Objective To systematically review the efficacy and safety of a very low-calorie ketogenic diet (VLCKD) in patients who were overweight or obese. Methods From inception to August 2021, the electronic databases PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM were searched for randomized controlled trials (RCTs) of VLCKD in patients with overweight or obesity. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Then, meta-analysis was performed using Stata 16.0 software. Results A total of 5 RCTs involving 245 patients were included. Among patients with baseline body mass index (BMI) ≥30 kg/m2, the meta-analysis showed that compared with the control group, VLCKD could significantly reduce the BMI (MD=?0.24, 95%CI ?0.39 to ?0.08, P<0.05), weight (MD=?7.00, 95%CI ?10.48 to ?3.53, P<0.05) and waist circumference (MD=?7.40, 95%CI ?12.68 to ?2.12, P<0.05) . The subgroup analysis results showed that compared with the control diet, VLCKD could significantly reduce the glucose (MD=?9.60, 95%CI ?17.52 to ?1.69, P<0.05), glycated hemoglobin (MD=?0.24, 95%CI ?0.39 to ?0.08, P<0.05), insulin resistance index (MD=?0.90, 95%CI ?1.08 to ?0.73, P<0.05) and triglycerides (MD=?41.42, 95%CI ?53.78, ?29.06, P<0.05) in patients with type 2 diabetes and with obesity or overweight. In patients with obesity or overweight, VLCKD could increase high-density lipoprotein cholesterol (MD=8.60, 95%CI 0.17 to 17.03, P<0.05) when the intervention lasted longer than 12 months. In patients with obesity or overweight, VLCKD had no effect on insulin, total cholesterol, low-density lipoprotein, urea, creatinine, or uric acid. Patients with VLCKD had a higher rate of adverse events than those in the control groups; however, there was no significant difference in the rate when the intervention lasted longer than 4 months. Conclusion The current evidence shows that VLCKD can reduce BMI, weight, and waist circumference and reduce fasting glucose, HbA1c, insulin resistance index, and triglycerides among patients with type 2 diabetes and with obesity or overweight. However, VLCKD has no effect on insulin, total cholesterol, low-density lipoprotein, urea, creatinine, or uric acid. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the intervention effects of high-intensity interval training (HIIT) on weight loss and blood lipid metabolism in overweight/obese populations. MethodsThe computer conducted searches in the PubMed, Embase, Cochrane Library, Web of Science, CNKI, and WanFang Data database to collect randomized controlled trials (RCTs) related to HIIT and weight loss, fat reduction, and blood lipid metabolism in overweight/obese populations. The search was conducted from the inception of the databases to March 31, 2023. Two researchers independently conducted literature screening and data extraction. After evaluating the risk of bias of the included studies, a meta-analysis was performed using RevMan 5.4 software. ResultsA total of 19 RCTs, involving 595 overweight/obese participants, were included. The meta-analysis results showed that compared wtih the control group, HIIT interventions effectively reduced body weight (MD=?2.63, 95%CI ?4.04 to ?1.23, P<0.05), BMI (MD=?1.21, 95%CI ?1.95 to ?0.48, P<0.05), Fat% (MD=?1.66, 95%CI ?2.28 to ?1.04, P<0.05), TG (MD=?0.13, 95%CI ?0.25 to ?0.01, P=0.04), HDL (MD=0.14, 95%CI 0.05 to 0.23, P<0.05), and LDL (MD=?0.26, 95%CI ?0.39 to ?0.13, P<0.05) levels but did not improve TC (MD=?0.15, 95%CI ?0.36 to 0.06, P=0.15) levels. ConclusionHIIT intervention can effectively improve body weight, BMI, Fat%, TG, HDL, and LDL levels in overweight/obese populations, particularly showing a more pronounced improvement in lipid profiles among overweight/obese adolescents, but it does not reduce TC levels. This study demonstrates that HIIT may be an effective strategy to assist in weight loss and prevent cardiovascular diseases in overweight/obese populations, with potential for broader application.
