Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the...Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.展开更多
Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries.Insulin resistance is a key factor in the pathogenesis of NAFLD,the latter being considered...Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries.Insulin resistance is a key factor in the pathogenesis of NAFLD,the latter being considered as the hepatic component of insulin resistance or obesity.Adiponectin is the most abundant adipose-specific adipokine.There is evidence that adiponectin decreases hepatic and systematic insulin resistance,and attenuates liver inflammation and fibrosis.Adiponectin generally predicts steatosis grade and the severity of NAFLD;however,to what extent this is a direct effect or related to the presence of more severe insulin resistance or obesity remains to be addressed.Although there is no proven pharmacotherapy for the treatment of NAFLD,recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications.In this adiponectin-focused review,the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are analyzed systematically.展开更多
Objective To determine the extent of the obesity epidemic in school‐aged Chinese children in 2010 and track the increasing trend in different socioeconomic regions over the preceding 25 years. Strategies for preventi...Objective To determine the extent of the obesity epidemic in school‐aged Chinese children in 2010 and track the increasing trend in different socioeconomic regions over the preceding 25 years. Strategies for preventing childhood obesity are suggested. Methods We used a dataset provided by the Chinese National Survey on Students’ Constitution and Health from 1985‐2010. Subjects were 7‐18‐year‐old students randomly selected from urban and rural areas in 30 provinces. Eight subgroups were created according to region and socioeconomic status. Results Increased rates of the epidemic （overweight and obesity combined） were greatest in large coastal cities‐32.6% and 19.1% among males and females, respectively. These rates has neared that of developed countries. Similar increases were found in all other regions, including the once poverty‐stricken rural west. The epidemic in most of the rural areas began after 2000, but has spread swiftly over the last decade. In 2010, it was estimated that 9.9% of Chinese school‐aged children and adolescents were overweight and that an additional 5.1% were obese, representing an estimated 30.43 million individuals. Conclusion The prognosis for China＇s childhood‐obesity epidemic is dire. To prevent childhood obesity, we suggest several strategies, including reasonable dietary intake, increase physical activity, a change in sedentary lifestyles and corresponding behavioral modifications.展开更多
Increases in the prevalence of obesity and gastroesophageal reflux disease (GERD) have paralleled one another over the past decade, which suggests the possibility of a linkage between these two processes. In both inst...Increases in the prevalence of obesity and gastroesophageal reflux disease (GERD) have paralleled one another over the past decade, which suggests the possibility of a linkage between these two processes. In both instances, surgical therapy is recognized as the most effective treatment for severe, refractory disease. Current surgical therapies for severe obesity include (in descending frequency) Roux-en-Y gastric bypass, adjustable gastric banding, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, while fundoplication remains the mainstay for the treatment of severe GERD. In several large series, however, the outcomes and durability of fundoplication in the setting of severe obesity are not as good as those in patients who are not severely obese. As such, bariatric surgery has been suggested as a potential alternative treatment for these patients. This article reviews current concepts in the putative pathophysiological mechanisms by which obesity contributes to gastroesophageal reflux and their implications with regards to surgical therapy for GERD in the setting of severe obesity.展开更多
Objective To test the validity of Working Group on Obesity in China （WGOC） reference in screening childhood obesity using obesity-related metabolic syndrome （MS） and its components as disease risk evidence. Method...Objective To test the validity of Working Group on Obesity in China （WGOC） reference in screening childhood obesity using obesity-related metabolic syndrome （MS） and its components as disease risk evidence. Methods A total of 2020 adolescents （1007 boys and 1013 girls） aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index （BMI） categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics （NCHS）. Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity （especially for girls since the mid- adolescence）, the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity （90.1% for boys and 89.2% for girls） and a relative high specificity （96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively） was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.展开更多
Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress ...Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis.Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis.Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronicliver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation.Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble,water-soluble vitamins and trace elements and should be supplemented appropriately.Diet,physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations.Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation.The risk of sarcopenia,micronutrient status,and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review.Furthermore,the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.展开更多
Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Ma...Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.展开更多
