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1.
Obesity (Silver Spring) ; 30(2): 338-346, 2022 02.
Article in English | MEDLINE | ID: covidwho-1750426

ABSTRACT

OBJECTIVE: A first-in-human responsive deep brain stimulation (rDBS) trial (NCT03868670) for obesity is under way, which is based on promising preclinical evidence. Given the upfront costs of rDBS, it is prudent to examine the success threshold for cost-effectiveness compared with laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Efficacy and safety data on LRYGB and safety data on rDBS were collected for established indications through a literature search. The success threshold was defined as minimum BMI reduction. Treatment costs were calculated via Medicare national reimbursement data. RESULTS: LRYGB had a mean BMI reduction of 13.75 kg/m2 . Based on adverse events, LRYGB was a less-preferred health state (overall adverse event utility of 0.96 [0.02]) than rDBS (0.98 [0.01]), but LRYGB ($14,366 [$6,410]) had a significantly lower treatment cost than rDBS ($29,951 [$4,490]; p < 0.0001). Therefore, for rDBS to be cost-effective compared with LRYGB, the multiple models yielded a success threshold range of 13.7 to 15.2 kg/m2 . CONCLUSIONS: This study established a preliminary efficacy success threshold for rDBS to be cost-effective for severe obesity, and results from randomized controlled trials are needed. This analysis allows for interpretation of the economic impact of advancing rDBS for obesity in light of ongoing trial results and suggests an attainable threshold is needed for cost-effectiveness.


Subject(s)
Deep Brain Stimulation , Gastric Bypass , Obesity, Morbid , Aged , Cost-Benefit Analysis , Gastrectomy/methods , Gastric Bypass/methods , Health Care Costs , Humans , Medicare , Obesity/etiology , Obesity, Morbid/surgery , Treatment Outcome , United States
2.
Orphanet J Rare Dis ; 17(1): 69, 2022 02 21.
Article in English | MEDLINE | ID: covidwho-1699715

ABSTRACT

BACKGROUND: Prader-Willi syndrome (PWS), is a genetically determined neurodevelopmental disorder, associated with intellectual disabilities and a high incidence of obesity, diabetes mellitus, and respiratory disorders. We hypothesised that COVID-19, a viral infection which more severely affects people with these conditions, would, in people with PWS, present atypically and result in severe outcomes. METHOD: A structured on-line questionnaire was piloted with parents and professionals at the International Prader-Willi Syndrome Organization (IPWSO) and promoted internationally through their global network. Family members/other carers were asked to complete if someone they cared for with PWS was strongly suspected or confirmed as having COVID-19. RESULTS: Over 1 year of the pandemic 72 responses were received, 47 adults, 25 children. The following underlying conditions were present: 16 people with PWS were overweight and 18 obese, five had diabetes mellitus and 18 sleep apnoea. Main presenting symptoms were raised temperature, fatigue/daytime sleepiness, dry cough, headache/pain, and feeling unwell, with illnesses generally lasting less than a week. Length of illness was not significantly related to age, BMI, sex, or genetic subtype. No one was ventilated or in an intensive care unit or died, one person was in hospital for four days needing oxygen. CONCLUSIONS: Contrary to our hypothesis, the PWS cohort had asymptomatic infection or mild illness. A possible explanation, supported by anecdotal evidence from parents and professional carers, is that people with PWS have a degree of innate immunity to viral infections. However, likely selection effects and a relatively low number of responses means that further evidence is needed to test this hypothesis.


Subject(s)
COVID-19 , Prader-Willi Syndrome , Adult , Child , Humans , Obesity/etiology , Prader-Willi Syndrome/genetics , SARS-CoV-2 , Surveys and Questionnaires
3.
Diabetes Metab Syndr ; 16(1): 102392, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1683071

