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Journal of Sports Science & Medicine Sep 2019A total of 17 participants (30.2 ± 4.8 years; 35.4 ± 4 kg/m; 38.2 ± 3.6 % body fat) were enrolled in this randomized crossover trial to analyze the effects of a... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of High-Intensity Interval and Moderate-Intensity Continuous Exercise on Physical Activity and Sedentary Behavior Levels in Inactive Obese Males: A Crossover Trial.
A total of 17 participants (30.2 ± 4.8 years; 35.4 ± 4 kg/m; 38.2 ± 3.6 % body fat) were enrolled in this randomized crossover trial to analyze the effects of a single session of high-intensity interval (HIIE) and moderate-intensity continuous exercise (MICE) on the physical activity and sedentary behavior levels in inactive obese males. The participants performed two exercise sessions and one control session (no exercise): i) low-volume HIIE (10 x 60 s at 90% of maximal aerobic velocity [MAV] interspaced by 60 s at 30% of MAV); ii) MICE (20 min at 70% of maximum heart rate); and iii) control (25 min in a seated position). After all sessions, the physical activity and sedentary behavior levels were monitored by accelerometer over seven consecutive days. No differences in the physical activity (activity counts, and time spent at light, moderate, and vigorous intensities) and sedentary behavior (time spent at sedentary behavior, breaks, and bouts) levels were found among the sessions (HIIE, MICE and control) (p > 0.05). In summary, a single session of HIIE and MICE does not change the physical activity and sedentary behavior levels in inactive obese males. Therefore, low-volume of both high- and moderate-intensity exercise should be considered for inactive obese males given that it does not reduce the physical activity level or increase the time spent at sedentary behavior.
Topics: Accelerometry; Adult; Cross-Over Studies; Exercise; Fitness Trackers; High-Intensity Interval Training; Humans; Intention to Treat Analysis; Male; Obesity; Sedentary Behavior; Time Factors
PubMed: 31427859
DOI: No ID Found -
International Journal of Molecular... Jan 2022The prevalence of obesity has increased dramatically in the Western population. Obesity is known to influence not only the proportion of adipose tissue but also... (Meta-Analysis)
Meta-Analysis Review
The prevalence of obesity has increased dramatically in the Western population. Obesity is known to influence not only the proportion of adipose tissue but also physiological processes that could alter drug pharmacokinetics. Yet, there are no specific dosing recommendations for radiopharmaceuticals in this patient population. This could potentially lead to underdosing and thus suboptimal treatment in obese patients, while it could also lead to drug toxicity due to high levels of radioactivity. In this review, relevant literature is summarized on radiopharmaceutical dosing and pharmacokinetic properties, and we aimed to translate these data into practical guidelines for dosing of radiopharmaceuticals in obese patients. For radium-223, dosing in obese patients is well established. Furthermore, for samarium-153-ethylenediaminetetramethylene (EDTMP), dose-escalation studies show that the maximum tolerated dose will probably not be reached in obese patients when dosing on MBq/kg. On the other hand, there is insufficient evidence to support dose recommendations in obese patients for rhenium-168-hydroxyethylidene diphosphonate (HEDP), sodium iodide-131, iodide 131-metaiodobenzylguanidine (MIBG), lutetium-177-dotatate, and lutetium-177-prostate-specific membrane antigen (PSMA). From a pharmacokinetic perspective, fixed dosing may be appropriate for these drugs. More research into obese patient populations is needed, especially in the light of increasing prevalence of obesity worldwide.
Topics: Biomarkers; Clinical Decision-Making; Disease Management; Drug Monitoring; Humans; Molecular Targeted Therapy; Obesity; Organ Specificity; Prognosis; Radiopharmaceuticals; Treatment Outcome
PubMed: 35055005
DOI: 10.3390/ijms23020818 -
The Journal of the Royal College of... Dec 2020Worldwide, the prevalence of both obesity and cancer are rising. So far, there is an association between obesity and an increased risk of at least 20 different cancers... (Review)
Review
Worldwide, the prevalence of both obesity and cancer are rising. So far, there is an association between obesity and an increased risk of at least 20 different cancers and this number is increasing. The mechanism behind obesity increasing the risk of cancer varies. The importance of looking at all aspects of obesity, such as hip to waist ratio, body fat distribution and waist circumference, in addition to BMI has been acknowledged in order to further understand these mechanisms. The duration of time a person is obese for, and whether their weight gain was in childhood or adulthood can also affect risk of cancer, however this can be hard to distinguish as obese children and adolescents frequently remain obese into adulthood.
