Weight‐Related Terms Differentially Affect Self‐Efficacy and Perception of Obesity

Objective

Little work has explored the effect of weight‐related terms on treatment initiation; only one study has investigated weight‐related terms and the psychological constructs associated with treatment uptake. The present study examines the effects of four common weight‐related terms on treatment initiation and the moderating effect of weight bias internalization.

Methods

Adult participants with overweight and obesity (n = 436) were recruited online and asked to read three vignettes describing clinical encounters; the weight‐related term (i.e., “weight,” “BMI,” “obesity,” or “fat”) was varied randomly. Participants then reported self‐efficacy, cognitive and emotional illness beliefs about obesity (i.e., illness perception), and interest in a weight loss program.

Results

The term “obesity” resulted in the greatest self‐efficacy and perceived control over obesity. “Fat” resulted in the least illness coherence (i.e., understanding of obesity). Weight bias internalization did not moderate the effect of term on self‐efficacy, nor did it moderate illness perception. No differences in weight loss program enrollment were observed.

Conclusions

Use of the term “obesity” may promote patients’ perceived control and self‐efficacy. Use of “fat” should be avoided. Results suggest that, despite patient and clinician preference for euphemistic weight terms, use of clinical language such as “obesity” may perform better in provider intervention.

     

Resistance Training Reduces Skeletal Muscle Work Efficiency in Weight‐Reduced and Non–Weight‐Reduced Subjects

Objective

The objective of this study is to determine whether resistance training is similarly effective in reducing skeletal muscle efficiency and increasing strength in weight‐reduced and maximal weight subjects.

Methods

This study examined the effects of supervised resistance exercise on skeletal muscle in 14 individuals with overweight and obesity sustaining a 10% or greater weight loss for over 6 months and a phenotypically similar group of 15 subjects who had not reduced weight and were weight stable at their maximal lifetime body weight. We assessed skeletal muscle work efficiency and fuel utilization (bicycle ergometry), strength (dynamometry), body composition (dual energy x‐ray absorptiometry), and resting energy expenditure (indirect calorimetry) before and after 12 weeks of thrice‐weekly resistance training.

Results

Non–weight‐reduced subjects were significantly (10%‐20%) stronger before and after the intervention than reduced‐weight subjects and gained significantly more fat‐free mass with a greater decline in percentage of body fat than weight‐reduced subjects. Resistance training resulted in similar significant decreases (~10%) in skeletal muscle work efficiency at low‐level exercise and ~10% to 20% increases in leg strength in both weight‐reduced and non–weight‐reduced subjects.

Conclusions

Resistance training similarly increases muscle strength and decreases efficiency regardless of weight loss history. Increased resistance training could be an effective adjunct to reduced‐weight maintenance therapy.

     

Racial Differences in Relative Skeletal Muscle Mass Loss During Diet‐Induced Weight Loss in Women

Objective

It is unclear whether there are race‐specific differences in the maintenance of skeletal muscle during energy restriction. Changes in relative skeletal muscle index (RSMI; limb lean tissue divided by height squared) were compared following (1) diet alone, (2) diet + aerobic training, or (3) diet + resistance training.

Methods

Overweight, sedentary African American (AA; n = 72) and European American (EA; n = 68) women were provided an 800‐kcal/d diet to reduce BMI < 25 kg/m². Regional fat‐free mass was measured with dual‐energy x‐ray absorptiometry. Steady‐state VO₂ and heart rate responses during walking were measured.

Results

AA women had greater RSMI and preserved RSMI during diet alone, while RSMI was significantly reduced among EA women (EA women –3.6% vs. AA women + 1.1%; P < 0.05). Diet + resistance training subjects retained RSMI (EA women + 0.2% vs. AA women + 1.4%; P = 50.05), whereas diet + aerobic training subjects decreased RSMI (EA women –1.4% vs. AA women –1.5%; P < 0.05). Maintenance of RSMI was related to delta walking ease and economy.

Conclusions

Compared with AA women, EA women are less muscular and lose more muscle during weight loss without resistance training. During diet‐induced weight loss, resistance training preserves skeletal muscle, especially among premenopausal EA women. Maintenance of muscle during weight loss associates with better ease and economy of walking.

