Evaluating the effect of energy-dense foods consumption on preschool children's body mass index: a prospective analysis from 2 to 4 years of age.

PubMed

Durão, Catarina; Severo, Milton; Oliveira, Andreia; Moreira, Pedro; Guerra, António; Barros, Henrique; Lopes, Carla

2015-08-01

The aim of this study was to study the association between the consumption of energy-dense foods at 2 years and body mass index (BMI) at 4 years, using a cross-lagged panel design. The present study included 589 children evaluated at 2 and 4 years of age, as part of the birth cohort generation XXI. Information was obtained by face-to-face interviews. Consumption of energy-dense foods (salty snacks, soft drinks, cakes, and sweets) was measured using a food frequency questionnaire. Children's weight and height were measured by standard procedures, and BMI standard deviation scores (BMI z-scores) were calculated according to the World Health Organization. Linear regression and cross-lagged panel design models were fitted to estimate the associations between the consumption of energy-dense foods and BMI z-scores (controlled for maternal age, education and prepregnancy BMI, and children's exact age at 2 years). The consumption of energy-dense foods at 2 years was significantly associated with their consumption at 4 years (β = 0.522, 95% CI 0.432-0.612). Children's BMI z-scores at 2 years were associated with posterior BMI z-scores (β = 0.747, 95% CI 0.688-0.806). In the cross-lagged analysis, consumption of energy-dense foods at 2 years had no effect on subsequent BMI z-scores (β = -0.030, 95% CI -0.095 to 0.035) and BMI z-scores at 2 years were not significantly associated with the consumption of energy-dense foods at 4 years (β = -0.012, 95% CI -0.086 to 0.062). Consumption of energy-dense foods and BMI tracked over time, but the consumption of energy-dense foods at 2 years was not associated with BMI z-scores at 4 years.

Comparison of relationships between four common anthropometric measures and incident diabetes.

PubMed

Lee, Crystal Man Ying; Woodward, Mark; Pandeya, Nirmala; Adams, Robert; Barrett-Connor, Elizabeth; Boyko, Edward J; Eliasson, Mats; Franco, Laercio J; Fujimoto, Wilfred Y; Gonzalez, Clicerio; Howard, Barbara V; Jacobs, David R; Keinanen-Kiukaanniemi, Sirkka; Magliano, Dianna; Schreiner, Pamela; Shaw, Jonathan E; Stevens, June; Taylor, Anne; Tuomilehto, Jaakko; Wagenknecht, Lynne; Huxley, Rachel R

2017-10-01

First, to conduct a detailed exploration of the prospective relations between four commonly used anthropometric measures with incident diabetes and to examine their consistency across different population subgroups. Second, to compare the ability of each of the measures to predict five-year risk of diabetes. We conducted a meta-analysis of individual participant data on body mass index (BMI), waist circumference (WC), waist-hip and waist-height ratio (WHtR) from the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox proportional hazard models were used to estimate the association between a one standard deviation increment in each anthropometric measure and incident diabetes. Harrell's concordance statistic was used to test the predictive accuracy of each measure for diabetes risk at five years. Twenty-one studies with 154,998 participants and 9342 cases of incident diabetes were available. Each of the measures had a positive association with incident diabetes. A one standard deviation increment in each of the measures was associated with 64-80% higher diabetes risk. WC and WHtR more strongly associated with risk than BMI (ratio of hazard ratios: 0.95 [0.92,0.99] - 0.97 [0.95,0.98]) but there was no appreciable difference between the four measures in the predictive accuracy for diabetes at five years. Despite suggestions that abdominal measures of obesity have stronger associations with incident diabetes and better predictive accuracy than BMI, we found no overall advantage in any one measure at discriminating the risk of developing diabetes. Any of these measures would suffice to assist in primary diabetes prevention efforts. Copyright © 2017 Elsevier B.V. All rights reserved.

Temporal divergence of percent body fat and body mass index in pre-teenage children: the LOOK longitudinal study.

