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Journal of Obesity 2016There is scientific consensus that obesity increases the risk of cardiovascular diseases, including heart failure. However, among persons who already have heart failure,... (Review)
Review
There is scientific consensus that obesity increases the risk of cardiovascular diseases, including heart failure. However, among persons who already have heart failure, outcomes seem to be better in obese persons as compared with lean persons: this has been termed the obesity paradox, the mechanisms of which remain unclear. This study systematically reviewed the evidence of the relationship between heart failure mortality (and survival) and weight status. Search of the PubMed/MEDLINE and EMBASE databases was done according to the PRISMA protocol. The initial search identified 9879 potentially relevant papers, out of which ten studies met the inclusion criteria. One study was a randomized clinical trial and 9 were observational cohort studies: 6 prospective and 3 retrospective studies. All studies used the BMI, WC, or TSF as measure of body fatness and NYHA Classification of Heart Failure and had single outcomes, death, as study endpoint. All studies included in review were longitudinal studies. All ten studies reported improved outcomes for obese heart failure patients as compared with their normal weight counterparts; worse prognosis was demonstrated for extreme obesity (BMI > 40 kg/m(2)). The findings of this review will be of significance in informing the practice of asking obese persons with heart failure to lose weight. However, any such recommendation on weight loss must be consequent upon more conclusive evidence on the mechanisms of the obesity paradox in heart failure and exclusion of collider bias.
Topics: Body Mass Index; Female; Heart Failure; Hemodynamics; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Obesity; Prognosis; Retrospective Studies; Risk Factors
PubMed: 26904277
DOI: 10.1155/2016/9040248 -
International Journal of Surgery... Aug 2018Trauma is one of the major causes of morbidity and mortality globally, especially in younger populations. With an increase in obesity globally, it is important to assess... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Trauma is one of the major causes of morbidity and mortality globally, especially in younger populations. With an increase in obesity globally, it is important to assess the potential differences in injury pattern and management of obese patients presenting with trauma compared to lean patients to try and improve patient care. This study aims to review the available literature comparing injury patterns between obese and non-obese patients.
METHODS
A systematic review of articles which assessed the association between obesity and different patterns of trauma and injury were assessed. Study quality was assessed using the Newcastle-Ottawa Scale. Data for injury patterns, type of trauma and patient course and outcome including length of ITU stay, length of intubation, length of hospital stay and mortality were collected. Summary data was assessed with random-effects meta-analysis.
RESULTS
21 studies with a total of 2,977,758 patients were identified. The majority of included patients had suffered blunt trauma. Lean patients were found to have a slightly increased risk of blunt trauma as a mechanism of injury (RR 1.02 p=<0.001), with a greater risk of head injury (lean patients RR 1.38 p=<0.001), reduced likelihood of extremity (lean RR 0.79 p=<0.001), and thoracic injury (lean RR 0.83 p = 0.002). There was no difference in risk of abdominal injury (p = 0.39).
DISCUSSION
Obese trauma patients present with different injury patterns compared to lean patients. This may have significant impact on resource requirements and patient outcomes and must be considered when planning or allocating resources for trauma care. Whether differing injury patterns relate to body habitus, lifestyle factors, or other confounders is unclear, but likely represents a combination of thereof.
Topics: Female; Humans; Obesity; Risk Factors; Thinness; Traumatology; Wounds, Nonpenetrating
PubMed: 29751089
DOI: 10.1016/j.ijsu.2018.05.004 -
PloS One 2021Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to...
INTRODUCTION
Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity.
METHOD
A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy.
RESULTS
From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively.
CONCLUSION
When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.
Topics: Child; Databases, Factual; Exercise; Humans; Pediatric Obesity; Physical Therapy Modalities; Sedentary Behavior; User-Computer Interface
PubMed: 34125850
DOI: 10.1371/journal.pone.0252572 -
Postgraduate Medical Journal Dec 2017Meta-analysis was used to assess the clinical efficacy of acupuncture treatment for simple obesity and to provide evidence-based medical data for treating obesity with... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Meta-analysis was used to assess the clinical efficacy of acupuncture treatment for simple obesity and to provide evidence-based medical data for treating obesity with acupuncture.
