International journal of obesity : journal of the International Association for the Study of Obesity
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Review
Managing obesity in primary care practice: an overview with perspective from the POWER-UP study.
Primary care practitioners (PCPs) have been encouraged to screen all adults for obesity and to offer behavioral weight loss counseling to the affected individuals. However, there is limited research and guidance on how to provide such intervention in primary care settings. This led the National Heart, Lung and Blood Institute in 2005 to issue a request for applications to investigate the management of obesity in routine clinical care. ⋯ The methods of delivering behavioral weight loss counseling differed markedly across the three trials, as captured by an algorithm presented in the article. Delivery methods ranged from having medical assistants and PCPs from the practices provide counseling to using a commercially available call center, coordinated with an interactive website. Evaluation of the efficacy of primary care-based weight loss interventions must be considered in light of costs, as discussed in relation to the recent treatment model proposed by the Centers for Medicare and Medicaid Services.
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Review Meta Analysis
The impact of cesarean section on offspring overweight and obesity: a systematic review and meta-analysis.
Studies have reported inconsistent results concerning the association of cesarean section with offspring obesity. We performed a systematic review and meta-analysis to examine whether cesarean section increases the risk of later overweight and obesity. Pubmed, Embase and Web of Science were searched using different combinations of two groups of keywords: 'cesarean' and 'overweight/obesity'. ⋯ The ORs for children, adolescents and adults all tended to be lower for high-quality studies compared with medium-quality studies. Our results indicated that cesarean section was moderately associated with offspring overweight and obesity. This finding has public health implications, given the increase in cesarean births in many countries.
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Review Meta Analysis
The impact of cesarean section on offspring overweight and obesity: a systematic review and meta-analysis.
Studies have reported inconsistent results concerning the association of cesarean section with offspring obesity. We performed a systematic review and meta-analysis to examine whether cesarean section increases the risk of later overweight and obesity. Pubmed, Embase and Web of Science were searched using different combinations of two groups of keywords: 'cesarean' and 'overweight/obesity'. ⋯ The ORs for children, adolescents and adults all tended to be lower for high-quality studies compared with medium-quality studies. Our results indicated that cesarean section was moderately associated with offspring overweight and obesity. This finding has public health implications, given the increase in cesarean births in many countries.
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MicroRNAs (miRNAs) are endogenous small RNAs that posttranscriptionally regulate gene expression and that have been shown to have important roles in numerous disease processes. There is growing evidence for an important role of miRNAs in regulating the pathways in adipose tissue that control a range of processes including adipogenesis, insulin resistance and inflammation. Several high-throughput studies have identified differentially expressed miRNAs in adipose tissue pathology and during adipogenesis and a number of these have now been characterised functionally in terms of their actions and targets. This review will summarise the current literature on miRNAs in adipose tissue, as well as discussing the methodologies used in this area of research and the potential application of miRNAs as biomarkers and as therapeutic targets.
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Obesity is associated with an increased risk for early death, heart disease and stroke, disability and several other comorbidities. Although there is concern about the potential burden on health-care services with the aging demographic and the increasing trend of obesity prevalence in older adults, evidence on which to base management strategies is conflicting for various reasons. The analytic framework for this review is based on a scoping review methodology, and was conducted to examine what is known about the diagnosis, treatment and management of obesity in older adults. ⋯ Consequently, the trend toward increasing prevalence of obesity in older adults will lead to an increase in unhealthy life years and health-care costs. The findings from this review also suggest that treatment strategies for obese older adults should focus on maintaining body weight and improving physical fitness and function rather than weight loss, and that a combination of aerobic and resistance exercise appears to be the most effective strategy. In conclusion, this review demonstrates the need for more research to clarify the definition of obesity in older adults, to establish criteria for evaluating when to treat older adults for obesity, and to develop effective treatment strategies focused on functional outcomes in obese older adults.