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International Journal of Obesity (2005) Jan 2012While many studies have demonstrated positive associations between childhood obesity and adult metabolic risk, important questions remain as to the nature of the... (Review)
Review
BACKGROUND
While many studies have demonstrated positive associations between childhood obesity and adult metabolic risk, important questions remain as to the nature of the relationship. In particular, it is unclear whether the associations reflect the tracking of body mass index (BMI) from childhood to adulthood or an independent level of risk. This systematic review aimed to investigate the relationship between childhood obesity and a range of metabolic risk factors during adult life.
OBJECTIVE
To perform an unbiased systematic review to investigate the association between childhood BMI and risk of developing components of metabolic disease in adulthood, and whether the associations observed are independent of adult BMI.
DESIGN
Electronic databases were searched from inception until July 2010 for studies investigating the association between childhood BMI and adult metabolic risk. Two investigators independently reviewed studies for eligibility according to the inclusion/exclusion criteria, extracted the data and assessed study quality using the Newcastle-Ottawa Scale.
RESULTS
The search process identified 11 articles that fulfilled the inclusion and exclusion criteria. Although several identified weak positive associations between childhood BMI and adult total cholesterol, low-density lipo protein-cholesterol, triglyceride and insulin concentrations, these associations were ameliorated or inversed when adjusted for adult BMI or body fatness. Of the four papers that considered metabolic syndrome as an end point, none showed evidence of an independent association with childhood obesity.
CONCLUSIONS
Little evidence was found to support the view that childhood obesity is an independent risk factor for adult blood lipid status, insulin levels, metabolic syndrome or type 2 diabetes. The majority of studies failed to adjust for adult BMI and therefore the associations observed may reflect the tracking of BMI across the lifespan. Interestingly, where adult BMI was adjusted for, the data showed a weak negative association between childhood BMI and metabolic variables, with those at the lower end of the BMI range in childhood, but obese during adulthood at particular risk.
Topics: Adolescent; Adult; Age of Onset; Biomarkers; Body Mass Index; Child; Child, Preschool; Cholesterol, HDL; Cholesterol, LDL; Female; Humans; Infant; Infant, Newborn; Male; Metabolic Syndrome; Middle Aged; Obesity; Risk Factors; Triglycerides; Young Adult
PubMed: 22041985
DOI: 10.1038/ijo.2011.186 -
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 -
International Journal of Obesity (2005) Nov 2015Job strain, the most widely used indicator of work stress, is a risk factor for obesity-related disorders such as cardiovascular disease and type 2 diabetes. However,... (Meta-Analysis)
Meta-Analysis Review
Job strain, the most widely used indicator of work stress, is a risk factor for obesity-related disorders such as cardiovascular disease and type 2 diabetes. However, the extent to which job strain is related to the development of obesity itself has not been systematically evaluated. We carried out a systematic review (PubMed and Embase until May 2014) and meta-analysis of cohort studies to address this issue. Eight studies that fulfilled inclusion criteria showed no overall association between job strain and the risk of weight gain (pooled odds ratio for job strain compared with no job strain 1.04, 95% confidence interval (CI) 0.99-1.09, NTotal=18 240) or becoming obese (1.00, 95% CI 0.89-1.13, NTotal=42 222). In addition, a reduction in job strain over time was not associated with lower obesity risk (1.13, 95% CI 0.90-1.41, NTotal=6507). These longitudinal findings do not support the hypothesis that job strain is an important risk factor for obesity or a promising target for obesity prevention.
Topics: Body Mass Index; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Employment; Humans; Obesity; Occupational Diseases; Stress, Psychological; Weight Gain
PubMed: 26041697
DOI: 10.1038/ijo.2015.103 -
PLoS Neglected Tropical Diseases Feb 2018Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity.
METHODS
We performed a systematic search of relevant studies on Ovid (MEDLINE), EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI).
FINDINGS
We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73) of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity.
CONCLUSION
This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection.