Topics: Adolescent; Adult; Body Mass Index; Child; Humans; Neoplasms; Obesity; Prevalence; Risk Factors; Waist Circumference
PubMed: 33469614
DOI: 10.4997/JRCPE.2020.408 -
Mucosal Immunology Aug 2023Obesity and type 2 diabetes (T2D) have been found to be associated with abnormalities in several organs, including the intestine. These conditions can lead to changes in...
Obesity and type 2 diabetes (T2D) have been found to be associated with abnormalities in several organs, including the intestine. These conditions can lead to changes in gut homeostasis, compromising tolerance to luminal antigens and increasing susceptibility to food allergies. The underlying mechanisms for this phenomenon are not yet fully understood. In this study, we investigated changes in the intestinal mucosa of diet-induced obese mice and found that they exhibited increased gut permeability and reduced Treg cells frequency. Upon oral treatment with ovalbumin (OVA), obese mice failed to develop oral tolerance. However, hyperglycemia treatment improved intestinal permeability and oral tolerance induction in mice. Furthermore, we observed that obese mice exhibited a more severe food allergy to OVA, and this allergy was alleviated after treatment with a hypoglycemic drug. Importantly, our findings were translated to obese humans. Individuals with T2D had higher serum IgE levels and downregulated genes related to gut homeostasis. Taken together, our results suggest that obesity-induced hyperglycemia can lead to a failure in oral tolerance and to exacerbation of food allergy. These findings shed light on the mechanisms underlying the relationship among obesity, T2D, and gut mucosal immunity, which could inform the development of new therapeutic approaches.
Topics: Humans; Mice; Animals; Diabetes Mellitus, Type 2; Mice, Obese; Food Hypersensitivity; Obesity; Immune Tolerance; Allergens; Administration, Oral; Ovalbumin; Mice, Inbred BALB C
PubMed: 37302712
DOI: 10.1016/j.mucimm.2023.05.008 -
Diabetic Medicine : a Journal of the... Sep 2023We aimed to quantify the use of person-first language (PFL) among scholarly articles focusing on diabetes or obesity. (Review)
Review
AIMS
We aimed to quantify the use of person-first language (PFL) among scholarly articles focusing on diabetes or obesity.
METHODS
PFL and condition-first language (CFL) terms for diabetes and obesity (e.g. diabetic, obese) were identified from existing guidelines and a review of the literature. Exact phrase literature searches were conducted between 2011 and 2020 and results were categorised as PFL, CFL or both.
RESULTS
Among diabetes articles, 43% used PFL, 40% used CFL and 17% contained both. Among obesity articles, 0.5% used PFL, 99% used CFL and 0.2% used both. The use of PFL increased by 3% per year for diabetes articles, compared to 117% for obesity articles. The rate of adoption of PFL in diabetes articles was unchanged in 2018-2020 compared to the 3 years prior.
CONCLUSIONS
While the use of person-first language in diabetes articles had increased over the review period, its rate of adoption has started to slow. Conversely, the use of PFL in obesity articles is nascent and increasing.
Topics: Humans; Diabetes Mellitus; Obesity; Language
PubMed: 36786059
DOI: 10.1111/dme.15067 -
Immunopharmacology and Immunotoxicology Aug 2022Obesity is a condition of excessive fat tissue and high body mass index (BMI ≥30), which is increasing worldwide. Excess body weight is associated with poorer results... (Review)
Review
Obesity is a condition of excessive fat tissue and high body mass index (BMI ≥30), which is increasing worldwide. Excess body weight is associated with poorer results in cancer treatments; however, recent studies emphasized that elevated BMI was associated with improved outcomes in cases treated by immune checkpoint inhibitor (ICI) therapies, which is called the obesity paradox. In this review, we discuss the correlation between obesity and cancer immunotherapy, especially ICIs, the underlying mechanisms, and the outcomes in different types of cancers. In addition, we describe the occurrence of immune-related adverse events and the effect of gender in obese patients during immunotherapy using all relevant studies with available full texts.
