Abdominal obesity (AO) is characterised by excess adipose tissue. It is a metabolic risk that affects the physical and mental health, particularly in women since they are more prone to mental health problems like depression. This study investigated the association between AO and depressive symptoms in Peruvian women of reproductive age (18–49 years).

This is a cross-sectional observational study.

Peruvian women population of reproductive age.

We used data from the Peruvian Demographic and Family Health Survey (DHS) for 2018 and 2019 to assess 17 067 women for the presence of depressive symptoms (using the Patient Health Questionnaire (PHQ-9): cut-off score ≥ 10) and AO (measured by abdominal circumference; cut-off score ≥88 cm).

We observed a 64·55 % prevalence of AO and 7·61 % of depressive symptoms in the study sample. Furthermore, 8·23 % of women with AO had depressive symptoms (P < 0·05). Initially, women with AO appeared to have a 26 % higher risk of depressive symptoms compared with women without AO (P = 0·028); however, after adjustment for covariates, no statistically significant association was observed.

Therefore, although both conditions are common in women of this age group, no significant association was found between AO and depressive symptoms.

To analyse the direct and indirect associations of experience of racial discrimination on dietary patterns (DP), obesity and abdominal obesity.

This is a cross-sectional population-based study. The main exposure was self-reported experiences of racial discrimination (Experiences of Discrimination scale). The mediator variables were the DP: healthy, Brazilian traditional, sugar and carbohydrates, and fast food. The outcomes were obesity (BMI ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 88 cm for women; ≥ 102 cm for men). Structural equation modelling was applied.

Porto Alegre, Brazil.

Totally, 400 adults aged between 20 and 70 years were participated.

The mean age of participants was 47·2 years (sd = 13·9), and 75 % were women. Experiencing racial discrimination had a positive direct effect on obesity (healthy DP: β = 0·153, P < 0·05; Brazilian DP: β = 0·156, P < 0·05; sugar and carbohydrates DP: β = 0·156, P < 0·05; and fast-food DP: β = 0·153, P < 0·05) and abdominal obesity (healthy DP: β = 0·206, P < 0·01; Brazilian DP: β = 0·210, P < 0·01; sugar and carbohydrates DP: β = 0·204, P < 0·01; and fast-food DP: β = 0·204, P < 0·01). The experience of racial discrimination did not have a direct effect on DP, nor did it exert an indirect effect on obesity and abdominal obesity through any DP.

A higher experience of racial discrimination is associated with obesity and abdominal obesity, independent of diet.

To examine the association between household food insecurity and overweight, obesity and abdominal obesity in Mexican adults.

Cross-sectional study.

We analysed data from the Mexican Halfway National Health and Nutrition Survey 2016, a nationally representative survey that accounted for rural and urban areas in four regions of Mexico: North, Centre, Mexico City and South.

Adults from 20 to 59 years old (n 5456, which represents 45 804 210 individuals at the national level).

70·8 % of the Mexican adults had some degree of household food insecurity. This situation showed larger proportions (P < 0·05) among indigenous people, those living in a rural area, in the Southern region or the lowest socio-economic quintiles. The prevalence of obesity and abdominal obesity was higher in female adults (P < 0·001), with the highest proportions occurring among those experiencing severe household food insecurity. Among women, mean BMI and waist circumference were higher as household food insecurity levels increased (P < 0·001). According to multivariate logistic regression models, severe household food insecurity showed to be positively associated with obesity (OR: 2·36; P = 0·001) in Mexican adult females.

Our findings confirm the association between household food insecurity and obesity among Mexican women. Given the socio-demographic characteristics of the food-insecure population, it is alarming that prevailing socio-economic inequalities in the country might also be contributing to the likelihood of obesity. Therefore, it is crucial to maintain and bolster surveillance systems to track both problems and implement adequate policies and interventions.

This study aimed to investigate the direct and indirect effects of poor sleep quality on BMI and waist circumference (WC), considering behavioural factors as intermediate variables.

A population-based cross-sectional study design was adopted. Data were collected between February and October 2015. Poor sleep quality was assessed using the Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR). Weight, height (used to calculate BMI) and WC were measured using standard protocols. Physical activity, sedentary behaviour and fast food consumption were considered intermediate variables. Non-standardised effects were estimated by path analysis with bootstrapped CI.

Urban region of the city of São Leopoldo, southern Brazil.

Representative sample of 1117 women aged between 20 and 69 years.