Topics: Adolescent; Case-Control Studies; Child; Child, Preschool; Cohort Studies; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Male; Obesity; Odds Ratio; Prognosis; Risk Factors; Severe Dengue; Severity of Illness Index
PubMed: 29415036
DOI: 10.1371/journal.pntd.0006263 -
Nutrients Oct 2017The specific eating pattern of Binge Eating Disorder (BED) patients has provoked the assumption that BED might represent a phenotype within the obesity spectrum that is... (Review)
Review
The specific eating pattern of Binge Eating Disorder (BED) patients has provoked the assumption that BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity. Following the guidelines of the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses), we here provide a systematic update on the evidence on food-related impulsivity in obese individuals, with and without BED, as well as normal-weight individuals. We separately analyzed potential group differences in the impulsivity components of reward sensitivity and rash-spontaneous behavior. Our search resulted in twenty experimental studies with high methodological quality. The synthesis of the latest evidence consolidates conclusions drawn in our initial systematic review that BED represents a distinct phenotype within the obesity spectrum that is characterized by increased impulsivity. Rash-spontaneous behavior in general, and specifically towards food, is increased in BED, while food-specific reward sensitivity is also increased in obese individuals without BED, but potentially to a lesser degree. A major next step for research entails the investigation of sub-domains and temporal components of inhibitory control in BED and obesity. Based on the evidence of impaired inhibitory control in BED, affected patients might profit from interventions that address impulsive behavior.
Topics: Binge-Eating Disorder; Feeding Behavior; Food; Humans; Impulsive Behavior; Inhibition, Psychological; Obesity; Phenotype; Reward
PubMed: 29077027
DOI: 10.3390/nu9111170 -
Obesity Reviews : An Official Journal... Nov 2012We undertook a systematic review of studies assessing the association between socioeconomic status (SES) and measured obesity in low- and middle-income countries... (Review)
Review
We undertook a systematic review of studies assessing the association between socioeconomic status (SES) and measured obesity in low- and middle-income countries (defined by the World Bank as countries with per capita income up to US$12,275) among children, men and women. The evidence on the subject has grown significantly since an earlier influential review was published in 2004. We find that in low-income countries or in countries with low human development index (HDI), the association between SES and obesity appears to be positive for both men and women: the more affluent and/or those with higher educational attainment tend to be more likely to be obese. However, in middle-income countries or in countries with medium HDI, the association becomes largely mixed for men and mainly negative for women. This particular shift appears to occur at an even lower level of per capita income than suggested by an influential earlier review. By contrast, obesity in children appears to be predominantly a problem of the rich in low- and middle-income countries.
Topics: Adult; Child; Developing Countries; Female; Humans; Income; Male; Obesity; Social Class; Socioeconomic Factors
PubMed: 22764734
DOI: 10.1111/j.1467-789X.2012.01017.x -
Obesity and mental disorders during pregnancy and postpartum: a systematic review and meta-analysis.Obstetrics and Gynecology Apr 2014To evaluate the prevalence and risk of antenatal and postpartum mental disorders among obese and overweight women. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the prevalence and risk of antenatal and postpartum mental disorders among obese and overweight women.
DATA SOURCES
Seven databases (including MEDLINE and ClinicalTrials.gov) were searched from inception to January 7, 2013, in addition to citation tracking, hand searches, and expert recommendations.
METHODS OF STUDY SELECTION
Studies were eligible if antenatal or postpartum mental disorders were assessed with diagnostic or screening tools among women who were obese or overweight at the start of pregnancy. Of the 4,687 screened articles, 62 met the inclusion criteria for the review. The selected studies included a total of 540,373 women.
TABULATION, INTEGRATION, AND RESULTS
Unadjusted odds ratios were pooled using random-effects meta-analysis for antenatal depression (n=29), postpartum depression (n=16), and antenatal anxiety (n=10). Obese and overweight women had significantly higher odds of elevated depression symptoms than normal-weight women and higher median prevalence estimates. This was found both during pregnancy (obese odds ratio [OR] 1.43, 95% confidence interval [CI] 1.27-1.61, overweight OR 1.19, 95% CI 1.09-1.31, median prevalence: obese 33.0%, overweight 28.6%, normal-weight 22.6%) and postpartum (obese OR 1.30, 95% CI 1.20-1.42, overweight OR 1.09, 95% CI 1.05-1.13, median prevalence: obese 13.0%, overweight 11.8%, normal-weight 9.9%). Obese women also had higher odds of antenatal anxiety (OR 1.41, 95% CI 1.10-1.80). The few studies identified for postpartum anxiety (n=3), eating disorders (n=2), or serious mental illness (n=2) also suggested increased risk among obese women.