ABSTRACT

BACKGROUND: The COVID-19 pandemic has affected the lives of people in many ways. However, little is known about weight gain in American adults during the pandemic. AIMS AND METHODS: The purpose of this study was to conduct a national assessment of weight gain in adult Americans after the first year of the pandemic. An online questionnaire was employed to explore perceptions of adults regarding pandemic weight gain and the relationship between weight gain and sociodemographic characteristics, pre-pandemic weight status, and psychological distress. Multiple methods were used to assess the psychometric properties of the questionnaire (i.e., face validity, content validity, and internal consistency reliability testing). Chi-Square tests and logistic regression analysis were used to assess group differences and predictors of weight gain in the study participants. RESULTS: A total of 3,473 individuals participated in the study with weight changes distributed as: gained weight (48%), remained the same weight (34%), or lost weight (18%). Those who reported being very overweight before the pandemic were most likely to gain weight (65%) versus those who reported being slightly overweight (58%) or normal weight (40%) before the pandemic. Weight gain was statistically significantly higher in those with anxiety (53%), depression (52%), or symptoms of both (52%). The final multiple regression model found that the statistically significant predictors of pandemic weight gain were psychological distress, pre-pandemic weight status, having children at home; and time since last bodyweight check. CONCLUSIONS: Population health promotion strategies in the pandemic should emphasize stress reduction to help individuals manage body weight and avoid chronic diseases in the future.


Subject(s)
COVID-19/epidemiology , Weight Gain/physiology , Adult , Anxiety/epidemiology , COVID-19/complications , COVID-19/psychology , Depression/epidemiology , Female , Humans , Life Style , Male , Obesity/epidemiology , Obesity/etiology , Overweight/epidemiology , Overweight/etiology , Pandemics , Psychological Distress , Risk Factors , Surveys and Questionnaires , United States/epidemiology
4.
Int J Behav Nutr Phys Act ; 18(1): 167, 2021 12 23.
Article in English | MEDLINE | ID: covidwho-1634087

ABSTRACT

BACKGROUND: The home environment is thought to influence children's weight trajectories. However, few studies utilise composite measures of the home environment to examine associations with energy balance behaviours and weight. The present study aimed to adapt and update a comprehensive measure of the obesogenic home environment previously developed for pre-schoolers, and explore associations with school-aged children's energy balance behaviours and weight. METHODS: Families from the Gemini cohort (n = 149) completed the Home Environment Interview (HEI) via telephone when their children were 12 years old. The HEI comprises four composite scores: one for each domain (food, activity and media) of the environment, as well as a score for the overall obesogenic home environment. The primary caregiver also reported each child's height and weight (using standard scales and height charts), diet, physical activity and sedentary screen-based behaviours. A test-retest sample (n = 20) of caregivers completed the HEI a second time, 7-14 days after the initial interview, to establish test-retest reliability. RESULTS: Children (n = 298) living in 'higher-risk' home environments (a 1 unit increase in the HEI obesogenic risk score) were less likely to consume fruits (OR; 95% CI = 0.40; 0.26-0.61, p < 0.001), and vegetables (0.30; 0.18-0.52, p < 0.001), and more likely to consume energy-dense snack foods (1.71; 1.08-2.69, p = 0.022), convenience foods (2.58; 1.64-4.05, p < 0.001), and fast foods (3.09; 1.90-5.04, p < 0.001). Children living in more obesogenic home environments also engaged in more screen-time (ß (SE) = 4.55 (0.78), p < 0.001), spent more time playing video games (ß (SE) = 1.56 (0.43), p < 0.001), and were less physically active (OR; 95% CI = 0.57; 0.40-0.80, p < 0.01). Additionally, there was a positive association between higher-risk overall home environment composite score and higher BMI-SDS (ß (SE) = 0.23 (0.09), p < 0.01). This finding was mirrored for the home media composite (ß (SE) = 0.12 (0.03), p < 0.001). The individual home food and activity composite scores were not associated with BMI-SDS. CONCLUSION: Findings reveal associations between the overall obesogenic home environment and dietary intake, activity levels and screen-based sedentary behaviours, as well as BMI in 12 year olds. These findings suggest that the home environment, and in particular the home media environment, may be an important target for obesity prevention strategies.


