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The Journal of Nutrition, Health & Aging 2023Obesity in the older adults is a health concern that increases the risk of several life-threatening diseases. Previous research has been revealed that alterations in the...
BACKGROUND
Obesity in the older adults is a health concern that increases the risk of several life-threatening diseases. Previous research has been revealed that alterations in the gut microbiota composition is related to obesity. So, understanding the gut microbiota changes in older adults' obesity may help to provide promising strategies for their health management.
OBJECTIVES
Here we conducted a systematic review that investigate the alteration of gut microbiota composition in association with obesity and its indices in the older adults.
DESIGN
Systematic review.
SETTING
A comprehensive systematic search was performed through PubMed, Web of Science, Scopus and Embase databases for all relative studies up to 2023 with the main search concepts as Microbiota, Obesity and Elderly. The data about gut microbiota in association with obesity indices had been extracted.
PARTICIPANTS
Older adults (≥60 years).
INTERVENTION
None.
MEASUREMENTS
None.
RESULTS
Within 10741 recordes, 11 studies met the inclusion criteria and were included in this systematic review. Most of them indicated the gut microbiota alterations in obese compared with non-obese older adults. However, the gut microbiome composition in obese older adults is affected by other underlying diseases like diabetes and metabolic syndrome. The most important taxa that had abundance alteration in association with obesity in older adults were Christensenellaceae, Porphyromonadaceae and Rikenellaceae, Akkermansia, Blautia, Prevotella, Ruminococcus, Bacteroides and Faecalibacterium.
CONCLUSION
The gut microbiota composition is associated with obesity in older adults. Considering the other factors affecting the composition of gut microbiota, such as age, underlying diseases and lifestyle, a more accurate conclusion about this matter requires more future studies.
Topics: Humans; Aged; Gastrointestinal Microbiome; Obesity; Microbiota; Metabolic Syndrome; Diabetes Mellitus
PubMed: 37960904
DOI: 10.1007/s12603-023-1988-8 -
Obesity Facts 2023Managing nutritional deficiencies is an essential component in the treatment of severe obesity. Vitamin D deficiency is often reported in investigations in severely... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Managing nutritional deficiencies is an essential component in the treatment of severe obesity. Vitamin D deficiency is often reported in investigations in severely obese cohorts. However, no prior study has summarized findings on this topic. Consequently, the aim of this systematic review and meta-analysis was to investigate the 25-hydroxyvitamin D [25(OH)D] status in individuals with severe obesity in different regions worldwide. We also evaluated levels of calcium, parathyroid hormone (PTH), and magnesium as secondary outcome measures.
METHODS
We searched Medline, PubMed, Scopus, the Cochrane Library, and EMBASE for relevant observational studies published in English from 2009 to October 2021. The heterogeneity index among the studies was determined using the Cochran (Q) and I2 tests. Based on the heterogeneity results, the random-effect model was applied to estimate the prevalence of vitamin D deficiency.
RESULTS
We identified 109 eligible observational studies. Overall, 59.44% of patients had vitamin D deficiency [25(OH)D <20 ng/mL], whereas 26.95% had vitamin D insufficiency [25(OH)D 20-30 ng/mL]. Moreover, the mean 25(OH)D level was 18.65 ng/mL in 96 studies. The pooled mean estimate of the serum calcium, PTH, and magnesium was 9.26 mg/dL (95% confidence interval [CI]: 9.19-9.32, I2 = 99.7%, p < 0.001), 59.24 pg/mL (95% CI: 54.98, 63.51, I2 = 99.7%, p < 0.001), and 0.91 mg/dL (95% CI: 0.84, 0.98, I2 = 100.0%, p < 0.001), respectively. The results of the subgroup analysis indicated that the mean estimates of 25(OH)D were highest in North America (21.71 ng/mL [19.69, 23.74], [I2 = 97.2%, p < 0.001]) and lowest in Southeast Asia (14.93 ng/mL [14.54, 15.33], [I2 = 0.0%, p = 0.778]).
CONCLUSION
The results obtained showed a significant prevalence of vitamin D deficiency among severely obese individuals in various geographical regions, whereas the highest and lowest mean estimates were reported for North America and Southeast Asia, respectively.
