Impact of excessive pregnancy weight gain on pregnancy outcomes and neonatal conditions in pre-pregnancy overweight and obese women / 上海预防医学

ObjectiveTo explore the influence of excessive weight gain during pregnancy in pre-pregnancy overweight and obese women on pregnancy outcomes and neonatal conditions， and to provide scientific evidence for formulating weight management strategies before and during pregnancy and prevent adverse pregnancy outcomes. MethodsClinical data of 2 172 parturients collected from a community in Huangpu District from 2017 to 2021 were retrospectively analyzed， and they were divided into pre-pregnancy overweight and obesity group （n=530）， normal pre-pregnancy weight group（n=937）， and underweight pre-pregnancy group（n=705） according to maternal precursor body mass index （BMI）. Based on their weight gain during pregnancy，the parturient were divided into moderate gestational weight gain （MGWG） group and excessive gestational weight gain （EGWG） group. Meanwhile， the pregnancy and neonatal outcomes such as postpartum hemorrhage， puerperal infection， placental abruption， premature rupture of membranes， mode of delivery， premature birth， stillbirth， fetal distress， admission to the intensive care unit （ICU）， macrosomia， and Apgar score， were recorded. Then the differences in pregnancy and neonatal outcomes between groups were compared. The effects of pre-pregnancy BMI and gestational weight gain on pregnancy outcomes and neonatal conditions was retrospectively analyzed. ResultsThe pre-pregnancy overweight and obese group had higher proportions of placental abruption， premature rupture of membranes， cesarean section， premature birth， fetal distress， and macrosomia compared to the normal pre-pregnancy weight group and the underweight pre-pregnancy group， with Apgar scores lower than the normal pre-pregnancy weight group and the underweight pre-pregnancy group （all P<0.05）. The EGWG group had higher proportions of postpartum hemorrhage， placental abruption， premature rupture of membranes， cesarean section， premature birth， fetal distress， admission to the ICU， and macrosomia than the MGWG group （all P<0.05）. In the pre-pregnancy overweight and obese group， the EGWG group had higher proportions of placental abruption， premature rupture of membranes， premature birth， fetal distress， admission to the ICU， and macrosomia than the MGWG group， with lower Apgar scores than the MGWG group （all P<0.05）. In the normal pre-pregnancy weight group， the EGWG group had higher proportions of placental abruption， premature rupture of membranes， premature birth， fetal distress， admission to the ICU， and macrosomia than the MGWG group （all P<0.05）. In the pre-pregnancy overweight and obese group， the EGWG group had higher proportions of premature rupture of membranes， cesarean section， premature birth， fetal distress， and macrosomia than the EGWG group in the normal pre-pregnancy weight group（all P<0.05）. Logistic regression analysis showed that EGWG in pre-pregnancy overweight and obese women was a risk factor for placental abruption （OR=2.971， 95%CI： 1.098‒8.042）， premature rupture of membranes （OR=4.662， 95%CI： 2.798‒7.770）， cesarean delivery （OR=1.375，95%CI： 1.260‒2.541）， premature birth （OR=4.249， 95%CI： 2.384‒7.573）， fetal distress （OR=3.238， 95%CI： 1.589‒6.598）， admission to the ICU （OR=3.010， 95%CI： 1.265‒7.164）， and macrosomia （OR=5.437， 95%CI： 3.392‒8.716） （all P<0.05）. ConclusionExcessive gestational weight gain in pre-pregnancy overweight and obese women is a risk factors for placental abruption， premature rupture of membranes， cesarean section， premature birth， fetal distress， admission to the ICU， and macrosomia.

Prediction and evaluation of nomogram model on risk of hyperuricemia in overweight and obese children and adolescents / 重庆医学

Objective To establish a nomogram prediction model of hyperuricemia(HUA)onset risk in overweight and obese children and adolescents in order to provide reference for the prevention and treatment of HUA in this population.Methods The clinical data of 1 410 overweight and obese children and adolescents aged 6-17 years old visiting in this hospital from September 2021 to August 2022 were retrospectively analyzed.A total of 987 overweight and obese children and adolescents were randomly extracted according to a ratio of 7:3 to establish the model,and the remaining 423 cases were validated internally.Referring to the definition of high uric acid in"Zhu-futang Practical Pediatrics",the subjects were divided into high uric acid group and non-high uric acid group.The logis-tic regression analysis was used to analyze the influencing factors of HUA in overweight and obese children and adoles-cents.The nomogram model was constructed by using the R language.The area under the receiver operating character-istic(ROC)curve(AUC),decision analysis curve(DIC),clinical impact curve(CIC)and C-index were used to evalu-ate the predictive ability of the model,and the Bootstrap repeated sampling method(taking samples for 1000 times)was used for internal validation of the model.Results The results of multivariate analysis showed that the age(OR=2.324,95％CI:1.155-4.672,P=0.018),gender(OR=0.456,95％CI:0.256-0.810,P=0.007),triglycerides(OR=3.775,95％CI:2.321-6.138,P＜0.001),blood calcium(OR=26.986,95％CI:3.186-228.589,P=0.003)and blood creatinine(OR=1.047,95％CI:1.026-1.070,P＜0.001)were the influen-cing factors of HUA in overweight and obese children and adolescents.AUC of the ROC curve of the model was 0.840,the sensitivity was 0.786,the specificity was 0.762,the Youden index was 0.548,and the C-index was 0.840.The risk probability of DC A was 0.1-0.8,the net benefit rate of both models was＞0,AUC of ROC curve in the internal verification was 0.871.Conclusion The constructed nomogram in this study has a good predictive efficiency for the onset risk of HUA in overweight and obese children and adolescents,and may provide reference for the early diagnosis and treatment of this population.

