48 ± 0.06 EU/mL, P < 0.05). We report the circulating endotoxin level in Korean obese women for the first time. Also, we establish that energy intake leads to endotoxemia and exercise suppresses the peak endotoxemia after meal. It suggests an impact for a better prognosis in obese women who follow regular exercise.

  2. 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.

  3. 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

  4. 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.

  5. Physical Activity Patterns in Normal-Weight and Overweight/Obese Pregnant Women

    PubMed Central

    Bacchi, Elisabetta; Bonin, Cecilia; Zanolin, Maria Elisabetta; Zambotti, Francesca; Livornese, Dario; Donà, Silvia; Tosi, Flavia; Baldisser, Giulia; Ihnatava, Tatsiana; Di Sarra, Daniela; Bonora, Enzo; Moghetti, Paolo

    2016-01-01

    The aims of the present study were to assess the volume of physical activity (PA) throughout pregnancy in normal-weight vs overweight/obese women, and to investigate which factors may predict compliance to PA recommendations in these women throughout gestation. In 236 pregnant women, 177 normal-weight and 59 overweight/obese (median[IQR] BMI 21.2[19.9–22.8] vs 26.5[25.5–29.0] kg/m2, respectively), medical history, anthropometry and clinical data, including glucose tolerance, were recorded. In addition, pre-pregnancy PA was estimated by the Kaiser questionnaire, while total, walking and fitness/sport PA during pregnancy were assessed by the Physical Activity Scale for the Elderly (PASE) modified questionnaire, at 14–16, 24–28 and 30–32 weeks of gestation. PA volume was very low in the first trimester of pregnancy in both groups of women. However, it increased in the second and third trimester in normal-weight, but not in overweight/obese subjects. Higher pre-pregnancy PA was a statistically significant predictor of being physically active (>150 minutes of PA per week) during all trimesters of gestation. In conclusion, physical activity volume is low in pregnant women, especially in overweight/obese subjects. PA volume increases during pregnancy only in normal-weight women. Pre-pregnancy PA is an independent predictor of achieving a PA volume of at least 150 min per week during pregnancy. PMID:27829017

  6. Exercise self-efficacy intervention in overweight and obese women.

    PubMed

    Buckley, Jude

    2016-06-01

    This study investigated the effects of a brief tailored intervention on self-efficacy beliefs and exercise energy expenditure in active and inactive overweight and obese women. Participants were randomly assigned to either control (N = 50) or intervention (N = 47) conditions, and their exercise self-efficacy was assessed three times over a 12-week period. Results showed that the intervention increased schedule, physical, exercise-worries efficacy, and energy expenditure in the previously inactive group. The results suggest that self-efficacy interventions are effective at increasing exercise energy expenditure in inactive overweight and obese women. © The Author(s) 2014.

  7. 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.

  8. 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.

  9. Association between Macronutrients Intake, Visceral Obesity and Blood Pressure in a Sample of Obese Egyptian Women.

    PubMed

    Hassan, Nayera E; El Shebini, Salwa M; Ahmed, Nihad H; Selim Mostafa, Mohamed

    2015-03-15

    Study the association between the total caloric intake, protein, lipid, and some classes of fatty acids of the diet, and their effects on blood pressure in a sample of Egyptian obese women with and without visceral obesity. Five hundred forty-nine obese women were included in the study with mean age of 38.1 ± 11.56 years and mean Body mass index [BMI] of 36.17 ± 7.23. They enrolled in a program for losing weight. Visceral fat was determined using ultrasound. Blood pressure was measured 3 times and the mean was recorded. Twenty four hours dietary recall was reported. Thirty point four percentages of samples has visceral obesity ≥ 7cm; they were the older, showed higher values of BMI, visceral obesity and blood pressure. Significant difference was found between groups regarding mean value of BMI, visceral obesity, both systolic blood pressure SBP and diastolic blood pressure DBP and most of the daily macronutrients intake. In groups (2&3) positive significant correlation was recorded between (SBP) & (DBP) and total daily intake of total calories, carbohydrate, total fat, saturated fatty acids and cholesterol, and negative significant correlation with total daily intake of total protein, animal and vegetable protein, linolenic and linoleic fatty acids, while oleic fatty acid showed negative correlation with SBP&DBP in all groups. This study emphasizes the hypothesis that the macronutrients composition of diet influences blood pressure in different ways, in obese patients with visceral obesity.

  10. Association between Macronutrients Intake, Visceral Obesity and Blood Pressure in a Sample of Obese Egyptian Women

    PubMed Central

    Hassan, Nayera E.; El Shebini, Salwa M.; Ahmed, Nihad H.; Selim Mostafa, Mohamed

    2015-01-01

    AIM: Study the association between the total caloric intake, protein, lipid, and some classes of fatty acids of the diet, and their effects on blood pressure in a sample of Egyptian obese women with and without visceral obesity. METHODS: Five hundred forty-nine obese women were included in the study with mean age of 38.1 ± 11.56 years and mean Body mass index [BMI] of 36.17 ± 7.23. They enrolled in a program for losing weight. Visceral fat was determined using ultrasound. Blood pressure was measured 3 times and the mean was recorded. Twenty four hours dietary recall was reported. RESULTS: Thirty point four percentages of samples has visceral obesity ≥ 7cm; they were the older, showed higher values of BMI, visceral obesity and blood pressure. Significant difference was found between groups regarding mean value of BMI, visceral obesity, both systolic blood pressure SBP and diastolic blood pressure DBP and most of the daily macronutrients intake. In groups (2&3) positive significant correlation was recorded between (SBP) & (DBP) and total daily intake of total calories, carbohydrate, total fat, saturated fatty acids and cholesterol, and negative significant correlation with total daily intake of total protein, animal and vegetable protein, linolenic and linoleic fatty acids, while oleic fatty acid showed negative correlation with SBP&DBP in all groups. CONCLUSION: This study emphasizes the hypothesis that the macronutrients composition of diet influences blood pressure in different ways, in obese patients with visceral obesity. PMID:27275219

  11. Morbid Obesity and the Transition from Welfare to Work

    ERIC Educational Resources Information Center

    Cawley, John; Danziger, Sheldon

    2005-01-01

    This paper utilizes a rich longitudinal data set--the Women's Employment Study (WES)--to investigate whether obesity, which is common among women of low socioeconomic status, is a barrier to employment and earnings for current and former welfare recipients. We find that former welfare recipients who are both White and morbidly obese have been less…

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Stress does not affect ghrelin secretion in obese and normal weight women.

    PubMed

    Kiessl, Gundula R R; Laessle, Reinhold G

    2017-03-01

    Stress has been supposed to increase appetite. The biological basis of this phenomenon may be a stress-induced alteration of the secretion of GUT peptides such as ghrelin. Stress-induced changes in ghrelin secretion could be a biological basis of overeating and a factor contributing to the development of obesity. Aim of the study was to analyze the effect of acute psychosocial stress on ghrelin secretion in obese and normal weight women. We compared pre- and postprandial plasma ghrelin secretion of 42 obese and 43 normal weight women in a randomized crossover design. Ghrelin and cortisol concentrations were measured and ratings of stress were also recorded in response to a psychological stressor (Trier Social Stress Test, TSST). Ghrelin samples were collected in the fasting state one time before participating in the TSST and one time before a control session. After the TSST, respectively, control session participants had a standardized ad libitum meal. 30 and 60 min after the TSST, respectively, control session preprandial ghrelin was measured again. Obese women showed lower pre- and postprandial release of ghrelin than normal weight controls. Moreover, obese women showed inhibited postprandial decrease of ghrelin secretion. Stress did not affect postprandial ghrelin secretion, but inhibited food intake in all subjects. The present data provide further evidence of altered ghrelin release in obesity. Acute stress did not affect postprandial ghrelin secretion, but inhibited food intake in all subjects. Results are discussed with regard to biological and psychological regulation of hunger and satiety in obesity.

  17. 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.

  18. A comparison of eating disorder psychopathology, appearance satisfaction, and self-esteem in overweight and obese women with and without binge eating.

    PubMed

    Herbozo, Sylvia; Schaefer, Lauren M; Thompson, J Kevin

    2015-04-01

    This study investigated the differences in eating disorder psychopathology, appearance satisfaction, and self-esteem between 194 overweight/obese college women with and without binge eating. Participants were categorized as binge eating (BE; n=56) or non-binge eating (NBE; n=138) based on reports of binge eating at least once per week on average for the past 28days and no episodes of vomiting or laxative use in the past 28days. The BE group had significantly greater levels of eating, weight, and shape concerns and lower levels of appearance satisfaction and self-esteem than the NBE group. For the BE group, binge eating frequency was negatively correlated with dietary restraint. Results are generally consistent with studies utilizing clinical and community samples. The findings extend such research by examining binge eating in a sample of overweight and obese college women and indicating that overall appearance satisfaction is lower among women with binge eating. Study findings also highlight potential issues to address in obesity and binge eating intervention efforts for college populations. Future research is needed to replicate these findings in additional samples of college women and men. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Lateral spine densitometry in obese women.

    PubMed

    Brooks, E R; Heltz, D; Wozniak, P; Partington, C; Lovejoy, J C

    1998-08-01

    The lateral (LAT) spine scan has been suggested as a more sensitive measure than posterior-anterior (PA) scanning for assessing age-related bone loss in normal-weight postmenopausal women. The measurement error of PA and LAT bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) has also been shown to rise with incremental increases in fat and from large variance in fat thickness, respectively. The purpose of this cross-sectional study was to determine specific affects of obesity on paired PA and LAT lumbar (L2-L4) BMD and Z score (BMD of patient versus age-matched reference data-base) correlation in 30 obese postmenopausal women (mean BMI +/- SD = 33.3 +/- 4.06). The mean PA and LAT BMD +/- SD were 0.946 +/- 0.123 and 0.749 +/- 0.134, respectively. The mean PA and LAT Z scores were -0.17 +/- 1.15 and 0.80 +/- 1.7. The correlation between PA and LAT BMD was significantly lower (r = 0.55; P < 0.05) than previously reported, and PA and LAT Z score correlation was (r = 0.57; P = 0.0016). After adjusting for body mass index (BMI), percent body fat, fat mass, and truncal fat by DXA, waist:hip ratio (WHR) and visceral and subcutaneous abdominal fat by computerized axial tomography (CT), PA and LAT Z score correlation increased to r = 0.62; P = 0.0065. In our subjects, the mean LAT Z score was 4.6 times higher than the mean AP Z, contrary to previous observations in normal-weight postmenopausal women. Our findings may be due to increased soft tissue composition and fat inhomogeneity in the LAT scanning field resulting in increased X-ray attenuation in obesity.

  20. 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

  1. 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.

  2. The Association between Obesity and Cognitive Function in Otherwise Healthy Premenopausal Arab Women.

    PubMed

    Farooq, Abdulaziz; Gibson, Ann-Marie; J Reilly, John; Gaoua, Nadia

    2018-01-01

    To examine the association between obesity and cognitive function in healthy premenopausal women. From a cohort of 220 women, 98 were randomly selected that provided complete data. Body composition was examined by dual-energy X-ray scan. All participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive performance in three domains: attention, memory, and planning executive function. The Reaction Time (RTI) test was used to assess motor and mental response speeds; the Stockings of Cambridge (SOC) test was used to assess planning executive function. For memory assessment, the Delayed Match to Sample (DMS), Pattern Recognition Memory (PRM), and Spatial Span (SSP) tests were used to assess forced choice recognition memory, visual pattern recognition memory, and working memory capacity, respectively. 36 (36.7%) were morbidly obese, 22 (22.4%) obese, and 23 (23.5%) overweight. Performance on RTI and SOC planning ability were not associated with body mass index (BMI). DMS mean time to correct response, when stimulus is visible or immediately hidden (0 ms delay), was higher by 785 ± 302 ms (milliseconds) ( p =0.011) and 587 ± 259 ms ( p =0.026) in morbidly obese women compared to normal weight women. Memory span length was significantly lower in overweight (5.5 ± 1.3, p =0.008) and obese women (5.6 ± 1.6, p =0.007) compared to normal weight (6.7 ± 0.9). DEXA-assessed body fat (%) showed similar associations as BMI, and latency to correct response on DMS and PRM was positively correlated with percentage of body fat, but not with VO 2 max. In otherwise healthy premenopausal women, obesity did not impact accuracy on cognitive tasks related to attention, memory, or planning executive function, but morbid obesity was associated with higher latency to correct response on memory-specific tasks and lower memory span length.

  3. 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.

  4. 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.

  5. [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.

  6. 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.

  7. 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.

  8. [Food insecurity is associated with obesity in adult women of Mexico].

    PubMed

    Morales-Ruán, Ma Del Carmen; Méndez-Gómez Humarán, Ignacio; Shamah-Levy, Teresa; Valderrama-Álvarez, Zaira; Melgar-Quiñónez, Hugo

    2014-01-01

    To describe the association of food insecurity (FI) and obesity in adults in Mexico. Cross-sectional design. We included adults' data from the health and nutrition national survey 2012 (Ensanut 2012). Measures of weight and height were obtained and BMI was calculated. The level of household food insecurity was measured through the Latin American Scale of Food Security (ELCSA). Linear and logistic regression models were adjusted. 70.6% of the population had some level of food insecurity, 42.6% mild insecurity, 17.7% moderate insecurity and 10.3% severe insecurity. Adults with mild FI had higher probability of obesity (OR: 1.66; 95%CI 1.11-2.50). Women were slightly more likely to be obese (OR: 1.78; 95%CI 1.01-3.12). Mild FI is associated with obesity, particularly among women.

  9. Effect of diet-induced weight loss on inflammatory cytokines in obese women.

    PubMed

    Tajik, N; Keshavarz, S A; Masoudkabir, F; Djalali, M; Sadrzadeh-Yeganeh, H Hale; Eshraghian, M R; Chamary, M; Ahmadivand, Z; Yazdani, T; Javanbakht, M H

    2013-04-01

    Obesity is associated with lowgrade systemic inflammation which has been linked to the increased risk of cardiovascular disease and Type 2 diabetes in obese patients. To evaluate changes in pro/anti-inflammatory adipocytokines and metabolic profile after moderate diet-induced weight loss. Twenty-nine pre-menopausal obese women (body mass index ≥30 kg/m2) aged 21 to 54 years without diabetes, hypertension, or hyperlipidemia, were enrolled in this study. We measured anthropometric parameters, lipid and glucose profiles, interleukin (IL)-6, IL-10, and IL-18 in obese women, who then entered a medically supervised program aimed at reducing body weight by 10% or more. Obese women restricted their caloric intake (by 500-1000 kcal/day) and consumed 50 g/day of a fiber supplement (Slim Last Powder) for 12 weeks. By completing the dietary intervention program, weight (Δ = -10.0%, p<0.0001), body mass index, waist circumference, triceps skinfold thickness, total cholesterol, triglyceride, and fasting plasma glucose significantly decreased, while HDL-cholesterol significantly increased. While plasma levels of IL-6 and IL-18 decreased by 27% after 12 weeks, no significant change was observed in circulating levels of IL-10. Our study suggests that an improved body composition induced by restriction of energy intake is associated with favorable serum concentrations of IL-6 and IL-18 in obese women. However, the anti-inflammatory IL-10 is not affected by a moderate weight decrease.

  10. An examination of obesity and breast cancer survival in post-menopausal women.

    PubMed Central

    Katoh, A.; Watzlaf, V. J.; D'Amico, F.

    1994-01-01

    A historical prospective study was conducted at the Mercy Hospital of Pittsburgh, Pennsylvania (USA), to study the role of post-menopausal obesity in the recurrence and survival of breast cancer. Records from 301 post-menopausal women diagnosed with breast cancer from 1977 to 1985 were followed for at least 5 years from data supplied by the Tumor Registry and medical records. Data collected included age, height, weight, race, hormone receptor status, stage and size of tumour, number of positive nodes, site of distant metastasis, first course of treatment, and 5 year recurrence and survival. Forty-five per cent of patients were obese (n = 136), while 55% were non-obese (n = 165). Obesity was defined by the Quetelet index (patients with values > 27 were considered obese). The recurrence rates for the obese and non-obese groups were 40% and 39% respectively, and were not significantly different. Univariate and multivariate analyses showed that there was no significant association between obesity in post-menopausal women and likelihood of recurrence of or death from breast cancer. PMID:7947099

  11. 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

  12. 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

  13. 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.

  14. Meaning of the Terms "Overweight" and "Obese" Among Low-Income Women

    PubMed Central

    Ellis, Samantha; Rosenblum, Katherine; Miller, Alison; Peterson, Karen E.; Lumeng, Julie C.

    2013-01-01

    Objective To determine how low-income United States women understand the meanings of the terms “overweight” and “obese”. Methods Low-income women [n = 145; 72% white, 12% black, 8% Hispanic; 59% obese, 21% overweight] each participated in an individual semi-structured interview during which they were asked to explain what the terms overweight and obese mean to them. Responses were transcribed and the constant comparative method was used to identify themes. Results Three themes emerged: (1) The terms are offensive and describe people who are unmotivated, depressed and do not care about themselves; (2) Obese is an extreme weight (e.g. 500 pounds and being immobile); (3) Being overweight is a matter of opinion; if a woman is “comfortable in her own skin” and “feels healthy” she is not overweight. Conclusions and Implications Health education focused on obesity should consider that vulnerable populations might consider the terms "overweight" and "obese" offensive and stigmatizing. PMID:24135314

  15. 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.

  16. Weight fluctuations could increase blood pressure in android obese women.

    PubMed

    Guagnano, M T; Pace-Palitti, V; Carrabs, C; Merlitti, D; Sensi, S

    1999-06-01

    Recent studies have documented a relationship between increased morbidity and mortality from cardiovascular diseases and a history of weight cycling (WC) in obese subjects. We performed a cross-sectional analysis in 96 weight-cycling android obese women, matched with 96 non-weight-cycling android obese women by age, body mass index (BMI) and waist-to-hip ratio (WHR), to evaluate any increase in blood pressure (BP) levels in association with WC. The patients were all between 20 and 45 years old, were non-menopausal, did not smoke, did not take any medication, had normal glucose tolerance and were otherwise healthy. A history of WC was established on the basis of at least five weight losses in the previous 5 years due to dieting, with a weight loss of at least 4.5 kg per cycle. We documented higher levels of casual BP in the weight-cycling obese compared with the non-weight-cycling subjects: 147+/-12/90+/-8 mmHg versus 125+/-14/79+/-8 mmHg (P<0.001). The women with WC showed a statistically significant positive correlation between BP and age, weight, BMI, waist circumference, WHR, total weight regained and weight cycling index (WCI). However, in a multiple regression model only the WHR and WCI contributed significantly to the BP variability. These findings could support the hypothesis that it is the combined exposure of central-type obesity and WC that strongly raises the prediction of hypertension.

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. Comparison of hip geometry, strength, and estimated fracture risk in women with anorexia nervosa and overweight/obese women.

    PubMed

    Bachmann, Katherine Neubecker; Fazeli, Pouneh K; Lawson, Elizabeth A; Russell, Brian M; Riccio, Ariana D; Meenaghan, Erinne; Gerweck, Anu V; Eddy, Kamryn; Holmes, Tara; Goldstein, Mark; Weigel, Thomas; Ebrahimi, Seda; Mickley, Diane; Gleysteen, Suzanne; Bredella, Miriam A; Klibanski, Anne; Miller, Karen K

    2014-12-01

    Data suggest that anorexia nervosa (AN) and obesity are complicated by elevated fracture risk, but skeletal site-specific data are lacking. Traditional bone mineral density (BMD) measurements are unsatisfactory at both weight extremes. Hip structural analysis (HSA) uses dual-energy X-ray absorptiometry data to estimate hip geometry and femoral strength. Factor of risk (φ) is the ratio of force applied to the hip from a fall with respect to femoral strength; higher values indicate higher hip fracture risk. The objective of the study was to investigate hip fracture risk in AN and overweight/obese women. This was a cross-sectional study. The study was conducted at a Clinical Research Center. PATIENTS included 368 women (aged 19-45 y): 246 AN, 53 overweight/obese, and 69 lean controls. HSA-derived femoral geometry, peak factor of risk for hip fracture, and factor of risk for hip fracture attenuated by trochanteric soft tissue (φ(attenuated)) were measured. Most HSA-derived parameters were impaired in AN and superior in obese/overweight women vs controls at the narrow neck, intertrochanteric, and femoral shaft (P ≤ .03). The φ(attenuated) was highest in AN and lowest in overweight/obese women (P < .0001). Lean mass was associated with superior, and duration of amenorrhea with inferior, HSA-derived parameters and φ(attenuated) (P < .05). Mean φ(attenuated) (P = .036), but not femoral neck BMD or HSA-estimated geometry, was impaired in women who had experienced fragility fractures. Femoral geometry by HSA, hip BMD, and factor of risk for hip fracture attenuated by soft tissue are impaired in AN and superior in obesity, suggesting higher and lower hip fracture risk, respectively. Only attenuated factor of risk was associated with fragility fracture prevalence, suggesting that variability in soft tissue padding may help explain site-specific fracture risk not captured by BMD.

  3. 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.

  4. 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.

  5. Effects of ear acupuncture therapy for obesity on the depression of obese women.

    PubMed

    Set, Turan; Cayir, Yasemin; Pirim, Asuman Bihter Guven

    2014-10-01

    Obesity is one of the leading health risks worldwide, and depression is among the leading causes of the burden of disease. These disorders are increasingly prevalent as comorbidities. Depressive symptoms are associated with obesity, and are more common in women. To evaluate the effectiveness of ear acupuncture for obesity on the depression of obese women. After baseline testing, 30 eligible patients with body mass index (BMI) >29.9 kg/m(2) were included. The Beck Depression Inventory for Primary Care (BDI-PC) was used to assess changes in depression. BMI was also measured. Patients had six ear acupuncture sessions, every 15 days and were followed up for 3 months. Twenty four patients completed the study. The mean±SD age of patients was 42.9±9.0 years. Their mean±SD BMI was 39.0±4.7 kg/m(2) before acupuncture, decreasing to 37.2±4.3 kg/m(2) after acupuncture therapy (p<0.001). The mean depression score was 4.4±2.3 before acupuncture, decreasing to 2.7±1.4 (p<0.001) after treatment. There was no significant correlation between BMI and depression score before acupuncture therapy (p=0.104). After acupuncture therapy, no significant correlation was found between the percentage reduction of BMI and percentage reduction of the depression score (p=0.119). Further research into the effects of ear acupuncture in the management of obesity and depression is justified. 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.

  6. 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

  7. Bone turnover biomarkers in obese postmenopausal Saudi women with type-II diabetes mellitus.

    PubMed

    Alselami, Nada M; Noureldeen, Amani F H; Al-Ghamdi, Maryam A; Khan, Jalaluddin A; Moselhy, Said S

    2015-03-01

    There is a high prevalence of diabetes mellitus type-2 (T2DM) and osteoporosis are problems worldwide. In this study, we evaluated the correlation between T2DM and bone turnover in diabetic obese postmenopausal Saudi women. The present study included total of 65 T2-DM obese postmenopausal Saudi women, (36 uncontrolled, 29 controlled). The following serum biochemical parameters were evaluated [fasting blood glucose (FBG), total calcium (Ca), phosphorus (Pi), parathyroid hormone (PTH), 1,25-(OH)2 Vitamin D3, osteocalcin (OC), procollagen (PICP) and cathepsin k (Cath K)]. Serum OC levels were significantly decreased in diabetic obese postmenopausal group compared to their respective healthy group (P < 0.004). PICP and Cath K were significantly elevated in diabetic postmenopausal group compared to the healthy group (P < 0.024 & 0.001). A significant elevation in 1,25(OH)2 Vitamin D3, Ca and Pi levels in diabetic obese postmenopausal patients group compared to the healthy group. However, a non-significant changes was observed in serum PTH level between different groups. In this study, the changes in the biochemical parameters and bone turnover markers in obese women are strong risk factors for diabetes development that may contribute to osteopenia and osteoporosis. The study showed the strong effect of T2DM on biochemical markers of bone turnover in obese postmenopausal Saudi women.

  8. Lifestyle Interaction With Fat Mass and Obesity-Associated (FTO) Genotype and Risk of Obesity in Apparently Healthy U.S. Women

    PubMed Central

    Ahmad, Tariq; Lee, I-Min; Paré, Guillaume; Chasman, Daniel I.; Rose, Lynda; Ridker, Paul M.; Mora, Samia

    2011-01-01

    OBJECTIVE Variation in the fat mass and obesity-associated (FTO) gene is associated with obesity. The extent to which separate and combined effects of physical activity and caloric intake modify this association remains unclear. RESEARCH DESIGN AND METHODS FTO polymorphism rs8050136 was measured, and physical activity, caloric intake, and anthropometrics were self-reported in 21,675 apparently healthy Caucasian women. RESULTS The effect of the risk allele (A) on BMI was larger among inactive or higher intake women, with additive effects of inactivity and high intake on the associated genetic risk. Specifically, each A allele was associated with mean BMI difference of +0.73 (SE 0.08) kg/m2 among inactive women (≤median, 8.8 MET-hours/week), compared with +0.31 (0.06) kg/m2, P < 0.0001, among active women (>8.8 MET-hours/week). Similarly, each A allele was associated with mean BMI difference of +0.65 (0.07) among high intake women (>median, 1,679 kcals/day), compared with +0.38 (0.07) kg/m2, P = 0.005, among low intake women (≤1,679 kcals/day). Among inactive/high intake women, each A allele was associated with mean BMI difference of +0.97 (0.11) kg/m2 vs. +0.22 (0.08) kg/m2 among inactive/low intake women, P < 0.0001. Among inactive/high intake women, each A allele carried increased risk of obesity (odds ratio 1.39, 95% CI 1.27–1.52) and diabetes (odds ratio 1.36, 95% CI 1.07–1.73). CONCLUSIONS In this study, lifestyle factors modified the genetic risk of FTO on obesity phenotypes, particularly among women who were both inactive and had high intake. Healthier lifestyle patterns blunted but did not completely eliminate the associated genetic risk. PMID:21266646

  9. 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.

  10. Effects of anti-obesity messages on women's body image and eating behaviour.

    PubMed

    Shentow-Bewsh, Rachel; Keating, Leah; Mills, Jennifer S

    2016-01-01

    It has been suggested that obesity stigmatization contributes to negative mental health outcomes, particularly among overweight individuals. This study examined the effects of exposure to media-portrayed anti-obesity messages on women's state self-esteem, body esteem, and food intake. It was hypothesized that exposure to anti-obesity messages would result in decreased state self-esteem and body esteem and in increased food intake, and that these effects would be more pronounced in individuals with either higher BMI or stronger perceived pressure to be thin. Participants were randomly assigned to one of three experimental conditions in which they either: read a fictitious media article containing either anti-obesity messages or non-obesity-related health messages, or completed a neutral control task (word search). State self-esteem and body esteem were measured before and after the manipulation. Participants also completed a candy taste rating task and ad lib consumption was surreptitiously measured. There was no main effect of condition on either psychological outcome variable or on grams consumed. Higher perceived sociocultural pressure to be thin was associated with a decrease in body esteem after reading the anti-obesity article only. Having a higher BMI was associated with greater candy intake in the word search condition. This trend was also apparent in the sun exposure condition, but not in the anti-obesity condition. Exposure to anti-obesity messages appears to decrease weight-related body esteem in women who already feel strong pressure to be thin, and may lead heavier women to suppress their food intake. Copyright © 2015. Published by Elsevier Ltd.

  11. Magnesium Status and Its Association with Oxidative Stress in Obese Women.

    PubMed

    Morais, Jennifer Beatriz Silva; Severo, Juliana Soares; de Oliveira, Ana Raquel Soares; Cruz, Kyria Jayanne Clímaco; da Silva Dias, Thaline Milany; de Assis, Régina Célia; Colli, Célia; do Nascimento Marreiro, Dilina

    2017-02-01

    The aim of this study was to assess the relationship between magnesium status and oxidative stress in obese and nonobese women. This cross-sectional study included 83 women, aged between 20 and 50 years, who were divided into two groups: the obese group (n = 31) and the control group (n = 52). The control group was age-matched with the obese group. Magnesium intake was monitored using 3-day food records and NutWin software version 1.5. The plasma and erythrocyte magnesium concentrations were determined by flame atomic absorption spectrophotometry. Plasma levels of thiobarbituric acid reactive substances (TBARS) were determined as biomarkers for lipid peroxidation and therefore of oxidative stress. The mean values of the magnesium content in the diet were found to be lower than those recommended, though there was no significant difference between groups (p > 0.05). The mean concentrations of plasma and erythrocyte magnesium were within the normal range, with no significant difference between groups (p > 0.05). The mean concentration of plasma TBARS was higher in obese woman, and the difference between the groups was statistically different (p < 0.05). There was a positive correlation between erythrocyte magnesium and plasma TBARS in the obese group (p = 0.021). Obese patients ingest low dietary magnesium content, which does not seem to affect the plasma and erythrocyte concentrations of the mineral. The study showed a negative correlation between erythrocyte magnesium concentrations and plasma TBARS, suggesting the influence of magnesium status on the parameters of oxidative stress in obese women.

  12. 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.

  13. Developing a clinical care pathway for obese pregnant women: A quality improvement project.

    PubMed

    Fealy, Shanna; Hure, Alexis; Browne, Graeme; Prince, Carol

    2014-12-01

    Obesity in pregnancy is associated with an increased incidence of maternal and foetal morbidity and mortality, from conditions like preeclampsia, gestational diabetes, preterm birth and stillbirth. Between 20% and 25% of pregnant women in Australia are presenting to their first antenatal appointment with a body mass index (BMI) ≥ 30 kg/m(2), defined as obesity in pregnancy. These figures are concerning for midwifery and obstetric staff directly involved in the clinical care of these women and their families. In the absence of national or state clinical practice guidelines for managing the risks for obese pregnant women, a local quality improvement project was conducted. To plan, implement, and evaluate the impact of an alternative clinical care pathway for pregnant women with a BMI ≥ 35 kg/m(2) at their first antenatal visit. The project was undertaken in the antenatal clinic of a rural referral hospital in NSW, Australia. Eighty-two women with a BMI ≥ 35 kg/m(2) were eligible for the alternative care pathway, offered between January and December 2010. The alternative care pathway included the following options, in addition to usual care: written information on obesity in pregnancy, referral to a dietitian, early plus repeat screening for gestational diabetes, liver and renal function pathology tests, serial self-weighing, serial foetal growth ultrasounds, and a pre-labour anaesthetic consultation. Despite being educated on the risk associated with obesity in pregnancy, women did not take up the offers of dietetic support or self-weighing at each antenatal visit. Ultrasounds were well received and most women underwent gestational diabetes screening. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  14. 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

  15. 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.

  16. Self-monitoring Lifestyle Behavior in Overweight and Obese Pregnant Women: Qualitative Findings.

    PubMed

    Shieh, Carol; Draucker, Claire Burke

    Excessive maternal gestational weight gain increases pregnancy and infant complications. Self-monitoring has been shown to be an effective strategy in weight management. Literature, however, is limited in describing pregnant women's engagement in self-monitoring. This qualitative study explored the experiences of overweight and obese pregnant women who self-monitored their eating, walking, and weight as participants in an intervention for excessive gestational weight gain prevention. Thirteen overweight and obese pregnant women participated in semistructured interviews. Reflexive iteration data analysis was conducted. Five themes were identified: making self-monitoring a habit, strategies for self-monitoring, barriers to self-monitoring, benefits of self-monitoring, and drawbacks of self-monitoring. The women viewed self-monitoring as a "habit" that could foster a sense of self-control and mindfulness. Visual or tracing aids were used to maintain the self-monitoring habit. Forgetting, defective tracking aids, complexities of food monitoring, and life events could impede self-monitoring. Being unable to keep up with self-monitoring or to achieve goals created stress. Self-monitoring is a promising approach to weight management for overweight and obese pregnant women. However, healthcare providers should be aware that, although women may identify several benefits to self-monitoring, for some women, consistently trying to track their behaviors is stressful.

  17. Beliefs about Causes and Consequences of Obesity among Women in Two Mexican Cities

    PubMed Central

    Jiménez-Cruz, Arturo; de Escobar-Aznar, Yolanda Martínez; Castillo-Ruiz, Octelina; Gonzalez-Ramirez, Raul

    2012-01-01

    Personal beliefs might be barriers to the prevention and treatment of obesity. To assess the beliefs about causes and consequences of and possible solutions to obesity among 18-40 years old women in two Mexican cities and to analyze the association with demographic variables, we developed a questionnaire and assessed the women's weight status. The questionnaire was applied at two outpatient healthcare centres and assessed the responses by the Likert scale. Results were analyzed by demographics, using the chi-square and Spearman correlations. One thousand one hundred adult women participated in the study. Mean age was 27.8 years, and mean BMI (kg/m2) was 27.05. The prevalence of overweight and obesity was 35% and 24% respectively. The most mentioned causes of obesity were eating oil and fat (4.1), fried foods (4.1), and eating too much (4.00). The most reported consequences were diseases (4.1), discrimination (3.9), and early death (3.7). The main solutions were physical activity (4.2), healthful eating (4.2), and personal motivation (4.1). Age of participants higher than 30 years, living with a partner, having more than 6 years of education, and having overweight and obesity were predictors of more knowledge about the causes, consequences, and solutions. These Mexican women from low SES had reasonably good knowledge about the causes and consequences of obesity. Although improving education might be beneficial to prevent obesity, changes in environmental contingencies are also necessary to prevent this epidemic. PMID:23082633

  18. [Lifestyle, socioeconomic status and morbidity in postmenopausal women with grade II and III obesity].

    PubMed

    Navarro Rodríguez, Mary Carmen; Saavedra Santana, Pedro; de Pablos Velasco, Pedro; Sablón González, Nery; de Miguel Ruiz, Emilio; Castro Medina, Rosa; Sosa Henríquez, Manuel

    2009-05-01

    Obesity has become a major public health problem in all western countries, and its prevalence is increasing. This condition is associated with a higher prevalence of diabetes mellitus, hypertension, and coronary heart disease; furthermore, obesity is a risk factor for mortality. To study the association of some prevalent diseases (diabetes mellitus, thyroid disease, obesity, hypertension, inflammatory rheumatic disease, urolithiasis), the distribution of some lifestyle factors (tobacco, alcohol and caffeine consumption and physical activity during leisure time) and the prevalence of poverty in a population of postmenopausal women in the Canary Islands with obesity class II or III (BMI>35). A personal interview was performed in all patients. A questionnaire was administered to assess their lifestyles and current medication use. The women's medical records were reviewed to confirm the existence of certain diseases. A complete physical examination was performed in all patients. Weight and height were measured with the patient dressed in light clothing. Blood samples were obtained with the patient in a fasting state for subsequent analysis. Poverty was defined according to the criteria of the Spanish National Institute of Statistics. Women with obesity class II or III were older (56.8+/-11 vs 53.9+/-11.6 years, p=0.02), shorter (153.7+/-6.3 vs 156.9+/-36.1 cm, p=0.001), heavier (89.6+/-9.3 vs 66.6+/-10.4 kg, p=0.001) and had a greater body surface than controls (1.73+/-0.13 vs 1.54+/-0.13 m2, p=0.001). Alcohol and tobacco consumption were lower in obese women than in controls. Obese women drank more coffee and took less physical activity during leisure time than controls. The prevalence of hypertension -36% vs 17.9%, p=0.001, odds ratio [OR] [95% confidence interval (IC)]=2.57 (1.56-4.24)-, diabetes mellitus -24.4% vs 11.3%, p=0.001, OR=2.52 (1.47-1.05)-and hypothyroidism -14.3% vs 8%, p=0.04; OR=1.91 (0.99-3.68)-was higher in obese women than in controls. More than

  19. 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.

  20. Relationships Among Obesity, Type 2 Diabetes, and Plasma Cytokines in African American Women.

    PubMed

    Denis, Gerald V; Sebastiani, Paola; Andrieu, Guillaume; Tran, Anna H; Strissel, Katherine J; Lombardi, Frank L; Palmer, Julie R

    2017-11-01

    The principal objective of this investigation was to identify novel cytokine associations with BMI and type 2 diabetes (T2D). Cytokines were profiled from African American women with obesity who donated plasma to the Komen Tissue Bank. Multiplex bead arrays of analytes were used to quantify 88 cytokines and chemokines in association with clinical diagnoses of metabolic health. Regression models were generated after elimination of outliers. Among women with obesity, T2D was associated with breast adipocyte hypertrophy and with six plasma analytes, including four chemokines (chemokine [C-C motif] ligand 2, chemokine [C-C motif] ligand 16, chemokine [C-X-C motif] ligand 1, and chemokine [C-X-C motif] ligand 16) and two growth factors (interleukin 2 and epidermal growth factor). In addition, three analytes were associated with obesity independently of diabetes: interleukin 4, soluble CD40 ligand, and chemokine (C-C motif) ligand 3. Profiling of inflammatory cytokines combined with measures of BMI may produce a more personalized risk assessment for obesity-associated disease in African American women. © 2017 The Obesity Society.

  1. Obesity measures, metabolic profiles and dietary fatty acids in lean and obese postmenopausal diabetic Asian Indian women.

    PubMed

    Ghosh, Arnab

    2009-03-01

    The present investigation was aimed to compare anthropometric, metabolic and dietary fatty acids profiles in lean and obese postmenopausal diabetic Asian Indian women. A total of 125 postmenopausal Asian Indian women (Group I: lean postmenopausal control, n = 50; Group II: lean postmenopausal diabetic, n = 40 and Group III: obese postmenopausal diabetic, n = 35) aged 40 years and above were studied. Anthropometric [height, weight, waist (WC) and hip circumference] metabolic [total cholesterol (TC), triglyceride (TG), high (HDL), low density lipoprotein (LDL) and fasting plasma glucose (FPG)] and dietary profiles were collected from each participant. Body mass index (BMI), waist-hip ratio (WHR) and conicity index (CI) were subsequently computed. Obesity was defined as women having a BMI > or = 25 kg/m2. An open-ended 24 h food recall schedule was used to collect nutrient information from each participant. Daily intake of nutrients including saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) were also estimated on weekly and monthly basis. Group I had significantly lower mean than both Group II and Group III for WC, WHR, CI, TC, TG, LDL, FPG and total carbohydrates. On the other hand, Group I had significantly greater mean than both Group II and Group III for UFA/SFA, MUFA/SFA and PUFA/SFA. Discriminant analysis had revealed that overall 88% of all cases were correctly (positively) classified in three groups using fatty acids and their ratios. It seems reasonable to argue that while dealing with postmenopausal diabetic women, clinicians should consider obesity measures, lipids and dietary fatty acids simultaneously to better comprehend clinical assessments and risk stratification.

  2. Personality, attrition and weight loss in treatment seeking women with obesity.

    PubMed

    Dalle Grave, R; Calugi, S; Compare, A; El Ghoch, M; Petroni, M L; Colombari, S; Minniti, A; Marchesini, G

    2015-10-01

    Studies on small samples or in single units applying specific treatment programmes found an association between some personality traits and attrition and weight loss in individuals treated for obesity. We aimed to investigate whether pre-treatment personality traits were associated with weight loss outcomes in the general population of women with obesity. Attrition and weight loss outcomes after 12 months were measured in 634 women with obesity (mean age, 48; body mass index (BMI), 37.8 kg m(-2)) seeking treatment at eight Italian medical centres, applying different medical/cognitive behavioural programmes. Personality traits were assessed with the Temperament and Character Inventory (TCI), eating disorder features with the Binge Eating Scale (BES) and Night Eating Questionnaire (NEQ). Within the 12-month observation period, 32.3% of cases were lost to follow-up. After adjustment for demographic confounders and the severity of eating disorders, no TCI personality traits were significantly associated with attrition, while low scores of the novelty seeking temperament scale remained significantly associated with weight loss ≥ 10% (odds ratio, 0.983; 95% confidence interval, 0.975-0.992). Additional adjustment for education and job did not change the results. We conclude that personality does not systematically influence attrition in women with obesity enrolled into weight loss programmes in the community, whereas an association is maintained between novelty seeking and weight loss outcome. Studies adapting obesity interventions on the basis of individual novelty seeking scores might be warranted to maximize the results on body weight. © 2015 World Obesity.

  3. 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

  4. 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

  5. Frequency of euploid miscarriage is increased in obese women with recurrent early pregnancy loss.

    PubMed

    Boots, Christina E; Bernardi, Lia A; Stephenson, Mary D

    2014-08-01

    To determine whether the frequency of euploid miscarriage is increased in obese women with recurrent early pregnancy loss (REPL). Observational cohort study using prospectively collected data. Academic RPL program. A total of 372 women with REPL, defined as ≥2 pregnancy losses<10 weeks, and at least one ultrasound-documented miscarriage with chromosome results. Body mass index (BMI) was measured at the initial consultation and at each subsequent pregnancy. Conventional cytogenetic analysis and, when indicated, microsatellite analysis and/or comparative genomic hybridization was performed. Frequency of euploid miscarriage in obese (BMI≥30 kg/m2) and nonobese (BMI<30 kg/m2) subjects, before and subsequent to REPL evaluation. There were 578 miscarriages with chromosome results. Of the subjects, 18% were obese at the time of miscarriage. The mean maternal age at miscarriage was similar between the obese and nonobese groups. Due to the high rate of maternal cell contamination in the prior miscarriages, only subsequent miscarriages with chromosome results were included in the primary analysis. Of the 117 subsequent miscarriages, the frequency of an euploid miscarriage among obese women was 58% compared with 37% of nonobese women (relative risk=1.63; 95% confidence interval 1.08-2.47). Obese women with REPL have an increased frequency of euploid miscarriage, which is a known risk factor for subsequent miscarriage. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. Social stress, obesity, and depression among women: clarifying the role of physical activity.

