Obesity Reviews
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Paediatric obesity, physical activity and the musculoskeletal system Summary The current epidemic of paediatric obesity is consistent with a myriad of health‐related comorbid conditions. Despite the higher prevalence of orthopaedic conditions in overweight children, a paucity of published research has considered the influence of these conditions on the ability to undertake physical activity. As physical activity participation is directly related to improvements in physical fitness, skeletal health and metabolic conditions, higher levels of physical activity are encouraged, and exercise is commonly prescribed in the treatment and management of childhood obesity. However, research has not correlated orthopaedic conditions, including the increased joint pain and discomfort that is commonly reported by overweight children, with decreases in physical activity. Research has confirmed that overweight children typically display a slower, more tentative walking pattern with increased forces to the hip, knee and ankle during ‘normal’ gait. This research, combined with anthropometric data indicating a higher prevalence of musculoskeletal malalignment in overweight children, suggests that such individuals are poorly equipped to undertake certain forms of physical activity. Concomitant increases in obesity and decreases in physical activity level strongly support the need to better understand the musculoskeletal factors associated with the performance of motor tasks by overweight and obese children.
Obesity Reviews - Tập 10 Số 5 - Trang 576-582 - 2009
Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews Summary Maternal obesity is linked with adverse outcomes for mothers and babies. To get an overview of risks related to obesity in pregnant women, a systematic review of reviews was conducted. For inclusion, reviews had to compare pregnant women of healthy weight with women with obesity, and measure a health outcome for mother and/or baby. Authors conducted full‐text screening, quality assurance using the AMSTAR tool and data extraction steps in pairs. Narrative analysis of the 22 reviews included show gestational diabetes, pre‐eclampsia, gestational hypertension, depression, instrumental and caesarean birth, and surgical site infection to be more likely to occur in pregnant women with obesity compared with women with a healthy weight. Maternal obesity is also linked to greater risk of preterm birth, large‐for‐gestational‐age babies, foetal defects, congenital anomalies and perinatal death. Furthermore, breastfeeding initiation rates are lower and there is greater risk of early breastfeeding cessation in women with obesity compared with healthy weight women. These adverse outcomes may result in longer duration of hospital stay, with concomitant resource implications. It is crucial to reduce the burden of adverse maternal and foetal/child outcomes caused by maternal obesity. Women with obesity need support to lose weight before they conceive, and to minimize their weight gain in pregnancy.
Obesity Reviews - Tập 16 Số 8 - Trang 621-638 - 2015
Associations of maternal stress with children's weight‐related behaviours: a systematic literature review Summary Low adherence to guidelines for weight‐related behaviours (e.g. dietary intake and physical activity) among US children underscores the need to better understand how parental factors may influence children's obesity risk. In addition to most often acting as primary caregiver to their children, women are also known to experience greater levels of stress than men. This study systematically reviewed associations between maternal stress and children's weight‐related behaviours. Our search returned 14 eligible articles, representing 25 unique associations of maternal stress with a distinct child weight‐related behaviour (i.e. healthy diet [n = 3], unhealthy diet [n = 6], physical activity [n = 7] and sedentary behaviour [n = 9]). Overall, findings for the relationship between maternal stress and children's weight‐related behaviours were mixed, with no evidence for an association with children's healthy or unhealthy dietary intake, but fairly consistent evidence for the association of maternal stress with children's lower physical activity and higher sedentary behaviour. Recommendations for future research include prioritizing prospective designs, identifying moderators, and use of high‐resolution, real‐time data collection techniques to elucidate potential mechanisms.
