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Scientific Reports Jun 2024To examine the influence of Body Mass Index (BMI) on laparoscopic gastrectomy (LG) short-term and long-term outcomes for gastric cancer. A retrospective analysis was...
To examine the influence of Body Mass Index (BMI) on laparoscopic gastrectomy (LG) short-term and long-term outcomes for gastric cancer. A retrospective analysis was conducted on gastric cancer patients undergoing LG at the Third Hospital of Nanchang City from January 2013 to January 2022. Based on WHO BMI standards, patients were categorized into normal weight, overweight, and obese groups. Factors such as operative time, intraoperative blood loss, postoperative complications, and overall survival were assessed. Across different BMI groups, it was found that an increase in BMI was associated with longer operative times (average times: 206.22 min for normal weight, 231.32 min for overweight, and 246.78 min for obese), with no significant differences noted in intraoperative blood loss, postoperative complications, or long-term survival among the groups. The impact of BMI on long-term survival following LG for gastric cancer was found to be insignificant, with no notable differences in survival outcome between different BMI groups. Although higher BMI is associated with increased operative time in LG for gastric cancer, it does not significantly affect intraoperative blood loss, postoperative complications, recovery, or long-term survival. LG is a feasible treatment choice for obese patients with gastric cancer.
Topics: Humans; Stomach Neoplasms; Gastrectomy; Body Mass Index; Male; Laparoscopy; Female; Middle Aged; Retrospective Studies; Aged; Treatment Outcome; Postoperative Complications; Operative Time; Obesity; Adult; Blood Loss, Surgical
PubMed: 38879651
DOI: 10.1038/s41598-024-64459-w -
Scientific Reports Jun 2024The purpose of this study was to investigate the causal association between unhealthy lifestyle style factors and the risk of colorectal cancer, with the aim of...
The purpose of this study was to investigate the causal association between unhealthy lifestyle style factors and the risk of colorectal cancer, with the aim of preventing the occurrence of colorectal cancer by modifying unhealthy lifestyles. A two-sample Mendelian randomization (MR) approach was employed in this study, utilizing the inverse-variance weighted method as the primary research method. This MR analysis analyzed data of 3022 colorectal cancer cases and 174,006 controls from the FinnGen database. Single nucleotide polymorphisms (SNPs) associated with unhealthy lifestyle factors were selected as instrumental variables (IVs), including two obesity-related indicators, BMI (body mass index) and WHR (waist-to-hip ratio). Four phenotypes of smoking (smoking initiation, ever smoked, smoking per day, smoking cessation) and one phenotype of alcohol consumption (drinks per week). Four phenotypes of physical activity (accelerometer-based physical activity, moderate-to-vigorous physical activity, vigorous physical activity, strenuous sports or other exercises). All SNPs were obtained from published genome-wide association studies. The study found that the obesity-related indicator, higher WHR (OR = 1.38, 95% CI 1.12-1.70; P = 0.002) were associated with an increased risk of colorectal cancer, and two smoking phenotypes, cigarettes per day(OR = 1.30, 95% CI 1.01-1.68; P = 0.042)and smoking initiation (OR = 3.48, 95% CI 1.15-10.55; P = 0.028), were potentially associated with an increased risk of colorectal cancer. However, there was no evidence to suggest that physical activities and alcohol consumption were associated with colorectal cancer (all p > 0.05). In addition, the study detected no pleiotropy (all p > 0.05). This MR analysis indicates a causal association between a higher waist-to-hip ratio and the risk of colorectal cancer and a suggestive association between smoking and the risk of colorectal cancer among Europeans. These findings contribute to the understanding of the etiology of colorectal cancer and have potential implications for its prevention.
Topics: Humans; Colorectal Neoplasms; Mendelian Randomization Analysis; Polymorphism, Single Nucleotide; Life Style; Risk Factors; Smoking; Exercise; Genome-Wide Association Study; Alcohol Drinking; Male; Body Mass Index; Female; Obesity; Waist-Hip Ratio
PubMed: 38879601
DOI: 10.1038/s41598-024-64813-y -
Cardiovascular Diabetology Jun 2024There has been a substantial increase in the use of laparoscopic sleeve gastrectomy (SG) to treat morbid obesity despite observational evidence demonstrating the... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
There has been a substantial increase in the use of laparoscopic sleeve gastrectomy (SG) to treat morbid obesity despite observational evidence demonstrating the superiority of Roux-en-Y gastric bypass (RYGB) for reducing low-density lipoprotein (LDL) cholesterol. The main aim was to ascertain whether high LDL cholesterol levels should be considered when selecting the most appropriate surgical procedure for each patient (RYGB or SG).
