Journal of Obesity The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. A Community-Based Nutrition and Physical Activity Intervention for Children Who Are Overweight or Obese and Their Caregivers Sun, 08 Oct 2017 00:00:00 +0000 There is a need for efficacious interventions to reduce the prevalence of childhood obesity, and a limited body of research suggests that collaborative community-based programs designed for children and their caregivers may be effective in reducing obesity rates. This paper reports the results of a community-based obesity intervention, South County Food, Fitness and Fun (SCFFF), designed for preadolescent children who are overweight or obese and their caregivers. SCFFF was developed in response to community concerns. Families were referred to the program by their physician and participated in the program at no cost. The 16-week intervention includes weekly group nutrition and physical activity sessions. Analyses determined that 65 out of the 97 children who completed SCFFF provided 2-year follow-up data and had reduced BMI z-scores over 2 years following the intervention. These participants decreased their energy, fat, carbohydrate, saturated fat, and sodium intake and increased core body strength and endurance from baseline to the end of the intervention. SCFFF was effective in reducing relative weight and improving diet and core muscle strength and endurance in children who are overweight or obese. Furong Xu, Stephanie Marchand, Celeste Corcoran, Heather DiBiasio, Rachel Clough, Christopher S. Dyer, Jennifer Nobles, Jade White, Mary L. Greaney, and Geoffrey W. Greene Copyright © 2017 Furong Xu et al. All rights reserved. Relationship between Obesity and Cognitive Function in Young Women: The Food, Mood and Mind Study Sun, 08 Oct 2017 00:00:00 +0000 Limited research addresses links between obesity and cognitive function in young adults. Objective. To investigate the relationship between obesity and cognitive function in young women. Methods. This cross-sectional study recruited healthy, young (18–35 y) women of normal (NW: BMI = 18.5–24.9 kg·m−2) or obese (OB: BMI ≥ 30.0 kg·m−2) weight. Participants completed a validated, computer-based cognitive testing battery evaluating impulsivity, attention, information processing, memory, and executive function. Questionnaires on depression and physical activity and a fasting blood sample for C-reactive protein and the Omega-3 Index were also collected. Cognition data are presented as z-scores (mean ± SD), and group comparisons were assessed via ANOVA. Potential confounding from questionnaire and blood variables were evaluated using ANCOVA. Results. 299 women (NW: n = 157; OB: n = 142) aged 25.8 ± 5.1 y were enrolled. Cognition scores were within normal range (±1 z-score), but OB had lower attention (NW: 0.31 ± 1.38; OB: −0.25 ± 1.39; ES: 0.41, CI: 0.17–0.64; ) and higher impulsivity (NW: 0.36 ± 1.14; OB: −0.07 ± 1.07; ES: 0.39, CI: 0.15–0.62; ). Confounder adjustment had minimal impact on results. Conclusion. The OB group had normal but significantly lower performance on attention and were more impulsive compared to NW participants. This may indicate early cognitive decline, but longitudinal research confirming these findings is warranted. Rebecca L. Cook, Nicholas J. O’Dwyer, Cheyne E. Donges, Helen M. Parker, Hoi Lun Cheng, Katharine S. Steinbeck, Eka P. Cox, Janet L. Franklin, Manohar L. Garg, Kieron B. Rooney, and Helen T. O’Connor Copyright © 2017 Rebecca L. Cook et al. All rights reserved. Three-Year Follow-Up of Participants from a Self-Weighing Randomized Controlled Trial Tue, 19 Sep 2017 07:31:40 +0000 Frequent self-weighing is associated with weight loss maintenance. Several years ago, we investigated frequent self-weighing’s effect on weight loss and found the participants lost a significant amount of weight. Three years after this trial's end, participants were contacted for an update on their weight and self-weighing frequency. Weight change and self-weighing frequency since the end of the study were assessed. We hypothesized that participants who maintained frequent self-weighing behavior would have maintained their weight loss. Out