Obesity, sedentarism and TMD‐pain in adolescents

Background: Obesity is a chronic and prevalent disorder, affecting individuals of all age. Previous evidence suggests that it is associated with some types of chronic pain, especially musculoskeletal pain. In addition, sedentarism is also associated with an increase of the inflammatory factors and chronic pain. So, we conducted a cross‐sectional study to evaluate the association between obesity, sedentarism and the presence of TMD‐pain in adolescents. Methods: Temporomandibular Disorders were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Obesity was assessed by the body mass index (BMI), bioimpedance (BIA), skinfold (triceps and subscapular) and circumferences (arm and abdominal). The level of physical activity was rated according to the instrument adopted by the Brazilian National School Health Survey. Descriptive statistics, univariate logistic regression and odds ratios (OR) with 95% confidence intervals (CI) were used to study the associations of interest. Results: The sample consisted of 690 individuals with a mean age of 12.7 (±0.76) years of whom 389 (56.4%) were girls. Of the total, 112 (16.2%) had TMD‐pain, 110 (15.9%) were obese according to BMI, 74 (10.8%) according to BIA, and 127 (18.4%) following the skinfolds and circumferences assessments. There was no significant association between TMD‐pain and obesity according to BMI (P = 0.95), BIA (P = 0.16), skinfold and circumference (P = 0.22), and neither with sedentarism (P = 0.94). Conclusion: Obesity and sedentarism were not associated with the presence of TMD‐pain in adolescents

COVID‐19 and non‐alcoholic fatty liver disease: Two intersecting pandemics

Background: Initial evidence from China suggests that most vulnerable subjects to COVID-19 infection suffer from pre-existing illness, including metabolic abnormalities. The pandemic characteristics and high-lethality rate of COVID-19 infection have raised concerns about interactions between virus pathobiology and components of the metabolic syndrome. Methods: We harmonized the information from the recent existing literature on COVID-19 acute pandemic and mechanisms of damage in non-alcoholic fatty liver disease (NAFLD), as an example of chronic (non-communicable) metabolic pandemic. Results: COVID-19-infected patients are more fragile with underlying metabolic illness, including hypertension, cardiovascular disease, type 2 diabetes, chronic lung diseases (e.g. asthma, chronic obstructive pulmonary disease and emphysema) and metabolic syndrome. During metabolic abnormalities, expansion of metabolically active fat ('overfat condition') parallels chronic inflammatory changes, development of insulin resistance and accumulation of fat in configuring NAFLD. The deleterious interplay of inflammatory pathways chronically active in NAFLD and acutely in COVID-19-infected patients, can explain liver damage in a subgroup of patients and might condition a worse outcome in metabolically compromised NAFLD patients. In a subgroup of patients with NAFLD, the underlying liver fibrosis might represent an additional and independent risk factor for severe COVID-19 illness, irrespective of metabolic comorbidities. Conclusions: NAFLD can play a role in the outcome of COVID-19 illness due to frequent association with comorbidities. Initial evidences suggest that increased liver fibrosis in NAFLD might affect COVID-19 outcome. In addition, long-term monitoring of post-COVID-19 NAFLD patients is advisable, to document further deterioration of liver damage. Further studies are required in this field

The obesity paradox in cancer: clinical insights and perspectives

A series of evidence demonstrated that obesity represents an established risk factor for an increase in the incidence of multiple cancer types and for poor cancer survival. Nevertheless, recent studies suggested that, in a series of cancers, patients with a normal body mass index (BMI) have worse outcomes than obese patients. This phenomenon, named 'obesity paradox' or 'reverse epidemiology' in cancer, is not well understood and presents controversial aspects. Therefore, this review aims to explore the available studies concerning the relationship between obesity and cancer incidence or survival and to highlight the hypothetical explanations and the methodological framework. In this regard, we underline the limits of BMI as a potential marker of adiposity and the relevance to assessing body composition, beyond the body size. Further studies are needed to define the impact of obesity in cancer patients, to tailor weight management after cancer diagnosis and to hopefully improve overall clinical outcome