ObjectiveTo systematically review the effectiveness of breastfeeding duration and intensity in reducing the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia. MethodsThe PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect observational studies on the associations of breastfeeding with the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia from inception to September 25th, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Stata 16.0 software was used for the meta-analysis. ResultsA total of 12 657 participants from 13 observational studies were included. The results of meta-analysis showed that breastfeeding could reduce the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia (OR=0.67, 95%CI 0.53 to 0.84, P=0.001). Subgroup analysis revealed a protective effect of breastfeeding for both 1-6 months (OR=0.53, 95%CI 0.37 to 0.75, P<0.001) and ≥6 months (OR=0.56, 95%CI 0.46 to 0.69, P<0.001); however, breastfeeding shorter than one month was suggested to increase the risk of overweight or obesity (OR=2.15, 95%CI 1.41 to 3.27, P<0.001). ConclusionAvailable evidence suggests that breastfeeding for more than one month is effective in reducing the risk of overweight or obesity in offspring exposed to intrauterine hyperglycemia, and women with hyperglycemia should be encouraged to breastfeed their offspring for at least 1 month to achieve the effect. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
【摘要】 目的 探討內江市企事業及機關單位從業人員20~60歲人群中超重、肥胖者及其相關因素。 方法 2009年6月－2010年9月采用整體隨機分層方法，對內江市企事業及機關單位從業人員共5 832例進行調查。用問卷了解吸煙、飲酒、運動、家族史、文化程度，并測定身高、體重、空腹血糖、甘油三酯、膽固醇等。采用SPSS 17.0軟件進行統計學分析，以雙側Plt;0.05為有統計學的意義。與肥胖有關的危險因素采用多因素logistic回歸分析。 結果 超重及肥胖者比例為27.16%，其中超重者1 377例，占23.6%，肥胖者207例，占3.55%；肥胖較超重者空腹血糖、甘油三酯、血壓更高；多因素logistic回歸分析提示:超重及肥胖與年齡、吸煙、性別、運動、家族史、文化程度有關，與飲酒無關。 結論 內江市企事業及機關單位從業人員20~60歲人群中超重、肥胖者比例為27.16%；肥胖較超重者更易發生高血糖、高血壓、高血脂、高尿酸血癥；超重及肥胖與年齡、吸煙、性別、運動、家族史、文化程度均有關。【Abstract】 Objective To investigate the prevalence and the risk factors of overweight and obesity among employees aged 20 to 60 years old in enterprises and government institutions in Neijiang city. Methods From June 2009 to September 2010, 5 832 employees in government departments, enterprises and institutions in Neijiang were surveyed using stratified random sampling method. Items like physical exercise, smoking, drinking, educational level, and family history were collected through face-to-face questionnaire, and their height, weight, fasting plasma glucose, triglyceride, cholesterol were measured. SPSS 17.0 was used for statistical analysis, and the relationship of each index was analyzed by Pearson correlative analysis. Bilateral Plt;0.05 was considered to be statistically significant. Risk factors associated with obesity were analyzed by Logistic regression analysis. Results The overweight and obesity morbidity rate was 27.16%, including 1377 cases of overweight (23.6%) and 207 cases of obesity (3.55%). Fasting plasma glucose, triglyceride, and blood pressure of obesity patients were higher than those of the overweight patients. Correlation analysis showed that overweight and obesity were positively correlated with fasting plasma glucose (r=0.116,Plt;0.01), triglyceride(r=0.319,Plt;0.01), uric acid (r=0.373,Plt;0.01), diastolic blood pressure (r=0.198,Plt;0.01), and systolic blood pressure (r=0.212,Plt;0.01), but not correlated with cholesterol. Logistic regression multivariate analysis showed that overweight and obesity were related with age, smoking, sex, sports, the educational level and family history, but not related with drinking. Conclusions The prevalence of overweight and obesity among employees aged 20 to 60 years old in enterprises and government institutions in Neijiang city is 27.16%. People with overweight and obesity are more susceptible to hyperglycemia, hypertension, hyperlipemia, and hyperuricemia. Overweight and obesity were closely related with age, smoking, gender, sports activities, family history, and educational level.
