Obesities, Volume 4, Issue 3 (September 2024) – 14 articles

Obesity is a growing epidemic that threatens to deplete healthcare resources by increasing the prevalence of diabetes, heart disease, high blood pressure, cancer, and chronic kidney disease. The prevalence of general and central obesity among the rural Black population in Limpopo Province is high; however, few studies have evaluated the association between obesity and its comorbidities among the rural Black population, and, hence, this study aims to determine the relationship between obesity and associated comorbidities. This study was cross-sectional and retrospective in design, using secondary data from the Africa Wits-INDEPTH Partnership for Genomic (AWI-Gen) research phase 1 study. A sample size of 791 participants was collected conveniently. Data were analysed using the Statistical Package for Social Sciences version 27 (SPSS). A chi-square, unpaired Student’s t-test, bivariate and partial correlation, and multivariate regression analysis were used for analysis. General obesity correlated positively and significantly with LDL-C/HDL-C ratio and hypertension, while central obesity correlated positively and significantly with diabetes, hypertension, chronic kidney disease, LDL-C/HDL-C ratio, and TC/HDL-C ratio. In the present study, obese participants were more likely to be hypertensive, and have an increased LDL-C/HDL-C ratio. Centrally obese participants were more likely to be diabetic, hypertensive, have dyslipidaemia, and exhibit reduced kidney function. Full article

This study analyzed changes in ultra-processed food consumption patterns during weekends in patients in the post-metabolic and bariatric surgery periods. It is a cross-sectional study, which recruited and collected data via social media from adults who underwent metabolic and bariatric surgery. The Brazil Food and Nutritional Surveillance System markers of dietary consumption and the NOVA Ultra-Processed Food Screening tools were applied to evaluate dietary patterns and ultra-processed food consumption from the previous day. A total of 1525 participants were included, with a mean age of 38 ± 8 years and a mean body mass index of 29.9 ± 5.8 kg/m². From these, 766 (50.3%) individuals answered the questionnaire referring to a weekend day. After adjusting for confounders, ultra-processed food consumption was higher on weekends compared to weekdays (NOVA Score 3.07 vs. 2.42; p < 0.01). The consumption of fruits and vegetables was lower on weekends, whereas the consumption of hamburgers/sausages, sugar-sweetened beverages, boxed/canned juice, and frozen pizza increased on weekends. Instant noodles and sandwich cookies did not show differences between weekdays and weekend days. This pattern suggests the need to monitor eating habits on weekends in individuals after metabolic and bariatric surgery. Full article

(1) Background: We aimed to associate the degree of food processing with blood pressure levels in adult women. (2) Methods: A cross-sectional study was carried out on 85 adult women. The participants were subdivided into three groups: normal weight (NW: 27.05%), overweight (OW: 34.1%) and obesity (OB: 38.8%). Their anthropometric parameters, food consumption and blood pressure (BP) were evaluated. The groups were compared using one-way ANOVA or the Kruskal–Wallis test, and correlations were established using Spearman’s correlation, partial correlations (adjusted for age, medications and pathologies) and simple linear regression. Significance was set at p < 0.05. (3) Results: Women with obesity had higher systolic and diastolic blood pressure (SBP = NW: 106.5 ± 11.6; OW: 111.60 ± 11.8; OB: 123.63 ± 14.0; p < 0.001 and DBP = NW: 66.5 ± 9.9; OW: 70.2 ± 8.7; OB: 80.6 ± 11.0; p < 0.001) and a lower consumption of unprocessed or minimally processed food (MPF) (NW: 0.25 ± 0.1; OW: 0.27 ± 0.09; OB: 0.21 ± 0.07; p = 0.027). Moreover, we found an inverse association among the consumption of MPF and diastolic blood pressure that remained after adjustments for covariates (r: −0.27; p = 0.01), suggesting that lower consumption of MPF is related to higher levels of DBP. (4) Conclusions: Our data suggest that women with obesity seem to have a lower consumption of MPF. In addition, MPF is negatively correlated with BP, suggesting an association with obesity and cardiovascular health. Full article

