Aim:
Obesity is one of the most common diseases and is the main risk factor for the occurrence of other non-communicable diseases such as: hypertension, diabetes, heart disease and cancer. Obesity can be prevented and controlled by doing healthy lifestyle. One strategy that can be done is through health promotion according to the culture and local context provided by trained community health workers (CHWs) to promote healthy lifestyle. This study protocol aimed to explain the protocol overview of the research to be conducted concerning the effects of health promotion interventions delivered by trained CHWs on obesity control in the adult population.

Content:
This study employs a sequential exploratory mixed-method design. Step one is a qualitative study exploring the needs assessment to develop a health promotion intervention model for adults with obesity based on the local sociocultural context. This study is followed by a quantitative study using quasi experimental pre-posttest design with a control group to evaluate the effects of health promotion interventions delivered by trained CHWs through the Integrated Health Post for Non-communicable Disease (POSBINDU PTM) in Indonesian primary care context especially at Depok District, Sleman Regency, Yogyakarta Province. This step examines the effect of interventions on the Knowledge, Attitude, and Practice about obesity, and includes anthropometry outcomes such as body mass index, waist circumference and quality of life among the adult people who participated in this study.

Goal:
The development of health promotion interventions requires a deep analysis of the sociocultural conditions that exist in society. This is necessary due to the health promotion for target population that can become more effective. The role of trained CHWs to help provide health promotion is critical in reducing the disparity in access to health information, and in controlling the occurrence of obesity in the adult population.

At the conclusion of my presentation attendees will take away:
1. Prevention strategy for controlling obesity is very important to reduce the incidence of other non-communicable diseases such as: cardiovascular disease, diabetes, and cancer.
2. Development of health promotion intervention strategy in primary care setting can be done according to local sociocultural context through community empowerment by increasing community health worker role in community.
3. Health promotion intervention delivered by trained community health workers is important in reducing the disparity in access to healthy lifestyle information among adult people with obesity.

Introduction
The evidence of the risk of all-cause mortality in sarcopenia and obese ageing people were controversial. Previous studies suggest low muscle mass was associated with higher mortality. However, “obesity paradox” has been found in ageing people, which suggest obesity decrease the risk of mortality.
Objectives
We aim to investigate the risk of mortality in ageing people with sarcopenic obesity (SO), sarcopenia only (S), and obesity only (O).
Methods
We collected participants above 65 years old in 2009 and followed up until 2021, and mortality data was recorded. Initially, body composition was measured by dual-energy X-ray. Grip strength and walking speed were also examined. Sarcopenia was defined according to Asian Working Group for Sarcopenia in 2019. Obesity was defined as body fat percentage (BF) > 25% in male and > 30% in female. The combination of both indicate SO. Cox regression was used for statistical analyses, adjusting for age, sex, physical activity, alcohol consumption, smoking, and baseline disease.
Results
Among 865 participants, the percentage of SO, S, and O group were 6.8%, 2.4%, and 62.7%, respectively. In SO group, the average of BF was 28±6.17% in male and 36.16±5.46% in female; for muscle mass, it was 6.36±0.53 kg/m2 in male and 5.12±0.47 kg/m2 in female. Compared with participants without sarcopenia nor obesity, SO and S group increased mortality significantly (P < 0.01). O group decreased mortality significantly compared with S and SO group (P < 0.001). The hazard ratio of all-cause mortality with S and O are 2.02 (95% CI: 1.12-3.64; P < 0.05) and 0.69 (95% CI: 0.52-0.91; P < 0.05), respectively.
Conclusion
Sarcopenia increased the risk of all-cause mortality, while obesity decreased the risk. Besides, there is no significant effect of sarcopenic obesity on all-cause mortality in our study.

1. Sarcopenia increase the risk of all-cause mortality
2. In ageing people, obese doesn't increase the risk of mortality
3. Sarcopenic obesity and sarcopenia are related to higher mortaliry compared with normal group

Background:
People living with severe mental illness die over 20 years earlier in South-Western Sydney. Poor physical health is a major factor, with rapid weight gain frequently occurring in the first 2 years after the diagnosis of psychosis. Limited local data exists to inform the implementation of targeted population health initiatives.

