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JAMA Network Open Oct 2023Clinical studies confirm that obesity is a risk factor for recurrence in postmenopausal women with hormone receptor-positive (HR+) breast cancer. Evidence suggests that...
IMPORTANCE
Clinical studies confirm that obesity is a risk factor for recurrence in postmenopausal women with hormone receptor-positive (HR+) breast cancer. Evidence suggests that women with obesity do not obtain similar protection from aromatase inhibitors as women with healthy weight.
OBJECTIVE
To examine the associations of body mass index (BMI) with recurrence.
DESIGN, SETTING, AND PARTICIPANTS
The cohort study was conducted using data from the Danish Breast Cancer Group and enrolled postmenopausal women diagnosed with stage I to III HR+ breast cancer from 1998 through 2016. Data analysis was conducted from November 2022 to April 2023.
EXPOSURES
BMI was classified as (1) healthy weight (18.5-24.9), (2) overweight (25.0-29.9), (3) obesity (30.0-34.9), and (4) severe obesity (≥35.0) using the World Health Organization guidelines. Healthy weight was considered the reference group in statistical analyses.
MAIN OUTCOMES AND MEASURES
Follow-up began 6 months after breast cancer surgery and continued until the first event of recurrence, contralateral breast cancer, new primary malignant neoplasm, death, emigration, end of clinical follow-up at 10 years, or September 25, 2018. Cox regression was used to estimate crude and adjusted hazard ratios with 95% CIs, adjusting for patient, tumor, and treatment characteristics.
RESULTS
A total of 13 230 patients (median [IQR] age at diagnosis, 64.4 [58.6-70.2] years) with information on BMI were enrolled. There were 1587 recurrences with a median (IQR) potential estimated follow-up of 6.2 (3.6-8.5) years. Multivariable analyses revealed increased recurrence hazards associated with obesity (adjusted hazard ratio, 1.18 [95% CI, 1.01-1.37]) and severe obesity (adjusted hazard ratio, 1.32 [95% CI, 1.08-1.62]) vs patients with healthy weight. Patients with overweight had a greater risk, but the results were not statistically significant (adjusted hazard ratio, 1.10 [95% CI, 0.97-1.24]).
CONCLUSIONS AND RELEVANCE
In this study, obesity was associated with an increased risk of breast cancer recurrence among postmenopausal patients with HR+ early-stage breast cancer treated with aromatase inhibitors. Physicians should be aware of the significance of obesity on breast cancer outcomes to secure optimal treatment benefit in all patients.
Topics: Humans; Female; Middle Aged; Aged; Breast Neoplasms; Aromatase Inhibitors; Overweight; Obesity, Morbid; Cohort Studies; Neoplasm Recurrence, Local; Obesity
PubMed: 37831449
DOI: 10.1001/jamanetworkopen.2023.37780 -
Eating and Weight Disorders : EWD Oct 2022Sleep impairment is reported to be a consequence of overweight and obesity. However, the weight-sleep relationship can alternately be explained by demographics (e.g....
PURPOSE
Sleep impairment is reported to be a consequence of overweight and obesity. However, the weight-sleep relationship can alternately be explained by demographics (e.g. age) and covariates (i.e. mood/affect and behaviour in overweight/obese people; e.g. night-eating). Thus, we examined the weight-sleep quality relationship after controlling for the effects of affect and common behaviour (i.e. night-eating, insufficient exercise, alcohol and electronic device use).
METHODS
Online questionnaires asked 161 overweight, obese or normal-weight participants about their sleep quality, night-eating, physical activity, alcohol use, electronic device use and anxiety and depression at T0 (baseline) and T1 (3 months later). Height and weight and waist and hip circumference were objectively measured at T0 and T1, and physical activity was assessed over 24 h (using actigraphy) at T0 and T1. Hierarchical multiple regression analyses evaluated whether the weight measures (i.e. body-mass-index [BMI], waist-to-hip ratio [WHR] and obesity category [overweight/obese vs. normal-weight]) predicted sleep quality and its components at T0 and T1, after controlling demographics (at step 1) and covariates (affective distress and behaviour) at step 2, and entering weight measures at step 3; maximum 8 variables in the analyses.
