Phenotyping Ethnic Differences in Body Fat Depots

There are remarkable ethnic differences in the incidence of metabolic syndrome associated features; including insulin resistance, type 2 diabetes, hypertension and cardiovascular diseases. Studies have suggested that South Asians (SA) present an unfavourable body fat phenotype, which includes a pattern of elevated visceral adipose tissue (VAT), and liver fat content; depots strongly associated with the progression of metabolic dysregulation. However, there are a limited number of studies examining body fat composition by ethnicity. The purpose of this thesis was to comprehensively phenotype VAT, abdominal subcutaneous adipose tissue (ASAT) and liver fat content in Caucasian (Cau), SA and Black African (BA) individuals from a large number of distinct populations. Here, I include data from three adult cohorts: the UK Biobank (n=9533) of mixed ethnicities, the DIRECT cohort (n=1553) of Cau pre-diabetic individuals and The West London Observation (TWLO) cohort (n=747) of mixed ethnicities. In addition, I present data from Pune Maternal Nutrition study (PMNS) cohort; comprising 423 young adults of SA descent in India. Analyses of body fat phenotype in Cau pre-diabetic populations showed higher VAT (mean differences= 0.5 litre, p<0.0001) and liver fat content (mean differences= 0.6%, p<0.0001), but lower ASAT (mean differences= -0.2 litre, p<0.0001) compared to Cau from the general population (free-living). I also observed negative associations between VAT, ASAT, liver fat content and day to day physical activity in both pre-diabetic and general populations (pre-diabetic; VAT; r= -0.296, ASAT; r= -0.163, liver fat: r= -0.186 and general population; VAT; r= -0.185, ASAT: r= -0.374, liver fat: r= -0.139, p<0.001 for all). Analysis of both the TWLO and UK Biobank revealed no differences in VAT or liver fat in SA in UK compared to other ethnic groups (TWLO; VAT: SA: 3.0 ± 1.6 litres, Cau: 3.3 ± 2.1 litres; liver fat: SA= 6.4 ± 11.1%, Cau= 6.5 ± 13.6%, p=ns - UK Biobank; VAT: SA: 3.6 ± 1.6 litres, Cau: 3.8 ± 1.5 litres; liver fat: SA: 4.6 ± 4.6%, Cau: 4.2 ± 4.6%, p=ns). Analysis of both these cohorts also revealed a more favourable body fat phenotype with BA males presenting significantly less VAT than SA and Cau males (p<0.05 for both). Data from the PMNS cohort revealed high levels of VAT in 18 year old India-based SA population. A high proportion (58.7%) of these lean individuals also presented with the thin-outside fat inside (TOFI) phenotype (a ratio of VAT to ASAT). A key finding is the lack of an unfavourable body fat phenotype in UK based SA. Therefore, the increased incidence of metabolic syndrome associated features in the SA population may arise via a mechanism unrelated to elevated levels of VAT or liver fat

Childhood Obesity

The prevalence of overweight and obesity has significantly increased over the past few decades and is linked to metabolic diseases across the lifespan. Its etiology has been attributed to a large number of sociodemographic, behavioral (e.g. unhealthy nutrition, low levels of physical activity), perinatal, and clinical risk factors, which are active already from childhood and adolescence. Still, their exact role, interplay, and mechanisms implicated in this process remain unclear. The trends of childhood obesity call for actions regarding the prevention and management of this disease early in life. The Special Issue “Childhood Obesity: Nutrition and Lifestyle Determinants, Prevention and Management” aims to host original articles, systematic reviews or meta- analyses that will advance the current knowledge on the role of health behaviors, especially of nutrition, on the development of overweight or obesity in childhood and adolescence, provide valuable information about the nutritional habits of overweight/obese children and adolescents, and describe novel approaches via lifestyle modification for the prevention or management of obesity in youth

