Journal of Obesity The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. The Effects of Food Labelling on Postexercise Energy Intake in Sedentary Women Thu, 25 May 2017 07:29:54 +0000 Food labelling has been previously reported to influence energy intake (EI). Whether food labels influence postexercise EI remains to be determined. We assessed how food labelling and exercise (Ex) interact to influence food perception and postexercise EI. In this randomized crossover design, 14 inactive women participated in 4 experimental conditions: Ex (300 kcal at 70% of ) and lunch labelled as low in fat (LF), Ex and lunch labelled as high in fat (HF), Rest and LF, and Rest and HF. The lunch was composed of a plate of pasta, yogurt, and oatmeal cookies, which had the same nutritional composition across the 4 experimental conditions. EI at lunch and for the 48-hour period covering the testing day and the following day was assessed. Furthermore, perceived healthiness of the meal and appetite ratings were evaluated. There were no effects of exercise and food labelling on EI. However, meals labelled as LF were perceived as heathier, and this label was associated with higher prospective food consumption. Initial beliefs about food items had a stronger effect on healthiness perception than the different food labels and explain the positive correlation with the amount of food consumed (, ). Jacynthe Lafrenière, Jessica McNeil, Véronique Provencher, and Éric Doucet Copyright © 2017 Jacynthe Lafrenière et al. All rights reserved. FTO Gene Associates and Interacts with Obesity Risk, Physical Activity, Energy Intake, and Time Spent Sitting: Pilot Study in a Nigerian Population Sun, 21 May 2017 00:00:00 +0000 Fat mass and obesity-associated (FTO) gene influences obesity but studies have shown that environmental/lifestyle variables like physical activity (PA), time spent sitting (TSS), and energy intake might mediate the effect. However, this is poorly understood in Nigeria due to scarce studies. We demystified association and interaction between FTO rs9939609, obesity, PA, TSS, and energy intake in Nigeria. FTO gene variant was genotyped by restriction fragment length polymorphism and gene sequencing analysis in 103 people with obesity and 98 controls. Anthropometrics and environmental variables were measured using standard procedures. Significant associations were found between FTO rs9939609 with obesity and environmental/lifestyle variables before and after adjusting for age. Carriers of allele A have significantly higher odds of being overweight/obese using BMI [0.191 (0.102–0.361), ] but this was attenuated by PA (); odds of being overweight reduced from 0.625 (0.181–2.159) to 0.082 (0.009–0.736) for low and high PA, respectively. Mediation analysis of total indirect effect also confirmed this by showing a simultaneous mediating role of total PA, energy intake, and TSS in the relationship between FTO and BMI (unstandardized-coefficient = 1.68; 95% CI: 1.26–2.22). This study shows a relationship between FTO and obesity phenotype and environmental/lifestyle factors might be an important modulator/mediator in the association. Bolaji Fatai Oyeyemi, Charles Ayorinde Ologunde, Ayonposi Bukola Olaoye, and Nanfizat Abiket Alamukii Copyright © 2017 Bolaji Fatai Oyeyemi et al. All rights reserved. Patient Factors Predicting Weight Loss after Roux-en-Y Gastric Bypass Wed, 17 May 2017 00:00:00 +0000 Objective. The purpose of this study was to identify preoperative factors predicting weight loss following Roux-en-Y gastric bypass (RYGB) surgery. Material and Methods. 281 patients subjected to RYGB between January 2006 and June 2012 were included. Demographic, physical, and socioeconomic factors were assessed with regression analysis. Dependent variable was percent of excess weight loss (% EWL) at follow-up. Results. Follow-up data at one year was available in 96%, at two years in 88%, and at three years in 65% of the patients. Mean EWL was 72.5%. The success rate (defined as ≥60% EWL) at 1 year was 73% and at 2 years 74% and was 71% after 3 years. An earlier onset of obesity and high preoperative BMI were independently associated with unsuccessful weight loss at 1-year follow-up. At 2-year follow-up, an association between unsuccessful weight loss and psychiatric disorder, diabetes, hypertension, and preoperative BMI was seen. At 3-year follow-up no statistically significant associations were detected. Conclusions. RYGB provides successful weight loss for most patients. The results from this study indicate that an earlier age of onset of obesity, high preoperative BMI, psychiatric disorder, diabetes, and hypertension are associated with unsuccessful weight loss. Linda Sillén and Ellen Andersson Copyright © 2017 Linda Sillén and Ellen Andersson. All rights reserved. Short- and Long-Term, 11–22 Years, Results after Laparoscopic Nissen Fundoplication in Obese versus Nonobese Patients Thu, 11 May 2017 09:56:16 +0000 Background. Some studies suggest that obesity is associated with a poor outcome after Laparoscopic Nissen Fundoplication (LNF), whereas others have not replicated these findings. The effect of body mass index (BMI) on the short- and long-term results of LNF is investigated. Methods. Inclusion criteria were only patients who undergone a LNF with at least 11-year follow-up data available, patients with preoperative weight and height data available for calculation of BMI (Kg/m2), and patients with a BMI up to a maximum of 34.9. Results. 