A case-control study on gut microbiota diversity and species composition in obese/overweight children aged 2-6 years in Shanghai / 环境与职业医学

Background Multiple studies have shown a close relationship between changes in gut microbiota composition and obesity, and research results are influenced by factors such as race and geographical location, but there are few studies on children. Objective To analyze the diversity of gut microbiota related to obesity in a population of 2-6 years old, observe the distribution characteristics and species differences of gut microbiota between obese/overweight and normal weight groups, and explore the association betweenobese/overweight and gut microbiota diversity. Methods Fecal samples were collected from 74 children aged 2-6 years in Shanghai, including 18 obese/overweight individuals, 6 males and 12 females (male to female ratio of 1∶2), and 56 normal weight individuals, 18 males and 38 females (male to female ratio is nearly 1∶2). The 16S rDNA was extracted from bacteria in fecal samples, followed by PCR amplification, cDNA construction, and high-throughput sequencing. Naive Bayes algorithm was used to perform taxonomic analysis (phylum, class, order, family, genus, species) and community diversity analysis (Sobs index, Shannon index, Shannoneven index, Coverage index, PD index, and principal co-ordinates analysis) on representative sequences and abundance of amplicon sequence variants (ASV). Wilcoxon rank sum test, P-value multiple test correction, and analysis of similarities were used to test differences between the two groups to obtain information on the distribution characteristics and species differences of intestinal microbiota in children. Results Seventy-four fecal samples were sequenced, and the sequencing results were subjected to quality control and filtering. A total of 4905306 optimized sequences were obtained, resulting in 1860 ASVs. The diversity data analysis of ASVs generated 889 species annotation results at 8 taxonomic levels. The alpha diversity analysis showed that the richness (Sobs index), diversity (Shannon index), evenness (Shannoneven index), and phylogenetic diversity (PD index) of fecal community of the obese/overweight children were increased compared to those of the normal weight children, but there were no statistical differences between the two groups (P>0.05). The beta diversity analysis showed that there was little difference in the composition of microbial species between the two groups, and no significant clustering separation was observed. The results of species composition analysis at phylum, order, family, and genus levels of 74 samples showed a consistent core microbiota structure in the two groups of gut microbiota, but there were differences in microbiota composition. The differences in microbial community composition between the two groups were manifested at the taxonomic levels of order, family, and genus, among which phylum Firmicutes, order Erysipelotrichales, family Erysipelatocyclostridiaceae, genus Erysipelotrichaceae_ UCG-003 and genus Catenibacterium were significantly enriched in the obese/overweight group and contributed significantly to the phenotypic difference of obese/overweight [linear discriminant analysis (LDA)=3.72, P<0.01; LDA=3.29, P<0.05). Phylum Proteobacteria, order Enterobacterales, family Enterobacteriaceae, genus unclassified was significantly enriched in the normal weight group and contributed significantly to the phenotypic difference of normal body weight (LDA=3.93, P<0.05). Conclusion The richness and diversity of gut microbiota in obese/overweight children aged 2-6 years in Shanghai are increased, but there is no difference compared to normal weight children. There is a difference in the composition of gut microbiota between the obese/overweight group and the normal weight group.

Study on the Risk Prediction Models of Overweight and Obesity in Medical Students / 中国卫生统计

Objective To construct logistic regression,random forest and SVM models to predict the influencing factors of overweight and obesity in medical students,and the prediction performance of the three models was compared,so as to obtain the optimal model for the risk assessment of overweight and obesity.Methods Participants included 1 866 medical students from a city in Hebei Province from May to December 2020.The relevant data of overweight and obesity screening were collected through self-test questionnaire;three models of logistic regression,random forest and SVM are constructed by python.Results The test set showed that the accuracy of logistic regression,random forest and SVM models were 96.26%,98.66%and 98.13%respectively;the specificity were 99.77%,100%and 99.00%,respectively;and the AUC were 0.88,0.99 and 0.88 respectively.Random forest is the optimal prediction model;according to the random forest model results,subjective well-being,negative events and students'economic status are more than 10%of weight in the model.Conclusion Subjective well-being,negative events and students'economic status are the main factors affecting the incidence of overweight and obesity in medical students;the prediction performance of random forest model was better than logistic regression model and SVM model.

Correlation analysis of middle school students' body mass index and dietary nutrition / 公共卫生与预防医学

