Journal of Obesity The latest articles from Hindawi © 2017 , Hindawi Limited . 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. Limited Effects of Endurance or Interval Training on Visceral Adipose Tissue and Systemic Inflammation in Sedentary Middle-Aged Men Thu, 29 Sep 2016 08:14:36 +0000 Purpose. Limited data exists for the effects of sprint-interval training (SIT) and endurance training (ET) on total body composition, abdominal visceral adipose tissue, and plasma inflammation. Moreover, whether “active” or “passive” recovery in SIT provides a differential effect on these measures remains uncertain. Methods. Sedentary middle-aged men (;  y;  kg·m2) underwent abdominal computed tomography, dual-energy X-ray absorptiometry, venepuncture, and exercise testing before and after the interventions, which included the following: 12 wks 3 d·wk−1 ET (; 50–60 min cycling; 80% ), SIT (4–10 × 30 s sprint efforts) with passive (P-SIT; ) or active recovery (A-SIT; ); or nonexercise control condition (CON; ). Changes in cardiorespiratory fitness, whole-body and visceral fat mass, and plasma systemic inflammation were examined. Results. Compared to CON, significant increases in interpolated power output (P-SIT, ; ET, ; A-SIT, ) and test duration (P-SIT, ; ET, ; A-SIT, ) occurred after training. Final VO2 consumption was increased after P-SIT only (). Despite >90% exercise compliance, there was no change in whole-body or visceral fat mass or plasma inflammation (). Conclusion. In sedentary middle-aged men, SIT was a time-effective alternative to ET in facilitating conditioning responses yet was ineffective in altering body composition and plasma inflammation, and compared to passive recovery, evidenced diminished conditioning responses when employing active recovery. Joshua H. F. Cooper, Blake E. G. Collins, David R. Adams, Robert A. Robergs, and Cheyne E. Donges Copyright © 2016 Joshua H. F. Cooper et al. All rights reserved. Breastfeeding Practices among Native Hawaiians and Pacific Islanders Wed, 28 Sep 2016 11:11:41 +0000 Background. Breastfeeding is associated with a decreased risk of obesity in the early and adult years. Native Hawaiians and Pacific Islanders (NHPI) experience high rates of obesity which is often obfuscated with aggregated data. Using disaggregated data, we examined breastfeeding practices among NHPI. Methods. Seven databases and reference lists were searched. Two independent researchers extracted relevant studies based on predetermined criteria. Nine studies met our inclusion criteria and a meta-analysis was conducted using random-effects, inverse-various weighted models. Results. Few studies disaggregated NHPI populations when examining breastfeeding practices. Most studies were cross-sectional and our search yielded no randomized or quasirandomized control trials. The results of the meta-analysis indicated that 46.5% NHPI women initiated breastfeeding with 40.8% breastfeeding exclusively. These pooled analyses show that NHPI breastfeeding practices are below the recommended national and international goals and guidelines. Conclusion. Breastfeeding practices among NHPI are heterogeneous and critical disparities exist among certain NHPI subgroups and additional research needs to be conducted to determine the reasons for the disparity. Future studies should work to disaggregate data for NHPI and the various subpopulations. Multicomponent, multilevel strategies are needed to support breastfeeding practices among NHPI. Ingrid K. Richards Adams, Chizimuzo T. C. Okoli, Akilah Dulin Keita, Ana Maria Linares, Keiko Tanaka, Joshua R. Polanin, and Annie Koempel Copyright © 2016 Ingrid K. Richards Adams et al. All rights reserved. Cardiovascular Endurance, Body Mass Index, Physical Activity, Screen Time, and Carotenoid Intake of Children: NHANES National Youth Fitness Survey Tue, 27 Sep 2016 11:44:46 +0000 Background. Approximately 17% of children aged 6–11 years were classified as obese in the United States. Obesity adversely affects physical functioning and leads to reduced quality of life. Heart function for overweight and obese children has not been reported. Methods. Data for this study were from NHANES National Youth Fitness Survey (NNYFS) conducted in conjunction with the National Health and Nutrition Examination Survey (NHANES) in 2012. This study used data from children aged 6–12 () that had the cardiorespiratory endurance measure, body