     

Phase II Feasibility Study of a Weight Loss Intervention in Female Breast and Colorectal Cancer Survivors (SWOG S1008)

Objective

This study aimed to test the feasibility of a 12‐month weight loss intervention using telephone‐based counseling plus community‐situated physical activity (PA) in female breast cancer (BC) and colorectal cancer (CRC) survivors.

Methods

This multisite cooperative group study enrolled sedentary, female, postmenopausal BC and CRC survivors with BMI ≥ 25 kg/m² to receive 12‐month fitness center memberships and telephone counseling encouraging 150 min/wk of PA and a 500‐kcal/ddecrease in energy intake. Feasibility criteria included accrual, adherence, and retention. Target weight loss was ≥ 5%.

Results

Among 25 BC survivors, median baseline BMI was 37.2 (range: 27.7‐54.6), accrual occurred in 10 months, 60% and 28% met diet and exercise goals, 80% provided 12‐month measures, and average weight loss was 7.6% (95% CI: ?3.9%, 19.2%). Among 23 CRC survivors, median BMI was 31.8 (range: 26.4‐48.7), accrual occurred in 24 months, 61% and 17% met diet and exercise goals, 87% provided measures, and average weight loss was 2.5% (95% CI: ?8.2%, 13.3%).

Conclusions

It is feasible to recruit and retain BC survivors in a cooperative group diet and PA weight loss trial. BC survivors achieved clinically meaningful weight loss but did not meet a priori adherence goals. In CRC survivors, recruitment was more difficult, and the intervention was less effective.

     

Effects of Self‐Conditioning Techniques (Self‐Hypnosis) in Promoting Weight Loss in Patients with Severe Obesity: A Randomized Controlled Trial

Objective

The usefulness of the rapid‐induction techniques of hypnosis as an adjunctive weight‐loss treatment has not been defined. This randomized controlled trial evaluated whether self‐conditioning techniques (self‐hypnosis) added to lifestyle interventions contributed to weight loss (primary outcome), changes in metabolic and inflammatory variables, and quality of life (QoL) improvement (secondary outcomes) in severe obesity.

Methods

Individuals (with BMI = 35‐50 kg/m²) without organic or psychiatric comorbidity were randomly assigned to the intervention (n = 60) or control arm (n = 60). All received exercise and behavioral recommendations and individualized diets. The intervention consisted of three hypnosis sessions, during which self‐hypnosis was taught to increase self‐control before eating. Diet, exercise, satiety, QoL, anthropometric measurements, and blood variables were collected and measured at enrollment and at 1 year (trial end).

Results

A similar weight loss was observed in the intervention (?6.5 kg) and control (?5.6 kg) arms (β = ?0.45; 95% CI: ?3.78 to 2.88; P = 0.79). However, habitual hypnosis users lost more weight (?9.6 kg; β = ?10.2; 95% CI: ?14.2 to ?6.18; P < 0.001) and greatly reduced their caloric intake (?682.5 kcal; β = ?643.6; 95% CI: ?1064.0 to ?223.2; P = 0.005) in linear regression models. At trial end, the intervention arm showed lower C‐reactive protein values (β = ?2.55; 95% CI: ?3.80 to ?1.31; P < 0.001), higher satiety (β = 19.2; 95% CI: 7.71‐30.6; P = 0.001), and better QoL (β = 0.09; 95% CI: 0.02‐0.16; P = 0.01).

Conclusions

Self‐hypnosis was not associated with differences in weight change but was associated with improved satiety, QoL, and inflammation. Indeed, habitual hypnosis users showed a greater weight loss.

     

Lifestyle Interventions Limit Gestational Weight Gain in Women with Overweight or Obesity: LIFE‐Moms Prospective Meta‐Analysis

Objective

This study aimed to evaluate the effects of varied lifestyle intervention programs designed to ameliorate excess gestational weight gain (GWG) in pregnant women with overweight or obesity compared with standard care, including effects on pregnancy outcomes.