of 98 participants enrolled in the RCT, 37% (n = 36) participated in this follow-up study. Total weight loss during the trial for the follow-up participants was 12.7 ± 19.4 lbs (). Three years after intervention, participants regained 0.9 ± 4.34 lbs, a value that was not statistically different from zero (). This did not differ by gender (). Over 75% of these participants continued to weigh themselves at least once a week. Frequent self-weighing may be an effective, low-cost strategy for weight loss maintenance. Future research should further investigate the role of self-weighing in long-term weight gain prevention. Lua Wilkinson, Carly R. Pacanowski, and David Levitsky Copyright © 2017 Lua Wilkinson et al. All rights reserved. Outcomes of Laparoscopic Gastric Greater Curvature Plication in Morbidly Obese Patients Wed, 16 Aug 2017 10:09:51 +0000 Background. Laparoscopic gastric greater curvature plication (LGGCP) is a restrictive bariatric procedure without gastrectomy. However, limited literature on effectiveness of gastric plication exists. Objectives. We assessed LGGCP’s efficacy, effects on associated comorbidities, safety and the rate of complications, and patient satisfaction with LGGCP’s outcomes among morbidly obese patients. Method. Analysis of retrospectively data collected from medical records of 26 patients who had undergone LGGCP at Hamad General Hospital, Qatar, during 2011-2012. Results. Most patients (92%) were Qatari nationals. The sample’s mean age was 35.1 years. Mean duration of hospital stay was days. Mean preoperative BMI was 40.7 kg/m2 that decreased at 2 years to 34.6 kg/m2. LGGCP’s effects on comorbidities were such that 7.6% of patients experienced resolutions of their comorbidities. There were no mortality or postoperative complications that required reoperation. Six patients (23%) were satisfied with the LGGCP’s outcomes while 10 patients (38.5%) underwent sleeve gastrectomy subsequently. Conclusion. LGGCP had acceptable short term weight loss results, exhibited almost no postoperative complications, and improved patients’ comorbidities. Despite the durability of the gastric fold, some patients regained weight. Future research may assess the possibility of an increase in the gastric pouch size postplication associated with weight regain. N. Khidir, M. Al Dhaheri, W. El Ansari, M. Al Kuwari, D. Sargsyan, and M. Bashah Copyright © 2017 N. Khidir et al. All rights reserved. Obesity Might Be a Predictor of Weight Reduction after Smoking Cessation Mon, 14 Aug 2017 00:00:00 +0000 Background and Objectives. Approximately one in five ex-smokers reduces or maintains weight after smoking cessation but little is known about who succeeds to avoid weight gain. The purpose of this study was to identify predictors of weight reduction after long-term smoking cessation in a general population. Methods. Data was obtained from two Danish population-based cohorts (the Inter99 and the Helbred2006 study). Anthropometric measurements were performed by trained research staff. Out of 3.577 daily smokers at baseline 317 participants had quit smoking at the five-year follow-up for at least one year. Multiple logistic regression analysis was performed to determine predictors of weight reduction. Results. Thirteen percent reduced weight by at least 1 kg and 4% maintained their weight. Quitters with obesity had more than seven times higher odds than normal weight quitters to lose weight (OR 7.13 (95% CI 2.76–19.71)), and they had the largest median weight loss of 4.45 kg. The only other significant predictor of weight reduction was low tobacco consumption at baseline. Conclusions. Predictors of weight reduction after smoking cessation were high body mass index and low tobacco consumption at baseline. This study might motivate smokers with obesity to quit smoking and health professionals to give them support. Charlotta Pisinger, Helle Øster Nielsen, Caroline Kuhlmann, and Susanne Rosthøj Copyright © 2017 Charlotta Pisinger et al. All rights reserved. Idiopathic Intracranial Hypertension: Prognostic Factors and Multidisciplinary Management Sun, 13 Aug 2017 06:19:59 +0000 Background. Idiopathic intracranial