201 patients met the inclusion criteria: 43 (21.4%) had a normal BMI, 89 (44.2%) were overweight, and 69 (34.4%) were obese. The operation was significantly longer in obese patients; the use of drains and graft was less in the normal BMI group (). The hospital stay, conversion (6,4%), and intraoperative and early postoperative complications were not influenced by BMI. Conclusions. BMI does not influence short-term outcomes following LNF, but long-term control of reflux in obese patients is worse than in normal weight subjects. Mario Schietroma, Federica Piccione, Marco Clementi, Emanuela Marina Cecilia, Federico Sista, Beatrice Pessia, Francesco Carlei, Stefano Guadagni, and Gianfranco Amicucci Copyright © 2017 Mario Schietroma et al. All rights reserved. The Role of Race and Gender in Nutrition Habits and Self-Efficacy: Results from the Young Adult Weight Loss Study Thu, 13 Apr 2017 08:03:42 +0000 Overweight and obesity are a massive public health problem and young adults are at high risk for gaining weight once they enter a college. This study sought to examine gender and race as they relate to nutrition habits and self-efficacy in a population of diverse young adults from the Young Adult Weight Loss Study. Participants were 29% males, 38.7% white, 33.8% Asian, and 12.9% African American. Males had lower self-efficacy for healthy eating (mean score = 92.5, SD = 17.1) compared to females (mean = 102.3, SD = 13.7, ). Males had higher consumption of sodium compared to females (4308 versus 3239 milligrams/day, ). There were no significant differences across racial subgroups in self-efficacy for healthy eating () or self-efficacy for exercise (). Higher self-efficacy scores for healthy eating were significantly associated with less total sodium (, ), greater fruit consumption, and less saturated fat. Our results indicate that weight loss interventions should be individualized and that there may be specific areas to target that are different for men and women. Additional larger studies should be conducted to confirm if racial differences exist across nutrition habits and self-efficacy and to confirm gender differences noted in this study. Janna D. Stephens, Andrew Althouse, Alai Tan, and Bernadette Mazurek Melnyk Copyright © 2017 Janna D. Stephens et al. All rights reserved. Web-Based Interventions Alone or Supplemented with Peer-Led Support or Professional Email Counseling for Weight Loss and Weight Maintenance in Women from Rural Communities: Results of a Clinical Trial Wed, 05 Apr 2017 10:20:05 +0000 Objective. This trial compared the effectiveness of a web-based only (WO) intervention with web-based supplemented by peer-led discussion (WD) or professional email counseling (WE) across 3 phases to achieve weight loss and weight maintenance in women from underserved rural communities. Methods. 301 women (BMI of 28–45 kg/m2) randomly assigned to groups participated in guided weight loss (baseline to 6 months), guided weight loss and maintenance (6 to 18 months), and self-managed weight maintenance (18 to 30 months). Results. Retention was 88.7%, 76.5%, and 71.8% at 6, 18, and 30 months, respectively. Intent-to-treat analyses demonstrated no group differences in change in weight within any phases. At 6 months, observed mean (SD) weight loss was 5.1 (6.0) kg in WO, 4.1 (5.6) kg in WD, and 6.0 (6.3) kg in WE, with 42%, 38%, and 51%, respectively, meeting ≥ 5% weight loss. These proportions dropped by a third after phase 2 with no further change during phase 3. Conclusion. Web-based interventions assisted women from rural communities in achieving 6-month weight loss, with weight regain by half at 30 months. No group differences were potentially due to the robust nature of the web-based intervention. Trial Registration. This trial is registered with NCT01307644. Patricia A. Hageman, Carol H. Pullen, Melody Hertzog, Bunny Pozehl, Christine Eisenhauer, and Linda S. Boeckner Copyright © 2017 Patricia A. Hageman et al. All rights reserved. Changes in the MicroRNA Profile Observed in the Subcutaneous Adipose Tissue of Obese Patients after Laparoscopic Adjustable Gastric Banding Mon, 13 Mar 2017 00:00:00 +0000 Background. Laparoscopic adjustable gastric banding (LAGB) results in significant lasting weight loss and improved metabolism in obese patients. To evaluate whether epigenetic factors could concur to these benefits, we investigated the subcutaneous adipose tissue (SAT) microRNA (miRNA) profile before (T0) and three years (T1) after LAGB in three morbidly obese women. Case Reports. SAT miRNA profiling, evaluated by TaqMan Array, showed four downexpressed (miR-519d, miR-299-5p, miR-212, and miR-671-3p) and two upexpressed (miR-370 and miR-487a) miRNAs at T1 versus T0. Bioinformatics predicted that these miRNAs regulate genes belonging to pathways associated with the cytoskeleton, inflammation, and metabolism. Western blot analysis showed that PPAR-alpha, which is the target gene of miR-519d, increased after LAGB, thereby suggesting an improvement in SAT lipid metabolism. Accordingly, the number and diameter of adipocytes were significantly higher and lower, respectively, at T1 versus T0. Bioinformatics predicted that the decreased levels of miR-212, miR-299-5p, and miR-671-3p