Methods

Seven clinical centers conducted separate randomized clinical trials to test different lifestyle intervention strategies to modify GWG in diverse populations. Eligibility criteria, specific outcome measures, and assessment procedures were standardized across trials. The results of the separate trials were combined using an individual‐participant data meta‐analysis.

Results

For the 1,150 women randomized, the percent with excess GWG per week was significantly lower in the intervention group compared with the standard care group (61.8% vs. 75.0%; odds ratio [95% CI]: 0.52 [0.40 to 0.67]). Total GWG from enrollment to 36 weeks' gestation was also lower in the intervention group (8.1 ± 5.2 vs. 9.7 ± 5.4 kg; mean difference: ?1.59 kg [95% CI:?2.18 to ?0.99 kg]). The results from the individual trials were similar. The intervention and standard care groups did not differ in preeclampsia, gestational diabetes, cesarean delivery, or birth weight.

Conclusions

Behavioral lifestyle interventions focusing primarily on diet and physical activity among women with overweight and obesity resulted in a significantly lower proportion of women with excess GWG. This modest beneficial effect was consistent across diverse intervention modalities in a large, racially and socioeconomically diverse US population of pregnant women.

     

Maternal High‐Fat Diet Effects on Adaptations to Metabolic Challenges in Male and Female Juvenile Nonhuman Primates

Objective

This study aimed to determine whether maternal high‐fat diet (HFD) consumption in nonhuman primates alters the ability of offspring to adapt metabolically to nutrient and caloric challenges.

Methods

Offspring from Japanese macaque dams fed either a control (CTR) diet or HFD were weaned onto a CTR diet creating two groups: maternal HFD (mHFD, n = 18) and maternal CTR (mCTR) diet (n = 12). Male and female offspring were exposed to a 5‐day 30% calorie restriction and to a 35‐day HFD challenge (HFDC), at 16 and 24 months of age, respectively. Caloric intake, body weight, and energy expenditure were measured.

Results

Offspring from both groups showed similar body weight, food intake, and metabolic adaptations to a 5‐day calorie restriction. mHFD offspring demonstrated increased food intake and early weight gain in response to a 35‐day HFDC; however, group differences in weight dissipated during the challenge. Unlike mCTR animals, the mHFD group had a significant increase in fasting insulin after acute HFD exposure.

Conclusions

The current findings indicate that offspring exposed to an mHFD show metabolic adaptations to calorie restriction that are largely similar to those of offspring exposed to a mCTR diet but show delayed adaptation upon exposure to an acute HFDC.

     

How Accurate are Recalls of Self‐Weighing Frequency? Data from a 24‐Month Randomized Trial

Introduction

Self‐weighing is an important component of self‐monitoring during weight loss. However, methods of measuring self‐weighing frequency need to be validated. This analysis compared self‐reported and objective weighing frequency.

Methods

Data came from a 24‐month randomized controlled trial. Participants received 12 months of a behavioral weight‐loss program and were randomly assigned to (1) daily self‐weighing, (2) weekly weighing, or (3) no weighing (excluded from analysis). Objective weighing frequency was measured by Wi‐Fi enabled scales, and self‐reported weighing frequency was assessed every 6 months by questionnaire. Objective weights were categorized to match the scale of the self‐report measure.

Results

At 12 months, there was 80.8% agreement between self‐reported and objective weighing frequency (weighted kappa = 0.67; P < 0.001). At 24 months, agreement decreased to 48.5% (kappa = 0.27; P < 0.001). At both time points in which disagreements occurred, self‐reported frequencies were generally greater than objectively assessed weighing. Both self‐reported and objectively assessed weighing frequency was associated with weight loss at 12 and 24 months (P < 0.001).

Conclusions

Self‐reported weighing frequency is modestly correlated with objective weighing frequency; however, both are associated with weight change over time. Objective assessment of weighing frequency should be used to avoid overestimating actual frequency.

     

Dissemination of the Look AHEAD Intensive Lifestyle Intervention in the United States Military: A Randomized Controlled Trial

Objective

The purpose of this study, “Fit Blue,” was to compare a translation of the Look AHEAD (Action for Heath in Diabetes) intensive lifestyle intervention with a self‐paced version of the same intervention among active duty military personnel.