    PubMed

    Lincoln, Karen D

    2017-07-01

    This study examined the role of stress in the association among physical activity, obesity, and depression among women. The extent to which physical activity moderated these relationships was also examined. Data from the National Survey of American Life (N = 3235) and multivariable regression analyses were used to examine the effects of chronic stress, material hardship, racial discrimination, and physical activity on obesity and depression among African American, Caribbean Black and White women. Stress was not related to body mass index (BMI) for African American or White women, but chronic stress was associated with higher BMI for Caribbean Black women. Stress was associated with depressive symptoms, but there was variation by the type of stressor under consideration. Physical activity was associated with fewer depressive symptoms and lower BMI, but the relationships varied by type of stressor and race/ethnicity. Physical activity moderated the effect of chronic stress on depressive symptoms and BMI, but only for African American women who reported high levels of chronic stress. Among White women, physical activity moderated the effect of racial discrimination on BMI for those who reported experiencing both high and low levels of discrimination. This study was the first to document physical activity as a moderator in the relationship among stress, depression, and obesity using a nationally representative sample of racially/ethnically diverse women. Findings provide insight into the role of stress in relation to depression and obesity while highlighting heterogeneity among Black Americans.

  8. [Obesity and components of metabolic syndrome in Mexican women survivors of cancer].

    PubMed

    Ortiz-Mendoza, Carlos Manuel; de la Fuente-Vera, Tania Angélica

    2014-01-01

    Some studies suggest that obesity and metabolic syndrome are frequent in cancer survivors. In our country, there is a lack of documentation with regards to this problem in women. Therefore, our aim is to establish the prevalence of obesity and metabolic syndrome components in surviving Mexican women. We elected women who received treatment for cancer with a surviving = 24 months. The data evaluated were demography, clinical anthropometry, blood pressure measurement, kind of cancer, surviving time, and comorbidities, as well as glucose, cholesterol, and triglyceride levels. We studied 107 women. Their average age was 60 ± 10 years, with a surviving time of 77 ± 43 months, and a body mass index of 31 ± 6 kg/m2. Their mean glucose level was 120 ± 58 mg/dL, cholesterol 228 ± 43 mg/dL, and triglycerides 207 ± 120 mg/dL. There were 55 (51 %) with glucose > 99 mg/dL, 85 (79 %) with cholesterol > 199 mg/dL, and 67 (63 %) with triglycerides > 149 mg/dL. Obesity (body mass index = 30 kg/m2) occurred in 49 (46 %) and metabolic syndrome in 27 (26 %). Due to a high prevalence of obesity, metabolic syndrome components were frequent.

  9. Body Mass Index, Overweight, and Obesity in Swedish Women Born Post-term.

    PubMed

    Derraik, José G B; Lundgren, Maria; Cutfield, Wayne S; Ahlsson, Fredrik

    2016-07-01

    There is increasing evidence that post-term birth (≥42 weeks of gestation) is associated with adverse long-term outcomes. We assessed whether women born post-term displayed increased risk of overweight and obesity in adulthood. Data were collected at first antenatal visit (~10-12 weeks of gestation) on singleton Swedish women aged ≥18 years in 1991-2009 (mean age 26.1 years), who were born post-term (n = 27 153) or at term (37-41 weeks of gestation; n = 184 245). Study outcomes were evaluated for continuous associations with gestational age. Stratified analyses were carried out comparing women born post-term or at term. Analyses were also run with a 2-week buffer between groups to account for possible errors in gestational age estimation, comparing women born very post-term (≥43 weeks of gestation; n = 5761) to those born within a narrower term window (38-40 weeks of gestation; n = 130 110). Increasing gestational age was associated with greater adult weight and body mass index (BMI). Stratified analyses showed that women born post-term were 0.5 kg heavier and had BMI 0.2 kg/m(2) greater than those born at term. Differences were more marked between women born very post-term (≥43 weeks) vs. a narrower term group (38-40 weeks): 1.0 kg and 0.3 kg/m(2) . The adjusted relative risks of overweight/obesity and obesity in women born very post-term were 1.13 and 1.12 times higher, respectively, than in those born at term. Post-term birth is associated with greater BMI and increased risk of overweight and obesity in adulthood, particularly among women born ≥43 weeks of gestation. © 2016 John Wiley & Sons Ltd.

  10. 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.

  11. 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

  12. 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.

  13. Steroid hormone profiling in obese and nonobese women with polycystic ovary syndrome.

    PubMed

    Deng, Yuying; Zhang, Yifei; Li, Shengxian; Zhou, Wenzhong; Ye, Lei; Wang, Lihua; Tao, Tao; Gu, Junjie; Yang, Zuwei; Zhao, Dandan; Gu, Weiqiong; Hong, Jie; Ning, Guang; Liu, Wei; Wang, Weiqing

    2017-10-26

    The study explored differences in the steroidogenic pathway between obese and nonobese women with polycystic ovary syndrome (PCOS) using liquid chromatography-tandem mass spectrometry (LC-MS/MS). 1044 women with PCOS (including 350 lean, 312 overweight and 382 obese) and 366 control women without PCOS (including 203 lean, 32 overweight and 131 obese) were enrolled. The differences in steroid hormones were amplified in lean PCOS versus lean controls compared with obese PCOS versus obese controls. Compared with obese PCOS, lean PCOS demonstrated increased dehydroepiandrosterone sulfate (P = 0.015), 17-hydropregnenolone (P = 0.003), 17-hydroprogesterone (17-OHP) (P < 0.001), progesterone (P < 0.001) and estrone (P < 0.001) levels. Enzyme activity evaluation showed that lean PCOS had increased activity of P450c17 (17-hydropregnenolone/pregnenolone, P < 0.001), P450aro (P < 0.001), 3βHSD2 (progesterone/ pregnenolone and 17-OHP/17-hydropregnenolone, both P < 0.001) and decreased activity of P450c21(11-deoxycorticorsterone/progesterone and 11-deoxycortisol/17-OHP, P < 0.001). Moreover, we found higher frequencies of CYP21A2- (encoding P450c21) c.552 C > G (p. D184E) in lean PCOS compared with obese PCOS patients (P = 0.006). In conclusion, this study demonstrated for the first time that the adrenal-specific enzyme P450c21 showed decreased activity in lean PCOS patients, and that the adrenal androgen excess may play different roles in lean and obese PCOS patients, which represents as different enzyme activity in the steroidogenic pathway.

  14. [Could we perform quality second trimester ultrasound among obese pregnant women?].

    PubMed

    Fuchs, F; Voulgaropoulos, A; Houllier, M; Senat, M-V

    2013-05-01

    To compare the quality of second trimester ultrasound images and their anatomical quality scores among obese women and those with a normal body mass index (BMI). This prospective study, which took place from 2009 to 2011, included every obese pregnant woman (prepregnancy BMI greater than 30 kg/m(2)) who had an ultrasound examination at 20 to 24 weeks in our hospital and a control group with a normal BMI (20-24.9kg/m(2)) who had the same examination. A single operator evaluated the quality of all images, reviewing the standardized ultrasound planes - three biometric and six anatomical - required by French guidelines and scoring the quality of the six anatomical images. Each image was assessed according to 4-6 criteria, each worth one point. We sought excellent quality, defined as the frequency of maximum points for a given image. The obese group included 223 women and the control group 60. The completion rate for each image was at least 95 % in the control group and 90 % in the obese group, except for diaphragm and right outflow tract images. Overall, the excellence rate varied from 35 % to 92 % in the normal BMI group and 18 % to 58 % in the obese group and was significantly lower in the latter for all images except abdominal circumference (P=0.26) and the spine (P=0.06). Anatomical quality scores were also significantly lower in the obese group (22.3 vs. 27.2 ; P=0.001). Image quality and global anatomical scores in second trimester ultrasound scans were significantly lower among obese than normal-weight women. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Metabolic Obesity Phenotypes and Risk of Breast Cancer in Postmenopausal Women.

    PubMed

    Kabat, Geoffrey C; Kim, Mimi Y; Lee, Jennifer S; Ho, Gloria Y; Going, Scott B; Beebe-Dimmer, Jennifer; Manson, JoAnn E; Chlebowski, Rowan T; Rohan, Thomas E

    2017-12-01

    Background: Obesity and the metabolic syndrome (MetS) have both been linked to increased risk of postmenopausal breast cancer; however, their relative contributions are poorly understood. Methods: We examined the association of metabolic phenotypes of obesity defined by presence of the MetS (yes and no) and body mass index (BMI; normal, overweight, obese) with risk of postmenopausal breast cancer in a prospective analysis of a cohort of postmenopausal women ( n ∼ 21,000) with baseline measurements of blood glucose, triglycerides, HDL-cholesterol, blood pressure, waist circumference, and BMI. Women were classified into 6 metabolic obesity phenotypes according to their BMI (18.5-<25.0, 25.0-<30.0, ≥30.0 kg/m 2 ) and presence of the MetS (≥3 of the following: waist circumference ≥88 cm, triglycerides ≥150 mg/dL, HDL-C <50 mg/dL, glucose ≥100 mg/dL, and systolic/diastolic blood pressure ≥130/85 mmHg or treatment for hypertension). HRs for incident breast cancer and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards models. Results: Over 15 years of follow-up, 1,176 cases of invasive breast cancer were diagnosed. Obesity, regardless of metabolic health, was associated with increased risk of breast cancer. Being obese and metabolically unhealthy was associated with the highest risk: HR, 1.62; 95% CI, 1.33-1.96. These associations were stronger in women who had never used hormone therapy. Conclusions: Our findings suggest that both obesity and metabolic dysregulation are associated with breast cancer risk. Impact: Beyond BMI, metabolic health should be considered a clinically relevant and modifiable risk factor for breast cancer. Cancer Epidemiol Biomarkers Prev; 26(12); 1730-5. ©2017 AACR . ©2017 American Association for Cancer Research.

  16. 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%).

  17. 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

  18. Restaurant foods, sugar-sweetened soft drinks, and obesity risk among young African American women

    PubMed Central

    Boggs, Deborah A.; Rosenberg, Lynn; Coogan, Patricia F.; Makambi, Kepher H.; Adams-Campbell, Lucile L.; Palmer, Julie R.

    2013-01-01

    Background 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. Objective 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. Design 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. Main outcome measures 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. Results 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 ≥2 times/week compared with <5 times/year was 1.26 (95% CI: 1.14–1.40; P-trend<0.001). For sugar-sweetened soft drink intake, the HR was 1.10 (95% CI: 0.99–1.23; P-trend=0.14) for ≥2 drinks/day compared with <1 drink/month. The associations were stronger among women younger than age 30 with normal weight at baseline. Conclusions Frequent consumption of burgers from restaurants and sugar-sweetened soft drinks contribute to obesity among young African American women. PMID:24392607

  19. Comparison of Hip Geometry, Strength, and Estimated Fracture Risk in Women With Anorexia Nervosa and Overweight/Obese Women

    PubMed Central

    Bachmann, Katherine Neubecker; Fazeli, Pouneh K.; Lawson, Elizabeth A.; Russell, Brian M.; Riccio, Ariana D.; Meenaghan, Erinne; Gerweck, Anu V.; Eddy, Kamryn; Holmes, Tara; Goldstein, Mark; Weigel, Thomas; Ebrahimi, Seda; Mickley, Diane; Gleysteen, Suzanne; Bredella, Miriam A.; Klibanski, Anne

    2014-01-01

    Context: Data suggest that anorexia nervosa (AN) and obesity are complicated by elevated fracture risk, but skeletal site-specific data are lacking. Traditional bone mineral density (BMD) measurements are unsatisfactory at both weight extremes. Hip structural analysis (HSA) uses dual-energy X-ray absorptiometry data to estimate hip geometry and femoral strength. Factor of risk (φ) is the ratio of force applied to the hip from a fall with respect to femoral strength; higher values indicate higher hip fracture risk. Objective: The objective of the study was to investigate hip fracture risk in AN and overweight/obese women. Design: This was a cross-sectional study. Setting: The study was conducted at a Clinical Research Center. Patients: Patients included 368 women (aged 19–45 y): 246 AN, 53 overweight/obese, and 69 lean controls. Main Outcome Measures: HSA-derived femoral geometry, peak factor of risk for hip fracture, and factor of risk for hip fracture attenuated by trochanteric soft tissue (φattenuated) were measured. Results: Most HSA-derived parameters were impaired in AN and superior in obese/overweight women vs controls at the narrow neck, intertrochanteric, and femoral shaft (P ≤ .03). The φattenuated was highest in AN and lowest in overweight/obese women (P < .0001). Lean mass was associated with superior, and duration of amenorrhea with inferior, HSA-derived parameters and φattenuated (P < .05). Mean φattenuated (P = .036), but not femoral neck BMD or HSA-estimated geometry, was impaired in women who had experienced fragility fractures. Conclusions: Femoral geometry by HSA, hip BMD, and factor of risk for hip fracture attenuated by soft tissue are impaired in AN and superior in obesity, suggesting higher and lower hip fracture risk, respectively. Only attenuated factor of risk was associated with fragility fracture prevalence, suggesting that variability in soft tissue padding may help explain site-specific fracture risk not captured by BMD. PMID

  20. Serum asymmetric dimethylarginine and nitric oxide levels in obese postmenopausal women.

    PubMed

    Kocak, Hikmet; Oner-Iyidogan, Yıldız; Gurdol, Figen; Oner, Pernur; Esin, Deniz

    2011-01-01

    It has been reported that estrogen deficiency after menopause might cause a decrement in nitric oxide (NO) bioavailability by increasing the level of asymmetric dimethylarginine (ADMA), a major endogenous nitric oxide synthase inhibitor, thus leading to abnormalities in endothelial function. Because NO plays an important role on feeding behavior, ADMA may be involved in the pathogenesis of obesity, too. This cross-sectional study aimed to evaluate the relations of ADMA and NO with the obesity-linked peptides, such as ghrelin, leptin, and adiponectin in postmenopausal women free of hormone replacement therapy. Adiponectin, ghrelin, leptin, ADMA, and NO(x) (total nitrite/nitrate) were measured in 22 obese (BMI: 30-47 kg/m(2)) and 19 normal weight (BMI: 21.5-26 kg/m(2)) postmenopausal women.Anthropometric measurements (height, weight, BMI, waist, and hip circumferences) were recorded. Statistics were made by the Mann-Whitney U-test. Ghrelin and adiponectin levels were significantly lower (P<0.001), whereas ADMA and leptin levels were higher in obese women than in normal weight controls (P<0.01 and 0.001, respectively). BMI was correlated negatively with adiponectin and ghrelin and positively with ADMA and leptin levels. No correlation existed between ADMA and NO. Estrogen deficiency alone may not cause an increase in ADMA levels unless the women are prone to disturbances in energy homeostasis. In spite of the high ADMA levels, the unaltered NO levels in plasma may be owing to ongoing inflammatory conditions. © 2011 Wiley-Liss, Inc.

  1. Obesity, Gynecological Factors, and Abnormal Mammography Follow-Up in Minority and Medically Underserved Women

    PubMed Central

    Wujcik, Debra; Lin, Jin-Mann S.; Grau, Ana; Wilson, Veronica; Champion, Victoria; Zheng, Wei; Egan, Kathleen M.

    2009-01-01

    Abstract Background The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients. Methods We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up ≤6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003–2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up. Results Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up ≤6 months (adjusted OR 7.95, p = 0.007). Conclusions Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women. PMID:19558307

  2. Group versus individual phone-based obesity treatment for rural women.

    PubMed

    Befort, Christie A; Donnelly, Joseph E; Sullivan, Debra K; Ellerbeck, Edward F; Perri, Michael G

    2010-01-01

    Rural women have among the highest rates of obesity and sedentary lifestyle, yet few studies have examined strategies for delivering state-of-the-art obesity treatment to hard-to-reach rural areas. The purpose of this pilot trial was to examine the impact and cost-effectiveness of a 6-month behavioral weight loss program delivered to rural women by phone either one-on-one with a counselor or to a group via conference call. Thirty-four rural women (mean BMI=34.4, SD=4.6) were randomized to group phone-based treatment or individual phone-based treatment. Completers analysis showed that weight loss was greater in the group condition (mean=14.9 kg=, SD=4.4) compared to the individual condition (mean=9.5 kg, SD=5.2; p=.03). Among the total sample, 62% of participants in the group condition achieved the 10% weight loss goal compared to 50% in the individual condition, and group treatment was found to be more cost-effective. Future research is warranted to examine the benefits of group phone-based treatment for long-term management of obesity among rural populations.

  3. Guidelines for dietary management of menopausal women with simple obesity.

    PubMed

    Brończyk-Puzoń, Anna; Piecha, Dariusz; Nowak, Justyna; Koszowska, Aneta; Kulik-Kupka, Karolina; Dittfeld, Anna; Zubelewicz-Szkodzińska, Barbara

    2015-03-01

    The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient's needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.

  4. [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.

  5. The comparison of serum vaspin and visfatin concentrations in obese and normal weight women.

    PubMed

    Saboori, S; Hosseinzadeh-Attar, M J; Yousefi Rad, E; Hosseini, M; Mirzaei, K; Ahmadivand, Z

    2015-01-01

    There is evidence based studies which show that plasma level of visfatin and vaspin in patients with type 2 diabetes mellitus elevate in comparison with healthy people. But there is no consistency in plasma visfatin and vaspin concentration between studies done on obese people. For this reason, the aim of this study is to investigate the serum level concentrations of visfatin and vaspin in obese women compared to normal weight women. The participants of this study consist of 43 women aged 20-50, and 43 healthy women with normal weight as a control group. They were matched for age and physical activity. 24h food recall was used to collect dietary information from subjects. Moreover, blood sampling was taken to measure the blood levels of sugar, lipid profile, vaspin and visfatin. The mean serum level of visfatin was not statistically different between obese and normal weight women. But, the obese women had statistically higher mean serum level of vaspin than normal women (p=0.04). We found no relations between serum levels of vaspin with serum concentration of visfatin. Also, serum levels of these two adipokines were not related to the serum concentrations of fasting glucose, total cholesterol, low-density lipoprotein cholesterol and triglyserides and high-density lipoprotein cholesterol. Also, there was a significant positive relationship between carbohydrate intake and serum visfatin level in women participating to this study (p=0.018, r=0.257). The results of this study demonstrated that the level of serum vaspin was significantly higher in obese women. But there were no differences in serum levels of visfatin in comparison to normal weight women. Meanwhile this study demonstrated a positive relationship between serum levels of visfatin with dietary intake of carbohydrate, but no relationship between serum level of visfatin and vaspin in women participating in this study. Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. Cardiac parasympathetic regulation in obese women with binge eating disorder.

    PubMed

    Friederich, H-C; Schild, S; Schellberg, D; Quenter, A; Bode, C; Herzog, W; Zipfel, S

    2006-03-01

    Obese individuals with a binge eating disorder (BED) differ from obese non-binge eaters (NBED) with respect to (a) eating behaviour, (b) psychiatric comorbidity and (c) level of psychosocial distress. The aim of the study was to explore whether these three factors have an influence on cardiac parasympathetic function, that is independent of obesity: as alterations in cardiac parasympathetic function may have a role in the higher cardiovascular mortality that is present in obese individuals. In total, 38 obese women (BMI>30 kg/m(2)), with a BED and 34 age and BMI matched healthy controls (NBED) completed a laboratory stress protocol that incorporated a baseline resting period, Head-up Tilt Testing (HUT) and two challenging mental tasks. Heart rate and blood pressure were measured continuously during the protocol. Parasympathetic cardiac regulation was assessed as the high frequency component of heart rate variability (HRV-HF). Mental challenge led to an augmented reduction of HRV-HF in obese binge eaters, which was linked to the binge eating frequency and hunger perception, but not to psychiatric comorbidity. During baseline conditions and HUT, no significant differences in parasympathetic measures were observed between the two subject groups. Subjects with a BED showed greater reduction in parasympathetic cardiac control (HRV-HF) during mental stress, suggesting higher stress vulnerability in women with a BED. Longitudinal investigations are necessary to evaluate whether this is associated with an increased cardiovascular mortality.

  7. Cardiac valve evaluation and adipokine levels in obese women treated with sibutramine.

    PubMed

    Saraç, Sefa; Saraç, Fulden

    2010-06-01

    The aims of present study were 1) to evaluate cardiac valve characteristics, 2) to determine the plasma concentrations of fibrinogen, high sensitivity C-reactive protein (hsCRP), adiponectin, and tumor necrosis factor-alpha (TNF-alpha) in the obese women before and after 19 months sibutramine treatment in the obese women. Sixty obese women were enrolled in this prospective, randomized study. Thirty women received 10 mg once daily dose of sibutramine for 19 months. The rest of the obese women received 15 mg once daily dose of sibutramine for 19 months. All patients were evaluated with echocardiography. Plasma levels of adiponectin and TNF-alpha were measured by enzyme-linked immunosorbent assay (ELISA) and hsCRP by immunoturbimetric assay. Student paired and unpaired t tests were used to compare the 10 mg or 15 mg dose sibutramine effects either in groups or between the groups. There were no signs of significant regurgitation or thickening of the mitral and aortic valves on echocardiographic evaluation performed after 19 months of treatment. Parameters of systolic function after 10 or 15 mg treatment were not different from pretreatment characteristics. Minimal tricuspid regurgitation was found in one (1/27) patient treated with 10 mg sibutramine after 19 months. Among obese patients treated with 15 mg sibutramine one patient (1/28) had minimal mitral valve regurgitation and 2 patients (2/28) had minimal aortic insufficiency. Stage II diastolic dysfunction in the 15 obese treated with 15 mg regressed to stage I diastolic dysfunction (50%). Stage II diastolic dysfunction in the 10 obese treated with 10 mg regressed to stage I diastolic dysfunction (33.3%). Mean levels of TNF-alpha(p=0.04), fibrinogen (p=0.03) and hsCRP (p=0.04)i decreased and adiponectin (p=0.03) levels increased in the obese treated with 10 mg sibutramine. Likewise, in the patients treated with 15 mg sibutramine, mean levels of TNF- alpha(p=0.01), fibrinogen (p= 0.02), and hsCRP (p= 0.04) decreased

  8. 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.

  9. 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.

  10. 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.

  11. Prediction of uncomplicated pregnancies in obese women: a prospective multicentre study.

    PubMed

    Vieira, Matias C; White, Sara L; Patel, Nashita; Seed, Paul T; Briley, Annette L; Sandall, Jane; Welsh, Paul; Sattar, Naveed; Nelson, Scott M; Lawlor, Debbie A; Poston, Lucilla; Pasupathy, Dharmintra

    2017-11-03

    All obese pregnant women are considered at equal high risk with respect to complications in pregnancy and birth, and are commonly managed through resource-intensive care pathways. However, the identification of maternal characteristics associated with normal pregnancy outcomes could assist in the management of these pregnancies. The present study aims to identify the factors associated with uncomplicated pregnancy and birth in obese women, and to assess their predictive performance. Data form obese women (BMI ≥ 30 kg/m 2 ) with singleton pregnancies included in the UPBEAT trial were used in this analysis. Multivariable logistic regression was used to identify sociodemographic, clinical and biochemical factors at 15 +0 to 18 +6 weeks' gestation associated with uncomplicated pregnancy and birth, defined as delivery of a term live-born infant without antenatal or labour complications. Predictive performance was assessed using area under the receiver operating characteristic curve (AUROC). Internal validation and calibration were also performed. Women were divided into fifths of risk and pregnancy outcomes were compared between groups. Sensitivity, specificity, and positive and negative predictive values were calculated using the upper fifth as the positive screening group. Amongst 1409 participants (BMI 36.4, SD 4.8 kg/m 2 ), the prevalence of uncomplicated pregnancy and birth was 36% (505/1409). Multiparity and increased plasma adiponectin, maternal age, systolic blood pressure and HbA1c were independently associated with uncomplicated pregnancy and birth. These factors achieved an AUROC of 0.72 (0.68-0.76) and the model was well calibrated. Prevalence of gestational diabetes, preeclampsia and other hypertensive disorders, preterm birth, and postpartum haemorrhage decreased whereas spontaneous vaginal delivery increased across the fifths of increasing predicted risk of uncomplicated pregnancy and birth. Sensitivity, specificity, and positive and negative

  12. Association of obesity with healthcare utilization and costs in a Medicare population.

    PubMed

    Suehs, Brandon T; Kamble, Pravin; Huang, Joanna; Hammer, Mette; Bouchard, Jonathan; Costantino, Mary E; Renda, Andrew

    2017-12-01

    To examine the association of obesity with healthcare resource utilization and costs in a Medicare population. This study was a retrospective cohort study using Humana Medicare Advantage (MA) claims data. Body mass index (BMI) was assessed using ICD-9-CM status codes (V85 hierarchy) that have been validated in the data source to classify patients into BMI categories: normal (N), overweight (Ow), obese class I (ObI), obese class II (ObII), and obese class III (ObIII). Healthcare resource utilization (HRU) and costs were determined based on claims data. Descriptive statistics were used to examine baseline characteristics and HRU across BMI classes. Multivariable analysis was used to examine the association between BMI class and outcome measures. Among the 172,866 patients aged ≥65 years that were identified, BMI distribution was: N, 21%; Ow 37%; ObI, 24%, ObII, 10%; and ObIII, 9%. Inpatient, emergency department and outpatient utilization increased with greater BMI level, and greater BMI level was associated with higher total healthcare, medical and pharmacy costs. Greater prevalence of several cardiometabolic conditions, total medication use, and use of specific medication classes was observed with increasing BMI class. Greater BMI was associated with greater HRU and costs and observed increase in prevalence of cardiometabolic conditions. These results reflect an urgent need to address the epidemic of obesity and the resulting excessive clinical and economic burden on the healthcare system.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. A clinical carepath for obese pregnant women: A pragmatic pilot cluster randomized controlled trial.

    PubMed

    McDonald, Sarah D; Viaje, Kristen A; Rooney, Rebecca A; Jarde, Alexander; Giglia, Lucia; Maxwell, Cynthia V; Small, David; Kelly, Tracy Pearce; Midwifery, B H Sc; Sabatino, Lisa; Thabane, Lehana

    2018-05-17

    Obese women are at increased risks for complications during pregnancy, birth and in their infants. Although guidelines have been established for the clinical care of obese pregnant women, management is sometimes suboptimal. Our goal was to determine the feasibility of implementing and testing a clinical carepath for obese pregnant women compared to standard care, in a pilot cluster randomized controlled trial (RCT). A pragmatic pilot cluster RCT was conducted, randomly allocating eight clinics to the carepath or standard care for obese pregnant women. Women were eligible if they had a prepregnancy body mass index of ≥ 30 kg/m 2 and a viable singleton < 21 weeks. The primary outcomes were the feasibility of conducting a full-scale cluster RCT (defined as > 80%: randomization of clinics, use in eligible women, and completeness of follow-up) and of the intervention (defined as > 80%: compliance with each step in the carepath, and recommendation of the carepath by clinicians to a colleague). All eight approached clinics agreed to participate and were randomized. Half of the intervention clinics used the carepath, resulting in < 80% uptake of eligible women. High follow-up (99.5%) was achieved, in 188 of 189 women. The carepath was feasible for numerous guideline-directed recommendations for screening, but less so for counselling topics. When the carepath was used in the majority of women, all clinicians, most of whom were midwives, reported they would recommend it to a colleague. The intervention group had significantly higher overall adherence to the guideline recommendations compared to control (relative risk 1.71, 95% confidence interval 1.57-1.87). In this pragmatic pilot cluster RCT, a guideline-directed clinical carepath improved some aspects of care of obese pregnant women and was recommended by clinicians, particularly midwives. A cluster RCT may not be feasible in a mix of obstetric and midwifery clinics, but may be feasible in midwifery clinics. This

  18. The Relationship between Food Insecurity and Obesity in Rural Childbearing Women

    ERIC Educational Resources Information Center

    Olson, Christine M.; Strawderman, Myla S.

    2008-01-01

    Context: While food insecurity and obesity have been shown to be positively associated in women, little is known about the direction of the causal relationship between these 2 constructs. Purpose: To clarify the direction of the causal relationship between food insecurity and obesity. Methods: Chi-square and logistic regression analysis of data…

  19. Effective connectivity of a reward network in obese women

    PubMed Central

    Stoeckel, Luke E.; Kim, Jieun; Weller, Rosalyn E.; Cox, James E.; Cook, Edwin W.; Horwitz, Barry

    2012-01-01

    Exaggerated reactivity to food cues in obese women appears to be mediated in part by a hyperactive reward system that includes the nucleus accumbens, amygdala, and orbitofrontal cortex. The present study used fMRI to investigate whether differences between 12 obese and 12 normal-weight women in reward-related brain activation in response to food images can be explained by changes in the functional interactions between key reward network regions. A two-step path analysis/General Linear Model approach was used to test whether there were group differences in network connections between nucleus accumbens, amygdala, and orbitofrontal cortex in response to high- and low-calorie food images. There was abnormal connectivity in the obese group in response to both high- and low-calorie food cues compared to normal-weight controls. Compared to controls, the obese group had a relative deficiency in the amygdala’s modulation of activation in both orbitofrontal cortex and nucleus accumbens, but excessive influence of orbitofrontal cortex’s modulation of activation in nucleus accumbens. The deficient projections from the amygdala might relate to suboptimal modulation of the affective/emotional aspects of a food’s reward value or an associated cue’s motivational salience, whereas increased orbitofrontal cortex to nucleus accumbens connectivity might contribute to a heightened drive to eat in response to a food cue. Thus, it is possible that not only greater activation of the reward system, but also differences in the interaction of regions in this network may contribute to the relatively increased motivational value of foods in obese individuals. PMID:19467298

  20. 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.

  1. Fetuin-A levels in lean and obese women with polycystic ovary syndrome.

    PubMed

    Kozakowski, Jarosław; Jeske, Wojciech; Zgliczyński, Wojciech

    2014-01-01

    The aim of this study was to estimate serum fetuin-A levels in lean and obese women with polycystic ovary syndrome (PCOS) and to find possible relationships between fetuin-A, metabolic factors and androgens in these patients. In 25 lean (18-38 years, BMI 17.5-25.0 kg/m2) and 15 obese women (20-41 years, BMI 28.1-53.2 kg/m2) with PCOS, anthropometric indices and body composition were measured. Fasting serum fetuin-A, adiponectin, leptin, glucose, lipids, hsCRP, insulin, androgens and SHGB levels were estimated. There was no significant difference in serum fetuin-A levels between lean and obese patients: 0.54 ± 0.13 g/L and 0.60 ± 0.14 g/L, respectively. We noted a correlation between BMI and leptin levels (r = 0.88; p < 0.0001) and a nearly significant negative correlation between BMI and adiponectin levels (r = -0.53; p = 0.11) in all subjects. In lean patients, we found a correlation between fetuin-A levels and ALT activity (r = 0.44; p < 0.05). In all participants, fetuin-A correlated directly with DHEA-S levels (r = 0.44; p < 0.03). Serum fetuin-A levels were similar in lean and obese women with PCOS. We found an association between fetuin-A levels and ALT activity in lean patients and between fetuin-A levels and DHEA-S in all women. The role of fetuin-A in the mechanisms of insulin resistance, and its potential impact on androgenic hormones production in women with PCOS, need to be tested in further studies.

  2. Factors affecting feasibility and quality of second-trimester ultrasound scans in obese pregnant women.

    PubMed

    Fuchs, F; Houllier, M; Voulgaropoulos, A; Levaillant, J-M; Colmant, C; Bouyer, J; Senat, M-V

    2013-01-01

    To evaluate the feasibility of completing in one session a second-trimester ultrasound scan in obese pregnant women, to compare the quality of images obtained with those of non-obese women and to analyze factors that can improve the completion rate. This prospective study, from 2009 to 2011, included all obese pregnant women (prepregnancy body mass index (BMI) > 30 kg/m2) who had an ultrasound examination at 20-24 weeks in our department, and a control group of pregnant women with normal BMI (20-24.9 kg/m2) who had the same examination. A single operator reviewed the standardized ultrasound images (three biometric and six to assess key anatomical features) required under French guidelines, to assess their presence, evaluate the quality of all images and score the quality of the six anatomical images. Each image was assessed according to between four and six criteria, each worth one point. We sought excellent quality, defined as the frequency of maximum points for a given image type. The factors associated with completing the scan in one session were evaluated with multivariate logistic regression. The obese group included 223 women and the control group 60; a complete scan in one session was achieved in 70.4% and 81.7% of these, respectively (P = 0.08). The completion rate for each image type was at least 95% in the control group and 90% in the obese group, except for diaphragm and right outflow tract images. Significant factors associated with completing the scan in the multivariate model were: having 10 additional minutes for the scan (P = 0.03), moving the fetus so that the back was in posterior or lateral position (P = 0.01), more experienced sonographer (P = 0.03) and thinner maternal abdominal wall thickness (P = 0.01). Overall, the excellence rate varied from 35% to 92% in the normal BMI group and from 18% to 58% in the obese group, and was significantly lower in the latter for all images except abdominal circumference (P

  3. Obesity and psychotropic medication: a prospective register linkage study among midlife women and men.

    PubMed

    Svärd, Anna; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea

    2016-06-06

    Both obesity and mental health are major public health issues. This study aimed to examine whether overweight and obesity among midlife employees are associated with subsequent psychotropic medication. A further aim was to examine the potential effect of key covariates on the association. The Helsinki Health Study baseline survey was conducted in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland (n = 8960). The participants were classified as of normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-34.9 kg/m(2)) or severely obese (≥35 kg/m(2)) based on self-reported body mass index. Data on psychotropic medication purchases from baseline to 2009 were derived from registers of the Social Insurance Institution of Finland. The final analysis included 4760 women and 1338 men. Antidepressants and sedatives were examined separately. Covariates included socio-demographic factors, workload, health behaviours, physical functioning, somatic ill-health and psychotropic medication prior to baseline. Hazard ratios (HR) for the first psychotropic medication purchase were calculated using Cox regression analysis. Third of women and quarter of men made at least one psychotropic medication purchase during the follow-up. Adjusting for age, obese (HR = 1.57; 95 % CI = 1.10-2.24) and severely obese (HR = 2.15; 95 % CI = 1.29-3.56) men were at risk of having psychotropic medication compared to men of normal weight. These associations disappeared after further adjustment. Severe obesity remained associated with subsequent sedative medication among the men even after full adjustment (HR = 2.12; 95 % CI = 1.17-3.84). No associations were found among the women. Obese and severely obese men, but not women, were at risk of psychotropic medication. Further studies are needed to deepen understanding of the relationship between obesity and mental ill-health, and the possible protecting effects of age, employment

  4. Culturally specific dance to reduce obesity in African American women.

    PubMed

    Murrock, Carolyn J; Gary, Faye A

    2010-07-01

    This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women.

  5. 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.

  6. 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.

  7. 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…

  8. Severe obesity, heart disease, and death among white, African American, and Hispanic postmenopausal women.

    PubMed

    McTigue, Kathleen M; Chang, Yue-Fang; Eaton, Charles; Garcia, Lorena; Johnson, Karen C; Lewis, Cora E; Liu, Simin; Mackey, Rachel H; Robinson, Jennifer; Rosal, Milagros C; Snetselaar, Linda; Valoski, Alice; Kuller, Lewis H

    2014-03-01

    To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity. Copyright © 2012 The Obesity Society.

  9. Metabolic obesity phenotypes and risk of colorectal cancer in postmenopausal women.

    PubMed

    Kabat, Geoffrey C; Kim, Mimi Y; Stefanick, Marcia; Ho, Gloria Y F; Lane, Dorothy S; Odegaard, Andrew O; Simon, Michael S; Bea, Jennifer W; Luo, Juhua; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

    2018-02-27

    Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR-a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5-<25.0, 25.0-<30.0 and ≥30.0 kg/m 2 ) and presence of the metabolic syndrome into 6 phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). Neither BMI nor presence of the metabolic syndrome was associated with risk of colorectal cancer, whereas waist circumference showed a robust positive association. Relative to the MHNW phenotype, the MUNW phenotype was associated with increased risk, whereas no other phenotype showed an association. Furthermore, HOMA-IR was not associated with increased risk. Overall, our results do not support a direct role of metabolic dysregulation in the development of colorectal cancer; however, they do suggest that higher waist circumference is a risk factor, possibly reflecting the effects of increased levels of cytokines and hormones in visceral abdominal fat on colorectal carcinogenesis. © 2018 UICC.

  10. 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.

  11. Obese Women Have Lower Monosodium Glutamate Taste Sensitivity and Prefer Higher Concentrations Than Do Normal-weight Women

    PubMed Central

    Pepino, M. Yanina; Finkbeiner, Susana; Beauchamp, Gary K.; Mennella, Julie A.

    2010-01-01

    The goal of this study was to determine whether obese women exhibit altered umami and sweet taste perception compared to normal-weight women. A total of 57 subjects (23 obese and 34 normal weight) participated in a 2-day study separated by 1 week. Half of the women in each group were evaluated using monosodium glutamate (MSG; prototypical umami stimulus) on the first test day and sucrose on the second test day; the order was reversed for the remaining women. We used two-alternative forced-choice staircase procedures to measure taste detection thresholds, forced-choice tracking technique to measure preferences, the general Labeled Magnitude Scale (gLMS) to measure perceived intensity of suprathreshold concentrations, and a triangle test to measure discrimination between 29 mmol/l MSG and 29 mmol/l NaCl. Obese women required higher MSG concentrations to detect a taste and preferred significantly higher MSG concentrations in a soup-like vehicle. However, their perception of MSG at suprathreshold concentrations, their ability to discriminate MSG from salt, and their preference for sucrose were similar to that observed in normal-weight women. Regardless of their body weight category, 28% of the women did not discriminate 29 mmol/l MSG from 29 mmol/l NaCl (nondiscriminators). Surprisingly, we found that, relative to discriminators, nondiscriminators perceived less savoriness when tasting suprathreshold MSG concentrations and less sweetness from suprathreshold sucrose concentrations but had similar MSG and sucrose detection thresholds. Taken together, these data suggest that body weight is related to some components of umami taste and that different mechanisms are involved in the perception of threshold and suprathreshold MSG concentrations. PMID:20075854

  12. Obesity and Associated Cardiometabolic Risk among Women from Tripura - A Northeastern State of India.

    PubMed

    Sen, Purnajita; Das, Sandeep; Hore, Samrat; Bhattacharjee, Surajit; Choudhuri, Dipayan

    2017-01-01

    Cardiometabolic health status of women is a serious public health concern. Markers of body fat content and their distribution are important indicators of cardiometabolic health risk in participants. In addition, socio-demographic status plays a determinant role. The aim of the study was to evaluate the influence of adiposity markers and socio-demographic determinants on various cardiovascular and metabolic risk factors in Indian women. The study was conducted on 388 women (age 25-65 years) from Tripura, a Northeastern state of India. Various obesity and atherogenic markers such as body mass index (BMI), waist circumference (WC), waist-hip ratio, waist - height ratio, high density lipoprotein-cholesterol (HDL-C)/total cholesterol, HDL-C/low density lipoprotein cholesterol, triglyceride/HDL-C ratio and traditional cardiometabolic risk factors such as high blood pressure, dyslipidemia, and glucose intolerance were evaluated in participant. The socio-demographic status included the level of education and monthly family income. The cardiometabolic risk in postmenopausal women were higher than premenopausal women. The risk increases with age in both groups. Women with lower educational level and higher income group were found to be prone to higher cardiometabolic risk. Receiver operating characteristics analysis revealed central obesity marked by increased WC was a better predictor of cardiometabolic risk than general obesity marked by increased BMI. The cardiometabolic risk among both premenopausal and postmenopausal women are associated with central obesity which can be predicted by increased WC in the subject. Socio-demographic status of the participant plays a definitive role in determining cardiometabolic risk in women.

  13. Family-planning practices among women with diabetes and overweight and obese women in the 2002 National Survey For Family Growth.

    PubMed

    Vahratian, Anjel; Barber, Jennifer S; Lawrence, Jean M; Kim, Catherine

    2009-06-01

    To examine contraceptive practices among diabetic women and obese women. We analyzed the responses of 5,955 participants aged 20-44 years in the 2002 National Survey for Family Growth. Diabetes, BMI, desire for pregnancy, history of infertility treatment, sexual activity, parity, and demographic variables (age, race/ethnicity, education, marital status, income, insurance, and smoking history) were obtained by self-report. Lack of contraception was defined as absence of hormonal-, barrier-, or sterilization-based methods. Associations among contraception, diabetes, and BMI category were assessed in multivariable logistic regression models in nonsterile, sexually active women. In unadjusted comparisons among sexually active women who were not sterilized, women with diabetes were more likely to lack contraception than women without diabetes (odds ratio [OR] 2.61 [95% CI 1.22-5.58]). Women with BMI >or=35 kg/m(2) were more likely to lack contraception than women with BMI <25 kg/m(2)(1.63 [1.16-2.28]), but associations between contraception use and lesser degrees of overweight and obesity were not significant. In multivariable models, women who were older (aged >or=30 vs. 20-29 years), were of non-Hispanic black race, were cohabitating, had a history of infertility treatment, and desired or were ambivalent about pregnancy were significantly more likely to lack contraception. The associations among diabetes, BMI, and contraception were no longer significant after these adjustments. Older women with diabetes and obesity who desire pregnancy, regardless of pregnancy intention, should be targeted for preconceptive management.