METHODS
In this single-center, randomized clinical trial using intention-to-treat analysis, 38 patients with severe obesity and elevated levels of LDL cholesterol were randomly assigned to undergo RYGB or SG. The primary outcome was LDL cholesterol remission at 12 months, defined as LDL cholesterol < 3.36 nmol/l without lipid-lowering medications. Secondary outcomes included changes in weight, other comorbidities, qualitative lipoprotein traits, cholesterol esters, glycoproteins, cholesterol absorption and synthesis metabolites and complications.
RESULTS
Intention-to-treat analysis revealed that LDL cholesterol remission occurred in 66.6% of RYGB patients compared to 27.8% of SG patients (p = 0.019). Among patients completing follow-up, RYGB demonstrated superior remission (80.0% vs. 29.4%, p = 0.005). Exclusive benefits of RYGB included a reduction in large, medium, and small LDL particles. Cholesterol absorption markers showed differential behavior after both techniques: campesterol (Δ -15.2 µg/mg, 95% CI -30.2 to -0.1) decreased after RYGB, and sitosterol (Δ 21.1 µg/mg, 95% CI 0.9 to 41.2), cholestanol (Δ 30.6 µg/mg, 95% CI 14.8 to 57.9) and campesterol (Δ 18.4 µg/mg, 95% CI 4.4 to 32.3) increased after SG. No differences in weight loss, cholesterol esters, glycoproteins, cholesterol synthesis metabolites or postoperative complications were observed between techniques.
CONCLUSION
In conclusion, RYGB is superior to SG in terms of short-term of high LDL cholesterol remission. Furthermore, RYGB also led to a greater improvement in lipoprotein parameters that confer an atherogenic profile. Therefore, the presence of elevated levels of LDL cholesterol should be considered when determining the optimal bariatric surgery procedure for each patient.
TRIAL REGISTRATION
Clinicaltrials.gov number, NCT03975478).
Topics: Humans; Male; Female; Gastric Bypass; Gastrectomy; Adult; Middle Aged; Cholesterol, LDL; Treatment Outcome; Obesity, Morbid; Time Factors; Biomarkers; Weight Loss; Remission Induction; Laparoscopy; Hypercholesterolemia; Sitosterols
PubMed: 38879559
DOI: 10.1186/s12933-024-02296-x -
BMC Research Notes Jun 2024Bariatric surgery induces a significant loss of both fat mass (FM) and fat-free mass (FFM). The proteoglycan receptor syndecan-4 (SDC4) plays a crucial role in adipose...
OBJECTIVE
Bariatric surgery induces a significant loss of both fat mass (FM) and fat-free mass (FFM). The proteoglycan receptor syndecan-4 (SDC4) plays a crucial role in adipose tissue and skeletal muscle functions. Thus, this study was performed (i) to assess plasma SDC4 levels after both Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) surgeries, and (ii) to explore potential associations with changes in body composition variables.
RESULTS
Twenty-six patients (17 females) with severe obesity underwent SG (n = 13) or RYGB (n = 13) and were followed up to 1 year (1Y). Body weight, FM, FFM, and SCD4 were measured at baseline (BL), and at week 11 (W11) and 1Y after surgery. Independently of procedure, there was a significant body weight loss at W11, with an average FM and FFM reduction of 13.7 ± 0.6 kg and 5.3 ± 0.5 kg, respectively. Participants continued to lose weight afterwards, with a total weigth loss of 38.2 ± 1.5 kg at 1Y. No associations were found at BL between SDC4 levels and any anthropometric variable; however, SDC4 levels were lower than BL at both W11 and 1Y, independently of type of surgery. Additionally, changes in SDC4 between BL and 1Y were positively correlated with weight and FFM loss during the same period.
TRIAL REGISTRATION
ClinicalTrials.gov NCT04051190 on 09/08/2019.
Topics: Humans; Syndecan-4; Female; Male; Weight Loss; Adult; Bariatric Surgery; Middle Aged; Obesity, Morbid; Body Composition; Gastric Bypass; Gastrectomy; Adipose Tissue
PubMed: 38879520
DOI: 10.1186/s13104-024-06822-8 -
Journal of Health, Population, and... Jun 2024The COVID-19 lockdown significantly impacted dietary habits and body weights globally, particularly in Egypt, where 57.03% of the population resides in rural areas,...
