可持续发展专题

Topics on sustainable development
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Obesogenic effects of six classes of emerging contaminants
There is growing concern about the concept that exposure to environmental chemicals may be contributing to the obesity epidemic. However, there is no consensus on the obesogenic effects of emerging contaminants from a toxicological and environmental perspective. The potential human exposure and experimental evidence for obesogenic effects of emerging contaminants need to be systematically discussed. The main objective of this review is to provide recommendations for further subsequent policy development following a critical analysis of the literature for humans and experimental animals exposed to emerging contaminants. This article reviews human exposure to emerging contaminants (with a focus on antimicrobials, preservatives, water and oil repellents, flame retardants, antibiotics and bisphenols) and the impact of emerging contaminants on obesity. These emerging contaminants have been widely detected in human biological samples. Epidemiological studies provide evidence linking exposure to emerging contaminants to the risks of obesity in humans. Studies based on animal models and adipose cells show the obesogenic effects of emerging contaminants and identify modes of action by which contaminants may induce changes in body fat accumulation and lipid metabolic homeostasis. Some knowledge gaps in this area and future directions for further investigation are discussed.
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Maternal obesity management: a narrative literature review of health policies.
Maternal obesity rates are increasing significantly, posing substantial risks to both mothers and their children. This study aims to introduce health policies addressing maternal obesity, identify preventive interventions, and highlight scientific gaps necessitating further research.We identified documents through electronic searches in PubMed, CINAHL Plus, EMBASE, and grey literature sources (ministry of health websites, national gynecology and obstetrics associations) from January 2013 to August 2023, updated in June 2024. The inclusion criteria focused on English-language documents discussing interventions or health policies that promote weight loss through lifestyle changes during pregnancy.A total of 22 documents (10 studies and 12 guidelines) were included. 12 studies (N=1244) identified via databases; included two Clinical Practice Guidelines (CPGs) from Canada and Singapore. Other 10 CPGs sourced from governmental websites and national associations: England (1), Australia (1), New Zealand (1), combined Australia and New Zealand (1), Canada (3), USA (1), Ireland (1), Germany (1). 10 guidelines focused on obesity in pregnancy, two on weight management during pregnancy. Covered interventions across pre-pregnancy, pregnancy, and postpartum periods (9 guidelines); pre-pregnancy and pregnancy (2); exclusively postpartum (1). Seven guidelines offered evidence-based recommendations on maintaining healthy weight in mothers, largely based on expert opinions.Maternal obesity poses significant risks to both mothers and children, underscoring the need for effective health policies and systems. However, few countries have integrated adequate responses into their healthcare policies and guidelines for professionals. Limited evidence exists on optimal practices to improve reproductive health outcomes in obese women. Hence, the crucial need to developing comprehensive guidelines and proactive strategies to manage maternal obesity. These measures can improve outcomes and reduce healthcare costs. Increased focus on research and policymaking is essential to protect the health of mothers and their children.
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Comparison of the measurement properties of the EQ-5D-5L and SF-6Dv2 among overweight and obesity populations in China
Objective To evaluate and compare the measurement properties of the EQ-5D-5L and SF-6Dv2 among Chinese overweight and obesity populations.Methods A representative sample of Chinese overweight and obesity populations was recruited stratified by age, gender, body mass index (BMI), and area of residence. Social-demographic characteristics and self-reported EQ-5D-5L and SF-6Dv2 responses were collected through the online survey. The agreement was assessed using intraclass correlation coefficients (ICC). Convergent validity and known-group validity were examined using Spearman's rank correlation and effect sizes, respectively. The test-retest reliability was assessed using among a subgroup of the total sample. Sensitivity was compared using relative efficiency and receiver operating characteristic.Results A total of 1000 respondents (52.0% male, mean age 51.7 years, 67.7% overweight, 32.3% obesity) were included in this study. A higher ceiling effect was observed in EQ-5D-5L than in SF-6Dv2 (30.6% vs. 2.1%). The mean (SD) utility was 0.851 (0.195) for EQ-5D-5L and 0.734 (0.164) for SF-6Dv2, with the ICC of the total sample was 0.639 (p < 0.001). The Spearman's rank correlation (range: 0.186-0.739) indicated an acceptable convergent validity between the dimensions of EQ-5D-5L and SF-6Dv2. The EQ-5D-5L showed basically equivalent discriminative capacities with the SF-6Dv2 (ES: 0.517-1.885 vs. 0.383-2.329). The ICC between the two tests were 0.939 for EQ-5D-5L and 0.972 for SF-6Dv2 among the subgroup (N = 150). The SF-6Dv2 had 3.7-170.1% higher efficiency than the EQ-5D-5L at detecting differences in self-reported health status, while the EQ-5D-5L was found to be 16.4% more efficient at distinguishing between respondents with diabetes and non-diabetes.Conclusions Both the EQ-5D-5L and SF-6Dv2 showed comparable reliability, validity, and sensitivity when used in Chinese overweight and obesity populations. The two measures may not be interchangeable given the systematic difference in utility values between the EQ-5D-5L and SF-6Dv2. More research is needed to compare the responsiveness.