  14. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.

    PubMed

    Rice, Jayne R; Larrabure-Torrealva, Gloria T; Luque Fernandez, Miguel Angel; Grande, Mirtha; Motta, Vicky; Barrios, Yasmin V; Sanchez, Sixto; Gelaye, Bizu; Williams, Michelle A

    2015-09-02

    Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors. Compared with lean women (<25 kg/m(2)), overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63). Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.

  15. [Circuit resistance training improved endothelial dysfunction in obese aged women].

    PubMed

    Rosety, Ignacio; Pery, María Teresa; Rosety, Jesús; García, Natalia; Rodríguez-Pareja, María Antonia; Brenes-Martín, Francisco; Díaz, Antonio; Rosety-Rodríguez, Manuel; Ordoñez, Francisco Javier; Rosety, Miguel Ángel

    2016-02-16

    It is widely accepted that obesity is associated with endothelial dysfunction. In a recent paper, we have also found circuit resistance training may reduce visceral fat in obese aged women. Accordingly, the current study was conducted to ascertain the effects of circuit resistance training on markers of endothelial dysfunction in this population group. In the present interventional study, a total of 48 obese aged women were recruited from the community. Twenty-four of them were randomly assigned to perform a 12-week resistance circuit training programme, 3-days per week. This training was circularly performed in 6 stations: arm curl, leg extension, seated row, leg curl, triceps extension and leg press. The Jamar handgrip electronic dynamometer was used to assess maximal handgrip strength of the dominant hand. Lastly, serum samples were analysed using an immunoassay (ELISA) for endothelin-1, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). When compared to baseline, resistance training significantly reduced serum levels of endothelin-1 (2.28 ± 0.7 vs. 1.98 ± 1.1 pg/ml; p = 0.019; d = 0.67) and ICAM-1 (290 ± 69 vs. 255 ± 76 ng/ml; p = 0.004; d = 0.92) in the experimental group. No significant changes in any of the tested outcomes were found in the control group. A short-term circuit resistance program improved endothelial dysfunction in aged obese women. Further studies on this topic are still required to consolidate this approach in clinical application.

  16. 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.

  17. Breast cancer subtype distribution is different in normal weight, overweight, and obese women.

    PubMed

    Gershuni, Victoria; Li, Yun R; Williams, Austin D; So, Alycia; Steel, Laura; Carrigan, Elena; Tchou, Julia

    2017-06-01

    Obesity is associated with tumor promoting pathways related to insulin resistance and chronic low-grade inflammation which have been linked to various disease states, including cancer. Many studies have focused on the relationship between obesity and increased estrogen production, which contributes to the pathogenesis of estrogen receptor-positive breast cancers. The link between obesity and other breast cancer subtypes, such as triple-negative breast cancer (TNBC) and Her2/neu+ (Her2+) breast cancer, is less clear. We hypothesize that obesity may be associated with the pathogenesis of specific breast cancer subtypes resulting in a different subtype distribution than normal weight women. A single-institution, retrospective analysis of tumor characteristics of 848 patients diagnosed with primary operable breast cancer between 2000 and 2013 was performed to evaluate the association between BMI and clinical outcome. Patients were grouped based on their BMI at time of diagnosis stratified into three subgroups: normal weight (BMI = 18-24.9), overweight (BMI = 25-29.9), and obese (BMI > 30). The distribution of breast cancer subtypes across the three BMI subgroups was compared. Obese and overweight women were more likely to present with TNBC and normal weight women with Her2+ breast cancer (p = 0.008). We demonstrated, for the first time, that breast cancer subtype distribution varied significantly according to BMI status. Our results suggested that obesity might activate molecular pathways other than the well-known obesity/estrogen circuit in the pathogenesis of breast cancer. Future studies are needed to understand the molecular mechanisms that drive the variation in subtype distribution across BMI subgroups.

  18. 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.

  19. Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women.

    PubMed

    Blümel, Juan E; Chedraui, Peter; Aedo, Sócrates; Fica, Juan; Mezones-Holguín, Edward; Barón, Germán; Bencosme, Ascanio; Benítez, Zully; Bravo, Luz M; Calle, Andrés; Flores, Daniel; Espinoza, María T; Gómez, Gustavo; Hernández-Bueno, José A; Laribezcoa, Fiorella; Martino, Mabel; Lima, Selva; Monterrosa, Alvaro; Mostajo, Desiree; Ojeda, Eliana; Onatra, William; Sánchez, Hugo; Tserotas, Konstatinos; Vallejo, María S; Witis, Silvina; Zúñiga, María C

    2015-01-01

    The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors. A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30 kg/m(2). Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69). Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Cost-effectiveness analysis of lifestyle intervention in obese infertile women.

    PubMed

    van Oers, A M; Mutsaerts, M A Q; Burggraaff, J M; Kuchenbecker, W K H; Perquin, D A M; Koks, C A M; van Golde, R; Kaaijk, E M; Schierbeek, J M; Klijn, N F; van Kasteren, Y M; Land, J A; Mol, B W J; Hoek, A; Groen, H

    2017-07-01

    What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint. In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women. The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women <36 years and ≥36 years of age and of completers of the lifestyle intervention. Bootstrap analyses were performed to assess the uncertainty surrounding cost-effectiveness. Infertile women with a BMI of ≥29 kg/m2 (no upper limit) were

  6. Weight loss improves biomarkers endothelial function and systemic inflammation in obese postmenopausal Saudi women.

    PubMed

    Abd El-Kader, Shehab Mahmoud; Saiem Al-Dahr, Mohammed H

    2016-06-01

    Although postmenopausal associated disorders are important public health problems worldwide, to date limited studies evaluated the endothelial function and systemic inflammation response to weight loss in obese postmenopausal women. This study was done to evaluate the endothelial function and systemic inflammation response to weight loss in obese postmenopausal Saudi women. Eighty postmenopausal obese Saudi women (mean age 52.64±6.13 year) participated in two groups: Group (A) received aerobic exercise on treadmill and diet whereas, group (B) received no intervention. Markers of inflammation and endothelial function were measured before and after 3 months at the end of the study. The values of body mass index(BMI), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1) and plasminogen activator inhibitor-1 activity (PAI-1:Ac) were significantly decreased in group (A), while changes were not significant in group (B). Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. Weight loss ameliorates inflammatory cytokines and markers of endothelial function in obese postmenopausal Saudi women.

  7. ALTERED HEPATIC GENE EXPRESSION IN MORBIDLY OBESE WOMEN AND ITS IMPLICATIONS FOR SUSCEPTIBILITY TO OTHER DISEASES

    EPA Science Inventory

    The objective of this study was to determine the molecular bases of disordered hepatic function and disease susceptibility in obesity. We compared global gene expression in liver biopsies from morbidly obese (MO) women undergoing gastric bypass (GBP) surgery with that of women un...

  8. Culturally Specific Dance to Reduce Obesity in African American Women

    PubMed Central

    Murrock, Carolyn J.; Gary, Faye A.

    2013-01-01

    This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women. PMID:19098267

  9. 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 ...

  10. Association between insulin resistance and preeclampsia in obese non-diabetic women receiving metformin.

    PubMed

    Balani, Jyoti; Hyer, Steve; Syngelaki, Argyro; Akolekar, Ranjit; Nicolaides, Kypros H; Johnson, Antoinette; Shehata, Hassan

    2017-12-01

    To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia. At 28 weeks, median HOMA-IR was significantly lower in the metformin group. Logistic regression analysis demonstrated that there was a significant contribution in the prediction of preeclampsia from maternal history of chronic hypertension and gestational weight gain, but not HOMA-IR either at randomisation ( p  = 0.514) or at 28 weeks ( p  = 0.643). Reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is unlikely to be due to changes in insulin resistance.

  11. 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

  12. The effect of cardiorespiratory fitness and obesity on cancer mortality in women and men.

    PubMed

    Evenson, Kelly R; Stevens, June; Cai, Jianwen; Thomas, Ratna; Thomas, Olivia

    2003-02-01

    The purpose of this study was to determine the independent and combined effects of cardiorespiratory fitness and obesity on all-cause cancer mortality for women and men. Using the Lipids Research Clinics Prevalence Study, we examined the relationship of fitness and obesity on cancer mortality among 2585 women and 2890 men followed from 1972-1976 to 1998. Cardiorespiratory fitness was measured using a treadmill test and obesity was assessed using body mass index (BMI) calculated from measured height and weight. Gender-specific hazard ratios (HR) were calculated from proportional hazard models, which included covariates for age, education, smoking, alcohol intake, Keys score, and menopause (women only). Adjusted cancer mortality was significantly lower in the most fit quintile relative to the other four quintiles for men (HR = 0.47; 95% CI, 0.27-0.81) but not for women (HR = 0.84; 95% CI, 0.52-1.36). Adjusted cancer mortality was significantly higher in the highest BMI quintile relative to the other four BMI quintiles for women (HR = 1.49; 95% CI, 1.06-2.09) but not for men (HR = 1.05; 95% CI, 0.77-1.43). Further adjustment for BMI on fitness and adjustment for fitness on BMI did not meaningfully change the HR. There were no significant interactions between fitness and obesity in predicting cancer mortality for either women or men. In this study, high fitness was a stronger predictor of cancer mortality in men, whereas high BMI was a stronger predictor of cancer mortality in women.

  13. Electrophysiological indices of visual food cue-reactivity. Differences in obese, overweight and normal weight women.

    PubMed

    Hume, David John; Howells, Fleur Margaret; Rauch, H G Laurie; Kroff, Jacolene; Lambert, Estelle Victoria

    2015-02-01

    Heightened food cue-reactivity in overweight and obese individuals has been related to aberrant functioning of neural circuitry implicated in motivational behaviours and reward-seeking. Here we explore the neurophysiology of visual food cue-reactivity in overweight and obese women, as compared with normal weight women, by assessing differences in cortical arousal and attentional processing elicited by food and neutral image inserts in a Stroop task with record of EEG spectral band power and ERP responses. Results show excess right frontal (F8) and left central (C3) relative beta band activity in overweight women during food task performance (indicative of pronounced early visual cue-reactivity) and blunted prefrontal (Fp1 and Fp2) theta band activity in obese women during office task performance (suggestive of executive dysfunction). Moreover, as compared to normal weight women, food images elicited greater right parietal (P4) ERP P200 amplitude in overweight women (denoting pronounced early attentional processing) and shorter right parietal (P4) ERP P300 latency in obese women (signifying enhanced and efficient maintained attentional processing). Differential measures of cortical arousal and attentional processing showed significant correlations with self-reported eating behaviour and body shape dissatisfaction, as well as with objectively assessed percent fat mass. The findings of the present study suggest that heightened food cue-reactivity can be neurophysiologically measured, that different neural circuits are implicated in the pathogenesis of overweight and obesity, and that EEG techniques may serve useful in the identification of endophenotypic markers associated with an increased risk of externally mediated food consumption. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Cardiometabolic risks profile of normal weight obese and multi-ethnic women in a developing country.

    PubMed

    Moy, Foong Ming; Loh, Debbie Ann

    2015-07-01

    To determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine its associations with cardiometabolic risks and lifestyle behaviours. This was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia. Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration. Body mass index, %BF, cardiometabolic risk factors, lifestyle behaviours. A total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3-22.5). NWO was more prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73-4.04), hypertriglyceridemia (2.51, 1.47-4.29) and hypertension (1.63, 1.15-2.31) compared to women with lower % body fat after adjusted for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0-9.8). None of the lifestyle behaviours were significantly associated with NWO. Women with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidaemia and increased blood pressure. Health promotion efforts should include NWO women who may be oblivious of their deleterious health risks. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Association between Obesity and Cervical Microflora Dominated by Lactobacillus iners in Korean Women

    PubMed Central

    Oh, Hea Young; Seo, Sang-Soo; Kong, Ji-Sook; Lee, Jae-Kwan

    2015-01-01

    Lactobacillus spp. are associated with the maintenance of reproductive health, but obesity reduces fertility and is a risk factor for obstetric and neonatal complications. We assessed the association between obesity and the cervical Lactobacillus composition, which has not been examined previously. Pyrosequencing was performed using cervical swabs collected from 76 normal participants with negative results for cervical intraepithelial neoplasia (CIN) and 57 participants with CIN, based on histological examinations. Cluster analysis of nine Lactobacillus spp. was performed, and five cluster types were identified. The association between obesity and the Lactobacillus community was assessed by logistic regression analysis after adjustment for confounding factors. The proportion of Lactobacillus iners increased and that of Lactobacillus crispatus decreased according to body mass index (BMI) categories, i.e., underweight (BMI of <18.5 kg m−2), normal weight (BMI of 18.5 to 22.9 kg m−2), overweight (BMI of 23.0 to 24.9 kg m−2), and obese (BMI of ≥25 kg m−2). The L. iners-dominant type had a significant association with obesity (odds ratio [OR], 7.55 [95% confidence interval [CI], 1.18 to 48.2]), compared to the L. crispatus-dominant type. The group with high values for the ratio obtained by dividing the relative abundance of L. iners by that of L. crispatus had a significant association with obesity (OR, 6.54 [95% CI, 1.22 to 35.1]), compared to the low-ratio group. Associations between obesity and the L. iners/L. crispatus ratio were observed among young women (OR, 6.26 [95% CI, 1.15 to 33.9]) but not older women and in the normal group (OR, 6.97 [95% CI, 1.20 to 70.4]) but not the CIN group. Obesity was associated with cervical microflora dominated by L. iners in reproductive-age women without dysplasia. PMID:26269625

  16. 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.

  17. The direct health services costs of providing assisted reproduction services in overweight or obese women: a retrospective cross-sectional analysis.

    PubMed

    Maheshwari, Abha; Scotland, Graham; Bell, Jacqueline; McTavish, Alison; Hamilton, Mark; Bhattacharya, Siladitya

    2009-03-01

    Prevalence of overweight and obesity is rising. Hence, it is likely that a higher proportion of women undergoing assisted reproduction treatment are overweight or obese. In a retrospective cross-sectional analysis using routinely collected data of an IVF Unit and maternity hospital in a tertiary care setting in the UK, direct costs were assessed for all weight classes. Costs for underweight, overweight and obese were compared with those for women with normal body mass index (BMI). Of 1756 women, who underwent their first cycle of IVF between 1997 and 2006, 43 (2.4%) were underweight; 988 (56.3%) had normal BMI; 491 (28.0%) were overweight; 148 (8.4%) were obese (class I) and 86 (4.9%) were obese (class II). The mean (95% CI) cost of each live birth resulting from IVF was pound 18,747 (13 864-27 361) in underweight group; pound 16,497 (15 374-17 817) in women with normal BMI; pound 18,575 (16,648-21,081) in overweight women; pound 18,805 (15 397-23 554) in obese class I; pound 20,282 (15 288-28 424) in obese class II or over. The cost of a live birth resulting from IVF is not different in underweight, overweight and obese class I when compared with women with normal BMI. However, due to increased obstetric complications weight loss should still be recommended prior to commencing IVF even in overweight or obese (class I) women.

  18. Android subcutaneous adipose tissue topography in lean and obese women suffering from PCOS: comparison with type 2 diabetic women.

    PubMed

    Horejsi, R; Möller, R; Rackl, S; Giuliani, A; Freytag, U; Crailsheim, K; Sudi, K; Tafeit, E

    2004-07-01

    The new optical device, the lipometer, enables the noninvasive, quick, safe, and precise determination of the thickness of subcutaneous adipose tissue (SAT) layers at any given site of the human body. Fifteen anatomically well-defined body sites from neck to calf describe a SAT topography (SAT-Top) like an individual "fingerprint" of a subject. This SAT-Top was examined in 16 women with polycystic ovary syndrome (PCOS) and compared to the body fat distribution of 87 age-matched healthy controls and 20 type-2 diabetic women. SAT-Top differences of these three groups were described and, to render the possibility of visual comparison, the 15-dimensional body fat information was condensed to a two-dimensional factor plot by factor analysis. All PCOS patients had an android body fat distribution with significantly thinner SAT layers on the legs as compared to healthy controls. Moreover, a hierarchical cluster analysis resulted in two distinctly different groups of PCOS women, a lean (PCOSL) and an obese (PCOSO) cluster: compared to healthy women, lean PCOS patients had significantly lower total SAT development, even though height, weight, and body mass index did not deviate significantly. Especially on the legs, their SAT layers were significantly lowered, indicating a more "apple-like" fat distribution type. Obese PCOS women showed a SAT-Top pattern very similar to that of women with type-2 diabetes, although the mean age difference between these groups was more than 30 years. Compared to healthy controls, the SAT-Top of these obese PCOS patients was strongly shifted into the android direction, appearing as "super-apples" with a significantly increased upper trunk obesity to 237.8% and a significantly decreased leg SAT development to 79.8%. Copyright 2004 Wiley-Liss, Inc.

  19. 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.

  20. Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity.

    PubMed

    Bond, Dale S; Pavlović, Jelena M; Lipton, Richard B; Graham Thomas, J; Digre, Kathleen B; Roth, Julie; Rathier, Lucille; O'Leary, Kevin C; Evans, E Whitney; Wing, Rena R

    2017-03-01

    Previous studies suggest that migraine might be associated with female sexual dysfunction (FSD), although this association may be complicated by overweight/obesity. To disentangle relationships of migraine and obesity with FSD, we examined: (1) FSD rates in women who had migraine and obesity with a matched sample of women with obesity who were free of migraine and (2) associations between indices of migraine severity and FSD in a larger sample of participants with migraine and overweight/obesity, controlling for important confounders. Women with migraine and obesity seeking behavioral weight loss treatment to decrease headaches (n = 37) and nonmigraine controls (n = 37) with obesity seeking weight loss via bariatric surgery were matched on age (±5 years), body mass index (BMI; ±3 kg/m 2 ), and reported sexual activity during the past month. Both groups completed the Female Sexual Function Index (FSFI), with a validated FSFI-total cutoff score used to define FSD. In participants with migraine and overweight/obesity (n = 105), separate logistic regression models evaluated associations of migraine attack frequency, intensity, and duration with odds of having FSD, controlling for age, BMI, depression, and anxiety. On average, participants and matched controls had severe obesity (BMI = 42.4 ± 3.8 kg/m 2 ; range = 35-49.9) and were 37.3 ± 7.2 years of age (range = 22-50). FSD rate did not differ between migraine participants and controls (56.8% vs. 54.1%, P = .82). In the larger sample of participants with migraine and overweight/obesity (38.2 ± 7.8 years of age; BMI = 34.8 ± 6.4 [range = 25-50 kg/m 2 ]; 8.0 ± 4.3 migraine days/month, maximum pain intensity = 5.9 ± 1.4 on 0-10 scale; average attack duration = 18.3 ± 9.7 hours), FSD was not associated with attack frequency (P = .31), pain intensity (P = .92), or attack duration (P = .35) but was associated with more severe anxiety

  1. 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

  2. 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.

  3. 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

  4. Venous thromboembolism in obese pregnant women: approach to diagnosis and management.

    PubMed

    Malinowski, Ann Kinga; Bomba-Opoń, Dorota; Parrish, Jacqueline; Sarzyńska, Urszula; Farine, Dan

    2017-01-01

    Venous thromboembolism (VTE) remains among the leading causes of maternal mortality in the developed world, presenting variably as deep vein thrombosis (DVT), pulmonary embolism (PE) or cerebral vein thrombosis (CVT), among others. Obesity in particular has been recognized as the principal contributing factor to the risk of VTE in pregnancy and with the global increase in the rates of obesity affecting reproductive age women, heightened awareness of the risk and consequences of VTE in this population are vital. Thus, prophylaxis, diagnosis and treatment of VTE in the obese gravida are discussed.

  5. 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.

  6. 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.

  7. 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...

  8. Very low food security predicts obesity predominantly in California Hispanic men and women.

    PubMed

    Leung, Cindy W; Williams, David R; Villamor, Eduardo

    2012-12-01

    A high prevalence of food insecurity has persisted in the USA for the past two decades. Previous studies suggest that the association between food insecurity and obesity may vary by gender and race/ethnicity. We examined whether food insecurity was associated with BMI and obesity within gender and racial/ethnic groups in a large, diverse sample of low-income adults. A cross-sectional analysis of a large population-based health survey. We compared the distribution of BMI and obesity by food security levels within gender and racial/ethnic categories. Data were derived from the 2003-2009 waves of the California Health Interview Survey. The study sample included 35 747 non-elderly adults with households ≤200 % of the federal poverty level. Among Hispanic men, very low food security was associated with a 1.0 kg/m2 higher BMI (95 % CI 0.3, 1.7 kg/m2) and a 36 % higher prevalence of obesity (95 % CI 17, 58 %) after multivariate adjustment. Among Hispanic women, very low food security was associated with a 1.1 kg/m2 higher BMI (95 % CI 0.4, 1.9 kg/m2) and a 22 % higher prevalence of obesity (95 % CI 8, 38 %). Positive associations were also observed for Asian women and multi-racial men. No significant associations were observed for non-Hispanic whites, African Americans, Asian men or multi-racial women. Our results suggest that the association of food insecurity and obesity is limited to individuals of certain low-income, minority racial/ethnic groups. Whether targeted interventions to address food insecurity in these individuals may also decrease obesity risk deserves further investigation.

  9. Influence of obesity assessments on cardiometabolic risks in African and European American women.

    PubMed

    Brandon, L Jerome; Proctor, Larry; Cole, Calvin L

    2014-01-01

    African American women (AAW) have increased odds of developing cardiometabolic (CME) risks and cardiovascular diseases (CVD) compared with European American women (EAW). The influence of obesity on other CME risks and the CVD disparity is unclear. The purpose of our study was to develop a CME index and evaluate the obesity and CME risk index relationships based on race. A comparative research design was employed in our study as 213 women (132 AAW; 81 EAW) from the Louisiana Delta were evaluated for CME risk clustering patterns by race, based on BMI, dual energy X-ray absorptiometry % body fat and waist conference. Fasting glucose, triglyceride (TC), high density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) were the measured CME risks. In summary, when the CME indexes were evaluated by obesity classification categories the ones that were CVD risk or near risk for the AAW were SBP and TG. The trend of CME index risk for the EAW was SBP and glucose. The stepwise regression equations indicate that HDL-C and SBP/DBP were the best indicators of the effects of obesity on CME risks in AAW and that SBP/DBP and glucose were the best indicators of CME risks in EAW. Our results indicate that CME risks as evaluated based on obesity categories are different for AAW than for EAW.

  10. Obesity-associated metabolic changes influence resting and peak heart rate in women and men.

    PubMed

    Strandheim, Astrid; Halland, Hilde; Saeed, Sahrai; Cramariuc, Dana; Hetland, Trude; Lønnebakken, Mai Tone; Gerdts, Eva

    2015-01-01

    To study the relationship between obesity and heart rate (HR) in women and men. We studied 241 overweight and obese subjects without known heart disease. All subjects underwent ergospirometry during maximal exercise testing on treadmill and recording of body composition, electrocardiogram and clinic and ambulatory blood pressure. Women (n = 132) were slightly older and had higher fat mass, but lower weight, blood pressure and prevalence of metabolic syndrome (MetS) than men (n = 109) (all p < 0.05), while prevalences of obesity and hypertension did not differ. A significant interaction between sex and HR was demonstrated (p < 0.05). In multivariate analysis, female sex (β = 0.99, p < 0.01) predicted higher resting HR independent of confounders. Higher resting HR was particularly associated with presence of MetS, hypertension, higher insulin resistance and lower relative muscle mass in men (all p < 0.05). Female sex also predicted higher peak exercise HR (β = 0.48, p < 0.01) independent of confounders. Higher peak exercise HR was particularly associated with higher exercise capacity and lower age and self-reported physical activity in men, while lower HbA1c and absence of obesity were the main covariates in women in multivariate analyses (all p < 0.05). In our study population, obesity and obesity-associated metabolic changes influenced both resting and peak exercise HR.

  11. Association between prepregnancy obesity and metabolic risk in Chilean premenopausal women 10 y postpartum.

    PubMed

    Garmendia, Maria Luisa; Zamudio, Carolina; Araya, Marcela; Kain, Juliana

    2017-06-01

    One of every four pregnant women in Chile is obese. Gestational obesity is associated with maternal metabolic complications in pregnancy (e.g., gestational diabetes, preeclampsia), but to our knowledge, there is little evidence on relationships with future metabolic risk. The aim of this study was to evaluate the association between prepregnancy obesity (prepregnancy body mass index ≥30 kg/m 2 ) or excessive gestational weight gain (GWG; according to the 2009 recommendations from the Institute of Medicine), and maternal metabolic complications 10 y postpartum in premenopausal Chilean women. A prospective study was conducted. In 2006, 1067 Chilean mothers of children born in 2002-participants of the GOCS (Growth and Obesity Cohort Study)-were recruited. Mothers completed a questionnaire concerning sociodemographic, anthropometric, and pregnancy characteristics. Of the sample, 402 women were randomly selected to participate in a study related to the determinants of breast cancer risk in 2012. At follow-up, anthropometry, blood pressure, and fasting labs were measured. Complete data was available for 366 women. Thirty-two percent of mothers had prepregnancy overweight/obesity and 39.1% had excessive GWG. In adjusted models, prepregnancy obesity was positively associated with increased insulin resistance (odds ratio [OR], 18; 95% confidence interval [CI], 5.2-62.7), metabolic syndrome (OR, 3.3; 95% CI, 1.3-8.3), and hyperglycemia (OR, 3; 95% CI, 1.1-8.6). Prepregnancy overweight/obesity was associated with increased risk for insulin resistance, metabolic syndrome, abdominal obesity, low high-density lipoprotein cholesterol, and hypertriglyceridemia (P < 0.05). Excessive GWG was not associated with metabolic risk in the main model but was found to be positively associated in models with correction of weight by possible recall bias. Gestational obesity was associated with maternal metabolic alterations 10 y postpartum. Prevention strategies for chronic diseases

  12. Perceived stress, unhealthy eating behaviors, and severe obesity in low-income women.

    PubMed

    Richardson, Andrea S; Arsenault, Joanne E; Cates, Sheryl C; Muth, Mary K

    2015-12-03

    Stress has been associated with poor eating behaviors and diet quality, as well as high body mass index (BMI). Low-income women may be particularly vulnerable to stress and severe obesity. Yet it is unknown how stress increases the risk of severe obesity through disordered eating behaviors and poor diet quality or through mechanisms independent of diet. We examined cross-sectional data from women (n = 101) with a child enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children in Cumberland County, North Carolina (spring 2012). We collected measured heights and weights to calculate BMI. Using structural equation modeling, we differentiated pathways from stress to weight status: (1) indirectly through eating behaviors (cognitive restraint, emotional eating, and uncontrolled eating) and diet quality, which we examined with the Healthy Eating Index 2010 and 24-h dietary recalls, and (2) directly through possible unmeasured risk factors independent of diet. The analysis controlled for race/ethnicity, income, age, whether the dietary recall day was typical, and whether the respondent completed one or two 24-h dietary recalls. Perceived stress was positively associated with uncontrolled eating (β = 0.38, p < 0.001) and emotional eating (β = 0.50, p < 0.001). However, higher stress was not associated with weight status through eating behaviors and diet quality. Independent of eating behaviors and diet quality, stress was positively associated with severe obesity (β = 0.26, p = 0.007). Improving stress coping strategies for low-income women may improve eating behaviors and reduce severe obesity.

  13. Influence of sucrose ingestion on brainstem and hypothalamic intrinsic oscillations in lean and obese women.

    PubMed

    Kilpatrick, Lisa A; Coveleskie, Kristen; Connolly, Lynn; Labus, Jennifer S; Ebrat, Bahar; Stains, Jean; Jiang, Zhiguo; Suyenobu, Brandall Y; Raybould, Helen E; Tillisch, Kirsten; Mayer, Emeran A

    2014-05-01

    The study of intrinsic fluctuations in the blood oxygen level-dependent signal of functional magnetic resonance imaging can provide insight into the effect of physiologic states on brain processes. In an effort to better understand the brain-gut communication induced by the absorption and metabolism of nutrients in healthy lean and obese individuals, we investigated whether ingestion of nutritive and non-nutritive sweetened beverages differentially engages the hypothalamus and brainstem vagal pathways in lean and obese women. In a 2-day, double-blind crossover study, 11 lean and 11 obese healthy women underwent functional magnetic resonance imaging scans after ingestion of 2 beverages of different sucrose content, but identical sweetness. During scans, subjects rested with eyes closed. Blood oxygen level-dependent fluctuations demonstrated significantly greater power in the highest frequency band (slow-3: 0.073-0.198 Hz) after ingestion of high-sucrose compared with low-sucrose beverages in the nucleus tractus solitarius for both groups. Obese women had greater connectivity between the right lateral hypothalamus and a reward-related brain region and weaker connectivity with homeostasis and gustatory-related brain regions than lean women. In a functional magnetic resonance imaging study, we observed sucrose-related changes in oscillatory dynamics of blood oxygen level-dependent fluctuations in brainstem and hypothalamus in lean and obese women. The observed frequency changes are consistent with a rapid vagally mediated mechanism due to nutrient absorption, rather than sweet taste receptor activation. These findings provide support for altered interaction between homeostatic and reward networks in obese individuals. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  14. Objectively measured physical activity in obese women with and without migraine.

    PubMed

    Bond, Dale S; Thomas, J Graham; O'Leary, Kevin C; Lipton, Richard B; Peterlin, B Lee; Roth, Julie; Rathier, Lucille; Wing, Rena R

    2015-09-01

    The aim of this article is to cross-sectionally compare objectively measured physical activity (PA) levels and their association with migraine characteristics in obese women with and without migraine. Obese women seeking weight loss treatment were divided into migraine (n = 25) and control (n = 25) groups matched by age and body mass index (BMI). Participants wore the SenseWear Armband monitor for seven days to objectively evaluate daily light-(LPA) and moderate-to-vigorous intensity PA (MVPA). Migraine diagnosis was confirmed by a neurologist using ICHD-3-beta criteria. Migraine characteristics were tracked daily using a smartphone-based diary over a four-week period immediately preceding the objective PA assessment. Migraine participants spent 57.9 fewer minutes/day in LPA (141.1 ± 56.4 vs. 199.1 ± 87.7, p = 0.019) and 24.5 fewer minutes/day in MVPA (27.8 ± 17.0 vs. 52.3 ± 26.0, p < 0.001), compared to controls. Migraine participants reported 4.8 ± 3.1 migraine days/month (mean duration = 17.1 ± 8.9 hours; mean maximum pain severity = 6.4 ± 1.7 on a 0-10 scale). Higher BMI (p < 0.05), but not migraine characteristics, were related to lower total PA. Additionally, total objectively measured PA was not associated with how often PA was reported to exacerbate migraine attacks during the four-week diary assessment. Obese women with migraine spent nearly 1.5 hours/day less in PA compared to controls; however, lower PA was not related to migraine characteristics. Further research is needed to identify PA barriers and effective interventions in obese women with migraine. © International Headache Society 2014.

  15. Divergent Effects of a Combined Hormonal Oral Contraceptive on Insulin Sensitivity in Lean versus Obese Women

    PubMed Central

    Cheang, Kai I.; Essah, Paulina A.; Sharma, Susmeeta; Wickham, Edmond P.; Nestler, John E.

    2011-01-01

    Objective To evaluate the effects of a commonly used combined hormonal oral contraceptive (OC) on carbohydrate metabolism in obese as compared with obese women. Design 6-month prospective study. Setting Clinical Research Center at an academic medical center. Patients Premenopausal non-diabetic women with BMI < 25 kg/m2 (n=15) or > 30 kg/m2 (n=14). Intervention Ethinyl estradiol 35mcg and norgestimate 0.18/0.215/0.25 mg for 6 cycles. Main Outcome Measures Insulin sensitivity (Si) by frequent sampling intravenous glucose tolerance test; other indices of insulin sensitivity (ISI HOMA, Matsuda index); fasting lipid panel. Results Si changed from 6.62±3.69 min−1/mu/L (baseline) to 8.23±3.30 min−1/mu/L (6 months) in lean women, and from 4.36±2.32 to 3.82±2.32 min−1/mu/L in obese women (p for interaction=0.0494). Divergent effects on insulin sensitivity were also observed with ISI HOMA (p=0.0128) and Matsuda index (p=0.0227). LDL increased by approximately 20 mg/dL in both groups (p<0.005 [lean]; p<0.01 [obese]). Conclusions Lean and obese women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used OC. The mechanisms of these differences, and whether these divergent effects persist long-term, require further investigations. Capsule Lean and obese non-diabetic women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used OC (ethinyl estradiol 35mcg and norgestimate 0.18/0.215/0.25 mg) PMID:21676394

  16. The utility of animal models to evaluate novel anti-obesity agents

    PubMed Central

    Vickers, Steven P; Jackson, Helen C; Cheetham, Sharon C

    2011-01-01

    The global incidence of obesity continues to rise and is a major driver of morbidity and mortality through cardiovascular and cerebrovascular diseases. Animal models used in the discovery of novel treatments for obesity range from straightforward measures of food intake in lean rodents to long-term studies in animals exhibiting obesity due to the continuous access to diets high in fat. The utility of these animal models can be extended to determine, for example, that weight loss is due to fat loss and/or assess whether beneficial changes in key plasma parameters (e.g. insulin) are evident. In addition, behavioural models such as the behavioural satiety sequence can be used to confirm that a drug treatment has a selective effect on food intake. Typically, animal models have excellent predictive validity whereby drug-induced weight loss in rodents subsequently translates to weight loss in man. However, despite this, at the time of writing orlistat (Europe; USA) remains the only drug currently marketed for the treatment of obesity, with sibutramine having recently been withdrawn from sale globally due to the increased incidence of serious, non-fatal cardiovascular events. While the utility of rodent models in predicting clinical weight loss is detailed, the review also discusses whether animals can be used to predict adverse events such as those seen with recent anti-obesity drugs in the clinic. LINKED ARTICLES This article is part of a themed issue on Translational Neuropharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.164.issue-4 PMID:21265828

  17. Serum concentrations of trace elements and their relationships with paraoxonase-1 in morbidly obese women.

    PubMed

    Luciano-Mateo, Fedra; Cabré, Noemí; Nadal, Martí; García-Heredia, Anabel; Baiges-Gaya, Gerard; Hernández-Aguilera, Anna; Camps, Jordi; Joven, Jorge; Domingo, José Luis

    2018-07-01

    The metabolic alterations associated with obesity include mineral dysregulation. Essential trace elements are nutrients with a relevant function in a large number of cellular processes and multiple roles in the correct functioning of metabolic enzymes. Paraoxonase-1 (PON1) is an antioxidant and anti-inflammatory enzyme that is compromised in obesity. In the present study, the potential alterations in trace elements in morbidly obese women were assessed in relation to serum PON1 activity and concentration, as well as to other obesity-related comorbidities such as diabetes mellitus and fatty liver. We recruited 41 morbidly obese women and 51 control individuals. The serum concentrations of 30 elements, PON1 paraoxonase and lactonase activities, and PON1 concentration were measured. We observed significant alterations in the levels of As, Ba, Cu, Ca, Fe, Mg, Na, Se, Sr, and Zn in obese women; some of them (As, Ca, Cr, Cu, Mg, and Se) being significantly correlated with serum PON1 values. The most relevant changes were observed in the concentrations of As, Sr and Mg, the last of which was also significantly associated with diabetes mellitus. The current results raise the possibility that increased ingestion and/or storage of a number of trace elements may be factors predisposing to obesity-related comorbidities and metabolic alterations. Copyright © 2018 Elsevier GmbH. All rights reserved.

  18. Term Elective Induction of Labor and Perinatal Outcomes in Obese Women: Retrospective Cohort Study

    PubMed Central

    Lee, Vanessa R.; Darney, Blair G.; Snowden, Jonathan M.; Main, Elliott K.; Gilbert, William; Chung, Judith; Caughey, Aaron B.

    2015-01-01

    Objective To compare perinatal outcomes between elective induction of labor (eIOL) and expectant management in obese women. Design Retrospective cohort study. Setting Deliveries in California in 2007. Population Term, singleton, vertex, nonanomalous deliveries among obese women (n=74,725). Methods Women who underwent eIOL at 37 weeks were compared with women who were expectantly managed at that gestational age. Similar comparisons were made at 38, 39, and 40 weeks. Results were stratified by parity. Chi-square tests and multivariable logistic regression were used for statistical comparison. Main Outcome Measures Method of delivery, severe perineal lacerations, postpartum hemorrhage, chorioamnionitis, macrosomia, shoulder dystocia, brachial plexus injury, respiratory distress syndrome. Results The odds of cesarean delivery were lower among nulliparous women with eIOL at 37 weeks (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.34–0.90) and 39 weeks (OR 0.77, 95% CI 0.63–0.95) compared to expectant management. Among multiparous women with a prior vaginal delivery, eIOL at 37 (OR 0.39, 95% CI 0.24–0.64), 38 (OR 0.65, 95% CI 0.51–0.82), and 39 weeks (OR 0.67, 95% CI 0.56–0.81) was associated with lower odds of cesarean. Additionally, eIOL at 38, 39, and 40 weeks was associated with lower odds of macrosomia. There were no differences in the odds of operative vaginal delivery, lacerations, brachial plexus injury, or respiratory distress syndrome. Conclusions In obese women, term eIOL may decrease the risk of cesarean delivery, particularly in multiparas, without increasing the risks of other adverse outcomes when compared with expectant management. Tweetable Abstract Elective induction of labor in obese women does not increase risk of cesarean or other perinatal morbidities. PMID:26840780

  19. 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.

  20. Sexual functioning of men and women with severe obesity before bariatric surgery.

    PubMed

    Steffen, Kristine J; King, Wendy C; White, Gretchen E; Subak, Leslee L; Mitchell, James E; Courcoulas, Anita P; Flum, David R; Strain, Gladys; Sarwer, David B; Kolotkin, Ronette L; Pories, Walter; Huang, Alison J

    2017-02-01

    Obesity may impair sexual function through multiple mechanisms, but little is known about sexual dysfunction among adults with severe obesity seeking bariatric procedures. To describe sexual function and associated factors before bariatric surgery. Ten U.S. clinical facilities. Before bariatric surgery, 2225 of 2458 Longitudinal Assessment of Bariatric Surgery-2 study participants (79% female, median age 45 years and median body mass index 46 kg/m 2 ) completed a survey about sexual function over the past month. Mixed effects ordinal logistic regression models were used to identify factors independently related to 4 domains of sexual function. One third of women (34%) and one quarter of men (25%) were not sexually active, alone or with a partner, in the past month. Twenty-six percent of women and 12% of men reported no sexual desire. Physical health limited sexual activity at least moderately in 38% of women and 44% of men. About one half of the women (49%) and the men (54%) were moderately or very dissatisfied with their sexual life. Among women, older age, being Caucasian, urinary incontinence, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. In men, older age, not being married, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. Before bariatric surgery, approximately one half of women and men with severe obesity are dissatisfied with their sexual life. Older age, severity of depressive symptoms, and antidepressant medication use are associated with poorer sexual function in both sexes. Copyright © 2016. Published by Elsevier Inc.

  1. Acceleration training for improving physical fitness and weight loss in obese women.

    PubMed

    So, Rina; Eto, Miki; Tsujimoto, Takehiko; Tanaka, Kiyoji

    2014-01-01

    Reducing body weight and visceral adipose tissue (VAT) are the primary goals for maintaining health in obese individuals as compared to those of normal weight, but it is also important to maintain physical fitness for a healthy life after weight-loss. Acceleration training (AT) has recently been indicated as an alternative to resistance training for elite athletes and also as a component of preventive medicine. However, it is unclear whether combining AT with a weight-loss diet will improve physical fitness in obese individuals. The present study aimed to determine the synergistic effects of AT on body composition and physical fitness with weight-loss program in overweight and obese women. Twenty-eight obese, middle-aged women were divided into two groups as follows: diet and aerobic exercise group (DA; BMI: 29.3 ± 3.0 kg/m2); and diet, aerobic exercise and acceleration training group (DAA; BMI: 31.2 ± 4.0 kg/m2). Both groups included a 12-week weight-loss program. Body composition, visceral adipose tissue (VAT) area and physical fitness (hand grip, side-to-side steps, single-leg balance with eyes closed, sit-and-reach and maximal oxygen uptake) were measured before and after the program. Body weight, BMI, waist circumference and VAT area decreased significantly in both groups. Hand grip (2.1 ± 3.0 kg), single-leg balance (11.0 ± 15.4 s) and sit-and-reach (6.5 ± 4.8 cm) improved significantly only in the DAA group. Our findings indicate that combining AT with classical lifestyle modifications is effective at reducing VAT, and it may enhance muscle strength and performance in overweight and obese women. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

  2. A Prospective Observational Study of Obesity, Body Composition, and Insulin Resistance in 18 Women With Bipolar Disorder and 17 Matched Control Subjects

    PubMed Central

    Fleet-Michaliszyn, Sara B.; Soreca, Isabella; Otto, Amy D.; Jakicic, John M.; Fagiolini, Andrea; Kupfer, David J.; Goodpaster, Bret H.