at T1 concur in reducing SAT inflammation. Conclusion. We show that the miRNA profile changes after LAGB. This finding, although obtained in only three cases, suggests that this epigenetic mechanism, by regulating the expression of genes involved in inflammation and lipid metabolism, could concur to improve SAT functionality in postoperative obese patients. Carmela Nardelli, Laura Iaffaldano, Vincenzo Pilone, Giuseppe Labruna, Maddalena Ferrigno, Nicola Carlomagno, Concetta Anna Dodaro, Pietro Forestieri, Pasqualina Buono, Francesco Salvatore, and Lucia Sacchetti Copyright © 2017 Carmela Nardelli et al. All rights reserved. Association between Sleep Habits and Metabolically Healthy Obesity in Adults: A Cross-Sectional Study Mon, 06 Mar 2017 00:00:00 +0000 Higher body mass index (BMI) increases the risk of cardiometabolic diseases, but nearly a third of the people living with obesity (BMI: ≥30 kg/m2) are metabolically healthy (MHO). Extreme sleep durations and poor sleep quality are associated with higher bodyweight and cardiometabolic dysfunction, but the full extent to which sleep habits may help differentiate those with MHO versus metabolically abnormal obesity (MAO) is not yet known. Data from the U.S. National Health and Nutritional Examination Survey 2005–08 was used (BMI: ≥30 kg/m2; ≥20 y; ). The absence of metabolic syndrome was used to define MHO. Those with MHO tended to be younger, female, Non-Hispanic Black, never smokers, more physically active, and with less physician diagnosed sleep disorders than MAO. Neither sleep duration nor overall sleep quality was related to MHO in crude or multivariable adjusted analyses; however, reporting “almost always” to having trouble falling asleep (OR (95% CI): 0.40 (0.20–0.78)), waking up during the night (0.38 (0.17–0.85)), feeling unrested during the day (0.35 (0.18–0.70)), and feeling overly sleepy during the day (0.35 (0.17–0.75)) was related to lower odds of MHO. Selected sleep quality factors, but not sleep quantity or overall sleep quality, are associated with the MHO phenotype. Thirumagal Kanagasabai, Ramandeep Dhanoa, Jennifer L. Kuk, and Chris I. Ardern Copyright © 2017 Thirumagal Kanagasabai et al. All rights reserved. Ethnic Differences in Risk Factors for Obesity among Adults in California, the United States Thu, 02 Mar 2017 00:00:00 +0000 Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites (gender, age, physical activity, smoking, arthritis, and diabetes medicine intake), Latinos (age, arthritis, and diabetes medicine intake), Asians (age, binge drinking, arthritis, and diabetes medicine intake), and African Americans (gender, physical activity, smoking, binge drinking, and diabetes medicine intake). Females were more likely to be obese among African Americans (odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.05–1.94), but less likely among Whites (OR = 0.80, 95% CI = 0.74–0.87). Race/ethnicity should be considered in developing obesity prevention strategies. Liang Wang, Jodi Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, and Youfa Wang Copyright © 2017 Liang Wang et al. All rights reserved. “Culture Is So Interspersed”: Child-Minders’ and Health Workers’ Perceptions of Childhood Obesity in South Africa Wed, 01 Mar 2017 08:36:18 +0000 Introduction. Forty-one million children globally are overweight or obese, with most rapid rate increases among low- and middle-income nations. Child-minders and health workers play a crucial role in obesity prevention efforts, but their perceptions of childhood obesity in low- and middle-income countries are poorly understood. This study aims to () explore child-minders and health workers’ perceptions of the causes, consequences, potential strategies, and barriers for childhood obesity prevention and intervention in Cape Town, South Africa and () to provisionally test the fit of a socioecological framework to explain these perceptions. Methods. Twenty-one interviews were recorded, transcribed, and analyzed through analytic induction. Results. Participants identified multilevel factors and contexts, as well as potential consequences and priorities of interest in addressing childhood obesity. An adapted childhood obesity perceptions model was generated, which introduces an overarching cultural dimension embedded across levels of the socioecological framework. Conclusions. Culture plays a pivotal role in explaining obesogenic outcomes, and the results of this study demonstrate the need for further research investigating how obesity perceptions are shaped by cultural frames (e.g., social, political, and historical). Understanding the causes, consequences, and potential interventions to address obesity through a cultural lens is critical for promoting health in low- and middle-income nations. Roger Figueroa, Jaclyn Saltzman, Jessica Jarick Metcalfe, and Angela Wiley Copyright © 2017 Roger Figueroa et al. All rights reserved. Values, Norms, and Peer Effects on Weight Status Tue, 28 Feb 2017 00:00:00 +0000 This study uses data from the European Social Survey in order to test the Prinstein-Dodge hypothesis that posits that peer effects may be larger in collectivistic than in individualistic societies. When defining individualism and collectivism at the country level, our results show that peer effects on obesity are indeed larger in collectivistic than in individualistic societies. However, when