Objective To explore the relationship between body mass index and dietary nutrition intake of middle school students. Methods Using stratified cluster sampling to select 1 000 middle school students in our city as the research object , of which 132 cases were over-recombination and 479 cases were the control group. Collect students’ basic information, dietary data and lifestyle information through questionnaire surveys, analyze and compare the energy and nutrient intake of the two groups of students ; use a multivariate Logistic regression model to analyze the relationship between children’s energy intake and dietary patterns and obesity. Results Among 1 000 middle school students, obese men accounted for 24.4%, women obese 23.5%, the gender difference was not significant (P>0.05); 11-13 years old obese accounted for 18.9%, 14-16 years old obese accounted for 29.0 %, the older the age, the higher the obesity rate (P0.05). The weight, BMI, waist circumference, hip circumference, waist-to-hip ratio, diastolic blood pressure and body fat rate of the obese group (64.68±12.4kg, (27.54±2.46 ) kg/m2 , 98.43±9.14cm , 102.45±9.23cm, 0.98±0.08, 120.43±8.45mm Hg, 86.76±6.43mm Hg, (36.54±3.42)% are all compared with the normal group 42.56±8.45kg , (17.43±1.98) kg/m2, 69.43±7.5cm, 80.45±7.32cm, 0.86±0.08, 95.43±4.54 mm Hg, 67.43±4.32 mm Hg, (18.43±2.13)%the value is large (P<0.05); the normal group students have energy, protein, fat/energy, carbohydrate, sodium, Iron intake 1765.59±345.79Kcal, 57.43±15.38g, (50.32±15.47) %, 128.43±29.43g, 1419.34±153.98mg, 14.54±4.21mg were all compared with the obese group (2361.56±354.78Kcal, 81.57±22.76g) , (90.43±15.23)%, 163.89±24.62g, 1587.43±123.32mg, 1.73±0.51mg) low (P<0.05); the intake of energy, carbohydrates, protein, sodium and iron is positively correlated with the occurrence of obesity. Risk factors for obesity; and intake of vitamin C, vitamin E, potassium, calcium, and magnesium is negatively correlated with obesity and is a protective factor for obesity. Conclusion The overall weight control of middle school students in our city is not optimistic. Obese students have an imbalance in the intake of the three major nutrients and minerals, which will easily lead to obesity in the long run. The school and parents should work together to manage the student’s diet and exercise to ensure Student health.

Metaflammation and Development of Diabesity / 中山大学学报(医学科学版)

Type 2 Diabetes occurring in the context of obesity is a term called diabesity， of which clinical outcome is more serious and complicated. Metaflammation is the main reason that causes insulin resistance and eventually leads to diabesity development. In this review， the author discusses the initiating factors that triggers metaflammation， and how this drives insulin resistance. This review also demonstrates our current work on pathogenesis of diabesity from the perspective of “gut microbiota-immune-metabolic axis”， as well as exploring effective treatments for diabesity through combination of body weight and glycemic control. In the end， the review briefly summarizes the "3+N" model for the treatment of diabesity and its complications from a multidisciplinary team （MDT） of the Third Affiliated Hospital of Sun Yat-sen University， providing one-stop comprehensive management services for patients.

Effects of Body Weight and Waist Circumference on Balance Function in Overweight and Obese Adults / 中山大学学报(医学科学版)

ObjectiveTo explore the effects of body weight and waist circumference on static and dynamic balance function in overweight and obese adults. MethodsParticipants （n=103） were selected by cluster random sampling from the Hypoglycemic Weight Loss Clinic of the Endocrinology Department of the Third Affiliated Hospital of Sun Yat-sen University. All participants were assessed for basic data collection， biochemical test， body weight， waist circumference and height measurement， static balance function assessed by balance error scoring system （BESS） and dynamic balance function assessed by functional reach test （FRT）. The BESS score and FRT distance of all participants were compared among groups according to different BMI grades and WC grades. Multivariate linear regression was used to analyze the influencing factors of participants' dynamic and static balance functions. Results① With the increase of BMI grading， the BESS score showed an upward trend， and the difference between groups was statistically significant （P = 0.004）. The BESS score of normal WC patients was lower than that of central obesity patients （P < 0.001）， which indicated that compared with normal BMI， overweight and obese people had poor dynamic and static balance ability； ② With the BMI grading， the FRT distance increased， showing a downward trend （P < 0.001）. The FRT distance in normal WC patients was significantly higher than that in central obesity patients （P < 0.001）， which indicated that the static and dynamic balance ability of central obesity patients was worse than that of normal WC patients； ③ In BMI overweight group， the FRT distance decreased significantly with the increase of WC （P = 0.02）. The results showed that under the condition of no difference in BMI， Compared with normal WC， the dynamic and static balance ability of central obese patients was worse； ④ The influence of BESS score on BMI（B=4.12，P =0.027， 95% CI=0.48-7.75）and WC（B = 3.47，P = 0.046， 95% CI = 0.07 - 6.88）was significant. The influence of FRT distance on BMI（B = -5.68，P = 0.001， 95% CI = -8.95 - 2.41）and WC（B = -4.71，P = 0.003， 95% CI = -7.83 to -1.61）was significant， which indicated that the static and dynamic balance ability of obese people was worse with the increase of BMI， and the ability of dynamic and static balance of central obesity was worse than that of normal WC. ConclusionWaist circumference is an independent factor affecting the dynamic and static balance function of overweight and obese people. Under similar BMI， the dynamic balance function of central obese people is worse than that of people with normal waist circumference， leading to higher risk of falling.

Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

Background: Hypertension is the leading cause of death throughout the world. The study was conducted to assess the prevalence, determinants and knowledge & practices about hypertension among rural adults in India. Methods: A community-based cross-sectional study was carried out in 10 major states of India. Information on socio-economic & demographic particulars was collected and anthropometric measurements like height, weight, waist & hip circumference and blood pressure were measured. Foods and nutrient intakes were assessed by 24-h recall method. Analysis was done using SPSS window 22. Results: The prevalence of pre-hypertension was 45.3% (95% CI: 44.6e46.0) and hypertension was 22% (95% CI: 21.5e22.3) (age standardized prevalence; 20.2%) while, overweight/obesity was 22.6% (95% CI: 22.2e23.0) as per Asian cut offs (BMI_x0001_23). The prevalence of hypertension was higher in West Bengal (29.5%) and Kerala (28.9%) and low in Madhya Pradesh and Uttar Pradesh (16e19%). The odds of hypertension was 1.2 times higher among forward communities, businessmen, tobacco users and those consuming alcohol, 2e3 times higher among overweight (CI: 1.87e2.25) and obese (2.65e3.27). The odds of hypertension was 1.2 times higher among those consuming lower tertile of carbohydrates (CI ¼ 1.02e1.41) and zinc (CI ¼ 1.11e1.42). About 76% were aware of hypertension, 21% were old hypertensive & 19% were on treatment. Conclusions: Age standardized prevalence of hypertension was 20% among adults and was associated with age, occupation, overweight/obesity, tobacco and alcohol use, low intake of carbohydrates and zinc. Therefore, increasing awareness and consumption of healthy diet through behavior change communication will help to control hypertension among adults.

Diseño de una intervención conductual para el control de peso en mujeres en edad fértil, con sobrepeso u obesidad, residentes de la Ciudad de México / Design of a behavioral intervention for weight control in women of childbearing age, with overweight or obesity, residents of Mexico City

Resumen Entender cómo las personas construyen y modifican sus decisiones y acciones en materia de salud, es indispensable para el abordaje del sobrepeso y la obesidad. El objetivo fue diseñar una intervención en salud que fomente el cambio de comportamientos que favorezcan la adherencia a un plan de alimentación y actividad física en mujeres en edad fértil. Se realizó un análisis mixto que incluyó la revisión de 193 expedientes clínicos en un consultorio privado de nutrición y la aplicación de 16 entrevistas semiestructuradas a mujeres con sobrepeso y obesidad, entre 20 y 49 años, con intención y sin intención de perder peso, para identificar factores relacionados con el aumento de peso. A partir de esto se diseñó una intervención en salud que busca fomentar el cambio de comportamientos para la pérdida de peso, a partir de modelos de cambio de comportamiento. Se encontró que factores relacionados con actitudes, normas percibidas y agencia personal estructuran el cambio de comportamiento y estos fueron distintos cuando sí hay intención de perder peso. Las intervenciones para control de peso deberían buscar la adherencia terapéutica; fomentar el fortalecimiento y creación de redes de apoyo; identificar y abordar las barreras de adherencia y adaptarse a las necesidades individuales.

Abstract To understand how people construct and modify their decisions and actions in health matters, is an essential requirement for the treatment of overweight and obesity. The objective was designing a health intervention that encourages behavior change that favors adherence to a diet and a physical activity plan in women of childbearing age. A mixed analysis was carried out that included the review of 193 clinical records in a private nutrition practice and the application of 16 semi-structured interviews to women with overweight, between 20 and 49 years old, with and without intention of losing weight, to identify factors related to the development of overweight. Based on this, a health intervention was designed to promote behavior change for weight loss, from de thranstheoretical model of change and integrated behavior. Factors related to attitudes, perceived norms, and personal agency were found to structure behavior change, and these were different when there is an intention to lose weight. Weight control interventions should seek adherence; promote the strengthening and creation of support social networks; identify and address barriers to adherence; adapt to the needs of the individual.

The relationship between socioeconomic status and childhood overweight/obesity is linked through paternal obesity and dietary intake: a cross-sectional study in Chongqing, China

BACKGROUND@#The prevalence of obesity and overweight in childhood has increased dramatically over the past decades globally. Thus, the risk factors of overweight and obesity in children and adolescents must be studied.@*OBJECTIVES@#This study aimed to reveal the prevalence of childhood obesity and examine the relationship between socioeconomic status (SES) and z-body mass index (z-BMI) via parental obesity and dietary intake using path analysis.@*METHODS@#Stratified cluster sampling was used to select 17,007 participants aged 6-12 years on two avenues per region in urban, suburban, and rural areas. Path analysis was conducted to examine the mediators between SES and z-BMI.@*RESULTS@#The prevalence rates of overweight and obesity were 13.36% and 8.60%, respectively, and were positively correlated with the father's education level, family income, a birth weight > 3000g, a parental obesity history, vegetable intake and red meat intake (all P < 0.05). Four mediators (paternal obesity history, red meat intake, vegetable intake, and nutritional supplements) were observed, and the four path analyses were significant (all P < 0.05). The adjusted total effects on z-BMI were significant for income (β@*CONCLUSIONS@#The prevalence of overweight/obesity in children was notable, and the relationship between SES and z-BMI was mediated by paternal obesity history and dietary intake.

