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Effects of Tai Chi or Conventional Exercise on Central Obesity in Middle-Aged and Older Adults : A Three-Group Randomized Controlled Trial.
Siu, PM, Yu, AP, Chin, EC, Yu, DS, Hui, SS, Woo, J, Fong, DY, Wei, GX, Irwin, MR
Annals of internal medicine. 2021;(8):1050-1057
Abstract
BACKGROUND Central obesity is a major manifestation of metabolic syndrome, which is a common health problem in middle-aged and older adults. OBJECTIVE To examine the therapeutic efficacy of tai chi for management of central obesity. DESIGN Randomized, controlled, assessor-blinded trial. (ClinicalTrials.gov: NCT03107741). SETTING A single research site in Hong Kong between 27 February 2016 and 28 February 2019. PARTICIPANTS Adults aged 50 years or older with central obesity. INTERVENTION 543 participants were randomly assigned in a 1:1:1 ratio to a control group with no exercise intervention (n = 181), conventional exercise consisting of aerobic exercise and strength training (EX group) (n = 181), and a tai chi group (TC group) (n = 181). Interventions lasted 12 weeks. MEASUREMENTS Outcomes were assessed at baseline, week 12, and week 38. The primary outcome was waist circumference (WC). Secondary outcomes were body weight; body mass index; high-density lipoprotein cholesterol (HDL-C), triglyceride, and fasting plasma glucose levels; blood pressure; and incidence of remission of central obesity. RESULTS The adjusted mean difference in WC from baseline to week 12 in the control group was 0.8 cm (95% CI, -4.1 to 5.7 cm). Both intervention groups showed reductions in WC relative to control (adjusted mean differences: TC group vs. control, -1.8 cm [CI, -2.3 to -1.4 cm]; P < 0.001; EX group vs. control: -1.3 cm [CI, -1.8 to -0.9 cm]; P < 0.001); both intervention groups also showed reductions in body weight (P < 0.05) and attenuation of the decrease in HDL-C level relative to the control group. The favorable changes in WC and body weight were maintained in both the TC and EX groups, whereas the beneficial effect on HDL-C was only maintained in the TC group at week 38. LIMITATIONS High attrition and no dietary intervention. CONCLUSION Tai chi is an effective approach to reduce WC in adults with central obesity aged 50 years or older. PRIMARY FUNDING SOURCE Health and Medical Research Fund.
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Visceral Adiposity Index (VAI) in Children and Adolescents with Obesity: No Association with Daily Energy Intake but Promising Tool to Identify Metabolic Syndrome (MetS).
Vizzuso, S, Del Torto, A, Dilillo, D, Calcaterra, V, Di Profio, E, Leone, A, Gilardini, L, Bertoli, S, Battezzati, A, Zuccotti, GV, et al
Nutrients. 2021;(2)
Abstract
(1) Background. Visceral adiposity index (VAI) has been recently identified as a new cardiometabolic risk marker reflecting abdominal fat distribution and dyslipidaemia. The aim of the present paper was to evaluate the relationship between VAI, daily energy intake and metabolic syndrome (MetS) in a cohort of obese Caucasian children and adolescents, aged 8 to 15 years. (2) Methods. Consecutive Italian children and adolescents with obesity, according to World Health Organization were enrolled. Anthropometric parameters and blood pressure were measured. Fasting blood samples have been analyzed for lipids, insulin and glucose levels. MetS was diagnosed using identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) or International Diabetes Federation (IDF) criteria according to age. Homeostatic model assessment index (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), A body shape index (ABSI) and VAI were calculated. Multivariable logistic regression analyses with sex, age and each anthropometric parameter (body mass index (BMI) z-score, ABSI, waist-to-height ratio (WHR)) or VAI was performed to predict MetS. Receiver operation curve (ROC) analysis was used to define the optimal VAI cut-off to identify MetS. Multiple regression was performed to predict the BMI z-score and VAI from daily energy intake after adjusting for age and sex. (3) Results. Six hundred and thirty-seven (313 boys and 324 girls) children and adolescents with obesity with median age 11 (interquartile range 10-13) years were included in the analysis. MetS was diagnosed in 79 patients. VAI correlated with BMI, WHR, ABSI, HOMA-IR, QUICKI, systolic blood pressure, low- and high-density lipoprotein cholesterol, triglycerides and triglycerides-to-HDL ratio (p < 0.050). Optimal VAI cut-off (AUC) values to identify MetS were 1.775 (0.774), 1.685 (0.776) and 1.875 (0.797) in the whole population, boys and girls, respectively. Energy intake was positively associated with BMI z-score but no association was found with VAI. (4) Conclusion. VAI is a promising tool to identify MetS in children and adolescents with obesity and should be used in the management of abdominal obesity together with dietary assessment.