    2012-01-01

    Objective Patients with bipolar disorder are at increased risk for diabetes and cardiovascular diseases, possibly because of more severe insulin resistance. The primary purpose of this study was to determine whether insulin resistance is characteristic of bipolar disorder. Method The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was performed in 18 women with DSM-IV bipolar I disorder, and results were compared to those of 17 matched controls. Other risk factors were compared, including blood pressure, blood lipids, and abdominal obesity by computed tomography (CT). Additionally, substrate utilization was measured by indirect calorimetry, and free-living energy expenditure was estimated using wearable activity monitors. All data were collected between February 2006 and December 2007. Results Patients with bipolar disorder were no more insulin resistant than controls after accounting for generalized obesity (mean ± SEM HOMA-IR = 2.7 ± 0.7 vs. 2.5 ± 0.7, for patients and controls, respectively; p = .79). Although blood lipid profiles were generally similar in patients and controls, obese patients had higher blood pressure than controls. Obese patients had more mean ± SEM total abdominal fat (718.1 ± 35.1 cm2 vs. 607.4 ± 33.6 cm2: p = .04), and tended (p = .06) to have more visceral abdominal fat. Patients oxidized 13% less fat during resting conditions, although their resting metabolic rate was similar to that of controls. Conclusion Women with bipolar I disorder were no more insulin resistant than matched controls after accounting for their level of obesity. However, they were more hypertensive, had higher amounts of abdominal obesity, and had reduced rates of fat oxidation. Therefore, women with bipolar I disorder may be at a heightened risk for future weight gain and concomitant risk for diabetes and cardiovascular disease. PMID:19026257

  3. 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.

  4. 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.

  5. [EFFECTIVENESS OF COMPREHENSIVE TREATMENT ON THE PREOPERATIVE CONDITIONS OF OBESE WOMEN CANDIDATES FOR BARIATRIC SURGERY].

    PubMed

    Delgado Floody, Pedro; Jerez Mayorga, Daniel; Caamaño Navarrete, Felipe; Concha Díaz, Manuel; Ovalle Elgueta, Héctor; Osorio Poblete, Aldo

    2015-12-01

    in Chile, a high prevalence of women presents morbid obesity, this condition generates serious medical complications and high costs for public health. to determine the effects of a total treatment program consisting of physical exercise, psychological therapy and nutrition education on the preoperative conditions of obese women candidates for bariatric surgery. nineteen women between the ages of 30 and 55 applicants to bariatric surgery, with morbid obesity (n=6) or obesity and comorbidities (n=13), underwent a program of comprehensive treatment of sixteen weeks duration (3 session/week). Before and 72 hours after the last intervention session was evaluated on fasting (≥12 hours): body weight, body mass index (BMI), percentage of body fat (% BF), contour waist (CW) and basal blood glucose. Cardiorespiratory fitness was also estimated. the average age was 40.32 years, post-sixteen weeks of comprehensive treatment study variables improved significantly (p. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. 24-h core temperature in obese and lean men and women.

    PubMed

    Hoffmann, Mindy E; Rodriguez, Sarah M; Zeiss, Dinah M; Wachsberg, Kelley N; Kushner, Robert F; Landsberg, Lewis; Linsenmeier, Robert A

    2012-08-01

    Maintenance of core temperature is a major component of 24-h energy expenditure, and its dysregulation could contribute to the pathophysiology of obesity. The relationship among temperature, sex, and BMI, however, has not been fully elucidated in humans. This study investigated core temperature in obese and lean individuals at rest, during 20-min exercise, during sleep, and after food consumption. Twelve lean (18.5-24.9 kg/m(2)) and twelve obese (30.0-39.9 kg/m(2)) healthy participants, ages 25-40 years old, were admitted overnight in a clinical research unit. Females were measured in the follicular menstrual phase. Core temperature was measured every minute for 24 h using the CorTemp system, a pill-sized sensor that measures core temperature while in the gastrointestinal tract and delivers the measurement via a radio signal to an external recorder. Core temperature did not differ significantly between the obese and lean individuals at rest, postmeals, during exercise, or during sleep (P > 0.5), but core temperature averaged over the entire study was significantly higher (0.1-0.2 °C) in the obese (P = 0.023). Each individual's temperature varied considerably during the study, but at all times, and across the entire study, women were ~0.4 °C warmer than men (P < 0.0001). These data indicate that obesity is not associated with a lower core temperature but that women have a higher core temperature than men at rest, during sleep, during exercise, and after meals.

  7. 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 ...

  8. Influence of PCOS in Obese vs. Non-Obese women from Mesenchymal Progenitors Stem Cells and Other Endometrial Cells: An in silico biomarker discovery.

    PubMed

    Desai, Ashvini; Madar, Inamul Hasan; Asangani, Amjad Hussain; Ssadh, Hussain Al; Tayubi, Iftikhar Aslam

    2017-01-01

    Polycystic ovary syndrome (PCOS) is endocrine system disease which affect women ages 18 to 44 where the women's hormones are imbalance. Recently it has been reported to occur in early age. Alteration of normal gene expression in PCOS has shown negative effects on long-term health issues. PCOS has been the responsible factor for the infertility in women of reproductive age group. Early diagnosis and treatment can improve the women's health suffering from PCOS. Earlier Studies shows correlation of PCOS upon insulin resistance with significant outcome, Current study shows the linkage between PCOS with obesity and non-obese patients. Gene expression datasets has been downloaded from GEO (control and PCOS affected patients). Normalization of the datasets were performed using R based on RMA and differentially expressed gene (DEG) were selected on the basis of p-value 0.05 followed by functional annotation of selected gene using Enrich R and DAVID. The DEGs were significantly related to PCOS with obesity and other risk factors involved in disease. The Gene Enrichment Analysis suggests alteration of genes and associated pathway in case of obesity. Current study provides a productive groundwork for specific biomarkers identification for the accurate diagnosis and efficient target for the treatment of PCOS.

  9. Changes in Global Transcriptional Profiling of Women Following Obesity Surgery Bypass.

    PubMed

    Pinhel, Marcela Augusta de Souza; Noronha, Natalia Yumi; Nicoletti, Carolina Ferreira; de Oliveira, Bruno Affonso Parente; Cortes-Oliveira, Cristiana; Pinhanelli, Vitor Caressato; Salgado Junior, Wilson; Machry, Ana Julia; da Silva Junior, Wilson Araújo; Souza, Dorotéia Rossi Silva; Marchini, Júlio Sérgio; Nonino, Carla Barbosa

    2018-01-01

    Differential gene expression in peripheral blood mononuclear cells (PBMCs) after Roux-en-Y gastric bypass (RYGB) is poorly characterized. Markers of these processes may provide a deeper understanding of the mechanisms that underlie these events. The main goal of this study was to identify changes in PBMC gene expression in women with obesity before and 6 months after RYGB-induced weight loss. The ribonucleic acid (RNA) of PBMCs from 13 obese women was analyzed before and 6 months after RYGB; the RNA of PBMCs from nine healthy women served as control. The gene expression levels were determined by microarray analysis. Significant differences in gene expression were validated by real-time quantitative polymerase chain reaction (RT-qPCR). Microarray analysis for comparison of the pre- and postoperative periods showed that 1366 genes were differentially expressed genes (DEGs). The main pathways were related to gene transcription; lipid, energy, and glycide metabolism; inflammatory and immunological response; cell differentiation; oxidative stress regulation; response to endogenous and exogenous stimuli; substrate oxidation; mTOR signaling pathway; interferon signaling; mitogen-activated protein kinases (MAPK), cAMP response element binding protein (CREB1), heat shock factor 1 (HSF1), and sterol regulatory element binding protein 1c (SREBP-1c) gene expression; adipocyte differentiation; and methylation. Six months after bariatric surgery and significant weight loss, many molecular pathways involved in obesity and metabolic diseases change. These findings are an important tool to identify potential targets for therapeutic intervention and clinical practice of nutritional genomics in obesity.

  10. Barriers to breast-feeding in obese women: A qualitative exploration.

    PubMed

    Keely, Alice; Lawton, Julia; Swanson, Vivien; Denison, Fiona C

    2015-05-01

    to explore the factors that influence breast-feeding practices in obese women who had either stopped breast-feeding or were no longer exclusively breast-feeding 6-10 weeks following the birth of their babies, despite an original intention to do so for 16 weeks or longer. Specifically (i) to identify the barriers to successful breast-feeding and reasons for introducing formula and/or stopping breast-feeding, and (ii) to explore the women׳s views and experiences of current breast-feeding support services. descriptive, qualitative study comprising semi-structured face-to-face interviews. Interviews were audio recorded and transcribed. The data were analysed using thematic analysis. participants recruited from one large maternity unit in Scotland and interviewed in their homes. 28 obese women at 6-10 weeks following birth. three major themes emerged from the data analysis: the impact of birth complications, a lack of privacy, and a low uptake of specialist breast-feeding support. Impact of birth complications: 19 of 28 women had given birth by caesarean section and some felt this led to feeling 'out of it' post-operatively, a delay in establishing skin-to-skin contact, and in establishing breast-feeding. Lack of privacy; several women described reluctance to breast feed in front of others, difficulties in achieving privacy, in hospital, at home and in public. Low uptake of postnatal breast-feeding support; despite experiencing problems such as physical difficulties during breast-feeding or a perception of low milk supply, breast-feeding support services were underused by this sample of women. A small number of the women in this study used breast-feeding clinics and reported finding these useful. A further small number felt they benefitted from the support of a friend who was successfully breast-feeding. midwives should be mindful of the presence of additional factors alongside maternal obesity, such as caesarean delivery, physical difficulties when breast

  11. What kind of sexual dysfunction is most common among overweight and obese women in reproductive age?

    PubMed

    Rabiepoor, S; Khalkhali, H R; Sadeghi, E

    2017-03-01

    The aim of this study was to investigate the association between body mass index (BMI) and sexual health and determine what kind of sexual dysfunction is most common among overweight and obese women in reproductive age from Iran. A cross-sectional descriptive design was adopted. The data of 198 women who referred to health centers during 2014-2015 in Iran were collected through convenient sampling. Data were collected using a demographic questionnaire, female sexual function and sexual satisfaction indexes. Participants' heights and weights were recorded in centimeters and kilogram. Data were analyzed applying descriptive statistics, one-way analysis of variance, regression logistic analysis and χ 2 . P-values<0.05 were considered significant. The mean age of women was 29.89±7.01 and ages ranged from 17 to 45 years. 85.9% of the participants had sexual dysfunction, and 69.7% had dissatisfaction and low satisfaction. According to our evaluations, orgasm dysfunction had the most frequency; on the other hand, desire dysfunction and pain dysfunction had the lowest frequency among overweight and obese women, respectively. Using logistic regression analysis, we have shown that BMI affected on sexual satisfaction, but there was not significant differences between BMI and sexual function. This article concludes that all women especially women with overweight and obesity should be counseled about health outcomes related to sexual activity. This article concludes that all women especially women with overweight and obesity should be counseled about health outcomes related to sexual activity.

  12. Mighty Mums - An antenatal health care intervention can reduce gestational weight gain in women with obesity.

    PubMed

    Haby, Karin; Glantz, Anna; Hanas, Ragnar; Premberg, Åsa

    2015-07-01

    overweight and obesity are growing public health problems and around 13% of women assigned to antenatal health care (AHC) in Sweden have obesity (Body Mass Index, BMI ≥30). The risk of complications during pregnancy and childbirth increase with increasing BMI. Excessive gestational weight gain (GWG) among obese women further increases the risks of adverse pregnancy outcomes. In this pilot-study from AHC in Gothenburg, a co-ordinated project with standardised care, given by midwives and supported by dietitian and aiming at reducing weight gain in obese pregnant women, is evaluated. to evaluate the effects of a behavioural intervention programme for women with BMI ≥30, with emphasis on nutrition and physical activity, with regards to GWG and effect on weight at the post partum check-up. in the pilot study, the intervention group consisted of the first 50 enrolled obese pregnant women in a large life style project within the AHC in Gothenburg. The control group consisted of 50 obese pregnant women in the same city. The intervention included 60 minutes extra time with the midwife and also offered food discussion group, walking poles and pedometers. The intervention group was prescribed physical activity and could choose from food advice with different content. If needed, the woman was offered referral to the dietitian for a personal meeting. A network was formed with the surrounding community. Outcome measures were GWG, weight change at the postnatal check-up compared with when signing in to antenatal health care, and change in BMI during the same period. women in the intervention group had a significantly lower GWG (8.6 ± 4.9 kg versus 12.5 ± 5.1 kg; p=0.001) and a significantly lower weight at the postnatal check up versus the first contact with AHC (-0.2 ± 5.7 kg versus +2.0 ± 4.5 kg; p=0.032), as well as a decrease in BMI (-0.04 ± 2.1 versus +0.77 ± 2.0; p=0.037). More women in the intervention than in the control group managed GWG <7 kg [18 (36%) versus

  13. 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.

  14. Pharmacokinetics of levonorgestrel and ulipristal acetate emergency contraception in women with normal and obese body mass index.

    PubMed

    Praditpan, Piyapa; Hamouie, Angie; Basaraba, Cale N; Nandakumar, Renu; Cremers, Serge; Davis, Anne R; Westhoff, Carolyn L

    2017-05-01

    This study compares the pharmacokinetics (PK) of levonorgestrel (LNG) emergency contraceptive (EC) and ulipristal acetate (UPA)-EC between normal-body mass index (BMI) and obese-BMI women. This prospective, randomized crossover study evaluates the PK of women after single doses of LNG-EC (1.5mg) and UPA-EC (30mg). Study procedures took place during clinical research unit admissions, where participants received a standardized meal and each study drug, in random order, during two separate 24-h admissions. Study staff collected 14 blood specimens (0, 0.5, 1.0, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 24 and 48h). We evaluated serum concentrations of LNG and UPA using liquid chromatography-tandem mass spectroscopy and estimated the PK parameters of both drugs using noncompartmental analysis. The main outcome of this study was a comparison of between-group differences in AUC 0-24 . Thirty-two women completed the study (16 in each group). Among normal-BMI and obese-BMI participants, the mean BMIs were 22.0 (range 18.8-24.6) and 34.3 (range 30.6-39.9), respectively. After LNG-EC, mean AUC 0-24 and maximum concentration (C max ) were 50% lower among obese-BMI women than among normal-BMI women (AUC 0-24 100.8 vs. 208.5ng*h/mL, IQR obese-BMI 35.8, IQR normal-BMI 74.2, p≤.01; C max 10.8 vs. 18.2ng/mL, p=.01). After UPA-EC, AUC 0-24 and C max were similar between obese-BMI and normal-BMI women (AUC 0-24 362.5 vs. 293.5ng*h/mL, IQR obese-BMI 263.2, IQR normal-BMI 112.5, p=.15; C max 95.6 vs. 89.3ng/mL, p=.70). After a single dose of EC, obese-BMI women are exposed to lower concentrations of LNG and similar concentrations of UPA, when compared to normal-BMI women. Differences in LNG-EC PK by BMI group may underlie and account for the lower LNG-EC efficacy reported among obese-BMI women, but modest differences in UPA-EC PK by BMI group provide less support for variable efficacy. A pharmacodynamic study may be able to clarify whether these PK differences account for observed differences

  15. 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.

  16. 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

  17. Risks of pregnancy and birth in obese primiparous women: an analysis of German perinatal statistics

    PubMed Central

    Briese, Volker; Voigt, Manfred; Borchardt, Ulrike; Straube, Sebastian

    2010-01-01

    Purpose To compare risks of pregnancy and birth in obese (body mass index, BMI ≥ 30) and normal weight women (BMI 18.5–24.99) giving birth to their first child. Methods We analysed data of 243,571 pregnancies in primiparous women from the German perinatal statistics of 1998–2000. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) for selected pregnancy and birth risks. ORs were adjusted for the confounding factors age, smoking status, single mother status, and maternal education. Results Obesity during pregnancy is common in primiparous women (n = 19,130; 7.9% of all cases) and it is significantly associated with a number of risks of pregnancy and birth, including diabetes [OR 3.71 (95% CI 2.93; 4.71); p < 0.001], hypertension [OR 8.44 (7.91; 9.00); p < 0.001], preecalmpsia/eclampsia [OR 6.72 (6.30; 7.17); p < 0.001], intraamniotic infection [OR 2.33 (2.05; 2.64); p < 0.001], birth weight ≥4,000 g [OR 2.16 (2.05; 2.28); p < 0.001], and an increased rate of Caesarean section [OR 2.23 (2.15; 2.30); p < 0.001]. Some risks were less frequent in the obese such as cervical incompetence [OR 0.55 (0.48; 0.63); p < 0.001] and preterm labour [OR 0.47 (0.43; 0.51); p < 0.001]. Conclusions Obesity during pregnancy is an important clinical problem in primiparous women because it is common and it is associated with a number of risks of pregnancy and birth. Because of these increased risks, obese women need special attention clinically during the course of their first pregnancy. Weight reduction before the first pregnancy is generally indicated in obese women to prevent the above-mentioned complications of pregnancy and birth. PMID:20098995

  18. 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.

  19. Racism, segregation, and risk of obesity in the Black Women's Health Study.

    PubMed

    Cozier, Yvette C; Yu, Jeffrey; Coogan, Patricia F; Bethea, Traci N; Rosenberg, Lynn; Palmer, Julie R

    2014-04-01

    We assessed the relation of experiences of racism to the incidence of obesity and the modifying impact of residential racial segregation in the Black Women's Health Study, a follow-up study of US black women. Racism scores were created from 8 questions asked in 1997 and 2009 about the frequency of "everyday" racism (e.g., "people act as if you are dishonest") and of "lifetime" racism (e.g., unfair treatment on the job). Residential segregation was measured by linking participant addresses to 2000 and 2010 US Census block group data on the percent of black residents. We used Cox proportional hazard models to estimate incidence rate ratios and 95% confidence intervals. Based on 4,315 incident cases of obesity identified from 1997 through 2009, both everyday racism and lifetime racism were positively associated with increased incidence. The incidence rate ratios for women who were in the highest category of everyday racism or lifetime racism in both 1997 and 2009, relative to those in the lowest category, were 1.69 (95% confidence interval: 1.45, 1.96; Ptrend < 0.01) and 1.38 (95% confidence interval: 1.15, 1.66; Ptrend < 0.01), respectively. These associations were not modified by residential segregation. These results suggest that racism contributes to the higher incidence of obesity among African American women.

  20. Racism, Segregation, and Risk of Obesity in the Black Women's Health Study

    PubMed Central

    Cozier, Yvette C.; Yu, Jeffrey; Coogan, Patricia F.; Bethea, Traci N.; Rosenberg, Lynn; Palmer, Julie R.

    2014-01-01

    We assessed the relation of experiences of racism to the incidence of obesity and the modifying impact of residential racial segregation in the Black Women's Health Study, a follow-up study of US black women. Racism scores were created from 8 questions asked in 1997 and 2009 about the frequency of “everyday” racism (e.g., “people act as if you are dishonest”) and of “lifetime” racism (e.g., unfair treatment on the job). Residential segregation was measured by linking participant addresses to 2000 and 2010 US Census block group data on the percent of black residents. We used Cox proportional hazard models to estimate incidence rate ratios and 95% confidence intervals. Based on 4,315 incident cases of obesity identified from 1997 through 2009, both everyday racism and lifetime racism were positively associated with increased incidence. The incidence rate ratios for women who were in the highest category of everyday racism or lifetime racism in both 1997 and 2009, relative to those in the lowest category, were 1.69 (95% confidence interval: 1.45, 1.96; Ptrend < 0.01) and 1.38 (95% confidence interval: 1.15, 1.66; Ptrend < 0.01), respectively. These associations were not modified by residential segregation. These results suggest that racism contributes to the higher incidence of obesity among African American women. PMID:24585257

  1. 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

  2. Influence of obesity on vertebral fracture prevalence and vitamin D status in postmenopausal women.

    PubMed

    El Maghraoui, A; Sadni, S; El Maataoui, A; Majjad, A; Rezqi, A; Ouzzif, Z; Mounach, A

    2015-01-01

    It is well established that weight is an important determinant of bone health. Whereas obesity is associated with increased mortality and morbidity from diabetes and cardiovascular diseases, high body weight is widely believed to be associated to hypovitaminosis D and protective against the development of osteoporosis and fracture risk. The objective of the study was to evaluate the effect of BMI on vitamin D status and on densitometric vertebral fractures (VFs) in a large series of asymptomatic women aged over 50 who had a VFA examination during their bone mineral density (BMD) testing. We enrolled 429 postmenopausal women (mean age, weight and BMI of 59.5 ± 8.3 (50 to 83) years, 75.8 ± 13.3 (35 to 165) kgs and 29.9 ± 5.2 (14.6 to 50.8) kg/m(2), respectively. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy densitometer. VFs were defined using the Genant semiquantitative (SQ) approach. Clinical risk factors of osteoporosis were collected and 25-hydroxivitamin D was measured using electrochimiluminescence (Roche). Prevalence of osteoporosis and hypovitaminosis D (<20 ng/ml) was 21.0 % and 78.1 % respectively. VFs grade 2/3were identified in 76 (17.7 %). Comparison between women according to their BMI showed that obese women had a higher BMD and less proportion of women with osteoporosis and VFs grade 2/3 than lean and overweight women. The prevalence of VFs globally increased with age and as BMI and BMD declined. Stepwise regression analysis showed that the presence of osteoporosis was independently related to BMI and history of fractures while the presence of grade 2/3 VFs was independently related to age, hypovitaminosis D and years of menopause. Obese women had a higher BMD and lower prevalence of VFs. VFs were significantly related to age, hypovitaminosis D and years since menopause. However, among obese women, prevalence of VFs was increased in osteoporotic women.

  3. Association between Obesity and Cervical Microflora Dominated by Lactobacillus iners in Korean Women.

    PubMed

    Oh, Hea Young; Seo, Sang-Soo; Kong, Ji-Sook; Lee, Jae-Kwan; Kim, Mi Kyung

    2015-10-01

    Lactobacillus spp. are associated with the maintenance of reproductive health, but obesity reduces fertility and is a risk factor for obstetric and neonatal complications. We assessed the association between obesity and the cervical Lactobacillus composition, which has not been examined previously. Pyrosequencing was performed using cervical swabs collected from 76 normal participants with negative results for cervical intraepithelial neoplasia (CIN) and 57 participants with CIN, based on histological examinations. Cluster analysis of nine Lactobacillus spp. was performed, and five cluster types were identified. The association between obesity and the Lactobacillus community was assessed by logistic regression analysis after adjustment for confounding factors. The proportion of Lactobacillus iners increased and that of Lactobacillus crispatus decreased according to body mass index (BMI) categories, i.e., underweight (BMI of <18.5 kg m(-2)), normal weight (BMI of 18.5 to 22.9 kg m(-2)), overweight (BMI of 23.0 to 24.9 kg m(-2)), and obese (BMI of ≥25 kg m(-2)). The L. iners-dominant type had a significant association with obesity (odds ratio [OR], 7.55 [95% confidence interval [CI], 1.18 to 48.2]), compared to the L. crispatus-dominant type. The group with high values for the ratio obtained by dividing the relative abundance of L. iners by that of L. crispatus had a significant association with obesity (OR, 6.54 [95% CI, 1.22 to 35.1]), compared to the low-ratio group. Associations between obesity and the L. iners/L. crispatus ratio were observed among young women (OR, 6.26 [95% CI, 1.15 to 33.9]) but not older women and in the normal group (OR, 6.97 [95% CI, 1.20 to 70.4]) but not the CIN group. Obesity was associated with cervical microflora dominated by L. iners in reproductive-age women without dysplasia. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  4. BMI may overestimate the prevalence of obesity among women of lower socioeconomic status.

    PubMed

    Kaluski, Dorit Nitzan; Keinan-Boker, Lital; Stern, Felicia; Green, Manfred S; Leventhal, Alex; Goldsmith, Rebecca; Chinich, Ayelet; Berry, Elliot M

    2007-07-01

    Our objective was to examine gender differences in height and weight associated with socioeconomic status (SES) and the consequent effect on body mass index in a multiethnic society. A cross-sectional study, the First Israeli National Health and Nutrition Survey, was performed on a representative population sample of 3246 adults 25 to 64 years of age, between the years 1999 to 2001. Height and weight were measured, and BMI and other weight-height indices were calculated. SES was assessed by income and education. Age-adjusted height was significantly lower at lower levels of SES among both women and men (p<0.001). As opposed to men, women of lower SES were heavier than those of higher SES, and the mean age-adjusted weight was 4.6 kg higher among those of lower SES (p<0.001). Thus, using the standard index of BMI, the prevalence of obesity was significantly higher among shorter women. In this group of Israeli adults, the unfavorable effect of low SES on BMI was evident among women, partly due to their decreased height combined with increased weight common in this socioeconomic sector. Since BMI is only partly independent of height, it may overestimate the prevalence of obesity among women of lower SES. Alternative measures for classifying obesity in the lower SES groups that put less emphasis on height may be considered and studied.

  5. Aerobic Exercise and Weight Loss Reduce Vascular Markers of Inflammation and Improve Insulin Sensitivity in Obese Women

    PubMed Central

    Ryan, Alice S.; Ge, Shealinna; Blumenthal, Jacob B.; Serra, Monica C.; Prior, Steven J.; Goldberg, Andrew P.

    2014-01-01

    Background/Objectives To examine the relationships of plasma and tissue markers of systemic and vascular inflammation to obesity and insulin resistance and determine the effects of aerobic exercise training+weight loss (AEX+WL) and weight loss (WL) on these biomarkers. Design Prospective controlled study. Participants Seventy-seven overweight and obese sedentary postmenopausal women. Interventions Six months, 3d/wk AEX+WL (n=37) or WL (n=40). Measurements Total body dual-energy x-ray absorptiometry, abdominal computed tomography scans, hyperinsulinemic-euglycemic clamps, adipose tissue biopsies (n=28), and blood for Homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule (sICAM-1) and vascular CAM-1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Results Body weight, %fat, visceral fat, triglyceride levels and systolic blood pressure decreased comparably after WL and AEX+WL (P<0.05). VO2max increased 16% after AEX+WL (P<0.001). Insulin resistance decreased in both groups (P<0.01). Glucose utilization increased 10% (P< 0.05) after AEX+WL and 8% with WL (P=0.07). AEX+WL and WL decreased CRP by 29% and 21%, (P<0.05). SAA levels decreased two-fold more after AEX+WL (−19%, P<0.05) than with WL (−9%, P=0.08). Plasma sICAM-1 and sVCAM-1 levels did not change; however, women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose, insulin and insulin resistance (P<0.05). Gluteal ICAM mRNA levels decreased 27% after AEX+WL (P<0.05) and did not change after WL. Conclusion Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP and SAA and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women. PMID:24635342

  6. Obesity in African-American Women--The Time Bomb is Ticking: An Urgent Call for Change.

    PubMed

    Fowler, Barbara A

    2015-12-01

    The "time bomb is ticking" because there is an obesity crisis associated with higher rates of chronic diseases such as stroke, hypertension, type 2 diabetes, and some forms of cancer in African-American women compared to White women. African-American women incur higher medical costs from hospitalizations, decreased productivity in the work setting, lost wages, the needfor medical benefits and pharmacy-associated costs, and more time away from family than White women. Numerous factors, such as the socio-cultural context of eating, acceptance of a larger weight status, the emotionally liberating effects offood, and preference for highfat and high caloric, sugary-content, and sodium-laden food influences the obesity crisis in African-American women. The interplay of poverty and lower socioeconomic status, residential segregation, health literacy, availability of fast foods and scarce produce in local convenience food marts, physical inactivity, and conflicting messages from social media public service announcements (PSAs) and ads in national magazines affect the obesity crisis in African-American women. There is an urgent call for sustainable, community-driven health policy initiatives that improve access to healthy foods in lower-income, minority communities. Furthermore, African-American women are challenged to modify their health behaviors by preparing healthy meals for themselves and theirfamilies, and by engaging in physical activity.

  7. Psychological Disturbances and Quality of Life in Obese and Infertile Women and Men

    PubMed Central

    Kocełak, Piotr; Chudek, Jerzy; Naworska, Beata; Bąk-Sosnowska, Monika; Kotlarz, Barbara; Mazurek, Monika; Madej, Paweł; Skrzypulec-Plinta, Violetta; Skałba, Piotr; Olszanecka-Glinianowicz, Magdalena

    2012-01-01

    Anovulatory cycles and endometriosis are the main causes of female infertility. The most frequently anovulatory cycles are related to polycystic ovary syndrome (PCOS) commonly associated with obesity and hormonal disturbances in the course of obesity. Recently published studies revealed that infertility affects about one in six couples during their lifetime and is more frequent in obese. Obesity is also associated with male infertility related to erectile dysfunction, hormonal disturbances and lower semen quality. Any of these above mentioned disorder is the important risk factor of psychological disturbances and poor quality of life among women and men in the reproductive age. On the other hand the mood disorders may exacerbate the hormonal disturbances and worsen the effectiveness of infertility management. Infertility, its therapy with accompanying psychological disturbances may also significantly affect the partners relationships. The review summarize the results described in the current literature on the association between obesity and infertility and psychological disturbances as well as their impact on quality of life and sexual functioning in women and men. Moreover, the impact of infertility and psychological disturbances on partners relationships is discussed. PMID:22844280

  8. Connections Between the Gut Microbiome and Metabolic Hormones in Early Pregnancy in Overweight and Obese Women.

    PubMed

    Gomez-Arango, Luisa F; Barrett, Helen L; McIntyre, H David; Callaway, Leonie K; Morrison, Mark; Dekker Nitert, Marloes

    2016-08-01

    Overweight and obese women are at a higher risk for gestational diabetes mellitus. The gut microbiome could modulate metabolic health and may affect insulin resistance and lipid metabolism. The aim of this study was to reveal relationships between gut microbiome composition and circulating metabolic hormones in overweight and obese pregnant women at 16 weeks' gestation. Fecal microbiota profiles from overweight (n = 29) and obese (n = 41) pregnant women were assessed by 16S rRNA sequencing. Fasting metabolic hormone (insulin, C-peptide, glucagon, incretin, and adipokine) concentrations were measured using multiplex ELISA. Metabolic hormone levels as well as microbiome profiles differed between overweight and obese women. Furthermore, changes in some metabolic hormone levels were correlated with alterations in the relative abundance of specific microbes. Adipokine levels were strongly correlated with Ruminococcaceae and Lachnospiraceae, which are dominant families in energy metabolism. Insulin was positively correlated with the genus Collinsella. Gastrointestinal polypeptide was positively correlated with the genus Coprococcus but negatively with family Ruminococcaceae This study shows novel relationships between gut microbiome composition and the metabolic hormonal environment in overweight and obese pregnant women at 16 weeks' gestation. These results suggest that manipulation of the gut microbiome composition may influence pregnancy metabolism. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  9. Dimensions of socioeconomic position related to body mass index and obesity among Danish women and men.

    PubMed

    Groth, M V; Fagt, S; Stockmarr, A; Matthiessen, J; Biltoft-Jensen, A

    2009-06-01

    The aim of this study was to examine the association between different dimensions of socioeconomic position, body mass index (BMI) and obesity in the Danish population. Possible interactions between the different dimensions and gender differences were also investigated. This was a cross-sectional survey conducted in 2000-2002 including a simple random sample from the civil registration system, comprising 1953 males and 2167 females aged 4-75 years. Information about different dimensions of socioeconomic position, height and weight was obtained by face-to-face interview. Associations between dimensions of socioeconomic position and weight status were examined by use of linear multiple regression analysis and logistic regression analysis. BMI and prevalence of obesity were significantly associated with education for both men and women. Odds ratios (ORs) for obesity were 2.9 (95% confidence interval (CI) 1.4-5.9) and 6.5 (95% CI 2.3-18.7) for those with basic school as compared with those with long higher education for men and women, respectively. Women outside the labour market had higher BMIs and a greater prevalence of obesity (OR 2.5 (95% CI 1.6-3.9)) after adjustment for educational level. Education was the dimension most consistently associated with BMI and obesity, indicating the importance of cultural capital for weight status. The gender-specific pattern showed a stronger social gradient for women, and indicated that a high relative body weight was associated with less favourable social and material conditions for women, but not for men. A public health strategy to prevent and reduce obesity should be gender-specific, focus on groups with short education, and incorporate cultural norms.

  10. Obesity prevalence and nutritional habits among Indian women: a comparison between Punjabi women living in India and Punjabi migrants in Vienna, Austria.

    PubMed

    Singh, Maryam; Kirchengast, Sylvia

    2011-01-01

    The current study aimed to determine the prevalence of obesity and overweight among Indian women living in Punjab, India and in Vienna, Austria. A series of 115 women ageing between 17 and 80 years (x = 38.7 yrs; +/- 14.5) was enrolled in the present study. 65 women lived in the district of Jalandhar in Punjab, 50 Punjabi women lived in as migrants in Vienna Austria. Data collection comprised an anthropometric analysis including stature height, body weight and the body mass index (BMI). For classification of the weight status the Indian BMI cutoffs defined by the WHO for Asian Indians were used. Data concerning dietary patterns and lifestyle parameters were collected by structured interviews using a standardized questionnaire. Among both subgroups overweight and obesity were highly prevalent. Underweight (18.5%) was significantly more prevalent in Punjab than in Vienna (6.0 %), while overweight and obesity were more frequently found among Punjabi women in Vienna (26.0%; 54.0%) than among Punjabi women in India (9.2%; 24.6 %). Analysing lifestyle and dietary patterns it turned out that energy dense meals were preferred and fat and sugar were used frequently among both subsamples. A statistically significant relationship between dietary habits and weight status could not be proved.

  11. 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.

  12. 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.

  13. 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) women (n = 9) had a significantly lower ALBMI and appendicular lean body mass than nonsarcopenic women (n = 127). In addition, class I sarcopenic women tended to have lower levels of insulin resistance (p = 0.070) and fasting glucose (p = 0.054). However, no difference between the groups was observed for quality of life. This study showed that, in our sample of class I sarcopenic overweight and obese postmenopausal women, subjects did not present an unfavourable metabolic or quality-of-life profile, compared with nonsarcopenic overweight and obese postmenopausal women.

  14. Serum lipids and risk of obesity-related cancers in postmenopausal women.

    PubMed

    Kabat, Geoffrey C; Kim, Mimi Y; Chlebowski, Rowan T; Vitolins, Mara Z; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

    2018-01-01

    Obesity, which is commonly accompanied by dyslipidemia, is associated with an increased risk of certain cancers. However, the association of serum lipids with specific obesity-related cancers is unclear. We examined the association of baseline lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides) with risk of developing seven obesity-related cancers in a subcohort of 24,208 participants in the Women's Health Initiative. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for quartiles of lipids with cancers of the breast, colorectum, pancreas, endometrium, ovary, and kidney, and multiple myeloma. Total cholesterol and LDL-C showed no association with these outcomes. HDL-C was inversely associated, and triglycerides were positively associated, with several cancers. However, after adjustment for other lipids or insulin, consideration of preclinical disease, and exclusion of women taking statins, most associations were attenuated and no longer significant. Only the inverse association of HDL-C with pancreatic cancer (HR for highest vs. lowest quartile 0.52, 95% CI 0.32-0.85, p for trend 0.007) and the positive association of triglycerides with kidney cancer (HR for highest vs. lowest quartile 3.21, 95% CI 1.63-6.33, p for trend = 0.0001) remained significant. However, the inverse association of HDL-C with pancreatic cancer was no longer significant when women who lost substantial weight before diagnosis were excluded. Our results suggest that when possible sources of confounding and bias are taken into account there are few robust associations of lipids with obesity-related cancers.

  15. Overweight and Obesity in Lesbian and Bisexual College Women

    ERIC Educational Resources Information Center

    Struble, Corrie Barnett; Lindley, Lisa L.; Montgomery, Kara; Hardin, James; Burcin, Michelle

    2010-01-01

    Objective: To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women. Methods: A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated…

  16. Cognitive function, iron status, and hemoglobin concentration in obese dieting women.

    PubMed

    Kretsch, M J; Fong, A K; Green, M W; Johnson, H L

    1998-07-01

    To determine the relationships between cognitive function and iron status in dieting obese women. Longitudinal weight loss study (repeated measures within-subject design) with 3 weeks of baseline, 15 weeks of 50% caloric restriction, and 3 weeks of weight stabilization. Dietary iron was fed at twice the US Recommended Dietary Allowance with half of the iron from food sources and half from an oral supplement. This was a free-living study with the exception that subjects came to the research center for one meal per day and were provided all other meals and snacks to take home. Healthy, premenopausal, obese women (mean BMI=31.5) were recruited through local newspaper, poster and radio advertising. Twenty-four women volunteers were recruited and 14 completed the study. Cognitive function, iron and hematological status, height, body weights and body composition were measured at baseline; at weeks 5, 10, and 15 of the energy restriction period; and at the end of weight stabilization. Computerized cognitive tests included: Bakan vigilance task, two finger tapping, simple reaction time, immediate word recall, and a focused attention task. Iron status and hematological measures included: serum iron, total iron binding capacity (TIBC), transferrin saturation, serum ferritin, hemoglobin (Hb), hematocrit, red cell count, MCV, MCH, MCHC, and RDW. A significant reduction in Hb, hematocrit, and red blood cell count occurred across the study. Hb at the end of the study was positively correlated (r=0.72, P < 0.01) with mean performance on a measure of sustained attention. Transferrin saturation also correlated positively to sustained attention task performance for those subjects whose Hb declined across the study (r=0.86, P < 0.01). These findings suggest that dieting diminishes iron status in obese women, even when sufficient dietary iron is available, and that the inability to sustain attention may be an early sign of developing iron deficiency in dieting women.

  17. Obesity, weight gain, and ovarian cancer risk in African American women.

    PubMed

    Bandera, Elisa V; Qin, Bo; Moorman, Patricia G; Alberg, Anthony J; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Schildkraut, Joellen M

    2016-08-01

    Although there is growing evidence that higher adiposity increases ovarian cancer risk, little is known about its impact in African American (AA) women, the racial/ethnic group with the highest prevalence of obesity. We evaluated the impact of body mass index (BMI) 1 year before diagnosis and weight gain since age 18 years on ovarian cancer risk in a population-based case-control study in AA women in 11 geographical areas in the US. Cases (n = 492) and age and site matched controls (n = 696) were identified through rapid case ascertainment and random-digit-dialing, respectively. Information was collected on demographic and lifestyle factors, including self-reported height, weight at age 18 and weight 1 year before diagnosis/interview. Multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential covariates. Obese women had elevated ovarian cancer risk, particularly for BMI ≥ 40 kg/m(2) compared to BMI <25 (OR = 1.72, 95% CI: 1.12-2.66; p for trend: 0.03). There was also a strong association with weight gain since age 18 (OR: 1.52; 95% CI: 1.07-2.16; p for trend: 0.02) comparing the highest to lowest quartile. In stratified analyses by menopausal status, the association with BMI and weight gain was limited to postmenopausal women, with a 15% (95% CI: 1.05-1.23) increase in risk per 5 kg/m(2) of BMI and 6% (95% CI: 1.01-1.10) increase in risk per 5 kg of weight gain. Excluding hormone therapy users essentially did not change results. Obesity and excessive adult weight gain may increase ovarian cancer risk in post-menopausal AA women. © 2016 UICC.

  18. Should obese women's access to assisted fertility treatment be limited? A scientific and ethical analysis.

    PubMed

    Tremellen, Kelton; Wilkinson, Dominic; Savulescu, Julian

    2017-10-01

    Obesity is associated with a reduction in fertility treatment success and increased risks to mother and child. Therefore guidelines of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) suggest that a body mass index exceeding 35 kg/m 2 should be an absolute contraindication to assisted fertility treatment such as in vitro fertilisation IVF. In this paper we challenge the ethical and scientific basis for such a ban. Livebirth rates for severely obese women are reduced by up to 30%, but this result is still far better than that observed for many older women who are allowed access to IVF. This prohibition is particularly unjust when IVF is the only treatment capable of producing a pregnancy, such as bilateral tubal blockage or severe male factor infertility. Furthermore, the absolute magnitude of risks to mother or child is relatively small, and while a woman has a right to be educated about these risks, she alone should be allowed to make a decision on proceeding with treatment. We do not prohibit adults from engaging in dangerous sports, nor do we force parents to vaccinate their children, despite the risks. Similarly, we should not prohibit obese women from becoming parents because of increased risk to themselves or their child. Finally, prohibiting obese women's access to IVF to prevent potential harms such as 'fetal programing' is questionable, especially when compared to that child never being born at all. As such, we believe the RANZCOG ban on severely obese women's access to assisted reproductive treatment is unwarranted and should be revised. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  19. 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.

  20. 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.

  1. 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.