mass index for age and sex, and dietary data (). Cardiovascular endurance was estimated by heart rate reserve. Results. Compared to the highest percentile of heart rate reserve, those in the first percentile had 3.52 (2.36, 5.24) odds and those in the second percentile had 3.61 (1.84, 7.06) odds of being in the overweight/obese as compared to the under/normal weight category. Considering the highest percentile, boys had a heart rate reserve of 35%, whereas girls had a heart rate reserve of 13% (less than half that of boys). Conclusion. Having an overweight or obese classification for children in this study demonstrated a compromise in cardiovascular endurance. Parental awareness should be raised as to the detrimental consequence of overweight and heart health. Joan A. Vaccaro and Fatma G. Huffman Copyright © 2016 Joan A. Vaccaro and Fatma G. Huffman. All rights reserved. Altered Left Ventricular Ion Channel Transcriptome in a High-Fat-Fed Rat Model of Obesity: Insight into Obesity-Induced Arrhythmogenesis Sun, 25 Sep 2016 09:21:23 +0000 Introduction. Obesity is increasingly common and is associated with an increased prevalence of cardiac arrhythmias. The aim of this study was to see whether in obesity there is proarrhythmic gene expression of ventricular ion channels and related molecules. Methods and Results. Rats were fed on a high-fat diet and compared to control rats on a normal diet (). After 8 weeks, rats on the high-fat diet showed significantly greater weight gain and higher adiposity. Left ventricle samples were removed at 8 weeks and mRNA expression of ion channels and other molecules was measured using qPCR. Obese rats had significant upregulation of , HCN4, , RYR2, NCX1, SERCA2a, and RYR2 mRNA and downregulation of ERG mRNA. In the case of HCN4, it was confirmed that there was a significant increase in protein expression. The potential effects of the mRNA changes on the ventricular action potential and intracellular Ca2+ transient were predicted using computer modelling. Modelling predicted prolongation of the ventricular action potential and an increase in the intracellular Ca2+ transient, both of which would be expected to be arrhythmogenic. Conclusion. High-fat diet causing obesity results in arrhythmogenic cardiac gene expression of ion channels and related molecules. Reza Ashrafi, Marianne Yon, Lucy Pickavance, Joseph Yanni Gerges, Gershan Davis, John Wilding, Kun Jian, Henggui Zhang, George Hart, and Mark Boyett Copyright © 2016 Reza Ashrafi et al. All rights reserved. Positioning of Weight Bias: Moving towards Social Justice Thu, 22 Sep 2016 12:31:40 +0000 Weight bias is a form of stigma with detrimental effects on the health and wellness of individuals with large bodies. Researchers from various disciplines have recognized weight bias as an important topic for public health and for professional practice. To date, researchers from various areas have approached weight bias from independent perspectives and from differing theoretical orientations. In this paper, we examined the similarities and differences between three perspectives (i.e., weight-centric, non-weight-centric (health-centric), and health at every size) used to understand weight bias and approach weight bias research with regard to (a) language about people with large bodies, (b) theoretical position, (c) identified consequences of weight bias, and (d) identified influences on weight-based social inequity. We suggest that, despite differences, each perspective acknowledges the negative influences that position weight as being within individual control and the negative consequences of weight bias. We call for recognition and discussion of weight bias as a social justice issue in order to change the discourse and professional practices extended towards individuals with large bodies. We advocate for an emphasis on social justice as a uniting framework for interdisciplinary research on weight bias. Sarah Nutter, Shelly Russell-Mayhew, Angela S. Alberga, Nancy Arthur, Anusha Kassan, Darren E. Lund, Monica Sesma-Vazquez, and Emily Williams Copyright © 2016 Sarah Nutter et al. All rights reserved. Influence of Nutrition Claims on Appetite Sensations according to Sex, Weight Status, and Restrained Eating Tue, 20 Sep 2016 16:53:28 +0000 Nutrition claims may help people to adopt healthier eating habits, but little is known about the potential cognitive effects of such claims on