Subject(s)
Feeding Behavior , Body Mass Index , Child , Fast Foods , Feasibility Studies , Humans , Obesity/etiology , Obesity/prevention & control , Reproducibility of Results
5.
Genes (Basel) ; 12(10)2021 09 26.
Article in English | MEDLINE | ID: covidwho-1480689

ABSTRACT

Trefoil Factor Family Member 2 (TFF2) belongs to TFF family peptides that includes TFF1, TFF2, TFF3. TFF2 is mainly known for its roles in the mucosal protection. In the context of obesity and high fat diet (HFD), Tff2 has been characterized as a HFD-induced gene. The knock-out of Tff2 in mice lead to the protection from HFD-induced obesity with a metabolic profile towards a negative energy balance. Such HFD-specific expression gives Tff2 a pattern worth exploring in biomedical research. Indeed, measuring TFF2/TFF2/Tff2 expression in biological samples following the ingestion of high-fat diet reflects the biological "responsiveness" to the lipids ingestion and would reflect the severity of obesity establishment afterwards. Such property could be explored for instance to screen animal models, evaluate the predisposition to HFD-induced obesity as well as in biomedical and clinical applications. Results might advance obesity research especially in terms of understanding lipid-induced signals, appetite control and adiposity storage.


Subject(s)
Obesity/metabolism , Trefoil Factor-2/genetics , Animals , Diet, High-Fat/adverse effects , Humans , Obesity/etiology , Obesity/genetics , Obesity/pathology , Trefoil Factor-2/metabolism
6.
Viruses ; 13(7)2021 07 01.
Article in English | MEDLINE | ID: covidwho-1448932

ABSTRACT

Infection has recently started receiving greater attention as an unusual causative/inducing factor of obesity. Indeed, the biological plausibility of infectobesity includes direct roles of some viruses to reprogram host metabolism toward a more lipogenic and adipogenic status. Furthermore, the probability that humans may exchange microbiota components (virome/virobiota) points out that the altered response of IFN and other cytokines, which surfaces as a central mechanism for adipogenesis and obesity-associated immune suppression, is due to the fact that gut microbiota uphold intrinsic IFN signaling. Last but not least, the adaptation of both host immune and metabolic system under persistent viral infections play a central role in these phenomena. We hereby discuss the possible link between adenovirus and obesity-related nonalcoholic fatty liver disease (NAFLD). The mechanisms of adenovirus-36 (Ad-36) involvement in hepatic steatosis/NAFLD consist in reducing leptin gene expression and insulin sensitivity, augmenting glucose uptake, activating the lipogenic and pro-inflammatory pathways in adipose tissue, and increasing the level of macrophage chemoattractant protein-1, all of these ultimately leading to chronic inflammation and altered lipid metabolism. Moreover, by reducing leptin expression and secretion Ad-36 may have in turn an obesogenic effect through increased food intake or decreased energy expenditure via altered fat metabolism. Finally, Ad-36 is involved in upregulation of cAMP, phosphatidylinositol 3-kinase, and p38 signaling pathways, downregulation of Wnt10b expression, increased expression of CCAAT/enhancer binding protein-beta, and peroxisome proliferator-activated receptor gamma 2 with consequential lipid accumulation.


Subject(s)
Inflammation , Lipid Metabolism , Non-alcoholic Fatty Liver Disease/complications , Obesity/etiology , Obesity/virology , Adenoviridae/immunology , Adenoviridae Infections/complications , Adenoviridae Infections/immunology , Animals , Diet, High-Fat , Glucose/metabolism , Humans , Lipogenesis , Mice , Mice, Inbred C57BL , Non-alcoholic Fatty Liver Disease/virology , Obesity/complications , Obesity/immunology , Signal Transduction
7.
Horm Metab Res ; 53(9): 575-587, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1397932

