An Intensive Culinary Intervention Programme to Promote Healthy Ageing: The SUKALMENA-InAge Feasibility Pilot Study.

Dietary interventions are a key strategy to promote healthy ageing. Cooking skills training emerges as a promising approach to acquiring and maintaining healthy eating habits. The purpose was to evaluate the effectiveness of a culinary programme to improve healthy eating habits among overweight/obese adults (55-70 years old). A total of 62 volunteers were randomly (1:1) assigned to an culinary intervention group (CIG) or a nutritional intervention group (NIG). Dietary, cooking, and health-related outcomes, including body advanced glycation end product (AGE) levels, were evaluated at baseline and after four weeks. Mixed-effects linear models were used to assess the effects of the interventions within and between groups. Among the 56 participants who completed the trial, CIG participants achieved a significant improvement in Mediterranean diet adherence (1.2; 95%CI, 0.2 to 2.2) and a reduction in the use of culinary techniques associated with a higher AGE formation in foods (-2.8; 95%CI, -5.6 to -0.2), weight (-1.5; 95%CI, -2.5 to -0.5), body mass index (-0.5; 95%CI, -0.8 to -0.2), waist circumference (-1.4; 95%CI, -2.6 to -0.2), and hip circumference (-1.4; 95%CI, -2.4 to -0.4) compared with the NIG participants. Although a greater confidence in cooking in the CIG was found, attitudes and cooking habits did not improve. No significant differences in biochemical parameters or AGEs were found between groups. In conclusion, a culinary intervention could be successful in promoting healthy eating and cooking habits compared to a programme based on nutrition education alone. Nevertheless, further efforts are needed to strengthen attitudes and beliefs about home cooking, to address potential barriers and understand the impact of cooking interventions on biological parameters. Larger studies with longer follow-ups are needed to evaluate the relationship between cooking, diet, and health.

Obesity is a communicable disease.

Obesity has multiple causes and correlates. Usually studied as a metabolic and endocrine disease, with mechanical and musculoskeletal comorbidities, obesity also has a communicable angle to it. Obesity can be considered a communicable disease from the conventional point of view, as it is associated with viral etiology in animal and human models. It is also associated with increased prevalence and worse prognosis of infectious diseases. Not only that, obesity is a 'socially communicable' disease, as it 'spreads' amongst people living in similar environments.

Ultra Processed Foods: A South Asian culinary perspective.

There is a vast multitude of foodstuffs available, and health care professionals find it challenging to distinguish between healthy and unhealthy offerings. Recent evidence suggests that ultra processed foods should be avoided, as they are associated with harmful effects on health. This communication defines and describes ultra-processed foods, using the internationally accepted NOVA classification. It uses South Asian examples to make the concept easy to understand for South Asian readers.

The Barocene Era.

This communication defines and describes the Barocene era, as that phase of human development which is characterized by a major impact of overweight and obesity. We use this term to highlight the fact that overweight and obesity need to be prevented and managed on an urgent footing. If not checked, these endocrine diseases will retard our growth and reduce our well being.

Exercise And Physical Activity Diversity.

In this reflective opinion piece, we introduce the concepts of exercise diversity and physical activity diversity. Similar to dietary diversity and dietary variety, exercise/physical activity diversity represents part of a comprehensive target of ideal health, an objective parameter to audit one's progress towards such a goal, and a means of accomplishing this aim. We define this concept as the number of types of exercise, the number of limbs and body parts exercised or muscle groups involved, the variety of intensity, or the number of variations in methods of exercise used. A non-weighted score may be allocated to each exercise, limb, and muscle group to get a raw idea of diversity.

Association of Adolescents' Body Mass Index Classification With Preventive Clinical Care Receipt.