appetite sensations. The main purpose of this study was to evaluate the impact of nutrition claims and individual factors on perceived appetite sensations. According to a three (“healthy” versus “diet” (i.e., satiating) versus “hedonic”) by two (restrained or not restrained) by two (normal-weight or overweight/obese) by two (men versus women) factorial design, 164 males and 188 females aged 18–65 were invited to taste an oatmeal-raisin snack in a blinded and ad libitum context. Visual analog scales (150 mm) were used to evaluate appetite sensations before and over 1 h after consumption period. BMI and Restraint Scale were used to categorize participants according to their weight and restraint status. No main condition effect was observed for any of the four appetite sensations. However, subgroups analysis revealed significant differences among specific subgroups. A main effect of sex was also observed for all appetite sensations with men reporting higher levels of desire to eat, hunger and prospective food consumption, and lower levels of fullness than women. These findings highlight the importance of considering individual characteristics in interaction when studying appetite sensations. Geneviève Painchaud Guérard, Simone Lemieux, Éric Doucet, Sonia Pomerleau, and Véronique Provencher Copyright © 2016 Geneviève Painchaud Guérard et al. All rights reserved. Disparities in Risk Factors Associated with Obesity between Zanzibar and Tanzania Mainland among Women of Reproductive Age Based on the 2010 TDHS Sun, 18 Sep 2016 14:31:50 +0000 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. Edwin Paul, Abdalla H. Mtumwa, Julius Edward Ntwenya, and Said A. H. Vuai Copyright © 2016 Edwin Paul et al. All rights reserved. Role of Gut Microbiota in the Aetiology of Obesity: Proposed Mechanisms and Review of the Literature Thu, 15 Sep 2016 12:22:32 +0000 The aetiology of obesity has been attributed to several factors (environmental, dietary, lifestyle, host, and genetic factors); however none of these fully explain the increase in the prevalence of obesity worldwide. Gut microbiota located at the interface of host and environment in the gut are a new area of research being explored to explain the excess accumulation of energy in obese individuals and may be a potential target for therapeutic manipulation to reduce host energy storage. Several mechanisms have been suggested to explain the role of gut microbiota in the aetiology of obesity such as short chain fatty acid production, stimulation of hormones, chronic low-grade inflammation, lipoprotein and bile acid metabolism, and increased endocannabinoid receptor system tone. However, evidence from animal and human studies clearly indicates controversies in determining the cause or effect relationship between the gut microbiota and obesity. Metagenomics based studies indicate that functionality rather than the composition of gut microbiota may be important. Further mechanistic studies controlling for environmental and epigenetic factors are therefore required to help unravel obesity pathogenesis. Muhammad Jaffar Khan, Konstantinos Gerasimidis, Christine Ann Edwards, and M. Guftar Shaikh Copyright © 2016 Muhammad Jaffar Khan et al. All rights reserved. Appetite Suppression and Antiobesity Effect of a Botanical Composition Composed of Morus alba, Yerba mate, and Magnolia officinalis Tue, 06 Sep 2016 17:34:09 +0000 Background. Obesity and its comorbidities continue to challenge the world at an alarming rate. Although the long term solution lies on lifestyle changes in the form of dieting and exercising, drug, medical food, or dietary supplement interventions are required for those who are already obese. Here we describe a standardized blend composed of extracts from three medicinal plants: Morus alba, Yerba mate, and Magnolia officinalis for appetite suppression and metabolic disorders management. Method. Extracts were standardized to yield a composition designated as UP601. Appetite suppression activity was tested in acute feed intake rat model. Efficacy was evaluated in C57BL/6J mouse models treated with oral doses of 1.3 g/kg/day for 7 weeks. Orlistat at 40 mg/kg/day was used as a positive control. Body compositions of mice were assessed using a dual energy X-ray absorptiometry (DEXA). ELISA was done for insulin, leptin, and ghrelin level quantitation. Nonalcoholic steatohepatitis (NASH) scoring was conducted. Results. Marked acute hypophagia with 81.8, 75.3, 43.9, and 30.9% reductions in food intake at 2, 4, 6, and 24 hours were observed for UP601. Decreases in body weight gain (21.5% compared to the HFD at weeks 7 and 8.2% compared to baseline) and calorie intake (40.5% for the first week) were observed. 