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Prevention and Healthcare for Populations at High Risk for Overweight and Obesity

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Public Health Statistics and Risk Assessment".

Deadline for manuscript submissions: closed (25 October 2023) | Viewed by 6699

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Special Issue Editor

Dr. Di Girolamo Filippo Giorgio

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Guest Editor

Department of Internal Medicine, University of Trieste, Ospedale di Cattinara, 34127 Trieste, Italy
Interests: cardiovascular health; diet; muscle; nutrition; body composition

Special Issue Information

Dear Colleagues,

Obesity is a complex chronic disease, characterized by frequent relapses and associated with numerous complications including, notoriously, arterial hypertension, dyslipidemia, type 2 diabetes mellitus, but also hepatic steatosis, sleep apnea, chronic renal failure, osteoarthritis, increased risk of myocardial infarction and stroke and some neoplasms, depression and other forms of psychological distress, associated with overweight, increased mortality from cardiovascular diseases and from all causes, including COVID-19 infections, as demonstrated by recent case studies. The etiology of obesity is multifactorial, mediated by genetic but above all behavioral and socio-environmental components, among which sedentary lifestyle, consumerism, globalization, impact, often negative, of the media and social networks, alteration of biorhythms, stigmatization of being overweight, and a deficit of health organization in this area.

The COVID-19 pandemic has largely confirmed the relationship between obesity, the environment and lifestyle. Obesity can also be associated with sarcopenia, characterized by loss of skeletal muscle mass and functions, resulting from a sedentary lifestyle, acute and chronic diseases and aging. The recognition of obesity as a multifactorial disease is therefore fundamental and cannot be deferred in order to ensure users the same level of care provided in other chronic diseases. It is also necessary to evaluate and further define the short and long-term effectiveness of the therapy dietetics, cornerstone of the conservative approach to overweight, on anthropometric, clinical and behavioral parameters and on morbidity and mortality, also taking into account the spread of alternative diets that have become very popular. In obesity therapy, the published guidelines of scientific societies are rarely followed, for which effective treatments require dietary modifications but also an increase in physical activity and appropriate psychoeducation and behavioral therapy paths.

This poor adherence to integrated models is the consequence of insufficient knowledge, persistent adherence to traditional interventions, skepticism, discriminatory attitudes towards patients and lack/low collaboration between different professional figures. It is also necessary to increase the sensitivity towards the recognition of the clinical picture of sarcopenic obesity whose diagnostic criteria are not fully defined. Prevention and therapy then require adequate solutions to reduce the impact of the current obesogenic environment. As regards drug therapy, particularly in cases of obesity associated with type 2 diabetes mellitus, promising new products are available, to be used in integrated pathways between different clinical specialties. All of these data indicate how obesity prevention and therapy require continuous updating of the operators involved. This requires scientific evidence to determine the best and most cost-effective measures in prevention, and healthcare. This Special Issue welcomes original research papers and reviews and other types of articles on obesity and overweight prevention.

Dr. Di Girolamo Filippo Giorgio
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

obesity
overweight
prevention and therapy
healthcare
type 2 diabetes
cardiovascular health
chronic diseases

Published Papers (2 papers)

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Research

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10 pages, 355 KiB

Open AccessArticle

Factors Associated with Symptoms of Depression among People with Obesity: Analysis of a 3-Year-Peruvian National Survey

by Víctor Juan Vera-Ponce, Jenny Raquel Torres-Malca, Willy Ramos, Rubén Espinoza Rojas, Jamee Guerra Valencia, Joan A. Loayza-Castro, Fiorella E. Zuzunaga-Montoya, Gianella Zulema Zeñas-Trujillo, Liliana Cruz-Ausejo and Jhony A. De La Cruz-Vargas

Int. J. Environ. Res. Public Health 2023, 20(3), 1816; https://doi.org/10.3390/ijerph20031816 - 18 Jan 2023