PubMed

Telford, R D; Cunningham, R B; Abhayaratna, W P

2014-12-01

The index of body mass related to stature, (body mass index, BMI, kgm(-2) ), is widely used as a proxy for percent body fat (%BF) in cross-sectional and longitudinal investigations. BMI does not distinguish between lean and fat mass and in children, the cross-sectional relationship between %BF and BMI changes with age and sex. While BMI increases linearly with age from age 8 to 12 years in both boys and girls, %BF plateaus off between 10 and 12 years. Repeated measures in children show a systematic decrease in %BF for any given BMI from age 8 to 10 to 12 years. Because changes in BMI misrepresent changes in %BF, its use as a proxy of %BF should be avoided in longitudinal studies in this age group. Body mass index (BMI, kgm(-2) ) is commonly used as an indicator of pediatric adiposity, but with its inability to distinguish changes in lean and fat mass, its use in longitudinal studies of children requires careful consideration. To investigate the suitability of BMI as a surrogate of percent body fat (%BF) in pediatric longitudinal investigations. In this longitudinal study, healthy Australian children (256 girls and 278 boys) were measured at ages 8.0 (standard deviation 0.3), 10.0 and 12.0 years for height, weight and percent body fat (%BF) by dual-energy X-ray absorptiometry. The patterns of change in the means of %BF and BMI were different (P < 0.001). While mean BMI increased linearly from 8 to 12 years of age, %BF did not change between 10 and 12 years. Relationships between %BF and BMI in boys and girls were curvilinear and varied with age (P < 0.001) and gender (P < 0.001); any given BMI corresponding with a lower %BF as a child became older. Considering the divergence of temporal patterns of %BF and BMI between 10 and 12 years of age, employment of BMI as a proxy for %BF in absolute or age and sex standardized forms in pediatric longitudinal investigations is problematical. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Nutritional status in sick children and adolescents is not accurately reflected by BMI-SDS.

PubMed

Fusch, Gerhard; Raja, Preeya; Dung, Nguyen Quang; Karaolis-Danckert, Nadina; Barr, Ronald; Fusch, Christoph

2013-01-01

Nutritional status provides helpful information of disease severity and treatment effectiveness. Body mass index standard deviation scores (BMI-SDS) provide an approximation of body composition and thus are frequently used to classify nutritional status of sick children and adolescents. However, the accuracy of estimating body composition in this population using BMI-SDS has not been assessed. Thus, this study aims to evaluate the accuracy of nutritional status classification in sick infants and adolescents using BMI-SDS, upon comparison to classification using percentage body fat (%BF) reference charts. BMI-SDS was calculated from anthropometric measurements and %BF was measured using dual-energy x-ray absorptiometry (DXA) for 393 sick children and adolescents (5 months-18 years). Subjects were classified by nutritional status (underweight, normal weight, overweight, and obese), using 2 methods: (1) BMI-SDS, based on age- and gender-specific percentiles, and (2) %BF reference charts (standard). Linear regression and a correlation analysis were conducted to compare agreement between both methods of nutritional status classification. %BF reference value comparisons were also made between 3 independent sources based on German, Canadian, and American study populations. Correlation between nutritional status classification by BMI-SDS and %BF agreed moderately (r (2) = 0.75, 0.76 in boys and girls, respectively). The misclassification of nutritional status in sick children and adolescents using BMI-SDS was 27% when using German %BF references. Similar rates observed when using Canadian and American %BF references (24% and 23%, respectively). Using BMI-SDS to determine nutritional status in a sick population is not considered an appropriate clinical tool for identifying individual underweight or overweight children or adolescents. However, BMI-SDS may be appropriate for longitudinal measurements or for screening purposes in large field studies. When accurate nutritional status classification of a sick patient is needed for clinical purposes, nutritional status will be assessed more accurately using methods that accurately measure %BF, such as DXA.

Prospective associations between sedentary lifestyle and BMI in midlife.