Topics: Humans; Obesity, Morbid; Calcium; Magnesium; Vitamin D; Vitamin D Deficiency; Obesity; Parathyroid Hormone
PubMed: 37640022
DOI: 10.1159/000533828 -
Seminars in Thrombosis and Hemostasis Nov 2011The world is experiencing an obesity pandemic, with rates of obesity rising for more than two decades. Obesity is defined as a body mass index (BMI) of 30 kg/m (2) or... (Review)
Review
The world is experiencing an obesity pandemic, with rates of obesity rising for more than two decades. Obesity is defined as a body mass index (BMI) of 30 kg/m (2) or greater. Of particular concern are the risks that millions of obese people are likely to develop chronic diseases and at earlier ages than their parents might have. The risk of venous thrombosis increases with obesity, so that the incidence of this pathology is also expected to rise significantly. There is remarkable and consistent evidence from a systematic review, as well as cohort and case-control studies that obesity might predispose to venous thromboembolism (VTE). The risk appears to be at least double that for normal weight subjects (BMI 20 to 24.9 kg/m (2)). Plausible mechanisms exist to explain this relationship, including the physical effects of body fat limiting venous return and a proinflammatory, prothrombotic, and hypofibrinolytic milieu. Loss of body weight has been shown to reduce the concentrations of coagulation factors and plasminogen activator inhibitor-1 toward the normal range. Whether weight loss would prevent secondary occurrence of VTE in the absence of anticoagulant therapy could not be discerned from this literature search.
Topics: Body Mass Index; Female; Humans; Male; Obesity; Risk Factors; Venous Thrombosis
PubMed: 22198855
DOI: 10.1055/s-0031-1297369 -
Critical Reviews in Food Science and... Jun 2008Recent studies suggest a possible comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and obesity. To gain insight into this potential association, we... (Review)
Review
Recent studies suggest a possible comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and obesity. To gain insight into this potential association, we performed a systematic review of the literature excluding case reports, non-empirical studies, and studies not using ADHD diagnostic criteria. Empirically based evidence suggests that obese patients referred to obesity clinics may present with higher than expected prevalence of ADHD. Moreover, all reviewed studies indicate that subjects with ADHD are heavier than expected. However, data on the prevalence of obesity in subjects with ADHD are still limited. As for the mechanisms underlying the potential association between ADHD and obesity, ADHD might lead to obesity via abnormal eating behaviors, impulsivity associated with binge eating might contribute to ADHD in obese patients, or, alternatively, both obesity and ADHD might be the expression of common underlying neurobiological dysfunctions, at least in a subset of subjects. In patients with obesity and ADHD, both conditions might benefit from common therapeutic strategies. Further empirically based studies are needed to understand the potential comorbidity between obesity and ADHD, as well as the possible mechanisms underlying this association. This might allow a more appropriate clinical management and, ultimately, a better quality of life for patients with both obesity and ADHD.
Topics: Attention Deficit Disorder with Hyperactivity; Central Nervous System Stimulants; Humans; Obesity; Weight Loss
PubMed: 18568858
DOI: 10.1080/10408390701540124 -
Teaching and Learning in Medicine 2012Obesity is the second leading cause of preventable death in the United States. However, physicians feel poorly trained to address the obesity epidemic. This article... (Review)
Review
BACKGROUND
Obesity is the second leading cause of preventable death in the United States. However, physicians feel poorly trained to address the obesity epidemic. This article examines effective training methods for overweight and obesity intervention in undergraduate medical education. Using indexing terms related to overweight, obesity, and medical student education, we conducted a literature searched PubMed PsycINFO, Cochrane, and ERIC for relevant articles in English. References from articles identified were also reviewed to located additional articles.
SUMMARY
We included all studies that incorporated process or outcome evaluations of obesity educational interventions for U.S. medical students. Of an initial 168 citations, 40 abstracts were retrieved; 11 studies were found to be pertinent to medical student obesity education, but only 5 included intervention and evaluation elements. Quality criteria for inclusion consisted of explicit evaluation of the educational methods used. Data extraction identified participants (e.g., year of medical students), interventions, evaluations, and results. These 5 studies successfully used a variety of teaching methods including hands on training, didactic lectures, role-playing, and standardized patient interaction to increase medical students' knowledge, attitudes, and skills regarding overweight and obesity intervention. Two studies addressed medical student bias toward overweight and obese patients. No studies addressed health disparities in the epidemiology and bias of obesity.
