Waist Circumference Thresholds Provide an Accurate and Widely Applicable Method for the Discrimination of Diabetes

Excess weight, particularly central obesity, is recognized to be a major determinant of diabetes risk in all populations, with the magnitude of the association reported as being stronger in Asians than whites (1–3). Consequently, indicators of overweight have been incorporated into several guidelines for the early identification of individuals with type 2 diabetes (4). However, the anthropometric cut points for different ethnic groups have been determined in various ways, leading to uncertainty about their applicability to diabetes screening. Here, we clarify current uncertainty regarding ethnic differences in the relationship between overweight and diabetes and whether there is a single measure of overweight that can be determined routinely and applied universally in clinical practice to facilitate earlier detection of diabetes in the general population

Impact of obesity on the metabolic control of type 2 diabetes: Results of the Turkish nationwide survey of glycemic and other metabolic parameters of patients with diabetes mellitus (TEMD obesity study)

Bu çalışmada sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır.Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity

Attendance patterns and factors affecting participation in organized walks: an investigation of Natural England's Walking for Health programme

This paper examines the Natural England database of registered walkers to identify patterns of attendance in organized walks and differences in walking behaviour based on the profile of participants in Walking for Health (WfH), one of the largest public health interventions for physical activity in the UK. The investigation is informed by walk-history data relating to more than 79,000 participants over a two-year period. Methods used include measures of participant adherence and chi-squared automatic interaction detector analysis. The results indicate that absolute participation numbers have a strong seasonal element, with a marked decline occurring around the Christmas period. Age emerges as the most significant determinant of organized walking behaviour, with older age groups exhibiting higher intensity of participation relative to younger age groups. The research facilitates a better understanding of participation in WfH and can serve to inform future delivery and the marketing of organized walking initiatives

Proceedings of the National Summit on Legal Preparedness for Obesity Prevention and Control

Editors' preface / Donald E. Benken, Meredith A. Reynolds, and Alicia S. Hunter -- Foreword: Legal preparedness for obesity prevention and control / George A. Mensah -- -- I. Introduction -- Legal preparedness for obesity prevention and control: the public health framework for action / William Dietz and Alicia S. Hunter -- Legal preparedness for obesity prevention and control: a framework for action / Judith A. Monroe, Janet L. Collins, Pamela S. Maier, Thomas Merrill, Georges C. Benjamin, and Anthony D. Moulton -- -- II. Public Health Legal Preparedness for Obesity Prevention and Control: Status of Core Elements -- Legal preparedness for obesity prevention and control: the structural framework and the role of government / Demetrios L. Kouzoukas -- Assessing laws and legal authorities for obesity prevention and control / Lawrence O. Gostin, Jennifer L. Pomeranz, Peter D. Jacobson, and Richard Gottfried -- Assessing competencies for obesity prevention and control / Wendy Collins Perdue, Alice Ammerman, and Sheila Fleischhacker -- Assessing coordination of legal-based efforts across jurisdictions and sectors for obesity prevention and control / Marice Ashe, Gary Bennett, Christina Economos, Elizabeth Goodman, Joseph Schilling, Lisa Quintiliani, Sara Rosenbaum, Jeffrey Vincent, and Aviva Must -- Assessing information on public health law best practices for obesity prevention and control / Peter D. Jacobson, Susan C. Kim, and Susan R. Tortolero -- -- III. Options for Improving Public Health Legal Preparedness for Obesity Prevention and Control -- Improving laws and legal authorities for obesity prevention and control / Jennifer L. Pomeranz and Lawrence O. Gostin -- Improving legal competencies for obesity prevention and control / Sheila Fleishhacker, Alice Ammerman, Wendy Collins Perdue, Joan Miles, Sarah Roller, Lynn Silver, Lisa Soronen, and the Honorable Leticia Van de Putte -- Improving coordination of legal-based efforts across jurisdictions and sectors for obesity prevention and control / Aviva Must, Gary Bennett, Christina Economos, Elizabeth Goodman, Joseph Schilling, Lisa Quintiliani, Sara Rosenbaum, Jeffrey Vincent, and Marice Ashe -- Improving information on public health law best practices for obesity prevention and control / Susan R. Tortolero, Karyn Popham, and Peter D. Jacobson -- Legal actions options table -- Obesity prevention and control legal bibliography -- Appendixguest edited by Donald E. Benken, Meredith A. Reynolds, and Alicia S. Hunter."Summer 2009."Papers from the National Summit on Legal Preparedness for Obesity Prevention and Control held June 18-20, 200 by the Centers for Disease Control and Prevention.Title from "cover" (viewed on March 4, 2009).Mode of access: Internet (Acrobat .pdf file: 5.02 MB, 152 p.).System requirements: Adobe Acrobat Reader