Topics: Adipose Tissue; Body Mass Index; Humans; Immunotherapy; Neoplasms; Obesity
PubMed: 35369842
DOI: 10.1080/08923973.2022.2061989 -
Critical Care Medicine Jun 2023In Asian populations, the correlation between sepsis outcomes and body mass is unclear. A multicenter, prospective, observational study conducted between September 2019... (Observational Study)
Observational Study
OBJECTIVES
In Asian populations, the correlation between sepsis outcomes and body mass is unclear. A multicenter, prospective, observational study conducted between September 2019 and December 2020 evaluated obesity's effects on sepsis outcomes in a national cohort.
SETTING
Nineteen tertiary referral hospitals or university-affiliated hospitals in South Korea.
PATIENTS
Adult patients with sepsis ( n = 6,424) were classified into obese ( n = 1,335) and nonobese groups ( n = 5,089).
MEASUREMENTS AND RESULTS
Obese and nonobese patients were propensity score-matched in a ratio of 1:1. Inhospital mortality was the primary outcome. After propensity score matching, the nonobese group had higher hospital mortality than the obese group (25.3% vs 36.7%; p < 0.001). The obese group had a higher home discharge rate (70.3% vs 65.2%; p < 0.001) and lower median Clinical Frailty Scale (CFS) (4 vs 5; p = 0.007) at discharge than the nonobese group, whereas the proportion of frail patients at discharge (CFS ≥ 5) was significantly higher in the nonobese group (48.7% vs 54.7%; p = 0.011). Patients were divided into four groups according to the World Health Organization body mass index (BMI) classification and performed additional analyses. The adjusted odds ratio of hospital mortality and frailty at discharge for underweight, overweight, and obese patients relative to normal BMI was 1.25 ( p = 0.004), 0.58 ( p < 0.001), and 0.70 ( p = 0.047) and 1.53 ( p < 0.001), 0.80 ( p = 0.095), and 0.60 ( p = 0.022), respectively.
CONCLUSIONS
Obesity is associated with higher hospital survival and functional outcomes at discharge in Asian patients with sepsis.
Topics: Adult; Humans; Prospective Studies; Obesity Paradox; Frailty; Obesity; Sepsis; Body Mass Index; Retrospective Studies
PubMed: 36762918
DOI: 10.1097/CCM.0000000000005801 -
Anesthesia and Analgesia May 2021Obesity hypoventilation syndrome (OHS) is considered as a diagnosis in obese patients (body mass index [BMI] ≥30 kg/m2) who also have sleep-disordered breathing and... (Review)
Review
Obesity hypoventilation syndrome (OHS) is considered as a diagnosis in obese patients (body mass index [BMI] ≥30 kg/m2) who also have sleep-disordered breathing and awake diurnal hypercapnia in the absence of other causes of hypoventilation. Patients with OHS have a higher burden of medical comorbidities as compared to those with obstructive sleep apnea (OSA). This places patients with OHS at higher risk for adverse postoperative events. Obese patients and those with OSA undergoing elective noncardiac surgery are not routinely screened for OHS. Screening for OHS would require additional preoperative evaluation of morbidly obese patients with severe OSA and suspicion of hypoventilation or resting hypoxemia. Cautious selection of the type of anesthesia, use of apneic oxygenation with high-flow nasal cannula during laryngoscopy, better monitoring in the postanesthesia care unit (PACU) can help minimize adverse perioperative events. Among other risk-reduction strategies are proper patient positioning, especially during intubation and extubation, multimodal analgesia, and cautious use of postoperative supplemental oxygen.
Topics: Humans; Lung; Obesity; Obesity Hypoventilation Syndrome; Pulmonary Ventilation; Respiration; Respiratory Insufficiency; Risk Assessment; Risk Factors; Surgical Procedures, Operative; Treatment Outcome
PubMed: 33857968
DOI: 10.1213/ANE.0000000000005352 -
Postgraduate Medical Journal Jun 2022Prior studies have identified paediatric attending physicians' screening and management patterns related to overweight/obesity, but less is known about resident...
STUDY PURPOSE
Prior studies have identified paediatric attending physicians' screening and management patterns related to overweight/obesity, but less is known about resident physicians' behaviour. The objective was to understand paediatric resident physicians' knowledge, attitude and practice patterns of overweight/obesity screening and management.