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Association Between Lifestyle and Hypertriglyceridemic Waist Phenotype in the PREDIMED-Plus Study.
Fernández-García, JC, Muñoz-Garach, A, Martínez-González, MÁ, Salas-Salvado, J, Corella, D, Hernáez, Á, Romaguera, D, Vioque, J, Alonso-Gómez, ÁM, Wärnberg, J, et al
Obesity (Silver Spring, Md.). 2020;(3):537-543
Abstract
OBJECTIVE The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and high levels of triglycerides. In a cross-sectional assessment of PREDIMED-Plus trial participants at baseline, HTGW phenotype prevalence was evaluated, associated risk factors were analyzed, and the lifestyle of individuals with metabolic syndrome and HTGW was examined. METHODS A total of 6,874 individuals aged 55 to 75 with BMI ≥ 27 and < 40 kg/m2 were included and classified by presence (HTGW+ ) or absence (HTGW- ) of HTGW (waist circumference: men ≥ 102 cm, women ≥ 88 cm; fasting plasma triglycerides ≥ 150 mg/dL). Analytical parameters and lifestyle (energy intake and expenditure) were analyzed. RESULTS A total of 38.2% of the sample met HTGW+ criteria. HTGW+ individuals tended to be younger, have a greater degree of obesity, be sedentary, and be tobacco users. They had higher peripheral glucose, total cholesterol, and low-density lipoprotein cholesterol levels; had lower high-density lipoprotein cholesterol levels; and had increased prevalence of type 2 diabetes mellitus. Mediterranean diet (MedDiet) adherence and physical activity were greater in HTGW- patients. Age, BMI, tobacco use, total energy expenditure, hypertension, type 2 diabetes mellitus, and MedDiet adherence were associated with HTGW+ . CONCLUSIONS HTGW is a highly prevalent phenotype in this population associated with younger age, higher BMI, tobacco use, and decreased MedDiet adherence. HTGW- individuals were more physically active with greater total physical activity, and fewer had hypertension.
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Intra-abdominal fat accumulation is an important predictor of metabolic syndrome in young adults.
Kobayashi, M, Ogawa, S, Tayama, J, Sagara, I, Takeoka, A, Bernick, P, Kawano, T, Abiru, N, Hayashida, M, Shirabe, S
Medicine. 2020;(37):e22202
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Abstract
Metabolic syndrome (MetS), mainly caused by intra-abdominal fat (IAF) accumulation, is an important risk factor for cardiovascular disease. The prevalence of MetS increases rapidly after the age of 40 years, and it is presumed that there is a substantial proportion of MetS in younger age groups. However, the association of IAF with MetS in adults aged 20 to 30 years has not been fully investigated.This study aimed to determine the prevalence of MetS and to verify whether IAF accumulation is associated with other MetS-related metabolic disorders including dyslipidemia, high blood pressure, and high blood glucose among the Japanese population in their 20s.In this cross-sectional study, IAF area (IAFA) and MetS-related metabolic parameters were evaluated in university students in their 20s (n = 1822, 21.5 ± 1.5 years). IAFA was measured using a non-invasive device, DUALSCAN, which can be readily measured through the dual impedance method. The participants were divided into four groups according to IAFA 0-49.9, 50-74.9, 75-99.9, and ≥100 cm.MetS was prevalent in 3.3% and 0.0% of the males and females, respectively, according to the Japanese criteria of MetS. The sex- and lifestyle-adjusted odds ratios (ORs) for the three metabolic component levels of Mets were elevated in the larger IAFA groups compared to the smallest IAFA group, according to the level of IAFA. The levels particularly increased in participants with abdominal obesity, defined by both, IAFA and waist circumference rather than by waist circumference alone.IAF accumulation was significantly associated with MetS-related metabolic disorders in young adults. An evaluation of IAFA may contribute to the early prediction of the risk of developing MetS in the future.