PURPOSE: To examine differences in screening and advising for modifiable risk behaviors during well-visits based on adolescents' body mass index categories. METHODS: Retrospective analyses were conducted with the National Institute of Health's NEXT Generation Health Study data, a nationally representative cohort of 10th graders. In wave 1 (2010), adolescents were classified as being underweight (<4.99th percentile), normal-weight (5-84.99th percentile), overweight (85-94.99th percentile), or with obesity (≥95th percentile) based on the body mass index categories described by the Centers for Disease Control and Prevention. In wave 2 (2011), adolescents were asked by their provider about smoking, alcohol use, use of other drugs, sexual activity, nutrition, and exercise, and whether they were advised about risks associated with these behaviors. RESULTS: The sample consisted of 1,639 eligible participants as follows: 57.8% females, 63.3% 16-year-olds, 47.8% non-Hispanic Whites, 41.5% living in the South, 75.4% with health insurance, and 29.8% with low family affluence. Screening rates for overweight compared to normal-weight males were 51% reduced for smoking, 46% for alcohol use, 47% for other drug use, 57% for nutrition, and 47% for exercise. Screening rates were 40% reduced for other drug use for males with obesity, and 89% reduced for alcohol use for underweight males compared to normal-weight males. Advice receipt for females with obesity compared to normal-weight females was 90% increased for nutrition and 78% increased for exercise. DISCUSSION: Overweight male adolescents reported being less likely to be screened across almost all preventive service topics representing missed opportunities for care delivery.

Bariatric Triage: Weight Loss As A Tool For Therapeutic Decision Making.

This communication highlights how early weight loss can be used as a technique for triage in persons who have undergone bariatric surgery, and as a tool for therapeutic decision making. Weight loss is a target for obesity medicine, but can also be used to plan further treatment strategies and interventions. In this manner, early weight loss is similar to HbA1c (glycated haemoglobin) which is a diagnostic tool, a monitoring device, a therapeutic target, and also a technique to decide intensity of treatment in diabetes.

The Bariatric Pyramid: A framework for therapeutic targets.

The Bariatric Pyramid is a model which serves to explain the goals of obesity management, act as a milestone for monitoring of therapy, and to benchmark the utility of various anti-obesity medications and interventions. Built upon a base of sustainability, it lists three more desired aspects of care: sufficiency (sufficient strength) safety and security. Each of the four aspects of the pyramid: sustainability, sufficiency safety and security have three angles, which allows the reader to understand them easily. The model that we propose is useful in training health care professionals, in therapeutic patient education, for assessing various anti-obesity therapies, and in reaching the right decision while managing obesity.

Intermittent energy restriction vs. continuous energy restriction on cardiometabolic risk factors in patients with metabolic syndrome: a meta-analysis and systematic review.

Background: This is a systematic review and meta-analysis to compare the efficacy of intermittent energy restriction (IER) vs. continuous energy restriction (CER) on weight loss, body composition, blood pressure, and other cardiometabolic risk factors in patients with metabolic syndrome (MetS) risk factors. Methods: We searched and screened PubMed, Embase, Cochrane Library, and Web of Science from inception to May 8, 2022 for randomized controlled trials. Two review authors independently selected studies, extracted data, assessed quality and risk of bias and cross-checked extracts to resolve discrepancies when required. We expressed effect size as mean difference (MD) and 95% confidence interval (CI). The major outcome was the improvement of MetS risk factors, including changes in waist circumference (WC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), blood pressure (BP), and fasting plasma glucose (FPG) levels. The secondary outcomes were body weight (BW), body mass index (BMI), body fat (BF), fat free mass (FFM), hip circumference (HC), fasting insulin (FINs), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-c). Results: The meta-analysis included 16 articles (20 trials) with a total of 1,511 participants. All studies had a low risk of bias for random sequence generation. The IER and CER intervention equally improved MetS risk factors WC (MD = -0.47, 95% CI [-1.19, 0.25]), TG (MD = -0.02 mmol/L, 95% CI [-0.11, 0.07]), FPG (MD = -0.02 mmol/L, 95% CI [-0.10, 0.05]) and BP (systolic blood pressure: MD = 0.93 mmHg, 95% CI [-2.74, 4.61]; diastolic blood pressure: MD =1.15 mmHg, 95% CI [-0.24, 2.55]), but HDL-c (MD = 0.03 mmol/L, 95% CI [0.01, 0.05]) was significant improved in IER when compared with CER. For second outcomes, BW (MD = -0.8 kg, 95% CI [-1.26, -0.33]), BF (MD = -0.75 kg, 95% CI [-1.73, -0.13]) and FFM (MD = -0.49 kg, 95% CI [-0.92, -0.05]) were also significant improved in IER, and not for other outcomes. Conclusion: Both IER and CER could improve MetS biomarkers, but IER was more effective than CER in the improvement of HDL-c only. For secondary outcomes, IER was also more effective for BW, BF and FFM, but there were no differences in effects for other outcomes.