The aim of this study is to assess the effectiveness of swimming training in reducing body mass index (BMI) and body fat percentage among individuals with Down syndrome (DS), utilizing a meta-analysis approach. We conducted a systematic search for studies examining the clinical impact of swimming training on individuals with DS. Inclusion criteria encompassed studies involving DS patients who underwent swimming training for a minimum duration of 4 weeks. The primary focus was to compare changes in BMI and body fat percentage from baseline to post-training. Our analysis incorporated four studies comprising a total of 48 participants. The results demonstrated that swimming training lasting from 8 to 36 weeks did not significantly decrease BMI among DS patients, with a weighted mean difference (WMD) post-training of −0.428 (95% confidence interval (CI): −1.721–0.865) and an I² of 0%. Subgroup analysis based on age or duration (≥33 weeks or 8 weeks) also showed no notable decrease in BMI. Conversely, the analysis of body fat percentage demonstrated a significant decrease, with a WMD of −2.946 (95% CI: −5.056–−0.837). Subgroup analysis indicated a consistent reduction in body fat percentage across all duration groups. Swimming training does not lead to a significant reduction in BMI among individuals with DS. This outcome may be attributed to concurrent muscle gain alongside decreased body fat, resulting in a notable decrease in body fat percentage. Full article

Weight stigma is described as prejudice and discrimination concerning body weight. People stigmatized by their body weight report worse physical and mental health and, consequently, poor psychosocial functioning. Research has shown a high prevalence of weight stigma among health professionals. However, less is known about weight stigma among healthcare undergraduate students. In this vignette study, we assessed weight stigma in 217 healthcare students, who filled sociodemographic and weight stigma measures, and read one of three vignettes at random, each one with a hypothetical patient which differs only in terms of body weight (underweight, healthy weight, and overweight). Then, participants answered ten questions/statements about patient characteristics described in the vignette to assess the influence of body weight on stigmatizing beliefs. Weight stigma was found in 39.44% of healthcare students. Moreover, weight stigma was higher among men, healthy weight people, and Physical Therapy students. This experimental study showed more negative attitudes in participants exposed to the patient with overweight and underweight vignettes compared to those exposed to the healthy weight patient vignette. Due to the known impacts of weight stigma, efforts are needed to address this issue during the training of healthcare undergraduate students. Full article

(1) Background: Few studies focus on the development of obesity as a chronic disease as opposed to an acute condition. The “general purpose” C3H/HeJ (C3H) mouse strain is an alternative model for obesity development with regards to sex disparities and non-predisposed populations over time. (2) Methods: In this study, 64 female and 64 male C3H mice were separated into two groups (n = 32) and maintained on a control or high-fat diet (HFD) for up to 18 months. At 6-month intervals, a cross-sectional cohort (n = ~8) was censored for evaluation. The mice were monitored for change in total, lean and fat mass, survivability, and tumor incidence. (3) Results: Both sexes in the C3H mouse strain developed diet-induced obesity (DIO). An increase in total mass consistent with a HF diet was observed in both female and male C3H mice. Survivorship at 18 months was the highest in the HF-diet-fed males (~62%) and lowest in the males fed the control diet (~19%). Females showed survivability at ~40%, regardless of diet. Cancer development increased more notably in the males with the HF diet and showed sex bias for liver cancer (males) and ovarian cancer (females) incidence with age. (4) Conclusions: This study establishes a baseline for future use of C3H mice as a strong model for studying obesity as a chronic disease, in both sexes, and as long-term model for age-related diet-induced obesity and cancer development. Full article

Silybum marianum (L.) Gaertn, commonly known as milk thistle, is an herbal medicine rich in silymarin, a bioflavonoid complex. Historically, silymarin was used for treating liver diseases, but recent studies highlight silymarin’s potential for obesity management. This narrative review aims to provide an in-depth examination of the existing knowledge of Silybum marianum (L.) and its secondary compounds concerning obesity and associated comorbidities, summarizing data from in vitro, preclinical, and clinical studies. Obesity is a significant public health issue, exacerbated during the COVID-19 pandemic, as a major risk factor for mortality. It contributes to metabolic dysfunction, including oxidative stress, metainflammation, cardiovascular diseases, and type 2 diabetes development. Silymarin has demonstrated benefits on insulin signaling and lipid metabolism, as well as antioxidant and anti-inflammatory properties at the molecular level. Innovative studies also suggest silymarin’s potential as a prebiotic, positively influencing gut microbiota composition, a key factor affected by obesity. These promising findings support the potential anti-obesity action of silymarin in clinical practice. Looking forward, using silymarin as an innovative complementary therapy could offer substantial benefits for natural health promotion and obesity management. Nevertheless, further research into optimal doses and cellular mechanisms is still needed. Full article