  2. Effects of tailored message education about breast cancer risk appraisal for obese Korean women.

    PubMed

    Park, Somi; Chung, ChaeWeon; Cochrane, Barbara B

    2013-11-01

    To examine the effects of tailored message education about breast cancer risk in obese Korean women. Pretest/post-test with two comparison treatments. Rural community settings in South Korea. Non-random sample of 64 obese women. Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p < 0.05), self-efficacy for breast self-examination (BSE) (F = 5.16, p < 0.001), intent to perform BSE (F = 6.24, p < 0.05), intent to have mammography (F = 5.45, p < 0.05), and intent to prevent breast cancer with eating habits (F = 7.28, p < 0.05) and exercising (F = 12.51, p < 0.001). Individually tailored education effectively enhanced awareness of personal risk for breast cancer, self-efficacy for BSE, and intent to screen and prevent breast cancer. Tailored message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

  3. Increased circadian prolactin release is blunted after body weight loss in obese premenopausal women.

    PubMed

    Kok, Petra; Roelfsema, Ferdinand; Langendonk, Janneke G; de Wit, Caroline C; Frölich, Marijke; Burggraaf, Jacobus; Meinders, A Edo; Pijl, Hanno

    2006-02-01

    We recently showed that prolactin (PRL) release is considerably enhanced in obese women in proportion to the size of their visceral fat mass. PRL release is inhibited by dopamine 2 receptor (D2R) activation, and dietary restriction/weight loss are associated with increased dopaminergic signaling in animals. Therefore, we hypothesized that enhanced PRL release in obese humans would be reversed by weight loss. To evaluate this postulate, we measured 24-h plasma PRL concentrations at 10-min intervals in 11 obese premenopausal women (BMI 33.3 +/- 0.7 kg/m2) before and after weight loss (50% reduction of overweight/15% absolute weight loss, using a very low-calorie diet) in the follicular phase of their menstrual cycle. The 24-h PRL concentration profiles were analyzed by a peak detection program (Cluster) and a wave form-independent deconvolution technique (Pulse). Spontaneous 24-h PRL secretion was significantly reduced in obese women [mean daily release, before 128 +/- 24 vs. after weight loss 110 +/- 17 microg/liter distribution volume (Vdl)(-1) x 24 h, P = 0.05]. Body weight loss particularly blunted PRL secretory burst mass (Pulse area, before 230 +/- 28 vs. after weight loss 221 +/- 31 microg/Vdl(-1) x 24 h, P = 0.03), whereas burst frequency was unaffected (no. of pulses, before 11 +/- 1 vs. after weight loss 12 +/- 1 n/24 h, P = 0.69). Thus elevated PRL secretion rate in obese women is significantly reduced after loss of 50% of overweight. We speculate that amelioration of deficit D2R-mediated neurotransmission and/or diminutions of circulating leptin/estrogen levels might be involved in the physiology of this phenomenon.

  4. 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.

  5. Health services utilization of women following a traumatic birth.

    PubMed

    Turkstra, E; Creedy, D K; Fenwick, J; Buist, A; Scuffham, P A; Gamble, J

    2015-12-01

    This cohort study compared 262 women with high childbirth distress to 138 non-distressed women. At 12 months, high distress women had lower health-related quality of life compared to non-distressed women (EuroQol five-dimensional (EQ-5D) scale 0.90 vs. 0.93, p = 0.008), more visits to general practitioners (3.5 vs. 2.6, p = 0.002) and utilized more additional services (e.g. maternal health clinics), with no differences for infants. Childbirth distress has lasting adverse health effects for mothers and increases health-care utilization.

  6. Impact of maternal obesity on very preterm infants.

    PubMed

    Khalak, Rubia; Rijhsinghani, Asha; McCallum, Sarah E

    2017-05-01

    Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed. BMI categorization followed the National Institutes of Health BMI classification that subdivides obesity into three ascending BMI groups. Records were obtained on 1,224 women, of whom 31.6% were classified with obesity. Despite similar mean gestational age (31 to 31.6 weeks, P = 0.57) and birth weight (1,488 to 1,569 g, P = 0.51) of the infants in the BMI categories, delivery room (DR) resuscitation was more common for infants of women with level III obesity (63.2%, P = 0.04) with a trend toward the continued need for assisted ventilation (54.7%, P = 0.06). Preterm infants of women with level III obesity were more likely to require DR resuscitation with a trend to continued need for ventilatory support beyond 6 hours of age. This could impact utilization of DR resources at delivering hospitals. © 2017 The Obesity Society.

  7. 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

  8. Voluntary food intake during prolonged exercise in obese women.

    PubMed

    Woo, R; Garrow, J S; Pi-Sunyer, F X

    1982-09-01

    The effect of 57 days of moderate physical activity on the energy intake and balance of three obese women (187% of ideal weight) was investigated in a metabolic balance study. Food was offered in extra quantity, prepared in a palatable but simple fashion, and intake was covertly monitored. Expenditure was measured using the factorial method and indirect calorimetry done every 3 to 4 days. After a 5-day evaluation phase which no exercise was done, individual treadmill assignments were given to subjects to increase daily expenditure to 125% of sedentary levels. Mean dialy intake (1903 kcal/day) and expenditure (2882 kcal/day) did not change with time. As a result, negative energy balance was obtained and sustained. A consistent rate of weight loss (0.12 kg/day) at a reasonable cost (8200 kcal/kg)occurred. Therefore, obese women doing long-term moderate exercise do not compensate by an increase in caloric intake. This can produce a negative caloric balance when exercise is coupled with ad libitum selection of ordinary foods.

  9. Assessment of fat-free mass from bioelectrical impedance analysis in obese women with Prader-Willi syndrome.

    PubMed

    Bedogni, Giorgio; Grugni, Graziano; Tringali, Gabriella; Agosti, Fiorenza; Sartorio, Alessandro

    2015-01-01

    Fat-free mass (FFM) is lower in obese subjects with Prader-Willi syndrome (PWS) than in obese subjects without PWS. FFM prediction equations developed in non-PWS subjects may, thus, not work in PWS subjects. To test whether the estimation of FFM from bioelectrical impedance analysis (BIA) in PWS subjects requires population-specific equations. Using dual-energy X-ray absorptiometry, this study measured FFM in 27 PWS and 56 non-PWS obese women and evaluated its association with the impedance index at 50 kHz (ZI50), i.e. the ratio between squared height and whole-body impedance at 50 kHz. At the same level of ZI50, PWS women had a lower FFM than non-PWS women. However, when PWS-specific equations were used, FFM was accurately estimated at the population level. An equation employing a dummy variable coding for PWS status was able to explain 85% of the variance of FFM with a root mean squared error of 3.3 kg in the pooled sample (n = 83). Population-specific equations are needed to estimate FFM from BIA in obese PWS women.

  10. Childbearing, stress and obesity disparities in women: a public health perspective

    PubMed Central

    Davis, Esa M; Stange, Kurt C; Horwitz, Ralph I

    2011-01-01

    The perinatal period, from early in the first trimester to 1 year postpartum, provides opportunities for novel public health interventions to reduce obesity disparities. We present a unifying socio-biological framework to suggest opportunities for multidisciplinary research and public health approaches to elucidate and target the mechanisms for the development of maternal obesity and related disparities. The framework illustrates the interplay of the social, cultural and physical environment; stress appraisal and response; and coping behaviors on short-term outcomes (e.g. allostatic load and gestational weight gain), the intermediate outcomes of persistent insulin resistance and post-partum weight retention, and longer term outcomes of obesity and its disease consequences. Testing the proposed relationships may provide insights into how childbearing risk factors such as gestational weight gain, postpartum weight retention and parity contribute to obesity, which are needed to inform public health policies and clinical care guidelines aimed at reducing obesity and improving the health of women. PMID:21088987

  11. Comparing men and women with binge-eating disorder and co-morbid obesity.

    PubMed

    Lydecker, Janet A; Grilo, Carlos M

    2018-05-01

    This study examined differences in clinical presentation of men and women with binge-eating disorder (BED) who participated in treatment research at a medical-school based program. Participants were 682 adults (n = 182 men, n = 500 women) with DSM-IV-defined BED. Doctoral-level research clinicians assessed eating-disorder psychopathology, including BED diagnosis, using the Structured Clinical Interview for DSM-IV Disorders (SCID) and Eating Disorder Examination (EDE) interview. Research clinicians measured height and weight and participants completed a battery of established self-report measures. Men had significantly higher body mass index (BMI) than women; women had significantly higher eating-disorder psychopathology (EDE scales and global score) and depression than men. Differences in eating-disorder psychopathology and depression remained higher for women than men after adjusting for race/ethnicity and BMI. Frequency of binge-eating episodes, subjective binge-eating episodes, and overeating episodes did not differ significantly by sex. Women had younger ages of onset for dieting and binge-eating behaviors than men but ages of onset for obesity and BED did not significantly differ between men and women. There are some sex differences in clinical presentation and age-of-onset timeline of adults with BED. Men and women develop obesity and BED (at diagnostic threshold) around the same age but women begin dieting and binge-eating behaviors earlier than men. At presentation for treatment for BED, men and women did not differ in binge-eating frequency and although men and women differed significantly on BMI and eating-disorder psychopathology, the magnitude of these differences was quite modest. © 2018 Wiley Periodicals, Inc.

  12. 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.

  13. 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

  14. 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

  15. Being overweight or obese and risk of developing rheumatoid arthritis among women: a prospective cohort study

    PubMed Central

    Lu, Bing; Hiraki, Linda; Sparks, Jeffrey A.; Malspeis, Susan; Chen, Chia-Yen; Awosogba, J. Adebukola; Arkema, Elizabeth V.; Costenbader, Karen H.; Karlson, Elizabeth W.

    2014-01-01

    Objectives To examine the relationship between being overweight or obese and developing rheumatoid arthritis (RA) in two large prospective cohorts, the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII) Methods We followed 109,896 women enrolled in NHS and 108,727 in NHSII who provided lifestyle, environmental exposure and anthropometric information through biennial questionnaires. We assessed the association between time-varying and cumulative body mass index (BMI) in WHO categories of normal, overweight, and obese (18.5-< 25, 25.0-<30, ≥30.0 kg/m2) and incident RA meeting the 1987 ACR criteria. We estimated hazard ratios (HRs) for overall RA and serologic subtypes with Cox regression models adjusted for potential confounders. We repeated analyses restricted to RA diagnosed at age 55 years or younger. Results During 2,765,195 person-years of follow-up (1976–2008) in NHS and 1,934,518 person-years (1989–2009) in NHSII, we validated 1181 incident cases of RA (826 in NHS, 355 in NHSII). There was a trend toward increased risk of all RA among overweight and obese women [HR (95% CI): 1.37 (0.95, 1.98) and 1.37 (0.91, 2.09), p for trend=0.068]. Among RA cases diagnosed at age 55 years or younger, this association appeared stronger [HR 1.45(1.03, 2.03) for overweight and 1.65(1.34, 2.05) for obese women (p trend <0.001)]. Ten cumulative years of being obese, conferred a 37% increased risk of RA at younger ages [HR 1.37 (1.11, 1.69)]. Conclusions Risks of both seropositive and seronegative RA were elevated among overweight and obese women, particularly among women diagnosed with RA at earlier ages. PMID:25057178

  16. 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.

  17. Association of residential greenness with obesity and physical activity in a US cohort of women.

    PubMed

    Villeneuve, Paul J; Jerrett, Michael; Su, Jason G; Weichenthal, Scott; Sandler, Dale P

    2018-01-01

    There is evidence of several health benefits associated with neighborhood greenness, but reasons for this are unclear. Studies have found that those who live in greener neighborhoods are more physically active, and have lower rates of obesity. Relatively few studies have attempted to characterize associations between greenness and both obesity and physical activity concurrently, or among women who are at higher risk of developing cancer and for whom physical activity may be important for primary prevention. To address these gaps, we undertook a cross-sectional analysis of data from 50,884 women who enrolled in the Sister Study between 2003 and 2009. This cohort includes women aged 35-74 whose sister had been diagnosed with breast cancer. Residential measures of greenness were determined using the US National Land Cover database. Logistic regression was used to characterize associations between greenness, obesity, and physical activity. Adjustments were made for other possible confounders. Women who lived in areas with the highest tertile of greenness (based on a 500m buffer) had a reduced risk of obesity (body mass index (BMI) ≥ 30) relative to those in the lowest tertile (odds ratio (OR) = 0.83, 95% CI = 0.79-0.87). We also found that those the upper tertile of greenness were 17% more likely to expend more than 67.1 metabolic equivalent (MET) hours per week when compared to those in the lowest tertile (OR = 1.17, 95% CI = 1.10-1.23). Beneficial associations between greenness and both obesity and physical activity were observed in urban and rural areas, and regionally, stronger associations were observed in the western census region in the US. Mediation analyses indicated that physical activity attenuated the association between greenness and obesity by 32%. Our findings indicate that, amongst US adult women at higher risks of breast cancer, residential proximity to greenness may help mitigate against sedentary behaviors that increase the risk of chronic disease

  18. 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.

  19. Prevention of obesity and diabetes in childbearing women.

    PubMed

    Trout, Kimberly K; Ellis, Kathryn K; Bratschie, Alexandra

    2013-01-01

    Obesity and diabetes have become pandemic in the United States, with more than one-third of the US population obese and 8.3% of the population affected by diabetes. Efforts to prevent type 2 diabetes focus primarily on healthy eating and physical activity. In particular, women from at-risk racial and ethnic groups and those who have experienced gestational diabetes are at high risk for developing type 2 diabetes. Achieving a healthy weight prior to conception, staying within weight gain guidelines during pregnancy, and losing accumulated pregnancy weight postpartum are key prevention factors. Maintaining a healthy weight in the long-term is a challenge. Behavioral psychology and coaching techniques are presented in this article that can be useful in sustaining behaviors that promote a healthy weight. © 2013 by the American College of Nurse-Midwives.

  20. Effectiveness of an Internet Community for Severely Obese Women.

    PubMed

    Chomutare, Taridzo; Årsand, Eirik; Hartvigsen, Gunnar

    2016-01-01

    While Internet communities have become thriving sources of support, little is yet known about their effectiveness. We retrospectively sampled morbidly obese (Body Mass Index, BMI > 40) women who were active for at least a year in an Internet community. We compared self-reported weight changes between women who had high online participation levels (n = 71) versus those with low participation levels as control (n = 69). Women who actively participated online lost on average 7.52%, while those who were passive lost 5.39% of their original body weight. For active women, there was positive, albeit weak, correlation (r = 0.22, p < 0.05) between online participation levels and weight loss, while no significant correlation was noted for the control. Current results indicate modest evidence supporting active participation in Internet groups as an effective weight loss strategy for the target group.

  1. Fundamental frequency, phonation maximum time and vocal complaints in morbidly obese women

    PubMed Central

    de SOUZA, Lourdes Bernadete Rocha; PEREIRA, Rayane Medeiros; dos SANTOS, Marquiony Marques; GODOY, Cynthia Meida de Almeida

    2014-01-01

    Background Obese people have abnormal deposition of fat in the vocal tract that can interfere with the acoustic voice. Aim To relate the fundamental frequency, the maximum phonation time and voice complaints from a group of morbidly obese women. Methods Observational, cross-sectional and descriptive study that included 44 morbidly obese women, mean age of 42.45 (±10.31) years old, observational group and 30 women without obesity, control group, with 33.79 (±4.51)years old. The voice recording was done in a quiet environment, on a laptop using the program ANAGRAF acoustic analysis of speech sounds. To extract the values ​​of fundamental frequency the subjects were asked to produce vowel [a] at usual intensity for a period in average of three seconds. After the voice recording, participants were prompted to produce sustained vowel [ a] , [ i] and [ u] at usual intensity and height, using a stopwatch to measure the time that each participant could hold each vowel. Results The majority, 31(70.5%), had vocal complaints, with a higher percentage for complaints of vocal fatigue 20(64.51%) and voice failures 19(61.29%) followed by dryness of the throat in 15 (48.38%) and effort to speak 13(41.93%). There was no statistically significant difference regarding the mean fundamental frequency of the voice in both groups, but there was significance between the two groups regarding maximum phonation. Conclusion Increased adipose tissue in the vocal tract interfered in the vocal parameters. PMID:24676298

  2. The impact of morbid obesity on resource utilization after renal transplantation.

    PubMed

    Kim, Young; Chang, Alex L; Wima, Koffi; Ertel, Audrey E; Diwan, Tayyab S; Abbott, Daniel E; Shah, Shimul A

    2016-12-01

    A growing number of renal transplant recipients have a body mass index ≥40. While previous studies have shown that patient and graft survival are significantly decreased in renal transplant recipients with body mass indexes ≥40, less is known about perioperative outcomes and resource utilization in morbidly obese patients. We aimed to analyze the effects of morbid obesity on these parameters in renal transplant. Using a linkage between the Scientific Registry of Transplant Recipients and the databases of the University HealthSystem Consortium, we identified 29,728 adult renal transplant recipients and divided them into 2 cohorts based on body mass index (<40 vs ≥40 kg/m 2 ). The body mass index ≥40 group comprised 2.5% (n = 747) of renal transplant recipients studied. Body mass index ≥40 recipients incurred greater direct costs ($84,075 vs $79,580, P < .01), index admission costs ($91,169 vs $86,141, P < .01), readmission costs ($5,306 vs $4,596, P = .01), and combined costs ($99,590 vs $93,939, P < .001). Thirty-day readmission rates were also greater among body mass index ≥40 recipients (33.92% vs 26.9%, P < .01). Morbid obesity was not predictive of stay (odds ratio 1.01, P = .75). Morbidly obese renal transplant recipients incur greater costs and readmission rates compared with nonobese patients. Recognition of increased resource utilization should be accompanied by appropriate, risk-adjustment reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Lipoprotein lipase variants interact with polyunsaturated fatty acids for obesity traits in women: replication in two populations.

    PubMed

    Ma, Y; Tucker, K L; Smith, C E; Lee, Y C; Huang, T; Richardson, K; Parnell, L D; Lai, C Q; Young, K L; Justice, A E; Shao, Y; North, K E; Ordovás, J M

    2014-12-01

    Lipoprotein lipase (LPL) is a candidate gene for obesity based on its role in triglyceride hydrolysis and the partitioning of fatty acids towards storage or oxidation. Whether dietary fatty acids modify LPL associated obesity risk is unknown. We examined five single nucleotide polymorphisms (SNPs) (rs320, rs2083637, rs17411031, rs13702, rs2197089) for potential interaction with dietary fatty acids for obesity traits in 1171 participants (333 men and 838 women, aged 45-75 y) of the Boston Puerto Rican Health Study (BPRHS). In women, SNP rs320 interacted with dietary polyunsaturated fatty acids (PUFA) for body mass index (BMI) (P = 0.002) and waist circumference (WC) (P = 0.001) respectively. Higher intake of PUFA was associated with lower BMI and WC in homozygotes of the major allele (TT) (P = 0.01 and 0.005) but not in minor allele carriers (TG and GG). These interactions were replicated in an independent population, African American women of the Atherosclerosis Risk in Communities (ARIC) study (n = 1334). Dietary PUFA modulated the association of LPL rs320 with obesity traits in two independent populations. These interactions may be relevant to the dietary management of obesity, particularly in women. Copyright © 2014. Published by Elsevier B.V.

  4. Lipoprotein lipase variants interact with polyunsaturated fatty acids for obesity traits in women: Replication in two populations

    PubMed Central

    Ma, Y.; Tucker, K.L.; Smith, C.E.; Lee, Y.C.; Huang, T.; Richardson, K.; Parnell, L.D.; Lai, C.Q.; Young, K.L.; Justice, A.E.; Shao, Y.; North, K.E.; Ordovás, J.M.

    2015-01-01

    Background and aims Lipoprotein lipase (LPL) is a candidate gene for obesity based on its role in triglyceride hydrolysis and the partitioning of fatty acids towards storage or oxidation. Whether dietary fatty acids modify LPL associated obesity risk is unknown. Methods and results We examined five single nucleotide polymorphisms (SNPs) (rs320, rs2083637, rs17411031, rs13702, rs2197089) for potential interaction with dietary fatty acids for obesity traits in 1171 participants (333 men and 838 women, aged 45–75 y) of the Boston Puerto Rican Health Study (BPRHS). In women, SNP rs320 interacted with dietary polyunsaturated fatty acids (PUFA) for body mass index (BMI) (P = 0.002) and waist circumference (WC) (P = 0.001) respectively. Higher intake of PUFA was associated with lower BMI and WC in homozygotes of the major allele (TT) (P = 0.01 and 0.005) but not in minor allele carriers (TG and GG). These interactions were replicated in an independent population, African American women of the Atherosclerosis Risk in Communities (ARIC) study (n = 1334). Conclusion Dietary PUFA modulated the association of LPL rs320 with obesity traits in two independent populations. These interactions may be relevant to the dietary management of obesity, particularly in women. PMID:25156894

  5. The Obesity-Fertility Protocol: a randomized controlled trial assessing clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women.

    PubMed

    Duval, Karine; Langlois, Marie-France; Carranza-Mamane, Belina; Pesant, Marie-Hélène; Hivert, Marie-France; Poder, Thomas G; Lavoie, Hélène B; Ainmelk, Youssef; St-Cyr Tribble, Denise; Laredo, Sheila; Greenblatt, Ellen; Sagle, Margaret; Waddell, Guy; Belisle, Serge; Riverin, Daniel; Jean-Denis, Farrah; Belan, Matea; Baillargeon, Jean-Patrice

    2015-01-01

    Obesity in infertile women increases the costs of fertility treatments, reduces their effectiveness and increases significantly the risks of many complications of pregnancy and for the newborn. Studies suggest that even a modest loss of 5-10 % of body weight can restore ovulation. However, there are gaps in knowledge regarding the benefits and cost-effectiveness of a lifestyle modification program targeting obese infertile women and integrated into the fertility clinics. This study will evaluate clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women. We hypothesize that the intervention will: 1) improve fertility, efficacy of fertility treatments, and health of mothers and their children; and 2) reduce the cost per live birth, including costs of fertility treatments and pregnancy outcomes. Obese infertile women (age: 18-40 years; BMI ≥30 kg/m(2) or ≥27 kg/m(2) with polycystic ovary syndrome) will be randomised to either a lifestyle intervention followed by standard fertility treatments after 6 months if no conception has been achieved (intervention group) or standard fertility treatments only (control group). The intervention and/or follow-up will last for a maximum of 18 months or up to the end of pregnancy. Evaluation visits will be planned every 6 months where different outcome measures will be assessed. The primary outcome will be live-birth rates at 18 months. The secondary outcomes will be sub-divided into four categories: lifestyle and anthropometric, fertility, pregnancy complications, and neonatal outcomes. Outcomes and costs will be also compared to similar women seen in three fertility clinics across Canada. Qualitative data will also be collected from both professionals and obese infertile women. This study will generate new knowledge about the implementation, impacts and costs of a lifestyle management program in obese infertile women. This information

  6. Mindfulness-Based Stress Reduction in Women with Overweight or Obesity: A Randomized Clinical Trial.

    PubMed

    Raja-Khan, Nazia; Agito, Katrina; Shah, Julie; Stetter, Christy M; Gustafson, Theresa S; Socolow, Holly; Kunselman, Allen R; Reibel, Diane K; Legro, Richard S

    2017-08-01

    To evaluate the feasibility and cardiometabolic effects of mindfulness-based stress reduction (MBSR) in women with overweight or obesity. Eighty-six women with BMI ≥ 25 kg/m 2 were randomized to 8 weeks of MBSR or health education and followed for 16 weeks. The primary outcome was the Toronto Mindfulness Scale. Secondary outcomes included the Perceived Stress Scale-10, fasting glucose, and blood pressure. Compared to health education, the MBSR group demonstrated significantly improved mindfulness at 8 weeks (mean change from baseline, 4.5 vs. -1.0; P = 0.03) and significantly decreased perceived stress at 16 weeks (-3.6 vs. -1.3, P = 0.01). In the MBSR group, there were significant reductions in fasting glucose at 8 weeks (-8.9 mg/dL, P = 0.02) and at 16 weeks (-9.3 mg/dL, P = 0.02) compared to baseline. Fasting glucose did not significantly improve in the health education group. There were no significant changes in blood pressure, weight, or insulin resistance in the MBSR group. In women with overweight or obesity, MBSR significantly reduces stress and may have beneficial effects on glucose. Future studies demonstrating long-term cardiometabolic benefits of MBSR will be key for establishing MBSR as an effective tool in the management of obesity. © 2017 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

  7. Differential Efficacy of Nicotine Replacement Among Overweight and Obese Women Smokers.

    PubMed

    Strong, David R; David, Sean P; Johnstone, Elaine C; Aveyard, Paul; Murphy, Michael F; Munafò, Marcus R

    2015-07-01

    Rates of obesity are higher among more dependent smokers and 37%-65% of smokers seeking cessation treatment are overweight or obese. Overweight or obese smokers may possess metabolic and neurobiological features that contribute to difficulty achieving cessation using front-line nicotine replacement products. Attention to factors that facilitate effective cessation treatment in this vulnerable population is needed to significantly reduce mortality risk among overweight and obese smokers. This secondary analysis of 2 large trials of transdermal nicotine replacement in general medical practices evaluated the hypothesis that higher body mass index (BMI) would moderate the efficacy of the nicotine patch. We examined the potential for gender to further moderate the relationship between BMI and treatment efficacy. In the placebo controlled trial (N = 1,621), 21-mg patch was no more effective than placebo for assisting biochemically verified point prevalence abstinence up to 1 year after quitting for women with higher BMI, but appeared to be effective for men at normal or high BMI (gender × BMI beta = -0.22, p = .004). We did not find differential long-term cessation outcomes among male or female smokers in the 15-mg patch trial (n = 705). However, we observed significantly higher rates of early lapse among women with higher BMI treated with nicotine patch across both trials. These results suggest that increased BMI may affect the efficacy of nicotine patch on reducing risk of early lapse in women. Additional research is needed to explore mechanisms of risk for decreased efficacy of this commonly used cessation aid. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Frequency of TV viewing and prevalence of overweight and obesity among adult women in Bangladesh: a cross-sectional study.

    PubMed

    Ghose, Bishwajit

    2017-01-31

    Research in developed countries has demonstrated an association of varying degrees between watching TV and the risk of being overweight and obese. However, there is no evidence of such an association in the context of the South Asian population. To investigate whether watching TV increases the risk of being overweight and obese among women in Bangladesh. Rural and urban areas in Bangladesh. Participants were 16 624 non-pregnant women aged between 15 and 49 years. The study was based on cross-sectional data from the Bangladesh Demographic and Health Survey (BDHS) conducted in 2014. The main outcome variables were overweight and obesity measured by body mass index. Data were analysed by using descriptive statistics, cross-tabulation and multivariable logistic regression models. The prevalence of overweight and obesity in the sample population were, respectively, 4.5% (4.18% to 4.82%) and 20% (95% CI 19.39% to 20.61%). In the multivariable analysis, no statistically significant association was found between watching TV and being overweight. However, the odds of being obese among rural women were 63% higher (adjusted OR (AOR) 1.625, 95% CI 1.179 to 2.241) among those who watched less than once a week, and 68% (AOR 1.683, 95% CI 1.029 to 2.751) higher among women who watched TV at least once a week compared to those who did not watch TV at all. Urban women who watched TV at least once a week were 67% more likely to be obese (AOR 1.665, 95% CI 1.079 to 2.568) compared to those who did not watch at all. Prevalence of overweight and obesity has risen considerably among women aged between 15 and 49 years since the previous estimates based on BDHS data. Frequent TV watching was associated with a higher risk of being obese among adult women in rural areas. 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/.

  9. Reproductive health, obesity, and cardiometabolic risk factors among Samoan women.

    PubMed

    Maredia, H; Hawley, N L; Lambert-Messerlian, G; Fidow, U; Reupena, M S; Naseri, T; McGarvey, S T

    2018-04-16

    Obesity leads to deleterious effects on not only cardiovascular health but also on the reproductive health of women. We estimate the prevalence of menstrual irregularity and of polycystic ovarian syndrome (PCOS) in Samoan women, among whom obesity prevalence is extremely high. We explore the association of these reproductive health conditions with adiposity, cardiometabolic risk factors, and androgen levels. A cross-sectional sample of Samoan women 25-39 years of age (n = 470) from a larger population-based genome-wide association study of adiposity and cardiometabolic disease was assessed for the prevalence of oligomenorrhea/amenorrhea (OM/AM) using a self-reported questionnaire. Serum androgens and anti-Müllerian hormone levels were assayed to determine hyperandrogenemia and presence of polycystic ovaries (PCO), respectively, using criterion values. PCOS was classified using NIH guidelines of having at least two of the three conditions: menstrual irregularity, hyperandrogenism, and PCO. We contrasted socio-demographic, reproductive health, and cardiometabolic risk factors between those with and without OM/AM and similarly for PCOS. The prevalence of OM/AM was 7.4% (95% CI: 5.1, 9.8), and women with OM/AM had significantly higher central adiposity. PCOS was estimated at 6.8% (95% CI: 4.5, 9.1), and those with PCOS were younger but had higher overall and central adiposity measures, higher triglycerides, and higher prevalence of insulin resistance than women without PCOS. The prevalence of menstrual irregularity and PCOS are less than hypothesized given the high levels of adiposity in this population. Nevertheless, Samoan women with menstrual irregularity and other features of PCOS have significantly poorer metabolic health. © 2018 Wiley Periodicals, Inc.

  10. Recruitment of obese black women into a physical activity and nutrition intervention trial.

    PubMed

    Sharp, Lisa K; Fitzgibbon, Marian L; Schiffer, Linda

    2008-11-01

    Despite the increased health risks for obese Black women, relatively little research has explored physical activity and nutrition interventions for these women. This article describes the recruitment strategies used in a program designed specifically for obese Black women. Recruitment of Black women age 30 to 65 years with body mass indices between 30 kg/m2and 50 kg/m2was completed using in-person recruitment and flyers within 2 miles of the intervention site along with mass e-mails within the sponsoring university system. Medical clearance from a physician was an eligibility requirement because of Institutional Review Board safety concerns. Of the 690 women who were screened, 213 (31%) were eligible and randomized. The most common reason for exclusion was failure to return a medical clearance form (n = 167, 39% of ineligible). Different rates of efficiency were noted across recruitment approaches. Black women were successfully recruited using in-person community recruitment, e-mail, and community flyers within close proximity to the intervention site. Careful consideration should be given to the advantages and disadvantages of various recruitment strategies that might not generalize across studies.

  11. Green tea consumption, abdominal obesity as related factors of lacunar infarction in Korean women.

    PubMed

    Ko, S-G; Go, H; Sun, S; Lee, S; Park, W; Choi, Y; Song, Y; Hwang, G; Kim, G; Jeon, C; Park, J; Lee, K; Cha, M; Bang, O; Jung, H; Kim, N; Shin, Y-C

    2011-08-01

    Our purpose was to evaluate interaction of green tea consumption and abdominal obesity as related factors for lacunar infarction in Korean women. A hospital-based, incident case-control study. The Prevention and Managements of Stroke in Women study. Cases (n=233) of first incident lacunar infarction were enrolled and matched by age to stroke-free hospital controls (n=204). The data were collected through face-to-face interviews by well trained research assistants to assess demographic, medical, lifestyle, marital status, religions status, green tea consumptions, family history of stroke, smoking status, alcohol consumption, meat and vegetable intake frequency, and past history of hypertension. Biochemical analysis, fasting blood specimens for lipid, glucose, and cholesterol level were acquired. Compared with the non green tea consumer and obese women group, only the green tea consumption and non obese women group had a protective effect of lacunar infarction when adjusted for age, and age plus diet factors (OR, 0.23; 95% CI, 0.09, 0.59; OR, 0.21; 95% CI, 0.08, 0.56 respectively), but lost their significance after adjustment for age, diet factors, vascular risk factors and full model included atherogenic index factors (OR, 0.32; 95% CI, 0.09 to 1.01; OR, 0.49; 95% CI, 0.12, 1.89 respectively). The interaction of green tea consumption and non obesity have reduced risk of lacunar infarction, but not after adjustment for age, diet factors, vascular risk factors and atherogenic index. Also individually green tea consumption and abdominal obesity have failed to find an independent relationship with lacunar infarction after adjustment by all risk factors. Green tea consumption and green tea consumption with non obese group seemed to have a protective effect for lacunar infarction. In the results of our study, these results still remain controversial, and then we need further and larger study to get at the root of real causal effect of both relationships.

  12. 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

  13. Perceived Environmental Factors Associated with Obesity in Libyan Men and Women

    PubMed Central

    Papadopoulos, Chris

    2018-01-01

    Background: There is a lack of research pertaining to the links between built environment attributes and obesity in adults in the Eastern Mediterranean Region. In the Libyan context, no previous studies have been conducted to investigate this relationship. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and obesity among Libyan men and women. The prevalence of overweight and obesity was also assessed. Methods: A cross-sectional study design was used for the population-based survey in Benghazi, Libya. A multi-stage cluster sampling technique was used to select Libyan adults from the Benghazi electoral register. The Physical Activity Neighbourhood Environment Scale (PANES) was used to measure participants’ perception of neighbourhood environmental factors. Using the Tanita BC-601 Segmental Body Composition Monitor and a portable stadiometer, anthropometric measurements were taken at a mutually agreeable place by qualified nurses. Results: Four hundred and one Libyan adults were recruited (78% response rate). Participants were aged 20–65 years, 63% were female, and all had lived in Benghazi for over 10 years. The prevalence of obesity and overweight was 42.4% and 32.9% respectively. A significant association was found between BMI and 6 neighbourhood environment attributes, specifically: street connectivity, unsafe environment and committing crimes at night, and neighbourhood aesthetics. For men only, these were: access to public transport, access to recreational facilities, and unsafe environment and committing crimes during the day. The attribute ‘residential density zones’ was only significant for women. Conclusions: The study suggests that Libyan people are at risk of living in neighbourhoods with unsupportive environmental features of physical activity, which are likely to promote obesity of both genders. The findings of this study could inform Libyan health policies about

  14. Association between periconceptional weight loss and maternal and neonatal outcomes in obese infertile women.

    PubMed

    van Oers, Anne M; Mutsaerts, Meike A Q; Burggraaff, Jan M; Kuchenbecker, Walter K H; Perquin, Denise A M; Koks, Carolien A M; van Golde, Ron; Kaaijk, Eugenie M; Broekmans, Frank J; de Bruin, Jan Peter; van der Veen, Fulco; Nap, Annemiek W; Gondrie, Ed T C M; Mol, Ben W J; Groen, Henk; Hoek, Annemieke

    2018-01-01

    Obesity in women of reproductive age has deleterious effects on reproductive and offspring health. In this study, we aimed to evaluate the association between the magnitude of periconceptional body-mass index (BMI) change and maternal and neonatal outcomes in obese infertile women who participated in the LIFEstyle study. The LIFEstyle study was a randomized controlled trial, evaluating if a six-month lifestyle intervention program prior to infertility treatment in obese infertile women improved birth rates, compared to prompt infertility treatment. This is an exploratory post hoc analysis of the LIFEstyle study. We recorded periconceptional BMI change in women with an ongoing pregnancy, pooling data of all women, regardless of randomization arm. Periconceptional BMI change was calculated using weight at randomization and the periconceptional weight (measured in kilograms 12 weeks before or after conception and expressed as BMI change in units BMI (kg/m2)). Subsequently, women were categorized into quartiles according to the magnitude of their periconceptional change in BMI. The odds of maternal and neonatal outcomes were calculated using logistic regression analysis, comparing women in each of the first three weight change quartiles separately, and combined, to women in the fourth quartile. The fourth quartile was chosen as reference group, since these women had the least weight loss. We adjusted for periconceptional BMI, nulliparity and smoking status. In addition, we performed a subgroup analysis for singleton pregnancies. In the LIFEstyle study, 321 obese infertile women achieved an ongoing pregnancy which was conceived within 24 months after randomization. Periconceptional BMI change was available in 244 of these women (76%). Median BMI at randomization was 35.9 kg/m2. Women in the first quartile (Q1) had a periconceptional BMI change of <-2.1 kg/m2, women in the second quartile (Q2) -2.1 to -0.9 kg/m2, women in the third quartile (Q3) -0.9 to 0.1 kg/m2 and

  15. Low estrogen levels and obesity are associated with shorter telomere lengths in pre- and postmenopausal women.

    PubMed

    Shin, Yun-A; Lee, Kyoung-Young

    2016-06-01

    The aim of this study was to determine whether there is an association between leukocyte telomere length (LTL), and estrogen level, oxidative stress, cardiovascular disease (CVD) risk factors, and cardiorespiratory fitness (CRF) in pre- and postmenopausal obese women. Fifty-four obese women (premenopausal, n=25; postmenopausal, n=29) were selected to participate in this study. The outcome measurements in the pre- and postmenopausal groups were compared using independent t-tests and Pearson correlation analysis. The estrogen level (P<0.001), LTL (P<0.05), high-density lipoprotein level (P<0.05), and CRF (P<0.001) were higher in premenopausal women than in postmenopausal women. The body fat percentage (P<0.05) and triglyceride concentration (P<0.05) were lower in premenopausal women than in postmenopausal women. There were no significant associations between LTL, CVD risk, CRF, and oxidative stress and antioxidant enzyme activity in pre-menopausal women. The body mass index (BMI) and body fat percent-age in postmenopausal women were negatively associated with LTL (P<0.05). When all women were considered (i.e., both pre- and post-menopause), the BMI, percentage of fat, and waist circumference had a negative association with LTL (P<0.05), and estrogen levels were positively associated with LTL (P<0.05). Decreased estrogen levels after menopause, a pivotal factor in the biology of aging, and obesity were more associated with shorter telomere lengths in pre- and postmenopausal women than aerobic capacity and other CVD risk factors.

  16. 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.

  17. [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.

  18. 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

  19. Diet composition and physical activity in overweight and obese premenopausal women with or without polycystic ovary syndrome.

    PubMed

    Álvarez-Blasco, Francisco; Luque-Ramírez, Manuel; Escobar-Morreale, Héctor F

    2011-12-01

    The polycystic ovary syndrome (PCOS) is a complex polygenic disorder in which environmental factors play an important modifying role. We aimed to find differences in diet and life-style that might contribute to the development of PCOS among overweight or obese premenopausal women. We compared diet composition and self-reported physical activity among 22 patients with PCOS and 59 women without androgen excess recruited from a total of 113 consecutive premenopausal women reporting for management of weight excess. After correcting for a difference in age between women with PCOS and controls, there were no overall statistical significant differences between them in the total caloric intake, in the intake of macro- and micro-nutrients, caffeine, fiber and alcohol, in the proportion of women exercising regularly, or in the number of hours of exercise per week. The proportion of fat in the diets of the overweight and obese women irrespective of PCOS was well-above current recommendations, yet this excessive fat intake occurred at the expense of monounsaturated fatty acids mostly. In conclusion, diet composition and physical activity were apparently not decisive for the development of PCOS among overweight and obese premenopausal women.

  20. Women's autonomy and maternal healthcare service utilization in Ethiopia.

    PubMed

    Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Chuang, Ying-Chih

    2017-11-13

    Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women's autonomy. We assessed whether women's autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women's decision-making power and permissive gender norms associated with wife beating. We used Spearman's correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women's autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Our study shows that women's autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution.

  1. Household food insecurity and excess weight/obesity among Brazilian women and children: a life-course approach.

    PubMed

    Schlüssel, Michael Maia; Silva, Antonio Augusto Moura da; Pérez-Escamilla, Rafael; Kac, Gilberto

    2013-02-01

    Household food insecurity (HFI) may increase obesity risk, but results are not consistent across the life course or between developed/underdeveloped settings. The objective of this paper is to review findings from previous analyses in Brazil among adult women, female adolescents, and children up to five. Data were derived from the 2006 Brazilian Demographic and Health Survey. Associations between HFI (measured with the Brazilian Food Insecurity Scale) and excess weight/obesity were investigated through Poisson regression models. While severe HFI was associated with obesity risk among adult women (PR: 1.49; 95%CI: 1.17-1.90), moderate HFI was associated with excess weight among female adolescents (PR: 1.96; 95%CI: 1.18-3.27). There was no association between HFI and obesity among children (either boys or girls). The nutrition transition in Brazil may be shaping the differential deleterious effect of HFI on body fat accumulation across the life course; the association is already evident among female adolescents and adult women but still not among children.

  2. Factors associated with being underweight, overweight and obese among ever-married non-pregnant urban women in Bangladesh.

