EC Clinical and Medical Case Reports

Research Article Volume 6 Issue 1 - 2023

A 5-Year Systematic Review (01 April 2017 to 31 March 2022) on the Causes of Abdominal Obesity

Ariel SY Ng1,2, Nur Khairina Binte Azan1,2, Farij Bin Samsudi1,2, Muhammad Rusydi Bin Mazlan1,2, Yuan Kai Loh1,2 and Maurice HT Ling1,2,3,4*

1School of Life Sciences, Management Development Institute of Singapore, Singapore

2Department of Life Sciences, University of Roehampton, United Kingdom

3School of Data Sciences, Perdana University, Malaysia

4HOHY PTE LTD, Singapore

*Corresponding Author: Maurice HT Ling, School of Life Sciences, Management Development Institute of Singapore, Singapore.
Received: December 12, 2022; Published: December 29, 2022



Abdominal obesity (AO) is a global public health concern with few reviews on the underlying causes. Here, we conduct a systematic review on the causes of AO using publications indexed in PubMed from April 1, 2017, to March 31, 2022. 46 out of 199 (23%) articles were included, revealing 10 themes of causes namely, (a) age, gender, socioeconomic, and genetic/biological determinants, (b) nutritional intake, (c) lifestyle habits, (d) mental and cognitive disorders, (e) smoking, (f) gastrointestinal microbiota, (g) alcohol consumption, (h) rural regions, (i) non-alcoholic fatty liver disease, and (j) noise pollution.

Keywords: Abdominal Obesity (AO); SARS-CoV-2; Visceral Fat; Metabolic Syndrome (MS); Cardiovascular Diseases (CVDs)

  1. Lange SJ., et al. “Longitudinal Trends in Body Mass Index Before and During the COVID-19 Pandemic Among Persons Aged 2-19 Years - United States, 2018-2020”. MMWR Morbidity and Mortality Weekly Report 37 (2021): 1278-1283.
  2. Sahakyan KR., et al. “Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality”. Annals of Internal Medicine 11 (2015): 827-835.
  3. Prasad DS., et al. “Gender Differences in Central Obesity: Implications for Cardiometabolic Health in South Asians”. Indian Heart Journal 3 (2020): 202-204.
  4. Lukács A., et al. “Abdominal Obesity Increases Metabolic Risk Factors in Non-Obese Adults: A Hungarian Cross-Sectional Study”. BMC Public Health 1 (2019): 1533.
  5. Fan H., et al. “Abdominal Obesity is Strongly Associated with Cardiovascular Disease and its Risk Factors in Elderly and Very Elderly Community-Dwelling Chinese”. Scientific Reports 6 (2016): 21521.
  6. Zhang C., et al. “Abdominal Obesity and the Risk of All-Cause, Cardiovascular, and Cancer Mortality: Sixteen Years of Follow-up in US Women”. Circulation 13 (2008): 1658-1667.
  7. Paley CA and Johnson MI. “Abdominal Obesity and Metabolic Syndrome: Exercise as Medicine?” BMC Sports Science, Medicine and Rehabilitation 10 (2018): 7.
  8. Kong Z., et al. “Short-Term Ketogenic Diet Improves Abdominal Obesity in Overweight/Obese Chinese Young Females”. Frontiers in Physiology 11 (2020): 856.
  9. Kim SK., et al. “Eating Control and Eating Behavior Modification to Reduce Abdominal Obesity: A 12-month Randomized Controlled Trial”. Nutrition Research and Practice 1 (2021): 38-53.
  10. Van Gemert WA., et al. “Effect of Diet with or Without Exercise on Abdominal Fat in Postmenopausal Women - A Randomised Trial”. BMC Public Health 1 (2019): 174.
  11. Moher D., et al. “Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement”. PLoS Medicine 7 (2009): e1000097.
  12. Liberati A., et al. “The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies that Evaluate Health Care Interventions: Explanation and Elaboration”. PLoS Medicine 7 (2009): e1000100.