RESULTS
High BMI predicted several aspects of sleep quality after taking into account co-existing behaviour, affect and demographics: sleep disturbances at T0 and lower sleep efficiency at T1. WHR and obesity category did not predict any aspects of sleep quality. Several co-existing behaviour were related to or predicted sleep quality score and aspects of sleep quality including night-eating, alcohol use and electronic device use and affective symptoms (i.e. anxiety, depression).
CONCLUSION
Results suggest that a person's weight may impact on their sleep quality above and beyond the effects of their co-existing behaviour and affect, although their co-existing behaviour and affect may also adversely impact on sleep quality.
LEVEL OF EVIDENCE
Level III, evidence obtained from well-designed cohort.
Topics: Body Mass Index; Humans; Obesity; Overweight; Sleep; Sleep Quality; Waist-Hip Ratio
PubMed: 35790669
DOI: 10.1007/s40519-022-01435-1 -
International Journal of Obesity (2005) Jul 2023Social isolation and loneliness are growing public health concerns in adults with obesity and overweight. Social media-based interventions may be a promising approach.... (Meta-Analysis)
Meta-Analysis Review
Social isolation and loneliness are growing public health concerns in adults with obesity and overweight. Social media-based interventions may be a promising approach. This systematic review aims to (1) evaluate the effectiveness of social media-based interventions on weight, body mass index, waist circumference, fat, energy intake and physical activity among adults with obesity and overweight and (2) explore potential covariates on treatment effect. Eight databases, namely, PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus PsycINFO and ProQuest, were searched from inception until December 31, 2021. The Cochrane Collaboration Risk of Bias Tool and Grading of Recommendations, Assessment, Development and Evaluation criteria evaluated the evidence quality. Twenty-eight randomised controlled trials were identified. Meta-analyses found that social media-based interventions had small-to-medium significant effects on weight, BMI, waist circumference, body fat mass and daily steps. Subgroup analysis found greater effect in interventions without published protocol or not registered in trial registries than their counterparts. Meta-regression analysis showed that duration of intervention was a significant covariate. The certainty of evidence quality of all outcomes was very low or low. Social media-based interventions can be considered an adjunct intervention for weight management. Future trials with large sample sizes and follow-up assessment are needed.
Topics: Humans; Adult; Overweight; Social Media; Obesity; Exercise; Body Mass Index
PubMed: 37012428
DOI: 10.1038/s41366-023-01304-6 -
Obesity (Silver Spring, Md.) Jul 2018The objective of this study is to critically review the literature on early life stress in relation to obesity in humans, including the multiple biological and... (Review)
Review
OBJECTIVE
The objective of this study is to critically review the literature on early life stress in relation to obesity in humans, including the multiple biological and behavioral mechanisms through which early life stress exposure (birth to the age of 5 years) may associate with obesity risk during childhood.
METHODS
A review of the literature was conducted to identify studies on associations between early childhood stress and risk for obesity and the mechanisms of association. Multiple databases (PubMed, PsycInfo, Google Scholar) were used in the search as well as a "snowball" search strategy. All study designs were included.
RESULTS
Early life stress and adverse childhood experiences are associated with obesity and overweight in adults. Evidence is less consistent in children. Studies vary in the nature of the stress examined (e.g., chronic vs. acute), sample characteristics, and study designs. Longitudinal studies are needed, as the effects of early life stress exposure may not emerge until later in the life-span. Early life stress exposure is associated with biological and behavioral pathways that may increase risk for childhood obesity.
CONCLUSIONS
There is evidence that early life stress is associated with multiple biological and behavioral pathways in children that may increase risk for later obesity. Little work has detailed the interconnections among these mechanisms across development or identified potential moderators of the association. Mapping the mechanisms connecting early life stress exposure to obesity risk in young children longitudinally should be a priority for obesity researchers. Recommendations for developmentally sensitive approaches to research that can inform obesity prevention strategies are presented.
Topics: Adult; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Longitudinal Studies; Overweight; Pediatric Obesity; Risk Factors; Signal Transduction; Stress, Psychological
PubMed: 29656595
DOI: 10.1002/oby.22155 -
Journal of Pediatric Gastroenterology... Feb 2023To evaluate whether a fish oil and/or probiotics intervention in pregnant women with overweight or obesity would influence the tendency of their 24-month-old children to... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To evaluate whether a fish oil and/or probiotics intervention in pregnant women with overweight or obesity would influence the tendency of their 24-month-old children to become overweight and alter their body fat percentage.