Research Aims: Obesity and type 2 diabetes are known to be associated with increased risk of various types of cancer. However, the molecular biological mechanism of how the risk of cancer is increased in obesity or ty...Research Aims: Obesity and type 2 diabetes are known to be associated with increased risk of various types of cancer. However, the molecular biological mechanism of how the risk of cancer is increased in obesity or type 2 diabetes is not known. The aim this research is to investigate if the decreased expression of p27Kip1, a cell cycle repressor protein, plays a central role in this mechanism. Research Methods, Previous Studies and Theoretical Backgrounds: It is well known that the expression of p27Kip1 is increased by numerous nutritional or chemopreventive anti-cancer agents. But it has never been known that the expression of p27Kip1 could be decreased, rather than increased, and the risk of cancer could be increased, rather than decreased. This problem was solved recently and this new analytical method was used in this study. Results: 1) The expression of p27Kip1 was indeed significantly decreased in human obese type 2 diabetic individuals relative to the lean normal controls. 2) The expression of p27Kip1 was also significantly decreased in genetically obese rodents relative to the lean normal controls. Additionally, in obese rodents, the concentrations of glucose or insulin were significantly increased relative to the lean normal controls. 3) Using human cells cultured in vitro it was found that the increased concentrations of glucose or insulin decrease the expression of p27Kip1. Conclusions: These results suggest that higher concentrations of glucose or insulin increase the risk of various types of cancer in obesity or type 2 diabetes by decreasing the expression of p27Kip1.展开更多
The prevalence of pediatric obesity continues to increase worldwide,bringing with it various metabolic,functional,social,and psychological complications.1 Both the prevention and treatment of childhood obesity must be...The prevalence of pediatric obesity continues to increase worldwide,bringing with it various metabolic,functional,social,and psychological complications.1 Both the prevention and treatment of childhood obesity must be based on multidisciplinary approaches combining nutrition,physical activity(PA),and psychological support.2 As an essential element of these multicomponent strategies,regular physical activity has been acknowledged as having beneficial effects on children's and adolescents,body composition,physical fitness,and metabolic profile,as well as on their health-related quality of life,social and psychological health,and academic achievement.3,4 Given that only a relatively small proportion of children and adolescents meet the public health recommendations for PA,5 and given that weight loss exercise-based interventions suffer from a high attrition rate,there is a clear need for appropriate PAs.展开更多
AIM: To evaluate and present our experience with laparoscopic Roux en Y gastric bypass (RYGB) in a selected patient population. METHODS: A cohort of 130 patients with a body mass index (BMI) between 35 and 50 kg/m2 we...AIM: To evaluate and present our experience with laparoscopic Roux en Y gastric bypass (RYGB) in a selected patient population. METHODS: A cohort of 130 patients with a body mass index (BMI) between 35 and 50 kg/m2 were evaluated in relation to postoperative morbidity,weight loss and resolution of co-morbidities for a period of 4 years following laparoscopic RYGB. RESULTS: Early morbidity was 10.0%,including 1 patient with peritonitis who was admitted to Intensive Care Unit (ICU) and 1 conversion to open RYGB early in the series. There was no early or late mortality. Maximum weight loss was achieved at 12 mo postoperatively,with mean BMI 30 kg/m2,mean percentage of excess weight loss (EWL%) 66.4% and mean percentage of initial weight loss (IWL%) 34.3% throughout the follow-up period. The majority of preexisting comorbidities were resolved after weight loss and no major metabolic disturbances or nutritional deficiencies were observed. CONCLUSION: Laparoscopic RYGB appears to be a safe and effective procedure for patients with BMI 35-50 kg/m2 with results that are comparable to previously published data mostly from the USA but from Europe as well.展开更多
Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures- as diets, physical activity, behavior therapy and pharmacotherapy- have been continuously implemented but still have relat...Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures- as diets, physical activity, behavior therapy and pharmacotherapy- have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical.展开更多
Childhood obesity is a growing concern world-wide, and obesity rates are higher in certain groups in the developed world, including Australian Aboriginal people. Community-based obesity prevention interventions (CBOPI...Childhood obesity is a growing concern world-wide, and obesity rates are higher in certain groups in the developed world, including Australian Aboriginal people. Community-based obesity prevention interventions (CBOPI) can help to address obesity, however the approach of such programs to reach diverse groups, including Aboriginal people, must be considered. This paper considers one mainstream1 CBOPI, the eat well be active (ewba) Community Programs in South Australia, which was delivered in two communities and sought to reach Aboriginal people as part of the overall program. This paper considers how well this approach was received by the Aboriginal people living and working in those communities. Semi-structured interviews were conducted with nine Aboriginal workers who had some connection to the ewba program, and seven ewba project staff. Qualitative data analysis was performed and factors found to affect how well the program was received by Aboriginal people include relationships, approach and project target group, including geographical area. A different response was observed in the two communities, with a more positive response being observed in the community where more relationships were developed between ewba and Aboriginal staff. For any CBOPI seeking to work with Aboriginal (or other Indigenous) communities, it is vital to consider and plan how the program will meet the needs and preferences of Aboriginal people in all stages of the project, in order to reach this group.展开更多