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Prevalence of overweight, obesity and abdominal obesity in Bangladeshi university students: A cross-sectional study.
Zamsad, M, Banik, S, Ghosh, L
Diabetes & metabolic syndrome. 2019;(1):480-483
Abstract
AIM: A sustained economic growth in Bangladesh leading to nutrition transition with negative impact on health followed to sedentary lifestyle, and obesity. Therefore, the study objective was to examine the prevalence of overweight, obesity and abdominal obesity among Bangladeshi university students. MATERIALS AND METHODS This cross-sectional study in Bangladeshi university students was conducted in December 2016 to April 2017. Randomly selected participants, aged 18-25 years were analyzed from three specific universities as per gender variation. The height and waist-circumference were measured using measuring tape and weight by personal weight scale. RESULTS Total samples 500, 64.6% (n = 323) were males, 34.5% (n = 117) were females and mean age (standard deviation) was 21.76 (1.86) years. The prevalence of overweight and obesity (14.86% vs. 11.86%) were significantly 1.29-fold higher in males than females (OR: 1.29, 95%CI: 0.75-2.25, p < 0.001). Mean waist-circumference was significantly (p < 0.001) higher in males than females, but the waist-to height ratio (WHtR) was higher in females than in males (p < 0.001). CONCLUSION We conclude that the prevalence of overweight and obesity is significantly higher in male students than female university students of Bangladesh because of girls were so much concerned their physical appearance and wish a slim body than boys. However, future study and public health efforts are necessary to address complications of obesity problem and to promote active lifestyles.
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Capacity adiposity indices to identify metabolic syndrome in subjects with intermediate cardiovascular risk (MARK study).
Gomez-Marcos, MA, Gomez-Sanchez, L, Patino-Alonso, MC, Recio-Rodriguez, JI, Gomez-Sanchez, M, Rigo, F, Marti, R, Agudo-Conde, C, Maderuelo-Fernandez, JA, Ramos, R, et al
PloS one. 2019;(1):e0209992
Abstract
BACKGROUND Obesity increases mortality, and is linked to cardiovascular diseases and metabolic syndrome (MetS). Therefore, the purpose of this study was to analyze the ability of different adiposity indices to identify subjects with MetS among people with intermediate cariovascular risk. MATERIALS AND METHODS The cross-sectional study involved 2478 subjects, recruited by the MARK study. Adiposity measures: general adiposity by body mass index (BMI), central adiposity by waist-to-height ratio (WHtR), fat mass percent by the Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), percentage of body fat and of visceral adipose tissue by body roundness index (BRI) and visceral obesity and general adiposity with body shape index (ABSI). The diagnosis of MetS was made in accordance with the criteria established in the international consensus of the Joint Scientific Statement National Cholesterol Education Program III. RESULTS The highest correlation coefficients were obtained by the glycemic components (HbA1c and FPG) of the MetS and ranged from 0.155 to 0.320. The exception was ABSI, which showed lower values in the global analysis and in the males. Values of the area under the ROC curve with the adiposity indices ranged from 0.773 with the BMI in males to 0.567 with ABSI in males. In the logistic regression analysis, all adiposity factors, except ABSI, showed similar OR values of MetS after adjusting for possible confounding factors. In the global analysis, the adiposity index that showed a highest OR of MetS was CUN-BAE (OR 5.50; 95% CI 4.27-7.09). In the analysis by gender, the highest ORs were BMI in males (OR 5.98; 95% CI 4.70-7.60) and both WHtR and BRI in females (OR 4.15; 95% CI 3.09-5.58). CONCLUSION All adiposity indices, except for ABSI, show an association with MetS and similar ability to detect subjects with MetS among people with intermediate cariovascular risk.