Introduction: Over the past 40 years, there has been a significant increase in the global prevalence of childhood obesity, which is associated with an increased risk of heart problems and the earlier onset of heart diseases. Objective: The aim of this research is to assess the prevalence of obesity and its risk factors in children and adolescents among students from the second and third cycle and secondary education of a school grouping in the interior of Portugal. Materials and Methods: The sample was collected from a school grouping in Alcains, among attending students from the fifth to the twelfth grade. The sample consisted of a total of 156 students aged between 10 and 18 years. A questionnaire was proposed, and blood pressure measurement and lipid profile evaluation were performed for each individual. The collection and statistical treatment of data for this study required a submission and authorization request to the Ethics Committee of the Polytechnic Institute of Castelo Branco, followed by authorization from the school group’s administration. Results: The percentage of elevated BMI was 30.8%, and was higher in males. A higher prevalence of hypertension (37.8%), elevated triglyceride levels in students who did not exercise outside of school, and in individuals who consumed larger amounts of meat, who also showed a higher prevalence of lower-than-expected high-density lipoprotein (HDL) cholesterol levels, were observed. Discussion: A high percentage of elevated BMI, high blood pressure levels, and changes in lipid profile were observed among high school students in this school in the interior of Portugal, as has been observed in other studies. Conclusions: It is essential to conduct more studies, screenings, and investigations that can identify these cases early, in order to mitigate risk factors. Full article

Start Strong, a 4-week culinary nutrition education and obesity prevention program designed for rural family care providers in low-income areas of Minnesota, was initially an in-person training program and was recently adapted into a virtual version. Using a quasi-experimental design, this study examined within-group and between-group (in-person versus virtual) changes in culinary skill confidence and familiarity with food assistance programs after Start Strong participation. Additionally, we examined post-program participant experiences. The in-person program (n = 12, mean age of 45 years, September 2019) took place at community locations. The virtual program (n = 27, mean age of 41 years, Fall 2021–Winter 2022) used online learning and videoconferencing. Following data collection pre- and post-program, we used t-tests to examine within-group changes after Start Strong participation, repeated measures analysis of variance tests to compare outcomes between the in-person and virtual implementations, and Fisher’s exact test to compare post-survey outcomes. The in-person and virtual programs demonstrated similar improvements in cooking skill confidence and familiarity with food assistance programs. Compared to the virtual program, in-person participants reported significantly greater connection with other providers. This evaluation is relevant to addressing disparities in obesity prevention and provides an initial model for public health and community partnerships with ECE providers. Full article

Quality glucose-like peptide-1 receptor agonist (GLP-1 RA)-supported digital weight-loss services (DWLSs) have the potential to play a significant role in shifting the alarming global obesity rate. Previous studies have demonstrated various aspects of their utility in Australian and British populations, but nothing has hitherto been investigated in real-world European settings, where GLP-1 RA weight therapy and digital healthcare are widely used. This study retrospectively analysed the 5-month (Mean = 160.14 days) weight-loss outcomes in a cohort of patients who received email-based health coaching and Semaglutide therapy via the Juniper Germany DWLS (n = 833). Mean weight loss was 9.52 (±5.46) percent, with 81.51% of the cohort losing a ‘meaningful’ (5% or more) amount of weight. Females (Mean = 9.75) tended to lose more weight than males (Mean = 8.41) and patients from the lowest two BMI categories (27.5–29.99 kg/m² Mean = 10.1; 30–34.99 kg/m² Mean = 9.74) lost significantly more weight than those in the highest BMI category (≥40 kg/m² Mean = 8.11). These findings indicate that GLP-1 RA-supported DWLSs can contribute to meaningful weight loss in Germany. Future research should seek to conduct a dedicated adherence analysis of the Juniper Germany DWLS and measure the effect of subsidisation and baseline body mass index on general DWLS effectiveness. Full article