Hidden Obesity.

This communication proposes the term "hidden obesity" to describe normal weight obesity, or increased adiposity without a corresponding increase in body mass index. It uses the concept of hidden hunger to craft semantics which will generate greater attention to this condition from all stake-holders, including policymakers and planners. The article describes simple tools which can be used to suspect and confirm the diagnosis of hidden obesity. This phenotype is very commonly seen in the south Asian population.

Culinary Counselling in Chronic Care: The Pentad of Cs & Ps.

Diet and nutrition are an integral part of chronic metabolic disease management. Medical nutrition therapy (MNT) providers focus upon caloric and nutrient adequacy, but do not necessarily incorporate person-friendly recipes in their ambit. In this communication, we share a simple framework of culinary counseling. This supplements MNT, and enhances its value by encouraging adherence and persistence to prescribed therapy.

Efeito do taping no Tendão de Aquiles nos parâmetros da marcha em indivíduos assintomáticos obesos e acima do peso / Effect of Achilles Tendon taping on parameters of gait in asymptomatic-overweight and obese individuals

INTRODUÇÃO: Sobrepeso e obesidade afetam variáveis de marcha tais como cadência, comprimento do degrau e comprimento dos passos junto com a deterioração do tendão de Aquiles. A rígida rosca do tendão de Aquiles reduz a tensão e aumenta a estabilidade da articulação e pode ser empregada como suporte externo durante o treinamento da marcha para modificar os parâmetros da marcha. OBJETIVO: Descobrir se o taping modifica os padrões de marcha com o aumento do peso. MÉTODOS E MATERIAIS: Foram recrutados 40 sujeitos (20 acima do peso e 20 obesos) cujo comprimento dos degraus, comprimento dos passos e cadência foram medidos antes e depois da fita rígida do tendão de Aquiles. Cada pessoa completou o teste de caminhada de 10 metros usando o aplicativo Gait Analyzer. RESULTADOS: O teste Shapiro-Wilk é usado para avaliar a normalidade dos dados. O Wilcoxon Signed Rank Test e o Mann-Whitney U Test são usados para diferenças dentro e entre grupos. As diferenças dentro do grupo foram significativas nos parâmetros de marcha p <0,05 (Passo comprimento p<0,001, Stride comprimento p<0,001 e cadência p=0,009). Os parâmetros de marcha não diferiram estatisticamente entre os grupos. CONCLUSÃO: A aplicação de fita rígida no tendão de Aquiles tem um efeito semelhante nos parâmetros da marcha em indivíduos com excesso de peso e obesos. Após a aplicação da fita adesiva, verificou-se uma diferença significativa em termos de comprimento da passada, comprimento do passo e cadência na população estudada antes e depois da aplicação da fita adesiva para Aquiles. Isto implica que, independentemente do peso corporal, a intervenção com fita adesiva afeta a mecânica da marcha de forma comparável e destina-se a evitar movimentos articulares excessivos, a fornecer informações proprioceptivas durante as atividades e a diminuir o desconforto.