Obesity Reviews - Tập 18 Số 5 - Trang 514-525 - 2017
Obesity and addiction: neurobiological overlaps Summary Drug addiction and obesity appear to share several properties. Both can be defined as disorders in which the saliency of a specific type of reward (food or drug) becomes exaggerated relative to, and at the expense of others rewards. Both drugs and food have powerful reinforcing effects, which are in part mediated by abrupt dopamine increases in the brain reward centres. The abrupt dopamine increases, in vulnerable individuals, can override the brain's homeostatic control mechanisms. These parallels have generated interest in understanding the shared vulnerabilities between addiction and obesity. Predictably, they also engendered a heated debate. Specifically, brain imaging studies are beginning to uncover common features between these two conditions and delineate some of the overlapping brain circuits whose dysfunctions may underlie the observed deficits. The combined results suggest that both obese and drug‐addicted individuals suffer from impairments in dopaminergic pathways that regulate neuronal systems associated not only with reward sensitivity and incentive motivation, but also with conditioning, self‐control, stress reactivity and interoceptive awareness. In parallel, studies are also delineating differences between them that centre on the key role that peripheral signals involved with homeostatic control exert on food intake. Here, we focus on the shared neurobiological substrates of obesity and addiction.
Obesity Reviews - Tập 14 Số 1 - Trang 2-18 - 2013
The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta‐analysis of randomized controlled clinical trials Summary Background Dietary approaches to stop hypertension (DASH) diet is rich in foods that are proposed to be inversely associated with obesity. Therefore, DASH might better affect body weight; however, published data are conflicting. Objective To assess the effect of DASH on body weight and composition in adults. Methods PubMed, EMBASE, Scopus and Google scholar were searched up to December 2015, for relevant randomized controlled clinical trials. Mean changes in body weight, body mass index (BMI) and waist circumference (WC) were extracted. Results Thirteen articles (ten for body weight, six for BMI and two for WC) were eligible. Meta‐analysis revealed that adults on DASH diet lose more weight (weighted mean difference [WMD] = −1.42 kg, 95% confidence interval [95%CI]: −2.03, −0.82) in 8–24 weeks, BMI (WMD = −0.42 kg m−2 , 95%CI: −0.64, −0.20) in 8–52 weeks and WC (WMD = −1.05 cm, 95%CI: −1.61, −0.49) in 24 weeks compared with controls. Low caloric DASH led to even more weight reduction when compared with other low‐energy diets. In addition, the effect was greater in overweight/obese participants and when compared with typical (Western or population's usual) diets. Conclusion DASH diet is a good choice for weight management particularly for weight reduction in overweight and obese participants. © 2016 World Obesity
Obesity Reviews - Tập 17 Số 5 - Trang 442-454 - 2016
Prevalence of obesity in Denmark Summary There has been a pronounced, distinctive increase of the prevalence of obesity within almost all age groups of the Danish population, during the last 25–30 years. The largest increase has been documented in studies based on objective data from total populations and the latest data show the increase will continue. The Danish studies show heterogeneity in the development of the obesity epidemic. A close association with birth cohorts indicates a need for further aetiological research, not only into behavioural factors, but also into early life factors that may explain some of this developmental pattern.
Obesity Reviews - Tập 8 Số 3 - Trang 187-189 - 2007
Tracking of childhood overweight into adulthood: a systematic review of the literature Summary Overweight and obesity in youth are important public health concerns and are of particular interest because of possible long‐term associations with adult weight status and morbidity. The aim of this study was to systematically review the literature and update evidence concerning persistence of childhood overweight. A computerized bibliographical search – restricted to studies with a prospective or retrospective longitudinal design – was conducted. Two authors independently extracted data and assessed the methodological quality of the included studies in four dimensions (i) study population and participation rate; (ii) study attrition; (iii) data collection and (iv) data analysis. Conclusions were based on a rating system of three levels of evidence. A total of 25 publications were selected for inclusion in this review. According to a methodological quality assessment, 13 studies were considered to be of high quality. The majority of these high‐quality studies were published after 2001, indicating that recently published data, in particular, provide us with reliable information. All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obese youth. However, predictive values varied considerably. Limiting aspects with respect to generalizability and methodological issues are discussed.