    PubMed

    Khan, M M H; Kraemer, A

    2009-08-01

    Extremes of body mass index (BMI), viz. underweight, overweight and obese categories, are associated with a variety of adverse health outcomes such as diabetes mellitus, cardiovascular diseases, low birth weight, poor quality of life and higher mortality. In Bangladesh, the prevalence of underweightness is very high with an increasing trend of overweightness and obesity. This is a serious public health concern as it indicates a dual burden of disease. The present study assessed the associations of being underweight, overweight and obese with socioeconomic, demographical and migration variables among ever-married non-pregnant urban Bangladeshi women aged 13-49 years. The data was extracted from the Bangladesh Demographic and Health Survey 2004. Bivariable, factor and multinomial logistic regression analyses were performed in this study. The prevalence of being underweight, overweight and obese among ever-married non-pregnant urban women in Bangladesh was 25.2 percent, 15.7 percent and 3.9 percent, respectively. Age, education, region of residence, marital status, current use of contraception and type of occupation were significantly associated with BMI categories. Adjusted multinomial logistic regression analysis indicated that women with a high socioeconomic status were significantly negatively associated with being underweight (odds ratio [OR] 0.55, 95 percent confidence interval [CI] 0.48-0.63) but positively associated with being overweight (OR 1.70, 95 percent CI 1.48-1.96) and obese (OR 2.48, 95 percent CI 1.89-3.26), as compared to the women with normal BMI. In contrast, women who migrated from rural to urban areas showed a significantly positive association with being underweight (OR 1.15, 95 percent CI 1.04-1.27) but negative associations with being overweight (OR 0.80, 95 percent CI 0.71-0.89) and obese (OR 0.75, 95 percent CI 0.62-0.92), when compared with women who did not migrate. Suitable interventions based on further studies are needed to reduce the

  3. Serum levels of leptin and adiponectin and clinical parameters in women with fibromyalgia and overweight/obesity.

    PubMed

    Paiva, Eduardo S; Andretta, Aline; Batista, Emmanuelle Dias; Lobo, Márcia Maria Marques Teles; Miranda, Renata Costa de; Nisihara, Renato; Schieferdecker, Maria Eliana Madalozzo; Boguszewski, César L

    2017-01-01

    The objectives of this study were to evaluate the serum levels of adipokines in women with fibromyalgia with and without overweight/obesity, and to correlate the adipokines levels with clinical parameters associated with fibromyalgia and adipose tissue mass (body fat). The study included 100 women divided into four groups: (a) fibromyalgia and overweight/obesity; (b) fibromyalgia and normal weight; (c) controls and overweight/obesity; and (d) controls and normal weight. Patients and controls were evaluated for clinical, anthropometric, and fibromyalgia-related parameters. Assessments included serum levels of leptin, adiponectin, monocyte chemoattractant protein-1 (MCP-1), and C-reactive protein (CRP). Levels of adipokines were further adjusted for fat mass. Fibromyalgia patients with overweight/obesity or normal weight had no differences in clinical parameters. Unadjusted leptin levels were lower in fibromyalgia patients than controls, a finding that was more remarkable in fibromyalgia patients with overweight/obesity. Leptin levels had no correlation with clinical parameters of fibromyalgia or inflammation markers (MCP-1 and CRP), and adiponectin levels showed no difference between groups. No correlation was observed between adjusted leptin levels and clinical parameters of fibromyalgia. Patients with fibromyalgia and overweight/obesity presented lower levels of leptin than controls with overweight/obesity.

  4. Stress inhibits PYY secretion in obese and normal weight women.

    PubMed

    Kiessl, Gundula R R; Laessle, Reinhold G

    2016-06-01

    The impact of stress on circulating levels of appetite-regulating hormones remains largely unknown. The aim of this study was to analyze the effect of acute psychosocial stress on the gut hormone peptide YY (PYY) secretion in obese and normal weight women. Therefore, we compared pre- and post-prandial plasma PYY secretion of 42 obese and 43 normal weight women in a repeated measure randomized controlled laboratory experiment. PYY and cortisol concentrations were measured and ratings of stress and satiety were also recorded in response to a psychological stressor (Trier Social Stress Test, TSST). PYY samples were collected in the fasting state both before participating in the TSST and before a control session. Participants had a standardized meal after the TSST and control session, respectively. PYY was measured both 30 and 60 min after the TSST and control session, respectively. Stress inhibited PYY secretion as well as food intake in all women, but did not influence subjective satiety perception. The present data indicate that despite of lower PYY levels the subjects' requirement to overeat was not increased. From an evolutionary perspective this finding is adaptive. After stress the organism is prepared for fight or flight reaction, whereas not primarily necessary functions are inhibited. Therefore, increased food intake during stress would be dysfunctional.

  5. '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

  6. Plasma galanin concentrations in obese, normal weight and anorectic women.

    PubMed

    Invitti, C; Brunani, A; Pasqualinotto, L; Dubini, A; Bendinelli, P; Maroni, P; Cavagnini, F

    1995-05-01

    Galanin is believed to play a role in the control of eating behavior. No information is available on its concentrations in the biological fluids in human obesity, and this study aimed to clarify this. We measured plasma galanin and serum insulin levels in 30 obese, 35 normal weight and 11 anorectic women. Mean galanin values were quite similar in obese and control subjects (76.8 +/- 3.20 vs 76.1 +/- 2.33 pg/ml) and only slightly reduced in anorectic patients (67.9 +/- 2.30 pg/ml). Insulin levels were significantly increased and decreased in obese and anorectic patients, respectively, compared to controls. Insulin correlated positively with BMI in the whole group of subjects studied (r = 0.72, P < 0.0001) and in the obese subgroup (r = 0.56, P < 0.02). No correlations could be detected between WH ratio, insulin and galanin concentrations and between galanin and BMI. In conclusion, plasma galanin concentrations appear to be comparable in obese, normal weight and anorectic subjects. This does not exclude a role of galanin in the regulation of eating behavior since variations of the peptide in discrete brain areas may not be detectable in general circulation and peripheral sources of the peptide may contribute to its plasma levels. Also, our data suggest that galanin does not play a major role in the regulation of insulin secretion in humans.

  7. Ethnicity and the association between anthropometric indices of obesity and cardiovascular risk in women: a cross-sectional study

    PubMed Central

    Goh, Louise G H; Dhaliwal, Satvinder S; Welborn, Timothy A; Lee, Andy H; Della, Phillip R

    2014-01-01

    Objectives The objectives of this study were to determine whether the cross-sectional associations between anthropometric obesity measures, body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR), and calculated 10-year cardiovascular disease (CVD) risk using the Framingham and general CVD risk score models, are the same for women of Australian, UK and Ireland, North European, South European and Asian descent. This study would investigate which anthropometric obesity measure is most predictive at identifying women at increased CVD risk in each ethnic group. Design Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. Setting Population-based survey in Australia. Participants 4354 women aged 20–69 years with no history of heart disease, diabetes or stroke. Most participants were of Australian, UK and Ireland, North European, South European or Asian descent (97%). Outcome measures Anthropometric obesity measures that demonstrated stronger predictive ability of identifying women at increased CVD risk and likelihood of being above the promulgated treatment thresholds of various risk score models. Results Central obesity measures, WC and WHR, were better predictors of cardiovascular risk. WHR reported a stronger predictive ability than WC and BMI in Caucasian women. In Northern European women, BMI was a better indicator of risk using the general CVD (10% threshold) and Framingham (20% threshold) risk score models. WC was the most predictive of cardiovascular risk among Asian women. Conclusions Ethnicity should be incorporated into CVD assessment. The same anthropometric obesity measure cannot be used across all ethnic groups. Ethnic-specific CVD prevention and treatment strategies need to be further developed. PMID:24852299

  8. 4G/5G polymorphism modulates PAI-1 circulating levels in obese women.

    PubMed

    Fernandes, Karla S; Sandrim, Valéria C

    2012-05-01

    The increase in plasminogen activator inhibitor type 1 (PAI-1) has been described as a risk factor to thrombosis-related diseases. In addition, it has been demonstrated that the variant 4G of polymorphism 4G/5G located in promoter region of PAI-1 gene is associated with higher PAI-1 levels. We investigate the role of this polymorphism on circulating PAI-1 concentration in a population of 57 obese women (23%, 4G/4G; 49%, 4G/5G and 28%, 5G/5G genotypes). Our results demonstrate a genotype-specific modulation on PAI-1 levels in obese women, thus 5G/5G genotype presented significantly lower levels of plasma PAI-1 when compared to 4G/4G group (46 ± 19 ng/mL vs. 63 ± 13 ng/mL, respectively). Our findings indicate that obese carriers of 4G/4G genotype may have increased risk to develop thrombotic diseases.

  9. Term elective induction of labour and perinatal outcomes in obese women: retrospective cohort study.

    PubMed

    Lee, V R; Darney, B G; Snowden, J M; Main, E K; Gilbert, W; Chung, J; Caughey, A B

    2016-01-01

    To compare perinatal outcomes between elective induction of labour (eIOL) and expectant management in obese women. Retrospective cohort study. Deliveries in California in 2007. Term, singleton, vertex, nonanomalous deliveries among obese women (n = 74 725). Women who underwent eIOL at 37 weeks were compared with women who were expectantly managed at that gestational age. Similar comparisons were made at 38, 39, and 40 weeks. Results were stratified by parity. Chi-square tests and multivariable logistic regression were used for statistical comparison. Method of delivery, severe perineal lacerations, postpartum haemorrhage, chorioamnionitis, macrosomia, shoulder dystocia, brachial plexus injury, respiratory distress syndrome. The odds of caesarean delivery were lower among nulliparous women with eIOL at 37 weeks [odds ratio (OR) 0.55, 95% confidence interval (CI) 0.34-0.90] and 39 weeks (OR 0.77, 95% CI 0.63-0.95) compared to expectant management. Among multiparous women with a prior vaginal delivery, eIOL at 37 (OR 0.39, 95% CI 0.24-0.64), 38 (OR 0.65, 95% CI 0.51-0.82), and 39 weeks (OR 0.67, 95% CI 0.56-0.81) was associated with lower odds of caesarean. Additionally, eIOL at 38, 39, and 40 weeks was associated with lower odds of macrosomia. There were no differences in the odds of operative vaginal delivery, lacerations, brachial plexus injury or respiratory distress syndrome. In obese women, term eIOL may decrease the risk of caesarean delivery, particularly in multiparas, without increasing the risks of other adverse outcomes when compared with expectant management. © 2015 Royal College of Obstetricians and Gynaecologists.

  10. 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

  11. Quality of life in overweight (obese) and normal-weight women with polycystic ovary syndrome

    PubMed Central

    Panico, Annalisa; Messina, Giovanni; Lupoli, Gelsy Arianna; Lupoli, Roberta; Cacciapuoti, Marianna; Moscatelli, Fiorenzo; Esposito, Teresa; Villano, Ines; Valenzano, Anna; Monda, Vincenzo; Messina, Antonietta; Precenzano, Francesco; Cibelli, Giuseppe; Monda, Marcellino; Lupoli, Giovanni

    2017-01-01

    Objective Polycystic ovary syndrome (PCOS) is characterized by phenotypic heterogeneity and has a wide variety of consequences. Approximately half of women with PCOS are overweight or obese, and their obesity may be a contributing factor to PCOS pathogenesis through different mechanisms. The aim of this study was to evaluate if PCOS alone affects the patients’ quality of life and to what extent obesity contributes to worsen this disease. Design To evaluate the impact of PCOS on health-related quality-of-life (HRQoL), 100 Mediterranean women with PCOS (group A), 50 with a body mass index (BMI) >25 kg/m2 (group A1) and 50 with BMI <25 kg/m2 (group A2), were recruited. They were evaluated with a specific combination of standardized psychometric questionnaires: the Symptom Checklist-90 Revised, the 36-Item Short-Form Health Survey, and the Polycystic Ovary Syndrome Questionnaire. The patients were compared with a normal-weight healthy control group of 40 subjects (group B). Another control group of 40 obese healthy women (group C) was used to make a comparison with PCOS obese patients (A1). Results Our results showed a considerable worsening of HRQoL in PCOS patients (A) compared with controls (B). In addition, patients with PCOS and BMI >25 (A1) showed a significant and more marked reduction in scores, suggesting a lower quality of life, compared with controls (B) and with normal-weight PCOS patients (A2). Conclusion PCOS is a complex disease that alone determines a deterioration of HRQoL. The innovative use of these psychometric questionnaires in this study, in particular the PCOS questionnaire, has highlighted that obesity has a negative effect on HRQoL. It follows that a weight decrease is associated to phenotypic spectrum improvement and relative decrement in psychological distress. PMID:28280314

  12. Utilization of maternal health-care services by tribal women in Kerala.

    PubMed

    Jose, Jinu Annie; Sarkar, Sonali; Kumar, S Ganesh; Kar, Sitanshu Sekhar

    2014-01-01

    The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services.

  13. Utilization of maternal health-care services by tribal women in Kerala

    PubMed Central

    Jose, Jinu Annie; Sarkar, Sonali; Kumar, S. Ganesh; Kar, Sitanshu Sekhar

    2014-01-01

    Background: The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. Aim: This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. Settings and Design: This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Materials and Methods: Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Statistical Analysis Used: Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. Results: The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Conclusions: Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services. PMID:24678214

  14. Aerobic exercise and weight loss reduce vascular markers of inflammation and improve insulin sensitivity in obese women.

    PubMed

    Ryan, Alice S; Ge, Shealinna; Blumenthal, Jacob B; Serra, Monica C; Prior, Steven J; Goldberg, Andrew P

    2014-04-01

    To examine the relationships between plasma and tissue markers of systemic and vascular inflammation and obesity and insulin resistance and determine the effects of aerobic exercise training plus weight loss (AEX+WL) and weight loss (WL) alone on these biomarkers. Prospective controlled study. Veterans Affairs Medical Center and University research setting. Overweight and obese sedentary postmenopausal women (N = 77). Six months, 3 d/wk AEX+WL (n = 37) or WL (n = 40). Total-body dual-energy X-ray absorptiometry, abdominal computed tomography, hyperinsulinemic-euglycemic clamps (a criterion standard method of assessing insulin sensitivity), adipose tissue biopsies (n = 28), and blood for homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Body weight (P < .001), percentage of fat (P < .001), visceral fat (P < .005), triglyceride levels (P < .001), and systolic blood pressure decreased comparably after WL and AEX+WL (P = .04). Maximal oxygen consumption increased 16% after AEX+WL (P < .001). Insulin resistance decreased in both groups (P = .005). Glucose utilization according to the clamp increased 10% (P = .04) with AEX+WL and 8% with WL (P = .07). AEX+WL decreased CRP by 29% (P < .001) and WL by 21% (P = .02). SAA levels decreased twice as much after AEX+WL (-19%, P = .02) as after WL (-9%, P = .08). Plasma sICAM-1 and sVCAM-1 levels did not change, but women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose (P = .02), insulin (P = .02), and insulin resistance (P = .004). Gluteal ICAM messenger ribonucleic acid levels decreased 27% after AEX+WL (P = .02) and did not change after WL. Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP, SAA, and

  15. The Expansion of the Pulmonary Rib Cage during Breath Stacking Is Influenced by Age in Obese Women

    PubMed Central

    Barcelar, Jacqueline de Melo; Aliverti, Andrea; Rattes, Catarina; Ximenes, Maria Eduarda; Campos, Shirley Lima; Brandão, Daniella Cunha; Fregonezi, Guilherme; de Andrade, Armèle Dornelas

    2014-01-01

    Objective To analyze in obese women the acute effects of the breath stacking technique on thoraco-abdominal expansion. Design and Methods Nineteen obese women (BMI≥30 kg/m2) were evaluated by anthropometry, spirometry and maximal respiratory muscle pressures and successively analyzed by Opto-Electronic Plethysmography and a Wright respirometer during quiet breathing and breath stacking maneuvers and compared with a group of 15 normal-weighted healthy women. The acute effects of the maneuvers were assessed in terms of total and compartmental chest wall volumes at baseline, end of the breath stacking maneuver and after the maneuver. Obese subjects were successively classified into two groups, accordingly to the response during the maneuver, group 1 = prevalent rib cage or group 2 = abdominal expansion. Results Age was significantly lower in group 1 than group 2. When considering the two obese groups, FEV1 was lower and minute ventilation was higher only in group 2 compared to controls group. During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2. A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen. Conclusions In obese women the maximal expansion of the rib cage and abdomen is influenced by age and breath stacking maneuver could be a possible therapy for preventing respiratory complications. PMID:25372469

  16. Weight Cycling, Psychological Health and Binge Eating in Obese Women.

    ERIC Educational Resources Information Center

    Venditti, Elizabeth M.; And Others

    1996-01-01

    Examined the relationship between weight cycling and psychological health in 120 obese women. Weight cycling was defined in two ways by retrospective self-report: total lifetime weight loss and total number of weight cycles greater than or equal to 20 pounds. Psychological self-report measures assessed psychiatric symptoms, eating behavior, mood,…

  17. Dropout is a problem in lifestyle intervention programs for overweight and obese infertile women: a systematic review.

    PubMed

    Mutsaerts, M A Q; Kuchenbecker, W K H; Mol, B W; Land, J A; Hoek, A

    2013-04-01

    What are the dropout rates in lifestyle intervention programs (LIPs) for overweight and obese infertile women and can intervention- or patient-related baseline factors associated with dropout be identified in these women? The median dropout rate was 24% in overweight and obese infertile women who participated in a LIP; clinical useful intervention or patient-related factors associated with dropout could not be identified. Overweight and obese infertile women might improve their chance of conception when they improve their lifestyle and lose weight. Dropout from LIPs reduces the chance of losing considerable weight and is therefore considered to be an important limiting factor of the success of LIPs. This systematic review included 15 studies published between January 1980 and December 2012. The included studies investigated the effect of LIPs for overweight and obese infertile women with infertility. From these studies, dropout rates and intervention- and patient-related baseline factors associated with dropout, as well as weight loss and pregnancy rates, were recorded. There were 15 studies identified, of which 10 reported dropout rates. The median dropout rate was 24% (range: 0-31%). Four studies reported baseline characteristics of women who dropped out, but modifiable predictors of dropout could not be identified. Weight loss and pregnancy rates were lower in women who dropped out than in women who completed the LIPs. There were limited numbers of studies investigating patient-related factors associated with dropout. The heterogeneity in the studies precluded us from drawing firm conclusions on the relation between the type of intervention and dropout. Dropout from LIPs is a major drawback because it predisposes to less weight loss and lower pregnancy rates. Identification of predictors of dropout is needed to identify overweight and obese infertile women who are prone for dropout. These women might benefit from extra support and monitoring, to potentially

  18. 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.

  19. Assessment of hot flushes and vaginal dryness among obese women undergoing bariatric surgery.

    PubMed

    Goughnour, S L; Thurston, R C; Althouse, A D; Freese, K E; Edwards, R P; Hamad, G G; McCloskey, C; Ramanathan, R; Bovbjerg, D H; Linkov, F

    2016-01-01

    Menopausal symptoms are associated with a negative impact on the quality of life, leading women to seek medical treatment. Obesity has been linked to higher levels of menopausal symptoms such as hot flushes. This assessment will explore whether the prevalence and bother of hot flushes and vaginal dryness change from pre- to post-bariatric surgery among obese midlife women. This study is a longitudinal analysis of data from 69 women (ages 35-72 years) undergoing bariatric surgery with reported reproductive histories and menopausal symptoms at preoperative and 6-month postoperative visits. Prevalence of and degree of bother of hot flushes and vaginal dryness at pre- and post-surgery were compared using McNemar's test and Wilcoxon signed-rank test. The reported degree of bother of symptoms associated with hot flushes decreased from pre- to post-surgery (p < 0.01). There was no significant change in the prevalence of hot flushes or vaginal dryness in the overall study sample. The degree of bother of symptoms associated with hot flushes among midlife women may decrease after bariatric surgery. These results highlight important secondary gains, including less bothersome menopausal symptoms, for women who choose bariatric surgery for weight loss.

  20. Association of obesity with healthcare resource utilization and costs in a commercial population.

    PubMed

    Kamble, Pravin S; Hayden, Jennifer; Collins, Jenna; Harvey, Raymond A; Suehs, Brandon; Renda, Andrew; Hammer, Mette; Huang, Joanna; Bouchard, Jonathan

    2018-05-10

    To examine the association of obesity with healthcare resource utilization (HRU) and costs among commercially insured individuals. This retrospective observational cohort study used administrative claims from 1 January 2007 to 1 December 2013. The ICD-9-CM status codes (V85 hierarchy) from 2008 to 2012 classified body mass index (BMI) into the World Health Organizations' BMI categories. The date of first observed BMI code was defined as the index date and continuous eligibility for one year pre- and post- index date was ensured. Post-index claims determined individuals' HRU and costs. Sampling weights developed using the entropy balance method and National Health and Nutrition Examination Survey data ensured representation of the US adult commercially insured population. Baseline characteristics were described across BMI classes and associations between BMI categories, and outcomes were examined using multivariable regression. The cohort included 9651 individuals with BMI V85 codes. After weighting, the BMI distribution was: normal (31.1%), overweight (33.4%), obese class I (22.0%), obese class II (8.1%) and obese class III (5.4%). Increasing BMI was associated with greater prevalence of cardiometabolic conditions, including hypertension, type 2 diabetes and metabolic syndrome. The use of antihypertensives, antihyperlipidemics, antidiabetics, analgesics and antidepressants rose with increasing BMI. Greater BMI level was associated with increased inpatient, emergency department and outpatient utilization, and higher total healthcare, medical and pharmacy costs. Increasing BMI was associated with higher prevalence of cardiometabolic conditions and higher HRU and costs. There is an urgent need to address the epidemic of obesity and its clinical and economic impacts.

  1. 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.

  2. Alterations of local cerebral glucose utilization in lean and obese fa/fa rats after acute adrenalectomy.

    PubMed

    Doyle, P; Rohner-Jeanrenaud, F; Jeanrenaud, B

    1994-08-29

    An animal model often used to investigate the aetiology of obesity is the genetically obese fa/fa rat. It has many abnormalities, including hyperphagia, hyper-insulinemia, insulin resistance, low cerebral glucose utilization and an overactive hypothalamo-pituitary adrenal (HPA) axis with resulting hypercorticism. Due to the latter consideration, the aim of this work was to study the impact of acute adrenalectomy (ADX) on the local cerebral glucose utilization (LCGU) of lean and obese fa/fa rats. ADX resulted in discrete increases in LCGU of regions common to both lean and obese rats. These common regions were found to belong to be related to the limbic system. Within this system, the LCGU of the brain of obese rats was either normalized to lean sham operated values or increased by ADX to a similar degree in both groups on a percentage basis. It was concluded that the LCGU of both lean and obese animals appears to be negatively regulated, albeit to different extents, by glucocorticoids. Such negative regulation is particularly salient within the limbic system of the lean rat and even more so in the fa/fa rat. It is suggested that the long-term hypercorticism of obese fa/fa rats due to abnormal regulation of the HPA axis may result in a decreased LCGU in limbic and related regions of the brain of fa/fa rats and contribute to the expression of the obese phenotype.

  3. 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.

  4. Obesity and stress urinary incontinence in women: compromised continence mechanism or excess bladder pressure during cough?

    PubMed

    Swenson, Carolyn W; Kolenic, Giselle E; Trowbridge, Elisa R; Berger, Mitchell B; Lewicky-Gaupp, Christina; Margulies, Rebecca U; Morgan, Daniel M; Fenner, Dee E; DeLancey, John O

    2017-09-01

    We compared two hypotheses as to why obesity is associated with stress urinary incontinence (SUI): (1) obesity increases demand on the continence system (e.g. higher cough pressure) and (2) obesity compromises urethral function and urethrovaginal support. A secondary analysis was performed using data from a case-control study of SUI in women. Measurements of urethrovaginal support (POP-Q point Aa, urethral axis), urethral function (maximal urethral closure pressure, MUCP), and measures of continence system demand (intravesical pressures at rest and during maximal cough) were analyzed. Cases and controls were divided into three body mass index (BMI) groups: normal (18.5-24.9 kg/m 2 ); overweight (25.0-29.9 kg/m 2 ); and obese (≥30 kg/m 2 ). Logistic regression models where created to investigate variables related to SUI for each BMI group. Structural equation modeling was used to test the direct and indirect relationships among BMI, SUI, maximal cough pressure, MUCP, and POP-Q point Aa. The study included 108 continent controls and 103 women with SUI. MUCP was the factor most strongly associated with SUI in all BMI groups. Maximal cough pressure was significantly associated with SUI in obese women (OR 3.191, 95% CI 1.326, 7.683; p < 0.01), but not in normal weight or overweight women. Path model analysis showed a significant relationship between BMI and SUI through maximal cough pressure (indirect effect, p = 0.038), but not through MUCP (indirect effect, p = 0.243) or POP-Q point Aa (indirect effect, p = 0.410). Our results support the first hypothesis that obesity is associated with SUI because of increased intravesical pressure, which therefore increases demand on the continence mechanism.

  5. Circulating endocannabinoids in insulin sensitive vs. insulin resistant obese postmenopausal women. A MONET group study.

    PubMed

    Abdulnour, Joseph; Yasari, Siham; Rabasa-Lhoret, Rémi; Faraj, May; Petrosino, Stefania; Piscitelli, Fabiana; Prud' Homme, Denis; Di Marzo, Vincenzo

    2014-01-01

    To measure the circulating levels of endocannabinoids and related molecules at fasting, after acute hyperinsulinemia and after weight loss in insulin sensitive vs. insulin resistant obese postmenopausal women. The sample consisted of 30 obese postmenopausal women (age: 58.9 ± 5.2 yrs; BMI: 32.9 ± 3.6 kg/m(2) ). Subjects underwent a 3-hour hyperinsulinaemic-euglycaemic clamp (HEC) (glucose disposal rate (M-value): 10.7 ± 3.3 mg min(-1) kg(-1) FFM) and 6-month weight loss intervention. Participants were classified as insulin sensitive obese (ISO) or insulin resistant obese (IRO) based on a predefined cutoff. Plasma levels of the endocannabinoids, anandamide (AEA), 2-arachidonoylglycerol (2-AG), and of the AEA-related compounds, palmitoylethanolamide (PEA) and oleoylethanolamide (OEA), were measured by liquid chromatography-mass spectrometry. IRO presented higher levels of 2-AG (P < 0.05) independently of the HEC and weight loss, whereas the HEC had an independent inhibitory effect on AEA, PEA, and OEA levels (P < 0.05) in both groups. Furthermore, there was an independent stimulatory effect of weight loss only on PEA levels in both groups (P < 0.05). This study is the first to show that higher circulating levels of the endocannabinoid 2-AG are found in IRO compared to ISO postmenopausal women, and that weight loss is associated with an increase in PEA, a PPAR-α ligand. © 2013 The Obesity Society.

  6. Environmental factors and beta2-adrenergic receptor polymorphism: influence on the energy expenditure and nutritional status of obese women.

    PubMed

    Rosado, Eliane Lopes; Bressan, Josefina; Martínez, J Alfredo

    2015-05-01

    Our aim was to evaluate the influence of the Gln27Glu polymorphism of the β2-adrenergic receptor (ADRβ2) gene, fat intake and physical activity on the energy expenditure (EE) and nutritional status of obese women. Sixty obese women (30-46 years) participated in the study and were assigned to three groups depending on the genotypes: Gln27Gln, Gln27Glu and Glu27Glu. At baseline and after nutritional intervention, the anthropometric and body composition (bioelectrical impedance), dietary, EE (indirect calorimetry) and biochemical variables were measured. All women received a high-fat test meal to determine the postprandial EE (short-term) and an energy-restricted diet for 10 weeks (long term). The frequencies of Gln27Gln, Gln27Glu and Glu27Glu were 36.67, 40.0 and 23.33 %, respectively. Anthropometric and biochemical variables and EE did not differ between groups, although women who had no polymorphism demonstrated decreased carbohydrate oxidation. On the other hand, the Glu27Glu genotype showed a positive relation with EE in physical activity and fat oxidation. The environmental factors and Gln27Glu polymorphism did not influence the nutritional status and EE of obese women, but physical activity in obese women with the polymorphism in the ADRβ2 gene can promote fat oxidation. The results suggest that encouraging the practice of physical exercise is important considering the high frequency of this polymorphism in obese subjects.

  7. Postnatal care utilization among urban women in northern Ethiopia: cross-sectional survey.

    PubMed

    Gebrehiwot, Genet; Medhanyie, Araya Abrha; Gidey, Gebreamlak; Abrha, Kidan

    2018-05-30

    Postnatal care service enables health professionals to identify post-delivery problems including potential complications for the mother with her baby and to provide treatments promptly. In Ethiopia, postnatal care service is made accessible to all women for free however the utilization of the service is very low. This study assessed the utilization of postnatal care services of urban women and the factors associated in public health facilities in Mekelle city, Tigrai Region, Northern Ethiopia. A facility based cross sectional study design was used to assess post natal service utilization. Using simple random sampling 367 women who visited maternal and child health clinics in Mekelle city for postnatal care services during January 27 to April 2014 were selected. Data was entered and analyzed using SPSS Version 20.0 software. A binary and multivariable logistic regression was used to identify risk factors associated with the outcome variables. P-value less than 0.05 is used to declare statistical significance. The prevalence of women who utilized postnatal care service was low (32.2%). Women who were private employees and business women were more likely to utilize postnatal care services (AOR = 6.46, 95% CI: 1.91-21.86) and (3.35, 95% CI: 1.10-10.19) respectively compared to house wives., Women who had history of one pregnancy were more likely to utilize the service (AOR = 3.19, 95% CI: 1.06-9.57) compared to women who had history of four and above pregnancies. Women who had knowledge of postnatal care service were also more likely to utilize postnatal care service (AOR = 14.46, 95% CI: 7.55-27.75) than women who lacked knowledge about the services. Postnatal care utilization in the study area is low. Knowledge on postnatal care services and occupation of women had positive impact on postnatal care service utilization. The Mekelle city administration health office and other stakeholders should support and encourage urban health extension workers and

  8. Non-targeted profiling of circulating microRNAs in women with polycystic ovary syndrome (PCOS): effects of obesity and sex hormones.

    PubMed

    Murri, Mora; Insenser, María; Fernández-Durán, Elena; San-Millán, José L; Luque-Ramírez, Manuel; Escobar-Morreale, Héctor F

    2018-02-02

    Circulating micro-ribonucleic acids (miRNAs) are small noncoding RNA molecules that influence gene transcription. We conducted the present profiling study to characterize the expression of circulating miRNAs in lean and obese patients with polycystic ovary syndrome (PCOS), the most common endocrine and metabolic disorder in premenopausal women. We selected 11 control women, 12 patients with PCOS and 12 men so that they were similar in terms of body mass index. Five control women, 6 men and 6 patients with PCOS had normal weight whereas 6 subjects per group were obese. We used miRCURY LNA™ Universal RT microRNA PCR for miRNA profiling. The expression of 38 miRNAs and was different between subjects with PCOS and male and female controls. The differences in 15 miRNAs followed a pattern suggestive of androgenization characterized by expression levels that were similar in patients with PCOS and men but were different compared with those of control women. The expression of 13 miRNAs in women with PCOS was similar to that of control women and different compared with the expression observed in men, suggesting sexual dimorphism and, lastly, we observed 5 miRNAs that were expressed differently in women with PCOS compared with both men and control women, suggesting a specific abnormality in expression associated with the syndrome. Obesity interacted with the differences in several of these miRNAs, and the expression levels of many of them correlated with the hirsutism score, sex hormones and/or indexes of obesity, adiposity and metabolic dysfunction. The present results suggest that several serum miRNAs are influenced by PCOS, sex hormones and obesity. Our findings may guide the targeted search of miRNAs as clinically relevant markers for PCOS and its association with obesity and metabolic dysfunction in future studies. Copyright © 2018. Published by Elsevier Inc.

  9. Obesity in the HIV-infected population in Northeast England: a particular issue in Black-African women.

    PubMed

    Ilozue, C; Howe, B; Shaw, S; Haigh, K; Hussey, J; Price, D A; Chadwick, D R

    2017-03-01

    People living with HIV are surviving longer on successful antiretroviral therapy and obesity rates are increasing. We sought to determine the prevalence of being overweight or obese in a regional population of people living with HIV and to explore the demographic and clinical characteristics associated with obesity or being overweight. Data on patients attending three Northeast England clinics were collected including body mass index and demographics. The prevalence of being overweight (body mass index ≥ 25 kg/m 2 ) or obese (body mass index ≥ 30 kg/m 2 ) was determined and compared with regional population data. Associations between being overweight or obese and demographic and other data were further explored using logistic regression models. In 560 patients studied (median age 45 years, 26% Black-African and 69% male), 65% were overweight/obese and 26% obese, which is similar to the local population. However, 83% and 48% of Black-African women were overweight/obese or obese, respectively, with 11% being morbidly obese (body mass index > 40 kg/m 2 ). In the multivariate analyses, the only factors significantly associated with obesity were Black-African race (adjusted odds ratio 2.78, 95% confidence interval 1.60-4.85) and type 2 diabetes (adjusted odds ratio 4.23, 95% confidence interval 1.81-9.91). Levels of obesity and overweight in people living with HIV are now comparable to the levels in the local population of Northeast England; however, the prevalence is significantly higher in Black-African women. Given the additional risk factors for cardiovascular disease inherent in people living with HIV, better strategies to prevent, identify and manage obesity in this population are needed.

  10. 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

  11. Obesity and the risk of systemic lupus erythematosus among women in the Nurses' Health Studies.

    PubMed

    Tedeschi, Sara K; Barbhaiya, Medha; Malspeis, Susan; Lu, Bing; Sparks, Jeffrey A; Karlson, Elizabeth W; Willett, Walter; Costenbader, Karen H

    2017-12-01

    Obesity is increasingly prevalent and related to increased risk of several autoimmune diseases, likely via generation of inflammatory adipokines. Prior studies have not evaluated obesity in relation to systemic lupus erythematosus (SLE) risk. We prospectively evaluated whether obesity was associated with increased SLE risk among women in the U.S. Nurses' Health Study cohorts. We conducted a prospective cohort study among 238,130 women in the Nurses' Health Studies (NHS, 1976-2012; NHSII, 1989-2013). Incident SLE was confirmed by American College of Rheumatology 1997 criteria and validated through medical record review. Body mass index (BMI, kg/m 2 ) was calculated at baseline and on biennial questionnaires. Cox proportional hazards models estimated HRs (95% CIs) for SLE by cumulative average BMI category {18.5 to <25 [normal (reference)], 25 to <30 (overweight), ≥30 (obese)}, adjusting for potential time-varying confounders. Models were performed separately in each cohort; results were meta-analyzed. Sensitivity analyses used simple time-varying BMI, a 4-year lag between exposure and SLE risk window to address potential reverse causation, and evaluated BMI at age 18 and weight change since age 18. A secondary analysis started follow-up in both cohorts at similar calendar years when the prevalence of obesity in the U.S. increased most dramatically [1988 (NHS)/1989 (NHSII)]. We identified 153 NHS incident SLE cases and 115 incident NHSII cases during 5,602,653 person-years of follow-up. At baseline, 8.4% of women in NHS and 11.8% in NHSII were obese. Mean age at enrollment was 42.5 (SD 7.2) years in NHS and 34.4 (SD 4.7) years in NHSII. Cumulative average obesity was significantly associated with SLE risk in NHSII [HR = 1.85 (1.17-2.91)], but not in NHS [HR = 1.11 (0.65-1.87)] compared to normal BMI. In the meta-analysis of both cohorts, obesity was not significantly associated with increased risk of SLE [HR = 1.46 (0.88-2.40)]. Simple time-varying BMI and lagging

  12. Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity.

    PubMed

    Blümel, Juan E; Fica, Juan; Chedraui, Peter; Mezones-Holguín, Edward; Zuñiga, María C; Witis, Silvina; Vallejo, María S; Tserotas, Konstantinos; Sánchez, Hugo; Onatra, William; Ojeda, Eliana; Mostajo, Desireé; Monterrosa, Alvaro; Lima, Selva; Martino, Mabel; Hernández-Bueno, José A; Gómez, Gustavo; Espinoza, María T; Flores, Daniel; Calle, Andrés; Bravo, Luz M; Benítez, Zully; Bencosme, Ascanio; Barón, Germán; Aedo, Sócrates

    2016-05-01

    The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.57 ± 6.71 vs 8.01 ± 6.27 points, P < 0.0001) and more depressive symptoms (Goldberg), anxiety (Goldberg), and insomnia (Athens Scale) compared with non-sedentary women. They also had greater mean waist circumference (86.2 ± 12.3 vs 84.3 ± 1.8 cm, P < 0.0001) and a higher prevalence of obesity (20.9% vs 14.3%, P < 0.0001). Logistic regression analysis showed that both obesity (odds ratio [OR] 1.52; 95% CI, 1.32-1.76) and severe menopausal symptoms (OR 1.28; 95% CI, 1.06-1.53), including insomnia and depressive mood, were positively associated with a sedentary lifestyle. Having a stable partner (OR 0.85; 95% CI, 0.76-0.96), using hormone therapy (OR 0.75; 95% CI, 0.64-0.87) and having a higher educational level (OR 0.66; 95% CI, 0.60-0.74) were negatively related to sedentary lifestyle. There was a high prevalence of sedentary lifestyle in this middle-aged Latin American female sample which was associated with more severe menopausal symptoms and obesity.

  13. Depression and Obesity/Overweight Association in Elderly Women: a Community-Based Case-Control Study.

    PubMed

    Ahmadi, Seyed Mehdi; Keshavarzi, Sareh; Mostafavi, Seyed-Ali; Bagheri Lankarani, Kamran

    2015-11-01

    Overweight/obesity and depression are common among women especially in the elderly and can lead to unfavorable outcomes. We aimed to determine the association of overweight with depression and also to find any correlation of depression with some anthropometric indices in old women. A total of 94 depressed elderly women were compared with 99 non-depressed controls. The structured diagnostic interview based on DSM-IV were performed to diagnose depression, and Geriatric Depression Scale (GDS) was completed to rate it. Anthropometric indices were measured and compared between groups. Pearson correlation coefficients were determined for linear relations between variables. Odds Ratio of obesity and overweight in depressed subjects comparing with normal participants was 1.45 (95%CI=0.63-3.32). A significant correlation was observed between BMI and GDS score (r=0.231, P-value=0.001). Total body fat (P-value=0.001) and BMI (P-value=0.016) were significantly higher in depressed women than non-depressed women. Despite the significantly higher total body fat and BMI among old women with depression, only a weak correlation was seen between BMI and GDS score.

  14. 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.

  15. The Intergenerational Cycle of Obesity and Its Implications for Nursing Care of Childbearing Women.

    PubMed

    Purnell, Molly C; MacKenzie, Meredith A

    2016-01-01

    Despite intensive focus and interventions at societal and individual levels, more than a third of people in the United States are overweight or obese, and childhood/adolescent obesity rates have dramatically increased during the past three decades. Biomedical research has shown a clear link between the prenatal environment and lifetime adiposity. Children born to overweight and obese women with impaired glucose metabolism show cardiometabolic consequences throughout their life spans that, in turn, affect their children's adiposity. Awareness of this intergenerational cycle of obesity can prompt nurses to intervene in the preconception, prenatal, and postnatal phases. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  16. Adipose tissue oxygenation is associated with insulin sensitivity independently of adiposity in obese men and women.

    PubMed

    Goossens, Gijs H; Vogel, Max A A; Vink, Roel G; Mariman, Edwin C; van Baak, Marleen A; Blaak, Ellen E

    2018-04-23

    Adipose tissue (AT) dysfunction contributes to the pathophysiology of insulin resistance and type 2 diabetes. Previous studies have shown that altered AT oxygenation affects adipocyte functionality, but it remains to be elucidated whether altered AT oxygenation is more strongly related to obesity or insulin sensitivity. In the present study, we tested the hypothesis that AT oxygenation is associated with insulin sensitivity rather than adiposity in humans. Thirty-five lean and obese individuals (21 men and 14 women, aged 40-65 years) with either normal or impaired glucose metabolism participated in a cross-sectional single-centre study. We measured abdominal subcutaneous AT oxygenation, body composition and insulin sensitivity. AT oxygenation was higher in obese insulin resistant as compared to obese insulin sensitive (IS) individuals with similar age, body mass index and body fat percentage, both in men and women. No significant differences in AT oxygenation were found between obese IS and lean IS men. Moreover, AT oxygenation was positively associated with insulin resistance (r = 0.465; P = .005), even after adjustment for age, sex and body fat percentage (standardized β = 0.479; P = .005). In conclusion, abdominal subcutaneous AT oxygenation is associated with insulin sensitivity both in men and women, independently of adiposity. AT oxygenation may therefore be a promising target to improve insulin sensitivity. © 2018 John Wiley & Sons Ltd.

  17. Diurnal glycemic profile in obese and normal weight nondiabetic pregnant women.

    PubMed

    Yogev, Yariv; Ben-Haroush, Avi; Chen, Rony; Rosenn, Barak; Hod, Moshe; Langer, Oded

    2004-09-01

    A paucity of data exists concerning the normal glycemic profile in nondiabetic pregnancies. Using a novel approach that provides continuous measurement of blood glucose, we sought to evaluate the ambulatory daily glycemic profile in the second half of pregnancy in nondiabetic women. Fifty-seven obese and normal weight nondiabetic subjects were evaluated for 72 consecutive hours with continuous glucose monitoring by measurement interstitial glucose levels in subcutaneous tissue every 5 minutes. Subjects were instructed not to modify their lifestyle or to follow any dietary restriction. For each woman, mean and fasting blood glucose values were determined; for each meal during the study period, the first 180 minutes were analyzed. For the study group, the fasting blood glucose level was 75 +/- 12 mg/dL; the mean blood glucose level was 83.7 +/- 18 mg/dL; the postprandial peak glucose value level was 110 +/- 16 mg/dL, and the time interval that was needed to reach peak postprandial glucose level was 70 +/- 13 minutes. A similar postprandial glycemic profile was obtained for breakfast, lunch, and dinner. Obese women were characterized by a significantly higher postprandial glucose peak value, increased 1- and 2-hour postprandial glucose levels, increased time interval for glucose peak, and significantly lower mean blood glucose during the night. No difference was found in fasting and mean blood glucose between obese and nonobese subjects. Glycemic profile characterization in both obese and normal weight nondiabetic subjects provide a measure for the desired level of glycemic control in pregnancy that is complicated with diabetes mellitus.

