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Diabetes and Obesity: Recent Reviews and Findings

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 39330

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Dr. María Rosa Bernal-López

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Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, 29010 Málaga, Spain
Interests: diabetes; obesity; lifestyle modification; atherosclerosis; cardiovascular system
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ricardo Gómez-Huelgas

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Internal Medicine Department, Regional University Hospital of Málaga, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Avda. Carlos Haya s/n., 29010 Málaga, Spain
Interests: elderly; diabetes; obesity; cardiometabolic diseases

Special Issue Information

Dear Colleagues,

Obesity is considered a pandemic in developing countries. Obesity is closely related to diabetes in all diagnoses (type I, type II, gestational, early-onset diabetes in youth (MODY), etc.). The promotion of a healthy lifestyle with effective strategies for the treatment of obesity and associated diseases, such as metabolic syndrome and/or type 2 diabetes, condition an increased risk of morbidity and mortality, an important healthcare and economic burden. Weight loss improves all metabolic disorders associated with overweight and obesity.

This Special Issue reports essential reviews of the most recent findings in the last year of these pathologies and the relationship between them, establishing the current scientific knowledge of the diabetic diet, physical activity, lifestyle modification, prevention of diabetes, and diabetes treatments for obesity or weight loss.

These studies should analyze the effect of nutritional diets, physical exercise, and behavioral therapy on weight loss and maintenance of lost weight, cardiovascular risk factors in the medium term, as well as the impact of this intervention on cardiovascular morbidity and mortality in the long term.

This Issue aims to provide effective tools to help alleviate the health consequences of obesity to reduce the risk of diabetes and cardiovascular disease and to improve quality of life and increase life expectancy. All these can have a large impact at the clinical and healthcare levels, as well as economic impacts as the results are expected to contribute to improving care for patients with obesity and metabolic syndrome, including the transfer of knowledge to clinical practice.

Dr. María Rosa Bernal-López
Prof. Ricardo Gómez-Huelgas
Guest Editors

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Keywords

obesity
diabetes
nutrition
physical activity
weight loss treatment

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Published Papers (11 papers)

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Research

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10 pages, 3275 KiB

Open AccessArticle

The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia

by Suliman Alghnam, Saleh A. Alessy, Mohamed Bosaad, Sarah Alzahrani, Ibrahim I. Al Alwan, Ali Alqarni, Riyadh Alshammari, Mohammed Al Dubayee and Majid Alfadhel

Int. J. Environ. Res. Public Health 2021, 18(23), 12361; https://doi.org/10.3390/ijerph182312361 - 24 Nov 2021

Cited by 16 | Viewed by 4082

Abstract

This cross-sectional study aimed to estimate the prevalence of obesity and its association with diabetes and hypertension among beneficiaries in the National Guard Health Affairs system of Saudi Arabia. We included individuals aged 17 years and older, and patients were classified as diabetic or hypertensive if they had any visit during the 4 years where the primary diagnosis was one of those conditions or they were taking diabetes or hypertension medications. The association between obesity (body mass index ≥30) and diabetes and hypertension were evaluated using a multiple logistic regression model, adjusting for age, gender, nationality, and region. A total of 616,092 individuals were included. The majority were Saudi nationals (93.1%). Approximately 68% of the population were either obese (38.9%) or overweight (29.30%). Obesity was more prevalent among Saudi nationals (39.8% vs. 26.7%, p < 0.01) and females (45.3% vs. 31.2%, p < 0.01). Obesity was independently associated with diabetes mellitus (OR = 2.24, p < 0.01) and hypertension (OR = 2.15, p < 0.01). The prevalence of obesity in the study population was alarming and more pronounced among women. Our findings call for efforts to intensify preventive measures to reduce obesity and associated conditions. Using electronic records to examine the impact of interventions to reduce obesity and chronic conditions may help monitor and improve population health. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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15 pages, 803 KiB

Open AccessArticle

Lifestyle Modification Program on a Metabolically Healthy Elderly Population with Overweight/Obesity, Young-Old vs. Old-Old. CONSEQUENCES of COVID-19 Lockdown in This Program

by Lidia Cobos-Palacios, Mónica Muñoz-Úbeda, Maria Isabel Ruiz-Moreno, Alberto Vilches-Perez, Antonio Vargas-Candela, Javier Benítez-Porres, Ana Navarro-Sanz, Maria Dolores Lopez-Carmona, Luis Miguel Pérez-Belmonte, Jaime Sanz-Canovas, Ricardo Gomez-Huelgas and Maria Rosa Bernal-Lopez

Int. J. Environ. Res. Public Health 2021, 18(22), 11926; https://doi.org/10.3390/ijerph182211926 - 13 Nov 2021

