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Obesity and Weight Management
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Another challenge to the simplistic concept that obesity can be diagnosed based on weight and height is Normal Weight Obesity (NWO), which is characterized by excess body fat in individuals with “normal weight” BMI (18.5–24.9 kg/m2) who have a high degree of metabolic dysregulation, including a higher risk of developing metabolic syndrome, cardiometabolic dysfunction, i.e., increased insulin resistance, hypertension, and/or dyslipidemia, and who also have low-grade proinflammatory status and increased oxidative stress (Oliveros et al., 2014; Franco et al., 2016). The term NWO was initially associated with low lean mass and CVD risk (DeLoreno et al., 2006), but subsequent research has focused on higher visceral fat in persons with NWO, which is estimated to affect about 30 million Americans (Franco et al., 2016). In a Korean study of over 5000 men and nearly 7000 women, using BMI cut-points of 18.5–22.9 kg/m2 for “normal weight” and percent body fat assessed by dual-energy X-ray absorptiometry, NWO prevalence was 36% in men and 29% in women (Kim et al., 2014). A prevalence of 29.1% was also reported for NWO, using the BMI 18.5–24.9 kg/m2 cut-points, in 1354 American Latin (Colombian) young adults (61% of whom were women), and the condition was associated with high abdominal obesity and increased CV risk, high blood pressure, low HDL-C, and low muscular strength early in life (Correa-Rodriguez et al., 2020).
Fat Cell Size and Number in Obese Children
Published in Fernand P. Bonnet, Adipose Tissue in Childhood, 2019
As compared with the age-matched controls of normal weight, obesity clearly reduced the regional differences in cell size and in local cellularity as well as the sex-dependent differences in these two parameters (Figures 2 and 3).41 In obese patients of both sexes, a similar hyperplasia of the subscapular adipocytes is observed whatever the age of onset of obesity. On an average, the epigastric local cellularity does not significantly change in obesity, whatever the sex and the age of onset as compared with normal controls; at this site, the only thing observed is a great increase in mean adipose cell size. In obese females, the local hypogastric, gluteal, and femoral cellularity is significantly higher in the juvenile onset obesity than in the adult onset type. On the other hand, in obese males no difference in local cellularity is observed according to the age of onset of obesity. However, it must be stressed that obese males are smaller in number than obese females.
Nutritional disorders
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
More recently, a newly defined type of obesity has emerged, termed normal-weight obesity (NWO) (Musalek et al., 2017;Nemet, 2018). Normal weight obesity is defined as having excessive body fat, but normal body mass index. (One contributor for this problem is extremely low lean body [muscle] mass.) Yet, health practices for treating obesity and its associated comorbidities in children and adolescents are based on screening criteria for high BMI and BMI percentiles and targeting those children for intervention who are at or above the 85th BMI percentile for age and gender. Although BMI has the advantages of simplicity and reproducibility for measuring body fatness, it cannot distinguish between fat mass and fat-free mass and thus fails to provide information on actual total body fatness and will routinely misdiagnose children with NWO. What is strongly alarming about children with NWO is that routinely they are not identified as being overweight or obese, in spite of the fact that they display the same potential health and motor problems as do overweight and obese children.