Calidad de vida de pacientes con depresión leve o moderada en México / Quality of life in patients with mild or moderate depression in Mexico

OBJETIVO: Identificar las características generales por género y grado de sobrepeso y obesidad y su afectación sobre la calidad de vida de pacientes con leve y moderada depresión en Sinaloa México. MATERIAL Y MÉTODOS. Se realizó un estudio de corte transversal con 182 pacientes con diagnósticos depresivos de leve a moderado. La muestra se caracterizó por género y grado de sobrepeso y obesidad, y se determinó su impacto y asociación sobre la calidad de vida. La calidad de vida se determinó con la encuesta SF-36. RESULTADOS. Se encontraron diferencias significativas entre los pacientes con depresión leve y moderada (p=0.000). El rol físico se vio afectado significativamente por el género (p=0.047), mientas que la función física (p=0.016) y dolor (p=0.040) por el grado de sobrepeso y obesidad en pacientes con depresión leve. Además, se encontraron correlaciones significativas entre la función física y el dolor con el rol físico, salud general y vitalidad. CONCLUSIONES: La depresión leve afectó las dimensiones de la calidad de vida de función física, dolor y rol físico. La depresión y las dimensiones de función física y dolor se ven afectadas por el grado de sobrepeso y obesidad en los pacientes con leve depresión.

OBJECTIVE: To identify the general characteristics by gender and degree of overweight and/or obesity and its effect on the quality of life of patients with mild and moderate depression in Sinaloa, Mexico. MATERIAL AND METHODS. A cross-sectional study was conducted with 182 patients with mild to moderate depressive diagnoses. The sample was characterized by gender and degree of overweight and/or obesity, and its impact and association on quality of life were determined. Quality of life was determined with the SF-36 survey. RESULTS: Significant differences were found between patients with mild and moderate depression (p = 0.000). Physical role was significantly affected by gender (p = 0.047), while physical function (p = 0.016) and pain (p = 0.040) by the adegree of overweight and/or obesity in patients with mild depression. Furthermore, significant correlations were found between physical function and pain with physical role, general health and vitality. CONCLUSIONS: Mild depression affected the quality of life dimensions of physical function, pain, and physical role. Depression and the dimensions of physical function and pain are affected by the degree of overweight and/or obesity in patients with mild depression

Effectiveness of a Nutrition Education Intervention for Primary School Children: the Healthy Kids Programme, Malaysia

@#Introduction: This paper discussed the effectiveness of “Healthy Kids Programme (HKP)”, specifically in improving the body weight status as well as knowledge, attitude and practice (KAP) of the children. Methods: In this longitudinal intervention study, a total of 12 primary schools in Klang Valley were randomly selected and divided into intervention and control groups. There were 386 standard three children participated at baseline. All children in the intervention group participated in the HKP that was conducted by nutritionists. The evaluations included the pre- and post-Immediate Impact survey (IIS) (every topic), and changes in nutrition KAP survey and anthropometric assessment of the children at the beginning and end of every year for three years. Results: School children in intervention group reported with an increased in the IIS score for each topic and achieved a significantly higher mean nutrition knowledge score than those in the control group over time. There were no significant differences in mean attitude and practice scores between two groups after the intervention. Children in the intervention group had lower rates of overweight and obesity (pre-test: 27.3%; post-test: 32.5%) than their counterpart (pre-test: 26.6%; post-test: 44.0%). Conclusions: The HKP is effective in improving nutrition knowledge of the children. A lower rate of overweight and obesity was observed in intervention group than control group. This approach will contribute towards inculcating healthy eating and active lifestyle habits among Malaysian children that bring about long-term health benefits.

Analysis of nutritional status among students benefitting from "nutrition improvement program" in Xi'an, 2017-2018 / 公共卫生与预防医学

Objective To analyze nutritional status among students participating in "nutrition improvement program" for the compulsory education students in Xi'an, and to provide a reference basis for student nutrition improvement. Methods Eleven districts and counties were selected. About 10% primary and junior high schools were selected from the nutrition improvement program. A total of 31,941 primary and junior high school students were selected. Height and weight were measured according to the standard methods. Results Malnutrition rate of 6~15 years old boys was 10.58% (stunting rate 2.40%, wasting rate 8.18%). Overweight and obesity rate was 14.23% and 11.22%, respectively. Malnutrition rate of 6~15 years old girls was 8.56% (stunting rate 2.17%, and wasting rate 6.40%). Overweight and obesity rate was 10.43% and 7.56%, respectively. The nutritional status of students in different gender, school period, feeding pattern and school location was analyzed. The malnutrition rate was higher in boys than in girls (10.58% vs 8.56%) (P<0.05). The combined obesity-overweight rate was higher in boys than girls (25.45% vs 17.99%) (P<0.05). The combined obesity-overweight rate was higher in 6~12 aged students than in 13-15 aged (22.82% vs 16.06%) (P<0.05). The combined obesity-overweight rate was higher (26.10%) (P<0.05) in the schools located in urban areas. The rate of malnutrition among students in the school-based cafeteria was higher (10.93%) (P<0.05), while the rate of overweight and obesity was higher in the students with meals supplied by the food suppling enterprise (25.18%) (P<0.05). Conclusions The malnutrition and overweight and obesity both existed in students who benefitted from the nutrition improvement program. Attention should be paid to the malnutrition of boys and county schools, the overweight and obesity of boys, 6-12 years old students, and urban students. It is suggested that while implementing the nutrition improvement plan, the nutrition health education in students should be strengthened to avoid an increase of overweight and obesity rate.