Methods

Active duty military personnel (N = 248; 49% male, 34% racial minority) with overweight or obesity were randomized to 12‐month distance‐based (i.e., phone and email) parallel programs, counselor‐initiated (CI) condition or self‐paced (SP) condition, from 2014 to 2016. Trained lay interventionists were retired military personnel or had extensive familiarity with the military.

Results

The CI condition had greater weight loss at 4 months (CI: mean ± SD = ?3.2 ± 3.4 kg; SP: ?0.6 ± 2.9 kg; P < 0.0001) and at 12 months (CI: mean ± SD = ?1.9 ± 4.1 kg; SP: ?0.1 ± 3.8 kg; P < 0.001). Participants in the CI condition also had a greater percent weight loss at both 4 months (CI: 3.5% ± 3.8, SP: 0.6% ± 3.1; P < 0.0001) and 12 months (CI: 2.1% ± 4.7, SP: 0.0% ± 4.0; P < 0.001). In addition, a greater proportion of CI participants lost 5% or more at 4 months (CI: 29.8%, SP: 10.5%; P < 0.001) and at 12 months (CI: 29.5%, SP: 15.6%; P < 0.05).

Conclusions

The CI behavioral weight loss intervention translated from Look AHEAD was well received and is a promising approach for managing weight in an active duty military population.

     

Adipose Tissue Dysfunction Occurs Independently of Obesity in Adipocyte‐Specific Oncostatin Receptor Knockout Mice

Objective

This study examined the phenotypic effects of adipocyte‐specific oncostatin M receptor (OSMR) loss in chow‐fed mice.

Methods

Chow‐fed adipocyte‐specific OSMR knockout (FKO) mice and littermate OSMR^fl/fl controls were studied. Tissue weights, insulin sensitivity, adipokine production, and stromal cell immunophenotypes were assessed in epididymal fat (eWAT); serum adipokine production was also assessed. In vitro, adipocytes were treated with oncostatin M, and adipokine gene expression was assessed.

Results

Body weights, fasting blood glucose levels, and eWAT weights did not differ between genotypes. However, the eWAT of OSMR^FKO mice was modestly less responsive to insulin stimulation than that of OSMR^fl/fl mice. Notably, significant increases in adipokines, including C‐reactive protein, lipocalin 2, intercellular adhesion molecule‐1, and insulinlike growth factor binding protein 6, were observed in the eWAT of OSMR^FKO mice. In addition, significant increases in fetuin A and intercellular adhesion molecule‐1 were detected in OSMR^FKO serum. Flow cytometry revealed a significant increase in leukocyte number and modest, but not statistically significant, increases in B cells and T cells in the eWAT of OSMR^FKO mice.

Conclusions

The chow‐fed OSMR^FKO mice exhibited adipose tissue dysfunction and increased proinflammatory adipokine production. These results suggest that intact adipocyte oncostatin M–OSMR signaling is necessary for adipose tissue immune cell homeostasis.

     

Lifestyle Intervention Decreases Urine Trimethylamine N‐Oxide Levels in Prepubertal Children with Obesity

Objective

Early lifestyle interventions in children with obesity decrease risk of obesity and metabolic disorders during adulthood. This study aimed to identify metabolic signatures associated with lifestyle intervention in urine samples from prepubertal children with obesity.

Methods

Thirty‐four prepubertal children with obesity were studied before and after a 6‐month lifestyle intervention program, and anthropometric, metabolic, and nutritional variables were collected. A nuclear magnetic resonance approach was applied to obtain the metabolomic profile from urine samples. Partial least squares‐discriminant analysis (PLS‐DA) was used to achieve group classification and variable importance on projection (VIP) for biomarker selection.

Results

The intervention reduced caloric intake by 10% (P < 0.05) and BMI standard deviation score by 0.47 SD (P < 0.001). PLS‐DA identified trimethylamine N‐oxide (TMAO, VIP = 2.21) as the metabolite with the highest discrimination properties between groups. Urine TMAO levels were reduced after the intervention (P < 0.05). TMAO is a biomarker of cardiovascular disease risk and is a product of gut microbiota‐dependent metabolism of certain dietary compounds, including choline. Notably, changes in TMAO levels after the intervention did not correlate to differences in choline intake but were inversely associated with fiber intake (P < 0.05).