defining individualism and collectivism with individual values based on the Shalom Schwartz universal values theory, we find little support for this hypothesis. Peng Nie, Wencke Gwozdz, Lucia Reisch, and Alfonso Sousa-Poza Copyright © 2017 Peng Nie et al. All rights reserved. Associations of Diabetes and Obesity with Risk of Abdominal Aortic Aneurysm in Men Thu, 23 Feb 2017 00:00:00 +0000 Background. The associations of diabetes and obesity with the risk of abdominal aortic aneurysm (AAA) are inconclusive in previous studies. Subjects/Methods. We conducted prospective analysis in the Physicians’ Health Study. Among 25,554 male physicians aged ≥ 50 years who reported no AAA at baseline, 471 reported a newly diagnosed AAA during a mean of 10.4 years’ follow-up. Results. Compared with men who had baseline body mass index (BMI) < 25 kg/m2, the multivariable hazard ratio (HR [95% CI]) of newly diagnosed AAA was 1.30 [1.06–1.59] for BMI 25–<30 kg/m2 and 1.69 [1.24–2.30] for BMI ≥ 30 kg/m2. The risk of diagnosed AAA was significantly higher by 6% with each unit increase in baseline BMI. This association was consistent regardless of the other known AAA risk factors and preexisting vascular diseases. Overall, baseline history of diabetes tended to be associated with a lower risk of diagnosed AAA (HR = 0.79 [0.57–1.11]); this association appeared to vary by follow-up time (HR = 1.56 and 0.63 during ≤ and >2 years’ follow-up, resp.). Conclusion. In a large cohort of middle-aged and older men, obesity was associated with a higher risk, while history of diabetes tended to associate with a lower risk of diagnosed AAA, particularly over longer follow-up. Lu Wang, Luc Djousse, Yiqing Song, Akintunde O. Akinkuolie, Chisa Matsumoto, JoAnn E. Manson, J. Michael Gaziano, and Howard D. Sesso Copyright © 2017 Lu Wang et al. All rights reserved. Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis Sun, 19 Feb 2017 00:00:00 +0000 Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypass , sleeve gastrectomy ), preoperative BMI was 46.5 ± 7.2 Kg/m2 and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population. Kalman Bencsath, Adham Jammoul, Ali Aminian, Hideharu Shimizu, Carolyn J. Fisher, Philip R. Schauer, Alexander Rae-Grant, and Stacy A. Brethauer Copyright © 2017 Kalman Bencsath et al. All rights reserved. Interleukin-1 Receptor Antagonist and Interleukin-4 Genes Variable Number Tandem Repeats Are Associated with Adiposity in Malaysian Subjects Wed, 15 Feb 2017 00:00:00 +0000 Interleukin-1 receptor antagonist (IL1RA) intron 2 86 bp repeat and interleukin-4 (IL4) intron 3 70 bp repeat are variable number tandem repeats (VNTRs) that have been associated with various diseases, but their role in obesity is elusive. The objective of this study was to investigate the association of IL1RA and IL4 VNTRs with obesity and adiposity in 315 Malaysian subjects (128 M/187 F; 23 Malays/251 ethnic Chinese/41 ethnic Indians). The allelic distributions of IL1RA and IL4 were significantly different among ethnicities, and the alleles were associated with total body fat (TBF) classes. Individuals with IL1RA I/II genotype or allele II had greater risk of having higher overall adiposity, relative to those having the I/I genotype or I allele, respectively, even after controlling for ethnicity [Odds Ratio (OR) of I/II genotype = 12.21 (CI = 2.54, 58.79; ); II allele = 5.78 (CI = 1.73, 19.29; )]. However, IL4 VNTR B2 allele was only significantly associated with overall adiposity status before adjusting for ethnicity [OR = 1.53 (CI = 1.04, 2.23; )]. Individuals with IL1RA II allele had significantly higher TBF than those with I allele ( versus ; ). Taken together, IL1RA intron 2 VNTR seems to be a genetic marker for overall adiposity status in Malaysian subjects. Yung-Yean Kok, Hing-Huat Ong, and Yee-How Say Copyright © 2017 Yung-Yean Kok et al. All rights reserved. The Effect of Early Life Factors and Early Interventions on Childhood Overweight and Obesity 2016 Sun, 05 Feb 2017 11:37:08 +0000 Li Ming Wen, Chris Rissel, and Gengsheng He Copyright © 2017 Li Ming Wen et al. All rights reserved. Integrated Approaches for the Management of Staple Line Leaks following Sleeve Gastrectomy Thu, 02 Feb 2017 00:00:00 +0000 Introduction. Aim of the study was trying to draw a final flow chart for the management of gastric leaks after laparoscopic sleeve gastrectomy, based on the review of our cases over 10 years’ experience. Material and Methods. We retrospectively reviewed all patients who underwent LSG as a primary operation at the Bariatric Unit of Tor Vergata University Hospital in Rome from 2007 to 2015. Results. Patients included in the study were 418. There were 6 staple line leaks (1.44%). All patients with diagnosis of a leak were initially discharged home in good clinical conditions and then returned to A&E because of the complication. The mean interval between surgery and readmission for leak was 13,4 days (range 6–34 days, SD ± 11.85). We recorded one death (16.67%) due to sepsis. The remaining five cases were successfully treated with a mean healing time of the gastric leak of 55,5 days (range 26–83 days; SD ± 25.44). Conclusion. Choosing the proper treatment depends on clinical stability and on the presence or not of collected abscess. Our treatment protocol showed being associated with low complication rate and