The relationship between obesity and asthma severity and control in adults. Obesity is associated with reduced white matter integrity in otherwise healthy adults. Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity. Association between obesity and atopic dermatitis in childhood: a case-control study. Abdominal visceral adipose tissue volume is associated with increased risk of erosive esophagitis in men and women. Value of oropharyngeal Mallampati classification in predicting difficult laryngoscopy among obese patients. Obesity and risk of esophageal adenocarcinoma and Barrett's esophagus: a Mendelian randomization study. Understanding the anatomic basis for obstructive sleep apnea syndrome in adolescents. Body mass index and neurocognitive functioning across the adult lifespan. Physical Activity, Obesity, and Risk for Colon Cancer and Adenoma in Men Impact of obesity in asthma: evidence from a large prospective disease management study. Obesity and colorectal cancer risk in women Prevalence and Correlates of Obesity in a Community Sample of Individuals with Severe and Persistent Mental Illness Increased body mass indexper se is not a predictor of difficult laryngoscopy Sarcopenic Obesity Is Associated with Severe Postoperative Complications in Gastric Cancer Patients Undergoing Gastrectomy: a Prospective Study Impact of Visceral Obesity and Sarcopenia on Short-Term Outcomes After Colorectal Cancer Surgery
BACKGROUND The association of obesity with asthma outcomes is not well understood . OBJECTIVE The objective of this study was to examine the association of obesity , as represented by a body mass index ( BMI ) of greater than 30 kg/m(2 ) , with quality -of-life scores , asthma control problems , and asthma-related hospitalizations . METHODS The study followed a cross-sectional design . Question naires were completed at home by a r and om sample of 1113 members of a large integrated health care organization who were 35 years of age or older with health care use suggestive of active asthma . Outcomes included the mini-Asthma Quality of Life Question naire , the Asthma Therapy Assessment Question naire , and self-reported asthma-related hospitalization . Several other factors known to influence asthma outcomes also were collected : demographics , smoking status , oral corticosteroid use in the past month , evidence of gastroesophageal reflux disease , and inhaled corticosteroid use in the past month . Multiple logistic regression models were used to measure the association of BMI status with outcomes . RESULTS Even after adjusting for demographics , smoking status , oral corticosteroid use , evidence of gastroesophageal reflux disease , and inhaled corticosteroid use , obese adults were more likely than those with normal BMI s ( < 25 kg/m(2 ) ) to report poor asthma-specific quality of life ( odds ratio [ OR ] , 2.8 ; 95 % CI , 1.6 - 4.9 ) , poor asthma control ( OR , 2.7 ; 95 % CI , 1.7 - 4.3 ) , and a history of asthma-related hospitalizations ( OR , 4.6 ; 95 % CI , 1.4 - 14.4 ) . CONCLUSIONS Our findings suggest that obesity is associated with worse asthma outcomes , especially an increased risk of asthma-related hospitalizations Existing work demonstrates that obesity is independently associated with cognitive dysfunction and macrostructural brain changes ; however , little is known about the association between obesity and white matter ( WM ) integrity . We explore this relationship in a large cohort of otherwise healthy subjects . The present study classified 103 adult participants from the Brain Re source International Data base between 21 and 86 years of age without history of neurological , medical , or psychiatric illness according to BMI ( normal weight , overweight , obese ) and subjected them to diffusion tensor imaging ( DTI ) .  Result ing fractional anisotropy ( FA ) indexes for the corpus callosum and fornix were examined in relation to BMI and age in a multiple regression framework . Results indicated that increasing BMI was independently associated with lower FA in the genu , splenium , and fornix , and a BMI × age interaction emerged for FA in the splenium and body of the corpus callosum . When categorized , obese persons demonstrated lower FA than normal and overweight persons for all WM indexes , but no FA differences emerged between overweight and normal persons . Results indicate both a direct association between obesity and reduced WM tract integrity and an interaction between obesity and aging processes on certain WM tracts in otherwise healthy adults . While such findings suggest a possible role for adiposity in WM dysfunction and associated cognitive deficits , prospect i ve studies are needed to clarify the nature of these relationships and eluci date underlying mechanisms BACKGROUND Diet , smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation . We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study , a r and omized dietary primary prevention