Association of Obesity with Periodontitis, Tooth Loss and Oral Hygiene in Non-smoking Adults

Background: Periodontitis was found to be significantly related to obesity as well as the number of missing teeth and oral hygiene. However, the studies addressing these relationships often included smokers and diabetics, and none was performed in Eastern European patients. The aim of this cross-sectional study was to investigate associations between obesity and periodontitis, oral hygiene, and tooth loss in a sample of non-smoking Croatian subjects aged 31-75 years. Methods: A total of 320 patients were recruited by convenient sampling at the Dental Clinic, Clinical Hospital Centre in Rijeka, Croatia. Periodontal examination and data on tooth loss were completed in 292 subjects and each participant completed a structured written questionnaire with questions regarding oral hygiene, education, height, and weight. Periodontitis was categorized as early, moderate and advanced. In multiple regression analysis, periodontitis was used as predictor variable, and BMI, oral hygiene, tooth loss, and education level were used as dependent variables. Results: Use of interdental brushes/flossing and number of missing teeth correlated significantly with BMI, but the same could not be proven for periodontitis and frequency of tooth brushing. However, logistic regression proved that the subset of obese, poorly educated women aged 36-55 years were 5-6 times more likely to develop severe forms of periodontal disease. Conclusions: Obesity was associated with tooth loss, oral hygiene, and education level in the investigated group. BMI could not be correlated with severity of periodontal disease, except in poorly educated women aged 36-55 year

Obesity and prevalence of chronic diseases in the 1999–2000 Italian National Health Survey

<p>Abstract</p> <p>Background</p> <p>There is consistent evidence that obesity is a correlate of mortality. Less information is available about the relation between body weight and the prevalence of diseases. We investigated the prevalence of overweight and obesity and their relationship with 14 groups of chronic diseases in a Mediterranean population using data from the Italian National Survey collected in 1999–2000.</p> <p>Methods</p> <p>A sample of 52,300 families was randomly selected using a complex stratified multistage design, within strata of geographical areas, municipalities, and household sizes, to produce estimates representative of the whole Italian population. Data were collected by civil servants both with an interview and a self-reported questionnaire.</p> <p>Results</p> <p>The present study documents an increase in the prevalence of overweight among Italian adults in the last decades and an increased prevalence of several chronic conditions in obese or overweight individuals. A general pattern of a positive association between excess weight and chronic disease was observed for both sexes. The ratio of the prevalences of cardiovascular diseases, diabetes and chronic respiratory diseases was higher in obese versus normal-weight individuals in the age group under 45 years.</p> <p>Conclusion</p> <p>To reduce the prevalence of chronic diseases a policy promoting a healthier individual lifestyle is becoming more and more desirable.</p

Burden of obesity in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study.

OBJECTIVES: We used the Global Burden of Disease (GBD) 2015 study results to explore the burden of high body mass index (BMI) in the Eastern Mediterranean Region (EMR). METHODS: We estimated the prevalence of overweight and obesity among children (2-19 years) and adults (≥20 years) in 1980 and 2015. The burden of disease related to high BMI was calculated using the GBD comparative risk assessment approach. RESULTS: The prevalence of obesity increased for adults from 15.1% (95% UI 13.4-16.9) in 1980 to 20.7% (95% UI 18.8-22.8) in 2015. It increased from 4.1% (95% UI 2.9-5.5) to 4.9% (95% UI 3.6-6.4) for the same period among children. In 2015, there were 417,115 deaths and 14,448,548 disability-adjusted life years (DALYs) attributable to high BMI in EMR, which constitute about 10 and 6.3% of total deaths and DALYs, respectively, for all ages. CONCLUSIONS: This is the first study to estimate trends in obesity burden for the EMR from 1980 to 2015. We call for EMR countries to invest more resources in prevention and health promotion efforts to reduce this burden

How children eat may contribute to rising levels of obesity children's eating behaviours: An intergenerational study of family influences

The term ‘obesogenic environment’ is rapidly becoming part of common phraseology. However, the influence of the family and the home environment on children's eating behaviours is little understood. Research that explores the impact of this micro environment and intergenerational influences affecting children's eating behaviours is long overdue. A qualitative, grounded theory approach, incorporating focus groups and semi-structured interviews, was used to investigate the family environment and specifically, the food culture of different generations within families. What emerged was a substantive theory based on ‘ordering of eating’ that explains differences in eating behaviours within and between families. Whereas at one time family eating was highly ordered and structured, typified by the grandparent generation, nowadays family eating behaviours are more haphazard and less ordered, evidenced by the way the current generation of children eat. Most importantly, in families with an obese child eating is less ordered compared with those families with a normal weight child. Ordering of eating' is a unique concept to emerge. It shows that an understanding of the eating process is crucial to the development and improvement of interventions targeted at addressing childhood obesity within the family context