1,721,100 research outputs found
Waist-to-Height Ratio Cut-Off Points for Central Obesity in Individuals with Overweight Across Different Ethnic Groups in NHANES 2011–2018
Full text linkBackground: The identification of surrogate measures of central obesity is of clinical importance, and the waist-to-height ratio (WtHR) has recently attracted great interest as an alternative method. Objective: For this reason, we aimed to establish specific WtHR cut-off points for adiposity (i.e., central obesity) in four different ethnicity groups across both sexes based on data from the National Health and Nutrition Examination Survey (NHANES) population. Methods: Of the total 23,037 participants who completed four cycles of the survey between the years 2011 and 2018, anthropometric measures (i.e., body weight, waist circumference, and height) and dual X-ray absorptiometry-derived visceral adipose tissue (DXA-derived VAT) results were available for 3566 individuals who were assessed in this cross-sectional study. Participants with an overweight status defined according to the World Health Organization (WHO) body mass index (BMI) cut-off points (25-29.9 kg/m2) were included. The sample was then categorized by adiposity according to the DXA-derived VAT tertiles (highest), and based on the receiver operating characteristic (ROC) curve analysis, the best sensitivity and specificity were attained for predicting central obesity using the WtHR. Results: The following WtHR cut-offs were identified as having the best discriminating ability for central obesity: 0.57 for White males and 0.58 for White females; 0.55 for Black males and 0.57 for Black females; 0.56 for Asian males and 0.59 for Asian females; and 0.57 for Hispanic males and 0.59 for Hispanic females. Conclusions: These new WtHR cut-off points should be utilized in adults with overweight to screen for central adiposity based on their sex and ethnicity, and obesity guidelines therefore need to be revised accordingly
Let food be the medicine, but not for coronavirus: Nutrition and food science, telling myths from facts
Full text linkThe entire globe is facing a dangerous pandemic due to the coronavirus disease (COVID-19). The medical and scientific community is trying to figure out and adopt effective strategies that can lead to (i) preventing virus expansion; (ii) identifying medications for the management of critical care and reducing rates of mortality; and (iii) finally discovering the highly anticipated vaccine. Nutritional interventions have attained considerable scientific evidence in disease prevention and treatment. The main question, “What is the role of nutrition and food science in this scenario?” requires urgent answer as many theories suggesting that specific food or dietary supplements can fight coronavirus infection have received extensive coverage in most popular social media platforms. In this editorial, we focus on some frequent statements on the role of nutrition and food science in the battle against COVID-19, distinguishing between myths and facts. We highlight that social distancing and hygiene precautions are the best practices for reducing the risk of COVID-19 transmission. We further underline the importance of nutrition in its wholistic concept, pointing out the risk of unproven dietary options that could lead individuals to weaken effective precautionary measures
Challenges and new directions in obesity management: Lifestyle modification programmes, pharmacotherapy and bariatric surgery
Full text linkObesity is a growing health problem worldwide, and it is associated with serious medical and psychosocial comorbidities, impairment of health-related quality of life (HRQoL) and an increased risk of mortality. This article aims to discuss challenges faced by health-care providers when managing patients with obesity and to highlight sustainable policies in clinical practice and future research. All health professionals dealing with obesity should consider lifestyle-modification programmes within a multidisciplinary setting as the key element of weight management. However, standardisation is needed in terms of nature, content and duration of these programmes in order to facilitate their implementation in clinical practice at different levels. Moreover, health professionals should be aware that these programmes, for patients indicating “non-response,” can be combined with recently approved anti-obesity drugs such as liraglutide, naltrexone/bupropion, lorcaserin and phentermine/topiramate, as well as with relatively less invasive bariatric surgery techniques such as Lap Band, endoscopic sleeve gastroplasty and gastric bypass. In any case, neither anti-obesity medication nor bariatric surgery should be considered as a miracle treatment in itself. At the same time, the field of obesity is still lacking in literature on some hot topics that need further investigation, including (i) a new phenotype termed sarcopenic obesity, to clarify its definition, potential health consequences and eventual treatment if necessary; (ii) issues that go beyond body weight, for instance, HRQoL that has been poorly studied in some populations affected by obesity; and (iii) the long-term effect of sleeve gastrectomy technique, which is becoming the most commonly used bariatric surgical procedure, perhaps to be studied using long-term randomised controlled trials that guarantee completeness of follow-up, in order to avoid misunderstanding and bias in interpretation of results
Body Mass Index and Body Fat in Anorexia Nervosa
No full textAnthropometry is considered one of the main methods of nutritional assessment in individuals with anorexia nervosa (AN). In this chapter, we will focus on body mass index (BMI) and total body fat (BF). We introduce the reliable and validated techniques for their assessment during underweight, weight gain and after complete weight restoration, and their changes during the course of the disease. The chapter also discusses the association/relationship between BMI and BF and the most important treatment clinical outcomes in this population: (i) relapse, remission, and/or recovery; (ii) reduction and normalization in bone mineral density (BMD); and (iii) amenorrhea, resumption of menstrual cycle, and reproductive function
