1-Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children With

1-Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study By:Pietrobelli, A (Pietrobelli, Angelo)[ 1,2 ] ; Pecoraro, L (Pecoraro, Luca)[ 1 ] ; Ferruzzi, A (Ferruzzi, Alessandro)[ 1 ] ; Heo, M (Heo, Moonseong)[ 3 ] ; Faith, M (Faith, Myles)[ 4 ] ; Zoller, T (Zoller, Thomas)[ 1 ] ; Antoniazzi, F (Antoniazzi, Franco)[ 1 ] ; Piacentini, G (Piacentini, Giorgio)[ 1 ] ; Fearnbach, SN (Fearnbach, S. Nicole)[ 2 ] ; Heymsfield, SB (Heymsfield, Steven B.)[ 2 ] OBESITY Volume: 28 Issue: 8 Pages: 1382-1385 DOI: 10.1002/oby.22861 Published: AUG 2020 Early Access: JUL 2020 Document Type:Article Abstract

Objective The aim of this study was to test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the coronavirus disease 2019 pandemic, will display unfavorable trends in lifestyle behaviors. Methods The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors was collected at baseline and 3 weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using pairedttests. Results There were no changes in reported vegetable intake; fruit intake increased (P = 0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (Pvalue range, 0.005 to < 0.001). Time spent in sports activities decreased by 2.30 (SD 4.60) h/wk (P = 0.003), and sleep time increased by 0.65 (SD 1.29) h/d (P = 0.003). Screen time increased by 4.85 (SD 2.40) h/d (P < 0.001). Conclusions Recognizing these adverse collateral effects of the coronavirus disease 2019 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child's or adolescent's adult adiposity level.

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KeyWords Plus:SCHOOL 2-Severe obesity, increasing age and male sex are independently associated with worse in - hospital outcomes, and higher in -hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York By:Palaiodimos, L (Palaiodimos, Leonidas)[ 1,2 ] ; Kokkinidis, DG (Kokkinidis, Damianos G.)[ 2,3 ] ; Li, WJ (Li, Weijia)[ 2,3 ] ; Karamanis, D (Karamanis, Dimitrios)[ 4 ] ; Ognibene, J (Ognibene, Jennifer)[ 2 ] ; Arora, S (Arora, Shitij)[ 1,2 ] ; Southern, WN (Southern, William N.)[ 1,2 ] ; Mantzoros, CS (Mantzoros, Christos S.)[ 5 ] METABOLISM-CLINICAL AND EXPERIMENTAL Volume: 108 Article Number: 154262 DOI: 10.1016/j.metabol.2020.154262 Published: JUL 2020 Document Type:Article 3-Association of Obesity with Disease Severity Among Patients with Coronavirus Disease 2019 By:Kalligeros, M (Kalligeros, Markos)[ 1 ] ; Shehadeh, F (Shehadeh, Fadi)[ 1 ] ; Mylona, EK (Mylona, Evangelia K.)[ 1 ] ; Benitez, G (Benitez, Gregorio)[ 1 ] ; Beckwith, CG (Beckwith, Curt G.)[ 1 ] ; Chan, PLA (Chan, Philip A.)[ 1,2 ] ; Mylonakis, E (Mylonakis, Eleftherios)[ 1 ] OBESITY Volume: 28 Issue: 7 Pages: 1200-1204 DOI: 10.1002/oby.22859 Published: JUL 2020 Early Access: JUN 2020 Document Type:Article Abstract

