The prevalence of knee osteoarthritis, a degenerative joint disease characterized by the degradation of articular cartilage, is correlated with the rise in obesity. The rising rates of obesity in children and adults highlight the need for identifying a sustainable physical activity that promotes fitness while mitigating initiation and progression of osteoarthritis. The objective of this study was to determine an effective rehabilitation and lifelong fitness sustainment exercise regimen that minimize risk of osteoarthritis in individuals with high body mass index (BMI). The aim was to examine knee medial and lateral contact forces in gait and cycling training. Gait at self-selected speeds and cycling at moderate resistance were studied using motion analysis in normal BMI and high BMI participants. Individuals with high BMI exhibited abnormal kinematics and increased kinetics in gait but neutral knee abduction-adduction angles, lower knee contact forces, and balanced mediolateral force distribution in cycling. The combination of maladaptive kinetics (excessive cartilage loading) and altered kinematics (primarily knee adduction angles) observed in gait for the high BMI cohort demonstrate the profound adverse effect of weight bearing and impact exercises on knee biomechanics. Exercise rehabilitation modalities should aim to minimize cartilage loading, correct altered knee angles, and prioritize balanced mediolateral force distributions in individuals with high BMI. Cycling, a non-weight bearing and low impact exercise, addresses all these factors because it constrains kinematic patterns with the pedals and carries significant body weight on the saddle.

Objective: This study presumed that a high or low bodymass index (BMI)might increase the risk of infant mortality. Therefore, a meta-analysis was performed to systematically assess the association between maternal BMI and the risk of infant mortality. Methods: The electronic databases, including Pubmed, Embase database, and Cochrane Library, were systemically searched by two investigators from inception to November 26th, 2020, with no language restriction. In parallel, a dose-response was assessed. Results: Finally, 22 cohort studies involving 13,532,293 participants were included into this paper, which showed that compared with normal BMI, maternal overweight significantly increased the risks of infant mortality [risk ratio (RR), 1.16; 95% confidence interval (CI), 1.13–1.19], neonatal mortality (RR, 1.23; 95% CI, 1.08–1.39), early neonatal mortality (RR, 1.55; 95% CI, 1.26–1.92) and post-neonatal mortality (RR, 1.18; 95% CI, 1.07–1.29). Similarly, maternal obesity significantly increased the risk of infant mortality (RR, 1.55; 95% CI, 1.41–1.70), neonatal mortality (RR, 1.55; 95% CI, 1.28–1.67), early neonatal mortality (RR, 1.37; 95% CI, 1.13–1.67), and post-neonatal mortality (RR, 1.30; 95% CI, 1.03–1.65), whereas maternal underweight potentially decreased the risk of infant mortality (RR, 0.93; 95% CI, 0.88–0.98). In the dose-response analysis, the risk of infant mortality significantly increased when the maternal BMI was >25 kg/m2. Conclusions: Maternal overweight or obesity significantly increases the risks of infant mortality, neonatal mortality, early neonatal mortality, and post-neonatal mortality compared with normal BMI in a dose-dependentmanner. Besides,maternal underweight will not increase the risk of infant mortality, neonatal mortality, early neonatal mortality, or postneonatal mortality; instead, it tends to decrease the risk of infant mortality. Early weight management may provide potential benefits to infants, and more large-scale prospective studies are needed to verify this finding in the future.

10,291 participants, aged 20 to 85 years of age, available from the 1999 through 2002 NHANES databases participated in this study. Only 8,485 (82%) of these participants were included in the data analysis. Participants who were pregnant (n = 603), not examined at a mobile examination center (n = 820), or had missing values for height (n = 164) and/or weight (n = 125) were eliminated. Individuals were classified into four groups (underweight, normal, overweight and obese) based on body mass index (BMI). Variables measured in the study included body mass index, physical fitness, dietary folic acid, c-reactive protein, homocysteine, folate, serum total cholesterol, serum triglycerides, HDL-C, and glucose. All data was collected at Mobile Examination Centers (MEC). The results of the present study showed that being overweight and obese were associated with a poor serum lipid profile, higher serum glucose levels, lower participation in physical activity and a lower physical fitness level. Being overweight and obese was also associated with higher serum levels of inflammatory markers for cardiovascular disease (CVD). Overweight and obese individuals are also being diagnosed with coronary heart disease (CHD) at a younger age.

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