The aim of this study was to characterize the obesity effect on children knee and hip joint range of motion. A randomized controlled trial was performed with goniometry evaluation for hip flexion, extension, abduction...The aim of this study was to characterize the obesity effect on children knee and hip joint range of motion. A randomized controlled trial was performed with goniometry evaluation for hip flexion, extension, abduction, adduction, external and internal rotation, and knee flexion in fifty male children (20 obese and 30 non obese), with age ranging from 6 to 12 years old. The obesity effect was found to be non-uniform across the joint range of motion. In the obesity group, a statistically significant reduction in the range of motion of hip flexion and adduction, and knee flexion was observed;and also an increase in external rotation in the hip was observed. Conclusion: Obese and overweight children present alterations in hip and knee joints mobility when compared to eutrophic children. The obesity/overweight associated with factors previously described in the literature, such as joint overload, postural deviation and sedentariness may influence the musculoskeletal development and, consequently, the motor function.展开更多
Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prev...Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prevalence of meeting the 24-h movement guidelines,its correlates,and its relationships with body mass index in children and adolescents in China.Methods:Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents(mean age=13.75 years,49.18%boys)were used.Meeting 24-h movement guidelines(60 min of daily moderate-to-vigorous physical activity,2 h of daily leisure screen time,911 h and 810 h nightly sleep duration for 613-year-olds and 1417-year-olds,respectively)and height and weight of all participants were assessed.The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined.Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight(OW)and obesity(OB).Results:Only 5.12%of Chinese children and adolescents met the 24-h movement guidelines,and 22.44%were classified as OW/OB.Older children and adolescents were less likely to meet the 24-h movement guidelines.Parental education level and family income were positively related to meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB.Compared with participants meeting the 24-h movement guidelines,boys in 4th6th grades met none of the recommendations(OR=1.22,95%CI:1.061.40),met the screen time recommendation only(OR=1.13,95%CI:1.011.28),met the nightly sleep duration recommendation only(OR=1.14,95%CI:1.031.28),and had significantly higher odds ratios for OW/OB.Similar trends were observed for girls in 4th6th grades:meeting none of the guidelines(OR=1.35,95%CI:1.141.59),meeting sleep duration guidelines only(OR=1.23,95%CI:1.081.39),and meeting moderate-to-vigorous physical activity+nightly sleep duration guidelines(OR=1.24,95%CI:1.011.54).For girls in 7th9th grades,the following trend was observed:meeting none of the guidelines(OR=1.30,95%CI:1.011.67).Conclusion:Very few Chinese children and adolescents met the 24-h movement guidelines.Age(negatively correlated),parental education level,and family income(both positively correlated)were correlates of meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB,especially in the youngest age group(Grades 46);and girls in the middle age group(Grades 79)were also more likely to have lower risks for OW/OB.Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines.Also,future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators,while taking sex and age differences into account.展开更多
Given the tremendous need for effective weight loss treatments, we read with interest the paper by Yan et al. and were intrigued by the reported finding that a form of massage produced weight loss in a randomized con...Given the tremendous need for effective weight loss treatments, we read with interest the paper by Yan et al. and were intrigued by the reported finding that a form of massage produced weight loss in a randomized controlled trial.展开更多
With over 420 million children(aged 0–19 years)worldwide living with overweight or obesity,the“obesity epidemic”or“globesity”is a defining public health challenge of this generation.While significant efforts have...With over 420 million children(aged 0–19 years)worldwide living with overweight or obesity,the“obesity epidemic”or“globesity”is a defining public health challenge of this generation.While significant efforts have been made to address obesity in adults,less attention has been given to the critical issue of childhood overweight and obesity.Alarmingly,these children are five times more likely to remain overweight and obese into adulthood compared to their non-obese counterparts.1 Consequently,there is a high likelihood that these children will contribute to a further increase in the prevalence of adulthood obesity in the future.展开更多
Estimates suggest that by 2035,overweight and obesity will affect 54%of the global adult population,totaling 3.3 billion individuals(1).In the U.S.,over 70%of adults are currently affected by overweight and obesity,wi...Estimates suggest that by 2035,overweight and obesity will affect 54%of the global adult population,totaling 3.3 billion individuals(1).In the U.S.,over 70%of adults are currently affected by overweight and obesity,with prevalence projected to exceed 80%by 2050,with obesity increasing at a faster rate than overweight(2).Considering that obesity is a chronic disease characterized by excessive adipose accumulation or distribution that presents a health risk and requires lifelong care,the Journal of the Academy of Nutrition and Dietetics published the“Position of the Academy of Nutrition and Dietetics:Medical Nutrition Therapy Behavioral Interventions Provided by Dietitians for Adults with Overweight or Obesity,2024”(3,4).展开更多