PubMed

Mortensen, Laust H; Siegler, Ilene C; Barefoot, John C; Grønbaek, Morten; Sørensen, Thorkild I A

2006-08-01

A strong positive cross-sectional relationship between BMI and a sedentary lifestyle has been consistently observed in numerous studies. However, it has been questioned whether high BMI is a determinant or a consequence of a sedentary lifestyle. Using data from four follow-ups of the University of North Carolina Alumni Heart Study, we examined the prospective associations between BMI and sedentary lifestyle in a cohort of 4595 middle-aged men and women who had responded to questionnaires at the ages of 41 (standard deviation 2.3), 44 (2.3), 46 (2.0), and 54 (2.0). BMI was consistently related to increased risk of becoming sedentary in both men and women. The odds ratios of becoming sedentary as predicted by BMI were 1.04 (95% confidence limits, 1.00, 1.07) per 1 kg/m(2) from ages 41 to 44, 1.10 (1.07, 1.14) from ages 44 to 46, and 1.12 (1.08, 1.17) from ages 46 to 54. Controlling for concurrent changes in BMI marginally attenuated the effects. Sedentary lifestyle did not predict changes in BMI, except when concurrent changes in physical activity were taken into account (p < 0.001). The findings were not confounded by preceding changes in BMI or physical activity, age, smoking habits, or sex. Our findings suggest that a high BMI is a determinant of a sedentary lifestyle but did not provide unambiguous evidence for an effect of sedentary lifestyle on weight gain.

Parity and Overweight/Obesity in Peruvian Women.

PubMed

Huayanay-Espinoza, Carlos A; Quispe, Renato; Poterico, Julio A; Carrillo-Larco, Rodrigo M; Bazo-Alvarez, Juan Carlos; Miranda, J Jaime

2017-10-19

The rise in noncommunicable diseases and their risk factors in developing countries may have changed or intensified the effect of parity on obesity. We aimed to assess this association in Peruvian women using data from a nationally representative survey. We used data from Peru's Demographic and Health Survey, 2012. Parity was defined as the number of children ever born to a woman. We defined overweight as having a body mass index (BMI, kg/m 2 ) of 25.0 to 29.9 and obesity as a BMI ≥30.0. Generalized linear models were used to evaluate the association between parity and BMI and BMI categories, by area of residence and age, adjusting for confounders. Data from 16,082 women were analyzed. Mean parity was 2.25 (95% confidence interval [CI], 2.17-2.33) among rural women and 1.40 (95% CI, 1.36-1.43) among urban women. Mean BMI was 26.0 (standard deviation, 4.6). We found evidence of an association between parity and BMI, particularly in younger women; BMI was up to 4 units higher in rural areas and 2 units higher in urban areas. An association between parity and BMI categories was observed in rural areas as a gradient, being highest in younger women. We found a positive association between parity and overweight/obesity. This relationship was stronger in rural areas and among younger mothers.

Clinical Correlates and Prognostic Significance of Change in Standardized Left Ventricular Mass in a Community‐Based Cohort of African Americans

PubMed Central

Fox, Ervin R.; Musani, Solomon K.; Samdarshi, Tandaw E.; Taylor, Jared K.; Beard, Walter L.; Sarpong, Daniel F.; Xanthakis, Vanessa; McClendon, Eric E.; Liebson, Philip R.; Skelton, Thomas N.; Butler, Kenneth R.; Mosley, Thomas H.; Taylor, Herman; Vasan, Ramachandran S.

2015-01-01

Background Though left ventricular mass (LVM) predicts cardiovascular events (CVD) and mortality in African Americans, limited data exists on factors contributing to change in LVM and its prognostic significance. We hypothesized that baseline blood pressure (BP) and body mass index (BMI) and change in these variables over time are associated with longitudinal increases in LVM and that such increase is associated with greater incidence of CVD. Methods and Results We investigated the clinical correlates of change in standardized logarithmically transformed‐LVM indexed to height2.7 (log‐LVMI) and its association with incident CVD in 606 African Americans (mean age 58±6 years, 66% women) who attended serial examinations 8 years apart. Log‐LVMI and clinical covariates were standardized within sex to obtain z scores for both visits. Standardized log‐LVMI was modeled using linear regression (correlates of change in standardized log‐LVMI) and Cox proportional hazards regression (incidence of CVD [defined as coronary heart disease, stroke, heart failure and intermittent claudication]). Baseline clinical correlates (standardized log‐LVM, BMI, systolic BP) and change in systolic BP over time were significantly associated with 8‐year change in standardized log‐LVMI. In prospective analysis, change in standardized LVM was significantly (P=0.0011) associated with incident CVD (hazards ratio per unit standard deviation change log‐LVMI 1.51, 95% CI 1.18 to 1.93). Conclusions In our community‐based sample of African Americans, baseline BMI and BP, and change in BP on follow‐up were key determinants of increase in standardized log‐LVMI, which in turn carried an adverse prognosis, underscoring the need for greater control of BP and weight in this group. PMID:25655570

Physical activity modifies the FTO effect on BMI change in Japanese adolescents.