Obesity Reviews - Tập 9 Số 5 - Trang 474-488 - 2008
Regulatory enzymes of mitochondrial β‐oxidation as targets for treatment of the metabolic syndrome Summary Insulin sensitizers like metformin generally act through pathways triggered by adenosine monophosphate‐activated protein kinase. Carnitine palmitoyltransferase 1 (CPT1) controls mitochondrial β‐oxidation and is inhibited by malonyl‐CoA, the product of acetyl‐CoA carboxylase (ACC). The adenosine monophosphate‐activated protein kinase‐ACC‐CPT1 axis tightly regulates mitochondrial long‐chain fatty acid oxidation. Evidence indicates that ACC2, the isoform located in close proximity to CPT1, is the major regulator of CPT1 activity. ACC2 as well as CPT1 are therefore potential targets to treat components of the metabolic syndrome such as obesity and insulin resistance. Reversible inhibitors of the liver isoform of CPT1, developed to prevent ketoacidosis and hyperglycemia, have been found to be associated with side effects like hepatic steatosis. However, stimulation of systemic CPT1 activity may be an attractive means to accelerate peripheral fatty acid oxidation and hence improve insulin sensitivity. Stimulation of CPT1 can be achieved by elimination or inhibition of ACC2 activity and through activating transcription factors like peroxisome proliferator‐activated receptors and their protein partners. The latter leads to enhanced CPT1 gene expression. Recent developments are discussed, including a recently identified CPT1 isoform, i.e. CPT1C. This protein is highly expressed in the brain and may provide a target for new tools to prevent obesity.
Obesity Reviews - Tập 11 Số 5 - Trang 380-388 - 2010
Macrophage recruitment in obese adipose tissue Summary Obesity is characterized as a chronic state of low‐grade inflammation with progressive immune cell infiltration into adipose tissues. Adipose tissue macrophages play critical roles in the establishment of the chronic inflammatory state and metabolic dysfunctions. The novel discovery that pro‐inflammatory macrophages are recruited to obese adipose tissue prompted an increased interest in the interplay between immune cells and metabolism. Since this discovery, many works have been published investigating the factors that lead to macrophage recruitment, the phenotypic change of adipose tissue macrophages, and metabolic dysfunctions. Adipokines and chemokines are key mediators that play crucial roles in crosstalk between adipocytes and macrophages and in regulating the adipose tissue inflammation. In the present review, we discuss the obesity‐mediated adipose tissue remodelling, and particularly, the role of adipokines/chemokines in macrophage recruitment to obese adipose tissue. This review provides new insights into the physiological role of these factors and identifies a potential therapeutic target for obesity and associated disorders.
Obesity Reviews - Tập 16 Số 2 - Trang 127-136 - 2015
The prevalence and trends of overweight, obesity and nutrition‐related non‐communicable diseases in the Arabian Gulf States Summary This paper reviews studies on the prevalence of overweight, obesity and related nutrition‐related non‐communicable diseases in Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and the UAE. Obesity is common among women; while men have an equal or higher overweight prevalence. Among adults, overweight plus obesity rates are especially high in Kuwait, Qatar and Saudi Arabia, and especially among 30–60 year olds (70–85% among men; 75–88% among women), with lower levels among younger and elderly adults. The rate of increase in obesity was pronounced in Saudi Arabia and Kuwait. Prevalence of obesity is high among Kuwaiti and Saudi pre‐schoolers (8–9%), while adolescent overweight and obesity are among the highest in the world, with Kuwait having the worst estimates (40–46%); however, comparison of child data is difficult because of differing standards. Among nutrition‐related non‐communicable diseases, hypertension and diabetes levels are very high and increase with age, with the UAE performing the worst because of a rapid rate of increase between 1995 and 2000. Additional monitoring of the prevalence of metabolic syndrome and cancers is necessary. Nationally representative longitudinal surveys with individual, household and community‐level information are needed to determine the importance of various factors that contribute to these troubling trends.
Obesity Reviews - Tập 12 Số 1 - Trang 1-13 - 2011
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