Conclusions

These results indicate that lifestyle intervention decreases TMAO levels in children with obesity.

     

Microparticle miRNAs as Biomarkers of Vascular Function and Inflammation Response to Aerobic Exercise in Obesity?

Objective

This study aimed to explore the role of nine microRNAs (miRNAs) in microparticles (MPs) on the efficacy of aerobic exercise in the regulation of inflammation and vascular function in obesity.

Methods

Sedentary women with normal weight (n = 6, BMI < 25 kg/m²) and women with obesity (n = 9, BMI > 30 kg/m²) were recruited at F. Hached Hospital (Sousse, Tunisia) and enrolled in an 8‐week aerobic program. Vascular function was assessed using laser Doppler flowmetry/iontophoresis, circulating MPs by flow cytometry, miRNAs by real‐time polymerase chain reaction, and inflammation by ELISA, before and after exercise.

Results

Women with obesity presented with high prevalence of cardiovascular risk factors and a higher circulating MP level compared with healthy subjects. The MP miRNA profile was significantly different in the two groups. Exercise reduced BMI and inflammation in both groups and significantly improved endothelial‐dependent response (acetylcholine cutaneous vascular conductance) for healthy subjects, with a trend for women with obesity. Circulating MP level was increased after exercise, and miRNA expression was differentially modulated in both populations. Pearson analysis revealed a correlation between MPs miR‐124a and miR150 and adiponectin, TNFα, or IL‐6 levels.

Conclusions

The relation between MPs and miRNA profile, inflammation, vascular function, and exercise is of particular interest for defining “miRNA biomarker signature” in patients with cardiovascular disease who are potentially susceptible to respond to exercise.

     

Night Shift Work Before and During Pregnancy and Offspring Weight Outcomes Through Adolescence

Objective

This study aimed to investigate associations between maternal history of rotating night shift nursing work before pregnancy and number of night shifts worked during pregnancy with offspring weight outcomes from early life through adolescence.

Methods

More than 4,000 children, enrolled in the second phase of the Growing Up Today Study between 2004 and 2013, and their mothers participating in the Nurses' Health Study II were included in our analyses.

Results

Children of women with and without a history of rotating night shift work before pregnancy were similar in birth weight and body size at age 5. However, for mothers with night shift work before pregnancy, their children had a modestly elevated risk of having overweight or obesity (relative risk = 1.11; 95% CI: 1.02‐1.21), which was stronger for persistently having overweight or obesity during adolescence and early adulthood. Longer duration of rotating night shift work was not associated with any of these weight outcomes. Weight outcomes of children of women with versus without night shift work during pregnancy were similar, regardless of frequency of night shifts worked during pregnancy (all P > 0.09).

Conclusions

Overall, nurses' night shift work before or during pregnancy did not affect offspring weight outcomes. Future larger studies should explore these associations in more detail.

     

Obesity in Adolescence Predicts Lower Educational Attainment and Income in Adulthood: The Project EAT Longitudinal Study

Objective

Prospective associations between obesity in adolescence and adult socioeconomic outcomes, and potential mediators, were examined in a contemporary cohort.

Methods

Longitudinal data collected in 1998 to 1999 (Project EAT‐I) and 2015 to 2016 (EAT‐IV) were analyzed for 1,796 participants who provided data at both time points. Adolescents (mean age = 14.8 years) self‐reported demographic and psychosocial variables (EAT‐I) and follow‐up outcomes (EAT‐IV). Body weight and height were directly measured. Bachelor's degree or more education, income ≥ US $50,000, and partnered status at follow‐up were examined by baseline obesity (>95th BMI percentile) using logistic regression. Self‐esteem, depression, and weight‐related teasing were examined as mediators using multivariate probit regressions. All analyses were adjusted for race, baseline age, and parent socioeconomic status.