trial conducted in Spain . METHODS 7000 subjects at high cardiovascular risk were assessed cross-sectionally . A  healthy lifestyle pattern ( HLP ) was determined using a score including :  adherence to the Mediterranean diet , moderate alcohol consumption , expending ≥200 kcal/day in leisure-time physical activity , and non-smoking . RESULTS Inverse linear trends were observed between the HLP-score and body-mass-index ( BMI ) or waist circumference ( p<0.001 ) . The BMI and waist circumference of participants with a HLP-score=4 were , respectively , 1.3 kg/m(2 ) ( 95 % CI : 0.9 to 1.7 ) and 4.3 cm ( 3.1 to 5.4 ) lower than those of subjects with an HLP≤1 . The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score≤1 were 0.50 ( 0.42 to 0.60 ) and 0.51 ( 0.41 to 0.62 ) , respectively . CONCLUSION A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk OBJECTIVES To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity . DESIGN Non-r and omized , prospect i ve . SETTING University hospital , operating room . SUBJECTS Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis . MAIN OUTCOME MEASURES Weight , body mass index ( BMI ) , co-morbid history , sagittal abdominal diameter , waist : hip ( W : H ) ratio and urinary bladder pressure , as an estimate of intra-abdominal pressure . RESULTS Urinary bladder pressure was greater in the obese than the non-obese ( 18 + /- 0.7 vs. 7 + /- 1.6 cm H2O , P < 0.001 ) , correlated with sagittal abdominal diameter ( r = + 0.67 , P < 0.001 ) and was greater ( P < 0.05 ) in patients with , than those without , morbidity probably ( hypoventilation , gastroesophageal reflux , venous stasis , stress incontinence , incisional hernia ) or possibly ( hypertension , diabetes ) due to increased abdominal pressure . W : H ratio correlated with urinary bladder pressure in men ( r = + 0.6 , P < 0.05 ) but not women ( r = -0.3 ) . CONCLUSIONS Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity-related comorbidity . W : H ratio was not a reliable indicator of intra-abdominal pressure for women who often have both peripheral and central obesity . Further studies are needed to evaluate the relationship between intra-abdominal pressure and Type II diabetes and hypertension BACKGROUND Obesity in children is associated with increased asthma and atopy .  OBJECTIVE We sought to determine whether obesity in childhood or adolescence increases the risk of atopic dermatitis . METHODS This retrospective , practice -based , case-control study r and omly sample d 414 children and adolescents ( age , 1 - 21 years ) with atopic dermatitis between January 2000 and December 2007 and 828 r and omly sample d healthy control subjects . Information was obtained from an electronic medical record . Observations were made before the a priori hypothesis . RESULTS Obesity in children is associated with increased atopic dermatitis ( conditional logistic regression : odds ratio , 2.00 ; 95 % CI , 1.22 - 3.26 ; P = .006 ) . These atopic dermatitis-predisposing effects are found when obesity started by less than 2 years of age ( adjusted odds ratio [ aOR ] , 15.10 ; 95 % CI , 1.51 - 151.21 ; P = .02 ) and 2 to 5 years ( aOR , 2.58 ; 95 % CI , 1.24 - 5.41 ; P = .01 ) but not greater than 5 years ( aOR , 1.32 ; 95 % CI , 0.66 - 2.64 ; P = .43 ) and when obesity was prolonged for 2.5 to 5 years ( aOR , 2.64 ; 95 % CI , 1.13 - 6.18 ; P = .03 ) and greater than 5 years ( aOR , 3.40 ; 95 % CI , 1.34 - 8.63 ; P = 0.01 ) . Obesity is associated with more severe atopic dermatitis ( ordinal logistic regression : aOR , 2.37 ; 95 % CI , 1.24 - 5.37 ; P = .01 ) . Obese children who eventually have atopic dermatitis require more frequent pediatrician visits for the management of atopic dermatitis ( ordinal logistic regression : aOR , 2.22 ; 95 % CI , 1.12 - 4.50 ; P = .03 ) . CONCLUSION Prolonged obesity in early childhood is a risk factor for atopic dermatitis . Weight loss might be an important approach for the prevention and treatment of atopic dermatitis in children BACKGROUND & AIMS Data on the association between erosive esophagitis and obesity are inconsistent because of variations in study population s and methods used to determine obesity . METHODS Participants in a prospect i ve health-screening cohort underwent esophagogastroduodenoscopy and computed tomography .  