Aims:
To describe the trajectory of weight gain in patients admitted to the Early Psychosis Intervention Program at Liverpool Hospital and explore the influence of potential predictors of the weight gain trajectories.

Method:
This was a retrospective observational study using routinely collected data from the South-Western Sydney Local Health District electronic medical records system. Data extracted from patients admitted to the Early Psychosis Intervention Program from 2017 to 2020 (n=110) were analysed using generalised additive models to produce descriptive, smooth weight gain trajectories up to a year after admission.

Results:
Patients admitted to the Early Psychosis Intervention Program experienced rapid weight gain, with body weight increasing by 4.8% from baseline at one month. This continued, reaching an overall gain of 18% by 12 months. 60.5% of patients experienced clinically significant weight gain within 5 months. Olanzapine and clozapine were associated with substantially faster increases in body weight compared to other atypical antipsychotics.

Conclusion:
Weight gain in patients living with early psychosis in South-Western Sydney is rapid and substantial. Treatment should avoid the unnecessary use of olanzapine or clozapine. This study demonstrated generalised additive models as a feasible method to construct detailed results from routinely collected data, that can be used for local benchmarking and target setting for quality improvement initiatives.

1. Weight gain in early psychosis in the South Western Sydney population is rapid and substantial.
2. Olanzapine and clozapine are associated with more weight gain compared to other atypical antipsychotics in this population.
3. Generalised additive models allow non-linear, routinely collected longitudinal data to be visualised and could be utilised more in the quality improvement and health services development space.

Obesity is a heterogenous complex disorder of multiple etiologies characterized by excessive accumulation of body fat that threatens or affects socioeconomic, mental, or physical health. We will target women with obesity and obesity-related pathologies and describe patients with altered body composition, cardiometabolic health, and increase visceral adipose tissue within premenopausal and postmenopausal women. We further aim to detail the causes of obesity in women and describe existing and innovative strategies to educate women in order to adapt to a lifestyle change as well as describe pharmaceutical developments which help in weight loss in all ages.

1. Identify the causes of obesity
2. Describe the importance of lifestyle and preventative medicine
3. Discuss new and innovative developments to pharmaceutically manage obesity

Introduction
Non-alcoholic fatty liver disease (NAFLD) is the main cause of chronic liver disease in adults/children in Western countries. Prevalence corresponded to 10% in children and in obese 38-80%. The “Viva Project” study (2018) found that a greater waist circumference at 3 years increases the probability that at 8 years they will have NAFLD markers. According to a study carried out by the OECD (2019), Spain ranks 7th in obese children aged 5-19 in the European Union. Once a diagnosis of obesity has been established, it is useful to identify early those patients with a higher risk of hydrocarbon metabolism disorders, dyslipidemia, high blood pressure and NAFLD.

Objectives

1) Early detection of NAFLD associated with childhood obesity and its comorbidities (children from 3 to 10 years of age).
2) Evaluation of cardiovascular risk factors in parents.
3) Nutritional and physical activity interventions (children/parents) and
assessment of its effectiveness.

Study design

Sequential, longitudinal and cross-sectional analysis. An initial assessment at 3 years and annual reassessment up to 10 years at Health-Center located in Lorca (Murcia, Spain) will be carried out.

Material and methods

Two branches: 1st, 3-year-old subjects will be selected in two groups: both in number of 50, G1 (overweight or obesity), G2 (normal weight). 2nd, 50 obese children of 8 years will be selected. In each evaluation and in both branches (children/parents) a liver ultrasound will be performed, analyzing demographic, anthropometric variables (body mass index/abdominal waist), blood pressure and biochemical data (ALT, AST, glucose, HbA1c, insulin, cholesterol, triglycerides, HDL, c-LDL, uric acid…). Nutritional survey and physical activity level will be performed, as well as annual interventions in nutrition and physical exercise for children/parents.

Ethical-Legal Aspects
It will be approved by the Health Area III Ethics Committee. Signing of the informed consent. Declaration of Helsinki.

1) Importance of early diagnosis of NAFLD and its associated comorbidities in children to avoid its repercussions in young adult
2) The effectiveness of early intervention through nutrition and physical activity in children on NAFLD/childhood obesity to try to avoid its repercussions in adulthood.
3) The best way for children and adults to combat fatty liver disease is to lose weight, eat less processed foods and exercise regularly.