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A posteriori healthy dietary patterns may decrease the risk of central obesity: findings from a systematic review and meta-analysis.
Rezagholizadeh, F, Djafarian, K, Khosravi, S, Shab-Bidar, S
Nutrition research (New York, N.Y.). 2017;:1-13
Abstract
Central obesity is a pivotal component of metabolic syndrome, and several studies have investigated the association of dietary patterns and central obesity. However, findings of studies are inconclusive. Therefore, we aimed to conduct the present study to summarize the available data regarding the association of a posteriori dietary patterns and central obesity in adults to test the hypothesis of whether a highly healthy dietary pattern is associated with decreased risk of central obesity. We searched all published English studies to identify related articles in MEDLINE, EMBASE, and Google Scholar databases up to December 2015. The meta-analysis was conducted on 13 studies including 12 cross-sectional studies and 1 case-control study that reported odds ratios (ORs), relative risks, or hazard ratios for risk of central obesity. The between-study variance was assessed using Cochran Q test and I2. Subgroup analysis was applied to define possible sources of heterogeneity. The highest category of healthy/prudent patterns compared with those in the lowest category resulted in significant decrease in the risk of central obesity (pooled OR was 0.81 [95% confidence interval 0.66-0.96]). Pooled results indicated a higher nonsignificant increase in the risk of central obesity (OR was 1.16 [95% confidence interval 0.96-1.35]) in the highest category of Unhealthy/Western pattern compared with those in the lowest category. There was also a significant heterogeneity in the observed associations. We found that sex, country, and continent were the potential sources of heterogeneity. The results of the present meta-analysis showed that a posteriori healthy dietary patterns may decrease the risk of central obesity, whereas no significant association was found between unhealthy dietary patterns and central obesity. Together, the results highlight the need for well-designed and carefully carried out clinical trials based on dietary patterns in future research.
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Age-related changes in basal substrate oxidation and visceral adiposity and their association with metabolic syndrome.
Siervo, M, Lara, J, Celis-Morales, C, Vacca, M, Oggioni, C, Battezzati, A, Leone, A, Tagliabue, A, Spadafranca, A, Bertoli, S
European journal of nutrition. 2016;(4):1755-67
Abstract
PURPOSE Ageing is directly associated with visceral fat (VAT) deposition and decline of metabolically active cellular mass, which may determine age-related shifts in substrate oxidation and increased cardiometabolic risk. We tested whether VAT and fasting respiratory quotient (RQ, an index of macronutrient oxidation) changed with age and if they were associated with increased risk of metabolic syndrome (MetSyn). METHODS A total of 2819 adult participants (age range: 18-81 years; men/women: 894/1925) were included; we collected history, anthropometric measures, biochemistry, smoking habits, and physical activity. The body mass index range was 18.5-60.2 kg/m(2). Gas exchanges (VO2 and VCO2) were measured by indirect calorimetry in fasting conditions, and RQ was calculated. Body composition was measured by bioelectrical impedance. Abdominal subcutaneous fat and VAT were measured by ultrasonography. MetSyn was diagnosed using harmonised international criteria. Multivariate linear and logistic regression models were utilised. RESULTS VAT increased with age in both men (r = 0.31, p < 0.001) and women (r = 0.37, p < 0.001). Basal RQ was not significantly associated with age (p = 0.49) and VAT (p = 0.20); in addition, basal RQ was not a significant predictor of MetSyn (OR 3.31, 0.57-19.08, p = 0.27). VAT was the primary predictor of MetSyn risk in a fully adjusted logistic model (OR 4.25, 3.01-5.99, p < 0.001). CONCLUSIONS Visceral adiposity remains one of the most important risk factors for cardiometabolic risk and is a significant predictor of MetSyn. Post-absorptive substrate oxidation does not appear to play a significant role in age-related changes in body composition and cardiometabolic risk, except for a correlation with triglyceride concentration.