BACKGROUND
The COVID-19 lockdown significantly impacted dietary habits and body weights globally, particularly in Egypt, where 57.03% of the population resides in rural areas, despite lack of information. The study examines the impact of COVID-19 lockdown on the weight changes of the rural Egyptian population through behavioral, physical, and dietary changes.
METHODS
A cross-sectional online survey using Microsoft Forms was distributed in Delta regions in Egypt. The questionnaire used a modified version of the validated 14- items PREDIMED MedDiet Adherence Screener (MEDAS). The first part of the questionnaire addressed sociodemographic variables whereas the second one included questions related to dietary, behavioral and weight changes of participants. These changes were statistically tested for significance in relation to BMI, gender, home living, current job and family history of obesity.
RESULTS
A total of 306 participated in the study (70% females, 13% obese, 95% living with family, 56% university students, and 36% with family history of obesity). Obese showed a significant increase in sweet intake whereas underweight and normal weight people displayed a significant decrease in eating desire. Both females and males showed significant increase in consumption of fruits and vegetables with significant decrease in soft drink. However, women showed a significant decrease in sport activity relative to men. Participants living with family showed an increase in sweet intake while those living alone explored an increase in meal frequency. Employers revealed a significant decrease in sport activities and people with family history of obesity reported more sleeping times than those without family history of obesity.
CONCLUSION
During Covid-19 quarantine, Egyptians' eating habits improved, but daily routines were disrupted. Raising awareness about obesity and providing guidance on maintaining activity, energy, and mood is crucial for future quarantine situations.
Topics: Humans; COVID-19; Male; Female; Egypt; Cross-Sectional Studies; Adult; Feeding Behavior; Rural Population; Obesity; Quarantine; Middle Aged; Retrospective Studies; SARS-CoV-2; Body Weight; Surveys and Questionnaires; Young Adult; Diet; Health Behavior; Body Mass Index
PubMed: 38879511
DOI: 10.1186/s41043-024-00558-8 -
Advances in Nutrition (Bethesda, Md.) Jun 2024Despite the well-documented adverse outcomes associated with obesity during pregnancy, this condition remains a promising modifiable risk factor. (Review)
Review
A Systematic Review and Bayesian Network Meta-Analysis Comparing In-Person, Remote, and Blended Interventions in Physical Activity, Diet, Education, and Behavioral Modification on Gestational Weight Gain Among Overweight or Obese Pregnant Individuals.
BACKGROUND
Despite the well-documented adverse outcomes associated with obesity during pregnancy, this condition remains a promising modifiable risk factor.
OBJECTIVE
The aim of this study was to ascertain the most effective treatment modalities for gestational weight gain (GWG) in pregnant women classified as overweight or obese.
METHODS
A systematic search was conducted across four electronic databases: Embase, EBSCOhost, PubMed, and Web of Science. To assess the quality of evidence, the Confidence In Network Meta-Analysis (CINeMA) approach, grounded in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, was employed. A Bayesian network meta-analysis was conducted to synthesize the comparative effectiveness of treatment modalities based on GWG outcomes.
RESULTS
The analysis incorporated 60 RCTs, encompassing 16,615 participants. Modes of intervention administration were classified as remote (R: eHealth (e) and mHealth (m)), in-person (I), and a combination of both (I+R). The interventions comprised five categories: education (E), physical activity (PA), dietary (D), behavior modification (B), and combinations thereof. The quality of the evidence, as evaluated by CINeMA, ranged from very low to high. Compared to the control group, the I-D intervention (mean difference (MD) = -1.27, 95% CI [-2.23, -0.32]), I-PADB (MD = -0.60, 95% CI [-1.19, -0.00]), and in I-B (MD = -0.34, 95% CI [-0.57, -0.10]) interventions showed significant efficacy in reducing GWG.
CONCLUSIONS
Preliminary findings suggest that the I-D intervention is the most efficacious in managing GWG among pregnant women who are overweight or obese, followed by I-PADB and I-B+R-B(m) treatments. These conclusions are drawn from evidence of limited quality and directness, including insufficient data on PA components used in the interventions. Owing to the absence of robust, direct evidence delineating significant differences among various GWG management strategies, it is tentatively proposed that the I-D intervention is likely the most effective approach. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: International Prospective Register of Systematic Reviews, CRD42023473627 STATEMENT OF SIGNIFICANCE: This study presents new methods using systematic review and Bayesian meta-analysis combined with direct and indirect evidence, to evaluate effective interventions for managing gestational weight gain in overweight and obese pregnant women. This approach addresses prior gaps by assessing various intervention methods' effectiveness and administration processes; providing more comprehensive analyses for this specific group of pregnant women.