  18. 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.

  19. Factors associated with lack of effective contraception among obese women in the United States.

    PubMed

    Callegari, Lisa S; Nelson, Karin M; Arterburn, David E; Prager, Sarah W; Schiff, Melissa A; Schwarz, Eleanor Bimla

    2014-09-01

    To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. We analyzed data from sexually active obese women (body mass index >30 kg/m²) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Of 1345 obese respondents, 21.5% used no method, 10.3% behavioral methods, 20.8% barrier methods and 47.4% prescription methods. Only 42.4% of respondents overall and 20.4% of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95% confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95% CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95% CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95% CI, 0.06-0.25, barrier methods: aRR, 0.15; 95% CI, 0.09-0.25) than prescription method users. Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy

  20. Racial/ethnic disparities in obesity among US-born and foreign-born adults by sex and education.

    PubMed

    Barrington, Debbie S; Baquero, Maria C; Borrell, Luisa N; Crawford, Natalie D

    2010-02-01

    This study examines sex and education variations in obesity among US- and foreign-born whites, blacks, and Hispanics utilizing 1997-2005 data from the National Health Interview Survey on 267,585 adults aged > or =18 years. After adjusting for various demographic, health, and socioeconomic factors via logistic regression, foreign-born black men had the lowest odds for obesity relative to US-born white men. The largest racial/ethnic disparity in obesity was between US-born black and white women. High educational attainment diminished the US-born black-white and Hispanic-white disparities among women, increased these disparities among men, and had minimal effect on foreign-born Hispanic-white disparities among women and men. Comprehension of these relationships is vital for conducting effective obesity research and interventions within an increasingly diverse United States.

  1. Relationships between blood pressure and health and fitness-related variables in obese women.

    PubMed

    Shin, Jeong Yeop; Ha, Chang Ho

    2016-10-01

    [Purpose] The present study aimed to separately compare systolic blood pressure and diastolic blood pressure with health and fitness-related variables among Asian obese and normal weight middle-aged women. [Subjects and Methods] The study included 1,201 women aged 30-59 years. The participants were classified into obese and normal weight groups. The blood pressure and health and fitness-related variables of all participants were assessed. [Results] Significant interaction effects were observed for most blood pressure and health and fitness-related variables between the groups. However, significant interaction effects were not observed for standard weight, basal metabolic rate, and heart rate. Blood pressure showed significant positive correlations with weight, body fat, fat weight, core fat, body mass index, and basal metabolic rate in both groups. Systolic blood pressure was significantly correlated with muscular endurance, power, and agility in the obese group and with VO2max and flexibility in the normal weight group. Diastolic blood pressure was significantly correlated with muscular endurance and power in the obese group and with VO2max in the normal weight group. [Conclusion] The relationships between systolic blood pressure and heart rate, muscle endurance, power, and agility are stronger than the relationships between diastolic blood pressure and these variables.

  2. 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.

  3. Physical activity in adolescence and abdominal obesity in adulthood: a case-control study among women shift workers.

    PubMed

    Garcez, Anderson da Silva; Olinto, Maria Teresa Anselmo; Canuto, Raquel; Olinto, Beatriz Anselmo; Pattussi, Marcos Pascoal; Paniz, Vera Maria Vieira

    2015-01-01

    Physical activity may have a protective effect against abdominal obesity, an important risk factor for cardiometabolic diseases. Thus, the aim of this study was to examine the association between the practice of physical activities in adolescence and abdominal obesity in adulthood among women shift workers in Southern Brazil in 2011. This case-control study included 215 cases (waist circumference greater than or equal to 88 cm) and 326 controls. For both the case and control groups, participation in leisure-time physical activities was most frequent in adolescence and was significantly less in adulthood. After adjusting for potential confounding factors, women who participated in five or more physical activities in adolescence were 50 percent less likely to have abdominal obesity than women who participated in one activity or no physical activities (Odds Ratio = 0.50; 95% confidential interval: 0.27-0.93, p value = .029). Participation in various types of leisure-time physical activities in adolescence may protect against abdominal obesity in adulthood, even if the number of physical activities decreases over time. This finding demonstrated the importance of physical activity as well as the period of life in which these should be encouraged for the prevention of health disorders, such as abdominal obesity.

  4. 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.

  5. Unconscious collusion: An interpretative phenomenological analysis of the maternity care experiences of women with obesity (BMI≥30kg/m²).

    PubMed

    Atkinson, Sandra; McNamara, Patricia Mannix

    2017-06-01

    obstetric and midwifery literature continually emphasise incidence and consequence of obesity in pregnancy. However, they offer less consensus on how best to support women who are obese. Therefore, this study explores in depth the lived experience of women who have a Body Mass Index (BMI) ≥30kg/m². This exploration provides a bio-psycho-social understanding of the lived experience of women to identify how best to support them throughout their childbirth experience. an Interpretative Phenomenological Analysis (IPA) design was adopted for this qualitative study. Purposive sampling of participants was conducted on the postnatal wards of a maternity hospital in the Republic of Ireland. In total, 15 participants volunteered to take part in semi-structured interviews conducted at six to ten weeks postnatally. Data were analysed utilising the IPA framework. the results indicate that participants were conscious of the problematics of communicating obesity in pregnancy. The narrative data revealed an unconscious collusion between healthcare professionals and women as they navigate obesity related conversations. The behaviours related to unconscious collusion are incorporated in the sub-ordinate themes; 'just recorded and that's all', 'but what's eating healthy? 'pussy footing around' and 'I hate that word obesity. the findings highlight a lack of information received by participants from healthcare professionals regarding increased BMI or weight management. The data suggests that healthcare professionals appeared to collude with women to avoid challenging discussions regarding obesity. This may be related to avoidance on participants' part and/or may be linked with healthcare professionals' reluctance to communicate issues relating to increased BMI. Although participants were generally unhappy with the communication skills of health professionals, they readily acknowledged the sensitive nature of obesity related communications. The findings provide healthcare

  6. 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

  7. Do factors related to endogenous and exogenous estrogens modify the relationship between obesity and risk of colorectal adenomas in women?

    PubMed

    Wolf, Lesley A; Terry, Paul D; Potter, John D; Bostick, Roberd M

    2007-04-01

    Obesity has consistently been associated with increased colorectal cancer risk in men, but not in women. In the absence of postmenopausal hormone use (PMH), adipose-derived estrogen is the primary determinant of circulating estrogen levels in postmenopausal women, perhaps ameliorating the mitogenic effects of obesity in this group. Using data from a case-control study in the United States, we examined associations among obesity, potential modifying effects of factors related to endogenous and exogenous estrogen levels, and risk of colorectal adenoma. Cases (n = 219) were women of ages 30 to 74 years with colonoscopy proven, incident, sporadic, pathology-confirmed, adenomatous polyps of the colon and rectum. Two control groups were recruited: colonoscopy-confirmed polyp-free women (n = 438) and age- and zip code frequency-matched women randomly selected from the community (n = 247). Multivariate odds ratios and 95% confidence intervals (95% CI) for obese [body mass index (BMI) >or=30.0; compared with nonobese, BMI <25.0] premenopausal women were 2.09 (95% CI, 0.81-5.41) versus colonoscopy controls, and 5.18 (95% CI, 1.40-19.32) versus population controls. For PMH users, the corresponding odds ratios were 0.29 (95% CI, 0.12-0.70) versus colonoscopy controls and 0.64 (95% CI, 0.23-1.83) versus population controls. There was no significant association of BMI with adenoma risk for PMH nonusers. Findings for waist-to-hip ratio were similar to those for BMI. These data support the hypothesis that risk for colorectal adenoma may be increased with obesity among premenopausal women but decreased among postmenopausal women, especially if they also take PMH.

  8. Socioeconomic changes as covariates of overweight and obesity among Tangkhul Naga tribal women of Manipur, north-east India.

    PubMed

    Mungreiphy, N K; Kapoor, Satwanti

    2010-05-01

    The prevalence of overweight/obesity is increasing worldwide. Although countries like India are typically thought of as having a high prevalence of undernutrition, significant proportions of overweight/obese now co-exist with the undernourished. This study aims to find the prevalence of overweight/obesity, and its association with socioeconomic change, among Tangkhul women in India. The cross-sectional study was carried out among 346 Tangkhul women aged 20-70 years, who were divided into five 10-year age groups. Mean BMI was found to be lowest among the youngest age group, and it increased with age until the age of 59 and then declined. The prevalence of overweight and obesity was found to be 27.1%, as assessed from the Asian cut-off point. Although the prevalence of obesity (2.0%) was low when compared with Indian non-tribal female populations, the prevalence of overweight (25.1%) was not far behind. Overweight and obesity were found to be associated with age, marital status, physical activity level, lifestyle and improvement in socioeconomic status, especially occupation and income. When compared with urban non-tribal Indian females, who have a higher socioeconomic status, the prevalence of overweight/obesity among Tangkhul females is lower, indicating its association with socioeconomic status. Tangkhul Naga is a population where the majority are believed to be thin traditionally owing to the difficult hilly terrain and their physically active lifestyle. With urbanization and economic development, nutritional transition, improved socioeconomic status and an increasingly sedentary lifestyle have been observed, which have contributed to the increasing prevalence of overweight/obesity among Tangkhul Naga women.

  9. Decreased plasma levels of ceruloplasmin after diet-induced weight loss in obese women.

    PubMed

    Tajik, N; Golpaie, A; Keshavarz, S A; Djalali, M; Sehat, M; Masoudkabir, F; Ahmadivand, Z; Fatehi, F; Zare, M; Yazdani, T

    2012-06-01

    Plasma ceruloplasmin (Cp) has been shown to be a risk factor for cardiovascular disease and also to be associated with obesity. However, it is not known whether weight loss could decrease the plasma Cp levels. To investigate the effect of diet-induced weight loss on plasma Cp in obese women. Sixty-seven healthy obese women [age =33.4±8.7 yr, body mass index (BMI) =36.0±4.8 kg/m2] were entered into a medically supervised program aimed at reducing body weight by 10% or more. Weight loss was achieved through a diet providing a daily energy deficit of 500-1000 kcal/day. In addition, all patients were prescribed to use 50 g of a fiber supplement per day. For all subjects, assessment of dietary intake, anthropometric indices, and plasma levels of C-reactive protein and Cp was performed at the first visit and repeated at 12th week of follow-up. By completing the program, weight (Δ=-9.5%, p<0.0001), BMI (Δ=-9.7%, p<0.0001), waist-circumference (Δ=-6.1%, p<0.0001), and triceps skinfold thickness (Δ=-14.9%, p<0.0001) significantly decreased. Plasma Cp significantly decreased after 12 weeks of dietary intervention (33.6±5.6 mg/dl vs 25.2±5.8 mg/dl, p<0.0001). Percent change in Cp was correlated with percent change in waist-circumference (r=446, p=0.015). Our study suggests that an improved body composition induced by restriction of energy intake is associated with decreased serum concentrations of Cp in obese women which in turn might have reduced the subjects' risk of developing cardiovascular disease.

  10. 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.

  11. Energy restriction and Roux-en-Y gastric bypass reduce postprandial α-dicarbonyl stress in obese women with type 2 diabetes.

    PubMed

    Maessen, Dionne E; Hanssen, Nordin M; Lips, Mirjam A; Scheijen, Jean L; Willems van Dijk, Ko; Pijl, Hanno; Stehouwer, Coen D; Schalkwijk, Casper G

    2016-09-01

    Dicarbonyl compounds are formed as byproducts of glycolysis and are key mediators of diabetic complications. However, evidence of postprandial α-dicarbonyl formation in humans is lacking, and interventions to reduce α-dicarbonyls have not yet been investigated. Therefore, we investigated postprandial α-dicarbonyl levels in obese women without and with type 2 diabetes. Furthermore, we evaluated whether a diet very low in energy (very low calorie diet [VLCD]) or Roux-en-Y gastric bypass (RYGB) reduces α-dicarbonyl stress in obese women with type 2 diabetes. In lean (n = 12) and obese women without (n = 27) or with type 2 diabetes (n = 27), we measured the α-dicarbonyls, methylglyoxal (MGO), glyoxal (GO) and 3-deoxyglucosone (3-DG), and glucose in fasting and postprandial plasma samples obtained during a mixed meal test. Obese women with type 2 diabetes underwent either a VLCD or RYGB. Three weeks after the intervention, individuals underwent a second mixed meal test. Obese women with type 2 diabetes had higher fasting and particularly higher postprandial plasma α-dicarbonyl levels, compared with those without diabetes. After three weeks of a VLCD, postprandial α-dicarbonyl levels in diabetic women were significantly reduced (AUC MGO -14%, GO -16%, 3-DG -25%), mainly through reduction of fasting plasma α-dicarbonyls (MGO -13%, GO -13%, 3-DG -33%). Similar results were found after RYGB. This study shows that type 2 diabetes is characterised by increased fasting and postprandial plasma α-dicarbonyl stress, which can be reduced by improving glucose metabolism through a VLCD or RYGB. These data highlight the potential to reduce reactive α-dicarbonyls in obese individuals with type 2 diabetes. ClinicalTrials.gov NCT01167959.

  12. Obesity, regional body fat distribution, and the metabolic syndrome in older men and women.

    PubMed

    Goodpaster, Bret H; Krishnaswami, Shanthi; Harris, Tamara B; Katsiaras, Andreas; Kritchevsky, Steven B; Simonsick, Eleanor M; Nevitt, Michael; Holvoet, Paul; Newman, Anne B

    2005-04-11

    The metabolic syndrome is a disorder that includes dyslipidemia, insulin resistance, and hypertension and is associated with an increased risk of diabetes and cardiovascular disease. We determined whether patterns of regional fat deposition are associated with metabolic syndrome in older adults. A cross-sectional study was performed that included a random, population-based, volunteer sample of Medicare-eligible adults within the general communities of Pittsburgh, Pa, and Memphis, Tenn. The subjects consisted of 3035 men and women aged 70 to 79 years, of whom 41.7% were black. Metabolic syndrome was defined by Adult Treatment Panel III criteria, including serum triglyceride level, high-density lipoprotein cholesterol level, glucose level, blood pressure, and waist circumference. Visceral, subcutaneous abdominal, intermuscular, and subcutaneous thigh adipose tissue was measured by computed tomography. Visceral adipose tissue was associated with the metabolic syndrome in men who were of normal weight (odds ratio, 95% confidence interval: 2.1, 1.6-2.9), overweight (1.8, 1.5-2.1), and obese (1.2, 1.0-1.5), and in women who were of normal weight (3.3, 2.4-4.6), overweight (2.4, 2.0-3.0), and obese (1.7, 1.4-2.1), adjusting for race. Subcutaneous abdominal adipose tissue was associated with the metabolic syndrome only in normal-weight men (1.3, 1.1-1.7). Intermuscular adipose tissue was associated with the metabolic syndrome in normal-weight (2.3, 1.6-3.5) and overweight (1.2, 1.1-1.4) men. In contrast, subcutaneous thigh adipose tissue was inversely associated with the metabolic syndrome in obese men (0.9, 0.8-1.0) and women (0.9, 0.9-1.0). In addition to general obesity, the distribution of body fat is independently associated with the metabolic syndrome in older men and women, particularly among those of normal body weight.

  13. Waist-to-Height Ratio in Indian Women: Comparison With Traditional Indices of Obesity, Association With Inflammatory Biomarkers and Lipid Profile.

    PubMed

    Dilip Malshe, Sharvari; Anand Udipi, Shobha

    2017-07-01

    We compared waist-to-height ratio (WHtR) with traditional anthropometric indices in healthy women aged 21 to 45 years from urban slums of Mumbai city, India. Lipid profile and inflammatory markers were measured in a subsample of 200 women, and their relationship with WHtR was examined. Mean WHtR was 0.50 ± 0.1, but a little more than half (51.9%) of the women had WHtR ≥0.50. WHtR could correctly identify centrally obese adult women, even when they were categorized as healthy or normal according to body mass index, waist circumference, waist to hip ratio, and percentage body fat. Also, in centrally obese women, inflammatory markers-namely, high-sensitivity C-reactive protein, interleukin-6, and interleukin-10-were significantly and positively correlated with WHtR. Thus, results of this study indicate that WHtR is a simple and effective anthropometric variable that has the potential to identify central obesity and the associated inflammation even in women with normal BMI.

  14. Disparities in Substance Abuse Treatment Utilization Among Women with Intellectual Disability.

    PubMed

    Slayter, Elspeth

    2016-01-01

    Despite concerns about health disparities among women with intellectual disabilities, little is known about substance abuse treatment access in this population. Using standardized performance measures, treatment initiation and engagement were examined retrospectively for women aged 18 to 64 (N = 3,752), men with (N = 5,732) and women without intellectual disability (N = 493,446). Logistic regression models of utilization were conducted. Women in the sample were less likely than men in the sample or women without intellectual disability to utilize treatment, suggesting both gender-related and disability-related barriers. Policy and practice implications for improving the health and welfare of women with intellectual disabilities are discussed.

  15. 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.

  16. Relationship between obesity and anti-Müllerian hormone in reproductive-aged African American women.

    PubMed

    Bernardi, Lia A; Carnethon, Mercedes R; de Chavez, Peter J; Ikhena, Deborah E; Neff, Lisa M; Baird, Donna D; Marsh, Erica E

    2017-01-01

    To determine whether there is an association between obesity and anti-Müllerian hormone (AMH) among reproductive-aged African American women (AAW). From the women participating in an ongoing National Institute of Environmental Health Sciences study, 1,654 AAW aged 23 to 35 were included in this study. Anthropometric measurements, personal health information, and serum AMH and adipokine levels were analyzed. The median body mass index (BMI) was 32.4 kg/m 2 , and the median AMH was 3.18 ng/mL. Participants with obesity had AMH concentrations that were 23.7% lower than those with a BMI ≤25 kg/m 2 (2.9 ng/mL vs. 3.8 ng/mL). In multivariable linear regression models, current BMI (β = -0.015; 95% CI -0.021 to -0.009), BMI at age 18 (β = -0.016; 95% CI -0.024 to -0.008), heaviest reported lifetime weight (β = -0.002; 95% CI -0.003 to -0.001), and leptin (β = -0.016; 95% CI -0.025 to -0.007) were inversely associated with AMH. There was no significant association between adiponectin and AMH. AMH was significantly lower (mean log = 0.91, SE = 0.11) in participants with obesity at age 18 and at enrollment when compared with those who were underweight or normal weight at age 18 but had obesity at enrollment (mean log = 1.16, SE = 0.12). In reproductive-aged AAW there is a significant association between obesity and AMH, suggesting that excess adiposity may compromise ovarian reserve. Effects of obesity on AMH may be cumulative. © 2016 The Obesity Society.

  17. Body mass index and weight loss in overweight and obese korean women: the mediating role of body weight perception.

    PubMed

    Boo, Sunjoo

    2013-12-01

    This study were to assess the relationships among BMI, body weight perception, and efforts to lose weight in a public sample of Korean women who are overweight and obese and to examine the mediating role of body weight perception on the relationship between BMI and weight loss efforts. This cross-sectional study used data from the 2008 Korea National Health and Nutrition Examination Survey. The sample was 1,739 Korean women 20 years old or older with body mass index (BMI) ≥ 23 kg/m(2). Bivariate relationships among variables of interests were assessed. Three separate regressions were used to test the mediating role of body weight perception on the relationship between BMI and weight loss efforts. BMI and body weight perception were significant correlates of weight loss efforts. BMI was significantly associated with weight perception, but a large proportion of women underestimated their weight. Weight perception partially mediated the relationship between BMI and weight loss efforts in Korean women. In light of the high prevalence of overweight or obesity and the many health consequences associated with obesity, Korean women should be aware of a healthy body weight and try to achieve that weight. Nursing interventions should consider body weight perception to effectively motivate overweight and obese Korean women to lose weight, as necessary. Copyright © 2013. Published by Elsevier B.V.

  18. Circuit resistance training attenuates acute exertion-induced reductions in arterial function but not inflammation in obese women.

    PubMed

    Franklin, Nina C; Robinson, Austin T; Bian, Jing-Tan; Ali, Mohamed M; Norkeviciute, Edita; McGinty, Patrick; Phillips, Shane A

    2015-06-01

    Cardiovascular disease (CVD) is a leading cause of preventable death among young women in the United States. Habitual resistance exercise training is known to have beneficial effects on endothelial function and CVD risk factors, including obesity; however, previous studies show that acute resistance exercise impairs endothelial function in obese adults who are sedentary, a response that may be linked to inflammation. We sought to determine if circuit-based resistance training (CRT) attenuates acute resistance exercise-induced reductions in endothelial function in a population of young, obese, sedentary women and whether or not inflammation plays a role in this response. Eighteen obese [body mass index (BMI) 30.0-40.0 kg · m(-2)] young premenopausal women were randomly assigned to either a CRT group or a no-exercise control group (CON). Conduit artery endothelial function was assessed using brachial artery flow-mediated dilation (FMD) determined by ultrasound before and after a single bout of strenuous weightlifting (SWL). In addition, circulating inflammatory mediators (tumor necrosis factor-α and C-reactive protein), blood pressure, fasting blood lipids, glucose, waist circumference, body composition, and aerobic capacity were assessed. Among participants randomized to the CRT group, 8 weeks of training led to considerable increases in FMD after SWL (P=0.001) compared to the CON group. However, no significant differences between the groups were observed in circulating inflammatory mediators, blood pressure, fasting blood lipids, or other physical and physiological characteristics. This study shows that CRT alleviates acute exertion-induced reductions in endothelial function among obese sedentary women in the absence of changes in inflammation.

  19. The relationship between the vitamin serum 25(OH)D and the B12 concentrations in obese women.

    PubMed

    Curic, Nikola; Ilincic, Branislava; Milic, Natasa; Cabarkapa, Velibor; Nikolic, Stanislava; Medic-Stojanoska, Milica; Pellicano, Rinaldo; Abenavoli, Ludovico

    2018-04-01

    In obesity, low levels of vitamin D (VD) and vitamin B12 (VB12) may be the result of different pathophysiological mechanisms, but the possible association between them has not been defined yet. The aim of this cross-sectional analysis was to investigate the possible relationship between serum 25-hydroxyvitamin D (25(OH)D) and VB12 levels in middle aged women. In 80 women, we indirectly evaluated body composition and body volumes [extracellular fluid volume (ECV) and total body water (TBW)] by anthropometric and bioelectrical impedance analysis. Vitamin D and VB12 status was assessed by laboratory measurement [serum 25(OH)D levels by electrochemiluminescent immunoassay; VB12 by chemiluminescent microparticle immunoassay]. Obese women were mostly VD deficient [25(OH)D below 50 nmol/L; 40/50, 80%]. Also, among obese we observed presence of VB12 deficiency [VB12 below 148 pmol/L; 13/50, 26%) and marginal depletion of VB12 level (marginal VB12 status 148-221 pmol/L; 20/50, 40%). All anthropometric indicators of obesity, ECV and TBW were significantly associated with both, 25(OH)D and VB12 (P<0.001) levels. In univariate regression analysis serum level of 25(OH)D was significantly associated with VB12 levels (R2=0.170, P<0.001). In regression models, 25(OH)D was significantly associated with VB12 level, independently of fat mass and extracellular fluid volume. Obesity may negatively affect VB12 level, indirectly, by reducing 25(OH)D level in middle aged women.

  20. Metformin and weight loss in obese women with polycystic ovary syndrome: comparison of doses.

    PubMed

    Harborne, Lyndal R; Sattar, Naveed; Norman, Jane E; Fleming, Richard

    2005-08-01

    Metformin treatment of women with polycystic ovary syndrome (PCOS) is widespread, as determined by studies with diverse patient populations. No comparative examination of weight changes or metabolite responses to different doses has been reported. The aim of this study was to determine whether different doses of metformin (1500 or 2550 mg/d) would have different effects on body weight, circulating hormones, markers of inflammation, and lipid profiles. The study included prospective cohorts randomized to two doses of metformin. The study was performed at a university teaching hospital with patients from gynecology/endocrinology clinics. The patients studied were obese (body mass index, 30 to <37 kg/m2; n = 42) and morbidly obese (body mass index, > or =37 kg/m2; n = 41) women with PCOS. Patients were randomized to two doses of metformin, and parameters were assessed after 4 and 8 months. The main outcome measures were changes in body mass, circulating hormones, markers of inflammation, and lipid profiles. Intention to treat analyses showed significant weight loss in both dose groups. Only the obese subgroup showed a dose relationship (1.5 and 3.6 kg in 1500- and 2550-mg groups, respectively; P = 0.04). The morbidly obese group showed similar reductions (3.9 and 3.8 kg) in both groups. Suppression of androstenedione was significant with both metformin doses, but there was no clear dose relationship. Generally, beneficial changes in lipid profiles were not related to dose. Weight loss is a feature of protracted metformin therapy in obese women with PCOS, with greater weight reduction potentially achievable with higher doses. Additional studies are required to determine whether other aspects of the disorder may benefit from the higher dose of metformin.

  1. [The impact of experience in bearing child on the body mass index and obesity in women].

    PubMed

    Lai, Jian-qiang; Yin, Shi-an

    2009-02-01

    To analyze the relations of body mass index(BMI)and obese prevalence in differently aged women and explore the effective strategy for preventing obesity among adult Chinese women. This study was based on the data from 2002 National Nutrition and Health Survey. The method of multi-steps cluster sampling was adopted. Total subjects including unmarried women (n = 2474), married women without the experience of childbearing (n = 10,816), and married and bearing-child women (n = 4103), were 17,393. In urban areas, the average body weights of unmarried, married and without childbearing experience, and the married with born-child were (53.7 +/- 9.0) kg, (57.6 +/- 9.4) kg and (54.5 +/- 8.5) kg respectively; the body weights of unmarried, married and without childbearing experience were significantly higher than that of the married with born-child women (t = 12.25, P < 0.001; t = 8.32, P < 0.001); the BMIs of unmarried, married without childbearing experience, and the married with born-child women were (21.1 +/- 3.3) kg/m(2), (22.8 +/- 3.4) kg/m(2) and (22.0 +/- 2.9) kg/m(2) respectively; the BMIs of married without childbearing experience and married with born-child women were significantly higher than that of unmarried women (t = 14.88, P < 0.001; t = 5.76, P < 0.001). In the rural areas, the body weights of unmarried, married without childbearing experience, and the married with born-child women were (52.3 +/- 7.8) kg, (55.3 +/- 8.6) kg and (52.8 +/- 8.1) kg respectively; the body weights of unmarried, the married with born-child women were significantly higher than that of married without childbearing experience (t = 11.67, P < 0.001; t = 14.15, P < 0.001); the BMIs of unmarried, married without childbearing experience, and the married with born-child women were (21.2 +/- 2.8) kg/m(2), (22.5 +/- 3.1) kg/m(2), and (21.8 +/- 3.0) kg/m(2) respectively; the BMIs of married and the married with born-child were significantly higher than that of unmarried women (t = 13.80, P

  2. Predictors of breastfeeding in overweight and obese women: data from Active Mothers Postpartum (AMP).

    PubMed

    Krause, Katrina M; Lovelady, Cheryl A; Østbye, Truls

    2011-04-01

    Excess maternal weight has been negatively associated with breastfeeding. We examined correlates of breastfeeding initiation and intensity in a racially diverse sample of overweight and obese women. This paper presents a secondary analysis of data from 450 women enrolled in a postpartum weight loss intervention (Active Mothers Postpartum [AMP]). Sociodemographic measures and body mass index (BMI), collected at 6 weeks postpartum, were examined for associations with breastfeeding initiation and lactation score (a measure combining duration and exclusivity of breastfeeding until 12 months postpartum). Data were collected September 2004-April 2007. In multivariable analyses, BMI was negatively associated with both initiation of breastfeeding (OR: .96; CI: .92-.99) and lactation score (β -0.22; P = 0.01). Education and infant gestational age were additional correlates of initiation, while race, working full-time, smoking, parity, and gestational age were additional correlates of lactation score. Some racial differences in these correlates were noted, but were not statistically significant. Belief that breastfeeding could aid postpartum weight loss was initially high, but unrelated to breastfeeding initiation or intensity. Maintenance of this belief over time, however, was associated with lower lactation scores. BMI was negatively correlated with breastfeeding initiation and intensity. Among overweight and obese women, unrealistic expectations regarding the effect of breastfeeding on weight loss may negatively impact breastfeeding duration. In general, overweight and obese women may need additional encouragement to initiate breastfeeding and to continue breastfeeding during the infant's first year.

  3. Predictors of Breastfeeding in Overweight and Obese Women: Data From Active Mothers Postpartum (AMP)

    PubMed Central

    Krause, Katrina M.; Lovelady, Cheryl A.; Østbye, Truls

    2011-01-01

    Excess maternal weight has been negatively associated with breastfeeding. We examined correlates of breastfeeding initiation and intensity in a racially diverse sample of overweight and obese women. This paper presents a secondary analysis of data from 450 women enrolled in a postpartum weight loss intervention (Active Mothers Postpartum [AMP]). Sociodemographic measures and body mass index (BMI), collected at 6 weeks postpartum, were examined for associations with breastfeeding initiation and lactation score (a measure combining duration and exclusivity of breastfeeding until 12 months postpartum). Data were collected September 2004–April 2007. In multivariable analyses, BMI was negatively associated with both initiation of breastfeeding (OR: .96; CI: .92–.99) and lactation score (β −0.22; P = 0.01). Education and infant gestational age were additional correlates of initiation, while race, working full-time, smoking, parity, and gestational age were additional correlates of lactation score. Some racial differences in these correlates were noted, but were not statistically significant. Belief that breastfeeding could aid postpartum weight loss was initially high, but unrelated to breastfeeding initiation or intensity. Maintenance of this belief over time, however, was associated with lower lactation scores. BMI was negatively correlated with breastfeeding initiation and intensity. Among overweight and obese women, unrealistic expectations regarding the effect of breastfeeding on weight loss may negatively impact breastfeeding duration. In general, overweight and obese women may need additional encouragement to initiate breastfeeding and to continue breastfeeding during the infant’s first year. PMID:20821042

  4. Subclinical hypothyroidism is not a risk factor for polycystic ovary syndrome in obese women of reproductive age.

    PubMed

    Zhang, Bingjie; Wang, Jing; Shen, Shanmei; Liu, Jiayi; Sun, Jie; Gu, Tianwei; Zhu, Dalong; Bi, Yan

    2018-04-16

    Obese women are at high risk for polycystic ovary syndrome (PCOS). Subclinical hypothyroidism (SCH) has been associated with weight gain, insulin resistance and impaired fertility, which are also factors involved in PCOS. However, there is limited information regarding the influence of SCH on the presence of PCOS. In order to determine whether SCH increases the prevalence of PCOS, we performed a cross-sectional study in a cohort of reproductive-aged obese women. All subjects underwent anthropometric evaluation, laboratory tests and ultrasound examination. Diagnosis of PCOS was based on the Rotterdam criteria. A total of 534 obese women were included and 108 (20.2%) of them were diagnosed with SCH. Patients with SCH showed similar insulin resistance, comparable androgen levels, and higher triglycerides levels (1.7 vs. 1.5 mmol/L, p = .002) compared to those with normal thyroid status. The frequency of PCOS did not differ between the two groups (56.1% for normal thyroid function vs. 60.2% for subclinical hypothyroidism, p = .514). In logistic regression analysis, SCH was not an independent risk factor for PCOS after adjusting for confounding factors (OR = 0.984, 95% CI 0.581-1.667). For the first time, our results suggest that SCH does not increase the risk of PCOS in obese women of reproductive age.

  5. Dental services utilization by women of childbearing age by socioeconomic status.

    PubMed

    Kaylor, Mary B; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G

    2010-04-01

    For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.

  6. Physical activity and hypocaloric diet recovers osteoblasts homeostasis in women affected by abdominal obesity.

    PubMed

    Bimonte, Viviana M; Fittipaldi, Simona; Marocco, Chiara; Emerenziani, Gian Pietro; Fornari, Rachele; Guidetti, Laura; Poggiogalle, Eleonora; Nicolai, Emanuele; Di Luigi, Luigi; Donini, Lorenzo M; Baldari, Carlo; Lenzi, Andrea; Greco, Emanuela A; Migliaccio, Silvia

    2017-11-01

    Obesity is a multifactorial disease linked to metabolic chronic disorders such as diabetes, and hypertension. Also, it has recently been associated with skeletal alterations and low bone mineral density. We previously demonstrated that exposure of osteoblasts to sera of sedentary subjects affected by obesity alters cell homeostasis in vitro, leading to disruption of intracellular differentiation pathways and cellular activity. Thus, the purpose of the present study has been to evaluate whether sera of sedentary obese women, subjected to physical activity and hypocaloric diet, could recover osteoblast homeostasis in vitro as compared to the sera of same patients before intervention protocol. To this aim, obese women were evaluated at time 0 and after 4, 6, and 12 months of individualized prescribed physical activity and hypocaloric diet. Dual-energy-X-ray absorptiometry measurements were performed at each time point, as well as blood was collected at the same points. Cells were incubated with sera of subjects before and after physical activity as described: obese at baseline and after for 4, 6, and 12 months of physical activity and nutritional protocol intervention. Osteoblasts exposed to sera of patients, who displayed increased lean and decreased fat mass (from 55.5 ± 6.5 to 57.1 ± 5.6% p ≤ 0.05; from 44.5 ± 1.1 to 40.9 ± 2.6% p ≤ 0.01 respectively), showed a time-dependent increase of Wnt/β-catenin signaling, versus cells exposed to sera of obese patients before intervention protocol, suggesting recovery of osteoblast homeostasis upon improvement of body composition. An increase in β-catenin nuclear accumulation and nuclear translocation was also observed, accompanied by an increase in Adiponectin receptor 1 protein expression, suggesting positive effect on cell differentiation program. Furthermore, a decrease in sclerostin amount and an increase of type 1 procollagen amino-terminal-propeptide were depicted as compared to

  7. The impact of cash transfers to poor women in Colombia on BMI and obesity: prospective cohort study.

    PubMed

    Forde, I; Chandola, T; Garcia, S; Marmot, M G; Attanasio, O

    2012-09-01

    Prevalence of obesity is rising in Latin America and increasingly affecting socially disadvantaged groups, particularly women. Conditional cash transfers are recently established welfare interventions in the region. One, Familias en Accion, transfers ∼20% of average monthly income to women in Colombia's poorest families. Previous work has found that families buy more food as a result. We tested the hypothesis that participation in Familias would be associated with increasing body mass index (BMI) in participating women. Women from participating areas and control areas (matched on environmental and socioeconomic criteria) were surveyed in 2002 and 2006. Pregnant, breast-feeding or women aged <18 or with BMI <18.5 kg m(-2) were excluded. The sample comprises 835 women from control and 1238 from treatment areas. Because some treatment areas started Familias shortly before baseline data collection, a dummy variable was created that identified exposure independent of time point or area. Follow-up was 61.5%. BMI was measured by trained personnel using standardized techniques. Overweight was defined as BMI ≥ 25 kg m(-2) and obesity as ≥ 30 kg m(-2). The effect of Familias was estimated using linear regression (or logistic regression for dichotomous outcomes) in a double-difference technique, controlling for several individual, household and area characteristics, including parity and baseline BMI, using robust standard-errors clustered at area-level in an intention-to-treat analysis. At baseline, women's mean age was 33.3 years and mean BMI 25.3 kg m(-2); 12.3% women were obese. After adjustment, exposure to Familias was significantly associated with increased BMI (β=0.25; 95% confidence interval (CI) 0.03, 0.47; P=0.03). Age (β=0.09; 95% CI 0.06, 0.13; P<0.001) and household wealth (β=0.78; 95% CI 0.41, 1.15; P<0.001) were also positively associated with BMI. Familias was also associated with increased odds of obesity (odds ratio (OR)=1.27; 95% CI

  8. Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study.

    PubMed

    Heslehurst, Nicola; Dinsdale, Sarah; Brandon, Helene; Johnston, Camilla; Summerbell, Carolyn; Rankin, Judith

    2017-06-01

    to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity. a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes. one NHS Trust maternity and dietetic services, North East England, UK. fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m 2 . four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring. women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base. it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of

  9. The association between obesity, depression, and educational attainment in women: The mediating role of body image dissatisfaction

    PubMed Central

    Gavin, Amelia R.; Simon, Greg E.; Ludman, Evette J.

    2011-01-01

    Objective We examine the mediating role of body image dissatisfaction (BID) on the association between obesity and depression and the variation of this association as a function of years of education among a population-based sample of women aged 40–65 years. Methods A series of sample-weighted logistic regression models were used to estimate the associations between obesity, BID, and depression, stratified by educational attainment. Data were obtained from a structured telephone interview of 4543 female health plan enrollees, including self-reported height and weight, the Patient Health Questionnaire assessment of depression, and a single-item measure of BID. Results Among those with <16 years of education, in both the unadjusted and adjusted models, obesity and BID were significantly associated with depression. Similarly, among those with ≥16 years of education, obesity and BID were significantly associated with depression in the unadjusted models. However, in the adjusted model, only BID was associated with depression. A formal test for mediation suggests that the association between obesity and depression was mediated by BID regardless of level of education. Conclusions Our data suggest that BID-mediated the obesity-depression association. In addition, obesity and BID may be salient risk factors for depression among middle-aged women as a function of the level of education. PMID:21109045

  10. Stress-induced laboratory eating behavior in obese women with binge eating disorder.

    PubMed

    Laessle, Reinhold G; Schulz, Simone

    2009-09-01

    To compare the microstructural eating behavior of obese patients with and without binge eating disorder (BED) after stress induction in laboratory. Forty-eight obese women were investigated. Seventeen were assigned to the group of BED. Group (BED vs. non-BED) by condition (stress vs. no stress) interaction effect on feeding variables, measured by a universal eating monitor, was tested. Stress was induced by the trier social stress test (TSST) and chocolate pudding served as laboratory food. From the nonstress to the stress condition, patients with BED, when compared with non-BED had a greater increase in average eating rate (p < .01) and a corresponding greater increase in the frequency of spoonfuls (p < .02). The BED group also showed a different change in acceleration/deceleration from the nonstress to the stress condition compared to the non-BED group (p < .04). Obese individuals with BED appear to exhibit a different response to stress than obese non-BED individuals and individuals with bulimia nervosa.

  11. Offspring body size and metabolic profile - effects of lifestyle intervention in obese pregnant women.

    PubMed

    Tanvig, Mette

    2014-07-01

    Worldwide, the prevalence of obesity has reached epidemic proportions. In Denmark one third of all pregnant women are overweight and 12 % are obese. Perhaps even more concerning, a dramatic rise in the prevalence of childhood overweight and obesity has also been evident over recent decades. The obesity epidemic is not simply a consequence of poor diet or sedentary lifestyles. Obesity is a multifactorial condition in which environmental, biological and genetic factors all play essential roles. The Developmental Origins of Health and Disease (DoHaD) hypothesis has highlighted the link between prenatal, perinatal and early postnatal exposure to certain environmental factors and subsequent development of obesity and non-communicable diseases. Maternal obesity and excessive gestational weight gain, resulting in over-nutrition of the fetus, are major contributors to obesity and metabolic disturbances in the offspring. Pregnancy offers the opportunity to modify the intrauterine environment, and maternal lifestyle changes during gestation may confer health benefits to the child. The overall aim with this PhD thesis was to study the effects of maternal obesity on offspring body size and metabolic outcomes, with special emphasis on the effects of lifestyle intervention during pregnancy. The thesis is based on a literature review, description of own studies and three original papers/manuscripts (I, II and III). In paper I, we used data from the Danish Medical Birth Registry. The aim of this paper was to examine the impact of maternal pregestational Body Mass Index (BMI) and smoking on neonatal abdominal circumference (AC) and weight at birth and to define reference curves for birth AC and weight in offspring of healthy, non-smoking, normal weight women. Data on 366,886 singletons were extracted and analyzed using multivariate linear regressions. We found that birth AC and weight increased with increasing pregestational BMI and decreased with smoking. Reference curves were

  12. 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.