ABSTRACT

Global warming and the rising prevalence of obesity are well described challenges of current mankind. Most recently, the COVID-19 pandemic arose as a new challenge. We here attempt to delineate their relationship with each other from our perspective. Global greenhouse gas emissions from the burning of fossil fuels have exponentially increased since 1950. The main contributors to such greenhouse gas emissions are manufacturing and construction, transport, residential, commercial, agriculture, and land use change and forestry, combined with an increasing global population growth from 1 billion in 1800 to 7.8 billion in 2020 along with rising obesity rates since the 1980s. The current Covid-19 pandemic has caused some decline in greenhouse gas emissions by limiting mobility globally via repetitive lockdowns. Following multiple lockdowns, there was further increase in obesity in wealthier populations, malnutrition from hunger in poor populations and death from severe infection with Covid-19 and its virus variants. There is a bidirectional relationship between adiposity and global warming. With rising atmospheric air temperatures, people typically will have less adaptive thermogenesis and become less physically active, while they are producing a higher carbon footprint. To reduce obesity rates, one should be willing to learn more about the environmental impact, how to minimize consumption of energy generating carbon dioxide and other greenhouse gas emissions, and to reduce food waste. Diets lower in meat such as a Mediterranean diet, have been estimated to reduce greenhouse gas emissions by 72%, land use by 58%, and energy consumption by 52%.


Subject(s)
Climate Change , Obesity/etiology , Agriculture/economics , Agriculture/trends , COVID-19/complications , COVID-19/epidemiology , COVID-19/pathology , Climate Change/history , Comorbidity , Endocrine Disruptors/toxicity , Environment , Environmental Exposure/history , Environmental Exposure/statistics & numerical data , Greenhouse Gases/toxicity , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Obesity/epidemiology , Obesity/metabolism , Pandemics , Risk Factors
8.
JAMA Netw Open ; 4(8): e2121675, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1372682

ABSTRACT

Importance: Previous studies have shown reductions in self-reported physical activity levels in children associated with implementation of COVID-19 mitigation measures, and data on objectively assessed health parameters are limited. Objective: To examine the association of COVID-19 mitigation measures with changes in cardiorespiratory fitness (CRF) measures and body mass index (BMI) among primary schoolchildren. Design, Setting, and Participants: This cohort study included children aged 7 to 10 years from 12 randomly selected primary schools in urban and rural districts of Klagenfurt, Austria. Baseline CRF and BMI measurements were obtained in September 2019 before COVID-19 mitigation measures were implemented, and follow-up measurements were obtained in June and September 2020. Exposures: COVID-19 mitigation measures. Main Outcomes and Measures: Cardiorespiratory fitness was measured with a 6-minute endurance run test. Height and weight were objectively measured. Standard deviation scores were calculated for CRF and BMI. Changes over time were analyzed using analyses of variance. Secondary analyses were performed for subgroups stratified by sex. Results: A total of 764 children (383 girls [50.1%]) aged 7 to 10 years had all measurements completed. From September 2019 to September 2020, CRF SD scores changed by -1.06 (95% CI, -1.13 to -1.00), with a similar decrease in both boys and girls. Body mass index SD scores had increased by 0.12 (95% CI, 0.06-0.16) in June 2020 and by 0.16 (95% CI, 0.12-0.20) in September 2020 compared with September 2019. The increase in BMI SD scores (from September 2019 to September 2020) was greater among boys (0.23; 95% CI, 0.18-0.29) than among girls (0.09; 95% CI, 0.04-0.15). During the 1-year period, the percentage of children with overweight or obesity increased from 20.3% (155 children) to 24.1% (184 children) (difference, 3.8% [29 children]). Conclusions and Relevance: In this cohort study of children in Austria, COVID-19 mitigation measures were associated with decreases in CRF measures and increases in BMI. The findings suggest that collaborative efforts are needed to reverse these changes in children's health to prevent long-term negative health outcomes.


Subject(s)
Body Mass Index , COVID-19 , Cardiorespiratory Fitness , Exercise , Obesity/etiology , Pandemics , Physical Distancing , Austria , COVID-19/prevention & control , Child , Child Health , Cohort Studies , Female , Humans , Male , Overweight , SARS-CoV-2 , Schools , Sports
9.
Int J Mol Sci ; 22(15)2021 Jul 31.
Article in English | MEDLINE | ID: covidwho-1346501

