Obesity during the COVID-19 pandemic: both cause of high risk and potential effect of lockdown? A population-based electronic health record study

Katsoulis, Michail; Pasea, Laura; Lai, Alvina G.; Dobson, Richard; Denaxas, Spiros; Hemingway, Harry; Banerjee, Amitava

doi:10.1016/j.puhe.2020.12.003

Cited by 38 publications

(41 citation statements)

References 21 publications

(22 reference statements)

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“…Finally, repeated lockdowns during the COVID-19 pandemic have profoundly reduced the amount of physical activity and energy expenditure in young adults, which has had adverse effects on weight gain. 27 Population-based EHRs are the only high-resolution source of information on changes in BMI with a sufficient sample size to estimate risk across combinations of age, sex, ethnicity, degree of social deprivation, and BMI category. Our study was the first large-scale study to focus on modern BMI change patterns at 1, 5, and 10 years at a high resolution, taking socioeconomic and demographic factors into consideration.…”

Section: Discussionmentioning

confidence: 99%

Identifying adults at high-risk for change in weight and BMI in England: a longitudinal, large-scale, population-based cohort study using electronic health records

Katsoulis

Lai

Díaz-Ordaz

et al. 2021

The Lancet Diabetes & Endocrinology

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Background Targeted obesity prevention policies would benefit from the identification of population groups with the highest risk of weight gain. The relative importance of adult age, sex, ethnicity, geographical region, and degree of social deprivation on weight gain is not known. We aimed to identify high-risk groups for changes in weight and BMI using electronic health records (EHR). MethodsIn this longitudinal, population-based cohort study we used linked EHR data from 400 primary care practices (via the Clinical Practice Research Datalink) in England, accessed via the CALIBER programme. Eligible participants were aged 18-74 years, were registered at a general practice clinic, and had BMI and weight measurements recorded between Jan 1, 1998, and June 30, 2016, during the period when they had eligible linked data with at least 1 year of follow-up time. We calculated longitudinal changes in BMI over 1, 5, and 10 years, and investigated the absolute risk and odds ratios (ORs) of transitioning between BMI categories (underweight, normal weight, overweight, obesity class 1 and 2, and severe obesity [class 3]), as defined by WHO. The associations of demographic factors with BMI transitions were estimated by use of logistic regression analysis, adjusting for baseline BMI, family history of cardiovascular disease, use of diuretics, and prevalent chronic conditions. Findings We included 2 092 260 eligible individuals with more than 9 million BMI measurements in our study. Young adult age was the strongest risk factor for weight gain at 1, 5, and 10 years of follow-up. Compared with the oldest age group (65-74 years), adults in the youngest age group (18-24 years) had the highest OR (4•22 [95% CI 3•86-4•62]) and greatest absolute risk (37% vs 24%) of transitioning from normal weight to overweight or obesity at 10 years. Likewise, adults in the youngest age group with overweight or obesity at baseline were also at highest risk to transition to a higher BMI category; OR 4•60 (4•06-5•22) and absolute risk (42% vs 18%) of transitioning from overweight to class 1 and 2 obesity, and OR 5•87 (5•23-6•59) and absolute risk (22% vs 5%) of transitioning from class 1 and 2 obesity to class 3 obesity. Other demographic factors were consistently less strongly associated with these transitions; for example, the OR of transitioning from normal weight to overweight or obesity in people living in the most socially deprived versus least deprived areas was 1•23 (1•18-1•27), for men versus women was 1•12 (1•08-1•16), and for Black individuals versus White individuals was 1•13 (1•04-1•24). We provide an open access online risk calculator, and present high-resolution obesity risk charts over a 1-year, 5-year, and 10-year follow-up period.Interpretation A radical shift in policy is required to focus on individuals at the highest risk of weight gain (ie, young adults aged 18-24 years) for individual-level and population-level prevention of obesity and its long-term consequences for health and health care.

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Section: Discussionmentioning

confidence: 99%

Identifying adults at high-risk for change in weight and BMI in England: a longitudinal, large-scale, population-based cohort study using electronic health records

Katsoulis

Lai

Díaz-Ordaz

et al. 2021

The Lancet Diabetes & Endocrinology

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“…In the pandemic context with SARS-CoV-2 infection, the recently released new guidelines and recommendations by international authorities have considered some medical services to be unessential in antenatal care in an attempt to lower the risk of pregnant women contracting the virus. Some of the recommendations of the Royal College of Obstetricians and Gynecologists (RCOG) [96][97][98] Australia 98,99 , and Canada 100 refer to screening for gestational diabetes, illustrated in Table1.…”