The association between erosive esophagitis and obesity ( measured by body mass index [ BMI ] , waist circumference , and abdominal visceral adipose tissue volume ) was estimated with odds ratios ( ORs ) and 95 % confidence intervals ( CIs ) , adjusting for confounding factors . We also analyzed the association between obesity and erosive esophagitis by sex . RESULTS The  prevalence of erosive esophagitis was 9.3 % ( 495/5329 ) . The OR for erosive esophagitis correlated with obesity measured by BMI , waist circumference , and abdominal visceral adipose tissue volume ( P < .001 for each factor ) . The multivariate OR for erosive esophagitis was 1.97 ( 95 % CI : 1.34 - 2.90 ) for a visceral adipose tissue volume of 500 - 999 cm(3 ) , 2.27 ( 95 % CI : 1.51 - 3.39 ) for 1000 - 1499 cm(3 ) , and 2.94 ( 95 % CI : 1.87 - 4.62 ) for ≥1500 cm(3 ) , compared with participants who had visceral adipose tissue volumes less than 500 cm(3 ) . When measures of obesity were analyzed simultaneously , abdominal visceral adipose tissue volume , but not BMI or waist circumference , was associated with erosive esophagitis . The 3 measures of obesity were significantly associated with erosive esophagitis in males , but only visceral adipose tissue volume was associated with erosive esophagitis in females ( P = .002 ) . CONCLUSIONS In contrast to BMI or waist circumference , abdominal visceral adipose tissue volume is associated with an increased risk of erosive esophagitis in males and females The prediction of difficult intubation in obese patients was investigated by co-estimating the degree of visibility of oropharyngeal structures in conjunction with the respective body mass index . Data were collected prospect ively in a series of 1833 consecutive adult patients .  Body mass index ( BMI ) in kg m-2 was used as a measure of obesity ( morbid : > 40 , moderate : 30 - 40 , no obesity : < 30 ) . The oropharyngeal class findings were assessed using the original methodology as well as by a modification requiring the tongue to be pulled forward by the examiner . Difficult intubation was defined as inadequate exposure of the glottis by  direct laryngoscopy  . Both oropharyngeal class method ologies were of equal sensitivity , whereas the modified technique presented a significantly higher positive predictive value ( 50.0 % vs. 37.2 % , P < 0.01 ) . Statistical analysis revealed an increased risk of difficult laryngoscopy among obese patients compared with subjects with normal body mass index ( 20.2 % vs. 7.6 % , P < 0.001 ) . When obesity is estimated with respect to oropharyngeal class the positive predictive value is greatly improved ( 66.7 % vs. 20.2 % , P < 0.001 ) . We conclude that obesity which is associated with a disproportionately large base of the tongue , is a predisposing factor for difficult laryngoscopy BACKGROUND Data from observational studies suggest that body mass index ( BMI ) is causally related to esophageal adenocarcinoma ( EAC ) and its precursor , Barrett 's esophagus ( BE ) . However , the relationships may be affected by bias and confounding . METHODS We used data from the Barrett 's and Esophageal Adenocarcinoma Genetic Susceptibility Study : 999 patients with EAC , 2061 patients with BE , and 2169 population controls . We applied the two-stage control function instrumental variable method of the Mendelian r and omization approach to estimate the unbiased , unconfounded effect of BMI on risk of EAC and BE . This was performed using a genetic risk score , derived from 29 genetic variants shown to be associated with BMI , as an instrument for lifetime BMI . A higher score indicates propensity to obesity . All tests were two-sided . RESULTS The genetic risk score was not associated with potential confounders , including gastroesophageal reflux symptoms and smoking . In the instrumental variable analyses ( IV ) , EAC risk increased by 16 % ( IV-odds ratio [ OR ] = 1.16 , 95 % confidence interval [ CI ] = 1.01 to 1.33 ) and BE risk increased by 12 % ( IV-OR = 1.12 , 95 % CI = 1.00 to 1.25 ) per 1kg/m(2 ) increase in BMI . BMI was statistically significantly associated with EAC and BE in conventional epidemiologic analyses . CONCLUSIONS People with a high genetic propensity to obesity have higher risks of esophageal metaplasia and neoplasia than people with low genetic propensity . These analyses provide the strongest evidence to date that obesity is independently associated with BE and EAC , and is not due to confounding or bias inherent in conventional epidemiologic analyses RATIONALE Structural risk factors for obstructive sleep apnea syndrome ( OSAS ) in adolescents have not been well characterized . Because many adolescents with OSAS are obese , we hypothesized that the anatomic OSAS risk factors would be more similar to those in adults than those in children . OBJECTIVES To investigate the anatomic risk factors in adolescents with OSAS compared with obese and lean control subjects using magnetic resonance imaging ( MRI ) . METHODS Three groups of adolescents ( age range : 12 - 16 yr ) underwent MRI : obese individuals with OSAS ( n = 49 ) , obese control subjects ( n = 38 ) , and lean control subjects ( n = 50 ) . MEASUREMENTS AND MAIN RESULTS We studied 137 subjects and found that ( 1 ) obese adolescents with OSAS had increased adenotonsillar tissue compared with obese and lean control subjects ; ( 2 ) obese OSAS adolescents had a smaller nasopharyngeal airway than control subjects ; ( 3 ) the size of other upper airway soft tissue structures ( volume of the tongue , parapharyngeal fat pads , lateral walls , and soft palate ) was similar between subjects with OSAS and obese control subjects ; ( 4 ) although there were no major craniofacial abnormalities in most of the adolescents with OSAS , the ratio of soft tissue to craniofacial space surrounding the airway was increased ; and ( 5 ) there were sex differences in the pattern of lymphoid proliferation . CONCLUSIONS Increased size of the pharyngeal lymphoid tissue , rather than enlargement of the upper airway soft tissue structures , is the primary anatomic risk factor for OSAS in obese adolescents . These results are important for clinical decision making and suggest that adenotonsillectomy should be considered as the initial treatment for OSAS in obese adolescents , a group that has poor continuous positive airway pressure adherence and difficulty in achieving weight loss OBJECTIVE Cognitive dysfunction and structural brain abnormalities have been observed in obese versus lean individuals , but with variability across age and weight groups . The current study was design ed to clarify the cognitive profile of obesity by examining performance across multiple cognitive domains in adults with wide-ranging age and weight status . METHOD Participants ( N = 732 ; 61 % women ; ages 18 - 88 ; BMI range 19 - 75 ) underwent assessment of cognitive functioning and relevant medical/demographic covariates .  Neuropsychological tests  were grouped by cognitive domain ( via confirmatory factor analysis ) , and st and ardized scores were averaged into composite variables . RESULTS Hierarchical linear regression analyses revealed main effects for BMI on motor ( ΔR2 = .02 , β = -.15 ) and attention/processing speed ( ΔR2 = .01 , β = -.07 ) , whereas a significant interaction between BMI and age was observed ( ΔR2 = .01 , β = -.08 ) for predicting executive functioning ( p < .05 ) . BMI was not independently associated with memory or language functioning and no interaction effects were observed for these variables . Although BMI was not independently related to executive dysfunction , a significant age × BMI interaction suggests that obesity-related executive deficits may increase with age . CONCLUSIONS Overall , these findings may support an independent association between obesity and a frontal-subcortical pathology , though prospect i ve studies are needed to further clarify this possibility Westernization or industrialization leads to an increase in rates of colon cancer , which is the second leading cause of malignant death in the United States [ 1 ] . Although the precise causes of colon cancer remain unclear , a diet high in red meat or animal fat and low in fruits and vegetables appears to increase the risk for this malignancy [ 2 , 3 ] . It is perhaps less well recognized that an inverse association between physical activity and risk for colon cancer has been seen in studies of occupational activity only [ 4 - 12 ] and of both job-related and recreational activity [ 13 - 23 ] . In addition , many studies have found an association between body mass and elevated risk for colon cancer in men ; this association is weaker in women [ 24 - 33 ] . The fact that the association is stronger in men suggests that the abdominal distribution of adiposity typical in men may be an important component of enhanced risk . More limited evidence suggests that height , which may be a proxy for a person 's net energy intake during childhood and adolescence , is related to a higher risk for colon cancer [ 33 - 35 ] . We examine the association between physical activity , obesity , and attained height in relation to risk for colon cancers and their precursory adenomas in a large cohort of male health professionals in the United States . Waist and hip circumferences were available for a subcohort of the study population . We address the hypotheses that physical inactivity , obesity , and height increase the risk for colon cancer and adenoma independently of each other and of diet , and that the abdominal pattern of obesity is an additional independent risk factor . Methods Study Population The Health Professionals Follow-up Study [ 36 ] was started in 1986 ; in that year , 51 529 male dentists , optometrists , osteopaths , podiatrists , pharmacists , and veterinarians in the United States between 40 and 75 years of age responded to a mailed question naire . They reported on their leisure-time physical activity ( described below ) ; current body weight ; weight at age 21 years ; height ; history of cancer and other medical conditions ; parental history of various diseases , including colorectal cancer ; and use of aspirin and other nonsteroidal anti-inflammatory medications . They also reported dietary and alcohol intake using a vali date d [ 37 , 38 ] , semi-quantitative food-frequency question naire . We mailed an optional question naire in 1987 to assess  waist and hip circumferences . In 1988 , 1990 , and 1992 , we up date d exposure information and ascertained newly