METHODS
Women (n = 439) were double-blindly randomized into 4 intervention groups: fish oil+placebo, probiotics+placebo, probiotics+fish oil, and placebo+placebo (fish oil: 1.9 g docosahexaenoic acid and 0.22 g eicosapentaenoic acid, probiotics: Lacticaseibacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each). The intervention lasted from early pregnancy until 6 months postpartum. Children's (n = 330) growth data (height, weight, head circumference), a secondary outcome of the trial, were evaluated at birth, 3, 6, 12, and 24 months of age and compared to Finnish growth charts. Body fat percentage was measured with air displacement plethysmography (24 months). Logistic regression and general linear models were used to analyze the data.
RESULTS
Probiotics+placebo [weight-for-height% adj. Odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.14-0.95] and probiotics+fish oil [weight-for-age standard deviation score (SD-score) adj. OR = 0.22, 95% CI = 0.07-0.71] associated with lower overweight odds in 24-month-old children compared to placebo+placebo. Results remained essentially the same, when probiotics' main effect (combined probiotics+placebo and probiotics+fish oil) was estimated; that is, lower overweight odds (weight-for-height% adj. OR = 0.48, 95% CI = 0.25-0.95 and weight-for-age SD-score adj. OR = 0.42, 95% CI = 0.20-0.88) compared to non-probiotics. No fish oil main effect (combined fish oil+placebo and probiotics+fish oil) was seen. The intervention did not influence body fat percentage.
CONCLUSIONS
The administration of probiotics solely and in combination with fish oil during pregnancy to women with overweight or obesity lowered the overweight odds of their 24-month-old children.
Topics: Child; Female; Humans; Pregnancy; Bifidobacterium animalis; Double-Blind Method; Fish Oils; Obesity; Overweight; Pregnant Women; Probiotics
PubMed: 36705702
DOI: 10.1097/MPG.0000000000003659 -
BMC Pediatrics Sep 2022A lack of adequate dietary knowledge may result in poor health. The purpose of this study was to study the association between dietary knowledge and overweight/obesity...
BACKGROUND
A lack of adequate dietary knowledge may result in poor health. The purpose of this study was to study the association between dietary knowledge and overweight/obesity in children and adolescents. METHOD: Data from the China Health and Nutrition Survey (CHNS) 2004, 2006, 2009, 2011, and 2015 were used in this cross-sectional study. The dietary knowledge of children and adolescents was evaluated by the questionnaire in the database. The overweight and obesity status was evaluated by body mass index (BMI). Cluster analysis was performed to establish different groups based on dietary knowledge level. Logistic regression analysis and subgroup analysis were conducted.
RESULTS
A total of 2,701 children and adolescents were finally selected. Cluster A (n = 837, 30.99%), Cluster B (n = 1,264, 46.80%) and Cluster C (n = 600, 22.21%) were high, medium and low dietary knowledge level, respectively. Participants with high dietary knowledge levels [OR = 0.56 (95%CI: 1.40-0.78)] may be negatively associated with overweight and obesity. Similar results were found among adolescents, males, females, people living in eastern and northeastern China, and rural areas, after adjusting for age, gender, geographic region, maternal education level, alcohol consumption, waist-to-hip ratio, systolic blood pressure and diastolic blood pressure.
CONCLUSION
Improving the dietary knowledge level of children and adolescents was associated with decreased risk of overweight and obesity. Our study provided a theoretical basis for the relationship between dietary knowledge and overweight/obesity in Chinese children and adolescents and suggested strengthening the publicity and popularization of dietary knowledge in schools and communities.
Topics: Adolescent; Body Mass Index; Child; China; Cross-Sectional Studies; Female; Humans; Male; Overweight; Pediatric Obesity
PubMed: 36138367
DOI: 10.1186/s12887-022-03618-2 -
Seminars in Reproductive Medicine Jul 2023Obesity has been associated with a multitude of medical comorbidities, infertility, and adverse obstetric outcomes. Weight stigma and weight bias pervade not only the... (Review)
Review
Obesity has been associated with a multitude of medical comorbidities, infertility, and adverse obstetric outcomes. Weight stigma and weight bias pervade not only the medical field but also education, employment, and activities of daily living. The experience of weight stigma has been shown to adversely impact not only the mental health of individuals with overweight or obesity but also worsen obesogenic behaviors, and medical comorbidities. This review frames the rise of weight stigma and weight bias within the context of the "obesity epidemic" and explores its associations with infertility and decreased access to health care and its subsequent impact on the lives of individuals. Furthermore, it explores the concepts of intrinsic and extrinsic weight stigma/bias and highlights the need for further examination and research into the impact of these factors on access to reproductive medicine and subsequent outcomes.