La perspectiva histórica y el análisis crítico en el abordaje del desafío alimentario y social del hambre oculta / The historical perspective and critical analysis in addressing the food and social challenge of hidden hunger

El trabajo plantea la necesidad de abordar el hambre oculta a partir de los retos alimentarios y la casuística socioeconómica que la explican. Se analizan los usos que ha recibido desde la historia de la población y su asociación con los síndromes de miseria, atraso social y pauperización, Así como la nueva dimensión que ha adquirido con la emergencia de la pandemia de obesidad y la doble carga de la malnutrición y el sobrepeso. Tanto las lecciones de la historia, como el reto que representan los más de 2.000 millones de seres humanos afectados por el hambre oculta, muestran que para superarla, más allá de suplementar el déficit de micronutrientes, hay que corregir las desigualdades sociales ante la disponibilidad de alimentos y otras necesidades básicas(AU)

The work raises the need to address hidden hunger based on food challenges and the socioeconomic casuistry that explain it. Are analysed the uses it has received from the history of the population and its association with the syndromes of misery, social backwardness and pauperization. As well as the new dimension that it has acquired with the emergence of the obesity pandemic and the double burden of malnutrition and overweight. Both the lessons of history, and the challenge posed by the more than 2 billion human beings affected by hidden hunger, show that to overcome it, beyond supplementing the deficit of micronutrients, it is necessary to correct social inequalities regarding the availability of food and other basic necessities(AU)

Análisis de sobrepeso y obesidad, niveles de actividad física y autoestima en escolares de San Pedro Sula, Honduras / Analysisof Overweight and Obesity, Levels of Physical Activity,and Self-Esteem in School Children of San Pedro Sula, Honduras / Análise de sobrepeso e obesidade, níveis de atividade física e autoestima em estudantes de San Pedro Sula, Honduras

Resumen El objetivo de este estudio fue analizar la prevalencia de sobrepeso, obesidad, niveles de actividad física y autoestima de la población escolar de San Pedro Sula. La muestra fue de 825 escolares con edades entre 9-13 años, los cuales fueron divididos en 416 mujeres y 409 hombres. Se realizaron mediciones del IMC (Kg/H^2), nivel de actividad física (PAQ-C) y autoestima (LAWSEQ). Se realizó un análisis factorial (ANOVA) para observar diferencias entre grupos y la correlación de Pearson para el estudio de relación de variables con intervalos de confianza del 95 %. Se encontró que el 79.8 % se encuentra en un estado de peso saludable; un 14.8 % en sobrepeso y obesidad y un 5.3 % en desnutrición, un nivel de actividad física moderado predomina en la mayoría de escolares, un nivel de autoestima bajo en 46.9 % y autoestima promedio de 50.5 %; también se mostró que el nivel de actividad física tiene correlación alta positiva con el sexo (r= 0.74 p= 0.02), siendo mayor en los escolares hombres que en las mujeres, también la actividad física tiene correlación positiva muy alta (r=0.81; p=0.001) con la autoestima. Nuestras conclusiones indican que se muestra una mayor práctica de actividad física por los escolares hombres de Honduras que por parte de las mujeres. Además, se encontró que un mayor nivel de realización de actividad física podría estar asociado a una mejor autoestima en los niños.

Abstract The objective of this study was to analyze the prevalence of overweight, obesity, physical activity levels, and self-esteem of the school children population of San Pedro Sula. The sample was 825 children aged 9-13 years, which were divided into 416 girls and 409 boys. Measurements of BMI (kg/H^2), Physical Activity level (PAQ-C) and Self-esteem (LAWSEQ) were made. A factorial analysis (ANOVA) was performed to observe differences between groups and the Pearson correlation for the study of the relationship of variables with 95% confidence intervals. It was found that 79.8% are in a healthy weight state; 14.8% in overweight and obesity, and 5.3% in malnutrition. It was also found that a moderate level of physical activity predominates in most of the children and a low self-esteem level in 46.9% and average self-esteem of 50.5%. Another finding was that the level of physical activity has a highly positive correlation with sex (r = 0.74 p = 0.02), being higher in boys than in girls; also physical activity has a very high positive correlation (r = 0.81, p = 0.001) with self-esteem. Our results indicate that children in Honduras show a greater practice of physical activity by children than that of girls. In addition, it was found that a higher level of physical activity could be associated with better self-esteem in children.

Resumo O objetivo deste estudo foi analisar a prevalência de sobrepeso, obesidade, níveis de atividade física e autoestima da população escolar de San Pedro Sula. A amostra foi de 825 escolares com idades entre 9-13 anos, divididos em 416 mulheres e 409 homens. Foram realizadas medidas de IMC (Kg/H^2), Nível de Atividade Física (PAQ-C) e Autoestima (LAWSEQ). Foi realizada análise fatorial (ANOVA) para observar as diferenças entre os grupos e a correlação de Pearson para o estudo das variáveis de relação com intervalos de confiança de 95%. Verificou-se que 79,8% estão em estado de peso saudável, 14,8% em sobrepeso e obesidade e 5,3% em desnutrição, predomina atividade física moderada na maioria dos escolares e baixa autoestima de 46,9% e autoestima média de 50.5%, também foi demonstrado que o nível de atividade física tem alta correlação positiva com o sexo (r= 0,74 p= 0,02), sendo maior em escolares do sexo masculino do que em mulheres, a atividade física também tem alta correlação positiva (r=0,81; p=0,001) com a autoestima. Nossas conclusões indicam que os estudantes do sexo masculino em Honduras são mais ativos fisicamente do que as mulheres. Além disso, verificou-se que um maior nível de atividade física poderia estar associado a uma melhor autoestima das crianças.