diagnosed medical conditions and history of colonoscopy or sigmoidoscopy , including the indications for endoscopy : bleeding in stool , positive results from tests for occult fecal blood , abdominal pain , diarrhea or constipation , family history of colorectal cancer , routine screening without symptoms , or follow-up [ 39 ] . Most of the deaths in the cohort were reported by family members or by the postal system in response to the follow-up question naires . We also used the National Death Index to identify deaths among nonrespondents [ 40 ] . Assessment of Physical Activity The 1986 question naire included a section about mainly recreational or leisure-time physical activity . The reliability and validity of question naires design ed to assess physical activity have been investigated [ 41 - 43 ] . A question naire such as the one used in our cohort was evaluated in a cohort of U.S. nurses and was found to provide useful information [ 44 ] , and similar results were found during a similar validation study done within the Health Professionals cohort ( Chasan-Taber S. Personal communication ) . Participants reported the average time per week spent doing each of eight moderate and vigorous activities , choosing from among 10 possible responses that ranged from 0 minutes to 11 or more hours per week . The specific activities listed were walking or hiking outdoors ( including walking during golf ) ; jogging ( slower than 10 minutes/mile ) ; running ( 10 minutes/mile or faster ) ; bicycling ( including that done on a stationary machine ) ; lap swimming ; tennis , squash , or racquetball ; and calisthenics or rowing . In addition , each respondent reported the number of flights of stairs he climbed daily and his usual walking pace . The reported time spent at each activity per week was multiplied by its typical energy expenditure requirements expressed in metabolic equivalents ( METs ) [ 45 ] to yield a MET-hour score . One MET , which is the energy expended by sitting quietly , is equivalent to 3.5 mL of oxygen uptake per kilogram of body weight per minute for a 70-kg adult . For example , 1 hour per week of running contributed 10.2 MET-hours , 1 hour of tennis contributed 6 MET-hours , and 1 hour of walking at a moderate pace contributed 3.2 MET-hours . Body weight was excluded from the derivation of energy expenditure from physical activity to avoid confounding the expenditure variable by body weight . If more than one published intensity level was available for a given activity , the moderate or general MET value was chosen . An average MET value was assigned to the categories that listed more than one activity , such as rowing or calisthenics , and squash or racquetball . Assessment of Anthropometric Variables  Each man reported his current weight and height and his weight at age 21 years on the 1986 question naire . In 1987 , we mailed an optional question naire once to obtain additional exposure information , including body circumference measurements . We instructed each participant to measure ( to the nearest quarter inch ) his waist at the umbilicus and his hips at the largest circumference between the waist and thighs while st and ing and without measuring over bulky clothing [ 46 ] . We provided a tape measure and an illustration to help st and ardize the measurements . Sixty-five percent of the cohort responded . We used the Quetelet index ( kilograms/height in meters2 ) as a measure of total adiposity , waist-to-hip ratio to measure relative distribution of fat , and waist circumference to estimate total abdominal fat . Although the waist-to-hip ratio has been used more widely , waist circumference provides an estimate of absolute abdominal adiposity , the component most closely related to important metabolic abnormalities , including hyperinsulinemia , hypertension , and high triglyceride levels . To remove extraneous variation in the waist circumference because of height ( taller men tend to have larger waist circumferences due to their larger body size rather than to obesity ) , we adjusted waist for height using residual analysis [ 47 ] . We first regressed waist on height using multiple linear regression and then added the residual to the average waist size ( 37.4 inches ) for a man of average height ( 70 inches ) to convert this measure back to the initial scale . This conversion created for each man a st and ardized waist circumference unconfounded by height . We evaluated the precision of self-reported anthropometric measures among 123 cohort members who were part of a dietary validation study [ 46 ] . Trained technicians paid the sub study participants two visits , approximately 6 months apart , to measure current weight and waist and hip circumferences . The Pearson correlation between self-report and the average of the technicians ' two measurements was 0.97 for weight , 0.95 for waist circumference , 0.88 for hip circumference , and 0.69 for waist-to-hip ratio . The