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International Journal of Environmental... Dec 2021The number of overweight (OW) and obese (OB) children, adolescents, and adults has increased globally. Exercise intensity, both actual and perceived, is a significant... (Meta-Analysis)
Meta-Analysis Review
The number of overweight (OW) and obese (OB) children, adolescents, and adults has increased globally. Exercise intensity, both actual and perceived, is a significant factor in a variety of health-related investigations and rehabilitation trainings. Despite this, literature on the connection between actual exercise intensity and the rating of perceived exertion (RPE) in overweight and obese populations is lacking. A systematic review, meta-analysis, combined analysis of variance (Brown-Forsythe ANOVA), and Spearman correlation were performed to fill this gap. After preliminary assessments, ten studies were classified as having a low risk of bias and a degree of heterogeneity (I = 34%; = 0.05). The RPE scores (F = 0.032; = 0.859), physiological index (percentage of maximal heart rate (%HR) (F = 0.028; = 0.869), and percentage of maximal oxygen uptake (%VO) (F = 2.434; = 0.136) demonstrated consistency without being significantly different between the normal weight (NW) and OW/OB groups. The RPE scores varied by age (NW (coefficient values) = 0.677 ***, OW = 0.585 **), as well as by indoor temperature (OW only, coefficient values = 0.422 *), body mass index (NW (coefficient values) = 0.516 **, OW = 0.580 **), and test time (NW only, coefficient values = 0.451 *). We conclude that RPE is appropriate for the following OW and OB people: (1) those who are older than 21.5 (the lowest age in the group of ≥18) years old and younger than 58.6 (the highest age in the group of ≥18) years old, without any other diseases, and (2) those who engage in low-intensity exercise while maintaining a standard indoor temperature. Future studies may address alternative techniques for increasing the reliability of longitudinal comparisons and gender comparisons, as well as investigate other possible confounding factors.
Topics: Adolescent; Adult; Body Mass Index; Child; Humans; Obesity; Overweight; Physical Exertion; Reproducibility of Results
PubMed: 34948522
DOI: 10.3390/ijerph182412912 -
Biology of Sex Differences Jul 2023Premature birth and/or low birthweight have long-lasting effects on cognition. The purpose of the present systematic review is to examine whether the effects of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Premature birth and/or low birthweight have long-lasting effects on cognition. The purpose of the present systematic review is to examine whether the effects of prematurity and/or low birth weight on neurodevelopmental outcomes differ between males and females.
METHODS
Web of Science, Scopus, and Ovid MEDLINE were searched for studies of humans born premature and/or of low birthweight, where neurodevelopmental phenotypes were measured at 1 year of age or older. Studies must have reported outcomes in such a way that it was possible to assess whether effects were greater in one sex than the other. Risk of bias was assessed using both the Newcastle-Ottawa scale and the National Institutes of Health Quality assessment tool for observational cohort and cross-sectional studies.
RESULTS
Seventy-five studies were included for descriptive synthesis, although only 24 presented data in a way that could be extracted for meta-analyses. Meta-analyses found that severe and moderate prematurity/low birthweight impaired cognitive function, and severe prematurity/low birthweight also increased internalizing problem scores. Moderate, but not severe, prematurity/low birthweight significantly increased externalizing problem scores. In no case did effects of prematurity/low birthweight differ between males and females. Heterogeneity among studies was generally high and significant, although age at assessment was not a significant moderator of effect. Descriptive synthesis did not identify an obvious excess or deficiency of male-biased or female-biased effects for any trait category. Individual study quality was generally good, and we found no evidence of publication bias.
CONCLUSIONS
We found no evidence that the sexes differ in their susceptibility to the effects of severe or moderate prematurity/low birthweight on cognitive function, internalizing traits or externalizing traits. Result heterogeneity tended to be high, but this reflects that one sex is not consistently more affected than the other. Frequently stated generalizations that one sex is more susceptible to prenatal adversity should be re-evaluated.