Asociación de las determinantes de la seguridad alimentaria nutricional con la presencia de sobrepeso y obesidad en la población que acude a la unidad de epidemiología clínica del IINSAD de la Facultad de Medicina ­ UMSA / Association of the determinants of nutritional food safety with the presence of overweight and obesity in the population that comes to the clinical epidemiology unit of the IINSAD of the Faculty of Medicine - UMSA

OBJETIVO: identificar la asociación de las determinantes de la seguridad alimentaria con el sobrepeso y obesidad de la población que acude a la Unidad de Epidemiología Clínica del IINSAD de la Facultad de Medicina, Enfermería, Nutrición y Tecnología Médica ­ UMSA. MATERIAL Y MÉTODO: estudio de Casos y Controles, desarrollado en la Unidad de Epidemiologia Clínica del IINSAD de la Facultad de Medicina, UMSA. Ingresaron al estudio 288 personas, 144 casos y 144 controles, se aplicó la encuesta alimentaria, identificando el consumo y la frecuencia de alimentos y preguntas específicas sobre disponibilidad, acceso físico y económico a los alimentos. Se realizó una evaluación antropométrica para identificar los casos y controles. RESULTADOS: existe una probabilidad mayor de presentar sobrepeso u obesidad en la población con insuficiente acceso económico a los alimentos OR= 2.1 (IC95% 1.3-3.6 p=0.003). A mayor proporción de gasto en alimentos de una familia, mayor es el consumo de energía provenientes de carbohidratos y grasas OR= 30 (IC95% 23.6-58.8) p=0.000. No se encontró asociación entre la disponibilidad de alimentos y el lugar de aprovisionamiento. CONCLUSIONES: son factores asociados para la presencia de sobrepeso y obesidad los determinantes de seguridad alimentaria nutricional como ingreso destinado a la compra de los alimentos, el consumo alimentario en cantidad y calidad de la dieta consumida y adecuación de nutrientes, la disponibilidad de alimentos y el lugar de aprovisionamiento no presenta asociación

OBJECTIVE: to identify the association of food security determinants of overweight and obesity in the population attending the Clinical Epidemiology Unit of IINSAD Faculty of Medicine, Nursing, Nutrition and Medical Technology - UMSA La Paz, 2015. MATERIAL AND METHODS: an observational analytical case-control study, 288 individuals attending the IINSAD of the Faculty of Medicine, Nursing, Nutrition and Medical Technology - UMSA. 144 cases and 144 controls were analyzed. A food survey, where the consumption and food frequency and specific questions about availability, physical and economic access to food occurred was applied. Anthropometric assessment was performed to identify cases and controls. RESULTS: there is a greater likelihood of becoming overweight or obese in people with insufficient economic access to food OR = 2.1 (95% CI 1.3-3.6 p = 0.003). The greater the food expenditure proportion of a family, the greater is the consumption the energy from carbohydrates and fats OR = 30 (95% CI 23.6-58.8 p = 0.000). No association between the availability of food and the place of supply is found. CONCLUSIONS: there are factors associated to the presence of overweight and obesity determinants of nutritional food security such as income for the purchase of food, food consumption in quantity and quality of consumed diet and nutrient adequacy, the availability of food and the place of supplying is not considered associated for this study

Overweight and obesity among Orang Asli adults in Krau Wildlife Reserve, Pahang: a four-year follow-up study

@# Introduction: Obesity and excess weight gain in adults are linked to an increased risk of cardiometabolic abnormalities. The changing lifestyle experienced by the Orang Asli predisposes the population to the risk of obesity and non-communicable diseases. This study aimed to describe the prevalence of overweight and obesity as well as body-weight change over a period of four years among Orang Asli adults. Methods: Data were collected from Orang Asli adults aged ≥18 years, who were enrolled in the 2011-2012 and 2015-2016 surveys, and who were residing within the Krau Wildlife Reserve. Weight and height of the adults (N2011-2012=828; N2015- 2016=662) were measured at both time points. Follow-up data were available for 378 adults (male:113; female:265). Results: The prevalence of overweight and obesity were 18.8% and 7.4% in 2011-2012 and 26.1% and 9.5% in 2015-2016. In the follow-up group, significant differences in body weight and body mass index (BMI) were observed in men and women, respectively. More than one-third (35.5%) of the adults had weight gain of more than 5.0%. The increasing percentage of body weight change was associated with being female, younger age, more years of schooling and reduced household income. Conclusion: Obesity is a growing health problem in the Orang Asli adult population. Weight gain was associated with socioeconomic indicators and it was more prominent in women. Effective strategies are needed to address the increasing prevalence of overweight and obesity in this population to further reduce adverse health outcomes.

Sintomatología asociada al estrés y condiciones laborales de operarios de taxi de un sitio de la Ciudad de México / Stress-related symptoms and working conditions among Mexico City taxi drivers