We evaluated the potential mechanisms responsible for inducing beta-cell decline during the progression of obesity to type 2 diabetes mellitus(T2DM).Between February 2021 and February 2022,25 subjects with non-diabeti...We evaluated the potential mechanisms responsible for inducing beta-cell decline during the progression of obesity to type 2 diabetes mellitus(T2DM).Between February 2021 and February 2022,25 subjects with non-diabetic obesity,20 subjects with obesity and new-onset T2DM,and 25 healthy volunteers were recruited.Circulating exosome-contained miRNA expression profiling was performed by miRNA sequencing.The role of specific miRNA was analyzed by a gain-of-function approach in Min6 beta-cells,mouse islets,and human islets.Expression of 83 exosomal miRNAs was differently regulated in the circulation of subjects with non-diabetic obesity.We focused on miR-146b,which was mildly up-regulated in non-diabetic obesity and dramatically up-regulated in obese new-onset T2DM.Using an obese diabetic db/db mouse model,we found the expression of miR-146b to be mainly increased in islets.Overexpression of miR-146b in mouse beta-cells,mouse islets,and human islets in vitro facilitated beta-cell apoptosis yet inhibited its proliferation and insulin synthesis,leading to impaired insulin secretion.Eventually,miR-146b directly targeted the B cell translocation gene 2(Btg2),an antiapoptotic transcriptional factor.Overexpression of Btg2 reversed miR-146b-induced apoptosis and-suppressed proliferation in beta-cells.miR-146b that targets Btg2 might be a predictive biomarker and an inducer of beta-cell decline.展开更多
Obesity,a global health concern,is associated with severe health issues like type 2 diabetes,heart disease,and respiratory complications.It also increases the risk of various cancers,including melanoma,endometrial,pro...Obesity,a global health concern,is associated with severe health issues like type 2 diabetes,heart disease,and respiratory complications.It also increases the risk of various cancers,including melanoma,endometrial,prostate,pancreatic,esophageal adenocarcinoma,colorectal carcinoma,renal adenocarcinoma,and pre-and post-menopausal breast cancer.Obesity-induced cellular changes,such as impaired CD8^(+)T cell function,dyslipi-demia,hypercholesterolemia,insulin resistance,mild hyperglycemia,and fluctuating levels of leptin,resistin,adiponectin,and IL-6,contribute to cancer development by promoting inflammation and creating a tumor-promoting microenvironment rich in adipocytes.Adipocytes release leptin,a pro-inflammatory substance that stimulates cancer cell proliferation,inflammation,and invasion,altering the tumor cell metabolic pathway.Adiponectin,an insulin-sensitizing adipokine,is typically downregulated in obese individuals.It has antipro-liferative,proapoptotic,and antiangiogenic properties,making it a potential cancer treatment.This narrative review offers a comprehensive examination of the molecular interconnections between obesity and cancer,draw-ing on an extensive,though non-systematic,survey of the recent literature.This approach allows us to integrate and synthesize findings from various studies,offering a cohesive perspective on emerging themes and potential therapeutic targets.The review explores the metabolic disturbances,cellular alterations,inflammatory responses,and shifts in the tumor microenvironment that contribute to the obesity-cancer link.Finally,it discusses poten-tial therapeutic strategies aimed at disrupting these connections,offering valuable insights into future research directions and the development of targeted interventions.展开更多
Background： Obesity has become a major health problem among children and adolescents worldwide. This study aimed to examine the trends of overweight and obesity among childhood in China and assess their associations ...Background： Obesity has become a major health problem among children and adolescents worldwide. This study aimed to examine the trends of overweight and obesity among childhood in China and assess their associations with family income, dietary intake, and physical activity （PA） between 1997 and 2009. Methods： Two waves of cross-sectional data of Chinese children and adolescents aged 7-17 years from the China Health and Nutrition Survey were used. Weight and height were measured following standardized procedures. Dietary intake was assessed by 3 consecutive 24-h recalls. Childhood overweight and obesity were defined using the International Obesity Task Force-recommended body mass index cut-offs. Multivariate linear regression analysis was used to examine the associations of family income with diet intakes and PA. Multivariate logistic regression analysis was conducted to assess the associations of overweight and obesity with family income, dietary intake, and PA. Results： The prevalence of childhood overweight and obesity increased from 12.6% in 1997 to 22.1% in 2009, particularly in the medium- and high-family income groups, which increased by 102.7% and 90.3%, respectively. Higher fat intake （% energy）, and moderate and vigorous PA were significantly associated with overweight and obesity in final model （odds ratio [OR] = 1.01, 95% confidence interval [CI]： 1.00-1.02, P = 0.004; and OR = 0.99, 95% CI： 0.98-1.00, P = 0.036, respectively）. Conclusions： The prevalence of overweight and obesity among Chinese children and adolescents has increased between 1997 and 2009. Reducing fat intake and increasing PA may help obesity prevention.展开更多
基金Funded by International Life Sciences Institute, Focal Point in China.