75.9% and 46.8% reductions in insulin and leptin, respectively, 4.2-fold increase in ghrelin level, and reductions of 18.6% in cholesterol and 59% in low-density lipoprotein were documented. A percentage body fat of 18.9%, 47.8%, 46.1%, and 30.4% was found for mice treated with normal control, HFD, Orlistat, and UP601, respectively. 59.3% less mesenteric fat pad and improved NASH scores were observed for UP601. Conclusion. UP601, a standardized botanical composition from Morus alba, Yerba mate, and Magnolia officinalis could be used as a natural alternative for appetite suppression, maintaining healthy body weight and metabolism management. Mesfin Yimam, Ping Jiao, Mei Hong, Lidia Brownell, Young-Chul Lee, Eu-Jin Hyun, Hyun-Jin Kim, Tae-Woo Kim, Jeong-Bum Nam, Mi-Ran Kim, and Qi Jia Copyright © 2016 Mesfin Yimam et al. All rights reserved. Design of a Digital-Based, Multicomponent Nutrition Guidance System for Prevention of Early Childhood Obesity Thu, 18 Aug 2016 06:22:35 +0000 Interventions targeting parenting focused modifiable factors to prevent obesity and promote healthy growth in the first 1000 days of life are needed. Scale-up of interventions to global populations is necessary to reverse trends in weight status among infants and toddlers, and large scale dissemination will require understanding of effective strategies. Utilizing nutrition education theories, this paper describes the design of a digital-based nutrition guidance system targeted to first-time mothers to prevent obesity during the first two years. The multicomponent system consists of scientifically substantiated content, tools, and telephone-based professional support delivered in an anticipatory and sequential manner via the internet, email, and text messages, focusing on educational modules addressing the modifiable factors associated with childhood obesity. Digital delivery formats leverage consumer media trends and provide the opportunity for scale-up, unavailable to previous interventions reliant on resource heavy clinic and home-based counseling. Designed initially for use in the United States, this system’s core features are applicable to all contexts and constitute an approach fostering healthy growth, not just obesity prevention. The multicomponent features, combined with a global concern for optimal growth and positive trends in mobile internet use, represent this system’s future potential to affect change in nutrition practice in developing countries. Keriann H. Uesugi, Anne M. Dattilo, Maureen M. Black, and Jose M. Saavedra Copyright © 2016 Keriann H. Uesugi et al. All rights reserved. Receptivity to Bariatric Surgery in Qualified Patients Tue, 19 Jul 2016 09:55:44 +0000 Objectives. Bariatric surgery has been shown to be an effective intervention for weight loss and diabetes management. Despite this, many patients qualified for bariatric surgery are not interested in undergoing the procedure. The objective of this study is to determine the factors influencing receptivity to bariatric surgery among those who qualify for the procedure. Methods. Patients attending a publicly funded weight management clinic who qualified for bariatric surgery were asked to complete an elective questionnaire between February 2013 and April 2014. Results. A total of 371 patients (72% female) completed the questionnaire. Only 87 of 371 (23%) participants were interested in bariatric surgery. Individuals interested in bariatric surgery had a higher BMI (48.0 versus 46.2 kg/m2, ) and believed that they would lose more weight with surgery (51 versus 44 kg, ). Those who scored highly on past weight loss success and financial concerns were less likely to be interested in bariatric surgery, whereas those who scored highly on high receptivity to surgery and positive social support were more likely to be interested in bariatric surgery. Conclusion. Although participants overestimated the effect of bariatric surgery on weight loss, most were still not interested in bariatric surgery. Michael Fung, Sean Wharton, Alison Macpherson, and Jennifer L. Kuk Copyright © 2016 Michael Fung et al. All rights reserved.