Cardiovascular and metabolic effects of long-term traffic noise exposure

Traffic noise is an increasingly common environmental exposure affecting large parts of the European population. Since the auditory system is directly linked to the sympathetic nervous and the endocrine systems, noise may induce a stress response, influencing several physiological, metabolic and immunological processes. Previous epidemiological studies suggest harmful effects of traffic noise on the cardiovascular system; however, the overall picture is inconclusive. The primary aim of this thesis was to investigate the long-term effects of traffic noise on cardiovascular and metabolic outcomes. A secondary aim was to apply and evaluate digital noise maps produced in Sweden in accordance with the European Environmental Noise Directive (END) for assessments of residential traffic noise exposure. The long-term effects of aircraft noise on hypertension, obesity and Type 2 diabetes were investigated using questionnaire and clinical data from a cohort within the Stockholm Diabetes Prevention Program. Aircraft noise exposure was assessed by Geographic Information Systems and based on the participants’ residential history. After exclusion of subjects who used tobacco prior to the clinical examinations, the risk of hypertension related to aircraft noise exposure was increased in males (RR per 5 dB(A) Lden 1.21; 95% CI 1.05-1.39) but not in females (RR 0.97; 0.83-1.13). Stronger associations were seen among noise annoyed (RR 1.42; 1.11-1.82). Regardless of sex, long-term exposure to aircraft noise also showed statistically significant associations with waist circumference: 0.62 cm (0.54-0.70) per 1 dB(A) Lden. Also, females exposed at ≥50 dB(A) Lden had a twofold increased risk of Type 2 diabetes, although adjustments for contextual confounding reduced the estimates. A sub-population of the National Environmental Health Survey 2007 (NEHS07) was used to evaluate the Swedish END maps of road traffic and railway noise. The observed proportion of annoyed subjects was plotted as a function of noise exposure and compared to already established exposure-response functions. Generally, there was a good agreement between observed and predicted proportions of annoyed, suggesting that the noise maps are useful for assessments of residential traffic noise exposure. The best agreement was found when the noise estimates derived from the maps were adjusted for how the dwellings were located within the buildings. Cross-sectional analyses were performed based on the NEHS07 of associations between neighborhood traffic load, Lden levels of road traffic and railway noise, respectively, and prevalence of self-reported hypertension and cardiovascular disease. Neither traffic load nor road traffic noise was associated with the cardiovascular outcomes; however, there was a borderline significant association between railway noise and cardiovascular disease. Methodological limitations make these results difficult to interpret. In conclusion, our findings suggest adverse effects of long-term traffic noise exposure on cardiovascular as well as metabolic outcomes. Thus, traffic noise may have detrimental public health effects and research in this area should be prioritized

Review about 3D-body scanning in the LIFE sample and their characteristics in anthropometric, actometric and medical context

Abstract Background The shape of the human body was, is and will be a major point of interest in healthcare: Researchers studied the different types of bodies for years, addressing a variety of different questions, but mostly focusing on classic anthropometric parameters like weight, height and index parameters (e.g. body mass index, waist to hip ratio and waist to height ratio). In the following, this view will be extended by utilizing 3D-body scanner data towards a holistic description of the previously defined body types of Leipzig population and with regard to their relation to activity parameters, physiological parameters, and predisposition to selected diseases. Data and methods The LIFE study is a population based cohort study with 10,000 participants (4,766 male and 5,234 female) recruited from the city of Leipzig covering a main age range from 40 to 80 years. The study has been designed to investigate civilization diseases, their risk factors, and potential early onset-markers. In the frame of this study, anthropometry was performed using a 3D-body scanner, and activity data was measured in a smaller subcohort of 2,429 participants using a BodySense Armlet. Anthropometric data were previously utilized to define so-called body types, which collect participants with similar body shapes. Results We figured out that most body types are gender-specific, however two body types lack gender-specifics. Moreover, anthropometric and activity parameters show gender-specific differences and change specifically upon ageing: In general, participants are getting smaller, are gaining weight while aging and are losing weight in higher age again. The index parameters are stagnating with growing age, because incremental changes are getting smaller. Also, the participants are less active with increasing age. For physical activity, we were able to confirm a relation between circumference body measures and activity parameters. In the study anthropometric and activity parameters are evaluated in terms of body type specificity: They reveal similar changes upon ageing as observed in the age strata, but some markedly deviate from these expected developments. We also found health risk body types with potential health issues. Furthermore, we have found that BMI levels are virtually constant in the body types upon ageing, while the activity parameters are steadily decreasing. The prevalence of a number of relevant diseases like hypertension, hyperlipidaemia, myocardial infarction, angina pectoris, arthrosis and diabetes, but not depression and rheumatism, showed clear associations to the parameters age, BMI, and MET. In general, the risk body types revealed highest prevalence among the body types, partly on gender-specifically differing overall prevalence levels. Paradoxically, obese and ‘inactive’ body types do not show increased prevalence of myocardial infarctions for men and, especially, for women. Summary and conclusion This study has presented a comprehensive and detailed characterization of the anthropometric body types of Leipzig population in the context of ageing, physical activity, and prevalence of major diseases. Understanding body type-associated risk profiles opens new options in diagnostics and therapy. In this sense, anthropometric body typing represents another step towards individualized medicine.:Table of content 1 Introduction 1 2 Background 3 2.1 Anthropometry 3 2.1.1 Classic measures 3 2.1.2 Physiological indices 4 2.1.3 Usage of 3D-body scanners in medical applications 5 2.2 Physiological parameters 5 2.2.1 Measurement of physical activity 6 2.2.2 Blood pressure 7 3 Data and Methods 8 3.1 LIFE – the Leipzig population study 8 3.2 Anthropometry using 3D-body scanning 9 3.3 Definition of meta-measures and body types 9 3.4 Methods for measuring the physical activity 10 3.4.1 Body SenseWear Pro Armband 10 3.4.2 IPAQ 11 3.4.3 Comparison of IPAQ and SWA 11 3.5 Units 12 4 General characterization of the study population 13 4.1 Anthropometric parameters vary upon aging 13 4.2 Activity level decreases with age 17 4.3 Body measures associated with activity parameters 20 5 Description of the body types 22 5.3 Physical activity parameters of the body types 26 5.4 Age related development of the body types 29 5.5 Body types of the oldest participants 33 5.6 Distribution widths 34 6 Body types and their prevalence of selected diseases 37 6.1 BMI and MET as risk factors 37 6.2 Hypertension 39 6.4 Hyperlipidaemia 43 6.5 Myocardial infarction 44 6.6 Angina pectoris 46 6.7 Arthrosis 48 6.8 Diabetes 49 6.9 Depression 51 6.10 Rheumatism 53 6.11 Disease prevalence and their relation to the body types 55 7 A holistic review of the body types in the LIFE study population 58 7.1 General aspects 58 7.2 Gender-unspecific body types B1 and B2 58 7.3 Female body types 59 7.4 Male body types 63 8 Summary and Conclusion 66 References 68 Appendix A Regression analysis of body measures towards MET. 77 Appendix B The ageing human body shape 79 Erklärung über die eigenständige Abfassung der Arbeit 114 Danksagung 115 Lebenslau