  13. Dietary Patterns Among Overweight and Obese African-American Women Living in the Rural South.

    PubMed

    Sterling, Samara; Judd, Suzanne; Bertrand, Brenda; Carson, Tiffany L; Chandler-Laney, Paula; Baskin, Monica L

    2018-02-01

    Obesity and chronic diseases disproportionately affect African-American women in the rural South (US) and may be influenced by adherence to a typical Southern-style diet. There is a need to examine dietary patterns of this population and to determine if consumption of nutritionally rich foods like nuts is associated with consumption of other nutritious foods. The objectives of this study were to identify (1) dietary patterns of overweight/obese African-American women in the rural South; (2) the role that nuts play in the diet; (3) and adherence to federal food group recommendations across dietary patterns. Secondary data analysis of two baseline 24-h dietary recalls was performed on 383 overweight/obese African-American women enrolled in a weight loss intervention in Alabama and Mississippi between 2011 and 2013. Cluster analysis identified dietary patterns. t tests and chi-square tests tested demographic and dietary differences across clusters. The proportion of women in each cluster who met federal recommendations for fruit, vegetable, nuts, added sugar, and sodium intake was calculated. Two dietary patterns were found. Nut intake frequency was higher in cluster 2 (P < .001), which was characterized by a higher intake frequency of fruits and vegetables, but high mean daily intake of added sugar (12.26 ± 7.67 tsp) and sodium (2800 ± 881 mg). Ninety-two percent of participants in this cluster consumed red/processed meats daily. Even among women in this population who consume a more plant-based dietary pattern containing nuts, there is still a need to decrease intake of added sugar, sodium, and red meat.

  14. Adipose tissue IL-8 is increased in normal weight women after menopause and reduced after gastric bypass surgery in obese women.

    PubMed

    Alvehus, Malin; Simonyte, Kotryna; Andersson, Therése; Söderström, Ingegerd; Burén, Jonas; Rask, Eva; Mattsson, Cecilia; Olsson, Tommy

    2012-11-01

    The menopausal transition is characterized by increased body fat accumulation, including redistribution from peripheral to central fat depots. This distribution is associated with an increased risk of type 2 diabetes and cardiovascular disease that are linked to low-grade inflammation. We determined whether postmenopausal women have higher levels of inflammatory markers, compared with premenopausal women. We also wanted to determine whether these markers are reduced by stable weight loss in obese women. Anthropometric data, blood samples and subcutaneous adipose tissue biopsies were collected from normal weight premenopausal and postmenopausal women and obese women before and 2 years after gastric bypass (GBP) surgery. Serum protein levels and adipose tissue gene expression of inflammatory markers were investigated. IL-8 expression in adipose tissue and circulating levels were higher in postmenopausal vs premenopausal women. IL-8 expression was associated with waist circumference, independent of menopausal status. IL-6 expression and serum levels of monocyte chemoattractant protein (MCP)-1 were higher in postmenopausal vs premenopausal women. Two years after GBP surgery, adipose expression of IL-8, tumour necrosis factor-α and MCP-1 decreased significantly. Serum insulin levels were associated with inflammation-related gene expression before GBP surgery, but these associations disappeared after surgery. Postmenopausal women have an increased inflammatory response in the subcutaneous fat and circulation. Inflammatory markers in adipose tissue decreased significantly after surgery-induced weight loss. This effect may be beneficial for metabolic control and reduced cardiovascular risk after weight loss. © 2011 Blackwell Publishing Ltd.

  15. Morbid obesity and the transition from welfare to work.

    PubMed

    Cawley, John; Danziger, Sheldon

    2005-01-01

    This paper utilizes a rich longitudinal data set--the Women's Employment Study (WES)--to investigate whether obesity, which is common among women of low socioeconomic status, is a barrier to employment and earnings for current and former welfare recipients. We find that former welfare recipients who are both White and morbidly obese have been less successful in transitioning from welfare to work. These women are less likely to work at any survey wave, spend a greater percentage of months between waves receiving cash welfare, and have lower monthly earnings at each wave. The magnitude of the difference in labor market outcomes between the morbidly obese and those who are less heavy is in some cases similar in magnitude to the differences in these labor market outcomes between high school dropouts and graduates. In contrast, we find no such labor market differences associated with morbid obesity for African-American respondents. This paper documents the relationship between weight and labor market outcomes for the first time among the welfare population. In addition, it investigates whether the correlation for White females is due to unobserved heterogeneity. We find that after controlling for individual fixed effects, the point estimate of the correlation of morbid obesity and each of the labor market outcomes falls considerably and is no longer statistically significant. These results are consistent with unobserved heterogeneity causing the correlation between morbid obesity and labor market outcomes. Findings are similar after controlling for the respondent's mental and physical health.

  16. Exercise training improves hemodynamic recovery to isometric exercise in obese men with type 2 diabetes but not in obese women.

    PubMed

    Kanaley, Jill A; Goulopoulou, Styliani; Franklin, Ruth; Baynard, Tracy; Carhart, Robert L; Weinstock, Ruth S; Fernhall, Bo

    2012-12-01

    Women with type 2 diabetes (T2D) show greater rates of mortality due to ischemic heart disease than men with T2D. We aimed to examine cardiovascular and autonomic function responses to isometric handgrip (IHG) exercise between men and women with T2D, before and after an exercise training program. Hemodynamic responses were measured in 22 men and women with T2D during and following a 3-min IHG test, and before and after 16 wks of aerobic exercise training. Women had a smaller decrease in mean arterial pressure (MAP) and systolic blood pressure (BP) during recovery from IHG (ΔMAP(REC)) than men pre- and post-training (P<0.05). Men showed a greater reduction in diastolic BP during recovery from IHG (P<0.05), and exercise training improved this response in men but not in women (men, pre-training: -13.9±1.8, post-training: -20.5±5.3 mmHg vs. women, pre-training: -10.7±1.7, post-training: -4.1±4.9 mmHg; P<0.05). Men had a greater reduction in sympathetic modulation of vasomotor tone (P<0.05), as estimated by blood pressure variability, following IHG. This response was accentuated after training, while this training effect was not seen in women. Post-training ΔMAP(REC) was correlated with recovery of low frequency component of the BP spectrum (ΔLF(SBPrec), r=0.52, P<0.05). Differences in BP recovery immediately following IHG may be attributed to gender differences in cardiovascular autonomic modulation. An improvement in these responses occurs following aerobic exercise training in obese men, but not in obese women with T2D which reflects a better adaptive autonomic response to exercise training. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Similarity in percent body fat between white and Vietnamese women: implication for a universal definition of obesity.

    PubMed

    Ho-Pham, Lan T; Lai, Thai Q; Nguyen, Nguyen D; Barrett-Connor, Elizabeth; Nguyen, Tuan V

    2010-06-01

    It has been widely assumed that for a given BMI, Asians have higher percent body fat (PBF) than whites, and that the BMI threshold for defining obesity in Asians should be lower than the threshold for whites. This study sought to test this assumption by comparing the PBF between US white and Vietnamese women. The study was designed as a comparative cross-sectional investigation. In the first study, 210 Vietnamese women ages between 50 and 85 were randomly selected from various districts in Ho Chi Minh City (Vietnam). In the second study, 419 women of the same age range were randomly selected from the Rancho Bernardo Study (San Diego, CA). In both studies, lean mass (LM) and fat mass (FM) were measured by dual-energy X-ray absorptiometry (DXA) (QDR 4500; Hologic). PBF was derived as FM over body weight. Compared with Vietnamese women, white women had much more FM (24.8 +/- 8.1 kg vs. 18.8 +/- 4.9 kg; P < 0.0001) and greater PBF (36.4 +/- 6.5% vs. 35.0 +/- 6.2%; P = 0.012). However, there was no significant difference in PBF between the two groups after matching for BMI (35.1 +/- 6.2% vs. 35.0 +/- 5.7%; P = 0.87) or for age and BMI (35.6 +/- 5.1% vs. 35.8 +/- 5.9%; P = 0.79). Using the criteria of BMI >or=30, 19% of US white women and 5% of Vietnamese women were classified as obese. Approximately 54% of US white women and 53% of Vietnamese women had their PBF >35% (P = 0.80). Although white women had greater BMI, body weight, and FM than Vietnamese women, their PBF was virtually identical. Further research is required to derive a more appropriate BMI threshold for defining obesity for Asian women.

  18. Age at menarche, androgen concentrations, and midlife obesity: findings from the Midlife Women's Health Study.

    PubMed

    Gallicchio, Lisa; Flaws, Jodi A; Smith, Rebecca L

    2016-11-01

    Studies have shown that earlier age at menarche is associated with a higher risk of midlife obesity; however, the mechanism underlying this association is not known. The purpose of this study was to examine whether the association between age at menarche and midlife obesity is due to variation in circulating androgen concentrations. Baseline data were analyzed from 748 women aged 45 to 54 years enrolled in the Midlife Women's Health Study, a prospective cohort study conducted in the Baltimore, MD region. Information on age at menarche was collected through a self-administered questionnaire. Body mass index (BMI) was calculated using height and weight measured at a clinic visit. Obesity was defined as a BMI between 30 and 34.9 kg/m; super obesity was defined as a BMI greater than 35 kg/m. Testosterone, estradiol, and sex hormone-binding globulin were measured in blood samples using enzyme-linked immunosorbent assays. The free androgen index (FAI) was calculated using the formula: (testosterone × 3.467)/sex hormone-binding globulin × 100. After adjustment for covariates, for each year increase in age at menarche, the odds of obesity and super obesity decreased by 31% (odds ratio (OR) 0.69; 95% confidence limits (CL) 0.59, 0.81) and 34% (OR 0.66; 95% CL 0.52, 0.83), respectively. Addition of the FAI into the models did not attenuate the observed estimates. The results of this study indicate that age at menarche is associated with midlife obesity independent of free testosterone concentrations measured in adulthood.

  19. Changes in resting and walking energy expenditure and walking speed during pregnancy in obese women.

    PubMed

    Byrne, Nuala M; Groves, Ainsley M; McIntyre, H David; Callaway, Leonie K

    2011-09-01

    Energy-conserving processes reported in undernourished women during pregnancy are a recognized strategy for providing the energy required to support fetal development. Women who are obese before conceiving arguably have sufficient fat stores to support the energy demands of pregnancy without the need to provoke energy-conserving mechanisms. We tested the hypothesis that obese women would show behavioral adaptation [ie, a decrease in self-selected walking (SSW) speed] but not metabolic compensation [ie, a decrease in resting metabolic rate (RMR) or the metabolic cost of walking] during gestation. RMR, SSW speed, metabolic cost of walking, and anthropometric variables were measured in 23 women aged 31 ± 4 y with a BMI (in kg/m(2)) of 33.6 ± 2.5 (mean ± SD) at ≈15 and 30 wk of gestation. RMR was also measured in 2 cohorts of nonpregnant control subjects matched for the age, weight, and height of the pregnant cohort at 15 (n = 23) and 30 (n = 23) wk. Gestational weight gain varied widely (11.3 ± 5.4 kg), and 52% of the women gained more weight than is recommended. RMR increased significantly by an average of 177 ± 176 kcal/d (11 ± 12%; P < 0.0001); however, the within-group variability was large. Both the metabolic cost of walking and SSW speed decreased significantly (P < 0.01). Whereas RMR increased in >80% of the cohort, the net oxygen cost of walking decreased in the same proportion of women. Although the increase in RMR was greater than that explained by weight gain, evidence of both behavioral and biological compensation in the metabolic cost of walking was observed in obese women during gestation. The trial is registered with the Australian Clinical Trials Registry as ACTRN012606000271505.

  20. Disordered eating behavior and mental health correlates among treatment seeking obese women.

    PubMed

    Altamura, M; Rossi, G; Aquilano, P; De Fazio, P; Segura-Garcia, C; Rossetti, M; Petrone, A; Lo Russo, T; Vendemiale, G; Bellomo, A

    2015-01-01

    Previous research has suggest that obesity is associated with increased risk for psychopathological disorders, however, little is known about which obese patients are most vulnerable to psychopathological disorders. We therefore investigated 126 treatment-seeking obese women to describe eating disorder pathology and mental health correlates, and to identify disordered eating behaviors that may place obese at increased risk for psychopathological disorders. The Structured Clinical Interview for DSM-IV (SCID) was used to identify Eating Disorders (ED). A battery of psychological tests, including the Anxiety Scale Questionnaire (ASQ,) Clinical Depression Questionnaire (CDQ), Eating Disorder Inventory-2 (EDI-2) Eating Attitudes Test-26 (EAT-26) scales and structured clinical interview were administered to all the patients. We analyzed the link between psychopathological disorders and eating attitudes by using both multiple regression analysis and non-parametric correlation. Disordered eating behaviors and emotional behavioral aspects related to Anorexia Nervosa, such as ineffectiveness, are strongly linked to the depression and anxiety in obese subjects. No correlation was found between psychopathological disorders and age or anthropometric measurements. Findings corroborate earlier work indicating that psychological distress is elevated in obese treatment seeking, bolstering the need for mental health assessment of such individuals. The feeling of ineffectiveness constitutes the major predictor of psychopathological aspects. This is an important result which may inform the development of effective interventions for obese patients and prevention of psychopathological disorders.

  1. 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.

  2. A Potential Role for Endoplasmic Reticulum Stress in Progesterone Deficiency in Obese Women.

    PubMed

    Takahashi, Nozomi; Harada, Miyuki; Hirota, Yasushi; Zhao, Lin; Azhary, Jerilee M K; Yoshino, Osamu; Izumi, Gentaro; Hirata, Tetsuya; Koga, Kaori; Wada-Hiraike, Osamu; Fujii, Tomoyuki; Osuga, Yutaka

    2017-01-01

    Obesity in reproductive-aged women is associated with a shorter luteal phase and lower progesterone levels. Lipid accumulation in follicles of obese women compromises endoplasmic reticulum (ER) function, activating ER stress in granulosa cells. We hypothesized that ER stress activation in granulosa-lutein cells (GLCs) would modulate progesterone production and contribute to obesity-associated progesterone deficiency. Pretreatment with an ER stress inducer, tunicamycin or thapsigargin, inhibited human chorionic gonadotropin (hCG)-stimulated progesterone production in cultured human GLCs. Pretreatment of human GLCs with tunicamycin inhibited hCG-stimulated expression of steroidogenic acute regulatory protein (StAR) and 3β-hydroxysteroid dehydrogenase (3β-HSD) messenger RNAs (mRNAs) without affecting expression of cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc), as determined by real-time quantitative polymerase chain reaction. Pretreatment with tunicamycin also inhibited hCG-stimulated expression of StAR protein and 3β-HSD enzyme activity in cultured human GLCs, as determined by Western blot analysis and an enzyme immunoassay, respectively, but did not affect hCG-induced intracellular 3',5'-cyclic adenosine monophosphate accumulation. Furthermore, tunicamycin attenuated hCG-induced protein kinase A and extracellular signal-regulated kinase activation, as determined by Western blot analysis. In vivo administration of tunicamycin to pregnant mare serum gonadotropin-treated immature mice prior to hCG treatment inhibited the hCG-stimulated increase in serum progesterone levels and hCG-induced expression of StAR and 3β-HSD mRNA in the ovary without affecting serum estradiol levels or the number of corpora lutea. Our findings indicate that ER stress in the follicles of obese women contributes to progesterone deficiency by inhibiting hCG-induced progesterone production in granulosa cells. Copyright © 2017 by the Endocrine Society.

  3. Evaluation of tumor necrosis factor alpha serum level in obese and lean women with clomiphene citrate-resistant polycystic ovary disease.

    PubMed

    Seyam, Emaduldin; Hasan, Momen; Khalifa, Eissa M; Ramadan, Ahmad; Hefzy, Enas

    2017-11-01

    The aim of this work was to investigate the level of the serum level of tumor necrosis factor alpha (TNF-α) as an inflammatory biomarker in lean and obese women with polycystic ovary disease (PCOD), who are resistant to clomiphene citrate (CCR-PCOD). It is a case-controlled study, where 150 (n = 150) PCOD women (study group), who are resistant to clomiphene citrate (CCR-PCOD) had been recruited, in addition to 100 (n = 100) women with PCOD, who are not resistant to clomiphene citrate (NCCR-PCOD) as the first control group, and another 100 women (n = 100) fertile women with normal reproductive health, as the second control group. All the recruited subjects had been divided into subgroups according to the BMI: One obese group with BMI ≥ 27 and the second lean group with BMI < 27. TNF-α had been measured in all women groups recruited, in addition to the other essential, basic and PCOD-relevant biochemical and hormonal tests. TNF-α level was found to be higher in all PCOD women, either the study or control PCOD groups, than the fertile control group (49.93 ± 3.39 versus 35.83 ± 2.47 pg/ml, p < 0.001). The level of TNF-α has come highest in the obese clomiphene citrate-resistant PCOD women (obese CCR-PCOD), while the lowest has come in the lean PCOD women, who are not resistant to clomiphene citrate (NCCR-PCOD). Free Androgen Index (FAI) and androgenic obesity with higher W/H ratio were clearly going with TNF-α pattern and have come higher in all PCOD compared to the fertile control group. Insulin resistance (IR) shows a positive correlation with BMI regardless off PCOD status and androgen level as well. The level of other basic and PCOD-relevant hormones like FSH, TSH and prolactin have never shown statistically significant differences between all the study and control groups, except LH serum level which has shown a nonsignificant higher level in all PCOD women included either resistant to CC or not. TNF-α serum level has

  4. Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome.

    PubMed

    Livadas, Sarantis; Kollias, Anastasios; Panidis, Dimitrios; Diamanti-Kandarakis, Evanthia

    2014-09-01

    Polycystic ovary syndrome (PCOS) represents a moving spectrum of hormonal to metabolic abnormalities, as women with the syndrome are aging. Hormonal abnormalities, anovulation, and hyperandrogenic signs were predominant during the early years of PCOS and fade away with the years. Metabolic abnormalities and insulin resistance (IR) remain throughout the PCOS life cycle; however, it is unclear as to how they change, as women with the syndrome are aging. To evaluate the changes in IR and its associations with clinical, biochemical, hormonal, and ultrasound findings in a large cohort of women with PCOS and controls, as they are aging. A cross-sectional study was carried out to evaluate the diverse impacts of aging on IR. An outpatient clinic was chosen for the study. A total of 1345 women with PCOS (Rotterdam criteria) and 302 controls of Caucasian origin and Greek ethnicity comprised the study group. The impact of age on IR, as calculated using homeostasis model assessment of IR (HOMA-IR) index, and several PCOS characteristics were evaluated. In PCOS, age (-0.045±0.008) was negatively, and BMI positively (0.18±0.007) associated with HOMA-IR (R(2)=0.36). When data were stratified with regard to the BMI status, a negative association of age with HOMA-IR was found in lean, normal, and overweight patients (r: -0.266, -0.233, -0.192, P<0.001), which was neutralized in obese patients (r: -0.009, P: NS). Free androgen index and BMI were positively associated with HOMA-IR in all age quartiles. When mean HOMA-IR values were plotted according to BMI subgroups at different age quartiles, a significant gradual decrease in HOMA-IR was observed in normal (P<0.001) and overweight (P: 0.004), but not obese, women (P: 0.202) across age quartiles. Aging increases IR in obese but not in lean and overweight women with PCOS. As BMI and androgens are positively associated with HOMA-IR and androgens decline through time, it appears that if women with PCOS do not become obese they may

  5. Circuit Resistance Training Attenuates Acute Exertion-Induced Reductions in Arterial Function but Not Inflammation in Obese Women

    PubMed Central

    Franklin, Nina C.; Robinson, Austin T.; Bian, Jing-Tan; Ali, Mohamed M.; Norkeviciute, Edita; McGinty, Patrick

    2015-01-01

    Abstract Background: Cardiovascular disease (CVD) is a leading cause of preventable death among young women in the United States. Habitual resistance exercise training is known to have beneficial effects on endothelial function and CVD risk factors, including obesity; however, previous studies show that acute resistance exercise impairs endothelial function in obese adults who are sedentary, a response that may be linked to inflammation. We sought to determine if circuit-based resistance training (CRT) attenuates acute resistance exercise-induced reductions in endothelial function in a population of young, obese, sedentary women and whether or not inflammation plays a role in this response. Methods: Eighteen obese [body mass index (BMI) 30.0–40.0 kg·m−2] young premenopausal women were randomly assigned to either a CRT group or a no-exercise control group (CON). Conduit artery endothelial function was assessed using brachial artery flow-mediated dilation (FMD) determined by ultrasound before and after a single bout of strenuous weightlifting (SWL). In addition, circulating inflammatory mediators (tumor necrosis factor-α and C-reactive protein), blood pressure, fasting blood lipids, glucose, waist circumference, body composition, and aerobic capacity were assessed. Results: Among participants randomized to the CRT group, 8 weeks of training led to considerable increases in FMD after SWL (P=0.001) compared to the CON group. However, no significant differences between the groups were observed in circulating inflammatory mediators, blood pressure, fasting blood lipids, or other physical and physiological characteristics. Conclusions: This study shows that CRT alleviates acute exertion-induced reductions in endothelial function among obese sedentary women in the absence of changes in inflammation. PMID:25844686

  6. Docosahexaenoic Acid Supplementation in Pregnancy Modulates Placental Cellular Signaling and Nutrient Transport Capacity in Obese Women.

    PubMed

    Lager, Susanne; Ramirez, Vanessa I; Acosta, Ometeotl; Meireles, Christiane; Miller, Evelyn; Gaccioli, Francesca; Rosario, Fredrick J; Gelfond, Jonathan A L; Hakala, Kevin; Weintraub, Susan T; Krummel, Debra A; Powell, Theresa L

    2017-12-01

    Maternal obesity in pregnancy has profound impacts on maternal metabolism and promotes placental nutrient transport, which may contribute to fetal overgrowth in these pregnancies. The fatty acid docosahexaenoic acid (DHA) has bioactive properties that may improve outcomes in obese pregnant women by modulating placental function. To determine the effects of DHA supplementation in obese pregnant women on maternal metabolism and placental function. Pregnant women were supplemented with DHA or placebo. Maternal fasting blood was collected at 26 and 36 weeks' gestation, and placentas were collected at term. Academic health care institution. Thirty-eight pregnant women with pregravid body mass index ≥30 kg/m2. DHA (800 mg, algal oil) or placebo (corn/soy oil) daily from 26 weeks to term. DHA content of maternal erythrocyte and placental membranes, maternal fasting blood glucose, cytokines, metabolic hormones, and circulating lipids were determined. Insulin, mTOR, and inflammatory signaling were assessed in placental homogenates, and nutrient transport capacity was determined in isolated syncytiotrophoblast plasma membranes. DHA supplementation increased erythrocyte (P < 0.0001) and placental membrane DHA levels (P < 0.0001) but did not influence maternal inflammatory status, insulin sensitivity, or lipids. DHA supplementation decreased placental inflammation, amino acid transporter expression, and activity (P < 0.01) and increased placental protein expression of fatty acid transporting protein 4 (P < 0.05). Maternal DHA supplementation in pregnancy decreases placental inflammation and differentially modulates placental nutrient transport capacity and may mitigate adverse effects of maternal obesity on placental function. Copyright © 2017 Endocrine Society

  7. Increasing overweight and obesity erodes engagement in one's neighborhood by women, but not men.

    PubMed

    Schuster, Roseanne C; Han, Seung Yong; Brewis, Alexandra A; Wutich, Amber

    2018-06-01

    Obesity is socially stigmatized in the U.S., especially for women. Significant research has focused on the role that the social and built environments of neighborhoods play in shaping obesity. However, the role of obesity in shaping neighborhood social structure has been largely overlooked. We test the hypothesis that large body size inhibits an individual's engagement in his or her neighborhood. Our study objectives are to assess if (1) body size (body mass index) interacts with gender to predict engagement in one's neighborhood (neighborhood engagement) and (2) if bonding social capital interacts with gender to predict neighborhood engagement independent of body size. We used data collected from the cross-sectional 2011 Phoenix Area Social Survey (PASS), which systematically sampled residents across four neighborhood types (core urban, urban fringe, suburban, retirement) across the Phoenix Metopolitian Area. Survey data was analyzed using logistic regression for 804 participants, including 35% for whom missing data was computed using multiple imputation. We found that as body size increases, women-but not men-have reduced engagement in their neighborhood, independent of bonding social capital and other key covariates (objective 1). We did not observe the interaction between gender and bonding social capital associated with neighborhood engagement (objective 2). Prior scholarship suggests obesity clusters in neighborhoods due to processes of social, economic, and environmental disadvantage. This finding suggests bi-directionality: obesity could, in turn, undermine neighborhood engagement through the mechanism of weight stigma and discrimination.

  8. Liver Enlargement Predicts Obstructive Sleep Apnea–Hypopnea Syndrome in Morbidly Obese Women

    PubMed Central

    Scartabelli, Giovanna; Querci, Giorgia; Marconi, Letizia; Ceccarini, Giovanni; Piaggi, Paolo; Fierabracci, Paola; Salvetti, Guido; Cizza, Giovanni; Mazzeo, Salvatore; Vitti, Jacopo; Berger, Slava; Palla, Antonio; Santini, Ferruccio

    2018-01-01

    Obstructive sleep apnea–hypopnea syndrome (OSAHS) is frequently present in patients with severe obesity, but its prevalence especially in women is not well defined. OSAHS and non-alcoholic fatty liver disease are common conditions, frequently associated in patients with central obesity and metabolic syndrome and are both the result of the accumulation of ectopic fat mass. Identifying predictors of risk of OSAHS may be useful to select the subjects requiring instrumental sleep evaluation. In this cross-sectional study, we have investigated the potential role of hepatic left lobe volume (HLLV) in predicting the presence of OSAHS. OSAHS was quantified by the apnea/hypopnea index (AHI) and oxygen desaturation index in a cardiorespiratory inpatient sleep study of 97 obese women [age: 47 ± 11 years body mass index (BMI): 50 ± 8 kg/m2]. OSAHS was diagnosed when AHI was ≥5. HLLV, subcutaneous and intra-abdominal fat were measured by ultrasound. After adjustment for age and BMI, both HLLV and neck circumference (NC) were independent predictors of AHI. OSAHS was found in 72% of patients; HLLV ≥ 370 cm3 was a predictor of OSAHS with a sensitivity of 66%, a specificity of 70%, a positive and negative predictive values of 85 and 44%, respectively (AUC = 0.67, p < 0.005). A multivariate logistic model was used including age, BMI, NC, and HLLV (the only independent predictors of AHI in a multiple linear regression analyses), and a cut off value for the predicted probability of OSAHS equal to 0.7 provided the best diagnostic results (AUC = 0.79, p < 0.005) in terms of sensitivity (76%), specificity (89%), negative and positive predictive values (59 and 95%, respectively). All patients with severe OSAHS were identified by this prediction model. In conclusion, HLLV, an established index of visceral adiposity, represents an anthropometric parameter closely associated with OSAHS in severely obese women. PMID:29928260

  9. Liver Enlargement Predicts Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women.

    PubMed

    Scartabelli, Giovanna; Querci, Giorgia; Marconi, Letizia; Ceccarini, Giovanni; Piaggi, Paolo; Fierabracci, Paola; Salvetti, Guido; Cizza, Giovanni; Mazzeo, Salvatore; Vitti, Jacopo; Berger, Slava; Palla, Antonio; Santini, Ferruccio

    2018-01-01

    Obstructive sleep apnea-hypopnea syndrome (OSAHS) is frequently present in patients with severe obesity, but its prevalence especially in women is not well defined. OSAHS and non-alcoholic fatty liver disease are common conditions, frequently associated in patients with central obesity and metabolic syndrome and are both the result of the accumulation of ectopic fat mass. Identifying predictors of risk of OSAHS may be useful to select the subjects requiring instrumental sleep evaluation. In this cross-sectional study, we have investigated the potential role of hepatic left lobe volume (HLLV) in predicting the presence of OSAHS. OSAHS was quantified by the apnea/hypopnea index (AHI) and oxygen desaturation index in a cardiorespiratory inpatient sleep study of 97 obese women [age: 47 ± 11 years body mass index (BMI): 50 ± 8 kg/m 2 ]. OSAHS was diagnosed when AHI was ≥5. HLLV, subcutaneous and intra-abdominal fat were measured by ultrasound. After adjustment for age and BMI, both HLLV and neck circumference (NC) were independent predictors of AHI. OSAHS was found in 72% of patients; HLLV ≥ 370 cm 3 was a predictor of OSAHS with a sensitivity of 66%, a specificity of 70%, a positive and negative predictive values of 85 and 44%, respectively (AUC = 0.67, p  < 0.005). A multivariate logistic model was used including age, BMI, NC, and HLLV (the only independent predictors of AHI in a multiple linear regression analyses), and a cut off value for the predicted probability of OSAHS equal to 0.7 provided the best diagnostic results (AUC = 0.79, p  < 0.005) in terms of sensitivity (76%), specificity (89%), negative and positive predictive values (59 and 95%, respectively). All patients with severe OSAHS were identified by this prediction model. In conclusion, HLLV, an established index of visceral adiposity, represents an anthropometric parameter closely associated with OSAHS in severely obese women.

  10. 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.

  11. [Nutritional knowledge and its association with overweight and obesity in Mexican women with low socioeconomic level].

    PubMed

    Galindo Gómez, Carlos; Juárez Martínez, Liliana; Shamah Levy, Teresa; García Guerra, Armando; Avila Curiel, Abelardo; Quiroz Aguilar, Marco Antonio

    2011-12-01

    The objective of this study was to identify the association between knowledge about nutrition with the presence of obesity or overweight in women with low income in Mexico City. Data was obtained with the Urban Food and Nutrition Survey 2002 in the Metropolitan Area of Mexico City (ENURBAL 2002), a stratified multistage and clustered design survey. An ordinal logistic regression model was used in order to estimate the probability to present obesity and overweight or obesity, in relation to nutritional knowledge, age, education, employment, socioeconomic status, and total fat consumption. The variables that were related to overweight or obesity: correct or regular nutrition knowledge (OR = 2,00; CI95% = 1,13-3,54) and (OR = 1,54; CI 95%= 1,03-2,30), respectively; age 30 years (OR = 3,00; CI 95% = 1,94-4,64), belonging to a medium- low socioeconomic status (OR = 2,04; CI 95% = 1,33-3,15), and high fat consumption (OR = 1,65; CI 95% = 1,07-2,55). For obesity was age 30 years (OR = 2,42; IC 95% = 1,48-3,94) and high fat consumption (OR = 1,67; IC 95% = 1,05-2,66). Our results helped to identify associated factors in women with obesity and overweight from low income households, mainly those concerning with nutrition knowledge. This emphasizes the importance of improving knowledge about nutrition, in planning the strategy for interventions aimed to prevent overweight and obesity.

  12. Iron stores and obesity are negatively associated with ovarian volume and anti-Müllerian hormone levels in women with polycystic ovary syndrome.

    PubMed

    Yang, Jehn-Hsiahn; Chou, Chia-Hung; Yang, Wei-Shiung; Ho, Hong-Nerng; Yang, Yu-Shih; Chen, Mei-Jou

    2015-12-01

    Obesity and insulin resistance are associated with increased iron stores, but have conflicting effects on ovarian reserve in women with polycystic ovary syndrome (PCOS). Iron-catalyzed oxidative stress might be detrimental to ovarian tissue and granulosa cell function. In this study we determined the association between body iron stores, obesity, and ovarian reserve in women with PCOS. One hundred and fifty-six women diagnosed with PCOS according to Rotterdam criteria and 30 normoweight healthy control women were enrolled in this cross-sectional study. Ovarian volume, total antral follicle count, and the anti-Müllerian hormone (AMH) level were measured as an indicator of ovarian reserve. Ferritin and transferrin-bound iron levels were significantly higher in women with PCOS than normoweight controls. Obese women with PCOS had higher ferritin levels (p = 0.006), but lower AMH levels (p < 0.0001) than nonobese women with PCOS. Using univariate analysis, the AMH level and mean ovarian volume were inversely related to the ferritin level, homeostasis model assessment of insulin resistance, and body mass index in women with PCOS. Body mass index and ferritin level remained significantly correlated with a lower AMH level and reduced ovarian volume, respectively, after considering other confounding variables. An elevated ferritin level and obesity were negatively associated with ovarian volume and the AMH level, respectively, in women with PCOS. Copyright © 2015. Published by Elsevier B.V.

  13. 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.

  14. 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.

  15. Unique barriers and needs in weight management for obese women with fibromyalgia.

    PubMed

    Craft, Jennifer M; Ridgeway, Jennifer L; Vickers, Kristin S; Hathaway, Julie C; Vincent, Ann; Oh, Terry H

    2015-01-01

    The aim of this study was to identify barriers, needs, and preferences of weight management intervention for women with fibromyalgia (FM). Obesity appears in higher rates in women with fibromyalgia compared to the population at large, and no study to date has taken a qualitative approach to better understand how these women view weight management in relation to their disease and vice versa. We designed a qualitative interview study with women patients with FM and obesity. Women (N = 15) were recruited by their participation in a fibromyalgia treatment program (FTP) within the year prior. The women approached for the study met the following inclusion criteria: confirmed diagnosis of FM, age between 30 and 60 years (M = 51 ± 6.27), and body mass index (BMI) ≥ 30 (M = 37.88 ± 4.87). Patients completed questionnaire data prior to their participation in focus groups (N = 3), including weight loss history, physical activity data, the Revised Fibromyalgia Impact Questionnaire (FIQR), and the Patient Health Questionnaire 9-item (PHQ-9). Three focus group interviews were conducted to collect qualitative data. Consistent themes were revealed within and between groups. Patients expressed the complex relationships between FM symptoms, daily responsibilities, and weight management. Weight was viewed as an emotionally laden topic requiring compassionate delivery of programming from an empathetic leader who is knowledgeable about fibromyalgia. Patients view themselves as complex and different, requiring a specifically tailored weight management program for women with FM. Women with FM identify unique barriers to weight management, including the complex interrelationships between symptoms of FM and health behaviors, such as diet and exercise. They prefer a weight management program for women with FM that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program. Feasibility may be one of the biggest barriers

  16. [Cardiovascular exercise on obese women: effects on adiponectine, leptine, and tumour necrosis factor-alpha].

    PubMed

    Landeros-Olvera, Erick; López-Alvarenga, Juan Carlos; Nava-González, Edna J; Gallegos-Cabriales, Esther; Lavalle-González, Fernando; Bastarrachea, Raúl A; Salazar González, Bertha Cecilia

    2014-01-01

    The relationship of hormones adiponectin, leptin and tumor necrosis factor-alpha in adipose tissue on the atherogenic process is one of the most promising models in preventive medicine. The numerous tests performed to identify the effect of exercise on these hormones have not been clear on the type of exercise routine and physical effort calculated to contribute to changing plasma concentrations in obese women. Analyze controlledcardiovascular exercise effect on serum level of adiponectin, leptin, and tumournecrosis factor-alpha in obese young women. A simple blind clinical essay. The intervention covered a 10-week controlled, cardiovascular exercise program by 34 women (cases n=17, controls n=17) with a body mass index>27kg/m(2). Molecular analysis was performed by immune-fluorescence. Following the intervention, cases and controls means were as follows: adiponectin 19.0 vs. 12.2μ/ml (P=.008); leptin 20.0 vs. 28.0μ/L (P=.02); and tumour necrosis factor-alpha 4.7 vs. 5.1pg/ml (P=.05). The established exercise (5 sessions a week of exercise of 40min each for 10 weeks with a heart rate reserve of 40 to 80%) improved plasma concentrations of these hormones in the expected direction. This finding highlights an unpublished amount of exercise, controlled by the reserve cardiac frequency that might contribute the cardiovascular and metabolic protection to obese women. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  17. Overweight and obesity doubled over a 6-year period in young women living in poverty in Mexico.

    PubMed

    Neufeld, Lynnette M; Hernández-Cordero, Sonia; Fernald, Lia C; Ramakrishnan, Usha

    2008-03-01

    To document the changes in BMI and the prevalence of overweight and obesity in young women living in poverty in a semi-urban community in Mexico. Women who had previously participated in a longitudinal research study (1997-2000) were re-assessed in 2005. Anthropometric measurements were obtained using standard procedures, and socio-demographic questionnaires were administered. Total and annual rate of change in BMI and change in the prevalence of overweight and obesity (BMI > or = 25.0 and > or =30.0) were estimated. Mean age in 2005 was 30.0 +/- 5.7 years (n = 683) and time between recruitment and follow-up was 6.4 +/- 1.0 years. Mean change in BMI was +3.6 +/- 2.7 (range -8.2 to +14.6). In 2005, 500 (73.2%) women were overweight, up from 263 (38.5%) in the original assessment. The prevalence of obesity tripled over the follow-up period (from 9.8% to 30.3%). The mean annual rate of change in BMI was +0.6 (+/-0.4). After adjustment for age and parity at baseline, an annual rate of change of BMI above the sample median (>0.5) was associated with lower levels of formal education. The annual increase in the prevalence of overweight and obesity in this sample is double that which was reported at a national level in Mexico. An understanding of the determinants of this rapid increase among the women living in poverty in Mexico is urgently needed.

  18. Short-term effects of chewing gum on satiety and afternoon snack intake in healthy weight and obese women.

    PubMed

    Park, Eunyoung; Edirisinghe, Indika; Inui, Taichi; Kergoat, Sophie; Kelley, Michael; Burton-Freeman, Britt

    2016-05-15

    Afternoon snacking contributes significantly to total energy intake. Strategies to enhance the satiety value of lunch and reduce afternoon snacking are of interest for body weight management. To assess whether between-meal gum chewing would enhance the satiety response to a fixed lunch meal; and assess the role of cholecystokinin (CCK) as a potential mediator of the response in non-obese healthy weight and obese women. Fifty unrestrained obese (n=25) and non-obese healthy weight (n=25) women participated in a two-arm cross-over study assessing multiple (15min per hour×3h) gum chewing (GUM) occurrences or no gum (Control) on subjective ratings of satiety, subsequent sweet and salty snack intake, CCK and general metabolic responses. GUM compared to Control resulted in significant suppression of hunger, desire to eat and prospective consumption (p<0.05). Total snack energy intake was reduced ~9.3% by GUM, but not significantly different from Control (p=0.08). However, overall carbohydrate intake was reduced by GUM (p=0.03). This was consistent with a reduction in snacks characterized as high carbohydrate, low fat (p=0.02). BMI specific effects indicated GUM reduced pretzel intake in obese women (p=0.05) and Oreo cookie intake in healthy weight women (p=0.03) 3h after lunch. Metabolic responses and CCK did not differ between experimental conditions. Chewing gum intermittently post-lunch enhances perceptions of satiety and may have important implications in reducing afternoon high carbohydrate-snack intake. Copyright © 2016. Published by Elsevier Inc.

  19. Recall of Prenatal Counselling Among Obese and Overweight Women from a Canadian Population: A Population Based Study.

    PubMed

    Vinturache, Angela E; Winn, Anika; Tough, Suzanne C

    2017-11-01

    Objective The objective of this study was to evaluate the recall of prenatal counselling received among overweight and obese women in primary care settings. Methods A sample of 1996 women with singleton, term deliveries and pre-pregnancy BMI >18.5 kg/m 2 were identified from the All Our Babies pregnancy cohort. Information on socio-demographic characteristics and women's experiences with prenatal counselling on nutrition, vitamin and mineral supplements, exercise, weight gain, employment, alcohol and drug use, and smoking during pregnancy were collected through questionnaires administered at <25 weeks and 34-36 weeks gestation. Multivariable logistic regression analyses explored the associations between pre-pregnancy BMI and the domains of prenatal counselling, controlling for confounders. Results Women reported high levels of comfort asking questions and satisfaction with their health care provider. Women reported getting information about nutrition (69.3%), weight gain (67.8%), exercise (64.4%), vitamins and minerals supplementation (86.1%). Obese women (211, 10.6%) were more likely than normal weight women (1313, 65.8%) to be Caucasian (p = 0.004), less educated (p = 0.001), and to have been born or lived in Canada for at least 5 years (p = 0.01). There was no difference in the prenatal advice received on nutrition, weight gain and exercise in pregnancy between obese, overweight, and normal weight women. Conclusions for Practice Pre-pregnancy BMI did not appear to influence the recall of prenatal counselling women receive in community health care centers. Given the importance of nutrition and weight gain during pregnancy, and guidelines for weight gain based on pre-pregnancy BMI, there are missed opportunities in knowledge exchange between women and providers in the prenatal period.

  20. Social and cultural construction of obesity among Pakistani Muslim women in North West England.

    PubMed

    Ludwig, Alison F; Cox, Peter; Ellahi, Basma

    2011-10-01

    The present qualitative study explored health perceptions, diet and the social construction of obesity and how this relates to the initiation and maintenance of a healthier diet in UK Pakistani women. Pakistani women in Greater Manchester participated in focus group and one-to-one discussions. Semi-structured interviews employing fictional vignettes and body shape images were used to explore the participants' beliefs and practices regarding diet, overweight/obesity and the risk of type 2 diabetes. Transcripts were analysed using phenomenological and sociological approaches. Interviews took place either in local community and Pakistani resource centres or in private homes. First- and second-generation women who were both active in the community and housebound. The women spoke English and/or Urdu. The fifty-five participants lacked the motivation to address weight gain and were unsure how to do so. There was a limited awareness of the link between weight gain and type 2 diabetes. Other barriers included the influence of Islam, culture and familial expectations on home cooking, perceptions that weight gain is inevitable (owing to ageing, childbirth or divine predestination) and the prioritisation of family concerns over individual lifestyle changes. As the findings of the present research did not correspond to existing educational and behaviour change models, a new Health Action Transition conceptual model is proposed. Health education programmes that aim to address obesity and its associated risks in the South Asian community must take into account the complex beliefs and practices and the multiple dimensions of religion, ethnic and social identity within this population. The present study provides further insight into these factors and proposes a novel model for use in designing and implementing education interventions for British Pakistani women.