  13. Page MJ., et al. “The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews”. BMJ 372 (2021): n71.
  14. Turé R., et al. “Prevalence of Underweight, Overweight and Obesity among Adults in Urban Bissau, Western Africa”. Nutrients12 (2021): 4199.
  15. Saito A., et al. “HIV Infection, and Overweight and Hypertension: A Cross-Sectional Study of HIV-Infected Adults in Western Kenya”. Tropical Medicine and Health 48 (2020): 31.
  16. Ben-Yacov L., et al. “Prevalence and Sex-Specific Patterns of Metabolic Syndrome in Rural Uganda”. BMJ Nutrition, Prevention and Health 1 (2020): 11-17.
  17. Liu M., et al. “Predicted Fat Mass and Lean Mass in Relation to All-Cause and Cause-Specific Mortality”. Journal of Cachexia, Sarcopenia and Muscle 2 (2022): 1064-1075.
  18. Begum T., et al. “Associations of Caesarean Section with Body Mass and Waist Circumference Trajectories from Age 2 to 13 years: A Nationally Representative Birth Cohort Study in Australia”. Pediatric Obesity 7 (2021): e12769.
  19. Tang R., et al. “General and Central Obesity Are Associated with Increased Severity of the VMS and Sexual Symptoms of Menopause Among Chinese Women: A Longitudinal Study”. Frontiers in Endocrinology 13 (2022): 814872.
  20. Lopez DS., et al. “Double Trouble: Co-Occurrence of Testosterone Deficiency and Body Fatness Associated with All-Cause Mortality in US Men”. Clinical Endocrinology 1 (2018): 58-65.
  21. Zhou H., et al. “Prevalence and Gender-Specific Influencing Factors of Hypertension among Chinese Adults: A Cross-Sectional Survey Study in Nanchang, China”. International Journal of Environmental Research and Public Health 2 (2018): 382.
  22. Li K., et al. “Associations Between Exposure to Polycyclic Aromatic Hydrocarbons and Metabolic Syndrome in U.S. Adolescents: Cross-Sectional Results from the National Health and Nutrition Examination Survey (2003-2016) Data”. Environmental Research 202 (2021): 111747.
  23. Khosravi-Boroujeni H., et al. “Secular Trend of Metabolic Syndrome and Its Components in a Cohort of Iranian Adults from 2001 to 2013”. Metabolic Syndrome and Related Disorders 3 (2017): 137-144.
  24. Brenner DR., et al. “Measures of Excess Body Weight and Anthropometry Among Adult Albertans: Cross-Sectional Results from Alberta’s Tomorrow Project Cohort”. BMC Public Health 1 (2017): 899.
  25. Quoc Cuong T., et al. “Associated Factors of Hypertension in Women and Men in Vietnam: A Cross-Sectional Study”. International Journal of Environmental Research and Public Health 23 (2019): 4714.
  26. Kołtuniuk A and Rosińczuk J. “The Influence of Gender on Selected Risk Factors for Chronic Non-Communicable Diseases in Patients Hospitalized in Surgical Wards: A Cross-Sectional Study”. Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University 4 (2018): 515-523.
  27. Zhao J., et al. “New Evidence on the Effect of Medical Insurance on the Obesity Risk of Rural Residents: Findings from the China Health and Nutrition Survey (CHNS, 2004-2011)”. International Journal of Environmental Research and Public Health 2 (2018): 383.
  28. Pitchika A., et al. “Associations of Maternal Type 1 Diabetes with Childhood Adiposity and Metabolic Health in the Offspring: A Prospective Cohort Study”. Diabetologia11 (2018): 2319-2332.
  29. Yasar Firat Y., et al. “Relationship Between Dairy Consumption and Abdominal Obesity”. Journal of the American Nutrition Association 6 (2022): 569-576.
  30. Chang X., et al. “The Risks of Overweight, Obesity and Abdominal Obesity in Middle Age after Exposure to Famine in Early Life: Evidence from the China’s 1959-1961 Famine”. The Journal of Nutrition, Health and Aging 10 (2018): 1198-1204.