Cited by 3 | Viewed by 2122

Abstract

Introduction: Obesity and depression contribute to the global burden of economic cost, morbidity, and mortality. Nevertheless, not all people with obesity develop depression. Objective: To determine the factors associated with depressive symptoms among people aged 15 or older with obesity from the National Demographic and Family Health Survey (ENDES in Spanish 2019–2021). Methods: Cross-sectional analytical study. The outcome of interest was the presence of depressive symptoms, assessed using the Patient Health Questionnaire-9 (PHQ-9). Crude (cPR) and adjusted (aPR) prevalence ratios were estimated using GLM Poisson distribution with robust variance estimates. Results: The prevalence of depression symptoms was 6.97%. In the multivariate analysis, a statistically significant association was found between depressive symptoms and female sex (PRa: 2.59; 95% CI 1.95–3.43); mountain region (PRa: 1.51; 95% CI 1.18–1.92); wealth index poor (PRa: 1.37; 95% CI 1.05–1.79, medium (PRa: 1.49; 95% CI 1.11–2.02), and rich (PRa: 1.65; 95% CI 1.21–2.26); daily tobacco use (PRa: 2.05, 95% CI 1.09–3.87); physical disability (PRa: 1.96, 95% CI 1.07–3.57); and a history of arterial hypertension (PRa: 2.05; 95% CI 1.63–2.55). Conclusion: There are several sociodemographic factors (such as being female and living in the Andean region) and individual factors (daily use of tobacco and history of hypertension) associated with depressive symptoms in Peruvian inhabitants aged 15 or older with obesity. In this study, the COVID-19 pandemic was associated with an increase in depressive symptoms. Full article

(This article belongs to the Special Issue Prevention and Healthcare for Populations at High Risk for Overweight and Obesity)

Review

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25 pages, 1190 KiB

Open AccessReview

Lipoprotein(a) as a Risk Factor for Cardiovascular Diseases: Pathophysiology and Treatment Perspectives

by Pierandrea Vinci, Filippo Giorgio Di Girolamo, Emiliano Panizon, Letizia Maria Tosoni, Carla Cerrato, Federica Pellicori, Nicola Altamura, Alessia Pirulli, Michele Zaccari, Chiara Biasinutto, Chiara Roni, Nicola Fiotti, Paolo Schincariol, Alessandro Mangogna and Gianni Biolo

Int. J. Environ. Res. Public Health 2023, 20(18), 6721; https://doi.org/10.3390/ijerph20186721 - 6 Sep 2023

Cited by 3 | Viewed by 4184

Abstract

Cardiovascular disease (CVD) is still a leading cause of morbidity and mortality, despite all the progress achieved as regards to both prevention and treatment. Having high levels of lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular disease that operates independently. It can increase the risk of developing cardiovascular disease even when LDL cholesterol (LDL-C) levels are within the recommended range, which is referred to as residual cardiovascular risk. Lp(a) is an LDL-like particle present in human plasma, in which a large plasminogen-like glycoprotein, apolipoprotein(a) [Apo(a)], is covalently bound to Apo B100 via one disulfide bridge. Apo(a) contains one plasminogen-like kringle V structure, a variable number of plasminogen-like kringle IV structures (types 1–10), and one inactive protease region. There is a large inter-individual variation of plasma concentrations of Lp(a), mainly ascribable to genetic variants in the Lp(a) gene: in the general po-pulation, Lp(a) levels can range from <1 mg/dL to >1000 mg/dL. Concentrations also vary between different ethnicities. Lp(a) has been established as one of the risk factors that play an important role in the development of atherosclerotic plaque. Indeed, high concentrations of Lp(a) have been related to a greater risk of ischemic CVD, aortic valve stenosis, and heart failure. The threshold value has been set at 50 mg/dL, but the risk may increase already at levels above 30 mg/dL. Although there is a well-established and strong link between high Lp(a) levels and coronary as well as cerebrovascular disease, the evidence regarding incident peripheral arterial disease and carotid atherosclerosis is not as conclusive. Because lifestyle changes and standard lipid-lowering treatments, such as statins, niacin, and cholesteryl ester transfer protein inhibitors, are not highly effective in reducing Lp(a) levels, there is increased interest in developing new drugs that can address this issue. PCSK9 inhibitors seem to be capable of reducing Lp(a) levels by 25–30%. Mipomersen decreases Lp(a) levels by 25–40%, but its use is burdened with important side effects. At the current time, the most effective and tolerated treatment for patients with a high Lp(a) plasma level is apheresis, while antisense oligonucleotides, small interfering RNAs, and microRNAs, which reduce Lp(a) levels by targeting RNA molecules and regulating gene expression as well as protein production levels, are the most widely explored and promising perspectives. The aim of this review is to provide an update on the current state of the art with regard to Lp(a) pathophysiological mechanisms, focusing on the most effective strategies for lowering Lp(a), including new emerging alternative therapies. The purpose of this manuscript is to improve the management of hyperlipoproteinemia(a) in order to achieve better control of the residual cardiovascular risk, which remains unacceptably high. Full article

(This article belongs to the Special Issue Prevention and Healthcare for Populations at High Risk for Overweight and Obesity)

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