men 's self- measurements of their waist circumferences were 0.36 inches greater , their self- measurements of hip circumferences were 0.78 inches smaller , and their self- measurements of weight were 2.3 pounds less than the technician 's measurements . Identification of Patients with Colorectal Cancers In 1988 , 1990 , and 1992 , we asked each participant whether cancer had been diagnosed during the previous 2 years . The response rate to the follow-up question naires was 94 % through 31 January 1992 . When a participant ( or a decedent 's next-of-kin ) reported a diagnosis of cancer of the colon or rectum , we sought permission to obtain hospital records and pathology reports . A study physician , blinded to exposure information , review ed all medical records received and extracted data about histologic type , anatomic location , and stage of the cancer . Proximal colon cancers were defined as those from the cecum to and including the splenic flexure , and distal colon cancers were defined as those in the descending and sigmoid colon . We confirmed 249 new cases of colorectal adenocarcinoma ( excluding carcinoma in situ ) , 90 % by medical records and the remainder with corroborating information about diagnosis and treatment from the cohort member . Two hundred three cancers were in the colon and 46 were in the rectum . Identification of Patients with Colorectal Adenomas and Controls Because more than 90 % of the adenomas were diagnosed during endoscopic procedures for screening or for unrelated gastrointestinal conditions , we restricted the adenoma analysis to men who had had a colonoscopy or sigmoidoscopy .  This was done to reduce the potential for detection bias . Most procedures were sigmoidoscopies ; thus , we analyzed only adenomas of the distal colorectum . Although we did not examine proximal colon adenomas , this should not have biased inferences for the distal colorectum . However , different causes for proximal adenomas may exist . A total of 12 879 men who did not meet any of the exclusion criteria ( see Data Analysis ) reported having had an endoscopy between 1986 and 1992 . In 1993 , we sent a mailing to a r and om sample of 200 controls ( men who reported negative results from an endoscopy ) to confirm that they did not have adenomas . After one mailing , 140 ( 70 % ) controls granted us permission to review the medical records of their endoscopic procedure ; none had an unreported , histologically confirmed adenoma . We were able to recontact 96 % of the men who reported a diagnosis of polyp , and we received medical records in response to more than 96 % of the requests sent to medical record departments , BACKGROUND asthma and obesity continue to have a significant effect on public health . It is widely accepted that obesity may be an independent risk factor for asthma and affect asthma severity and quality of life ( QOL ) . OBJECTIVE to examine the relationship between body mass index ( BMI [ calculated as weight in kilograms divided by height in meters squared ] ) and asthma severity , spirometry findings , health care utilization ( HCU ) , and QOL . METHODS this 12-month prospect i ve r and omized controlled trial comparing disease management with traditional care enrolled 902 patients ( 473 pediatric and 429 adults ) representing an underserved population . Data collected at baseline and at 6-month intervals included demographics , asthma severity , medication use , spirometry findings , and HCU . The QOL was assessed using the pediatric and adult versions of the Asthma Quality of Life Question naire and the 36-Item Short Form Health Survey .  All HCU was determined by means of patient interview and extensive medical record review . Data were analyzed using negative binomial regression and analysis of variance . RESULTS in children , 45 % were overweight/obese ( 17 % with BMI s > 85th percentile ; 28 % with BMI s ≥ 95th percentile ) . In adults , 58 % were obese ( BMI s ≥ 30 ) . There was no relationship in children between BMI and severity of asthma , spirometry findings , QOL , or HCU . In adults , there was no relationship between BMI and asthma severity or HCU . Higher BMI was associated with a significant reduction in QOL ( P < .001 ) . The BMI had an inverse relationship with forced vital capacity but with no other spirometric values . CONCLUSIONS obesity was not associated with worse asthma severity , spirometry findings , QOL , or HCU in children . In adults with asthma , obesity was associated with lower forced vital capacity and QOL but not with severity or HCU Background : Several large studies of obesity and  colorectal cancer risk have found no association among women but a reasonably consistent positive association among men . In women , a positive association that is stronger among , or limited to , those who are premenopausal has been suggested by studies that stratified analyses by age , although no previous study has examined the association