  31. Canto-Osorio F., et al. “Dietary Inflammatory Index and Metabolic Syndrome in Mexican Adult Population”. The American Journal of Clinical Nutrition 2 (2020): 373-380.
  32. Zhao L., et al. “Quercetin Ameliorates Gut Microbiota Dysbiosis That Drives Hypothalamic Damage and Hepatic Lipogenesis in Monosodium Glutamate-Induced Abdominal Obesity”. Frontiers in Nutrition 8 (2021): 671353.
  33. Sotos-Prieto M., et al. “Association Between the Mediterranean Lifestyle, Metabolic Syndrome and Mortality: A Whole-Country Cohort in Spain”. Cardiovascular Diabetology 1 (2021): 5.
  34. Santos-Sánchez G., et al. “Lupinus angustifolius Protein Hydrolysates Reduce Abdominal Adiposity and Ameliorate Metabolic Associated Fatty Liver Disease (MAFLD) in Western Diet Fed-ApoE-/- Mice”. Antioxidants8 (2021): 1222.
  35. Tunc-Ata M., et al. “Ileal Interposition Improves Metabolic Syndrome Parameters in a Rat Model of Metabolic Syndrome Induced by Monosodium Glutamate”. Life Sciences 266 (2021): 118846.
  36. Lidin M., et al. “Long-Term Effects on Cardiovascular Risk of a Structured Multidisciplinary Lifestyle Program in Clinical Practice”. BMC Cardiovascular Disorders 1 (2018): 59.
  37. Bhaswant M., et al. “Beetroot and Sodium Nitrate Ameliorate Cardiometabolic Changes in Diet-Induced Obese Hypertensive Rats”. Molecular Nutrition and Food Research 12 (2017).
  38. Mamani-Ortiz Y., et al. “Prevalence and Determinants of Cardiovascular Disease Risk Factors Using the WHO STEPS Approach in Cochabamba, Bolivia”. BMC Public Health 1 (2019): 786.
  39. Kimball SM., et al. “Retrospective Analysis of Cardiovascular Disease Risk Parameters in Participants of a Preventive Health and Wellness Program”. Integrative Medicine 3 (2019): 78-95.
  40. Gradel AKJ., et al. “Long-Term Diet-Induced Hypertension in Rats is Associated with Reduced Expression and Function of Small Artery SKCa, IKCa, and Kir2.1 Channels”. Clinical Science 4 (2018): 461-474.
  41. Doustmohammadian A., et al. “Favorable Association Between Mediterranean diet (MeD) and DASH with NAFLD Among Iranian Adults of the Amol Cohort Study (AmolCS)”. Scientific Reports 1 (2022): 2131.
  42. Ma S., et al. “Trends in the Prevalence of Overweight, Obesity, and Abdominal Obesity Among Chinese Adults Between 1993 and 2015”. International Journal of Obesity 2 (2021): 427-437.
  43. Betancourt Núñez A., et al. “Metabolic Syndrome Components in Young Health Professionals; LATIN America METabolic Syndrome (LATINMETS) Mexico Study”. Nutricion Hospitalaria 4 (2018): 864-873.
  44. Ramirez-Jimenez M., et al. “Effects of Exercise Training during Christmas on Body Weight and Cardiometabolic Health in Overweight Individuals”. International Journal of Environmental Research and Public Health 13 (2020): 4732.
  45. Kikuchi K., et al. “Validity of “One-size-fits-all” Approaches for the National Health Screening and Education Program: A Large-scale Cohort Study of Corporate Insurance Beneficiaries”. Internal Medicine 11 (2021): 1681-1689.
  46. Hamasaki H., et al. “Association of Handgrip Strength with Hospitalization, Cardiovascular Events, and Mortality in Japanese Patients with Type 2 Diabetes”. Scientific Reports 1 (2017): 7041.
  47. Zavala GA., et al. “Association Between Obesity and Depressive Symptoms in Mexican Population”. Social Psychiatry and Psychiatric Epidemiology 6 (2018): 639-646.