METHODS
A comprehensive search of studies on MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and Chinese databases (Wan Fang,CNKI and VIP) from 1 January 1915 through 30 November 2015 (MEDLINE search updated through 31 December 2015) was performed. We included only randomised controlled trials (RCTs) that used acupuncture and sham acupuncture to treat simple obesity. The effect of acupuncture on simple obesity was measured using body mass index (BMI), body fat mass (BFM), waist circumference (WC), hip circumference (HC), and body weight (BW). The Jadad scale was used to assess methodological quality. The random effects model was used in the pooled analysis to adjust for the heterogeneity of the included studies, and funnel plots were used to examine publication bias. The differences between treatment groups were reported as mean differences (MD).
RESULTS
Eleven RCTs were selected after all relevant literature from the electronic databases had been screened. There were 338 and 305 participants in the acupuncture and sham acupuncture groups, respectively. Auricular and electro acupuncture were both able to reduce BMI in obese patients (MD 0.47 kg/m, 95% CI 0.35 to 0.58, p<0.001; MD 0.50 kg/m, 95% CI 0.38 to 0.62, p<0.001). BFM change after acupuncture treatment compared with sham treatment was statistically significant (MD 0.66 kg, 95% CI 0.51 to 0.80, p<0.001). There were also significant differences in WC and HC between the acupuncture and sham acupuncture groups (MD2.02 cm, 95% CI 0.21 to 3.83, p=0.03; MD2.74 cm, 95% CI 1.21 to 4.27, p=0.0004). BW was not statistically significantly different between the acupuncture and sham acupuncture groups (MD 0.60 kg, 95% CI -0.20 to 1.39, p=0.14). Begg's test and funnel plots showed that the potential publication bias of the included studies was very slight (p>0.05).
CONCLUSION
Acupuncture for simple obesity appeared to be an effective treatment, but more studies on the safety of acupuncture used to treat simple obesity are required.
Topics: Acupuncture Therapy; Adult; Evidence-Based Medicine; Humans; Obesity
PubMed: 28689171
DOI: 10.1136/postgradmedj-2017-134969 -
American Journal of Preventive Medicine May 2013Latinos are the largest and fastest-growing ethnically diverse group in the U.S.; they are also the most overweight. Mexico is now second to the U.S. in experiencing the... (Review)
Review
CONTEXT
Latinos are the largest and fastest-growing ethnically diverse group in the U.S.; they are also the most overweight. Mexico is now second to the U.S. in experiencing the worst epidemic of obesity in the world. Objectives of this study were to (1) conduct a systematic review of obesity-related interventions targeting Latinos living in the U.S. and Latin America and (2) develop evidence-based recommendations to inform culturally relevant strategies targeting obesity.
EVIDENCE ACQUISITION
Obesity-related interventions, published between 1965 and 2010, were identified through searches of major electronic databases in 2010-2011. Selection criteria included evaluation of obesity-related measures; intervention conducted in a community setting; and at least 50.0% Latino/Latin American participants, or with stratified results by race/ethnicity.
EVIDENCE SYNTHESIS
Body of evidence was based on the number of available studies, study design, execution, and effect size. Of 19,758 articles, 105 interventions met final inclusion criteria. Interventions promoting physical activity and/or healthy eating had strong or sufficient evidence for recommending (1) school-based interventions in the U.S. and Latin America; (2) interventions for overweight or obese children in the healthcare context in Latin America; (3) individual-based interventions for overweight or obese adults in the U.S.; (4) individual-based interventions for adults in Latin America; and (5) healthcare-based interventions for overweight or obese adults in Latin America.
CONCLUSIONS
Most intervention approaches combined physical activity and healthy eating to address both sides of the energy-balance equation. Results can help guide comprehensive evidence-based efforts to tackle the obesity epidemic in the U.S. and Latin America.