Objective The aim of this study was to explore the potential association of obesity and other chronic diseases with severe outcomes, such as intensive care unit (ICU) admission and invasive mechanical ventilation (IMV), in patients hospitalized with coronavirus disease 2019 (COVID-19). Methods This study analyzed a retrospective cohort of 103 patients hospitalized with COVID-19. Demographic data, past medical history, and hospital course were collected and analyzed. A multivariate logistic regression analysis was implemented to examine associations. Results From February 17 to April 5, 103 consecutive patients were hospitalized with COVID-19. Among them, 44 patients (42.7%) were admitted to the ICU, and 29 (65.9%) required IMV. The prevalence of obesity was 47.5% (49 of 103). In a multivariate analysis, severe obesity (BMI >= 35 kg/m(2)) was associated with ICU admission (adjusted odds ratio [aOR]: 5.39, 95% CI: 1.13-25.64). Moreover, patients who required IMV were more likely to have had heart disease (aOR: 3.41, 95% CI: 1.05-11.06), obesity (BMI = 30-34.9 kg/m(2); aOR: 6.85, 95% CI: 1.05-44.82), or severe obesity (BMI >= 35 kg/m(2); aOR: 9.99, 95% CI: 1.39-71.69). Conclusions In our analysis, severe obesity (BMI >= 35 kg/m(2)) was associated with ICU admission, whereas history of heart disease and obesity (BMI >= 30 kg/m(2)) were independently associated with the use of IMV. Increased vigilance and aggressive treatment of patients with obesity and COVID-19 are warranted. 4-High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation By:Simonnet, A (Simonnet, Arthur)[ 1 ] ; Chetboun, M (Chetboun, Mikael)[ 2 ] ; Poissy, J (Poissy, Julien)[ 1 ] ; Raverdy, V (Raverdy, Violeta)[ 2 ] ; Noulette, J (Noulette, Jerome)[ 2 ] ; Duhamel, A (Duhamel, Alain)[ 3 ] ; Labreuche, J (Labreuche, Julien)[ 3 ] ; Mathieu, D (Mathieu, Daniel)[ 1 ] ; Pattou, F (Pattou, Francois)[ 2,4 ] ; Jourdain, M (Jourdain, Merce)[ 1,2 ] Group Author(s): LICORN Lille COVID-19 Obesity Stud OBESITY Volume: 28 Issue: 7 Pages: 1195-1199 DOI: 10.1002/oby.22831 Published: JUL 2020 Early Access: JUN 2020 Document Type:Article Abstract

Objective The COVID-19 pandemic is rapidly spreading worldwide, notably in Europe and North America where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has not been fully documented. Methods This retrospective cohort study analyzed the relationship between clinical characteristics, including BMI, and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted in intensive care for SARS-CoV-2 in a single French center. Results Obesity (BMI > 30) and severe obesity (BMI > 35) were present in 47.6% and 28.2% of cases, respectively. Overall, 85 patients (68.6%) required IMV. The proportion of patients who required IMV increased with BMI categories (P < 0.01, chi(2) test for trend), and it was greatest in patients with BMI > 35 (85.7%). In multivariate logistic regression, the need for IMV was significantly associated with male sex (P < 0.05) and BMI (P < 0.05), independent of age, diabetes, and hypertension. The odds ratio for IMV in patients with BMI > 35 versus patients with BMI < 25 was 7.36 (1.63-33.14; P = 0.02). Conclusions The present study showed a high frequency of obesity among patients admitted in intensive care for SARS-CoV-2. Disease severity increased with BMI. Obesity is a risk factor for SARS- CoV-2 severity, requiring increased attention to preventive measures in susceptible individuals. 5-Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic By:Luzi, L (Luzi, Livio)[ 1,2 ] ; Radaelli, MG (Radaelli, Maria Grazia)[ 1 ] ACTA DIABETOLOGICA Volume: 57 Issue: 6 Pages: 759-764 DOI: 10.1007/s00592-020-01522-8 Published: JUN 2020 Early Access: APR 2020 Document Type:Article Abstract

Aims Analyze the relationship between obesity and influenza. Methods Basal hormone milieu, defective response of both innate and adaptive immune system and sedentariness are major determinants in the severity of influenza viral infection in obese patients. Being overweight not only increases the risk of infection and of complications for the single obese person, but a large prevalence of obese individuals within the population might increase the chance of appearance of more virulent viral strain, prolongs the virus shedding throughout the total population and eventually might increase overall mortality rate of an influenza pandemic. Results Waiting for the development of a vaccination against COVID-19, isolation of positive cases and social distancing are the primary interventions. Nonetheless, evidence from previous influenza pandemics suggests the following interventions aimed at improving immune response: (1) lose weight with a mild caloric restriction; (2) include AMPK activators and PPAR gamma activators in the drug treatment for obesity associated with diabetes; and (3) practice mild-to-moderate physical exercise. Conclusions Due to prolonged viral shedding, quarantine in obese subjects should likely be longer than normal weight individuals.