  48. Storch Jakobsen A., et al. “Associations Between Clinical and Psychosocial Factors and Metabolic and Cardiovascular Risk Factors in Overweight Patients with Schizophrenia Spectrum Disorders - Baseline and Two-Years Findings from the CHANGE Trial”. Schizophrenia Research 199 (2018): 96-102.
  49. Santosa A., et al. “Psychosocial Risk Factors and Cardiovascular Disease and Death in a Population-Based Cohort From 21 Low-, Middle-, and High-Income Countries”. JAMA Network Open 12 (2021): e2138920.
  50. Ploubidis GB., et al. “Association of Early-Life Mental Health with Biomarkers in Midlife and Premature Mortality: Evidence From the 1958 British Birth Cohort”. JAMA Psychiatry 1 (2021): 38-46.
  51. Wei X., et al. “Association between Marginally Low Birth Weight and Obesity-Related Outcomes and Indirect Effects via Attention-Deficit Hyperactivity Disorder and Abnormal Eating”. Obesity Facts2 (2022): 197-208.
  52. Chen H., et al. “Differential Effects of “Vaping” on Lipid and Glucose Profiles and Liver Metabolic Markers in Obese Versus Non-Obese Mice”. Frontiers in Physiology 12 (2021): 755124.
  53. Xu Q., et al. “Mendelian Randomization Analysis Reveals Causal Effects of the Human Gut Microbiota on Abdominal Obesity”. The Journal of Nutrition 6 (2021): 1401-1406.
  54. Jung SE., et al. “Obesity Is Inversely Related to Hydrogen-Producing Small Intestinal Bacterial Overgrowth in Non-Constipation Irritable Bowel Syndrome”. Journal of Korean Medical Science 6 (2017): 948-953.
  55. Åberg F., et al. “Combined Effects of Alcohol and Metabolic Disorders in Patients with Chronic Liver Disease”. Clinical Gastroenterology and Hepatology 4 (2020): 995-997.
  56. Kamdem F., et al. “Prevalence and Determinants of Abnormal Glucose Metabolism in Urban and Rural Secondary Schools in Cameroon: A Cross-Sectional Study in a Sub-Saharan Africa Setting”. Primary Care Diabetes 4 (2019): 370-375.
  57. Song P., et al. “Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children”. International Journal of Environmental Research and Public Health 5 (2017): 465.
  58. Kim G., et al. “Association of Occupational Noise Exposure and Incidence of Metabolic Syndrome in a Retrospective Cohort Study”. International Journal of Environmental Research and Public Health 4 (2022): 2209.
  59. Li C-W., et al. “Pathogenesis of Sarcopenia and the Relationship with Fat Mass: Descriptive Review”. Journal of Cachexia, Sarcopenia and Muscle 2 (2022): 781-794.
  60. Holdsworth M., et al. “Perceptions of Healthy and Desirable Body Size in Urban Senegalese Women”. International Journal of Obesity and Related Metabolic Disorders 12 (2004): 1561-1568.
  61. Brown LM and Clegg DJ. “Central Effects of Estradiol in the Regulation of Food Intake, Body Weight, and Adiposity”. The Journal of Steroid Biochemistry and Molecular Biology 1-3 (2010): 65-73.
  62. Gunderson EP., et al. “Childbearing May Increase Visceral Adipose Tissue Independent of Overall Increase in Body Fat”. Obesity5 (2008): 1078-1084.
  63. Steptoe A and Zaninotto P. “Lower Socioeconomic Status and the Acceleration of Aging: An Outcome-Wide Analysis”. Proceedings of the National Academy of Sciences of the United States of America26 (2020): 14911-14917.
  64. McMaughan DJ., et al. “Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging”. Frontiers in Public Health 8 (2020): 231.
  65. Becker G and Newsom E. “Socioeconomic Status and Dissatisfaction with Health Care Among Chronically Ill African Americans”. American Journal of Public Health 5 (2003): 742-748.