PubMed: 38879168
DOI: 10.1016/j.advnut.2024.100253 -
Complementary Therapies in Medicine Jun 2024Obesity is associated with many chronic non-communicable diseases, including hypertension, diabetes, cardiovascular and cerebrovascular diseases, cancer, gallbladder...
INTRODUCTION
Obesity is associated with many chronic non-communicable diseases, including hypertension, diabetes, cardiovascular and cerebrovascular diseases, cancer, gallbladder disease, bone and joint disorders, skin diseases, fatty liver disease, etc. [1] The recent report revealed that overweight and obesity were prevalent in 60% of the adult population. Several studies have been published to determine the effect of Hibiscus sabdariffa Linn. on obesity treatment, but the findings are still inconclusive. The purpose of this study was to determine the efficacy and safety of H. sabdariffa Linn in the treatment of obesity.
METHODS
We searched PubMed, EMBASE, and CENTRAL from inception to February 2024. Randomized controlled trials (RCTs) were included if they explored the effect of H. sabdariffa on one of the following outcomes: body weight, body mass index (BMI), waist circumference, and waist-to-hip ratio. A random-effects model was used to meta-analyze the data. I was used to quantify statistical heterogeneity among the included RCTs. PROSPERO registered protocol: CRD42023408880.
RESULTS
A total of six RCTs with 339 participants were included. Four trials used H. sabdariffa extract in capsules as the intervention of interest compared to placebo, while the other two trials used H. sabdariffa tea compared to black or green tea. Our meta-analyses showed that the mean difference in weight reduction between H. sabdariffa and control was -0.27 kilograms (95% confidence interval (CI); -1.98 to 1.42, I = 0.0%). The mean differences for BMI and waist circumference reduction were -0.06 kilograms/meter (95% CI; -0.58 to 0.47, I = 0.0%) and -0.20 centimeters (95% CI; -2.06 to 1.66, I = 0.00%). No safety concerns were reported in the included studies.
CONCLUSION
Our study did not show a clinical benefit of H. sabdariffa extract in obesity treatment. However, further high-quality RCTs with a longer treatment duration and a standard dose are still warranted.
PubMed: 38878905
DOI: 10.1016/j.ctim.2024.103063 -
The International Journal of Behavioral... Jun 2024Front-of-package nutritional warning labels (WLs) are designed to facilitate identification and selection of healthier food choices. We assessed self-reported changes in...
BACKGROUND
Front-of-package nutritional warning labels (WLs) are designed to facilitate identification and selection of healthier food choices. We assessed self-reported changes in purchasing different types of unhealthy foods due to WLs in Mexico and the association between the self-reported reductions in purchases of sugary beverages and intake of water and sugar-sweetened beverages.
METHODS
Data came from 14 to 17 year old youth (n = 1,696) and adults ≥ 18 (n = 7,775) who participated in the Mexican arm of the 2020-2021 International Food Policy Study, an annual repeat cross-sectional online survey. Participants self-reported whether the WLs had influenced them to purchase less of each of nine unhealthy food categories due to WLs. Among adults, a 23-item Beverage Frequency Questionnaire was used derive past 7-day intake of water and sugary beverages analyzed to determine the relationship between self-reported reductions in purchasing sugary drinks due to the WLs. Multilevel mixed-effects logistic regression models were fitted to estimate the percentage of participants who self-reported reducing purchases within each food group, and overall. Sociodemographic characteristics associated with this reduction were investigated as well.
RESULTS
Overall, 44.8% of adults and 38.7% of youth reported buying less of unhealthy food categories due to the implementation of WL, with the largest proportion reporting decreased purchases of cola, regular and diet soda. A greater impact of WLs on the reported purchase of unhealthy foods was observed among the following socio-demographic characteristics: females, individuals who self-identified as indigenous, those who were overweight, individuals with lower educational levels, those with higher nutrition knowledge, households with children, and those with a significant role in household food purchases. In addition, adults who reported higher water intake and lower consumption of sugary beverages were more likely to report reduced purchases of sugary drinks due to the WLs. Adults who reported greater water intake and lower sugary beverages intake were significantly more likely to report buying fewer sugary drinks due to the WLs.
CONCLUSION
Our findings suggest that implementation of WLs has reduced perceived purchases of unhealthy foods in Mexico. These results underscore the potential positive impact of the labeling policy particularly in subpopulations with lower levels of education and among indigenous adults.