Cited by 3 | Viewed by 2629

Abstract

The SARS-CoV-2 pandemic led to lockdowns, which affected the elderly, a high-risk group. Lockdown may lead to weight gain due to increased food intake and reduced physical activity (PA). Our study aimed to analyze the impact of a 12-month lifestyle intervention on a metabolically healthy overweight/obese elderly (MHOe) population and how the lockdown by COVID-19 affected this program. Methods: MHOe participants (65–87 years) were recruited to participate in a lifestyle modification intervention based on the Mediterranean diet (MedDiet) and regular PA. Participants were classified into two groups: young-old (<75 years) or old-old (≥75 years). Anthropometric and clinical characteristics, energy intake, and energy expenditure were analyzed at baseline and after 12 months of intervention. Results: The final sample included 158 MHOe participants of both sexes (age: 72.21 ± 5.04 years, BMI: 31.56 ± 3.82 kg/m²): 109 young-old (age: 69.26 ± 2.83 years, BMI: 32.0 ± 3.85 kg/m²) and 49 old-old (age: 78.06 ± 2.88 years, BMI: 30.67 ± 3.64 kg/m²). After 12 months of intervention and despite lockdown, the young-old group increased MedDiet adherence (+1 point), but both groups drastically decreased daily PA, especially old-old participants. Fat mass significantly declined in the total population and the young-old. Depression significantly increased (26.9% vs. 21.0%, p < 0.0001), especially in the old-old (36.7% vs. 22.0%, p < 0.0001). No significant changes were found in the glycemic or lipid profile. Conclusions: This study indicates that ongoing MedDiet intake and regular PA can be considered preventative treatment for metabolic diseases in MHOe subjects. However, mental health worsened during the study and should be addressed in elderly individuals. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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12 pages, 987 KiB

Open AccessArticle

Adiposity and Long-Term Adiposity Change Are Associated with Incident Diabetes: A Prospective Cohort Study in Southwest China

by Yun Chen, Yiying Wang, Kelin Xu, Jie Zhou, Lisha Yu, Na Wang, Tao Liu and Chaowei Fu

Int. J. Environ. Res. Public Health 2021, 18(21), 11481; https://doi.org/10.3390/ijerph182111481 - 31 Oct 2021

Cited by 5 | Viewed by 2143

Abstract

In order to estimate the associations of different adiposity indicators and long-term adiposity changes with risk of incident type 2 diabetes (T2DM), we conducted a 10-year prospective cohort study of 7441 adults in Guizhou, China, from 2010 to 2020. Adiposity was measured at baseline and follow-up. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs). A total of 764 new diabetes cases were identified over an average follow-up of 7.06 years. Adiposity indicators, body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), and long-term adiposity changes (both weight change and WC change) were significantly associated with an increased risk of T2DM (adjusted HRs: 1.16–1.48). Significant non-linear relationships were found between weight/WC change and incident T2DM. Compared with subjects with stable WC from baseline to follow-up visit, the subjects with WC gain ≥9 cm had a 1.61-fold greater risk of T2DM; those with WC loss had a 30% lower risk. Furthermore, the associations were stronger among participants aged 40 years or older, women, and Han Chinese. Preventing weight or WC gain and promoting maintenance of normal body weight or WC are important approaches for diabetes prevention, especially for the elderly, women, and Han Chinese. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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15 pages, 744 KiB

Open AccessArticle

Psychosocial and Diet-Related Lifestyle Clusters in Overweight and Obesity

by Débora Godoy-Izquierdo, Raquel Lara, Adelaida Ogallar, Alejandra Rodríguez-Tadeo, María J. Ramírez, Estefanía Navarrón and Félix Arbinaga

Int. J. Environ. Res. Public Health 2021, 18(12), 6461; https://doi.org/10.3390/ijerph18126461 - 15 Jun 2021

Cited by 3 | Viewed by 3163

Abstract

This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of 100 adult individuals (60% females) with excessive weight (69% overweight; 31% obesity) was recruited. They completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis was performed. Three distinct intraindividual psychosocial and diet-related profiles were identified: a group of healthy individuals with excess weight (46%); a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile (18%); and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles, but were troubled by their weight (36%). Furthermore, individuals in the affected cluster had higher obesity (mean BMI ± SD = 32.1 ± 3.7) than those in the clusters of healthy (28.0 ± 3.0) and dysfunctional individuals (28.1 ± 3.3) (p < 0.05). The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to the individual’s overall well-being. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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8 pages, 383 KiB

Open AccessArticle

Association of Body Composition with Type 2 Diabetes: A Retrospective Chart Review Study

by Chia-Ling Lin, Neng-Chun Yu, Hsueh-Ching Wu, Yung-Yen Lee, Wan-Chun Lin, I-Ying Chiu, Wu-Chien Chien and Yuan-Ching Liu