文摘Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.
文摘Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries.Insulin resistance is a key factor in the pathogenesis of NAFLD,the latter being considered as the hepatic component of insulin resistance or obesity.Adiponectin is the most abundant adipose-specific adipokine.There is evidence that adiponectin decreases hepatic and systematic insulin resistance,and attenuates liver inflammation and fibrosis.Adiponectin generally predicts steatosis grade and the severity of NAFLD;however,to what extent this is a direct effect or related to the presence of more severe insulin resistance or obesity remains to be addressed.Although there is no proven pharmacotherapy for the treatment of NAFLD,recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications.In this adiponectin-focused review,the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are analyzed systematically.
文摘Objective To determine the extent of the obesity epidemic in school‐aged Chinese children in 2010 and track the increasing trend in different socioeconomic regions over the preceding 25 years. Strategies for preventing childhood obesity are suggested. Methods We used a dataset provided by the Chinese National Survey on Students’ Constitution and Health from 1985‐2010. Subjects were 7‐18‐year‐old students randomly selected from urban and rural areas in 30 provinces. Eight subgroups were created according to region and socioeconomic status. Results Increased rates of the epidemic （overweight and obesity combined） were greatest in large coastal cities‐32.6% and 19.1% among males and females, respectively. These rates has neared that of developed countries. Similar increases were found in all other regions, including the once poverty‐stricken rural west. The epidemic in most of the rural areas began after 2000, but has spread swiftly over the last decade. In 2010, it was estimated that 9.9% of Chinese school‐aged children and adolescents were overweight and that an additional 5.1% were obese, representing an estimated 30.43 million individuals. Conclusion The prognosis for China＇s childhood‐obesity epidemic is dire. To prevent childhood obesity, we suggest several strategies, including reasonable dietary intake, increase physical activity, a change in sedentary lifestyles and corresponding behavioral modifications.
文摘Increases in the prevalence of obesity and gastroesophageal reflux disease (GERD) have paralleled one another over the past decade, which suggests the possibility of a linkage between these two processes. In both instances, surgical therapy is recognized as the most effective treatment for severe, refractory disease. Current surgical therapies for severe obesity include (in descending frequency) Roux-en-Y gastric bypass, adjustable gastric banding, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, while fundoplication remains the mainstay for the treatment of severe GERD. In several large series, however, the outcomes and durability of fundoplication in the setting of severe obesity are not as good as those in patients who are not severely obese. As such, bariatric surgery has been suggested as a potential alternative treatment for these patients. This article reviews current concepts in the putative pathophysiological mechanisms by which obesity contributes to gastroesophageal reflux and their implications with regards to surgical therapy for GERD in the setting of severe obesity.
基金International Life Sciences Institute, Focal Point in China
文摘Objective To test the validity of Working Group on Obesity in China （WGOC） reference in screening childhood obesity using obesity-related metabolic syndrome （MS） and its components as disease risk evidence. Methods A total of 2020 adolescents （1007 boys and 1013 girls） aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index （BMI） categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics （NCHS）. Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity （especially for girls since the mid- adolescence）, the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity （90.1% for boys and 89.2% for girls） and a relative high specificity （96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively） was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.
文摘Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis.Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis.Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronicliver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation.Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble,water-soluble vitamins and trace elements and should be supplemented appropriately.Diet,physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations.Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation.The risk of sarcopenia,micronutrient status,and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review.Furthermore,the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.
文摘Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.