  66. Oliver LN and Hayes MV. “Neighbourhood Socio-Economic Status and the Prevalence of Overweight Canadian Children and Youth”. Canadian Journal of Public Health = Revue Canadienne De Sante Publique 6 (2005): 415-420.
  67. Chavarro JE., et al. “Association of Birth by Cesarean Delivery with Obesity and Type 2 Diabetes Among Adult Women”. JAMA Network Open 4 (2020): e202605.
  68. Ralphs E., et al. “Association Between Mode of Delivery and Body Mass Index at 4-5 years in White British and Pakistani Children: The Born in Bradford Birth Cohort”. BMC Public Health 1 (2021): 987.
  69. Masukume G., et al. “Association Between Caesarean Section Delivery and Obesity in Childhood: A Longitudinal Cohort Study in Ireland”. BMJ Open 3 (2019): e025051.
  70. Heslehurst N., et al. “The Association Between Maternal Body Mass Index and Child Obesity: A Systematic Review and Meta-Analysis”. PLoS Medicine 6 (2019): e1002817.
  71. Michaëlsson K., et al. “Milk Intake and Risk of Mortality and Fractures in Women and Men: Cohort Studies”. BMJ 349 (2014): g6015.
  72. Marcone S., et al. “Milk-Derived Bioactive Peptides and Their Health Promoting Effects: A Potential Role in Atherosclerosis”. British Journal of Clinical Pharmacology 1 (2017): 152-162.
  73. Riuzzi G., et al. “Multivariate Modelling of Milk Fatty Acid Profile to Discriminate the Forages in Dairy Cows’ Ration”. Scientific Reports 1 (2021): 23201.
  74. Zanfirescu A., et al. “A Review of the Alleged Health Hazards of Monosodium Glutamate”. Comprehensive Reviews in Food Science and Food Safety 4 (2019): 1111-1134.
  75. Niaz K., et al. “Extensive Use of Monosodium Glutamate: A Threat to Public Health?” EXCLI journal 17 (2018): 273-278.
  76. Yang L., et al. “Trends in Sedentary Behavior Among the US Population, 2001-2016”. The Journal of the American Medical Association16 (2019): 1587-1597.
  77. Lau JH., et al. “Prevalence and Patterns of Physical Activity, Sedentary Behaviour, and Their Association with Health-Related Quality of Life Within a Multi-Ethnic Asian Population”. BMC Public Health 1 (2021): 1939.
  78. Bernaards CM., et al. “Correlates of Sedentary Time in Different Age Groups: Results from a Large Cross Sectional Dutch Survey”. BMC Public Health 1 (2016): 1121.
  79. Bressan J., et al. “Social Components of the Obesity Epidemic”. Current Obesity Reports 1 (2013): 32-41.
  80. Parra DC., et al. “Automobile, Construction and Entertainment Business Sector Influences on Sedentary Lifestyles”. Health Promotion International 2 (2018): 239-249.
  81. Tremblay MS., et al. “Systematic Review of Sedentary Behaviour and Health Indicators in School-Aged Children and Youth”. The International Journal of Behavioral Nutrition and Physical Activity 8 (2011): 98.
  82. Steel Z., et al. “The Global Prevalence of Common Mental Disorders: A Systematic Review and Meta-Analysis 1980-2013”. International Journal of Epidemiology 2 (2014): 476-493.
  83. Clemente-Suárez VJ., et al. “The Impact of the COVID-19 Pandemic on Mental Disorders. A Critical Review”. International Journal of Environmental Research and Public Health 19 (2021): 10041.
  84. Tong L., et al. “Associations Among ADHD, Abnormal Eating and Overweight in a Non-Clinical Sample of Asian Children”. Scientific Reports 7(1): 2844.
  85. Nadar MS., et al. “The Negative Impact of Chronic Tobacco Smoking on Adult Neuropsychological Function: A Cross-Sectional Study”. BMC Public Health 1 (2021): 1278.
  86. Lie RT., et al. “Maternal Smoking and Oral Clefts: The Role of Detoxification Pathway Genes”. Epidemiology 4 (2008): 606-615.