PubMed

Shinozaki, Keiko; Okuda, Masayuki; Okayama, Naoko; Kunitsugu, Ichiro

2018-04-14

Evidence of the effects of fat mass and obesity-associated (FTO) gene variation and long-term effects of physical activity (PA) on adiposity in adolescents is largely scarce. This study aimed to investigate whether physical activity modulates the effects of the FTO gene on body mass index (BMI) changes in Japanese adolescents between the ages of 13 and 18 years. Data of 343 subjects (156 boys; 187 girls) who were enrolled in 2006 and 2007 from schools on Shunan City, Japan, were collected. Genotyping (rs1558902) was conducted, and anthropometric measurements and blood test results were recorded for subjects in the eighth grade. A second survey involving self-reporting of anthropometric measurements was conducted when the subjects were in the twelfth grade. PA was estimated using the International Physical Activity Questionnaire in this survey. BMI and the standard deviation score for BMI (BMI-SDS) were calculated. BMI changes and BMI-SDS changes were compared among FTO genotypes using a multivariate model. The effect of the interaction between PA and the FTO genotype on BMI changes was significant among boys but not girls. Among boys, PA had a significant negative influence on BMI-SDS changes in those with the AA genotype and a significant positive influence on BMI and BMI-SDS changes in those with the TT genotype. These data suggest that the influence of PA on BMI changes and BMI-SDS changes varied on the basis of genotype. PA modified the effect of the FTO gene on BMI changes in Japanese boys. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Obesity and its relation with diabetes and hypertension: a cross-sectional study across four low- and middle-income country regions

PubMed Central

Patel, Shivani A.; Ali, Mohammed K.; Alam, Dewan; Yan, Lijing L.; Levitt, Naomi S.; Bernabe-Ortiz, Antonio; Checkley, William; Wu, Yangfeng; Irazola, Vilma; Gutierrez, Laura; Rubinstein, Adolfo; Shivashankar, Roopa; Li, Xian; Miranda, J. Jaime; Chowdhury, Muhammad Ashique Haider; Siddiquee, Ali Tanweer; Gaziano, Thomas A.; Kadir, M. Masood; Dorairaj, Prabhakaran

2016-01-01

Background The implications of rising obesity for cardiovascular health in low- and middle-income countries (LMICs) has generated much interest, in part because associations between obesity and cardiovascular health appear to vary across ethnic groups. Objective We assessed general and central obesity in four regions—Africa, East Asia, South America, and South Asia. We further investigate whether 1) body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and 2) associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results 31,118 participants aged 20 to 79 years were analyzed. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women respectively, aged 40–69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women respectively, aged 40–69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both men and women. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk. PMID:27102024

The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects

PubMed Central

Kim, Jae Hyun; Yun, Sungha; Hwang, Seung-sik; Shim, Jung Ok; Chae, Hyun Wook; Lee, Yeoun Joo; Lee, Ji Hyuk; Kim, Soon Chul; Lim, Dohee; Yang, Sei Won