Results

Girls with obesity were significantly less likely to have achieved a bachelor’s degree (OR 0.32, 95% CI [0.18, 0.58]; P < 0.001), earn ≥ $50,000 annually (OR 0.57, 95% CI [0.33, 0.99]; P < 0.04), or be partnered (OR 0.45, 95% CI [0.27, 0.75]; P < 0.002) in adulthood. No associations were observed among boys. Among girls, depression mediated 8.5% and 23.6% of the association between adolescent obesity and adult education and income, respectively.

Conclusions

Adolescent girls with obesity have lower educational attainment and income and are less likely to be partnered in later adulthood. Depression may partly mediate the associations.

     

Body Composition Percentiles in Urban South Indian Children and Adolescents

Objective

This study aimed to generate age‐ and sex‐specific percentiles for body composition indices in children and to assess the variability in these indices, in relation to BMI.

Methods

Anthropometry and body fat were measured with the BOD POD (Cosmed; Rome, Italy) in 9,702 children from Bangalore, India. Smoothed percentile curves using the lambda‐mu‐sigma method were obtained for BMI, fat‐free mass index (FFMI), fat mass index (FMI), and body fat percentage (% BF).

Results

Percentile curves for % BF and FMI in boys increased from 6 to 12 years and declined from 13 years on, while in girls, it increased until 15 years. The FFMI percentile curves increased with age in both sexes. The mean FMI declined from 12 years on in boys, corresponding to a large increase in FFMI from that age, while in girls, both FMI and FFMI continued to increase. The 75th percentile of % BF and FMI had greater sensitivity to identify children with obesity.

Conclusions

This study developed smoothed percentile curves for body composition in Indian children and suggests FMI and FFMI as good indicators of growth in children.

     

Oral Glucose Tolerance is Associated with Neuroelectric Indices of Attention Among Adults with Overweight and Obesity

Objective

This study aimed to elucidate the relationship between glucose levels and insulin resistance and sensitivity obtained from oral glucose tolerance tests and neurophysiological indices of attention among adults with overweight and obesity.

Methods

Forty adults with overweight or obesity (BMI ≥ 25 kg/m²) underwent dual‐energy x‐ray absorptiometry to assess visceral adipose tissue. Repeated venous blood samples were collected during an oral glucose tolerance test to measure insulin resistance (homeostatic model assessment of insulin resistance) and indices of insulin sensitivity (Matsuda index and Stumvoll metabolic clearance rate). Attention was assessed using event‐related brain potentials recorded during a visual oddball task. Amplitude and latency of the P3 wave form in a central‐parietal region of interest were used to index attentional resource allocation and information processing speed.

Results

Following adjustment for visceral adipose tissue, reduced values of Matsuda index and Stumvoll metabolic clearance rate (indicating poor insulin sensitivity) were correlated with longer peak latency, whereas insulin area under the curve was positively related to peak latency, indicating slower information processing. Individuals with decreased insulin sensitivity (Matsuda index < 4.3) had significantly longer P3 latencies compared with individuals with normal insulin sensitivity.

Conclusions

Higher fasting glucose, but not homeostatic model assessment of insulin resistance, and reduced indices of glucose sensivity are associated with decrements in attention characterized by slower reaction time and slower information processing speed among adults with overweight and obesity.

     

It Weigh(t)s on You: Everyday Discrimination and Adiposity Among Latinos

Objective

Evidence suggests discrimination increases the risk of obesity. The biopsychosocial model of racism posits that psychological factors such as depressive symptoms may link experiences of perceived interpersonal discrimination to obesity. This study tested whether self‐reported experiences of everyday discrimination were associated with adiposity indicators and whether depressive symptoms explained these associations.

Methods

Cross‐sectional survey data of 602 Latino adults living in Lawrence, Massachusetts, from the Latino Health and Well‐being Project (2011‐2013) were used. Participants completed questionnaires assessing perceived everyday discrimination and depressive symptoms. Anthropometric measures (i.e., BMI and waist circumference [WC]) were obtained by trained staff. Structural equation modeling was employed to test for direct and indirect effects of perceived everyday discrimination on adiposity.