Poor sleep quality (higher PSQI-BR scores) was significantly associated with low physical activity levels (β = –0·05; 95 % CI –0·09, –0·01). High physical activity levels were associated with lower BMI (β = –0·21; 95 % CI –0·37, –0·07) and WC (β = –0·64; 95 % CI –1·00, –0·30). There was a non-significant direct effect of poor sleep quality on BMI and WC. However, low physical activity showed a significant indirect effect on the association between poor sleep quality and increased WC (β = 0·03; 95 % CI 0·01, 0·07).

The results indicate that the association between sleep quality and WC is mediated by physical activity. This finding can assist in the development of strategies to prevent and reduce abdominal obesity in adult women.

To assess the association between patterns of nutrient intake and metabolic syndrome (MetS) in a large sample of Iranian adults.

Baseline data from the Shahedieh cohort study were used in the current cross-sectional study. Dietary intakes were assessed through the use of a validated semi-quantitative FFQ. Nutrient patterns (NP) were derived using factor analysis. The MetS was defined according to criteria introduced from the National Cholesterol Education Program Adult Treatment Panel III, modified for Iranian adults.

Yazd, Iran.

A total of 7325 Iranian adults aged between 30 and 75 years.

Three NP were identified. A significant positive association was found between adherence to semi-plant NP (characterised by the high intakes of P; vitamins B1, B3, B6 and B5; Se; Mg; Fe; protein; Cr; Cu; fibre; biotin; Mn; Zn and Na) and odds of MetS (OR 1·68, 95 % CI 1·43, 1·98). However, after adjusting for potential confounders, this association became non-significant. In addition, after taking potential confounders into account, individuals in the highest quintile of the semi-animal NP, rich in Ca; K; vitamins B2, B12, A, D, K and C; SFA; dietary cholesterol and trans-fatty acid, were 26 % more likely to have MetS compared with those in the lowest quintile (OR 1·26, 95 % CI 1·05, 1·51). No significant association was seen between adherence to the high-carbohydrate/low-fat NP and odds of MetS.

We found that adherence to a semi-animal NP was associated with increased odds of MetS.

Elevated levels of C-reactive protein (CRP) have repeatedly been observed in schizophrenia (SZ) and related disorder but without clear description of the associated clinical variables. The objectives of this study were:

– to determine the prevalence of abnormal CRP levels in an observational sample of patients with SZ or schizoaffective disorders;

– to identify the clinical variables associated with elevated CRP levels as well as the effects of treatments.

Two hundred and nineteen stable patients with schizophrenia or schizoaffective disorder (mean age = 31.6 years, 75.3% male gender) were systematically included in the network of FondaMental Expert Center for schizophrenia and assessed with a dedicated electronic medical records including the Structured Clinical Interview for DSM-IV Axis I Disorders and validated scales for depressive and psychotic symptomatology. High sensitivity CRP (hs-CRP) was measured with an assay using nephelometry (Dade Behring). Abnormal CRP level was defined by levels > 3 mg/L. Metabolic syndrome was defined according to the International Diabetes Federation.

Overall, 63 patients (28.8%) were found to have abnormal CRP levels. In univariate analysis, abnormal CRP levels were found to be significantly associated with the DSM-IV-TR schizophrenia diagnosis compared to schizoaffective disorder (32.6% vs. 10.5%, P = 0.006). This association remained significant after adjustment for BMI (P = 0.007) and antidepressants (P = 0.043). Abnormal CRP levels were also found to be significantly associated with BMI (P < 0.0001), hypertriglyceridemia (P = 0.0015), high waist circumference (P < 0.0001), metabolic syndrome (P = 0.0011) and abdominal obesity (P < 0.0001), while current tobacco status, hypertension or high fasting glucose were not (all P > 0.05). All patients were treated by antipsychotics. Patients treated by antidepressant were found to have less abnormal CRP levels than others (P = 0.01), contrary to those treated by mood stabilizing agents (P > 0.05).

CRP may be considered as a biomarker of interest to differentiate schizophrenia from schizoaffective disorder, and as a marker of inflammation induced by perivisceral fat. Treatment with antidepressant appears as a protective anti-inflammatory agent.

Abdominal obesity was suggested to be a better predictor than Metabolic Syndrome (MetS) for cardiovascular mortality, however is has not been extensively studied in schizophrenia. Hyperuricemia (HU) was also suggested to be both an independent risk factor for greater somatic comorbidity and a global metabolic stress maker in patients with schizophrenia. The aim of this study was to estimate the prevalence of MetS, abdominal obesity and HU and to examine the association between metabolic parameters with HU in a cohort of French patients with schizophrenia or schizoaffective disorder (SZ), and to explore if patients were correctly treated.