Section: Covid 19 and Diabetes Mellitus In Pregnancymentioning

confidence: 99%

Endocrine Flawed In COVID-19 Era

Akter

Ahmad

Haque

2021

Bangladesh J Med Sci

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The clinical practice and social relationships have been changed since the emergence of COVID-19. It is declared a global pandemic affecting millions of people across the world. SARS-CoV-2 virus while infecting human has been noted to affect several vital organs and biological systems. This can occur directly through virus-induced damage or indirectly due to the host response after virus entry, which produce a negative impact on body systems. Human endocrine system similar fatal effect. Thereafter, the knowledge and clinical expertise about the management of the endocrine pathological consequences of COVID-19 is essential in the current pandemic situation. The need of such clinical proficiency is increasing more demanding as SARS-CoV-2 pandemic is growing towards more devastating phase. The coronavirus enters the human body by using the angiotensin converting enzyme 2 (ACE-2). Other than the pneumocytes, ACE-2 is expressed by several endocrine glands like the pancreas, pituitary gland, adrenal glands, thyroid, ovary, and testes. Diabetes has a significant impact on covid 19. Diabetes Mellitus is one of the comorbidities most frequently linked to severity and mortality resulting from COVID-19 infection. Thus, careful management that includes modification of treatment may be needed to protect from the most dangerous outcomes of the virus infection or hospitalization with COVID-19, not only for patients with a known history of diabetes but also those suffering SARS-CoV-2 induced new-onset diabetes. Those suffering from obesity are more susceptible to SARS-CoV-2 as well as to adverse effects. In order to limit the susceptibility and severity of SARS-CoV-2 infection, there needs to be adequate management of nutrition of obese and undernourished patients. Hypothalamic-pituitary axis suppression, adrenal insufficiency, thyroid dysfunction, hypocalcemia, vitamin D lack, and vertebral fractures have also been reported as frequent findings in COVID-19 infected individuals who needed to be hospitalized and often associated with fatal clinical outcomes. Prompt glucocorticoid adjustment is also required in patients with COVID-19 having adrenal insufficiency. Addressing hormonal status may limit further treatment burden for a COVID-19 infected patient. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.49-64

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“…В Российской Федерации ожирение регистрируется у 23,1% населения, что составляет более 33 млн человек [6]. Важно отметить, что начавшаяся в конце 2019 г. пандемия новой коронавирусной инфекции COVID-19 может являться катализатором роста доли лиц с избыточной массой тела и ожирением, что обусловлено повсеместным введением карантинных мер, локдауна, самоизоляции и ассоциированным с этими факторами снижением физической активности населения [7][8][9].…”

Section: Introductionunclassified

Obesity as a risk factor for diseases of the digestive system

Andreev

Николаевич²,

Kucheryavy³

et al. 2021

Terapevticheskii arkhiv

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Currently, the global prevalence of obesity among the worlds adult population is about 650 million people, which makes it possible to consider this chronic metabolic disease as a non-infectious pandemic of the 21st century. It has been proven that obesity is associated with several gastroenterological diseases, while the mechanisms of these associations are extremely heterogeneous and multifactorial. Hypertrophy and hyperplasia of adipocytes in obesity lead to a change in the profile of adipokine production (a decrease in adiponectin, an increase in leptin), an increase in the production of pro-inflammatory cytokines (interleukin-1, 6, 8, tumor necrosis factor ), C-reactive protein, free fatty acids, as well as active forms of oxygen (superoxide radicals, H2O2). All the above induces the development of chronic slowly progressive inflammation, oxidative stress, and insulin resistance. In addition, peptides secreted by adipocytes (adiponectin, leptin, nesfatin-1 and apelin) can modulate gastrointestinal motility, acting both centrally and peripherally. The qualitative and quantitative changes in the intestinal microbiota observed in obese patients (increased Firmicutes and decreased Bacteroidetes) lead to a decrease in the production of short-chain fatty acids and an increase in the intestinal permeability due to disruption of intercellular tight junctions, which leads to increased translocation of bacteria and endotoxins into the systemic circulation. Numerous studies have demonstrated the association of obesity with diseases of the esophagus (gastroesophageal reflux disease, Barretts esophagus, esophageal adenocarcinoma, esophageal motility disorders), stomach (functional dyspepsia, stomach cancer), gallbladder (cholelithiasis, gallbladder cancer), pancreas (acute pancreatitis, pancreatic cancer), liver (non-alcoholic fatty liver disease, hepatocellular carcinoma), intestine (diverticular disease, irritable bowel syndrome, colorectal cancer).

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Obesity during the COVID-19 pandemic: both cause of high risk and potential effect of lockdown? A population-based electronic health record study

Cited by 38 publications

References 21 publications

Identifying adults at high-risk for change in weight and BMI in England: a longitudinal, large-scale, population-based cohort study using electronic health records

Identifying adults at high-risk for change in weight and BMI in England: a longitudinal, large-scale, population-based cohort study using electronic health records

Endocrine Flawed In COVID-19 Era

Obesity as a risk factor for diseases of the digestive system

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