文摘Research Aims: Obesity and type 2 diabetes are known to be associated with increased risk of various types of cancer. However, the molecular biological mechanism of how the risk of cancer is increased in obesity or type 2 diabetes is not known. The aim this research is to investigate if the decreased expression of p27Kip1, a cell cycle repressor protein, plays a central role in this mechanism. Research Methods, Previous Studies and Theoretical Backgrounds: It is well known that the expression of p27Kip1 is increased by numerous nutritional or chemopreventive anti-cancer agents. But it has never been known that the expression of p27Kip1 could be decreased, rather than increased, and the risk of cancer could be increased, rather than decreased. This problem was solved recently and this new analytical method was used in this study. Results: 1) The expression of p27Kip1 was indeed significantly decreased in human obese type 2 diabetic individuals relative to the lean normal controls. 2) The expression of p27Kip1 was also significantly decreased in genetically obese rodents relative to the lean normal controls. Additionally, in obese rodents, the concentrations of glucose or insulin were significantly increased relative to the lean normal controls. 3) Using human cells cultured in vitro it was found that the increased concentrations of glucose or insulin decrease the expression of p27Kip1. Conclusions: These results suggest that higher concentrations of glucose or insulin increase the risk of various types of cancer in obesity or type 2 diabetes by decreasing the expression of p27Kip1.
文摘The prevalence of pediatric obesity continues to increase worldwide,bringing with it various metabolic,functional,social,and psychological complications.1 Both the prevention and treatment of childhood obesity must be based on multidisciplinary approaches combining nutrition,physical activity(PA),and psychological support.2 As an essential element of these multicomponent strategies,regular physical activity has been acknowledged as having beneficial effects on children's and adolescents,body composition,physical fitness,and metabolic profile,as well as on their health-related quality of life,social and psychological health,and academic achievement.3,4 Given that only a relatively small proportion of children and adolescents meet the public health recommendations for PA,5 and given that weight loss exercise-based interventions suffer from a high attrition rate,there is a clear need for appropriate PAs.
文摘AIM: To evaluate and present our experience with laparoscopic Roux en Y gastric bypass (RYGB) in a selected patient population. METHODS: A cohort of 130 patients with a body mass index (BMI) between 35 and 50 kg/m2 were evaluated in relation to postoperative morbidity,weight loss and resolution of co-morbidities for a period of 4 years following laparoscopic RYGB. RESULTS: Early morbidity was 10.0%,including 1 patient with peritonitis who was admitted to Intensive Care Unit (ICU) and 1 conversion to open RYGB early in the series. There was no early or late mortality. Maximum weight loss was achieved at 12 mo postoperatively,with mean BMI 30 kg/m2,mean percentage of excess weight loss (EWL%) 66.4% and mean percentage of initial weight loss (IWL%) 34.3% throughout the follow-up period. The majority of preexisting comorbidities were resolved after weight loss and no major metabolic disturbances or nutritional deficiencies were observed. CONCLUSION: Laparoscopic RYGB appears to be a safe and effective procedure for patients with BMI 35-50 kg/m2 with results that are comparable to previously published data mostly from the USA but from Europe as well.
文摘Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures- as diets, physical activity, behavior therapy and pharmacotherapy- have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical.
文摘Childhood obesity is a growing concern world-wide, and obesity rates are higher in certain groups in the developed world, including Australian Aboriginal people. Community-based obesity prevention interventions (CBOPI) can help to address obesity, however the approach of such programs to reach diverse groups, including Aboriginal people, must be considered. This paper considers one mainstream1 CBOPI, the eat well be active (ewba) Community Programs in South Australia, which was delivered in two communities and sought to reach Aboriginal people as part of the overall program. This paper considers how well this approach was received by the Aboriginal people living and working in those communities. Semi-structured interviews were conducted with nine Aboriginal workers who had some connection to the ewba program, and seven ewba project staff. Qualitative data analysis was performed and factors found to affect how well the program was received by Aboriginal people include relationships, approach and project target group, including geographical area. A different response was observed in the two communities, with a more positive response being observed in the community where more relationships were developed between ewba and Aboriginal staff. For any CBOPI seeking to work with Aboriginal (or other Indigenous) communities, it is vital to consider and plan how the program will meet the needs and preferences of Aboriginal people in all stages of the project, in order to reach this group.
文摘The aim of this study was to characterize the obesity effect on children knee and hip joint range of motion. A randomized controlled trial was performed with goniometry evaluation for hip flexion, extension, abduction, adduction, external and internal rotation, and knee flexion in fifty male children (20 obese and 30 non obese), with age ranging from 6 to 12 years old. The obesity effect was found to be non-uniform across the joint range of motion. In the obesity group, a statistically significant reduction in the range of motion of hip flexion and adduction, and knee flexion was observed;and also an increase in external rotation in the hip was observed. Conclusion: Obese and overweight children present alterations in hip and knee joints mobility when compared to eutrophic children. The obesity/overweight associated with factors previously described in the literature, such as joint overload, postural deviation and sedentariness may influence the musculoskeletal development and, consequently, the motor function.