Topics: Adult; Child; Health Behavior; Health Promotion; Hispanic or Latino; Humans; Latin America; Life Style; Obesity; United States
PubMed: 23597819
DOI: 10.1016/j.amepre.2013.01.023 -
International Journal of Molecular... Dec 2022Asthma and obesity are considered as highly prevalent diseases with a great impact on public health. Obesity has been demonstrated to be an aggravating factor in the... (Meta-Analysis)
Meta-Analysis Review
Asthma and obesity are considered as highly prevalent diseases with a great impact on public health. Obesity has been demonstrated to be an aggravating factor in the pathogenesis of asthma. Adipose tissue secretes proinflammatory cytokines and mediators, including leptin, which may promote the development and severity of asthma in obese patients. This study is a systematic review and a meta-analysis based on the relationship between leptin and asthma during obesity. MEDLINE, Cochrane, EMBASE and CINAHL databases were used. Data heterogeneity was analyzed using Cochran’s Q and treatment effect with the DerSimonian and Laird method. Random effect analyses were carried out to test data sensitivity. Asymmetry was estimated using Begg’s and Egger’s tests. All studies showed significant differences in leptin levels. The effect of the measures (p < 0.001), data sensitivity (p < 0.05) and data asymmetry were statistically significant, as well as tBegg’s test (p = 0.010) and Egge’s test (p < 0.001). Despite the existing limiting factors, the results of this study support the relevant role of leptin in the pathophysiology of asthma in obese subjects. Nevertheless, further studies are needed to obtain better insight in the relationship between leptin and asthma in obesity.
Topics: Humans; Adipose Tissue; Asthma; Cytokines; Leptin; Obesity
PubMed: 36613991
DOI: 10.3390/ijms24010546 -
Journal of General Internal Medicine May 2009Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography.
OBJECTIVES
To quantify the relationship between body weight and mammography in white and black women.
DATA SOURCES AND REVIEW METHODS
We identified original articles evaluating the relationship between weight and mammography in the United States through electronic and manual searching using terms for breast cancer screening, breast cancer, and body weight. We excluded studies in special populations (e.g., HIV-positive patients) or not written in English. Citations and abstracts were reviewed independently. We abstracted data sequentially and quality information independently.
RESULTS
Of 5,047 citations, we included 17 studies in our systematic review. Sixteen studies used self-reported body mass index (BMI) and excluded women <40 years of age. Using random-effects models for the six nationally representative studies using standard BMI categories, the combined odds ratios (95% CI) for mammography in the past 2 years were 1.01 (0.95 to 1.08), 0.93 (0.83 to 1.05), 0.90 (0.78 to 1.04), and 0.79 (0.68 to 0.92) for overweight (25-29.9 kg/m(2)), class I (30-34.9 kg/m(2)), class II (35-39.9 kg/m(2)), and class III (> or =40 kg/m(2)) obese women, respectively, compared to normal-weight women. Results were consistent when all available studies were included. The inverse association was found in white, but not black, women in the three studies with results stratified by race.
CONCLUSIONS
Morbidly obese women are significantly less likely to report recent mammography. This relationship appears stronger in white women. Lower screening rates may partly explain the higher breast cancer mortality in morbidly obese women.
Topics: Breast Neoplasms; Cross-Sectional Studies; Female; Humans; Longitudinal Studies; Mammography; Obesity
PubMed: 19277790
DOI: 10.1007/s11606-009-0939-3 -
Endocrine Regulations Oct 2022Postmenopausal women are at great risk of mental health deterioration, which may lead to morbidity and mortality. The decrement of mental health with aging is attributed...