ABSTRACT

17,18-Epoxyeicosatetraenoic acid (17,18-EEQ) and 19,20-epoxydocosapentaenoic acid (19,20-EDP) are bioactive epoxides produced from n-3 polyunsaturated fatty acid eicosapentaenoic acid and docosahexaenoic acid, respectively. However, these epoxides are quickly metabolized into less active diols by soluble epoxide hydrolase (sEH). We have previously demonstrated that an sEH inhibitor, t-TUCB, decreased serum triglycerides (TG) and increased lipid metabolic protein expression in the brown adipose tissue (BAT) of diet-induced obese mice. This study investigates the preventive effects of t-TUCB (T) alone or combined with 19,20-EDP (T + EDP) or 17,18-EEQ (T + EEQ) on BAT activation in the development of diet-induced obesity and metabolic disorders via osmotic minipump delivery in mice. Both T + EDP and T + EEQ groups showed significant improvement in fasting glucose, serum triglycerides, and higher core body temperature, whereas heat production was only significantly increased in the T + EEQ group. Moreover, both the T + EDP and T + EEQ groups showed less lipid accumulation in the BAT. Although UCP1 expression was not changed, PGC1α expression was increased in all three treated groups. In contrast, the expression of CPT1A and CPT1B, which are responsible for the rate-limiting step for fatty acid oxidation, was only increased in the T + EDP and T + EEQ groups. Interestingly, as a fatty acid transporter, CD36 expression was only increased in the T + EEQ group. Furthermore, both the T + EDP and T + EEQ groups showed decreased inflammatory NFκB signaling in the BAT. Our results suggest that 17,18-EEQ or 19,20-EDP combined with t-TUCB may prevent high-fat diet-induced metabolic disorders, in part through increased thermogenesis, upregulating lipid metabolic protein expression, and decreasing inflammation in the BAT.


Subject(s)
Anti-Obesity Agents/therapeutic use , Arachidonic Acids/therapeutic use , Benzoates/therapeutic use , Obesity/drug therapy , Phenylurea Compounds/therapeutic use , Adipogenesis , Adipose Tissue, Brown/cytology , Adipose Tissue, Brown/drug effects , Adipose Tissue, Brown/metabolism , Animals , Anti-Obesity Agents/administration & dosage , Anti-Obesity Agents/pharmacology , Arachidonic Acids/administration & dosage , Arachidonic Acids/pharmacology , Benzoates/administration & dosage , Benzoates/pharmacology , Blood Glucose/metabolism , Carnitine O-Palmitoyltransferase/metabolism , Diet, High-Fat , Epoxide Hydrolases/antagonists & inhibitors , Fatty Acids/metabolism , Male , Mice , Mice, Inbred C57BL , NF-kappa B/metabolism , Obesity/etiology , Obesity/metabolism , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/metabolism , Phenylurea Compounds/administration & dosage , Phenylurea Compounds/pharmacology
10.
Przegl Epidemiol ; 75(1): 45-50, 2021.
Article in English | MEDLINE | ID: covidwho-1337908

ABSTRACT

Currently, the issue of lifestyle combined with lack of physical activity in quarantine conditions during the COVID-19 pandemic has become a major health problem in many countries around the world. Increased inactivity is associated with increased obesity as well as decreased physical activity and general health. Kidney stones are the third most common urinary tract disease. Prevention of non-communicable diseases depends on controlling risk factors such as low levels of physical activity. Kidney stones are also among the noncommunicable diseases that can be prevented by changing behavioral habits. Physical activity is a behavior that has many proven health benefits and is one of the most effective ways to prevent chronic diseases. The aim of this study was to investigate sedentary lifestyle and its relationship with oxidative stress and kidney stone formation, and finally to provide medical solutions and recommendations.