Topics: Humans; Adolescent; Male; Female; Mexico; Food Labeling; Adult; Self Report; Cross-Sectional Studies; Consumer Behavior; Food Preferences; Sugar-Sweetened Beverages; Young Adult; Choice Behavior; Nutrition Policy; Middle Aged; Diet, Healthy
PubMed: 38877496
DOI: 10.1186/s12966-024-01609-3 -
BMC Urology Jun 2024Indwelling urinary catheters often lead to complications such as symptomatic urinary tract infections. In nursing home residents, catheter prevalence is high, but...
BACKGROUND
Indwelling urinary catheters often lead to complications such as symptomatic urinary tract infections. In nursing home residents, catheter prevalence is high, but prevalence differences by sociodemographic characteristics, comorbidities, and health services use have rarely been investigated. The purpose of this work was to describe the use of indwelling urinary catheters in nursing home residents and to examine whether catheter use is associated with individual characteristics.
METHODS
Cross-sectional data of the "Inappropriate Medication in patients with REnal insufficiency in Nursing homes" (IMREN) study conducted in 21 German nursing homes between October 2014 and April 2015 were analyzed. For all residents of the involved care units, nurses of the participating institutions completed an anonymous questionnaire including the Modified Rankin Scale to assess physical impairments. The proportion of nursing home residents with indwelling urinary catheter was determined. Associations between catheter use and individual characteristics were investigated via cluster-adjusted multivariable logistic regression.
RESULTS
Of 852 residents (76.5% female; mean age 83.5 years), 13.4% had an indwelling urinary catheter. The adjusted odds ratios for catheter use for men vs. women was 2.86 (95% confidence interval 1.82-4.50). For residents with "moderate" disability vs. those with "no to slight" disability it was 3.27 (1.36-7.85), for individuals with "moderately severe" disability vs. the reference group it was 9.03 (3.40-23.97), and for those with "severe" disability vs. the reference group it was 26.73 (8.60-83.14). For residents who had been hospitalized within the last 12 months vs. those without a hospitalization it was 1.97 (1.01-3.87). For age, dementia, overweight/obesity, other indwelling devices, and long-term medications no significant associations were found.
CONCLUSIONS
Male nursing home residents, residents with a higher degree of physical impairment, and those who had been hospitalized within the last 12 months were more likely to use an indwelling urinary catheter than their counterparts. Data on circumstances of and indications for catheters, catheter types, and duration of catheterization are needed to evaluate the appropriateness of catheter use in nursing home residents and the need for interventions.
Topics: Humans; Cross-Sectional Studies; Nursing Homes; Male; Female; Germany; Catheters, Indwelling; Aged, 80 and over; Aged; Urinary Catheters; Urinary Catheterization
PubMed: 38877475
DOI: 10.1186/s12894-024-01512-w -
Scientific Reports Jun 2024Knee osteoarthritis (OA) and obesity are major public health concerns that are closely intertwined. This intimate relationship was documented by considering obesity as...
Knee osteoarthritis (OA) and obesity are major public health concerns that are closely intertwined. This intimate relationship was documented by considering obesity as the most significant preventable risk factor associated with knee OA. To date, however, the effects of obesity on the knee joint's passive-active structure and cartilage loading have been inconclusive. Hence, this study investigates the intricate relationship between obesity and knee OA, centering on the biomechanical changes in knee joint active and passive reactions during the stance phase of gait. Using a subject-specific musculoskeletal and finite element approach, muscle forces, ligament stresses, and articular cartilage contact stresses were analyzed among 60 individuals with different body mass indices (BMI) classified under healthy weight, overweight, and obese categories. Our predicted results showed that obesity significantly influenced knee joint mechanical reaction, increasing muscle activations, ligament loading, and articular cartilage contact stresses, particularly during key instances of the gait cycle-first and second peak loading instances. The study underscores the critical role of excessive body weight in exacerbating knee joint stress distribution and cartilage damage. Hence, the insights gained provide a valuable biomechanical perspective on the interaction between body weight and knee joint health, offering a clinical utility in assessing the risks associated with obesity and knee OA.
Topics: Humans; Knee Joint; Biomechanical Phenomena; Finite Element Analysis; Body Weight; Obesity; Osteoarthritis, Knee; Male; Gait; Female; Cartilage, Articular; Adult; Body Mass Index; Middle Aged
PubMed: 38877075
DOI: 10.1038/s41598-024-63745-x