In total, 240 SZ patients (age = 31.4 years, male gender 74.3%) were systematically included. Metabolic syndrome was defined according to the International Diabetes Federation and HU if serum uric acid level was above 360 μmol/L.

MetS, abdominal obesity and HU were found respectively in 24.2%, 21.3% and 19.6% of patients. In terms of risk factors, multiple logistic regression showed that after taking into account the potential confounders, the risk for HU was higher in males (OR = 5.9, IC 95 [1.7–21.4]) and with subjects with high waist circumference (OR = 3.1, IC 95 [1.1–8.3]) or hypertriglyceridemia (OR = 4.9, IC 95 [1.9–13]). No association with hypertension, low HDL cholesterol or high fasting glucose was observed. Only 10% of patients with hypertension received a specific treatment, 18% for high fasting glucose and 8% for dyslipidemia.

The prevalence of MetS, abdominal obesity and hyperuricemia is elevated in French patients with schizophrenia, all of which are considerably under-diagnosed and undertreated. HU is strongly associated with abdominal obesity but not with psychiatric symptomatology.

High sugar-sweetened beverage (SSB) intake has been shown to correlate with a higher risk for CVD and metabolic disorders, while the association between SSB intake and the risk of metabolic syndrome (MetS) remains unclear. The present study aimed to explore the association between SSB intake and MetS among children and adolescents in urban China.

A cross-sectional study involving 7143 children and adolescents was conducted in urban China. MetS definition proposed by the International Diabetes Federation was adopted. Data on SSB intake, diet, physical activity and family environment factors were obtained through questionnaires. Logistic regression models with multivariable adjustment were adopted to analyse the association between SSB intake and the risk of MetS and its components.

Primary and secondary schools in three urban cities of China.

Children and adolescents (n 5258) aged 7–18 years.

Among the participants, 29·9 % of them had high SSB intake (at least 0·3 servings/d) and the overall MetS prevalence was 2·7 %. Participants with high SSB intake were at higher risk for MetS (OR = 1·60; 95 % CI 1·03, 2·54) and abdominal obesity (OR = 1·55; 95 % CI 1·28, 1·83) compared with their counterparts with no SSB intake (0 servings/d).

High SSB intake is significantly associated with increased MetS and abdominal obesity risk among children and adolescents in urban China. These results suggest that strong policies focusing on controlling SSB intake might be effective in preventing MetS and abdominal obesity.

Abdominal obesity (AO) is a relative risk factor for cardiovascular events. We aimed to determine the 6-year incidence of AO and its risk factors among Tehranian adults.

In this population-based cohort study, non-abdominally obese participants, aged ≥20 years, were followed for incidence of AO. Cumulative incidence and incidence rate of AO were calculated for each sex. Cox proportional hazard regression was used to determine the association of potential risk factors including age, BMI, dysmetabolic state, smoking, marital status, educational level and physical activity (PA).

A total of 5044 participants (1912 men) were followed for a median of 6 years. Mean age was 37·7 (sd 13·5) years at baseline, with mean BMI of 24·3 (sd 3·1) kg/m2 (men, 23·0 (sd 2·4) kg/m2; women, 25·0 (sd 3·2) kg/m2). During follow-up, 3093 (1373 men) developed AO with total cumulative incidence of 76·02, 83·59 and 70·90 %, for the whole population, men and women, respectively. Corresponding incidence rates were 96·0, 138·7 and 77·1 per 1000 person-years. The highest incidence rate was observed during their 30s and 50s, in men and women, respectively. Subjects with dysmetabolic state in both sexes, married women, men with lower PA and higher educational levels at baseline were at higher risk of AO.

The incidence of AO is high among Tehranian adults, especially in young men. The risk factors for developing AO should be highlighted to halt this growing trend of AO.

To evaluate the performance of waist-to-height ratio (WHtR) in predicting cardiometabolic outcomes and compare cut-off points for Brazilian adults.

Cross-sectional study. WHtR areas under the curve (AUC) were compared with those for BMI, waist circumference (WC) and waist-to-hip ratio (WHR). The outcomes of interest were hypertension, diabetes, hypertriacylglycerolaemia and presence of at least two components of metabolic syndrome (≥2 MetS). Cut-offs for WHtR were compared and validity measures were estimated for each point.

Teaching and research institutions in six Brazilian state capitals, 2008–2010.

Women (n 5026) and men (n 4238) aged 35–54 years who participated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) at baseline.