Subject(s)
COVID-19/prevention & control , Exercise/physiology , Kidney Calculi/etiology , Obesity/etiology , Pandemics/prevention & control , Quarantine , Sedentary Behavior , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Poland , Risk Assessment , Risk Factors , SARS-CoV-2
11.
Nutrients ; 13(6)2021 Jun 20.
Article in English | MEDLINE | ID: covidwho-1273495

ABSTRACT

Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients by means of CDSS during the COVID-19 pandemic. In total, 55 BC women at stages I-IIIA were enrolled. They were randomly assigned either to Control group, receiving general lifestyle advice (n = 28) or the CDSS group (n = 27), to whom the CDSS provided personalised dietary plans based on the Mediterranean diet (MD) together with physical activity guidelines. Food data, anthropometry, blood markers and quality of life were evaluated. At 3 months, higher adherence to MD was recorded in the CDSS group, accompanied by lower body weight (kg) and body fat mass percentage compared to control (p < 0.001). In the CDSS arm, global health/quality of life was significantly improved at the trial endpoint (p < 0.05). Fasting blood glucose and lipid levels (i.e., cholesterol, LDL, triacylglycerols) of the CDSS arm remained unchanged (p > 0.05) but were elevated in the control arm at 3 months (p < 0.05). In conclusion, CDSS could be a promising tool to assist BC patients with lifestyle modifications during the COVID-19 pandemic.


Subject(s)
Breast Neoplasms , COVID-19 , Decision Support Systems, Clinical , Diet, Mediterranean , Life Style , Obesity/prevention & control , Pandemics , Adipose Tissue/metabolism , Adult , Behavior Therapy , Blood Glucose/metabolism , Body Mass Index , Body Weight , Cholesterol, LDL/blood , Female , Health Status , Humans , Middle Aged , Obesity/etiology , Patient Compliance , Quality of Life , SARS-CoV-2 , Triglycerides/blood
12.
Int J Environ Res Public Health ; 18(11)2021 06 04.
Article in English | MEDLINE | ID: covidwho-1266735

ABSTRACT

Soybean koji refers to steamed soybeans inoculated with microbial species. Soybean fermentation improves the health benefits of soybeans. Obesity is a serious health concern owing to its increasing incidence rate and high association with other metabolic diseases. Therefore, we investigated the effects of soybean and soybean koji on high-fat diet-induced obesity in rats. Five-week-old male Sprague-Dawley rats were randomly divided into four groups (n = 8/group) as follows: (1) regular diet (RD), (2) high-fat diet (HFD), (3) HFD + steamed soybean (HFD+SS), and (4) HFD + soybean koji (HFD+SK). SK contained more free amino acids and unsaturated fatty acids than SS. In a rat model of obesity, SK consumption significantly alleviated the increase in weight of white adipose tissue and mRNA expression of lipogenic genes, whereas SS consumption did not. Both SS and SK reduced serum triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels, and increased high-density lipoprotein cholesterol levels. SS and SK also inhibited lipid accumulation in the liver and white adipose tissue and reduced adipocyte size. Although both SS and SK could alleviate HFD-induced dyslipidemia, SK has better anti-obesity effects than SS by regulating lipogenesis. Overall, SK is an excellent functional food that may prevent obesity.


Subject(s)
Diet, High-Fat , Dyslipidemias , Animals , Diet, High-Fat/adverse effects , Dyslipidemias/etiology , Dyslipidemias/prevention & control , Liver , Male , Obesity/etiology , Obesity/prevention & control , Rats , Rats, Sprague-Dawley , Soybeans
13.
Nutrients ; 13(6)2021 Jun 03.
Article in English | MEDLINE | ID: covidwho-1259554

ABSTRACT

The pandemic of Coronavirus Disease 2019 (COVID-19) has shocked world health authorities generating a global health crisis. The present study discusses the main finding in nutrition sciences associated with COVID-19 in the literature. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding nutrition interventions and nutrition-related factors during the COVID-19 pandemic. The main search engines used in the present research were PubMed, SciELO, and Google Scholar. We found how the COVID-19 lockdown promoted unhealthy dietary changes and increases in body weight of the population, showing obesity and low physical activity levels as increased risk factors of COVID-19 affection and physiopathology. In addition, hospitalized COVID-19 patients presented malnutrition and deficiencies in vitamin C, D, B12 selenium, iron, omega-3, and medium and long-chain fatty acids highlighting the potential health effect of vitamin C and D interventions. Further investigations are needed to show the complete role and implications of nutrition both in the prevention and in the treatment of patients with COVID-19.