Topics: United States; Pregnancy; Female; Male; Humans; Infant, Newborn; Premature Birth; Sex Characteristics; Birth Weight; Cross-Sectional Studies; Infant, Low Birth Weight
PubMed: 37434174
DOI: 10.1186/s13293-023-00532-9 -
Ultrasound in Obstetrics & Gynecology :... Aug 2014The aim of this systematic review was to explore the relationship between crown-rump length (CRL) discordance detected at 11-14 weeks of gestation and adverse outcome in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review was to explore the relationship between crown-rump length (CRL) discordance detected at 11-14 weeks of gestation and adverse outcome in twin pregnancy and to assess its predictive accuracy.
METHODS
A protocol designed a priori following MOOSE guidelines and recommended for systematic review and meta-analysis was used. The outcomes observed were: total fetal and perinatal loss, fetal loss at <24 weeks, fetal loss at ≥ 24 weeks, birth-weight (BW) discordance, preterm delivery (PTD) at < 34 weeks and fetal anomalies. The analysis was performed for all twins and for dichorionic (DC) and monochorionic (MC) twins separately.
RESULTS
A total of 2008 articles were identified and 17 studies were included in the systematic review. Twin pregnancies with CRL discordance ≥ 10% were at significantly higher risk of perinatal loss (RR, 2.80; 95% CI, 1.25-6.27; P = 0.012), fetal loss at ≥ 24 weeks (RR, 4.07; 95% CI, 1.47-11.23; P = 0.006), BW discordance (RR, 2.24; 95% CI, 1.89-2.64; P < 0.001) and PTD at < 34 weeks (RR, 1.49; 95% CI, 1.23-1.80; P < 0.001) but not of fetal loss at < 24 weeks (P = 0.130). A meta-analysis of fetal anomalies was not possible because fewer than two studies explored this outcome. However, when used alone to screen for adverse pregnancy outcome, the predictive accuracy of CRL discordance was low for each of the outcomes explored.
CONCLUSION
CRL discordance is associated with an increased risk of adverse pregnancy outcome. However, the accuracy of CRL discordance in predicting adverse outcome is poor and thus limits its routine use in clinical practice.
Topics: Birth Weight; Crown-Rump Length; Female; Fetus; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Pregnancy, Twin; Twins, Dizygotic; Twins, Monozygotic; Ultrasonography, Prenatal
PubMed: 24585501
DOI: 10.1002/uog.13335 -
Bioscience Reports Dec 2017The association between abdominal obesity (as measured by waist circumference (WC) and waist-to-hip ratio (WHR)) and colorectal cancer (CRC) has not been fully... (Meta-Analysis)
Meta-Analysis Review
The association between abdominal obesity (as measured by waist circumference (WC) and waist-to-hip ratio (WHR)) and colorectal cancer (CRC) has not been fully quantified, and the magnitude of CRC risk associated with abdominal obesity is still unclear. A meta-analysis of prospective studies was performed to elucidate the CRC risk associated with abdominal obesity. Pubmed and Embase were searched for studies assessing the association between abdominal obesity and CRC risk. Relative risks (RRs) with 95% confidence intervals (95% CIs) were pooled using random-effects model of meta-analysis. Nineteen prospective cohort studies from eighteen publications were included in this meta-analysis. A total of 12,837 CRC cases were identified among 1,343,560 participants. Greater WC and WHR were significantly associated with increased risk of total colorectal cancer (WC: RR 1.42, 95% CI 1.30, 1.55; WHR: RR 1.39, 95% CI 1.25, 1.53), colon cancer (WC: RR 1.53, 95% CI 1.36, 1.72; WHR: 1.39, 95% CI 1.18, 1.63), and rectal cancer (WC: RR 1.20, 95% CI 1.03, 1.39; WHR: RR 1.22, 95% CI 1.05, 1.42). Subgroup analyses further identified the robustness of the association above. No obvious risk of publication bias was observed. In summary, abdominal obesity may play an important role in the development of CRC.