Objective To understand the prevalence of overweight and obesity and its influence factors in Zhuhai inhabitants. Methods Applying multi-stage cluster random sampling in the three administrative areas of Zhuhai including Xiangzhou, Doumen and Jinwan, A questionnaire-based survey was performed in conjunction of the measurement of height and weight among 961 inhabitants aged 15-69 years. In addition, a multivariate unconditional logistic regression model was employed to analyze the influence factors of overweight and obesity. Results The prevalence and standardized rates of overweight and obesity in the study population were 18.1%, 17.6%, 6.6%, 6.5%, respectively. The standardized rates of overweight and obesity in male and female were 18.4%, 5.8%, 16.5%, 7.2%, respectively. Age, drinking, smoking and regional difference were identified as the 4 risk factors of overweight and obesity, their OR values being 1.028, 1.683, 0.677, 1.404, Plt;0.05, respectively. Conclusion The prevalence of overweight and obesity in Zhuhai’s inhabitants was over the average level of Chinese residents, and overweight and obesity has become a major risk factor influencing the health of Zhuhai’s inhabitants. In view of the influence factors of overweight and obesity, timely and effective prevention and control measures should be taken.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.
ObjectiveTo determine the influence of high BMI on postoperative complications in a cohort of squamous esophageal cancer patients.
MethodsWe retrospectively analyzed the clinical data of 450 consecutive esophageal cancer patients who underwent esophagectomy in our hospital from September 2010 through November 2012 year. The patients were divided into three groups. Forty-five patients were classified as a low BMI group (BMI < 18.5 kg/m2), 304 patients were classified as a normal BMI group (18.5≤BMI < 25.0 kg/m2), and 101 patients as a high BMI group (BMI≥25.0 kg/m2). Patients' demographics, tumor characteristics, and postoperative complications were compared among the three groups.
ResultsThe comorbidity of diabetes was higher in the high BMI group compared with the other two groups (P=0.025). Longer operative time, wound infection or delayed healing were more frequent in the high BMI group (P=0.010 and P=0.039, respectively). Pneumonia and length of hospital stay had a tendency to increase in the high BMI group (P=0.052 and P=0.081, respectively). However, the differences did not reach statistical significance. There was no statistical difference in pulmonary embolism, respiratory failure, anastomotic leakage, vocal code paresis, chylothorax, other organ damage, reoperation, arrhythmia, or in-hospital mortality among the three groups.
ConclusionsHigh BMI has a negative impact on postoperative morbidity after esophagectomy. However, overweight is not a postoperative complications which should always be paid attention to.
ObjectiveTo review the current epidemiological status and trends of overweight and obesity globally and in China, and to analyze its hazards, causes, and prevention strategies. MethodsRecent global and Chinese studies and reports on obesity epidemiology were retrieved. Data from the latest World Obesity Federation’s reports and authoritative national statistics were comprehensively analyzed. ResultsThe prevalence of overweight and obesity was rising worldwide. According to the World Obesity Atlas 2025, it was predicted that by 2030, nearly 3 billion adults worldwide (approximately 50% of the adult population) would be affected by overweight or obesity. The overweight rate in youth aged 5–19 increased from 8% in 1990 to 20% in 2022. In China, over half of adults were overweight or obese, totaling over 402 million and ranking first in the world; the overweight/obesity rate in children and adolescents approached 20%. Gaps between urban and rural obesity had narrowed in China, and males and northern regions had higher rates than females and southern regions. Unhealthy diet patterns, reduced physical activity and other lifestyle changes were the main reasons for the prevalence of obesity. Obesity greatly increased the risk of type 2 diabetes, cardiovascular diseases, and other chronic diseases. ConclusionsBoth globally and in China, obesity has become a serious epidemic challenge. Strengthened prevention and control strategies are urgently needed, including comprehensive treatment based on healthy lifestyle intervention, drugs, endoscopy, weight loss surgery, etc, adoption of new weight management therapies and supportive policies are also needed. Special attention should be paid to preventing childhood obesity to curb the rising trend and reduce the associated health burden.
Orlistat, which has a new mechanism of action, is currently the only approved weight-loss drug in China. In addition to controlling body weight, orlistat can significantly improve blood glucose, blood pressure, dyslipidemia, adiponectin, insulin concentration and other obesity-related biochemical indicators in patients with overweight/obese. Recently, orlistat was approved for weight management in patients with polycystic ovary syndrome. Although there are clinical trials supporting the good weight loss efficacy of orlistat, its long-term safety and effectiveness in obesity-related diseases still need to be further determined. This article provides a brief review of the new progress in the clinical efficacy and safety of orlistat, aiming to provide a reference for the more rational drug application.