WHtR age-adjusted AUC ranged from 0·68 to 0·72 in men and 0·69 to 0·75 in women, with smaller AUC for hypertriacylglycerolaemia and the largest for ≥2 MetS. WHtR performed better than BMI for practically all outcomes; better than WHR for hypertension in both sexes; and displayed larger AUC than WC in predicting diabetes mellitus. It also offered better discriminatory power for ≥2 MetS in men; and was better than WC, but not WHR, in women. Optimal cut-off points of WHtR were 0·55 (women) and 0·54 (men), but they presented high false-negative rate compared with 0·50.

We recommend using WHtR (which performed similarly to, or better than, other available indices of adiposity) as an anthropometric index with good discriminatory power for cardiometabolic outcomes in Brazilian adults, indicating the already referenced limit of WHtR≥0·50.

Abdominal obesity is associated with obesity-related health risks regardless of body weight. The present study aimed to determine whether alcohol drinking pattern is associated with abdominal obesity in normal-weight, middle-aged adults.

Cross-sectional study using complex sampling design analyses.

The Korea National Health and Nutrition Examination Survey, which was conducted from 2008 to 2013.

Normal-weight participants aged 40–69 years with BMI of 18·5–25·0 kg/m2 (n 11 289, 4491 men and 6798 women) were included. Abdominal obesity was defined as waist circumference ≥90 cm for men or ≥85 cm for women. Alcohol drinking pattern was assessed by self-report on questionnaires.

Among 11 289 normal-weight participants, 7·9 % (n 379) of men and 7·6 % (n 609) of women had abdominal obesity. Both men and women who consumed a higher quantity of alcohol per drinking occasion had higher odds (OR; 95 % CI) for abdominal obesity compared with individuals who consumed fewer than 2 drinks (1·86; 1·04, 3·32 for ≥10 drinks/typical occasion in men; and 3·28; 1·13, 9·46 in women). Men who binge drink every day had higher odds for abdominal obesity (2·10; 1·21, 3·63). In both sexes, frequency of alcohol drinking was not associated with normal-weight abdominal obesity.

Our study showed that the amount of alcohol drinking per occasion influenced abdominal obesity in normal-weight, middle-aged individuals that may have impacted obesity-related health risks. Healthy alcohol drinking habits need to be controlled for prevention of abdominal obesity even among persons with normal weight.

To determine the prevalence of high weight at different characteristics, understand the perceptions and behaviours towards high body weight, and determine potential influencing factors of body weight misperception among high-weight adults in Jilin Province.

A cross-sectional survey with complex sampling design was conducted. We described the prevalence and perception of high body weight.

Northeast China in 2012.

Adults (n 20 552) aged 18–79 years.

Of overweight individuals, 37·4 % considered themselves as ‘normal weight’, 4·8 % reported themselves as being ‘very thin’ and only 53·1 % were aware of their own weight being ‘overweight’. About 1·8 % of both male and female obese individuals perceived themselves as ‘very thin’. Only 29·1 % of obese people thought of themselves as ‘too fat’. Nearly 30·0 % of centrally obese men and women perceived that their waist circumference was about right and they were of ‘normal weight’; 5·7 % of the centrally obese even perceived themselves as being ‘very thin’. Only 51·8 and 12·5 % of centrally obese individuals reported themselves to be ‘overweight’ or ‘too fat’. Body weight misperception was more common in rural residents (OR; 95 % CI: 1·340; 1·191, 1·509). The prevalence of body weight misperception increased with age (middle age: 1·826; 1·605, 2·078; old people: 3·101; 2·648, 3·632) and declined with increased education level (junior middle school: 0·628; 0·545, 0·723; senior middle school: 0·498; 0·426, 0·583; undergraduate and above: 0·395; 0·320, 0·487).

Body weight misperception was common among adults from Jilin Province.

The relation between body weight status and depressive symptoms in the elderly differs according to age and country of origin. The goal of this study was to analyze the cross-sectional and longitudinal relationship between body mass index (BMI), waist circumference (WC) and depressive symptoms in the elderly.

A population-based cohort study of 1,702 elderly individuals (70.6+8.0 years) in Southern Brazil evaluated in 2009/10 and 2013/14 was accessed. The body weight status was assessed using measured data of BMI and WC. The Geriatric Depression Scale (GDS-15) was used to determine depressive symptoms. Logistic regression analysis adjusted for sociodemographic and behavioral variables was performed.