INTRODUCTION: Overweight and obesity affect gait variables such as cadence, step length, stride length, and Achilles tendon deterioration. Rigid Achilles tendon Taping reduces stress and enhances joint stability and can be employed as external support during gait training to modify gait parameters. OBJECTIVE: To find out whether taping modifies gait patterns with increasing weight. METHODS AND MATERIALS: 40 subjects were recruited (20 overweight and 20 obese) whose step length, stride length, and cadence were measured before and after rigid Achilles tendon taping. Each person completed the 10-meter walk test using Gait Analyzer application. RESULTS: The Shapiro-Wilk test is used to assess the normality of the data. Wilcoxon Signed Rank Test is used for within-group differences. Within-group differences were significant in gait parameters p <0.05 (Step length p<0.001, Stride length p<0.001 and cadence p=0.009). CONCLUSION: Rigid Achilles tendon taping have a similar effect on gait parameters in overweight and obese individuals. After taping, there was a significant difference in terms of stride length, step length and cadence in the study population before and after Achilles taping. This implies that regardless of body weight, the tape intervention affects gait mechanics in a comparable way and is intended to prevent excessive joint motion, provide proprioceptive input during activities, and lessen discomfort.

Impacto do taping no Tendão de Aquiles nos parâmetros da marcha em indivíduos assintomáticos obesos e acima do peso / Impact of Achilles Tendon taping on parameters of gait in asymptomatic-overweight and obese individuals

INTRODUÇÃO: O taping do Tendão de Aquiles afeta os parâmetros da marcha em adultos com sobrepeso e obesos? O comprimento dos passos, o comprimento das passadas e a cadência são todos mais curtos nestes indivíduos, com maiores índices queda. OBJETIVO: Saber o efeito do taping do Tendão de Aquiles nos parâmetros de marcha em indivíduos obesos e com sobrepeso. MÉTODOS: Um ensaio clínico será realizado em um ambulatório de fisioterapia. Um total de quarenta participantes com Índice de Massa Corporal (IMC) maior que 25 serão recrutados pelo método de amostragem por conveniência. Cada grupo terá 20 participantes, com idade entre 18 e 35 anos, sobrepeso com IMC>25 a 29,9 e obesidade com IMC>30. Ambos os grupos caminharão por 10 metros e um minuto usando um analisador de marcha, e ambos os grupos terão taping nos Tendões de Aquiles. A variável preditora será o taping do Tendão de Aquiles e as variáveis de resultado serão o comprimento do passo, o comprimento da passada e a cadência, que serão medidos antes e imediatamente após a bandagem. O software SPSS 20.0 será utilizado para análise estatística, com nível de significância de p<0.05. PERSPECTIVAS: A conclusão do ensaio clínico fornecerá informações sobre o impacto da bandagem do Tendão de Aquiles na marcha em indivíduos com sobrepeso ou obesos. Além disso, poderia potencialmente demonstrar que a bandagem pode reduzir o risco de quedas e, assim, impactar positivamente na qualidade de vida.

INTRODUCTION: Does Achilles Tendon taping affect gait parameters in overweight and obese adults? Step length, stride length, and cadence are all shorter in these individuals, with increased fall ratios. OBJECTIVE: To know the effect of Achilles Tendon taping on gait parameters in overweight and obese individuals. METHODS: A clinical trial will be conducted in a physical therapy outpatient clinic. A total of forty participants with a Body Mass Index (BMI) greater than 25 will be recruited by convenience sampling method. Each group will have 20 participants, aged between 18 and 35 years old, overweight with BMI>25 to 29.9, and obese with BMI>30. Both groups will walk for 10 meters and one minute using a gait analyzer and both groups will have taping on the Achilles Tendons. The predictor variable will be the taping of the Achilles Tendon, and the outcome variables will be step length, stride length, and cadence, which will be measured before and immediately after taping. SPSS 20.0 software will be used for statistical analysis with a significance level of p<0.05. PERSPECTIVES: Completion of the clinical trial will provide information on the impact of Achilles Tendon taping on gait in overweight or obese individuals. In addition, it could potentially demonstrate that taping can reduce the risk of falls and thus positively impact the quality of life.