Exploring the effectiveness of a 1.5-Year weight management intervention for adults with obesity
No full textBackground & aim: Obesity is a growing healthcare problem in Arabic-speaking countries although the effectiveness of the lifestyle modification program for weight management in this region is still lacking. Accordingly, this study aimed to assess long-term outcomes following an adapted lifestyle modification program based on cognitive behavioral therapy for obesity (CBT-OB) in Lebanon. Methods: Forty-five adult participants with obesity were recruited consecutively at the Outpatient Clinic of the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). Patients were offered an individualized form of CBT-OB lasting 18 months comprising two phases (a weight loss phase of 6 months and a weight-maintenance phase of 12 months). Results: Twenty-five patients completed the treatment, with a mean weight loss of −11.58% after 6 months (−11.46% in the intention-to-treat analysis) and −8.84% after 18 months (−9.51% in the intention-to-treat analysis). Weight loss was associated with improvement in Health-Related Quality of Life (HRQoL) at six-month follow-up and in glycated hemoglobin (HbA1c) and body composition patterns at 18-month follow-up. Conclusion: Our findings provide evidence supporting the use of CBT-OB for obesity as a standard in ‘real-world’ clinical setting in Lebanon. Future studies are needed on larger samples and other populations in Arab-speaking countries
Weight cycling in adults with severe obesity: A longitudinal study
No full textAim: Although weight cycling is a common phenomenon in treatment-seeking patients with obesity, its consequences on health outcomes have not yet been completely clarified. We therefore aimed to investigate the effect of one cycle of intentional weight loss and regain on energy expenditure, body composition, cardiovascular risk factors and psychosocial variables in patients with severe obesity. Methods: Clinical and psychosocial variables were measured in 38 adult patients with severe obesity (body mass index (BMI): 43.5 ± 7.2 kg/m2) consecutively readmitted to rehabilitative residential treatment (T1) for severe obesity after a cycle of weight loss (16.7 ±7.7 kg) and regain (15.1 ±11.3 kg), and compared with those recorded at a prior admission (T0). Results: No significant differences were found between T0 and T1 values for weight, BMI, waist circumference, total body fat percentage, fat-free mass percentage, respiratory quotient, measured or predicted resting energy expenditure, metabolic adaptation, cardiovascular risk factors or psychosocial variables. However, younger patients (r = −0.38, P = 0.023) and those with higher historical weight (r = 0.43, P = 0.010) tended to regain more weight. Conclusions: The absence of negative physical and psychological effects of weight cycling indicates that the risk of weight regain should not be a barrier to encouraging weight loss efforts in patients with severe obesity
Management of ischiopubic stress fracture in patients with anorexia nervosa and excessive compulsive exercising
Full text linkThis case report describes a 28-year-old non-athlete female patient with anorexia nervosa who was diagnosed with an ischiopubic ramus stress fracture and treated successfully as an inpatient with a cognitive behaviour-based therapy. The patients clinical picture, diagnosis and treatment are described, and a brief review of the relevant literature is included. The importance of this case report stems from the rarity of descriptions of this kind of injury in such patients, despite their inherent risk, and the originality of the treatment applied. This, in addition to the usual approach to medical management, exploited specific cognitive and behavioural procedures and strategies to address the patients excessive compulsive exercising, promoting rest and movement avoidance in order to allow the fracture to heal, while simultaneously addressing the underlying psychopathology
Personalized multistep cognitive behavioral therapy for obesity
Full text linkRiccardo Dalle Grave, Massimiliano Sartirana, Marwan El Ghoch, Simona Calugi Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy Abstract: Multistep cognitive behavioral therapy for obesity (CBT-OB) is a treatment that may be delivered at three levels of care (outpatient, day hospital, and residential). In a stepped-care approach, CBT-OB associates the traditional procedures of weight-loss lifestyle modification, ie, physical activity and dietary recommendations, with specific cognitive behavioral strategies that have been indicated by recent research to influence weight loss and maintenance by addressing specific cognitive processes. The treatment program as a whole is delivered in six modules. These are introduced according to the individual patient’s needs in a flexible and personalized fashion. A recent randomized controlled trial has found that 88 patients suffering from morbid obesity treated with multistep residential CBT-OB achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between months 6 and 12. The treatment has also shown promising long-term results in the management of obesity associated with binge-eating disorder. If these encouraging findings are confirmed by the two ongoing outpatient studies (one delivered individually and one in a group setting), this will provide evidence-based support for the potential of multistep CBT-OB to provide a more effective alternative to standard weight-loss lifestyle-modification programs. Keywords: obesity, cognitive behavioral therapy, lifestyle modification, weight loss, weight maintenance, outcom
Editorial: Metabolic consequences in children and adolescents with obesity: latest insights
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