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Author Keywords:Obese subjects; COVID-19; Influenza; Immune-modulation KeyWords Plus:HUMAN ADENOVIRUS-36; METABOLIC SYNDROME; VIRUS; INFLAMMATION; EXERCISE; RECEPTOR; TRENDS; MICE 6-Obesogenic environmental factors of adult obesity in China: a nationally representative cross- sectional study By:Zhang, X (Zhang, Xiao)[ 1 ] ; Zhang, M (Zhang, Mei)[ 1 ] ; Zhao, ZP (Zhao, Zhenping)[ 1 ] ; Huang, ZJ (Huang, Zhengjing)[ 1 ] ; Deng, Q (Deng, Qian)[ 1 ] ; Li, YC (Li, Yichong)[ 1 ] ; Pan, A (Pan, An)[ 2 ] ; Li, C (Li, Chun)[ 1 ] ; Chen, ZH (Chen, Zhihua)[ 1 ] ; Zhou, MG (Zhou, Maigeng)[ 1 ] ...More ENVIRONMENTAL RESEARCH LETTERS Volume: 15 Issue: 4 Article Number: 044009 DOI: 10.1088/1748-9326/ab6614 Published: APR 2020 Document Type:Article Abstract

The prevalence of obesity is still rising among Chinese adults and may be attributed to environmental factors, which, however, has only been examined in western countries before. This study aimed to estimate associations between obesogenic environments and adult obesity in China, on the basis of the official 2013-4 nationally representative survey. General and abdominal obesity were defined by body mass index and waist circumference, respectively, according to both the Chinese and international criteria. The mean summer/winter temperature in provinces, the mean fine particulate matter (PM2.5) concentration, gross domestic product per capita, and education level in districts/counties, and the densities of fast-food restaurants, full-service restaurants, grocery stores, and supermarkets in subdistricts/towns were calculated. Five-level logistic regression models were used to estimate their associations with obesity, also in urban and rural regions separately. Both general and abdominal obesity in men were associated with the highest PM2.5 concentration, summer temperature, and density of full-service restaurants and grocery stores, as well as the lowest winter temperature. These associations were also observed in women except for summer temperature and density of full-service restaurants with abdominal obesity. Some associations varied by urban-rural regions. Also, the higher regional education level was associated with general and abdominal obesity in men. Additionally, obesity was associated with the increasing number of coexisting obesogenic environmental factors. Our findings call for more attention to citizens living in certain environments in China, such as cold winters and with more full-service restaurants and grocery stores. This is the first national, comprehensive obesogenic environment study in China, which generated evidence-based hypotheses for future longitudinal research and interventions on obesogenic environments in China.

Keywords

Author Keywords:obesity; adult; physical environment; built environment; food environment; socioeconomic environment KeyWords Plus:FINE PARTICULATE MATTER; AMBIENT AIR-POLLUTION; SOCIOECONOMIC- STATUS; CHILDHOOD OBESITY; ASSOCIATION; PREVALENCE; STRESS; WEIGHT; DIET 7-Projected US State-Level Prevalence of Adult Obesity and Severe Obesity By:Ward, ZJ (Ward, Zachary J.)[ 1 ] ; Bleich, SN (Bleich, Sara N.)[ 2 ] ; Cradock, AL (Cradock, Angie L.)[ 3 ] ; Barrett, JL (Barrett, Jessica L.)[ 3 ] ; Giles, CM (Giles, Catherine M.)[ 3 ] ; Flax, C (Flax, Chasmine)[ 3 ] ; Long, MW (Long, Michael W.)[ 4 ] ; Gortmaker, SL (Gortmaker, Steven L.)[ 3 ] NEW ENGLAND JOURNAL OF MEDICINE Volume: 381 Issue: 25 Pages: 2440-2450 DOI: 10.1056/NEJMsa1909301 Published: DEC 19 2019 Document Type:Article Abstract

BACKGROUND Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity.

METHODS We developed methods to correct for self-reporting bias and to estimate state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI). BMI data reported by 6,264,226 adults (18 years of age or older) who participated in the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias with the use of measured data from 57,131 adults who participated in the National Health and Nutrition Examination Survey. We fitted multinomial regressions for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI [the weight in kilograms divided by the square of the height in meters], <25), overweight (25 to <30), moderate obesity (30 to <35), and severe obesity (>= 35). We evaluated the accuracy of our approach using data from 1990 through 2010 to predict 2016 outcomes.

RESULTS The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low- income adults (31.7%; 95% CI, 30.2 to 33.2).

CONCLUSIONS Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with large disparities across states and demographic subgroups.