Adolescents with anorexia nervosa or atypical anorexia nervosa with premorbid overweight/obesity: What should we do about their weight loss?

Traditionally, anorexia nervosa (AN) was understood to exist exclusively among underweight individuals and weight was used to assess level of severity and course of treatment. Recent trends have found a growing number of individuals presenting with AN or atypical AN (AAN) (i.e., those who remain with weight in a "normal" or "healthy" range despite significant weight loss) have a premorbid history of overweight/obesity. Individuals with AN/AAN and premorbid overweight/obesity represent an especially metabolically vulnerable population as with either AN or AAN, there is marked weight loss. Patients with AAN present a specific challenge as healthcare professionals must identify a clinically significant eating disorder in adolescents of potentially "normal" weights and then must balance their knowledge and training of traditional treatment of AN with obesity treatment and prevention. Currently, there are no evidence-based treatments to guide medical and mental health professionals regarding weight restoration, medical stabilization, and psychological treatment in patients with AN/AAN with a history of overweight/obesity while also addressing risk prevention for obesity.

Supervivencia global y libre de enfermedad en mujeres con sobrepeso/obesidad al diagnóstico de cáncer de mama: Un estudio observa-cional de centro único / Overall and disease-free survival in women being over-weight/obesityat the diagnosis of breast cancer. A single-center observationalstudy

Introducción:El objetivo del presente estudio fue evaluar las características clínicas, patológi-cas e histológicas tumorales y su asociación con la recurrencia, metástasis y pronóstico en términos de supervivencia global y libre de enfermedad, de las pacientes que padecen sobre-peso u obesidad al momento del diagnóstico de cáncer de mama.Materiales y métodos:Se condujo un estudio descriptivo,longitudinal,retrospectivo, en un centro oncológico de referencia de Medellín. Se recolectó información de pacientes mayores de 18 años, con cáncer de mama infiltrante temprano y avanzado, entre los años 2012 ­2017, quienes presentaran IMC ≥ 25 kg/m2 al momento del diagnóstico. Las medianas de supervi-vencia se calcularon a través de curvas de Kaplan Meier y las diferencias mediante Log Rank Test.Resultados:Se analizó información de 1.349 pacientes. La mortalidad por todas las causas fue de 13.6% y aumentó proporcionalmente con el IMC (HR = 1.03, IC 1.0-1.05). Se identifica-ron 12.6% de recurrencias y el riesgo con el aumento de IMC no fue estadísticamente signifi-cativo (HR =1.02, IC 0.99 -1.05). Características como mala diferenciación tumoral, invasión linfovascular y estadio tumoral se asociaron de forma univariada con mayor mortalidad.Conclusión:Se demostró una asociación positiva e independiente entre el IMC elevado, la mortalidad y el riesgo de recurrencia en pacientes con cáncer de mama. Así como una aso-ciación con fenotipos tumorales agresivos y características de peor pronóstico. Se sugiere considerar modificaciones en el estilo de vida y un manejo multidisciplinario, como estrate-gias que posiblemente impacten en estos desenlaces