Postmenopausal women are at great risk of mental health deterioration, which may lead to morbidity and mortality. The decrement of mental health with aging is attributed to hormonal changes, lowered physical activity, sleep disturbances, economic factors, as well as modifiable variables such as smoking and obesity. Studies have shown controversial results on the association between obesity and mental health in postmenopausal women. This study is a systematic review of the evidence available on the association between obesity and mental health in postmenopausal women with the aim to identify the most reliable obesity measure that has been shown in association with mental health as well as the effective measures that have been practiced for improving mental health in postmenopausal obese women. CINAHL, Scopus, Science Direct and PubMed including Medline databases were searched. Out of 3,766 articles, 23 studies of average to good quality were included, out of which 17 were cross-sectional and 6 interventional. Out of the 17 studies, 12 showed a positive association between obesity and deterioration of mental health, 3 showed a negative association and two showed no association. From the interventional studies, 4 showed positive and two not significant impact of the intervention used on obesity and mental health. In conclusion, more studies showed a positive association between obesity, especially visceral obesity, and mental health issues particularly depression, anxiety, and sleep disorders. Combination of caloric restriction and exercise seems to have a better impact on the mental health of the postmenopausal in comparison with other interventions.
Topics: Humans; Female; Mental Health; Postmenopause; Obesity; Exercise; Anxiety
PubMed: 36270346
DOI: 10.2478/enr-2022-0032 -
Postgraduate Medicine Mar 2017The relationship between overweightness, obesity and arterial stiffness remains unclear. We performed a meta-analysis evaluating the impact of obesity/overweightness on... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The relationship between overweightness, obesity and arterial stiffness remains unclear. We performed a meta-analysis evaluating the impact of obesity/overweightness on arterial stiffness in healthy subjects.
METHODS
Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies evaluating the relationship between obesity/overweightness and cfPWV, baPWV, and AIx were systematically searched. A total of 10 studies (1,124 obese/overweight subjects, 1,884 controls) were included.
RESULTS
Compared to controls, obese/overweight subjects showed a significantly higher cfPWV (SMD 0.50 m/s; 95%CI 0.15, 0.86; P = 0.005), baPWV (SMD 0.41 m/s; 95% CI 0.08, 0.74; P = 0.014), and AIx (SMD 1.02;95%CI 0.16, 1.87; P < 0.0001). When analyzing 'high quality' studies, the difference in arterial stiffness among obese/overweight subjects and controls remain (SMD 0.73 m/s; 95%CI 0.16, 1.30; P = 0.013).
CONCLUSION
Arterial stiffness, a recognized marker of cardio vascular risk, is increased in obese/overweight subjects without overt cardiovascular diseases.
Topics: Atherosclerosis; Cardiovascular Diseases; Humans; Obesity; Overweight; Risk Factors; Vascular Stiffness
PubMed: 27915493
DOI: 10.1080/00325481.2017.1268903 -
Obesity Reviews : An Official Journal... Jan 2014In order to examine (i) the association between weight status and musculoskeletal complaints (MSC) in children, and (ii) whether overweight and obese children have a... (Review)
Review
In order to examine (i) the association between weight status and musculoskeletal complaints (MSC) in children, and (ii) whether overweight and obese children have a higher risk of developing MSC than normal-weight children Medline, Embase, Web of Science and Cochrane were searched (all years up to 2 January 2013) for observational studies studying direct associations between body mass index (or weight status) and MSC in children. Forty studies, together studying over one million children, were included. There was moderate quality of evidence that being overweight in childhood is positively associated with musculoskeletal pain (risk ratio [RR] 1.26; 95% confidence interval [CI]: 1.09-1.45). In addition, low quality of evidence was found for a positive association between overweight and low back pain (RR 1.42; 95% CI: 1.03-1.97) and between overweight and injuries and fractures (RR 1.08; 95% CI: 1.03-1.14). Although the risk of developing an injury was significantly higher for overweight than for normal-weight adolescents (RR: 2.41, 95% CI: 1.42 to 4.10), this evidence was of very low quality. Overweight and obesity are associated with musculoskeletal pain, injuries and fractures as early as childhood. More high-quality prospective cohort studies are needed to study the nature of this relationship.
Topics: Adolescent; Age of Onset; Body Mass Index; Child; Child, Preschool; Comorbidity; Cross-Sectional Studies; Female; Fractures, Bone; Humans; Low Back Pain; Male; Musculoskeletal Diseases; Obesity; Risk Factors; Young Adult
PubMed: 23941399
DOI: 10.1111/obr.12067