Obesity has emerged as a major public health challenge in the 21st century, contributing to the rising prevalence of metabolic syndrome (MetS), a cluster of interrelated health risk factors. These factors include obesity or abdominal obesity, type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidaemia. In this review, we will explore important aspects of metabolic regulation and the dynamics of lipoprotein metabolism to see how they underlie each of these major health risks. Additionally, we will highlight the role of ferroptosis, an iron-dependent regulated cell death process, in relation to inflammatory responses and its critical contribution to the pathophysiology of MetS. These inflammatory responses include inflammasome activation, lipotoxicity, the influence of adipocytokines, and the role of adipose tissue macrophages. By exploring these interconnections, this review aims to provide insights into metabolic crosstalk, outline the pathological mechanisms occurring, and identify potential therapeutic targets for managing and preventing the progression of these health risk factors. Full article

The consumption of ultra-processed foods is associated with abdominal obesity, but this association has not yet been investigated in individuals on hemodialysis. This cross-sectional study, developed with 1014 individuals, aimed to analyze the prevalence of abdominal obesity and its association with the consumption of ultra-processed foods in individuals on hemodialysis in Brazil. The consumption of ultra-processed foods was measured using a questionnaire, whose list of foods was based on the Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases through Telephone Enquiry. Waist circumference was used to determine the presence of abdominal obesity. The difference in proportions between the independent variables and the outcome was verified using Pearson’s chi-square test. Hierarchical logistic regression was used to determine the association between the outcome and the independent variables. The prevalence of abdominal obesity was 77.22%. In the final model, higher levels of consumption of ultra-processed foods, being male and an adult, having between 8 and 11 years of schooling, and practicing physical activity below the recommended level increased the chances of having abdominal obesity. This research provides a basis for the creation and improvement of public policies that promote improvements in these health determinants. Full article

Background: The increase in the prevalence of obesity in South Africa is a problem, and weight management plays an important role in the treatment of the high prevalence. For this purpose, a quantitative study was carried out using a structured questionnaire to assess the predictors of attempts and failures to lose weight. Methods: One thousand and fifty adults were enrolled in the study, and 54% (n = 562) were overweight and obese (BMI ≥ 25 kg/m²). Descriptive statistics were analysed. Inferential statistical tests (chi-square tests, logistic regression, and Pearson’s correlation coefficients) were used to determine the relationship between variables. Results: The results revealed that age, sex, marital status, educational level, employment status, income level, area of residence, ethnic groups, and self-perceived BMI (normal weight, overweight, and obese) were predictors of the attempt and failure to lose weight (p < 0.05). There was a positive correlation between self-perceived BMI and the attempt and failure to lose weight, r = 0.2015 (p < 0.0001). Conclusion: Weight management is important in the realm of public health and can be regarded as an investment in the population, as it leads people toward weight control strategies grounded in empirical evidence. In addition, the findings can inform public health policies and interventions to improve weight management strategies at the population level. Full article

The aim of this study was to analyze the factors associated with overweight and obesity in a sample of university students. This was a quantitative, cross-sectional analytical observational study conducted with undergraduate students at the main campus of the Federal University of Acre. The study included a total of 655 students, 58.3% being female and 41.7% male. The overweight was 48.9%, with higher rates among males (53.8%), those aged 30 years and older (76.6%), and those from families with incomes above three minimum wages (57.2%). Obesity was present in 18.2% of students, with higher rates among females (18.8%), those aged 30 years and older (34.2%), and 19.1% among those from families with incomes above three minimum wages. The age group of 30 years and older; non-utilization of the university restaurant; being female; and self-rated health as regular, poor, or very poor emerged as associated factors with overweight in university students in the adjusted final model. The same association pattern for obesity was observed, except for the variable of gender. The findings of this study point to a higher prevalence of overweight and obesity among older university students, those who reported unfavorable self-rated health, and those who reported not consuming meals offered at the UR. Full article