by menopausal status . Methods : We used proportional hazards analyses to estimate hazard ratios relating obesity to colorectal cancer risk among 89 835 women aged 40–59 years at recruitment into the Canadian National Breast Screening Study , a multicentre r and omised controlled trial of mammography screening for breast cancer . During an average 10.6 years of follow up ( 936 433 person years ) , a total of 527 women were diagnosed with incident colorectal cancer ( 363 colon and 164 rectal ) . Results : We found that obesity ( body mass index ≥30 kg/m2 ) was associated with an approximately twofold increased risk of colorectal cancer among women who were premenopausal at baseline ( hazard ratio 1.88 , 95 % confidence interval 1.24–2.86 ) . There was no association among postmenopausal women ( p for interaction=0.01 ) , and there was only a weak positive association in the entire cohort . Conclusions : Our data suggest that obesity is associated with a twofold increased risk of colorectal cancer  in premenopausal women but is not associated with altered risk in postmenopausal women . Effect modification by menopausal status may better explain the inconsistent or weak findings in previous studies than the presumed lack of an association among women Individuals with severe and persistent mental illness ( SPMI ) have a preponderance of weight problems , possibly even greater than the obesity epidemic in the general population . Although atypical antipsychotics cause weight gain , their contribution to obesity has not been characterized in a community setting where individuals may take multiple psychotropics associated with weight gain . Using survey information including measured height and weight from a r and om sample of Maryl and Medicaid recipients with SPMI , we compared obesity prevalence to the National Health and Nutrition Examination Survey ( NHANES III ) sample and a Maryl and sample ( Behavioral Risk Factor Surveillance System ) of the general population adjusted to SPMI demographic characteristics . We investigated correlates of obesity in the SPMI sample . The results indicate that both men and especially women with SPMI had a higher prevalence of obesity than the general population ; this portends substantial health implication s. A fourfold association between atypical antipsychotics and prevalent obesity was found in men but not in women ; further work should clarify mechanisms of obesity in the SPMI Purpose We investigated the association between morbid obesity and difficult laryngoscopy ( DL ) .  Methods In a prospect i ve , controlled study we evaluated the impact of different variables on the prediction of DL in 200 morbidly obese ( study group-SG ) , and 1,272 non-obese ( control group-CG ) patients undergoing elective surgery .  Variables assessed included age , sex , body mass index ( BMI ) , protruding , loose , and missing upper teeth , thyro-mental distance , temporo-m and ibular joint ( TMJ ) function , neck extension , and Mallampati class . A Cormack grade III or IV was considered DL . Results The SG patients were younger ( P < 0.000 ) , there were more females in the SG ( P < 0.000 ) and more in the SG had teeth problems ( P = 0.026 ) . More patients in the SG ( 10%vs 1 % ) , had obstructive sleep apnea ( P < 0.001 ) with 90 % of them in the SG having a grade III laryngoscopy . High BMI did not affect the laryngoscopy difficulty ( P = 0.56 ) . Multivariable regression analysis revealed that morbid obesity , increased age , male sex , pathology of TMJ , and higher Mallampati class , were independent predictors of DL . When interaction between the predictors and the group was added to the multivariable model , the SG was no longer a predictor by itself , rather its association with abnormal upper teeth turned to be significant for prediction of DL . Conclusions Increased age , male sex , TMJ pathology , Mallampati 3 and 4 , a history of obstructive sleep apnea and abnormal upper teeth were associated with a higher incidence of DL . The magnitude of BMI had no influence on difficulty with laryngoscopy . RésuméObjectifNous avons examiné le lien entre l’obésité morbide et la laryngoscopie difficile (LD).MéthodeDans une étude prospect i ve et contrôlée , nous avons évalué l’impact de différentes variables sur la prédiction de LD chez 200 patients présentant une obésité morbide ( groupe expérimentai — GE ) et 1272 patients non obèses ( groupe témoin — GT ) devant subir une intervention chirurgicale réglée . Les variables évaluées ont été : l’âge , le sexe , l’indice de masse corporelle ( IMC ) , la protrusion , la mobilité et l’absence de dents supérieures , la distance thyromentonnière , la compétence de l’articulation temporo-m and ibulaire ( ATM ) , l’extension du cou et la classification de Mallampati . Une cote III ou IV de Cormack a été considérée comme une LD.RésultatsLes patients du GE étaient plus jeunes ( P < 0,000 ) , comprenaient plus de femmes ( P < 