CONCLUSIONS
Despite the commonly cited "obesity epidemic," there are very few published studies that report the effectiveness of medical school obesity educational programs. Gaps still exist within undergraduate medical education including specific training that addresses obesity and long-term studies showing that such training is retained.
Topics: Curriculum; Education, Medical, Undergraduate; Educational Status; Health Education; Health Knowledge, Attitudes, Practice; Health Promotion; Health Status Disparities; Humans; Obesity; Patient Education as Topic; Schools, Medical; Social Marketing; United States
PubMed: 22775792
DOI: 10.1080/10401334.2012.692286 -
Obesity, diabetes and pneumonia: the menacing interface of non-communicable and infectious diseases.Tropical Medicine & International... Dec 2013To review current knowledge on the epidemiological, clinical and biological impact of the pandemic of obesity and diabetes on pneumonias. (Review)
Review
OBJECTIVES
To review current knowledge on the epidemiological, clinical and biological impact of the pandemic of obesity and diabetes on pneumonias.
METHODS
We conducted a literature review using PubMed and EMBASE, supplemented by various sources. Given the disparate and fragmented nature of the literature, a formal systematic review was not possible.
RESULTS
In 2008, globally 10% of men and 14% of women were obese and an estimated 371 million had diabetes; half undiagnosed and many obese. Numbers are rising rapidly in low- and middle-income countries where the majority reside, but reliable data are lacking. The most frequent pneumonias in obesity and diabetes are tuberculosis, influenza and pneumococcal, staphylococcal and opportunistic pathogens. Diabetes impacts tuberculosis control and increases drug resistance and mortality. Mortality and morbidity from pneumococcal pneumonia and influenza are increased in obesity and diabetes. In addition to mechanical and physiological effects, there are considerable immunological abnormalities characterised by chronic, low-grade inflammation. Simultaneous up-regulation and dysregulation of both innate and adaptive immune responses impair control and killing of invading organisms. Prevention in those at risk is poorly practised, although screening for tuberculosis in diabetes is beginning in high-burden settings.
CONCLUSIONS
Pneumonia is a threat globally in obesity and diabetes with increased incidence and severity of disease. There is uncertainty about whether vaccines are equally effective in those with obesity and diabetes. Increased epidemiological, clinical and biological knowledge will be crucial to face this 21st century challenge.
Topics: Diabetes Complications; Diabetes Mellitus; Female; Global Health; Humans; Influenza, Human; Male; Obesity; Pneumonia, Bacterial; Pneumonia, Viral; Risk Factors; Tuberculosis, Pulmonary
PubMed: 24237786
DOI: 10.1111/tmi.12206 -
Obesity (Silver Spring, Md.) Sep 2006Although obesity is increasing in older U.S. adults, treatment is controversial in this age group. We sought to examine evidence concerning obesity's health-related... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Although obesity is increasing in older U.S. adults, treatment is controversial in this age group. We sought to examine evidence concerning obesity's health-related risks, diagnostic methods, and treatment outcomes in older individuals.
RESEARCH METHODS AND PROCEDURES
We searched MEDLINE and Cochrane Library databases, consulted with experts, and examined bibliographies for English language studies discussing obesity in older adults (mean age > or = 60), published between January 1980 and November 2005. Inclusion criteria were met by 32 longitudinal analyses, seven diagnostic studies, and 17 randomized controlled trial articles. At least two authors independently reviewed and abstracted study design, population, results, and quality information.
RESULTS
Correlations between body fat and three anthropometric measures (BMI, waist circumference, waist-to-hip ratio) decrease with age but remain clinically significant. Obesity contributes to risk for several cardiovascular endpoints, some cancers, and impaired mobility but protects against hip fracture. The association between obesity and mortality declines as age increases. Intensive counseling strategies incorporating behavioral, dietary, and exercise components promote a weight loss of 3 to 4 kg over 1 to 3.3 years. The loss is linked with improved glucose tolerance, improved physical functioning, reduced incidence of diabetes and a combined hypertension and cardiovascular endpoint, and reduced bone density.
DISCUSSION
In older adults, obesity can be diagnosed with standard clinical measures. Intensive counseling can promote modest sustained weight loss, but data are insufficient to evaluate surgical or pharmacological options. Obesity treatment is most likely to benefit individuals with high cardiovascular risk. Limited data suggest possible functional improvement. Treatment should incorporate measures to avoid bone loss.