hypertension (IIH) mostly affects young obese women and can lead to permanent visual impairment. However, prognostic factors and therapeutic strategy remain unclear. Methods. We retrospectively collected data from all patients diagnosed and managed for IIH in our university center from January 2001 to December 2016. Results. Seventy-nine patients were diagnosed with IIH. Bilateral transverse sinus stenosis (TSS) was found in 74% of the population. Visual outcome at 6 months was poor for 46% of patients, including all patients presenting weight gain of at least 5% since diagnosis (), whereas mean body mass index at diagnosis was not different between patients with poor versus good outcome ( versus 34.6 ± 9.4 kg·m−2). Other significant factors of poor prognosis were bilateral TSS (OR = 5.2; 95 CI: 1.24–24.9; ). Thirteen patients with poor outcome after 6-month assessment underwent unilateral TSS stenting leading to visual improvement in 11 cases. Conclusion. Weight gain, rather than initial weight, emerged as the leading factor of poor visual outcome in patients with IIH, followed by presence of bilateral TSS. Consequently, first-line treatment must include dietary measures to control weight. Unilateral stenting appears to be a safe second-line treatment option for patients with bilateral TSS. Claire Chagot, Marie Blonski, Jean-Loup Machu, Serge Bracard, Jean-Christophe Lacour, and Sébastien Richard Copyright © 2017 Claire Chagot et al. All rights reserved. Trends and Disparities in the Prevalence of Childhood Obesity in South Texas between 2009 and 2015 Tue, 18 Jul 2017 00:00:00 +0000 Background. Recent reports have highlighted possible decreases over time in obesity, particularly among children aged 2–5 years. Hispanic children experience significantly higher obesity rates, and less is known about trends for Hispanic children. Methods. A large healthcare system-based dataset from south Texas was used to analyze body mass index (BMI) values obtained clinically from 2009 through 2015. Age and race/ethnicity specific prevalence of overweight and obesity were calculated using CDC standards and trends were examined over time using regression analyses, and mapping software was used to identify geographic variation. Results. Hispanic children in south Texas experience levels of obesity (25.3%, 95% CI: 25.1–25.6) significantly higher than their white (16.6%, 95% CI: 16.0–17.2) or black (18.2%, 95% CI: 17.3–19.1) peers. Obesity in Hispanic children aged 2–5 years decreased from 18.5%, 95% CI: 16.6–20.5, in 2009 to 15.1%, 95% CI: 14.3–15.9, in 2015. Obesity in Hispanic adolescents was stable at 30.4%, 95% CI: 28.5–32.4, in 2009 and 31.3, 95% CI: 30.3–32.2, in 2015. Conclusions. While obesity decreased in the youngest age group of Hispanic children, south Texas continues to experience high levels of obesity that exceed national averages with significant disparities. Byron A. Foster, Trevor M. Maness, and Christian A. Aquino Copyright © 2017 Byron A. Foster et al. All rights reserved. Corrigendum to “Experimental Evidence on the Impact of Food Advertising on Children’s Knowledge about and Preferences for Healthful Food” Wed, 12 Jul 2017 08:43:20 +0000 Lucia A. Reisch, Wencke Gwozdz, Gianvincenzo Barba, Stefaan De Henauw, Natalia Lascorz, and Iris Pigeot Copyright © 2017 Lucia A. Reisch et al. All rights reserved. Effect of the Holiday Season on Weight Gain: A Narrative Review Tue, 04 Jul 2017 08:01:40 +0000 Several studies suggest that the holiday season, starting from the last week of November to the first or second week of January, could be critical to gaining weight. This study aims to review the literature to determine the effects of the holidays on body weight. In studies of adults, a significant weight gain was consistently observed during this period (0.4 to 0.9 kg, ). The only study in college students found an effect on body fat but not on weight (0.1 kg, ). The only study found in children did not show an effect on BMI percentile (−0.4%, ) during this period. Among individuals with obesity who attempt to lose weight, an increase in weight was observed (0.3 to 0.9 kg, significant in some but not in all studies), as well