Topics: Animals; Colorectal Neoplasms; Humans; Obesity, Abdominal; Prospective Studies; Risk Factors; Waist Circumference; Waist-Hip Ratio
PubMed: 29026008
DOI: 10.1042/BSR20170945 -
PloS One 2024Stress during pregnancy is detrimental to maternal health, pregnancy and birth outcomes and various preventive relaxation interventions have been developed. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Stress during pregnancy is detrimental to maternal health, pregnancy and birth outcomes and various preventive relaxation interventions have been developed. This systematic review and meta-analysis aimed to evaluate their effectiveness in terms of maternal mental health, pregnancy and birth outcomes.
METHOD
The protocol for this review is published on PROSPERO with registration number CRD42020187443. A systematic search of major databases was conducted. Primary outcomes were maternal mental health problems (stress, anxiety, depression), and pregnancy (gestational age, labour duration, delivery mode) and birth outcomes (birth weight, Apgar score, preterm birth). Randomized controlled trials or quasi-experimental studies were eligible. Meta-analyses using a random-effects model was conducted for outcomes with sufficient data. For other outcomes a narrative review was undertaken.
RESULT
We reviewed 32 studies comprising 3,979 pregnant women aged 18 to 40 years. Relaxation interventions included yoga, music, Benson relaxation, progressive muscle relaxation (PMR), deep breathing relaxation (BR), guided imagery, mindfulness and hypnosis. Intervention duration ranged from brief experiment (~10 minutes) to 6 months of daily relaxation. Meta-analyses showed relaxation therapy reduced maternal stress (-4.1 points; 95% Confidence Interval (CI): -7.4, -0.9; 9 trials; 1113 participants), anxiety (-5.04 points; 95% CI: -8.2, -1.9; 10 trials; 1965 participants) and depressive symptoms (-2.3 points; 95% CI: -3.4, -1.3; 7 trials; 733 participants). Relaxation has also increased offspring birth weight (80 g, 95% CI: 1, 157; 8 trials; 1239 participants), explained by PMR (165g, 95% CI: 100, 231; 4 trials; 587 participants) in sub-group analysis. In five trials evaluating maternal physiological responses, relaxation therapy optimized blood pressure, heart rate and respiratory rate. Four trials showed relaxation therapy reduced duration of labour. Apgar score only improved significantly in two of six trials. One of three trials showed a significant increase in birth length, and one of three trials showed a significant increase in gestational age. Two of six trials examining delivery mode showed significantly increased spontaneous vaginal delivery and decreased instrumental delivery or cesarean section following a relaxation intervention.
DISCUSSION
We found consistent evidence for beneficial effects of relaxation interventions in reducing maternal stress, improving mental health, and some evidence for improved maternal physiological outcomes. In addition, we found a positive effect of relaxation interventions on birth weight and inconsistent effects on other pregnancy or birth outcomes. High quality adequately powered trials are needed to examine impacts of relaxation interventions on newborns and offspring health outcomes.
CONCLUSION
In addition to benefits for mothers, relaxation interventions provided during pregnancy improved birth weight and hold some promise for improving newborn outcomes; therefore, this approach strongly merits further research.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Cesarean Section; Maternal Health; Mental Health; Birth Weight; Premature Birth; Labor, Obstetric
PubMed: 38271440
DOI: 10.1371/journal.pone.0278432 -
Obesity Reviews : An Official Journal... Mar 2017Post-term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and... (Meta-Analysis)
Meta-Analysis Review
Post-term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and post-term birth at ≥42 and ≥41 weeks' gestation. Five databases, reference lists and citations were searched from May to November 2015. Observational studies published in English since 1990 were included. Linear and nonlinear dose-response meta-analyses were conducted by using random effects models. Sensitivity analyses assessed robustness of the results. Meta-regression and sub-group meta-analyses explored heterogeneity. Obesity classes were defined as I (30.0-34.9 kg m ), II (35.0-39.9 kg m ) and III (≥40 kg m ; IIIa 40.0-44.9 kg m , IIIb ≥ 45.0 kg m ). Searches identified 16,375 results, and 39 studies met the inclusion criteria (n = 4,143,700 births). A nonlinear association between maternal BMI and births ≥42 weeks was identified; odds ratios and 95% confidence intervals for obesity classes I-IIIb were 1.42 (1.27-1.58), 1.55 (1.37-1.75), 1.65 (1.44-1.87) and 1.75 (1.50-2.04) respectively. BMI was linearly associated with births ≥41 weeks: odds ratio is 1.13 (95% confidence interval 1.05-1.21) for each 5-unit increase in BMI. The strength of the association between BMI and post-term birth increases with increasing BMI. Odds are greatest for births ≥42 weeks among class III obesity. Targeted interventions to prevent the adverse outcomes associated with post-term birth should consider the difference in risk between obesity classes.