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KeyWords Plus:BODY-MASS INDEX; UNITED-STATES; CHILDHOOD OBESITY; WEIGHT- LOSS; HEALTH; OVERWEIGHT; TRENDS; COST; INTERVENTIONS; PREVENTION 8-Gut microbial metabolites in obesity, NAFLD and T2DM By:Canfora, EE (Canfora, Emanuel E.)[ 1 ] ; Meex, RCR (Meex, Ruth C. R.)[ 1 ] ; Venema, K (Venema, Koen)[ 1 ] ; Blaak, EE (Blaak, Ellen E.)[ 1 ] NATURE REVIEWS ENDOCRINOLOGY Volume: 15 Issue: 5 Pages: 261-273 DOI: 10.1038/s41574-019-0156-z Published: MAY 2019 Document Type:Review Abstract

Evidence is accumulating that the gut microbiome is involved in the aetiology of obesity and obesity- related complications such as nonalcoholic fatty liver disease (NAFLD), insulin resistance and type 2 diabetes mellitus (T2DM). The gut microbiota is able to ferment indigestible carbohydrates (for example, dietary fibre), thereby yielding important metabolites such as short-chain fatty acids and succinate. Numerous animal studies and a handful of human studies suggest a beneficial role of these metabolites in the prevention and treatment of obesity and its comorbidities. Interestingly, the more distal colonic microbiota primarily ferments peptides and proteins, as availability of fermentable fibre, the major energy source for the microbiota, is limited here. This proteolytic fermentation yields mainly harmful products such as ammonia, phenols and branched-chain fatty acids, which might be detrimental for host gut and metabolic health. Therefore, a switch from proteolytic to saccharolytic fermentation could be of major interest for the prevention and/or treatment of metabolic diseases. This Review focuses on the role of products derived from microbial carbohydrate and protein fermentation in relation to obesity and obesity-associated insulin resistance, T2DM and NAFLD, and discusses the mechanisms involved.

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KeyWords Plus:CHAIN FATTY-ACIDS; GLUCAGON-LIKE PEPTIDE-1; DIETARY RESISTANT STARCH; ADIPOSE-TISSUE; BODY-WEIGHT; INSULIN-RESISTANCE; HYDROGEN-SULFIDE; LIVER- DISEASE; NONALCOHOLIC STEATOHEPATITIS; INTESTINAL MICROBIOTA 9-Obesity: global epidemiology and pathogenesis By:Bluher, M (Blueher, Matthias)[ 1 ] NATURE REVIEWS ENDOCRINOLOGY Volume: 15 Issue: 5 Pages: 288-298 DOI: 10.1038/s41574-019-0176-8 Published: MAY 2019 Document Type:Review Abstract

The prevalence of obesity has increased worldwide in the past similar to 50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies - both at the individual and population level - have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.

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KeyWords Plus:SUGAR-SWEETENED BEVERAGES; BODY-MASS INDEX; TYPE-2 DIABETES- MELLITUS; EARLY-ONSET OBESITY; WEIGHT-GAIN; ENERGY HOMEOSTASIS; EATING BEHAVIOR; RISK- FACTORS; PREVALENCE; PREVENTION 10-The epidemiology of obesity By:Chooi, YC (Chooi, Yu Chung)[ 1 ] ; Ding, C (Ding, Cherlyn)[ 1 ] ; Magkos, F (Magkos, Faidon)[ 1,2,3 ] METABOLISM-CLINICAL AND EXPERIMENTAL Volume: 92 Pages: 6-10 DOI: 10.1016/j.metabol.2018.09.005 Published: MAR 2019 Document Type:Article Abstract

Obesity is a complex multifactorial disease. The worldwide prevalence of overweight and obesity has doubled since 1980 to an extent that nearly a third of the world's population is now classified as overweight or obese. Obesity rates have increased in all ages and both sexes irrespective of geographical locality, ethnicity or socioeconomic status, although the prevalence of obesity is generally greater in older persons and women. This trend was similar across regions and countries, although absolute prevalence rates of overweight and obesity varied widely. For some developed countries, the prevalence rates of obesity seem to have levelled off during the past few years. Body mass index (BMI) is typically used to define overweight and obesity in epidemiological studies. However, BMI has low sensitivity and there is a large inter-individual variability in the percent body fat for any given BMI value, partly attributed to age, sex, and ethnicity. For instance, Asians have greater percent body fat than Caucasians for the same BMI. Greater cardiometabolic risk has also been associated with the localization of excess fat in the visceral adipose tissue and ectopic depots (such as muscle and liver), as well as in cases of increased fat to lean mass ratio (e.g. metabolically-obese normal-weight). These data suggest that obesity may be far more common and requires more urgent attention than what large epidemiological studies suggest. Simply relying on BMI to assess its prevalence could hinder future interventions aimed at obesity prevention and control. (C) 2018 Elsevier Inc. All rights reserved.