Autophagy in peripheral blood mononuclear cells is associated with body fat percentage
Published in Archives of Physiology and Biochemistry, 2023
Fabiano T. Amorim, Roberto C. Nava, Kurt A. Escobar, Zidong Li, Anna M. Welch, Zachary J. Fennel, Zachary J. McKenna, Ann L. Gibson
In the present study, we also reported no correlation between BMI and markers of autophagic flux. Jansen et al. (2012) evaluated markers of autophagy in adipose tissue samples from participants ranging in BMI from 19 to 40 kg/m2 and reported a direct correlation between LC3-II levels and BMI, with notably increased LC3-II levels for their obese participants. Although the use of BMI is recommended for populational studies, it lacks the ability to differentiate between lean mass and fat mass obscuring the influence of inter-individual variability in body composition at a given BMI. For example, the singular 30 kg/m2 criterion for obesity is known to miscategorise individual risk for obesity-related disorders (Kosacka et al.2015), be an inappropriate indicator of obesity in some population subgroups (Seidell and Halberstadt 2015, Batsis et al.2016), and obscure normal weight obesity (excessively high levels of adipose tissue at a normal weight (19–25.9 kg/m2) BMI) (Franco et al.2016). Tomiyama et al. (2016) reported that over 70 million American adults would be misclassified in terms of their cardiometabolic risk based solely on BMI. The current study builds upon that of Jansen et al. (2012) and the recommendation by Heymsfield et al. (2016); to our knowledge, this is the first study to investigate the relationship between autophagy markers in PBMCs and measured %BF.
Heightened risks of cardiovascular disease in South Asian populations: causes and consequences
Published in Expert Review of Cardiovascular Therapy, 2023
Maria Stefil, Jack Bell, Peter Calvert, Gregory YH Lip
BMI can be a useful tool for identifying individuals at higher cardiometabolic risk with traditional cutoffs being ≥25 kg/m2 to indicate overweight status and ≥30 kg/m2 to indicate obesity. BMI is a poor predictor of cardiometabolic disease in Asians in general, and it has been proposed by the WHO that lower BMI targets of a BMI of ≥23 kg/m2 for overweight status and ≥27.5 kg/m2 for obesity should be used in South Asian people in order to identify those at higher cardiometabolic risk [55,56]. This is due to a ‘thin-fat’ phenotype, otherwise known as ‘normal weight obesity,’ that is prevalent among South Asian people. Here, the body habitus may not appear overweight, but there is a different pattern of body fat distribution with greater visceral adiposity, predominantly affecting the intra-abdominal organs[57]. For any given BMI, a South Asian individual is likely to have a higher percentage of body fat than a non-South Asian individual [58,59] and a greater risk of complications, such as cardiovascular disease and type 2 diabetes [60,61]. Compared to BMI, waist circumference, and waist-to-height ratio better capture abdominal obesity and are more predictive of obesity-associated metabolic risks in a Sri Lankan cohort. The WHO recommends lower thresholds for abdominal obesity in Asian individuals (≥90 cm in men and ≥80 cm in women) compared to White individuals (≥94 cm in men and ≥80 cm in women)[62].
Comparing the performance of body mass index, waist circumference and waist-to-height ratio in predicting Malaysians with excess adiposity
Published in Annals of Human Biology, 2022
Nie Yen Low, Chin Yi Chan, Shaanthana Subramaniam, Kok-Yong Chin, Soelaiman Ima Nirwana, Norliza Muhammad, Ahmad Fairus, Pei Yuen Ng, Nor Aini Jamil, Noorazah Abd Aziz, Norazlina Mohamed
BMI is the most widely used index to define obesity and predict CVD mortality due to its simplicity, affordability and convenience (Centers for Disease Control and Prevention 2022). Despite its clinical relevance, the reliability of BMI in measuring adipose tissue and its physical distribution remains debatable (Ode et al. 2007; Nuttall 2015; Ortega et al. 2016). Aside from its inability to distinguish between fat and lean tissues (Romero-Corral et al. 2006), BMI cannot discriminate CVD risk accurately in individuals with intermediate BMI values, particularly those with normal-weight obesity (Bosomworth 2019). BMI classifies fewer individuals as obese as compared to other obesity indices (Swainson et al. 2017). Numerous studies have analysed the performance of BMI in identifying adiposity with heterogeneous results. Some studies revealed a good diagnostic performance of BMI (Ranasinghe et al. 2013), while others reported insensitivity of BMI in identifying adiposity (Akindele et al. 2016). Thus, further studies are necessary to determine the performance of BMI in detecting excessive body adiposity to justify its use in clinical practice.