Development and evaluation of the America On the Move program for university students

2013 Fall.Includes bibliographical references.To view the abstract, please see the full text of the document

Mediterranean Diet and Metabolic Diseases

Dear Colleagues, There is increasing interest regarding the protective effect of dietary patterns on a series of metabolic diseases as compared to specific food items and nutrients, since it is well accepted that foods act synergistically. In recent years, the Mediterranean diet (MD) has gained popularity as one such dietary pattern, demonstrated to deliver many benefits according to a variety of different studies (cohort, RCT, etc.), adding to its legacy. The intention of this Special Issue is to stimulate sharing of additional clues that may further develop our understanding of the relationship between the Mediterranean diet and metabolic diseases. Another aim is to clarify potential differences in the benefits observed by different MD patterns. Moreover, as more info becomes available on the effect of MD patterns in the microbiome but also in the area of proteomics and epigenetics, relevant mechanisms and involved key mediators still need to be identified in order to provide further clarity in the description of the underlying mechanisms and the potential health outcomes occurring in response to adhering to MD. You are cordially invited to submit proposals for manuscripts that bring new elements into this interesting and promising topic. We invite clinicians and researchers to submit relevant scientific work from epidemiological or clinical studies, either original articles or reviews, to this Special Issue of Nutrients entitled “Mediterranean Diet and Metabolic Diseases”

Dietary Habits, Beneficial Exercise and Chronic Diseases

Several lines of evidence indicate that healthy diet and exercise can prevent cardiovascular diseases, stroke, diabetes, and some types of cancer such as colon cancer, and smoking-related cancers. Dietary patterns defined as the quantities, proportions, variety, or combination of different foods and drinks, and the frequency with which they are habitually consumed are also associated with an increased or decreased incidence of chronic diseases. Lately, an association has been found between eating habits, exercise, and psychological and/or mental disorders. This Special Issue of Nutrients, entitled “Dietary Habits, Beneficial Exercise, and Chronic Diseases: Latest Advances and Prospects”, contains 20 manuscripts, either describing original research or reviewing the scientific literature, focused on the relationship between dietary habits (macronutrients, micronutrients, etc.) and/or exercise with metabolic, cardiovascular, neurological, mental, rheumatic, inflammatory, gastrointestinal, odontostomatological, and other chronic diseases

Nutritional Habits and Interventions in Childhood

The objective of this book is to present nutritional and educational interventions for children and their families. The creation of healthy preferences is a key determinant of food choices and therefore diet quality. Food choices have important implications for health, particularly for food-related diseases, such as feeding difficulties and the development of non-communicable diseases. The first years of a child's life are fundamental for the creation of tastes, eating habits and the relationship with food. Preferences for certain foods are neither innate nor unchangeable. Eating behaviour is the result of experience and learning, and, through the repeated offering of food by parents, especially those less accepted, it is possible to promote good nutrition. Behaviour depends on the interaction of environmental factors, genetics, sex, and age. The environment in which the child is immersed, and which influences them, includes family, other children, society, media and the supply of food. Achieving an adequate intake of macro and micro-nutrients is an important objective for all ages of life and, particularly, for those of pediatric age, since it is crucial for cognitive development. Nutrition has also a therapeutic effect. Nutritional interventions tailored to specific pathologies are needed to prevent nutritional deficiencies and maintain an adequate nutritional status, since children and adolescents with chronic or inflammatory diseases are particularly vulnerable and at major risk of developing malnutrition