CONCLUSION
Health care providers should be aware that women who are obese when they become pregnant are more likely to experience elevated antenatal and postpartum depression symptoms than normal-weight women, with intermediate risks for overweight women.
Topics: Anxiety; Female; Humans; Mental Disorders; Obesity; Odds Ratio; Overweight; Pregnancy; Pregnancy Complications; Prevalence; Puerperal Disorders
PubMed: 24785615
DOI: 10.1097/AOG.0000000000000170 -
The Gerontologist May 2019Obesity is increasing among people residing in nursing homes, and resident obesity substantially affects services needed, equipment and facilities provided, and...
BACKGROUND AND OBJECTIVES
Obesity is increasing among people residing in nursing homes, and resident obesity substantially affects services needed, equipment and facilities provided, and morbidity in this setting. The purpose of this article is to describe the scope and depth of evidence regarding the impact of obesity among nursing home residents in the United States.
RESEARCH DESIGN AND METHODS
A systematic literature review was performed in PubMed, EMBASE, CINAHL, and Web of Science databases as well as additional hand-searched documents. Included articles were published from 1997 to March 2017. The characteristics and content of the included articles were systematically reviewed and reported.
RESULTS
Twenty-eight studies met inclusion criteria for review. The median study size was 636 residents (interquartile range 40-11,248); 18 (64%) studies were retrospective and 10 (36%) were prospective in nature. Ten (36%) studies examined medical and functional morbidity, 10 (36%) examined health system effects, and 5 (18%) examined the risk of admission to nursing homes. Most studies found that obesity poses serious issues to resident health and the provision of health care, as well as broad health system and nursing challenges in the provision of high-quality nursing home care and services.
DISCUSSION AND IMPLICATIONS
Although obesity affects about one in four nursing home residents in the United States, relatively limited evidence exists on the complex challenges of obesity for their residents and their care. A continued focus on resident quality of life, health system improvement, and nursing best practices for properly caring for individuals with obesity is needed.
Topics: Humans; Nursing Homes; Obesity; United States
PubMed: 29253135
DOI: 10.1093/geront/gnx128 -
The Cochrane Database of Systematic... Feb 2014Obesity is a global public health threat. The transtheoretical stages of change (TTM SOC) model has long been considered a useful interventional approach in lifestyle... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obesity is a global public health threat. The transtheoretical stages of change (TTM SOC) model has long been considered a useful interventional approach in lifestyle modification programmes, but its effectiveness in producing sustainable weight loss in overweight and obese individuals has been found to vary considerably.
OBJECTIVES
To assess the effectiveness of dietary intervention or physical activity interventions, or both, and other interventions based on the transtheoretical model (TTM) stages of change (SOC) to produce sustainable (one year and longer) weight loss in overweight and obese adults.
SEARCH METHODS
Studies were obtained from searches of multiple electronic bibliographic databases. We searched The Cochrane Library, MEDLINE, EMBASE and PsycINFO. The date of the last search, for all databases, was 17 December 2013.
SELECTION CRITERIA
Trials were included if they fulfilled the criteria of randomised controlled clinical trials (RCTs) using the TTM SOC as a model, that is a theoretical framework or guideline in designing lifestyle modification strategies, mainly dietary and physical activity interventions, versus a comparison intervention of usual care; one of the outcome measures of the study was weight loss, measured as change in weight or body mass index (BMI); participants were overweight or obese adults only; and the intervention was delivered by healthcare professionals or trained lay people at the hospital and community level, including at home.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted the data, assessed studies for risk of bias and evaluated overall study quality according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). We resolved disagreements by discussion or consultation with a third party. A narrative, descriptive analysis was conducted for the systematic review.