minor discomfort to the patients, reducing the need for more invasive procedures. Mauro Montuori, Domenico Benavoli, Stefano D’Ugo, Luca Di Benedetto, Emanuela Bianciardi, Achille L. Gaspari, and Paolo Gentileschi Copyright © 2017 Mauro Montuori et al. All rights reserved. Excess Body Mass Index Loss at 3 Months: A Predictive Factor of Long-Term Result after Sleeve Gastrectomy Sun, 29 Jan 2017 00:00:00 +0000 Introduction. Laparoscopic Sleeve Gastrectomy (SG) is considered as successful if the percentage of Excess Body Mass Index Loss (% EBMIL) remains constant over 50% with long-term follow-up. The aim of this study was to evaluate whether early % EBMIL was predictive of success after SG. Methods. This retrospective study included patients who had SG with two years of follow-up. Patients had follow-up appointments at 3 (M3), 6, 12, and 24 months (M24). Data as weight and Body Mass Index (BMI) were collected systematically. We estimated the % EBMIL necessary to establish a correlation between M3 and M24 compared to % EBMIL speeds and calculated a limit value of % EBMIL predictive of success. Results. Data at operative time, M3, and M24 were available for 128 patients. Pearson test showed a correlation between % EBMIL at M3 and that at M24 (). % EBMIL speed between surgery and M3 () was significant but not between M3 and M24. A linear regression analysis proved that % EBMIL over 20.1% at M3 () predicted a final % EBMIL over 50%. Conclusions. % EBMIL at M3 after SG is correlated with % EBMIL in the long term. % EBMIL speed was significant in the first 3 months. % EBMIL over 20.1% at M3 leads to the success of SG. Guillaume Philouze, Eglantine Voitellier, Laurence Lacaze, Emmanuel Huet, Antoine Gancel, Gaëtan Prévost, Michael Bubenheim, and Michel Scotté Copyright © 2017 Guillaume Philouze et al. All rights reserved. Effects of a Twelve-Week Weight Reduction Exercise Programme on Selected Spatiotemporal Gait Parameters of Obese Individuals Wed, 11 Jan 2017 07:01:55 +0000 Objectives. This study was carried out to investigate the effects of twelve-week weight reduction exercises on selected spatiotemporal gait parameters of obese individuals and compare with their normal weight counterparts. Methods. Sixty participants (30 obese and 30 of normal weight) started but only 58 participants (obese = 30, normal weight = 28) completed the quasi-experimental study. Only obese group had 12 weeks of weight reduction exercise training but both groups had their walking speed (WS), cadence (CD), step length (SL), step width (SW), and stride length (SDL) measured at baseline and at the end of weeks 4, 8, and 12 of the study. Data were analysed using appropriate descriptive and inferential statistics. Results. There was significantly lower WS, SL, and SDL but higher CD and SW in obese group than the normal weight group at baseline and week 12. However, the obese group had significantly higher percentage changes in all selected spatiotemporal parameters than the normal weight group. Conclusion. The 12-week weight reduction exercise programme produced significantly higher percentage changes in all selected spatiotemporal gait parameters in the obese than normal weight individuals and is recommended for improvement of these parameters among the obese individuals with gait related problems. Joseph A. Jegede, Babatunde O. A. Adegoke, and Oladapo M. Olagbegi Copyright © 2017 Joseph A. Jegede et al. All rights reserved. Objective Estimates of Physical Activity and Sedentary Time among Young Adults Mon, 02 Jan 2017 11:47:29 +0000 Background. This study examines factors associated with physical activity (PA) and sedentary behaviors (SB) in young adults (18–35 years) and compares objective and subjective assessment measures of PA and SB. Methods. 595 young adults ( years;  kg/m2) enrolled in the Study of Novel Approaches to Weight Gain Prevention (SNAP) trial. Hours/day spent in SB (<1.5 METs) and minutes/week spent in bout-related moderate-to-vigorous intensity PA (MVPA; ≥3 METs and ≥10 min) were assessed using self-report and objective measures. Demographic factors associated with SB and MVPA were also explored (i.e., age, gender, BMI, ethnicity, work and relationship status, and number of children). Results. Objective MVPA ( min/wk) was greater than self-report estimates ( min/wk; ) and differed by  min/wk at the individual level (i.e., the absolute difference). Females, overweight participants, African Americans, and those with children participated in the least amount of MVPA. Objective estimates of SB ( hr/day; 64.5% of wear time) were lower than subjective estimates ( hr/day; ), differing by  hr/day for each participant. Conclusion. Young adults interested in weight gain prevention engage in both high levels of MVPA and SB, with participants self-reporting fewer MVPA minutes and more SB compared to objective estimates. This study is registered at (NCT01183689). Jessica L. Unick, Wei Lang, Deborah F. Tate, Dale S. Bond, Mark A. Espeland, and Rena R. Wing Copyright © 2017 Jessica L. Unick et al. All rights reserved. Acute Exercise and Appetite-Regulating Hormones in Overweight and Obese Individuals: A Meta-Analysis Tue, 27 Dec 2016 13:49:16 +0000 In lean individuals, acute aerobic exercise is reported to transiently suppress sensations of appetite, suppress blood concentrations of acylated ghrelin (AG), and increase