The prevalence of depressive symptoms in 2009/10 was 23.3% (95% CI 20.3–26.6) and the cumulative incidence in the 4-years period was 10.9% (95% CI 8.7–13.6). Elderly people with obesity class II–III and WC in the highest quartile had higher prevalence odds ratio of being depressed than individuals with normal weight or WC in the lower quartile (OR 2.34; 95% CI 1.42–3.87 and OR 1.73; 95% CI 1.13–2.65, respectively). Meanwhile, intermediary values of BMI and WC were associated with a lower prevalence. When evaluating the incidence of depressive symptoms, overweight individuals and those in the second quartile of WC had a lower risk (58% and 57%, respectively), but severely obese individuals had the same risk compared to those with normal BMI/WC.

Severely obese individuals presented a similar incidence of depressive symptoms compared to those with normal BMI/WC, but higher prevalence. Intermediary values of body weight status decrease the risk of depressive symptoms.

To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period.

Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI.

São Paulo, Brazil.

Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed.

The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001). This pattern was observed in all BMI levels. In regression models, abdominal obesity remained associated with disability incidence (incidence rate ratio=1·90; P<0·03), even after controlling for BMI, gender, age, low grip strength, cognitive impairment, physical inactivity and chronic diseases.

Abdominal obesity was strong risk factor for disability, showing a more significant effect than BMI, and thus should be an intervention target for older adults. Waist measure is simple, cost-effective and easily interpreted, and therefore can be used in several settings to identify individuals at higher risk of disability.

Depression is associated with the metabolic syndrome (MS). We examined whether metabolic dysregulation predicted the 2-year course of clinical depression.

A total of 285 older persons (⩾60 years) suffering from depressive disorder according to DSM-IV-TR criteria was followed up for 2 years. Severity of depression was assessed with the Inventory of Depressive Symptomatology (IDS) at 6-month intervals. Metabolic syndrome was defined according the National Cholesterol Education Programme (NCEP-ATP III). We applied logistic regression and linear mixed models adjusted for age, sex, years of education, smoking, alcohol use, physical activity, somatic co-morbidity, cognitive functioning and drug use (antidepressants, anti-inflammatory drugs) and severity of depression at baseline.

MS predicted non-remission at 2 years (odds ratioper component = 1.26, 95% confidence interval 1.00–1.58), p = 0.047), which was driven by the waist circumference and HDL cholesterol. MS was not associated with IDS sum score. Subsequent analyses on its subscales, however, identified an association with the somatic symptom subscale score over time (interaction time × somatic subscale, p = 0.005), driven by higher waist circumference and elevated fasting glucose level.

Metabolic dysregulation predicts a poor course of late-life depression. This finding supports the concept of ‘metabolic depression’, recently proposed on population-based findings of a protracted course of depressive symptoms in the presence of metabolic dysregulation. Our findings seem to be driven by abdominal obesity (as indicated by the waist circumference) and HDL cholesterol dysregulation.

To examine the relationship between dietary energy density (DED) and risk of metabolic syndrome (MetS), its components and inflammatory markers.

Cross-sectional study. Dietary intakes were assessed using a validated dish-based semi-quantitative FFQ. DED was calculated by dividing energy intake (kcal/d) by the total weight of foods only (g/d). MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria. All associations were examined in the quartiles of DED, with higher quartiles indicating more energy-dense diets.

Isfahan, Iran.

Female nurses (n 1036) aged >30 years.

After controlling for potential confounders, individuals in the top quartile of DED had 78 % greater chance of MetS compared with those in the first (OR=1·78; 95 % CI 1·36, 2·98; P<0·001). Individuals in the highest quartile of DED were more likely to be abdominally obese (OR=1·51; 95 % CI 1·00, 2·63) and have hypertriacylglycerolaemia (OR=2·95; 95 % CI 1·58, 3·91) and low HDL cholesterol levels (OR=1·36; 95 % CI 1·17, 2·54) compared with those in the lowest quartile. Mean concentration of plasma high-sensitivity C-reactive protein (hs-CRP) across increasing quartiles of DED was 1·7, 1·7, 2·0, 2·4 mg/l (P for trend=0·04). Such increasing concentrations across increasing quartiles of DED were also seen for TNF-α (4·1, 4·5, 4·5, 4·8 ng/l; P for trend=0·03) and IL-6 (1·6, 1·6, 1·5, 2·5 ng/l; P for trend <0·01).

Consumption of high-energy-dense foods was associated with increased chance of MetS, most of its features and inflammatory markers including hs-CRP, TNF-α and IL-6.