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Author Keywords:Prevalence; BMI; Adiposity; Health risk KeyWords Plus:BODY-MASS INDEX; PHYSICAL-ACTIVITY; CHINESE ADULTS; UNITED-STATES; RISK- FACTORS; METAANALYSIS; PREVALENCE; OVERWEIGHT; PERCENTAGE; FATNESS 11-The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report By:Swinburn, BA (Swinburn, Boyd A.)[ 1,3 ] ; Kraak, VI (Kraak, Vivica I.)[ 2 ] ; Allender, S (Allender, Steven)[ 3 ] ; Atkins, VJ (Atkins, Vincent J.)[ 4 ] ; Baker, PI (Baker, Phillip I.)[ 5 ] ; Bogard, JR (Bogard, Jessica R.)[ 7 ] ; Brinsden, H (Brinsden, Hannah)[ 8 ] ; Calvillo, A (Calvillo, Alejandro)[ 9 ] ; De Schutter, O (De Schutter, Olivier)[ 10 ] ; Devarajan, R (Devarajan, Raji)[ 11 ] ...More LANCET Volume: 393 Issue: 10173 Pages: 791-846 DOI: 10.1016/S0140-6736(18)32822-8 Published: FEB 23 2019 Document Type:Review

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KeyWords Plus:BREAST-MILK SUBSTITUTES; ULTRA-PROCESSED FOODS; UNHEALTHY WEIGHT- GAIN; NONCOMMUNICABLE DISEASES; PUBLIC-HEALTH; CHILDHOOD OBESITY; PHYSICAL- ACTIVITY; URBAN GOVERNANCE; NUTRITION POLICY; PREVENTION 12-Consumption of ultra-processed foods and obesity in Canada By:Nardocci, M (Nardocci, Milena)[ 1 ] ; Leclerc, BS (Leclerc, Bernard-Simon)[ 1,2 ] ; Louzada, ML (Louzada, Maria-Laura)[ 3,4 ] ; Monteiro, CA (Monteiro, Carlos Augusto)[ 4 ] ; Batal, M (Batal, Malek)[ 2 ] ; Moubarac, JC (Moubarac, Jean-Claude)[ 2 ] CANADIAN JOURNAL OF PUBLIC HEALTH-REVUE CANADIENNE DE SANTE PUBLIQUE Volume: 110 Issue: 1 Pages: 4-14 DOI: 10.17269/s41997-018-0130-x Published: FEB 2019 Document Type:Article Abstract

Objectives To assess the association between consumption of ultra-processed foods and obesity in the Canadian population.

Methods

Cross-sectional study including 19,363 adults aged 18 years or more from the 2004 Canadian Community Health Survey, cycle 2.2. Ultra-processed food intake was estimated using daily relative energy intake of ultra-processed food (% of total energy intake) from data obtained by 24-h food recalls. Obesity was assessed using body mass index (BMI >= 30 kg/m(2)). Univariate and multivariate linear regressions were performed to describe ultra-processed food consumption according to socioeconomic and demographic variables, and multivariate logistic regression was performed to verify the association between ultra-processed food consumption and obesity, adjusting for potential confounders, including socio-demographic factors, physical activity, smoking, immigrant status, residential location, and measured vs self-reported weight and height. Results

Ultra-processed foods make up almost half (45%) of the daily calories consumed by Canadian adults. Consumption of these foods is higher among men, younger adults, those with fewer years of formal education, smokers, those physically inactive, and Canadian-born individuals. Ultra-processed food consumption is positively associated with obesity. After adjusting for confounding factors, individuals in the highest quintile of ultra-processed food consumption were 32% more likely of having obesity compared to individuals in the first quintile (predicted OR = e(0.005 x 56) = 1.32; 95% CI = 1.05-1.57). Conclusion

Canadians would benefit from reducing consumption of ultra-processed foods and beverages and increasing consumption of freshly prepared dishes made from unprocessed or minimally processed foods.

Keywords

Author Keywords:Ultra-processed food; Food processing; Obesity; Diet quality

KeyWords Plus:DIET QUALITY; NUTRITIONAL QUALITY; SHARE