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The Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review.
Cebron Lipovec, N, Beijers, RJ, van den Borst, B, Doehner, W, Lainscak, M, Schols, AM
COPD. 2016;(3):399-406
Abstract
Type 2 Diabetes Mellitus (T2DM) and cardiovascular diseases (CVD) are common in patients with chronic obstructive pulmonary disease (COPD). Prevention of these co-morbidities in COPD requires knowledge on their risk factors. Metabolic syndrome (MetS) predisposes to the development of T2DM and CVD but its prevalence in COPD remains unclear. The aim of this review was to assess the prevalence of MetS and its components in COPD patients compared to controls and to investigate the contribution of clinical characteristics to MetS prevalence. We systematically searched PubMed and EMBASE for original studies in COPD that have investigated the prevalence of MetS and its components. In total, 19 studies involving 4208 COPD patients were included. The pooled MetS prevalence was 34%. Compared to controls, the prevalence was higher in COPD (10 studies, 32% and 30%, p = 0.001). The three most prevalent components in both COPD and controls were arterial hypertension (56% and 51%), abdominal obesity (39% and 38%) and hyperglycemia (44% and 47%). Compared to COPD patients without MetS, those with MetS had higher body mass index (BMI) (29.9 and 24.6 kg/m(2), p < 0.001), higher forced expiratory volume in 1 second (FEV1) % predicted (54 and 51, p < 0.001) and were more frequently female (31% and 25%, p = 0.011). In conclusion, the prevalence of MetS in COPD patients is high and hypertension, abdominal obesity and hyperglycemia are the most prevalent components. Further studies are needed to evaluate the impact of lifestyle factors and medications on MetS in COPD.
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Effects of canola and high-oleic-acid canola oils on abdominal fat mass in individuals with central obesity.
Liu, X, Kris-Etherton, PM, West, SG, Lamarche, B, Jenkins, DJ, Fleming, JA, McCrea, CE, Pu, S, Couture, P, Connelly, PW, et al
Obesity (Silver Spring, Md.). 2016;(11):2261-2268
Abstract
OBJECTIVE To determine the effect of diets low in saturated fatty acids and high in monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids on body composition in participants at risk for metabolic syndrome (MetS). METHODS This study was a randomized, crossover, controlled feeding study. Participants (n = 101, ages 49.5 ± 1.2, BMI 29.4 ± 0.4 kg/m2 ) were randomized to five isocaloric diets containing treatment oils: Canola, CanolaOleic, CanolaDHA, Corn/Safflower, and Flax/Safflower. Each diet period was 4 weeks followed by a 2- to 4-week washout period. RESULTS Canola (3.1 kg, P = 0.026) and CanolaOleic oil diets (3.09 kg, P = 0.03) reduced android fat mass compared with the Flax/Saff oil diet (3.2 kg), particularly in men. The decrease in abdominal fat mass was correlated with the reduction in blood pressure after the Canola (systolic blood pressure: r = 0.26, P = 0.062; diastolic blood pressure: r = 0.38, P = 0.0049) and CanolaOleic oil diets (systolic blood pressure: r = 0.39 P = 0.004; diastolic blood pressure: r = 0.45, P = 0.0006). The decrease in abdominal fat mass also was associated with a reduction in triglyceride levels after the CanolaOleic oil diet (r = 0.42, P = 0.002). CONCLUSIONS Diets high in MUFA (compared with PUFA) reduced central obesity with an accompanying improvement in MetS risk factors. Diets high in MUFA may be beneficial for treating and perhaps preventing MetS.