基金the Key Project of the National Social Science Foundation of China(No.16ZDA227)The first and corresponding authors(STC and YL)are supported by grants from the National Social Science Foundation of China(No.19BTY077)+1 种基金the Philosophy and Social Science Foundation of Shanghai(No.A1904)the Shanghai Key Laboratory of Human Performance(Shanghai University of Sport,No.11DZ2261100)。
文摘Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prevalence of meeting the 24-h movement guidelines,its correlates,and its relationships with body mass index in children and adolescents in China.Methods:Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents(mean age=13.75 years,49.18%boys)were used.Meeting 24-h movement guidelines(60 min of daily moderate-to-vigorous physical activity,2 h of daily leisure screen time,911 h and 810 h nightly sleep duration for 613-year-olds and 1417-year-olds,respectively)and height and weight of all participants were assessed.The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined.Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight(OW)and obesity(OB).Results:Only 5.12%of Chinese children and adolescents met the 24-h movement guidelines,and 22.44%were classified as OW/OB.Older children and adolescents were less likely to meet the 24-h movement guidelines.Parental education level and family income were positively related to meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB.Compared with participants meeting the 24-h movement guidelines,boys in 4th6th grades met none of the recommendations(OR=1.22,95%CI:1.061.40),met the screen time recommendation only(OR=1.13,95%CI:1.011.28),met the nightly sleep duration recommendation only(OR=1.14,95%CI:1.031.28),and had significantly higher odds ratios for OW/OB.Similar trends were observed for girls in 4th6th grades:meeting none of the guidelines(OR=1.35,95%CI:1.141.59),meeting sleep duration guidelines only(OR=1.23,95%CI:1.081.39),and meeting moderate-to-vigorous physical activity+nightly sleep duration guidelines(OR=1.24,95%CI:1.011.54).For girls in 7th9th grades,the following trend was observed:meeting none of the guidelines(OR=1.30,95%CI:1.011.67).Conclusion:Very few Chinese children and adolescents met the 24-h movement guidelines.Age(negatively correlated),parental education level,and family income(both positively correlated)were correlates of meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB,especially in the youngest age group(Grades 46);and girls in the middle age group(Grades 79)were also more likely to have lower risks for OW/OB.Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines.Also,future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators,while taking sex and age differences into account.
文摘Given the tremendous need for effective weight loss treatments, we read with interest the paper by Yan et al. and were intrigued by the reported finding that a form of massage produced weight loss in a randomized controlled trial.
文摘With over 420 million children(aged 0–19 years)worldwide living with overweight or obesity,the“obesity epidemic”or“globesity”is a defining public health challenge of this generation.While significant efforts have been made to address obesity in adults,less attention has been given to the critical issue of childhood overweight and obesity.Alarmingly,these children are five times more likely to remain overweight and obese into adulthood compared to their non-obese counterparts.1 Consequently,there is a high likelihood that these children will contribute to a further increase in the prevalence of adulthood obesity in the future.
文摘Estimates suggest that by 2035,overweight and obesity will affect 54%of the global adult population,totaling 3.3 billion individuals(1).In the U.S.,over 70%of adults are currently affected by overweight and obesity,with prevalence projected to exceed 80%by 2050,with obesity increasing at a faster rate than overweight(2).Considering that obesity is a chronic disease characterized by excessive adipose accumulation or distribution that presents a health risk and requires lifelong care,the Journal of the Academy of Nutrition and Dietetics published the“Position of the Academy of Nutrition and Dietetics:Medical Nutrition Therapy Behavioral Interventions Provided by Dietitians for Adults with Overweight or Obesity,2024”(3,4).
基金supported by the Natural Science Foundation of Chongqing,China(No.CSTC2020jcyj-msxmX0093 to Qian Ge)the National Key R&D Program of China(No.2018YFA0800401 to Xi Li)+2 种基金the National Natural Science Foundation of China(No.81770861,82070899 to Xi Li)the general project of the Natural Sciences Foundation of Chongqing,China(No.CSTB2022NSCQ-MSX0827 to Xi Li)the CQMU Program for Youth Innovation in Future Medicine(Chongqing,China)(No.W0046 to Xi Li).