Topics: Female; Pregnancy; Humans; Weight Prejudice; Activities of Daily Living; Obesity; Overweight; Reproductive Medicine; Infertility; Body Weight
PubMed: 37992727
DOI: 10.1055/s-0043-1777016 -
Nutrients Jul 2023(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2)... (Meta-Analysis)
Meta-Analysis Review
(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2) Methods: Scoping review with meta-analysis. Data were obtained by consulting the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature on Health Sciences (LILACS), and Medicina en Español (MEDES). The terms used as descriptors and as text in the title and abstract fields of the records were "health workers", "overnutrition", and "occupational health", using the filters "human", "adult": 19+ years", and "clinical trial". The search update date was January 2023. The documentary quality of the articles was evaluated using the CONSORT questionnaire and the presence of bias was assessed using the Rob 2.0 tool. (3) Results: From the 611 digitally retrieved references, 17 clinical trials were selected after applying the inclusion and exclusion criteria. CONSORT scores ranged from a minimum of 14.6% to a maximum of 91.7%, with a median of 68.8%. According to the SIGN criteria, this review provided "1" evidence with a grade B recommendation. Six different types of intervention were tested, grouped into strategies ranging from a single intervention to a combination of four interventions. The summary effect of the meta-analysis showed significant weight loss, but no association with reduced body mass index. (4) Conclusions: While workplace interventions have been shown to be potentially effective, and strategies using different types of interventions have been proven to be useful in tackling overnutrition, an effective and sustainable solution for changing the behavior of health professionals to tackle overweight and obesity has yet to be identified.
Topics: Humans; Obesity; Overweight; Health Personnel; Body Mass Index; Occupational Health
PubMed: 37571353
DOI: 10.3390/nu15153416 -
Nutrients Apr 2022Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are... (Review)
Review
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
Topics: Africa South of the Sahara; Child, Preschool; Home Environment; Humans; Obesity; Overweight; Risk Factors
PubMed: 35565675
DOI: 10.3390/nu14091706 -
Microbiology Spectrum Apr 2022Diet and gut microbiota are known to modulate metabolic health. Our aim was to apply a metagenomics approach to investigate whether the diet-gut microbiota-metabolism...
Diet and gut microbiota are known to modulate metabolic health. Our aim was to apply a metagenomics approach to investigate whether the diet-gut microbiota-metabolism and inflammation relationships differ in pregnant overweight and obese women. This cross-sectional study was conducted in overweight ( = 234) and obese ( = 152) women during early pregnancy. Dietary quality was measured by a validated index of diet quality (IDQ). Gut microbiota taxonomic composition and species diversity were assessed by metagenomic profiling (Illumina HiSeq platform). Markers for glucose metabolism (glucose, insulin) and low-grade inflammation (high sensitivity C-reactive protein [hsCRP], glycoprotein acetylation [GlycA]) were analyzed from blood samples. Higher IDQ scores were positively associated with a higher gut microbiota species diversity ( = 0.273, = 0.007) in obese women, but not in overweight women. Community composition (beta diversity) was associated with the GlycA level in the overweight women (= 0.04) but not in the obese. Further analysis at the species level revealed a positive association between the abundance of species Alistipes finegoldii and the GlycA level in overweight women (logfold change = 4.74, = 0.04). This study has been registered at ClinicalTrials.gov under registration no. NCT01922791 (https://clinicaltrials.gov/ct2/show/NCT01922791). We observed partially distinct diet-gut microbiota-metabolism and inflammation responses in overweight and obese pregnant women. In overweight women, gut microbiota community composition and the relative abundance of A. finegoldii were associated with an inflammatory status. In obese women, a higher dietary quality was related to a higher gut microbiota diversity and a healthy inflammatory status.
Topics: Cross-Sectional Studies; Diet; Feces; Female; Humans; Inflammation; Metagenomics; Microbiota; Obesity; Overweight; Pregnancy; Pregnant Women
PubMed: 35343768
DOI: 10.1128/spectrum.00893-21