Overweight and obesity are abnormal or excessive body fat accumulation that presents a risk to health. The World Health Organisation defines overweight and obesity with the Body Mass Index (BMI)... Show moreOverweight and obesity are abnormal or excessive body fat accumulation that presents a risk to health. The World Health Organisation defines overweight and obesity with the Body Mass Index (BMI) classification, which is a measure of a person’s weight in kilograms (kg) divided by the square of height in meters (m2). Overweight is defined as a BMI of 25 kg/m2 or higher, whereas obesity is defined as a BMI of 30 kg/m2 or higher. It is estimated that one of every three individuals in the global population has overweight. The prevalence of obesity is increased threefold from 1975 to 2016, with a faster-growing pace in low- and middle-income countries than high-income countries. One common complication of obesity is the metabolic syndrome, which is defined as the co-occurrence of at least three out of five cardiometabolic abnormalities (abdominal obesity, hypertension, hyperglycaemia, hypertriglyceridemia, and low HDL-cholesterol). The metabolic syndrome is a strong risk factor for type 2 diabetes and cardiovascular diseases, and is considered a pathway from obesity to the cardiometabolic diseases occurrence. Thus, if metabolic syndrome or its components are identified and treated early, type 2 diabetes and cardiovascular diseases may be prevented. In this multi-ethnic global population, it is well-established that different ethnic populations have different cardiometabolic risks. Studies have shown that Asian populations develop cardiometabolic complications earlier at the same amount of adiposity as the Western populations. Show less
The main objective of this thesis is to improve understanding of the role of helminth infections in the development of insulin resistance (IR), hence Type 2 Diabetes (T2D), in the light of... Show moreThe main objective of this thesis is to improve understanding of the role of helminth infections in the development of insulin resistance (IR), hence Type 2 Diabetes (T2D), in the light of increasing urbanization in Indonesia. Our large-scale cluster-randomized controlled trial was performed in a rural area of Indonesia, which is endemic for soil-transmitted helminth (STH), and has been previously reported to have a low prevalence of IR and T2D. In STH-infected subjects, as assessed by microscopy, 12-month anthelmintic treatment increased IR, which was mediated by an increase in BMI and leptin to adiponectin ratio, as well as reduction in eosinophil count. Next, we also aimed to assess the different metabolic profile between populations living in rural and urban area, and to study the relative protective effect of rural environment to high-fat diet (HFD). In comparison to those living in rural area, individuals living in urban area had higher whole body IR, which was mainly mediated by the higher adiposity and leptin level, which were progressively increased with increased duration of time spent in urban area. Different environmental factors (including past or current exposure to STH) did not seem to affect the metabolic response to HFD intervention, independent from adiposity. Show less