Topics: Body Mass Index; Body Weight; Databases, Factual; Female; Gestational Age; Humans; Infant, Newborn; Infant, Postmature; Mothers; Non-Randomized Controlled Trials as Topic; Obesity; Observational Studies as Topic; Pregnancy; Pregnancy Complications; Socioeconomic Factors
PubMed: 28085991
DOI: 10.1111/obr.12489 -
The Journal of Pediatrics Aug 2015To test whether earlier age at weaning (age 3-6 months) may promote faster growth during infancy. (Review)
Review
OBJECTIVE
To test whether earlier age at weaning (age 3-6 months) may promote faster growth during infancy.
STUDY DESIGN
Weaning at age 3.0-7.0 months was reported by 571 mothers of term singletons in a prospective birth cohort study conducted in Cambridge, UK. Infant weight and length were measured at birth and at age 3 months and 12 months. Anthropometric values were transformed into age- and sex-adjusted z-scores. Three linear regression models were performed, including adjustment for confounders in a stepwise manner. Measurements at age 3 months, before weaning, were used to consider reverse causality.
RESULTS
Almost three-quarters (72.9%) of infants were weaned before age 6 months. Age at weaning of 3.0-7.0 months was inversely associated with weight and length (but not with body mass index) at 12 months (both P ≤ .01, adjusted for maternal and demographic factors). These associations were attenuated after adjustment for type of milk feeding and weight or length at age 3 months (before weaning). Rapid weight gain between 0 and 3 months predicted subsequent earlier age at weaning (P = .01). Our systematic review identified 2 trials, both reporting null effects of age at weaning on growth, and 15 observational studies, with 10 reporting an inverse association between age at weaning and infant growth and 4 reporting evidence of reverse causality.
CONCLUSION
In high-income countries, weaning between 3 and 6 months appears to have a neutral effect on infant growth. Inverse associations are likely related to reverse causality.
Topics: Anthropometry; Breast Feeding; Child Development; Cohort Studies; Female; Humans; Infant; Linear Models; Male; Prospective Studies; United Kingdom; Weaning
PubMed: 26073105
DOI: 10.1016/j.jpeds.2015.05.003 -
Archives of Gynecology and Obstetrics Sep 20237-Keto-DHEA has been commercially advertised as a dietary supplement to support weight loss. The objective of the present systematic review it to summarize the evidence... (Review)
Review
7-Keto-DHEA has been commercially advertised as a dietary supplement to support weight loss. The objective of the present systematic review it to summarize the evidence supporting the use of 7-keto-DHEA in overweight and obese population. The systematic search was conducted in Medline, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, ICTRP, and ClinicalTrials.gov. Additionally, reference lists of eligible studies were considered, and authors of relevant studies were contacted. Two authors independently screened the studies against the inclusion criteria and assessed their risk of bias. In total, 4 out of 686 studies were included in the review. They all held a low risk of bias. Half of them showed a significant reduction in body weight. One study found a decrease in body fat percentage and another one reported a decrease in BMI. Two studies stated an increase in resting metabolic rate. No serious adverse effects were reported. Various possible mechanisms in favor of weight loss are discussed; however, with the evidence currently available, no clear answer can be given regarding 7-keto-DHEA and weight loss. Further studies need to be conducted to clarify the efficacy and safety of this drug before it can be recommended for therapeutic use.