Topics: Adipose Tissue; Aged; Anthropometry; Cardiovascular Diseases; Diagnosis, Differential; Female; Geriatrics; Humans; Life Style; Male; Obesity; Risk Factors; Treatment Outcome; Weight Loss
PubMed: 17030958
DOI: 10.1038/oby.2006.171 -
Journal of Reconstructive Microsurgery Jun 2018Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstruction following mastectomy.
METHODS
Cochrane, PUBMED, and EMBASE electronic databases were screened and data were extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate, and patient satisfaction.
RESULTS
Out of 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71,368 patients, 20,061 of whom were obese). Obese women (body mass index > 30 kg/m) were 2.29 times more likely to experience surgical complications (95% confidence interval (CI) 2.19-2.39; < 0.00001), 2.89 times more likely to have medical complications (95% CI 2.50-3.35; < 0.00001), and had a 1.91 times higher risk of reoperation (95% CI 1.75-2.07; < 0.00001). The most common complication, wound dehiscence, was 2.51 times more likely in obese women (95% CI 1.80-3.52; < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (risk ratio 2.36, 95% CI 2.22-2.52; < 0.00001).
CONCLUSIONS
This study provides evidence that obesity increases the risk of complications in both implant-based and autologous reconstruction. Additional prospective and observational studies are needed to determine if the weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.
Topics: Adult; Body Mass Index; Breast Neoplasms; Female; Graft Rejection; Humans; Length of Stay; Mammaplasty; Mastectomy; Middle Aged; Obesity; Postoperative Complications; Prognosis; Reoperation; Risk Assessment
PubMed: 29510420
DOI: 10.1055/s-0038-1627449 -
International Journal of Environmental... Aug 2022Overweight and obesity, including their prevalence and consequences, reflect a leading public health problem. Studies have already shown that physical activity leads to... (Review)
Review
Overweight and obesity, including their prevalence and consequences, reflect a leading public health problem. Studies have already shown that physical activity leads to a reduction in body weight in children and adults. However, the university setting has rarely been investigated. The aim of this review is, therefore, to examine and summarize the effectiveness of physical-activity-based interventions to reduce obesity and overweight in university students. Three databases (PubMed, Scopus, and Web of Science) were searched for relevant studies published in English between January 2010 and February 2022. Quantitative studies conducting a physical-activity-based intervention with overweight or obese university students and reporting changes in BMI were included. Data were described in a narrative synthesis. Out of 16 included studies, 11 reported a significant reduction in BMI. However, all studies except one were able to demonstrate some BMI improvements, whereas all studies reported significant changes in at least one health-related indicator. Aerobic exercises were able to demonstrate the greatest reductions in BMI. This review is the first systematic presentation on the effectiveness of physical-activity-based interventions in overweight and obese university students. Future work should reconsider BMI as the primary outcome if appropriate within the respective study design (i.e., to measure long-term effects). More interventions are needed to improve strategies.
Topics: Adult; Child; Exercise; Humans; Obesity; Overweight; Students; Universities
PubMed: 35954789
DOI: 10.3390/ijerph19159427 -
The Journal of Nutrition, Health & Aging Jan 2012Obesity is a risk factor for chronic diseases and premature mortality, but the extent of these associations among the elderly is under debate. The aim of this systematic... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Obesity is a risk factor for chronic diseases and premature mortality, but the extent of these associations among the elderly is under debate. The aim of this systematic literature review (SR) is to collate and critically assess the available information of the impact of obesity on mortality in the elderly.
METHODS
In PubMed, there are three-hundred twelve papers on the relationship between obesity and mortality among older adults. These papers were analysed on the basis of their abstracts, and sixteen studies were considered suitable for the purpose of the study. It was possible to perform a pooled estimate for aggregated data in three different studies.
CONCLUSION
The results of this SR document that an increased mortality in obese older adults. The limitation of BMI to index obesity and the noted protective action of a moderate increase in BMI on mortality are highlighted. Waist circumference is an indicator of central adiposity and potentially as good a risk factor for mortality as BMI in obese elderly adults.
Topics: Aged; Body Mass Index; Cause of Death; Humans; Obesity; Obesity, Abdominal; Risk Factors; Waist Circumference
PubMed: 22238007
DOI: 10.1007/s12603-011-0073-x