MAIN RESULTS
A total of three studies met the inclusion criteria, allocating 2971 participants to the intervention and control groups. The total number of participants randomised to the intervention groups was 1467, whilst 1504 were randomised to the control groups. The length of intervention was 9, 12 and 24 months in the different trials. The use of TTM SOC in combination with diet or physical activity, or both, and other interventions in the included studies produced inconclusive evidence that TTM SOC interventions led to sustained weight loss (the mean difference between intervention and control groups varied from 2.1 kg to 0.2 kg at 24 months; 2971 participants; 3 trials; low quality evidence). Following application of TTM SOC there were improvements in physical activity and dietary habits, such as increased exercise duration and frequency, reduced dietary fat intake and increased fruit and vegetable consumption (very low quality evidence). Weight gain was reported as an adverse event in one of the included trials. None of the trials reported health-related quality of life, morbidity, or economic costs as outcomes. The small number of studies and their variable methodological quality limit the applicability of the findings to clinical practice. The main limitations include inadequate reporting of outcomes and the methods for allocation, randomisation and blinding; extensive use of self-reported measures to estimate the effects of interventions on a number of outcomes, including weight loss, dietary consumption and physical activity levels; and insufficient assessment of sustainability due to lack of post-intervention assessments.
AUTHORS' CONCLUSIONS
The evidence to support the use of TTM SOC in weight loss interventions is limited by risk of bias and imprecision, not allowing firm conclusions to be drawn. When combined with diet or physical activity, or both, and other interventions we found very low quality evidence that it might lead to better dietary and physical activity habits. This systematic review highlights the need for well-designed RCTs that apply the principles of the TTM SOC appropriately to produce conclusive evidence about the effect of TTM SOC lifestyle interventions on weight loss and other health outcomes.
Topics: Adult; Diet, Reducing; Exercise; Health Behavior; Humans; Models, Psychological; Obesity; Overweight; Randomized Controlled Trials as Topic; Weight Loss
PubMed: 24500864
DOI: 10.1002/14651858.CD008066.pub3 -
Journal of Traditional Chinese Medicine... Dec 2022To systematically review and analyze the effect of acupuncture and acupoint catgut embedding in treatment of abdominal obesity to provide a more reasonable clinical... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review and analyze the effect of acupuncture and acupoint catgut embedding in treatment of abdominal obesity to provide a more reasonable clinical treatment regimen.
METHODS
Ten databases were searched as of August 2022: the English databases PubMed, Embase, Cochrane Library, Web of Science, Wiley, and Scopus and the Chinese databases China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang, and SinoMed/Chinese Biomedical Literature Database. Randomized controlled trials (RCTs) of acupuncture and acupoint catgut embedding as the main interventions to treat abdominal obesity were extracted. The investigators imported the citations into EndNote version X9.1 for deduplication, screening, extraction, and integration. The risk of bias in the included RCTs was assessed according to the Cochrane Handbook. RevMan 5.4 software was used to conduct a Meta-analysis of RCTs that met the inclusion criteria.
RESULTS
Thirteen RCTs (1069 patients) were included in this study, and the data of eleven RCTs (966 patients) were include in the Meta-analysis. The results showed that acupoint catgut embedding can significantly change the weight and waist circumference of patients with abdominal obesity when compared to sham acupuncture or no treatment [mean difference () = 2.32, 95% confidence interval () (1.88, 2.76), < 0.000 01], [ = 3.47, 95% (1.99, 4.94), < 0.000 01]. The change in hip circumference after acupuncture was also significant [ = 0.89, 95% (0.12, 1.66), = 0.02].
CONCLUSION
This study found that acupuncture and acupoint catgut embedding can effectively treat abdominal obesity, therefore, these interventions can be used as clinical supplements and alternative therapies. The diagnostic criteria of the existing studies and the intervention measures of the control group are not unified. It will be necessary to improve the clinical study protocols and expand the sample size to further validate the reliability of the results obtained of this study.
Topics: Humans; Catgut; Acupuncture Points; Obesity, Abdominal; Acupuncture Therapy; Obesity
PubMed: 36378041
DOI: 10.19852/j.cnki.jtcm.2022.06.002