glucagon-like peptide-1 (GLP-1) and peptide-YY (PYY). Findings in overweight/obese individuals have yet to be synthesised. In this systematic review and meta-analysis, we quantified the effects that acute exercise has on AG and total PYY and GLP-1 in overweight/obese individuals. The potential for body mass index (BMI) to act as a moderator for AG was also explored. Six published studies (73 participants, 78% male, mean BMI: 30.6 kg·m−2) met the inclusion criteria. Standardised mean differences (SMDs) and standard errors were extracted for AG and total PYY and GLP-1 concentrations in control and exercise trials and synthesised using a random effects meta-analysis model. BMI was the predictor in metaregression for AG. Exercise moderately suppressed AG area-under-the-curve concentrations (pooled SMD: −0.34, 95% CI: −0.53 to −0.15). The magnitude of this reduction was greater for higher mean BMIs (pooled metaregression slope: −0.04 SMD/kg·m−2 (95% CI: −0.07 to 0.00)). Trivial SMDs were obtained for total PYY (0.10, 95% CI: −0.13 to 0.31) and GLP-1 (−0.03, 95% CI: −0.18 to 0.13). This indicates that exercise in overweight/obese individuals moderately alters AG in a direction that could be associated with decreased hunger and energy intake. This trial is registered with PROSPERO: CRD42014006265. Jessica Anne Douglas, Kevin Deighton, Jan Maria Atkinson, Vahid Sari-Sarraf, David John Stensel, and Greg Atkinson Copyright © 2016 Jessica Anne Douglas et al. All rights reserved. Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People Tue, 27 Dec 2016 13:08:30 +0000 Background. In clinical practice, serum ferritin is used as a screening tool to detect iron deficiency. However, its reliability in obesity has been questioned. Objectives. To investigate the role of ferritin in overweight and obese people, either as a marker of inflammation or iron deficiency. Methods. On the basis of body mass index (BMI), 150 participants were divided into three equal groups: A: BMI 18.5–25 kg/m2, B: BMI 25–30 kg/m2, and C:  kg/m2. Serum iron, total iron binding capacity (TIBC), transferrin saturation, ferritin, C-reactive protein, and hemoglobin (Hb) were measured for each participant and analyzed through SPSS version 16. One-way ANOVA and Pearson’s correlation tests were applied. Results. Ferritin was the highest in group C (, ) and the lowest in group A, (, ). Contrarily to ferritin, transferrin was the lowest in group C, (, ) and the highest in group A, (, ). Ferritin had a strong positive correlation with both BMI (, ) and CRP (, ) and strong negative correlation with Hb, iron, TIBC, and transferrin saturation (). Conclusion. Ferritin is a marker of inflammation rather than iron status in overweight and obese people. Complete iron profile including transferrin, rather than serum ferritin alone, can truly predict iron deficiency in such people. Abidullah Khan, Wazir Muhammad Khan, Maimoona Ayub, Mohammad Humayun, and Mohammad Haroon Copyright © 2016 Abidullah Khan et al. All rights reserved. Recommendations and Improvements for the Evaluation of Integrated Community-Wide Interventions Approaches Mon, 26 Dec 2016 07:59:59 +0000 Background. Integrated community-wide intervention approaches (ICIAs) are implemented to prevent childhood obesity. Programme evaluation improves these ICIAs, but professionals involved often struggle with performance. Evaluation tools have been developed to support Dutch professionals involved in ICIAs. It is unclear how useful these tools are to intended users. We therefore researched the facilitators of and barriers to ICIA programme evaluation as perceived by professionals and their experiences of the evaluation tools. Methods. Focus groups and interviews with 33 public health professionals. Data were analysed using a thematic content approach. Findings. Evaluation is hampered by insufficient time, budget, and experience with ICIAs, lack of leadership, and limited advocacy for evaluation. Epidemiologists are regarded as responsible for evaluation but feel incompetent to perform evaluation or advocate its need in a political environment. Managers did not prioritise process evaluations, involvement of stakeholders, and capacity building. The evaluation tools are perceived as valuable but too comprehensive considering limited resources. Conclusion. Evaluating ICIAs is important but most professionals are unfamiliar with it and management does not prioritise process evaluation nor incentivize professionals to evaluate. To optimise programme evaluation, more resources and coaching are required to improve professionals’ evaluation capabilities and specifically the use of evaluation. Tessa M. van Koperen, Carry M. Renders, Eline J. M. Spierings, Anna-Marie Hendriks, Marjan J. Westerman, Jacob C. Seidell, and Albertine J. Schuit Copyright © 2016 Tessa M. van Koperen et al. All rights reserved. The Effect of Eighteen-Month Metformin Treatment in Obese Adolescents: Comparison of Results Obtained in Daily Practice with Results from a Clinical Trial Thu, 22 Dec 2016 07:42:55 +0000 Background. In a recent randomized controlled trial (RCT) in obese adolescents, 18 month-treatment with metformin versus placebo was reported to lead to stabilisation of the BMI. This study aimed to compare the effect of metformin on BMI in obese adolescents in daily practice versus results obtained in an RCT. Methods. Obese