文摘We evaluated the potential mechanisms responsible for inducing beta-cell decline during the progression of obesity to type 2 diabetes mellitus(T2DM).Between February 2021 and February 2022,25 subjects with non-diabetic obesity,20 subjects with obesity and new-onset T2DM,and 25 healthy volunteers were recruited.Circulating exosome-contained miRNA expression profiling was performed by miRNA sequencing.The role of specific miRNA was analyzed by a gain-of-function approach in Min6 beta-cells,mouse islets,and human islets.Expression of 83 exosomal miRNAs was differently regulated in the circulation of subjects with non-diabetic obesity.We focused on miR-146b,which was mildly up-regulated in non-diabetic obesity and dramatically up-regulated in obese new-onset T2DM.Using an obese diabetic db/db mouse model,we found the expression of miR-146b to be mainly increased in islets.Overexpression of miR-146b in mouse beta-cells,mouse islets,and human islets in vitro facilitated beta-cell apoptosis yet inhibited its proliferation and insulin synthesis,leading to impaired insulin secretion.Eventually,miR-146b directly targeted the B cell translocation gene 2(Btg2),an antiapoptotic transcriptional factor.Overexpression of Btg2 reversed miR-146b-induced apoptosis and-suppressed proliferation in beta-cells.miR-146b that targets Btg2 might be a predictive biomarker and an inducer of beta-cell decline.
基金supported by Sidra Medicine Research Fund to Ajaz A.Bhat(grant number:SDR400190)Ammira S.Al-Shabeeb Akil(grant number:SDR400175).
文摘Obesity,a global health concern,is associated with severe health issues like type 2 diabetes,heart disease,and respiratory complications.It also increases the risk of various cancers,including melanoma,endometrial,prostate,pancreatic,esophageal adenocarcinoma,colorectal carcinoma,renal adenocarcinoma,and pre-and post-menopausal breast cancer.Obesity-induced cellular changes,such as impaired CD8^(+)T cell function,dyslipi-demia,hypercholesterolemia,insulin resistance,mild hyperglycemia,and fluctuating levels of leptin,resistin,adiponectin,and IL-6,contribute to cancer development by promoting inflammation and creating a tumor-promoting microenvironment rich in adipocytes.Adipocytes release leptin,a pro-inflammatory substance that stimulates cancer cell proliferation,inflammation,and invasion,altering the tumor cell metabolic pathway.Adiponectin,an insulin-sensitizing adipokine,is typically downregulated in obese individuals.It has antipro-liferative,proapoptotic,and antiangiogenic properties,making it a potential cancer treatment.This narrative review offers a comprehensive examination of the molecular interconnections between obesity and cancer,draw-ing on an extensive,though non-systematic,survey of the recent literature.This approach allows us to integrate and synthesize findings from various studies,offering a cohesive perspective on emerging themes and potential therapeutic targets.The review explores the metabolic disturbances,cellular alterations,inflammatory responses,and shifts in the tumor microenvironment that contribute to the obesity-cancer link.Finally,it discusses poten-tial therapeutic strategies aimed at disrupting these connections,offering valuable insights into future research directions and the development of targeted interventions.
基金Source of Support： This study was supported by in part by research grants from the US National Institutes of Health （NIH, U54, HD070725, R01-HD30880 and R01-HD38700）, the National Natural Science Foundation of China （No. 81172666）, and Chinese Center for Disease Control and Prevention （No. 2013B 103）. Conflict of Interest： None declared.ACKNOWLEDGMENTS We would like to thank all collaborators from the nine provinces for their support in the fieldwork.
文摘Background： Obesity has become a major health problem among children and adolescents worldwide. This study aimed to examine the trends of overweight and obesity among childhood in China and assess their associations with family income, dietary intake, and physical activity （PA） between 1997 and 2009. Methods： Two waves of cross-sectional data of Chinese children and adolescents aged 7-17 years from the China Health and Nutrition Survey were used. Weight and height were measured following standardized procedures. Dietary intake was assessed by 3 consecutive 24-h recalls. Childhood overweight and obesity were defined using the International Obesity Task Force-recommended body mass index cut-offs. Multivariate linear regression analysis was used to examine the associations of family income with diet intakes and PA. Multivariate logistic regression analysis was conducted to assess the associations of overweight and obesity with family income, dietary intake, and PA. Results： The prevalence of childhood overweight and obesity increased from 12.6% in 1997 to 22.1% in 2009, particularly in the medium- and high-family income groups, which increased by 102.7% and 90.3%, respectively. Higher fat intake （% energy）, and moderate and vigorous PA were significantly associated with overweight and obesity in final model （odds ratio [OR] = 1.01, 95% confidence interval [CI]： 1.00-1.02, P = 0.004; and OR = 0.99, 95% CI： 0.98-1.00, P = 0.036, respectively）. Conclusions： The prevalence of overweight and obesity among Chinese children and adolescents has increased between 1997 and 2009. Reducing fat intake and increasing PA may help obesity prevention.