Introducción: Los estilos de vida no saludables se relacionan con hábitos y conductas que deterioran los órganos y sus funciones generando envejecimiento prematuro y enfermedades crónicodegenerativas, estas condiciones se ven agravadas por las desigualdades sociales en ciertos grupos laborales, tal es el caso de los conductores de taxis, los cuales presentan riesgos ambientales, físicos, químicos, bioquímicos, así como exigencias laborales como son extensión de jornada, bajos salarios, las formas de organización y la falta de apoyo sindical. Estudiar el proceso salud/enfermedad de estos trabajadores, permite identificar el desgaste laboral y la integridad mental determinada por la cantidad e intensidad de trabajo y proponer medidas de prevención. Método: Se diseñó un estudio transversal, observacional y descriptivo, se aplicó una encuesta, valoración antropométrica, análisis bioquímicos, cuyos resultados tuvieron un procesamiento para identificar asociaciones y significancia estadística. Resultados: el 32.5% de la muestra conduce más de 9 horas. al día sin descansos, el 21.8% presentó supervisión estricta y 48.7% son obligados a cubrir cuotas diarias. Más de la mitad de la muestra se encuentra con exposición constante a condiciones adversas tanto en la unidad como en el lugar de trabajo. Se encontró asociación de estas condiciones con la prevalencia de enfermedades crónico degenerativas como diabetes mellitus, hipertrigliceridemia e hipercolesterolemia, más altas con las reportadas a nivel nacional. Conclusiones: las condiciones de los conductores de taxis tanto laborales como de salud mental y física se encuentran deterioradas de manera extrema por lo cual se necesitan estrategias multidisciplinarias para su disminución(AU)

Introduction: Unhealthy lifestyles are related to habits and behaviors that can contribute to the deterioration and function of organ systems, leading to premature aging and degenerative chronic diseases. These conditions are aggravated due to the social inequality in certain occupations. Such is the case of taxi drivers, who experience environmental, physical, chemical, and biochemical risks, as well as high work demands such as long work days, low pay and little union support. By studying the health / disease process of these workers we can identify occupational burnout and mental integrity determined by the amount and intensity of the work, and propose preventive measures. Methods: A cross-sectional, observational and descriptive study was designed. We obtained data via a survey, anthropometric measurements, and laboratory testing. We examined associations and tested them for statistical significance. Results: Of the overall respondents, 32.5% reported driving more than 9 hours a day without breaks; 21.8% mentioned strict supervision and 48.7% reported being required to meet daily fee quotas. More than half the sample was continuously exposed to adverse conditions in the cab and the workplace. We found associations between these working conditions and the prevalence of chronic degenerative diseases, including diabetes, hypertriglyceridemia and hypercholesterolemia, higher than national average prevalence figures. Conclusion: occupational, physical and psychological working conditions among taxi drivers are very poor, and multidisciplinary strategies are needed to diminish them(AU)

Empleo materno y exceso de peso en escolares mexicanos en 2012: la importancia de las características del hogar / Maternal employment and Mexican school-age children overweight in 2012: the importance of households features

Resumen Introducción: La evidencia respecto a la relación entre la participación laboral de las madres y el sobrepeso y la obesidad de los niños en edad escolar presenta resultados divergentes en todo el mundo. En México, dicha relación no ha sido analizada con datos representativos nacionales. Por lo anterior, el objetivo de este artículo fue evaluar el papel de la participación laboral materna extradoméstica en el peso elevado de la población mexicana en edad escolar (5 a 11 años). Métodos: Se realizó un estudio transversal a partir de una muestra de 17,418 individuos provenientes de la Encuesta Nacional de Salud y Nutrición 2012, utilizando modelos de regresión logística binomial. Resultados: En el modelo en el que se controló por características individuales de la madre y de contexto se encontró una relación entre la participación materna en el mercado laboral y la composición corporal de los escolares. Sin embargo, al incorporar las características del hogar (arreglos residenciales, etnicidad, tamaño, seguridad alimentaria y nivel socioeconómico) al modelo estadístico, el empleo materno dejó de ser estadísticamente significativo. Dicho modelo fue el que presentó mayor bondad de ajuste. Conclusiones: Las características del hogar, más allá de que la madre trabaje, son aspectos cruciales para entender las tasas de prevalencia de obesidad y sobrepeso en los escolares mexicanos.

Abstract Background: International evidence regarding the relationship between maternal employment and school-age children overweight and obesity shows divergent results. In Mexico, this relationship has not been confirmed by national data sets analysis. Consequently, the objective of this article was to evaluate the role of the mothers' participation in labor force related to excess body weight in Mexican school-age children (aged 5-11 years). Methods: A cross-sectional study was conducted on a sample of 17,418 individuals from the National Health and Nutrition Survey 2012, applying binomial logistic regression models. Results: After controlling for individual, maternal and contextual features, the mothers' participation in labor force was associated with children body composition. However, when the household features (living arrangements, household ethnicity, size, food security and socioeconomic status) were incorporated, maternal employment was no longer statically significant. Conclusions: Household features are crucial factors for understanding the overweight and obesity prevalence levels in Mexican school-age children, despite the mother having a paid job.

Gender Differences in the Prevalence of Overweight and Obesity, Associated Behaviors, and Weight-related Perceptions in a National Survey of Primary School Children in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children.</p><p><b>METHODS</b>Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders.</p><p><b>RESULTS</b>Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio (OR) 2.30, 95% CI 2.00 to 2.65] and rural areas (OR = 1.85, 95% CI 1.55 to 2.20). Girls reported healthier diets (e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85) whereas boys consumed fried food (OR = 1.21, 95% CI 1.06 to 1.38) and sugar-sweetened drinks more often (OR = 1.49, 95% CI 1.34 to 1.65). Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers (OR = 1.35, 95% CI 1.09 to 1.68), less educated fathers (OR = 0.79, 95% CI 0.63 to 0.99), and if they frequently consumed carbonated drinks (OR = 1.48, 95% CI 1.07 to 2.05).</p><p><b>CONCLUSION</b>Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.</p>