STUDY DESIGN
We performed a retrospective chart review of preventive visits conducted by residents between August and October 2019. Charts of patients 2-18 years with body mass index ≥85th percentile at the visit were reviewed (85th-<95th for age and sex defined as overweight, ≥95th defined as obese). A survey was distributed to residents assessing knowledge, attitudes and barriers towards obesity management.
RESULTS
Of 1250 visits reviewed, 405 (32%) patients met the criteria for overweight or obesity. 39% were identified correctly by the provider, 53% were not identified and 8% were identified incorrectly. 89% of patients had diet history, 31% had physical activity and 43% had family history documented. Patients with obesity received physical activity documentation/counselling, portion size counselling, at least one referral, laboratory tests and a diagnosis more often than overweight patients. 84% of residents completed the survey. Although the majority of residents felt 'somewhat' or 'very' well prepared to counsel families about overweight/obesity, the majority thought their counselling on overweight/obesity was 'not at all' or 'slightly' effective.
CONCLUSION
Despite residents feeling prepared and comfortable discussing overweight/obesity with patients, these diagnoses were often under-recognised or incorrectly made and appropriate counselling was lacking. Future work will focus on specific strategies to improve diagnosis, screening and management of overweight/obesity and include educational interventions and electronic medical record adaptations.
Topics: Body Mass Index; Child; Health Knowledge, Attitudes, Practice; Humans; Obesity; Overweight; Practice Patterns, Physicians'; Retrospective Studies
PubMed: 33541933
DOI: 10.1136/postgradmedj-2020-139318 -
Obstetrical & Gynecological Survey Jan 2023Obesity is one of the most common clinical entities complicating pregnancies and is associated with short- and long-term consequences for both the mother and the... (Review)
Review
IMPORTANCE
Obesity is one of the most common clinical entities complicating pregnancies and is associated with short- and long-term consequences for both the mother and the offspring.
OBJECTIVE
The aim of this study were to review and compare the most recently published influential guidelines on the management of maternal obesity in the preconceptional, antenatal, intrapartum, and postpartum period.
EVIDENCE ACQUISITION
A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the International Federation of Gynecology and Obstetrics, the Society of Obstetricians and Gynecologists of Canada, the Royal College of Obstetricians and Gynecologists, and the Royal Australian and New Zealand College of Obstetricians and Gynecologists on obesity in pregnancy was carried out.
RESULTS
There is an overall agreement among the reviewed guidelines regarding the importance of prepregnancy weight loss with behavioral modification, optimization of gestational weight gain, and screening for comorbidities in improving pregnancy outcomes of obese women. Women with previous bariatric surgery should be screened for nutritional deficiencies and have a closer antenatal surveillance, according to all guidelines. In addition, folic acid supplementation is recommended for 1 to 3 months before conception and during the first trimester, but several discrepancies were identified with regard to other vitamins, iodine, calcium, and iron supplementation. All medical societies recommend early screening for gestational diabetes mellitus and early anesthetic assessment in obese women and suggest the use of aspirin for the prevention of preeclampsia when additional risk factors are present, although the optimal dosage is controversial. The International Federation of Gynecology and Obstetrics, Society of Obstetricians and Gynecologists of Canada, Royal College of Obstetricians and Gynecologists, and Royal Australian and New Zealand College of Obstetricians and Gynecologists point out that specific equipment and adequate resources must be readily available in all health care facilities managing obese pregnant women. Moreover, thromboprophylaxis and prophylactic antibiotics are indicated in case of cesarean delivery, and intrapartum fetal monitoring is justified during active labor in obese patients. However, there are no consistent protocols regarding the fetal surveillance, the monitoring of multiple gestations, the timing and mode of delivery, and the postpartum follow-up, although weight loss and breastfeeding are unanimously supported.
CONCLUSIONS
Obesity in pregnancy is a significant contributor to maternal and perinatal morbidity with a constantly rising global prevalence among reproductive-aged women. Thus, the development of uniform international protocols for the effective management of obese women is of paramount importance to safely guide clinical practice and subsequently improve pregnancy outcomes.
Topics: Pregnancy; Female; Humans; Adult; Obesity, Maternal; Anticoagulants; Australia; Venous Thromboembolism; Obesity
PubMed: 36607201
DOI: 10.1097/OGX.0000000000001091