as increase in weight in motivated self-monitoring people (0.4 to 0.6%, ). Programs focused on self-monitoring during the holidays (phone calls and daily mailing) appeared to prevent weight gain, but information is limited. The holiday season seems to increase body weight in adults, even in participants seeking to lose weight and in motivated self-monitoring people, whereas in children, adolescents, and college students, very few studies were found to make accurate conclusions. Rolando G. Díaz-Zavala, María F. Castro-Cantú, Mauro E. Valencia, Gerardo Álvarez-Hernández, Michelle M. Haby, and Julián Esparza-Romero Copyright © 2017 Rolando G. Díaz-Zavala et al. All rights reserved. Determinants of Walking among Middle-Aged and Older Overweight and Obese Adults: Sociodemographic, Health, and Built Environmental Factors Tue, 04 Jul 2017 00:00:00 +0000 Background. This study examined the association between selected sociodemographic, health, and built environmental factors and walking behaviors of middle-aged and older overweight/obese adults. Methods. Subjective data were obtained from surveys administered to community-dwelling overweight/obese adults aged ≥50 years residing in four Texas cities from October 2013 to June 2014, along with objective data on neighborhood walkability (Walk Score™). Multivariate logistic regression identified factors predicting the odds of walking the recommended ≥150 minutes per week for any purpose. Results. Of 253 participants, the majority were non-Hispanic white (81.8%), married (74.5%), and male (53.4%) and reported an annual income of ≥$50,000 (65.5%). Approximately, half were employed (49.6%) or had at least a college degree (51.6%). Walking the recommended ≥150 minutes per week for any purpose (, 22.5%) was significantly associated with having at least a college degree (, 95% CI = 1.79–17.25), having no difficulty walking a quarter of a mile (, 95% CI = 1.30–20.83), and being unemployed (, 95% CI = 1.18–8.93) as well as perceived presence of sidewalks/protected walkways (, 95% CI = 1.10–11.50) and perceived absence of distracted drivers in the neighborhood (, 95% CI = 1.47–11.36). Conclusion. Addressing neighborhood conditions related to distracted drivers and pedestrian infrastructure may promote walking among middle-aged and older overweight/obese individuals. Samuel N. Forjuoh, Marcia G. Ory, Jaewoong Won, Samuel D. Towne Jr., Suojin Wang, and Chanam Lee Copyright © 2017 Samuel N. Forjuoh et al. All rights reserved. Preoperative Assessment of Patients Undergoing Elective Gastrointestinal Surgery: Does Body Mass Index Matter? Mon, 12 Jun 2017 00:00:00 +0000 Background. At Queen Elizabeth Hospital Birmingham (QEHB), no specific protocol to stratify patients by body mass index (BMI) exists. This study sought to evaluate outcomes following gastrointestinal surgery. Methods. Patients undergoing gastrointestinal surgery attending preassessment screening clinic (PAS) from August to September 2016 at the QEHB were identified. Primary outcome was postoperative complications. Secondary outcomes were major complications and 30-day readmission rates. Results. Of 368 patients preassessed, 31% (116/368) were overweight and 35% (130/368) were obese. Median age was 57 (range: 17–93). There was no difference of BMI between the low risk and high risk clinics. Patients in high risk clinic had significantly higher rates of comorbidities, major surgical grades, and malignancy as the indication for surgery. Overall complication rates were 14% (52/368), with 3% (10/368) having major complications (Clavien-Dindo Grades III-IV). Whilst BMI was associated with comorbidity () and ASA grade (), it was not associated with worse outcomes. Patients attending high risk clinic had significantly higher rates of complications. Conclusions. Surgery grade was found to be an independent risk factor of complication rates. Use of BMI as an independent factor for preassessment level is not justified from our cohort. Sivesh K. Kamarajah, Mustafa Sowida, Amirul Adlan, Behrad Barmayehvar, Christina Reihill, and Parvez Ellahee Copyright © 2017 Sivesh K. Kamarajah et al. 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.