0.000 ) et présentaient plus de problèmes dentaires ( P = 0,026 ) . Un plus gr and nombre de patients du GE ( 10 % vs 1 % ) avaient une apnée du sommeil d’origine obstructive ( P < 0,001 ) do nt 90 % présentaient une laryngoscopie de classe III . Un IMC élevé n’a pas eu d’influence sur la laryngoscopie difficile ( P = 0,56 ) . Une analyse de régression multivariable a révélé que l’obésité morbide , l’âge avancé , le sexe mâle , une pathologie de l’ATM et une cote de Mallampati plus élevée ont été des prédicteurs indépendants de LD . Si on ajoute l’interaction entre les prédicteurs et le groupe au modèle multivariable , le GE n’est pius un prédicteur en lui-même , quoique son association avec une dentition supérieure anormale apparaisse significative pour prédire une LD . Conclusion Le vieillissement , le sexe masculin , une pathologie de l’ATM , une ciasse 3 ou 4 de Mallampati , des antécédents d’apnée du sommeil d’origine obstructive et des anomalies de la dentition supérieure ont été associés à une plus gr and e incidence de LD . Un IMC plus élevé n’a pas d’influence sur les difficultés laryngoscopiques Objective This study aim ed to determine the risk of severe postoperative complications ( SPCs ) in patients with gastric cancer and to construct a nomogram based on independently related factors to identify high-risk patients . Methods We conducted a prospect i ve study of 636 consecutive patients with gastric cancer who underwent radical gastrectomy . Degrees of sarcopenia and obesity were calculated before surgery . Factors contributing to SPCs were determined using univariate and multivariate analysis . A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of SPCs . Results Logistic analysis revealed that sarcopenic obesity , age , open surgery , and combined resection were independent prognostic factors for SPCs . Sarcopenic obese patients have the highest risk in all patients ( sarcopenic obesity vs normal , OR = 6.575 p = 0.001 ; sarcopenic obesity vs obesity , OR = 5.833 p = 0.001 ; sarcopenic obesity vs sarcopenia , OR = 2.571 p = 0.032 ) , while obese patients share the similar rate of SPCs with normal people ( obesity vs normal , OR = 1.056 p = 0.723 ) . The nomogram we constructed was able to quantify the risk of SPCs reliably ( c-index , 0.737 ) . Conclusions Sarcopenic obesity , together with age , open surgery , and combined resection are independent predictors of SPCs . Obesity will significantly increase the risk of SPCs in sarcopenic patient with gastric cancer , but it will not bring higher risk to normal patients . Our nomogram is a simple and practical instrument to identify patients at high risk of surgical complications Background With the increased prevalence of obesity and sarcopenia , those patients with both visceral obesity and sarcopenia were at higher risk of adverse outcomes . Aim The aim of this study was to ascertain the combined impact of visceral obesity and sarcopenia on short-term outcomes in patients undergoing colorectal cancer surgery . Methods We conducted a prospect i ve study from July 2014 to February 2017 . Patients ’ demographic , clinical characteristics , physical performance , and postoperative short-term outcomes were collected . Patients were classified into four groups according to the presence of sarcopenia or visceral obesity . Clinical variables were compared . Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed . Results A total of 376 patients were included ; 50.8 and 24.5 % of the patients were identified as having “ visceral obesity ” and “ sarcopenia , ” respectively . Patients with sarcopenia and visceral obesity had the highest incidence of total , surgical , and medical complications . Patients with sarcopenia or/ and visceral obesity all had longer hospital stays and higher hospitalization costs . Age ≥ 65 years , visceral obesity , and sarcopenia were independent risk factors for total complications . Rectal cancer and visceral obesity were independent risk factors for surgical complications . Age ≥ 65 years and sarcopenia were independent risk factors for medical complications .  Laparoscopy-assisted operation was a protective factor for total and medical complications . Conclusion Patients with both visceral obesity and sarcopenia had a higher complication rate after colorectal cancer surgery . Age ≥ 65 years , visceral obesity , and sarcopenia were independent risk factors for total complications . Laparoscopy-assisted operation was a protective factor
Conclusions Most studies revealed a positive association between mastication and obesity among adults .
Background A substantial number of adults suffer from obesity , that is caused by the risk factor , masticatory dysfunction .
The association between mastication and obesity , however , is inconclusive .
This systematic review aims to provide literature regarding the association between mastication and factors affecting masticatory function , and obesity in adults .