Int. J. Environ. Res. Public Health 2021, 18(9), 4421; https://doi.org/10.3390/ijerph18094421 - 21 Apr 2021

Cited by 13 | Viewed by 3808

Abstract

This study analyzed the body composition of individuals with type 2 diabetes (T2DM). In this retrospective chart review study, body composition was measured through multifrequency bioelectrical impedance analysis (InBody 770). Body composition assessments were conducted in individuals with T2DM, who were aged ≥18 years. The parameters included body mass index (BMI), body fat mass (BFM), fat-free mass (FFM), visceral fat area, percent body fat (PBF), appendicular skeletal muscle mass (ASM), and skeletal muscle index (SMI). One-way ANOVA and independent t-tests were used to calculate differences in body composition distribution by age and sex. A total of 2404 participants were recruited. The prevalence of overall low muscle mass and sarcopenic obesity was 28.0% and 18.7%, respectively, which increased with age. The overall prevalence of obesity when PBF was used was 71.5%, which was higher than that when BMI was applied (32.4%). The normal BMI group exhibited a prevalence of low muscle mass of 55.6% and sarcopenic obesity of 34.8%. For both men and women, bodyweight, BFM, FFM, ASM, and SMI all decreased with age. The prevalence of low muscle mass and sarcopenic obesity was high in older adults and people with normal BMI. Using BMI to assess obesity and determine insufficient muscle mass underestimates the prevalence of obesity and neglects the problems of sarcopenia and high body fat in people with normal BMI. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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Review

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13 pages, 959 KiB

Open AccessReview

Obesity, Diabetes, and Cardiovascular Risk Burden in Systemic Lupus Erythematosus: Current Approaches and Knowledge Gaps—A Rapid Scoping Review

by Halbert Hernández-Negrín, Michele Ricci, Juan José Mancebo-Sevilla, Jaime Sanz-Cánovas, Almudena López-Sampalo, Lidia Cobos-Palacios, Carlos Romero-Gómez, Iván Pérez de Pedro, María del Mar Ayala-Gutiérrez, Ricardo Gómez-Huelgas and María Rosa Bernal-López

Int. J. Environ. Res. Public Health 2022, 19(22), 14768; https://doi.org/10.3390/ijerph192214768 - 10 Nov 2022

Cited by 9 | Viewed by 2217

Abstract

Obesity, diabetes mellitus, and cardiovascular risk are real challenges in systemic lupus erythematosus (SLE) clinical practice and research. The evidence of the burden of these health problems in SLE patients is determined by the methods used to assess them. Therefore, the aim of this scoping review is to map current approaches in assessing obesity, diabetes mellitus, and cardiovascular risk burden in SLE patients and to identify existing knowledge gaps in this field. This rapid scoping review was conducted according to the Joanna Briggs Institute methodology and identified 274 articles, of which 73 were included. Most studies were conducted at European institutions and patients were recruited from specialist hospital clinics, the majority of whom were women. The burden of obesity and diabetes mellitus for SLE patients was assessed mainly in terms of prevalence, impact on disease activity, and cardiometabolic risk. The burden of cardiovascular risk was assessed using multiple approaches, mainly imaging and laboratory methods, and risk factor-based scores, although there is great heterogeneity and uncertainty between the methods used. This review highlights the importance of improving and standardizing the approach to obesity, diabetes, and cardiovascular risk in SLE patients through a holistic assessment that includes lifestyle, clinical, biological, and social aspects. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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13 pages, 609 KiB

Open AccessReview

Management of Type 2 Diabetes Mellitus in Elderly Patients with Frailty and/or Sarcopenia

by Jaime Sanz-Cánovas, Almudena López-Sampalo, Lidia Cobos-Palacios, Michele Ricci, Halbert Hernández-Negrín, Juan José Mancebo-Sevilla, Elena Álvarez-Recio, María Dolores López-Carmona, Luis Miguel Pérez-Belmonte, Ricardo Gómez-Huelgas and Maria Rosa Bernal-López

Int. J. Environ. Res. Public Health 2022, 19(14), 8677; https://doi.org/10.3390/ijerph19148677 - 16 Jul 2022

Cited by 39 | Viewed by 11699

Abstract

The life expectancy of the population is increasing worldwide due to improvements in the prevention, diagnosis, and treatment of diseases. This favors a higher prevalence of type 2 diabetes mellitus (T2DM) in the elderly. Sarcopenia and frailty are also frequently present in aging. These three entities share common mechanisms such as insulin resistance, chronic inflammation, and mitochondrial dysfunction. The coexistence of these situations worsens the prognosis of elderly patients. In this paper, we review the main measures for the prevention and management of sarcopenia and/or frailty in elderly patients with T2DM. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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19 pages, 1378 KiB