Subject(s)
COVID-19 , Communicable Disease Control , Diet , Feeding Behavior , Life Style , Nutritional Status , Pandemics , Exercise , Female , Health Behavior , Hospitalization , Humans , Male , Nutrients/deficiency , Obesity/etiology , SARS-CoV-2
14.
Physiol Rev ; 101(4): 1745-1807, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1216831

ABSTRACT

The prevalence of heart failure is on the rise and imposes a major health threat, in part, due to the rapidly increased prevalence of overweight and obesity. To this point, epidemiological, clinical, and experimental evidence supports the existence of a unique disease entity termed "obesity cardiomyopathy," which develops independent of hypertension, coronary heart disease, and other heart diseases. Our contemporary review evaluates the evidence for this pathological condition, examines putative responsible mechanisms, and discusses therapeutic options for this disorder. Clinical findings have consolidated the presence of left ventricular dysfunction in obesity. Experimental investigations have uncovered pathophysiological changes in myocardial structure and function in genetically predisposed and diet-induced obesity. Indeed, contemporary evidence consolidates a wide array of cellular and molecular mechanisms underlying the etiology of obesity cardiomyopathy including adipose tissue dysfunction, systemic inflammation, metabolic disturbances (insulin resistance, abnormal glucose transport, spillover of free fatty acids, lipotoxicity, and amino acid derangement), altered intracellular especially mitochondrial Ca2+ homeostasis, oxidative stress, autophagy/mitophagy defect, myocardial fibrosis, dampened coronary flow reserve, coronary microvascular disease (microangiopathy), and endothelial impairment. Given the important role of obesity in the increased risk of heart failure, especially that with preserved systolic function and the recent rises in COVID-19-associated cardiovascular mortality, this review should provide compelling evidence for the presence of obesity cardiomyopathy, independent of various comorbid conditions, underlying mechanisms, and offer new insights into potential therapeutic approaches (pharmacological and lifestyle modification) for the clinical management of obesity cardiomyopathy.


Subject(s)
Cardiomyopathies/etiology , Cardiomyopathies/pathology , Obesity/complications , COVID-19/complications , COVID-19/mortality , Cardiomyopathies/mortality , Humans , Obesity/etiology , Obesity/genetics , SARS-CoV-2
16.
Clin Obes ; 11(4): e12453, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1186146

ABSTRACT

The study aims to examine the impact of the coronavirus disease-2019 (COVID-19) pandemic lockdown on weight, overweight and obesity, and identify factors associated with weight gain. At a safety net health system in Massachusetts, 11 534 adults were retrospectively followed within 3 months of the COVID-19 lockdown. Chi-square and 95% confidence intervals (CI) were reported for categorical and continues variables, respectively. Multivariate analyses were performed to identify factors associated with weight gain (≥0.01 kg and 5%). During the lockdown period, greater proportion of women gained weight compared to men (46.1% vs 40.6%, P < .01). The obesity rate after the lockdown increased among women (40.7%-41.7, P < .01) but decreased among men (39.6%-38.6, P < .01) compared to before the lockdown. Post-lockdown obesity rates increased among Haitian (51.2%-55.0%, P < .01) and Hispanic women (50.7%-51.8%, P < .01). More than 5% weight gain was associated with 18 to 39 vs ≥60 years of age (OR = 1.45, 95% CI = 1.07, 1.97), food and housing insecurity (OR = 1.44, 95% CI = 1.05, 1.97) and tobacco use (OR = 1.38, 95% CI = 1.07, 1.78) among men; and 18 to 39 vs ≥60 years of age (OR = 1.55, 95% CI = 1.25, 1.91), Hispanics (OR = 1.25, 95% CI = 1.01, 1.54), Brazilians (OR = 1.22, 95% CI = 1.03, 1.45), and tobacco use (OR = 1.36, 95% CI = 1.10, 1.69) among women. During the COVID-19 lockdown, significant proportion of participants gained weight, but subgroup variations existed. Our study can inform healthcare professionals about the impact of the lockdown on unhealthy weight gain and identify vulnerable populations. Strategies are needed to combat unhealthy weight gain during and beyond the pandemic.