  87. Velilla S., et al. “Smoking and Age-Related Macular Degeneration: Review and Update”. Journal of Ophthalmology (2013): 895147.
  88. Bandi P., et al. “Trends in E-Cigarette Use by Age Group and Combustible Cigarette Smoking Histories, U.S. Adults, 2014-2018”. American Journal of Preventive Medicine 2 (2021): 151-158.
  89. Thursby E and Juge N. “Introduction to the Human Gut Microbiota”. The Biochemical Journal 11 (2017): 1823-1836.
  90. Dukowicz AC., et al. “Small Intestinal Bacterial Overgrowth: A Comprehensive Review”. Gastroenterology and Hepatology 2 (2007): 112-122.
  91. Siniewicz-Luzeńczyk K., et al. “Small Intestinal Bacterial Overgrowth Syndrome in Children”. Przeglad Gastroenterologiczny 1 (2015): 28-32.
  92. Fine KD and Schiller LR. “AGA Technical Review on the Evaluation and Management of Chronic Diarrhea”. Gastroenterology6 (1999): 1464-1486.
  93. Arumugam M., et al. “Enterotypes of the Human Gut Microbiome”. Nature7346 (2011): 174-180.
  94. Zumbrun SD., et al. “When a Healthy Diet Turns Deadly”. Gut Microbes 1 (2014): 40-43.
  95. Hira T., et al. “Improvement of Glucose Tolerance by Food Factors Having Glucagon-Like Peptide-1 Releasing Activity”. International Journal of Molecular Sciences 12 (2021): 6623.
  96. Aoun A., et al. “The Influence of the Gut Microbiome on Obesity in Adults and the Role of Probiotics, Prebiotics, and Synbiotics for Weight Loss”. Preventive Nutrition and Food Science 2 (2020): 113-123.
  97. Manthey J., et al. “Global Alcohol Exposure Between 1990 and 2017 and Forecasts Until 2030: A Modelling Study”. Lancet 10190 (2019): 2493-2502.
  98. Chikritzhs T and Livingston M. “Alcohol and the Risk of Injury”. Nutrients 8 (2021): 2777.
  99. Chaveepojnkamjorn W and Pichainarong N. “Current Drinking and Health-Risk Behaviors Among Male High School Students in Central Thailand”. BMC Public Health 1 (2011): 233.
  100. Morteza Bagi HR., et al. “Epidemiology of Alcohol Poisoning and Its Outcome in the North-West of Iran”. Emergency1 (2015): 27-32.
  101. Biddinger KJ., et al. “Association of Habitual Alcohol Intake with Risk of Cardiovascular Disease”. JAMA Network Open 3 (2022): e223849.
  102. Rumgay H., et al. “Global burden of Cancer in 2020 Attributable to Alcohol Consumption: A Population-Based Study”. The Lancet Oncology 8 (2021): 1071-1080.
  103. Yen F-S., et al. “The Impact of Heavy Alcohol Consumption on Cognitive Impairment in Young Old and Middle Old Persons”. Journal of Translational Medicine 1 (2022): 155.
  104. Liangpunsakul S., et al. “Relationship Among Alcohol Intake, Body Fat, and Physical Activity: A Population-Based Study”. Annals of Epidemiology 9 (2010): 670-675.
  105. Lourenço S., et al. “The Effect of Current and Lifetime Alcohol Consumption on Overall and Central Obesity”. European Journal of Clinical Nutrition 7 (2012): 813-818.
  106. Cains S., et al. “Agrp Neuron Activity is Required for Alcohol-Induced Overeating”. Nature Communications 8 (2017): 14014.
  107. Dunbar RIM., et al. “Functional Benefits of (Modest) Alcohol Consumption”. Adaptive Human Behavior and Physiology 2 (2017): 118-133.
  108. Zhang R., et al. “Association of Low to Moderate Alcohol Drinking with Cognitive Functions From Middle to Older Age Among US Adults”. JAMA Network Open 6 (2020): e207922.
