{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:53Z","timestamp":1787028353500,"version":"build-2736575974"},"reference-count":66,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Nacional de Perinatolog\u00eda","award":["212250-3300-11402-01-15"],"award-info":[{"award-number":["212250-3300-11402-01-15"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Gastrointestinal functional disorders are characterized by abnormalities in motility with visceral hypersensitivity, representing a global public health problem. We aimed to determine whether eating habits, lifestyle characteristics, and body mass index (BMI) are associated with gastrointestinal health risk. The Gastrointestinal Health (GIH) test of the World Gastroenterology Organization (WGO) and the Roma IV criteria were applied. We obtained information on food consumption habits and aerobic exercise, among other variables. Not exercising regularly, drinking water and eating vegetables less than recommended, having high body weight, and taking symptomatic medication were variables that explained 73% of the probabilities of not having good GIH (R2 = 0.734). According to Rome IV criteria, women had a 50% higher risk than men of having functional bowel disorder (RR 1.6, 95% CI: 1.04, 2.45). Among the men studied, eating few or no vegetables and drinking less than 1 L of water daily was more frequent; however, the women had significantly more intestinal symptoms. In addition, constipation was higher among women than men (p = 0.020). All of the above explains the prognostic value of eating habits and the importance of paying attention to body weight to reduce the risk of gastrointestinal disease.<\/jats:p>","DOI":"10.3390\/ijerph191710569","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T01:50:26Z","timestamp":1661392226000},"page":"10569","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association of Diet, Body Mass Index, and Lifestyle on the Gastrointestinal Health Risk in a Sample of Adults"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-1363","authenticated-orcid":false,"given":"Reyna","family":"S\u00e1mano","sequence":"first","affiliation":[{"name":"Coordinacion de Nutricion y Bioprogramacion, Instituto Nacional de Perinatologia, Secretaria de Salud, Mexico City 11000, Mexico"},{"name":"Programa de Posgrado Doctorado en Ciencias Biologicas y de la Salud, Division de Ciencias Biologicas y de la Salud, Universidad Autonoma Metropolitana, Mexico City 04960, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-201X","authenticated-orcid":false,"given":"Fernanda","family":"Esparza-Ju\u00e1rez","sequence":"additional","affiliation":[{"name":"Escuela de Dietetica y Nutricion del ISSSTE, Mexico City 14070, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5741-0241","authenticated-orcid":false,"given":"Gabriela","family":"Chico-Barba","sequence":"additional","affiliation":[{"name":"Coordinacion de Nutricion y Bioprogramacion, Instituto Nacional de Perinatologia, Secretaria de Salud, Mexico City 11000, Mexico"},{"name":"Escuela de Enfermeria, Facultad de Ciencias de la Salud, Universidad Panamericana, Mexico City 03920, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Gonz\u00e1lez-Medina","sequence":"additional","affiliation":[{"name":"Escuela de Dietetica y Nutricion del ISSSTE, Mexico City 14070, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernarda","family":"S\u00e1nchez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Coordinacion de Nutricion y Bioprogramacion, Instituto Nacional de Perinatologia, Secretaria de Salud, Mexico City 11000, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Hern\u00e1ndez-Trejo","sequence":"additional","affiliation":[{"name":"Departamento de Neurobiolog\u00eda del Desarrollo, Instituto Nacional de Perinatologia, Secretaria de Salud, Mexico City 11000, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"ref_1","first-page":"72","article-title":"The Black Box Revelation: Monitoring Gastrointestinal Function","volume":"50","author":"Moonen","year":"2018","journal-title":"Anaesthesiol. Intensiv. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/j.0269-2813.2004.01807.x","article-title":"Impact of Functional Gastrointestinal Disorders on Health-Related Quality of Life: A Population-Based Case-Control Study","volume":"19","author":"Halder","year":"2004","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1177\/1756283X16633050","article-title":"New and Emerging Therapies for the Treatment of Irritable Bowel Syndrome: An Update for Gastroenterologists","volume":"9","year":"2016","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1007\/s00394-018-1627-z","article-title":"The Nutritional and Health Attributes of Kiwifruit: A Review","volume":"57","author":"Richardson","year":"2018","journal-title":"Eur. J. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1159\/000485409","article-title":"Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview","volume":"35","author":"Holtmann","year":"2017","journal-title":"Dig. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Emerenziani, S., Guarino, M.P.L., Asensio, L.M.T., Altomare, A., Ribolsi, M., Balestrieri, P., and Cicala, M. (2019). Role of Overweight and Obesity in Gastrointestinal Disease. Nutrients, 12.","DOI":"10.3390\/nu12010111"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1440-1746.2011.06632.x","article-title":"Epidemiology of FGID Symptoms in Japanese General Population with Reference to Lifestyle","volume":"26","author":"Hongo","year":"2011","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5056\/jnm.2010.16.2.131","article-title":"Are Rice and Spicy Diet Good for Functional Gastrointestinal Disorders?","volume":"16","author":"Gonlachanvit","year":"2010","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1365-2982.2011.01872.x","article-title":"Lifestyle in Persons with Functional Gastrointestinal Disorders-Large-Scale Internet Survey of Lifestyle in Japan","volume":"24","author":"Miwa","year":"2012","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_10","first-page":"180","article-title":"Respuesta Cl\u00ednica En Pacientes Mexicanos Con S\u00edndrome De Intestino Irritable Tratados Con Dieta Baja En Carbohidratos Fermentables (FODMAP)","volume":"80","year":"2015","journal-title":"Rev. Gastroenterol. Mex."},{"key":"ref_11","unstructured":"Cat\u00e1logo Maestro de Gu\u00edas de Pr\u00e1ctica Cl\u00ednica*IMSS 042-08 (2022, August 19). Diagn\u00f3stico y Tratamiento del Intestino Irritable en el Adulto. Available online: https:\/\/www.imss.gob.mx\/sites\/all\/statics\/guiasclinicas\/042GRR.pdf."},{"key":"ref_12","unstructured":"World Gastroenterology Organisation (2022, August 19). Global Guardian of Digestive Health. Serving the World. Available online: https:\/\/www.worldgastroenterology.org\/forms\/health-test.php."},{"key":"ref_13","unstructured":"De La Salud, P. (1987). Reglamento de la ley general de salud en materia de investigaci\u00f3n para la salud. Diario Oficial de la Federaci\u00f3n, Available online: https:\/\/www.diputados.gob.mx\/LeyesBiblio\/regley\/Reg_LGS_MIS.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","article-title":"Bowel Disorders","volume":"150","author":"Mearin","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_15","first-page":"332","article-title":"Clinical Practice Guideline: Irritable Bowel Syndrome with Constipation and Functional Constipation in the Adult","volume":"108","author":"Mearin","year":"2016","journal-title":"Rev. Esp. Enfermedades Dig."},{"key":"ref_16","unstructured":"Lohman, T.J., Roache, A.F., and Martorell, R. (1988). Anthropometric Standardization Reference Manual, Human Kinetics Books."},{"key":"ref_17","unstructured":"World Health Organization Obesity and Overweight (2022, August 19). Factsheet. Updated 2020. Available online: www.who.int\/mediacentre\/factsheets\/fs311\/en\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1053\/j.gastro.2006.03.008","article-title":"The Functional Gastrointestinal Disorders and the Rome III Process","volume":"130","author":"Drossman","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1053\/j.gastro.2020.04.014","article-title":"Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study","volume":"160","author":"Sperber","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_20","first-page":"755","article-title":"A Systematic Review of the Economic and Humanistic Burden of Illness in Irritable Bowel Syndrome and Chronic Constipation","volume":"19","author":"Nellesen","year":"2013","journal-title":"J. Manag. Care Pharm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1111\/j.1572-0241.2005.40674.x","article-title":"Bowel Habit Subtypes and Temporal Patterns in Irritable Bowel Syndrome: Systematic Review","volume":"100","author":"Guilera","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1111\/j.1365-2036.2010.04409.x","article-title":"Meta-Analysis: Do Irritable Bowel Syndrome Symptoms Vary between Men and Women?","volume":"32","author":"Adeyemo","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_23","unstructured":"World Gastroenterology Organization (2022, August 19). Global Guidelines. S\u00edndrome de Intestino Irritable. Available online: https:\/\/www.worldgastroenterology.org\/guidelines\/global-guidelines\/irritable-bowel-syndrome-ibs\/irritable-bowel-syndrome-ibs-spanish."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.cgh.2012.02.029","article-title":"Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis","volume":"10","author":"Lovell","year":"2012","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_25","first-page":"2283","article-title":"Evaluation of Constipation","volume":"65","author":"Arce","year":"2002","journal-title":"Am. Fam. Physician"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"11362","DOI":"10.3748\/wjg.v21.i40.11362","article-title":"Irritable Bowel Syndrome and Chronic Constipation: Fact and Fiction","volume":"21","author":"Bellini","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e04488","DOI":"10.1016\/j.heliyon.2020.e04488","article-title":"Empathy and Mentalizing Abilities in Relation to Psychosocial Stress in Healthy Adult Men and Women","volume":"6","author":"Tollenaar","year":"2020","journal-title":"Heliyon"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1038\/sj.ejcn.1602367","article-title":"Perceived Food Intolerance in Subjects with Irritable Bowel Syndrome\u2013Etiology, Prevalence and Consequences","volume":"60","author":"Monsbakken","year":"2005","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1463897","DOI":"10.1080\/21688370.2018.1463897","article-title":"Pathophysiology of IBD Associated Diarrhea","volume":"6","author":"Anbazhagan","year":"2018","journal-title":"Tissue Barriers"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s12664-020-01144-6","article-title":"The Role of Diet in the Pathophysiology and Management of Irritable Bowel Syndrome","volume":"40","author":"Patcharatrakul","year":"2021","journal-title":"Indian J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Gros, M., Gros, B., Mesonero, J., and Latorre, E. (2021). Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153429"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"106499","DOI":"10.1016\/j.prostaglandins.2020.106499","article-title":"Prostaglandin E2 Receptors and Their Role in Gastrointestinal Motility\u2013Potential Therapeutic Targets","volume":"152","author":"Heeney","year":"2020","journal-title":"Prostaglandins Other Lipid Mediat."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Mesa, M.D., Loureiro, B., Iglesia, I., Fernandez Gonzalez, S., Llurba Oliv\u00e9, E., Garc\u00eda Algar, O., Solana, M.J., Cabero Perez, M.J., Sainz, T., and Martinez, L. (2020). The Evolving Microbiome from Pregnancy to Early Infancy: A Comprehensive Review. Nutrients, 12.","DOI":"10.3390\/nu12010133"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/j.1440-1746.2009.06149.x","article-title":"Evidence-Based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP approach","volume":"25","author":"Gibson","year":"2010","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Ibrahim, F., and Stribling, P. (2019). A 5Ad Dietary Protocol for Functional Bowel Disorders. Nutrients, 11.","DOI":"10.3390\/nu11081938"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/ajg.2012.414","article-title":"Relationship Between Patterns of Alcohol Consumption and Gastrointestinal Symptoms Among Patients with Irritable Bowel Syndrome","volume":"108","author":"Reding","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"832","DOI":"10.14309\/ajg.0000000000000608","article-title":"Effect of Lifestyle Factors on Outcomes in Patients with Inflammatory Bowel Diseases","volume":"115","author":"Rozich","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1038\/ejcn.2016.271","article-title":"No Association of Alcohol Use and the Risk of Ulcerative Colitis or Crohn\u2019s Disease: Data from A European Prospective Cohort Study (EPIC)","volume":"71","author":"Bergmann","year":"2017","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e15795","DOI":"10.1097\/MD.0000000000015795","article-title":"Beverage Intake and Risk of Crohn Disease: A Meta-Analysis of 16 Epidemiological Studies","volume":"98","author":"Yang","year":"2019","journal-title":"Medicine"},{"key":"ref_40","unstructured":"Scientific Advisory Committee on Nutrition 2015 (2021, May 19). Carbohydrates and Health, Available online: https:\/\/assets.publishing.ser-vice.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/445503\/SACN_Carbohydrates_and_Health.pdf."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/s41575-020-00375-4","article-title":"Dietary Fibre in Gastrointestinal Health and Disease","volume":"18","author":"Gill","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5151","DOI":"10.3748\/wjg.v18.i37.5151","article-title":"Irritable Bowel Syndrome: Diagnosis and Pathogenesis","volume":"18","year":"2012","journal-title":"World J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1038\/ajg.2013.63","article-title":"Fiber and Functional Gastrointestinal Disorders","volume":"108","author":"Eswaran","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.pop.2017.07.009","article-title":"Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment","volume":"44","author":"Defrees","year":"2017","journal-title":"Prim. Care: Clin. Off. Pract."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1038\/s41395-018-0195-4","article-title":"A Systematic Review and Meta-Analysis Evaluating the Efficacy of a Gluten-Free Diet and a Low FODMAPS Diet in Treating Symptoms of Irritable Bowel Syndrome","volume":"113","author":"Dionne","year":"2018","journal-title":"Am. J. Gastroenterol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0195-6663(03)00014-X","article-title":"Sex Differences in Fruit and Vegetable Intake in Older Adults","volume":"40","author":"Baker","year":"2003","journal-title":"Appetite"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"649","DOI":"10.5009\/gnl13437","article-title":"Association between Diet and Lifestyle Habits and Irritable Bowel Syndrome: A Case-Control Study","volume":"9","author":"Guo","year":"2015","journal-title":"Gut Liver"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"289","DOI":"10.4236\/health.2019.113025","article-title":"Irritable Bowel Syndrome and Dietary Habits in Northern Saudi Arabia","volume":"11","author":"Alharbi","year":"2019","journal-title":"Health"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Salari-Moghaddam, A., Keshteli, A.H., Esmaillzadeh, A., and Adibi, P. (2020). Water Consumption and Prevalence of Irritable Bowel Syndrome Among Adults. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0228205"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1038\/s41430-018-0109-y","article-title":"Empirically Derived Dietary Habits Are Associated with Irritable Bowel Syndrome","volume":"72","author":"Zaribaf","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/MEG.0b013e32832ffd9b","article-title":"The Relationship Between Symptoms, Body Mass Index, Gastrointestinal Transit and Stool Frequency in Patients with Irritable Bowel Syndrome","volume":"22","author":"Sadik","year":"2010","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e13549","DOI":"10.1111\/nmo.13549","article-title":"General and Abdominal Obesity in Relation to the Prevalence of Irritable Bowel Syndrome","volume":"31","author":"Akhondi","year":"2019","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1038\/ajg.2014.422","article-title":"Visceral Abdominal Obesity Is Associated with an Increased Risk of Irritable Bowel Syndrome","volume":"110","author":"Lee","year":"2015","journal-title":"Am. J. Gastroenterol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.5152\/tjg.2019.19882","article-title":"Population-Based Assessment of Gastrointestinal Symptoms and Diseases: Cappadocia Cohort, Turkey","volume":"30","author":"Sezgin","year":"2020","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1159\/000051878","article-title":"Food-Related Gastrointestinal Symptoms in the Irritable Bowel Syndrome","volume":"63","author":"Langkilde","year":"2001","journal-title":"Digestion"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"323","DOI":"10.5009\/gnl15557","article-title":"Obesity-Related Digestive Diseases and Their Pathophysiology","volume":"11","author":"Nam","year":"2017","journal-title":"Gut Liver"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Shamah-Levy, T., Romero-Mart\u00ednez, M., Barrientos-Guti\u00e9rrez, T., Cuevas-Nasu, L., Bautista-Arredondo, S., Colchero, M.A., Gaona-Pineda, E.B., Lazcano-Ponce, E., Mart\u00ednez-Barnetche, J., and Alpuche-Arana, C. (2022). Encuesta Nacional de Salud y Nutrici\u00f3n 2021 sobre COVID-19, Instituto Nacional de Salud P\u00fablica. Available online: https:\/\/www.insp.mx\/resources\/images\/stories\/2022\/docs\/220801_Ensa21_digital_29julio.pdf.","DOI":"10.21149\/12580"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"886291","DOI":"10.3389\/fnut.2022.886291","article-title":"Exercise Outcomes in Childhood Obesity-Related Inflammation and Oxidative Status","volume":"9","author":"Huang","year":"2022","journal-title":"Front. Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1152\/japplphysiol.00431.2016","article-title":"Two Weeks of Moderate-Intensity Continuous Training, But Not High-Intensity Interval Training, Increases Insulin-Stimulated Intestinal Glucose Uptake","volume":"122","author":"Motiani","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1249\/MSS.0000000000002112","article-title":"Exercise Training Modulates Gut Microbiota Profile and Improves Endotoxemia","volume":"52","author":"Motiani","year":"2020","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.2337\/db21-0160","article-title":"Subcutaneous Adipose Tissue Metabolic Function and Insulin Sensitivity in People with Obesity","volume":"70","author":"Koh","year":"2021","journal-title":"Diabetes"},{"key":"ref_62","first-page":"139","article-title":"Gut clock: Implication of Circadian Rhythms in the Gastrointestinal Tract","volume":"62","author":"Konturek","year":"2011","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_63","first-page":"e8112","article-title":"Irritable Bowel Syndrome in a Population of a Developing Country: Prevalence and Association","volume":"12","author":"Latif","year":"2020","journal-title":"Cureus"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Chung, W., Kim, J., Lim, S.-J., and Lee, S. (2018). Sex-Specific Role of Education on the Associations of Socioeconomic Status Indicators with Obesity Risk: A Population-Based Study in South Korea. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0190499"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.15585\/mmwr.mm6650a1","article-title":"Prevalence of Obesity Among Adults, by Household Income and Education\u2014United States, 2011\u20132014","volume":"66","author":"Ogden","year":"2017","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e2017005","DOI":"10.4178\/epih.e2017005","article-title":"Irritable Bowel Syndrome Is Concentrated in People with Higher Educations in Iran: An Inequality Analysis","volume":"39","author":"Mansouri","year":"2017","journal-title":"Epidemiol. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/17\/10569\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:14:55Z","timestamp":1760141695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/17\/10569"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,25]]},"references-count":66,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["ijerph191710569"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191710569","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,25]]}}}