Subject(s)
Body Mass Index , COVID-19 , Communicable Disease Control , Obesity/etiology , Pandemics , Weight Gain , Adolescent , Adult , Aged , Female , Humans , Male , Massachusetts , Middle Aged , Obesity/epidemiology , Obesity/ethnology , Odds Ratio , Overweight , Prevalence , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sex Factors , Social Isolation , Young Adult
17.
Geriatr Nurs ; 42(1): 57-64, 2021.
Article in English | MEDLINE | ID: covidwho-1172446

ABSTRACT

Type 2 diabetes (T2D) contributes to reduced quality of life in older adults, especially in those with comorbidities such as being overweight or obese. Personal fitness technology (Fitbit ®) has the potential to improve the management of T2D. Using a semi-structured interview guide, focus groups were conducted to explore participants' acceptability and experiences following a behavioral lifestyle intervention that integrated Fitbit in overweight/obese older adults with T2D amid the COVID-19 pandemic which began during the time of this study. Focus group transcripts were transcribed and analyzed using thematic analysis. Eighteen (18) of the 20 participants completed the program and focus group interviews. Overall, we observed high acceptability of the program, and participants reported favorable experiences such as increased knowledge of health behaviors, improved diabetes management, and improved quality of life following the behavioral lifestyle intervention, even under stressful life circumstances from COVID-19.


Subject(s)
Behavior Therapy , COVID-19/epidemiology , Diabetes Mellitus, Type 2/psychology , Fitness Trackers , Life Style , Obesity/psychology , Aged , Diabetes Mellitus, Type 2/complications , Female , Focus Groups , Health Behavior , Humans , Male , Obesity/etiology , Obesity/therapy , Patient Acceptance of Health Care , Patient Satisfaction , Quality of Life
19.
Neuromuscul Disord ; 31(7): 607-611, 2021 07.
Article in English | MEDLINE | ID: covidwho-1164255

ABSTRACT

Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy. As a result of progressive muscle weakness, pulmonary function decreases during the second decade of life and lung disease contributes significantly to morbidity and mortality in these patients. Corticosteroids are the current standard of care for patients with DMD, despite known adverse effects such as obesity and immunosuppression. Over the past year (2020), the novel coronavirus (COVID-19/SARS-CoV2) outbreak has caused a global pandemic. Restrictive lung disease due to low lung volumes, chronic immunosuppressive treatment with corticosteroids, and obesity are potential risk factors that may contribute to a more severe course of the disease. Out of 116 Duchenne/Becker muscular dystrophy patients treated in our tertiary neuromuscular center, six patients with DMD and one with advanced Becker muscular dystrophy were found to be positive for COVID-19 infection. Two of the DMD patients were admitted for hospitalization, of whom one was dependent on daily nocturnal non-invasive ventilation. All patients recovered without complications despite obesity, steroid treatment and severe restrictive lung disease.


Subject(s)
COVID-19/therapy , Lung Diseases/therapy , Muscular Dystrophy, Duchenne/therapy , Noninvasive Ventilation , Adolescent , Adrenal Cortex Hormones/therapeutic use , COVID-19/epidemiology , COVID-19/physiopathology , Child , Comorbidity , Hospitalization , Humans , Lung Diseases/epidemiology , Lung Diseases/etiology , Male , Muscular Dystrophy, Duchenne/complications , Muscular Dystrophy, Duchenne/epidemiology , Obesity/etiology , Severity of Illness Index , Tertiary Care Centers , Treatment Outcome
20.
Curr Obes Rep ; 10(2): 181-190, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1141527

ABSTRACT

PURPOSE OF REVIEW: This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS: Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.


Subject(s)
COVID-19 , Communication , Obesity , Pandemics , Public Health , Social Stigma , Weight Prejudice , Body Weight , Bulimia/etiology , Humans , Mass Media , Obesity/etiology , Obesity/psychology , Physical Distancing , Psychological Distress , Social Isolation , Stress, Psychological/etiology , Weight Gain , Weight Prejudice/psychology
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