Topics: Humans; Body Weight; Obesity; Overweight; Weight Loss
PubMed: 36566478
DOI: 10.1007/s00404-022-06884-8 -
International Journal of Environmental... May 2021In the last decade, active video games (exergames) have been proposed in obesity prevention and treatment as a potential tool to increase physical activity. This review... (Review)
Review
In the last decade, active video games (exergames) have been proposed in obesity prevention and treatment as a potential tool to increase physical activity. This review was aimed to assess the possible role of exergames in reducing weight-related outcomes among overweight/obese children and/or adolescents. The databases PubMed, Scopus, Web of Science and SPORTDiscus were interrogated to detect controlled studies involving healthy overweight/obese children and adolescents in interventions based exclusively on exergames. Out of a total of 648 articles found, 10 met the inclusion criteria and were included in the review. The included studies differ for duration, setting and type of intervention, frequency of active game sessions, and outcomes considered. Seven out of ten studies reported better outcomes in children/adolescents involved in the interventions, with significant differences between groups in four, while three studies found better outcomes in control groups. These results suggest a possible positive effect of active video games on weight-related outcomes in obese children and adolescents. However, further research is still needed to define if they can be effectively used in childhood obesity treatment and which may be the most effective approach. The potentiality of the new digital media in this field should be explored.
Topics: Adolescent; Body Weight; Child; Exercise; Humans; Internet; Pediatric Obesity; Video Games
PubMed: 34066369
DOI: 10.3390/ijerph18094938 -
BMC Public Health Nov 2023The diagnostic criteria for abdominal obesity are usually waist circumference or waist-to-hip ratio. The magnitude of the risks for cancers of the digestive system and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The diagnostic criteria for abdominal obesity are usually waist circumference or waist-to-hip ratio. The magnitude of the risks for cancers of the digestive system and abdominal obesity is unknown. To assess whether abdominal obesity increases the risk of digestive cancer, we conducted a systematic review and meta-analysis of prospective cohort studies in a database.
METHODS
PubMed, Embase, and Web of Science databases were searched from their inception to December 2022. The 9-star Newcastle Ottawa Scale was used to assess study quality. Pooled relative risks and 95% confidence intervals were calculated using fixed or random effect models respectively. The stability of the results was explored by one-by-one exclusion. Subgroup analysis was conducted to explore sources of heterogeneity. Publication bias was evaluated by Begg's and Egger's tests.
RESULTS
A total of 43 cohort studies were included. There were 42 and 31 studies in the meta-analysis of waist circumference and waist-to-hip ratio on digestive system cancer, respectively. The results of the meta-analysis revealed that the greater waist circumference and waist-to-hip ratio were correlated with increased incidence of digestive system cancers: waist circumference: RR 1.48, 95% CI 1.38-1.59, p < 0.001; waist-to-hip ratio: RR 1.33, 95% CI 1.28-1.38, p = 0.001. Subgroup analysis by cancer type showed that higher WC and WHR would increase the prevalence of LC, PC, GC, EC, and CRC. The sensitivity analysis was conducted by a one-by-one elimination method, and the results of the meta-analysis remained stable. It is proved that the results were robust by the trim-and-fill method.
CONCLUSIONS
There was evidence to suggest that abdominal obesity increased the incidence of digestive cancer, it is necessary to take appropriate measures to reduce abdominal obesity. Waist circumference and waist-to-hip ratio may be better predictors of digestive system cancers. However, the association between waist circumference and digestive system cancer was greater, so more attention should be paid to measuring abdominal obesity with waist circumference.
Topics: Humans; Obesity, Abdominal; Prospective Studies; Risk Factors; Waist-Hip Ratio; Waist Circumference; Obesity; Digestive System Neoplasms; Body Mass Index
PubMed: 38012596
DOI: 10.1186/s12889-023-17275-2