Open AccessReview

Effects of High-Intensity Interval Training on Inflammatory Biomarkers in Patients with Type 2 Diabetes. A Systematic Review

by José Manuel Leiva-Valderrama, Adrián Montes-de-Oca-Garcia, Edgardo Opazo-Diaz, Jesus G. Ponce-Gonzalez, Guadalupe Molina-Torres, Daniel Velázquez-Díaz and Alejandro Galán-Mercant

Int. J. Environ. Res. Public Health 2021, 18(23), 12644; https://doi.org/10.3390/ijerph182312644 - 30 Nov 2021

Cited by 7 | Viewed by 3687

Abstract

Background: Due to the prevalence and incidence worldwide of type 2 diabetes, and the significant role physical activity plays in these patients, a systematic review has been conducted to find out the effects that high-intensity interval training has on inflammatory biomarkers in subjects with type 2 diabetes. This project aims to determine the effect this training modality has on inflammatory biomarkers, in addition to observing its effects on the values of body composition and determining if this is a more effective, less effective or equally effective alternative to standard aerobic or resistance training. Methods: A search was conducted in the months of November and December 2020 on different databases: Pubmed, WoS and PEDro. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42021281186). The studies selected met the previously defined inclusion criteria, and the methodological quality of the papers used was evaluated according to the Downs and Black Checklist. Results: Out of 46 studies found, seven were included. The most relevant data concerning the characteristics of the clinical trials and HIIT characteristics, the values of body composition and the biomarkers under study were extracted from each study. Moreover, the results obtained from the different studies were described. Conclusions: HIIT could have an effect on inflammatory biomarkers. There is likely to be a relationship between changes in inflammatory profile and fat loss. A controlled diet may be a good complement to reduce the inflammatory profile. Further studies are required to determine whether HIIT is a better, worse or an equivalent alternative to medium-intensity aerobic exercise to improve the inflammatory profile. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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10 pages, 1023 KiB

Open AccessStudy Protocol

Weight Control Registry Using Korean Medicine: A Protocol for a Prospective Registry Study

by Jiyun Cha, Eun Kyoung Ahn, Min-Ji Kim, So-Young Jung, Ho-Seok Kim, Eunjoo Kim, Hyun-Kyung Sung, Seon Mi Shin, Won-Seok Chung, Jun-Hwan Lee and Hojun Kim

Int. J. Environ. Res. Public Health 2022, 19(21), 13903; https://doi.org/10.3390/ijerph192113903 - 26 Oct 2022

Cited by 3 | Viewed by 1854

Abstract

Lifestyle and physical characteristics affect body weight, and understanding these factors improves the precision of weight loss treatment. Many obese patients in Korea are receiving Korean medicine (KM) treatment, including herbal medicine and acupuncture, for weight loss. However, the real-world data (RWD) are insufficient in terms of being longitudinal and diverse. Weight Control Registry using KM is a prospective registry study that enrolls patients receiving KM treatment for weight loss and collects RWD from multiple clinics. The patients who are eligible for this study are aged 19–65 years, receive KM weight loss treatment, understand the study objectives, and consent voluntarily. Clinical data of patient characteristics and KM treatment patterns will be regularly collected until 2026. The longitudinal accumulation of various RWD will establish a high-quality study database for KM weight loss treatment. With this study, we expect to contribute to understanding the current trend of weight loss treatment with KM and solve further questions regarding this treatment. Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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2 pages, 269 KiB

Open AccessReply

Reply to Alsarwani, R.M. Comment on “Alghnam et al. The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia. Int. J. Environ. Res. Public Health 2021, 18, 12361”

by Suliman Alghnam, Saleh A. Alessy, Mohamed Bosaad, Sarah Alzahrani, Ibrahim Al Alwan, Ali Alqarni, Riyadh Alshammari, Mohammed Al Dubayee and Majid Alfadhel

Int. J. Environ. Res. Public Health 2022, 19(16), 9848; https://doi.org/10.3390/ijerph19169848 - 10 Aug 2022

Viewed by 1254

Abstract

We genuinely thank Dr. Alsarwani for his insights [...] Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

2 pages, 266 KiB

Open AccessComment

Comment on Alghnam et al. The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia. Int. J. Environ. Res. Public Health 2021, 18, 12361

by Rakan M. Alsarwani

Int. J. Environ. Res. Public Health 2022, 19(16), 9846; https://doi.org/10.3390/ijerph19169846 - 10 Aug 2022

Cited by 1 | Viewed by 1405

Abstract

I have read the interesting and informative paper recently published by Alghnam and colleagues that examined associations between obesity and diabetes (DM) and hypertension (HTN) [...] Full article

(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)

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