Introduction:The objective of the present study was to evaluate the clinical, pathological, and histological characteristics of tumors and their associations with recurrence, metastasis,and prognosis in terms of overall and disease-free survival inoverweight or obese patients at the time of diagnosis.Materials and methods: A descriptive, longitudinal, retrospective study was conducted at a reference cancer center in Medellin. Information was collected from patients older than 18 years of age with early or advanced infiltrating breast cancer between 2012 and 2017 who had a BMI ≥ 25 kg/m2 at the time of diagnosis. Median survival rates were calculated using Kaplan­Meier curves, and differences were determined using the log-rank test.Results: Information from 1,349 patients was analyzed. All-cause mortality was 13.6% and increased proportionally with BMI (HR = 1.03, CI 1.0-1.05). A total of 12.6% of the recurrences were identified,and the risk with increasing BMI was not significantly different(HR =1.02, CI 0.99 -1.05). Patient characteristicssuch as poor tumor differentiation, lymphovascular inva-sion, and tumor stage were univariately associated with increasedmortality.Conclusion: Positiveand independent associations weredemonstrated between high BMI and mortality and between high BMI and the risk of recurrence in patients with breast cancer. In addition, there wasan association betweenaggressive tumor phenotypes and worse prog-nostic characteristics. Lifestylemodifications and multidisciplinary management should be considered strategies for impactingthese outcomes

Growth patterns of urban Malaysian children under 24 months of age in Selangor, Malaysia

@#Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age. Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards. Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor-age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months. Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.

The Role of Individually Selected Diets in Obese Women with PCOS-A Review.

Polycystic ovarian syndrome (PCOS) is one of the most common heterogeneous endocrine and metabolic disorders in premenopausal women. It is a complex multifactorial disorder with strong epigenetic and environmental influences, including factors related to eating habits and lifestyle. There is a close relationship between obesity and PCOS. Weight gain and obesity are often clinical symptoms manifested by biochemical markers. Moreover, abdominal obesity in women with PCOS is involved in the development of inflammatory changes. A significant share of balanced therapies correcting the lifestyle of patients is suggested, e.g., with the implementation of appropriate diets to minimize exposure to inflammatory factors and prevent abnormal immune system stimulation. In the case of obese patients with PCOS, planning a diet program and supporting the motivation to change eating habits play an important role to lose weight and lower BMI. Probiotics/synbiotic supplementation may enhance weight loss during the diet program and additionally positively affect metabolic and inflammatory factors by improving the intestinal microbiome.

Weight Management for Students with Attention-Deficit Hyperactivity Disorder (ADHD): A Qualitative Study.

(1) Background: Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) are more likely to respond with an ineffective coping behavior, combined with an increased risk of weight gain and unhealthy food consumption. The aim of the study was to examine coping strategies adopted by overweight adults with ADHD to promote healthy behaviors and weight-control management. (2) Methods: Descriptive qualitative research using semi-structured interviews analyzed through a thematic content-analysis approach. The study included 30 college students diagnosed with ADHD, with a BMI ≥25.5, who had lost ≥10 kg within at least one year and successfully maintained that weight for the past three years. (3) Results: The study yielded two main themes. The first is struggling with disappointments and negative feelings in the past, and the second is the reciprocity between weight management and coping skills strategies. The second theme includes three subthemes-cognitive strategies, behavioral strategies, and emotional strategies. (4) Conclusions: It is essential to understand the variety of coping strategies used by adults to cope with ADHD challenges that can potentially improve weight control management and healthy behaviors to design better, more accurate interventions, promoting the target population's well-being and health.

Baro-buddies: Supporting the fight against obesity.

Obesity has reached pandemic proportions across the world. Though novel therapies continue to emerge to promote weight loss, long term maintenance of the lost weight is one of the major challenges in obesity management. A multidisciplinary team approach is often useful in recommending the best patient centric method of losing weight, but this requires constant motivation, guidance, support and need for troubleshooting at times of need. To address this, we propose a new avatar in the obesity management of obesity called the "Baro-Buddy" which is a portmanteau, derived from 'baros'(weight) and buddy (friend). This brief manuscript describes the eligibility, role and utility of a barobuddy in day-to-day management of obesity.

Screening for syndromic causes of obesity.

Syndromic obesity is sometimes encountered in clinical practice, but may often be misdiagnosed. This is more often seen in the south Asian region due to higher rates of consanguinity. This article simplifies the clinical features which should prompt a high index of clinical suspicion, and ensure a detailed assessment for syndromic obesity including a genetic test. This manuscript lists various aspects of history and physical examination in an alliterative manner.