Results

Perceived everyday discrimination was directly and positively associated with higher BMI and WC, independent of sociodemographic factors, physical activity, and stressful life events. Perceived everyday discrimination was not indirectly associated with BMI and WC through depressive symptoms. However, perceived everyday discrimination was associated with higher levels of depressive symptoms.

Conclusions

Self‐reported everyday discrimination among Latino adults is associated with adiposity. Day‐to‐day interpersonal discrimination may be implicated in obesity disparities for Latino adults.

     

Associations of Body Composition with Blood Pressure and Hypertension

Objective

The present study investigated the associations of body composition, including skeletal muscle and fat mass, with blood pressure (BP) and hypertension.

Methods

Data from 3,130 participants aged 18 to 80 years were analyzed. Body composition and total skeletal muscle (TSM) were measured or calculated based on dual‐energy x‐ray absorptiometry. Multivariate linear and logistic regression models were used to analyze the associations of TSM, body fat percentage, android to gynoid fat ratio, and leg and arm lean body mass (LBM) with BP and hypertension. The Wald test was used to estimate the differences in the coefficients.

Results

TSM indices, body fat percentage, and android to gynoid fat ratio were significantly associated with higher odds ratio for prehypertension and hypertension, except for TSM/weight, after controlling for potential confounders. The standardized beta coefficients of arm LBM indices for systolic and diastolic BP were higher than relevant indices of leg LBM.

Conclusions

Different indices of TSM, especially in arm LBM, were all positively associated with elevated BP, prehypertension, and hypertension in Chinese adults, after considering potential confounding factors, including body fat and fat distribution. Future longitudinal studies are warranted to confirm our findings.

     

Associations of Platelet Indices with Body Fat Mass and Fat Distribution

Objective

This study was undertaken to investigate the associations of platelet indices with body fat, including body fat mass and fat distribution.

Methods

A total of 3,327 individuals aged 18 to 80 were enrolled. Body fat was assessed by dual‐energy x‐ray absorptiometry. Blood samples were collected to measure platelet indices (platelet count [PLT], plateletcrit [PCT], mean platelet volume, platelet distribution width, and platelet large cell ratio). Adjusted multivariate linear regression models were used to identify the associations of platelet indices with body fat.

Results

PLT was positively associated with BMI, waist circumference, waist‐hip ratio, total fat mass percentage, trunk fat mass percentage, android fat mass percentage, and android to gynoid fat ratio but negatively associated with gynoid fat mass percentage, total lean mass percentage, and skeletal muscle mass index. Similar associations were found between PCT and body fat. However, no significant associations were found between the other three platelet indices and body fat.

Conclusions

Both PLT and PCT were associated with body fat, and the associations depended on fat location. Because PCT is mainly influenced by PLT, these associations suggest that platelet quantity is more closely related to body fat mass and fat distribution.

     

Adiposity and Diabetes Risk in Adults with Prediabetes: Heterogeneity of Findings Depending on Age and Anthropometric Measure

Objective

The study aimed to evaluate the effect of age on diabetes incidence by general and central adiposity after 3‐year follow‐up in adults with prediabetes.

Methods

Data were taken from a cohort of 1,184 subjects with prediabetes included in The Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS). General adiposity was defined using body mass index (BMI), and central adiposity was defined with waist circumference and waist to height ratio. Data were analyzed by age groups 30 to 59 and 60 to 74 years. The association between adiposity and diabetes incidence was assessed using hazard ratios (HR).

Results

Adjusting for sociodemographic characteristics, lifestyles, and metabolic parameters, diabetes HR for central adiposity based on the waist circumference clinical cutoff were 2.14 (1.12‐4.09) and 1.48 (0.80‐2.74) for people aged 30 to 59 and 60 to 74 years, respectively. In the model additionally adjusted for BMI, diabetes HR were 2.65 (1.24‐5.65) and 1.33 (0.68‐2.59), respectively. The use of a 1‐SD increase rather than cutoff points did not alter this pattern. Similar findings were observed with central adiposity based on waist to height ratio.

Conclusions

The association of central adiposity with type 2 diabetes incidence was lower for people in the older age group than for those in the younger age group.