  109. Chiva-Blanch G and Badimon L. “Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies”. Nutrients1 (2019): 108.
  110. Xi B., et al. “Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults”. Journal of the American College of Cardiology 8 (2017): 913-922.
  111. Zhang X., et al. “Alcohol Consumption and Risk of Cardiovascular Disease, Cancer and Mortality: A Prospective Cohort Study”. Nutrition Journal 1 (2021): 13.
  112. Pickett W., et al. “Farmers, Mechanized Work, and Links to Obesity”. Preventive Medicine 70 (2015): 59-63.
  113. Ge X., et al. “Prevalence Trends in Non-Alcoholic Fatty Liver Disease at the Global, Regional and National Levels, 1990-2017: A Population-Based Observational Study”. BMJ Open 8 (2020): e036663.
  114. Younossi ZM., et al. “Epidemiology of Nonalcoholic Fatty Liver Disease - Meta-Analytic Assessment of Prevalence, Incidence, and Outcomes”. Hepatology1 (2016): 73-84.
  115. Duseja A and Chalasani N. “Epidemiology and Risk Factors of Nonalcoholic Fatty Liver Disease (NAFLD)”. Hepatology International 2 (2013): 755-764.
  116. Yu EL and Schwimmer JB. “Epidemiology of Pediatric Nonalcoholic Fatty Liver Disease”. Clinical Liver Disease 3 (2021): 196-199.
  117. Schwimmer JB., et al. “Prevalence of Fatty Liver in Children and Adolescents”. Pediatrics 4 (2006): 1388-1393.
  118. Clemente APG., et al. “Waist Circumference as a Marker for Screening Nonalcoholic Fatty Liver Disease in Obese Adolescents”. Revista Paulista De Pediatria 1 (2016): 47-55.
  119. Gopinath B., et al. “Workplace Noise Exposure and the Prevalence and 10-Year Incidence of Age-Related Hearing Loss”. PloS One 7 (2021): e0255356.
  120. Pyko A., et al. “Exposure to Traffic Noise and Markers of Obesity”. Occupational and Environmental Medicine 8 (2015): 594-601.
  121. Foraster M., et al. “Long-Term Exposure to Transportation Noise and Its Association with Adiposity Markers and Development of Obesity”. Environment International 121 (2018): 879-889.
  122. Huang T., et al. “The Association between Noise Exposure and Metabolic Syndrome: A Longitudinal Cohort Study in Taiwan”. International Journal of Environmental Research and Public Health 12 (2020): 4236.
  123. Münzel T., et al. “The Adverse Effects of Environmental Noise Exposure on Oxidative Stress and Cardiovascular Risk”. Antioxidants and Redox Signaling 9 (2018): 873-908.
  124. Hahad O., et al. “Environmental Noise-Induced Effects on Stress Hormones, Oxidative Stress, and Vascular Dysfunction: Key Factors in the Relationship between Cerebrocardiovascular and Psychological Disorders”. Oxidative Medicine and Cellular Longevity (2019): 4623109.
  125. Yau YHC and Potenza MN. “Stress and Eating Behaviors”. Minerva Endocrinologica 3 (2013): 255-267.
  126. Hwee Teo Y and HT Ling M. “A Systematic Review on the Sufficiency of PubMed and Google Scholar for Biosciences”. Acta Scientific Medical Sciences 12 (2020): 03-08.
  127. Bramer WM., et al. “The Comparative Recall of Google Scholar Versus PubMed in Identical Searches for Biomedical Systematic Reviews: A Review of Searches Used in Systematic Reviews”. Systematic Reviews 1 (2013): 115.
  128. Bramer WM., et al. “Optimal Database Combinations for Literature Searches in Systematic Reviews: A Prospective Exploratory Study”. Systematic Reviews 1 (2017): 245.

Maurice HT Ling., et al. A 5-Year Systematic Review (01 April 2017 to 31 March 2022) on the Causes of Abdominal Obesity. EC Clinical and Medical Case Reports   6.1 (2023): 90-110.