期刊论文
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Probiotics for preventing gestational diabetes mellitus in overweight or obese pregnant women: A systematic review and meta-analysis
Background: Gestational diabetes mellitus was associated with increased risks of complications during pregnancy and delivery. The efficacy of probiotics for preventing atopic disease among overweight and obese pregnant women has not been a unified conclusion. Therefore, we aimed to determine the efficacy and safety of probiotics supplementation for overweight and obese pregnant women. Methods: We searched the Cochrane Library, Embase, PubMed, and Web of Science for randomized controlled trials from the earliest publication date available to September 23, 2020, regardless of language or publication status. Two reviewers independently extracted data with a standardized form. When disagreements arose, a third investigator was consulted. Data was pooled using the generic inverse variance method and expressed as mean differences and relative risk with 95% confidence interval (CI). Heterogeneity was measured and quantified by I-2 statistic. Results: There were no significant differences between probiotics and placebo on GDM (RR = 1.03; 95% CI, 0.81-1.30; P = 0.821; I-2 = 38.7%, P = 0.180), excess gestational weight gain (RR = 0.92; 95% CI, 0.79 -1.06; P = 0.223; I-2 = 91.2%, P = 0.001) and neonatal birth weight (WMD = 28.47; 95% CI, -34.80-91.73; P = 0.383; I-2 = 4.5%, P = 0.381). In addition, probiotics might increase the risk of preeclampsia including superimposed (RR = 1.91; 95% CI, 1.03-3.55; P = 0.001; I-2 = 0.0%, P = 0.994). Conclusions: Probiotics had no better efficacy for prevention of atopic disease in overweight or obese pregnant women. In contrast, excessive probiotics supplementation might increase the risk of preeclampsia. More data will be necessary to determine the prevention efficacy of probiotics with consideration of real-world and other epidemiological settings. (C) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
期刊论文
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Access to fruit and vegetable markets and childhood obesity: A systematic review.
The lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging access to venues that offer more unhealthy food (and thus the compensatory intake of those options). However, findings remain mixed, and there has not been a review of the association between FVM access and childhood obesity. A comprehensive and systematic understanding of this epidemiologic relationship is important to the design and implementation of relevant public health policies. In this study, a literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before 1 January 2019 that focused on the association between neighbourhood FVM access and weight-related behaviours and outcomes among children and adolescents. Eight cross-sectional studies, two longitudinal studies, and one ecological study conducted in five countries were identified. The median sample size was 2142 ± 1371. Weight-related behaviours and outcomes were used as the outcome variable in two and eight studies, respectively, with one study using both weight-related behaviours and outcomes as outcome variables. We still found a negative association between access to FVMs in children's residential and school neighbourhoods and weight-related behaviours and an inconclusive association between FVM access and overweight or obesity. This conclusion should be regarded as provisional because of a limited amount of relevant evidence and may not be a strong guide for policymaking. Nonetheless, it points to an important research gap that needs to be filled if successful public health interventions are to be undertaken.
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