adolescents treated off label with metformin in daily practice in an outpatient clinic with a follow-up of ≥18 months were identified. Anthropometric and biochemical data were collected at baseline and at 18 months. Patients treated with metformin for 18 months in an RCT were used for comparison. BMI was compared between the two groups. Results. Nineteen patients (median age 14.3 (interquartile range 11.7–15.7) years, BMI 31.3 (28.8–33.8) kg/m2) treated in daily practice were compared to 23 patients receiving metformin in the RCT (age 13.6 (12.6–15.3) years, BMI 29.8 (28.1–34.5) kg/m2). BMI change after 18 months was −0.36 (−2.10–1.58) versus +0.22 (−2.87–1.27) kg/m2 for the two groups, respectively. In the multivariable model, BMI change was not statistically significantly different between the two groups (). Conclusion. Treatment with metformin in obese adolescents in daily practice resulted in a comparable change in BMI as observed in an RCT. This trial is registered with number: NCT01487993. Marloes P. van der Aa, Vera Hoving, Ewoudt M. W. van de Garde, Antonius de Boer, Catherijne A. J. Knibbe, and Marja M. J. van der Vorst Copyright © 2016 Marloes P. van der Aa et al. All rights reserved. Lifestyle Modification in the Prevention and Management of Obesity Tue, 13 Dec 2016 13:07:24 +0000 Shirley Telles, Bangalore N. Gangadhar, and Kavita D. Chandwani Copyright © 2016 Shirley Telles et al. All rights reserved. Leptin, Leptin Soluble Receptor, and the Free Leptin Index following a Diet and Physical Activity Lifestyle Intervention in Obese Males and Females Tue, 06 Dec 2016 08:38:06 +0000 Leptin (LEP) is associated with appetite regulation and metabolism. Concentration is linear with adiposity, suggesting LEP resistance. LEP circulates freely and bound with its soluble receptor (sOB-r); the ratio is the free leptin index (FLI), an index of leptin resistance; lower FLI suggests reduced biological action. Purpose. The aim was to determine the effect of changes in adipose tissue distribution on LEP, sOB-r, and FLI following 6 months (6 M) of a diet/exercise weight loss program (WLP). In addition, we aim to identify predictors of the FLI. Methods. 6 M WLP consisted of diet/lifestyle interventions following ADA guidelines. Body composition was assessed by DXA. LEP and sOB-r analysis were done via ELISA. Results. 10 adults completed the WLP. Significant reductions were seen in total fat percentage (% fat), nontrunk fat, (NTF), and trunk fat (TF) from base to 3 m and 6 M (). The FLI were reduced at 3 M and 6 M for males and 6 M for females. Total body fat and body weight predicted the FLI in both sexes. Conclusions. LEP and FLI reductions following 6 M of WLP were achieved independent of sOB-r changes. We also demonstrate that the FLI can be predicted noninvasively through total fat mass and body weight in kilograms. Jeffrey E. Herrick, Gino S. Panza, and Jared M. Gollie Copyright © 2016 Jeffrey E. Herrick et al. All rights reserved. Impaired Visual Motor Coordination in Obese Adults Tue, 22 Nov 2016 08:35:29 +0000 Objective. To investigate whether obesity alters the sensory motor integration process and movement outcome during a visual rhythmic coordination task. Methods. 88 participants (44 obese and 44 matched control) sat on a chair equipped with a wrist pendulum oscillating in the sagittal plane. The task was to swing the pendulum in synchrony with a moving visual stimulus displayed on a screen. Results. Obese participants demonstrated significantly () higher values for continuous relative phase (CRP) indicating poorer level of coordination, increased movement variability (), and a larger amplitude () than their healthy weight counterparts. Conclusion. These results highlight the existence of visual sensory integration deficiencies for obese participants. The obese group have greater difficulty in synchronizing their movement with a visual stimulus. Considering that visual motor coordination is an essential component of many activities of daily living, any impairment could significantly affect quality of life. David Gaul, Arimin Mat, Donal O’Shea, and Johann Issartel Copyright © 2016 David Gaul et al. All rights reserved. Bariatric Surgery, Polycystic Ovary Syndrome, and Infertility Mon, 14 Nov 2016 13:35:32 +0000 Background. Polycystic ovary syndrome (PCOS) is the commonest cause of female infertility. Visceral obesity and insulin resistance are key pathophysiological mechanisms behind PCOS. Women suffering from this syndrome and infertility often seek bariatric surgery hoping that they would be able to conceive postoperatively. Objective. At present, there is no consensus on the role of bariatric surgery in the management of PCOS-associated infertility within the medical community, making it difficult to give specific advice to these women, so a review of the literature was necessary. Results. A detailed review of the literature was performed. Only 6 manuscripts were relevant and contained quantitative data. They demonstrated that bariatric surgery results in postoperative conception rates varying from 33% to 100%. Surgery is also associated with amelioration of menstrual irregularities, hormonal abnormalities, and hirsutism that are associated with PCOS. These studies were retrospective and only had a small number of participants with infertility. Conclusions. Bariatric surgery has been shown to conclusively improve life expectancy, quality of life, and comorbidities like type 2 diabetes and obstructive sleep apnea. However, further research is required to identify whether weight loss surgery results in significant improvement in fertility of women with PCOS and to investigate which operation has the best results. James Butterworth, Jean Deguara, and Cynthia-Michelle Borg Copyright © 2016 James Butterworth et al. All rights reserved. Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children Thu, 03 Nov 2016 13:54:22 +0000 The purpose of this study was to establish health-related waist-to-height ratio (WHtR) cut-points associating with FITNESSGRAM’s body mass index (BMI) criterion-referenced standards in low-income children. A secondary aim was to examine the classification agreement between the derived WHtR cut-points and various cardiometabolic blood markers using current recommendations. Participants were 219 children from low-income schools (mean age = 10.5 ± 0.6 years). Waist circumference, height, weight, and cardiometabolic blood markers were collected in a fasting state before school hours. Receiver operating characteristic (ROC) curves were used to determine WHtR cut-points that associated with a child meeting FITNESSGRAM’s age- and sex-specific criterion-referenced standards for BMI. The derived WHtR cut-point was 0.50 (AUC = 0.89, ; sensitivity = 0.86, specificity = 0.82, and accuracy = 84.3%). Classification agreement using the derived WHtR cut-point with various blood marker standards was statistically significant but considered weak to fair (kappa 0.14–0.34, agreement = 59%–67%, and ). The WHtR cut-point of 0.50 can be used with strong accuracy to distinguish low-income children who met FITNESSGRAM’s criterion-referenced standards for body composition; however, the evidence was weaker for its use in distinguishing low-income children meeting specific cardiometabolic blood marker recommendations. Ryan D. Burns, Timothy A. Brusseau, Yi Fang, You Fu, and James C. Hannon Copyright © 2016 Ryan D. Burns et al. All rights reserved. An Anthropometric Risk Index Based on Combining Height, Weight, Waist, and Hip Measurements Tue, 18 Oct 2016 12:39:59 +0000 Body mass index (BMI) can be considered an application of a power law model to express body weight independently of height. Based on the same power law principle, we previously introduced a body shape index (ABSI) to be independent of BMI and height. Here, we develop a new hip index (HI) whose normalized value is independent of height, BMI, and ABSI. Similar to BMI, HI demonstrates a U-shaped relationship to mortality in the Third National Health and Nutrition Examination Survey (NHANES III) population. We further develop a new anthropometric risk index (ARI) by adding log hazard ratios from separate nonlinear regressions of the four indicators, height, BMI, ABSI, and HI, against NHANES III mortality hazard. ARI far outperforms any of the individual indicators as a linear mortality predictor in NHANES III. The superior performance of ARI also holds for predicting mortality hazard in the independent Atherosclerosis Risk in Communities (ARIC) cohort. Thus, HI, along with BMI and ABSI, can capture the risk profile associated with body size and shape. These can be combined in a risk indicator that utilizes complementary information from height, weight, and waist and hip circumference. The combined ARI is promising for further research and clinical applications. Nir Y. Krakauer and Jesse C. Krakauer Copyright © 2016 Nir Y. Krakauer and Jesse C. Krakauer. All rights reserved. Objectively Quantified Physical Activity and Sedentary Behavior in Predicting Visceral Adiposity and Liver Fat Thu, 29 Sep 2016 16:58:12 +0000 Objective. Epidemiologic studies suggest an inverse relationship between nonalcoholic fatty liver disease (NAFLD), visceral adipose tissue (VAT), and self-reported physical activity levels. However, subjective measurements can be inaccurate and prone to reporter bias. We investigated whether objectively quantified physical activity levels predicted liver fat and VAT in overweight/obese adults. Methods. Habitual physical activity was measured by triaxial accelerometry for four days (). Time spent in sedentary behavior (MET < 1.6) and light (MET 1.6 < 3), moderate (MET 3 < 6), and vigorous (MET 6 < 9) physical activity was quantified. Magnetic resonance imaging and spectroscopy were used to quantify visceral and liver fat. Bivariate correlations and hierarchical multiple regression analyses were performed. Results. There were no associations between physical activity or sedentary behavior and liver lipid. Sedentary behavior and moderate and vigorous physical activity accounted for just 3% of variance for VAT () and 0.003% for liver fat (). Higher levels of VAT were associated with time spent in moderate activity (, ), but there was no association with sedentary behavior. Known risk factors for obesity-related NAFLD accounted for 62% and 40% of variance in VAT and liver fat, respectively (). Conclusion. Objectively measured levels of habitual physical activity and sedentary behavior did not influence VAT or liver fat. Shelley E. Keating, Helen M. Parker, Toby G. Pavey, Michael K. Baker, Ian D. Caterson, Jacob George, and Nathan A. Johnson Copyright © 2016 Shelley E. Keating et al. All rights reserved.