2018-01-01

Growth charts are curves or tables that facilitate the visualization of anthropometric parameters, and are widely used as an important indicator when evaluating the growth status of children and adolescents. The latest version of the Korean National Growth Charts released in 2007 has raised concerns regarding the inclusion of data from both breastfed and formula-fed infants, higher body mass index (BMI) values in boys, and smaller 3rd percentile values in height-for-age charts. Thus, new growth charts have been developed to improve the previous version. The 2006 World Health Organization Child Growth Standards, regarded as the standard for breastfed infants and children, were introduced for children aged 0–35 months. For children and adolescents aged 3–18 years, these new growth charts include height-for-age, weight-for-age, BMI-for-age, weight-for-height, and head circumference-for-age charts, and were developed using data obtained in 1997 and 2005. Data sets and exclusion criteria were applied differently for the development of the different growth charts. BMI-for-age charts were adjusted to decrease the 95th percentile values of BMI. Criteria for obesity were simplified and defined as a BMI of ≥95th percentile for age and sex. The 3rd percentile values for height-for-age charts were also increased. Additional percentile lines (1st and 99th) and growth charts with standard deviation lines were introduced. 2017 Korean National Growth Charts are recommended for the evaluation of body size and growth of Korean children and adolescents for use in clinics and the public health sector in Korea. PMID:29853938

Growth curves and the international standard: How children's growth reflects challenging conditions in rural Timor-Leste.

PubMed

Spencer, Phoebe R; Sanders, Katherine A; Judge, Debra S

2018-02-01

Population-specific growth references are important in understanding local growth variation, especially in developing countries where child growth is poor and the need for effective health interventions is high. In this article, we use mixed longitudinal data to calculate the first growth curves for rural East Timorese children to identify where, during development, deviation from the international standards occurs. Over an eight-year period, 1,245 children from two ecologically distinct rural areas of Timor-Leste were measured a total of 4,904 times. We compared growth to the World Health Organization (WHO) standards using z-scores, and modeled height and weight velocity using the SuperImposition by Translation And Rotation (SITAR) method. Using the Generalized Additive Model for Location, Scale and Shape (GAMLSS) method, we created the first growth curves for rural Timorese children for height, weight and body mass index (BMI). Relative to the WHO standards, children show early-life growth faltering, and stunting throughout childhood and adolescence. The median height and weight for this population tracks below the WHO fifth centile. Males have poorer growth than females in both z-BMI (p = .001) and z-height-for-age (p = .018) and, unlike females, continue to grow into adulthood. This is the most comprehensive investigation to date of rural Timorese children's growth, and the growth curves created may potentially be used to identify future secular trends in growth as the country develops. We show significant deviation from the international standard that becomes most pronounced at adolescence, similar to the growth of other Asian populations. Males and females show different growth responses to challenging conditions in this population. © 2017 Wiley Periodicals, Inc.

Self-esteem outcomes over a summer camp for obese youth.

PubMed

McGregor, S; McKenna, J; Gately, P; Hill, A J

2016-12-01

Variation in the existing literature on the psychosocial benefits of weight loss in obese youth results, in part, from methodological limitations and modest weight loss. Accordingly, this research assessed perceived self-competence and low self-esteem during an intensive weight loss programme in a large sample of obese youth and related these to starting weight, gender and weight loss. Over 4 years, 303 obese male and female adolescents (body mass index [BMI] 34.3 kg m -2 , BMI standard deviation score 2.99; 14.7 years) attended a residential weight loss camp for a mean duration of 31 d. Outcome variables included dimensional self-esteem (Harter) and weight change over the camp. At the start of camp, obese youth scored highest on social acceptance and lowest on physical appearance and athletic competence. Global self-worth and most domains of self-competence improved significantly over the intervention. The proportion with low global self-worth reduced from 35% to 16%, but there was little change in the proportion reporting high self-competence (23%). Mean weight loss was -5.5 kg (BMI standard deviation scores -0.25) with boys and those heaviest at the start losing most. Weight loss was significantly correlated with improved physical appearance (r = 0.13) and athletic competence (r = 0.19), but not global self-worth. This intensive weight loss intervention yielded significant psychological benefit, especially in self-competence and among individuals achieving most weight loss. The weak association with weight loss suggests the influence of other contributing environmental or social features that should be the focus of further research. © 2016 World Obesity Federation.

Prevalence of subclinical hypothyroidism in obese children or adolescents and association between thyroid hormone and the components of metabolic syndrome.

PubMed

Jin, Hye Young

2018-05-16

Subclinical hypothyroidism is defined as elevated thyroid-stimulating hormone (TSH) levels with the normal concentrations of thyroxine (T4) or free thyroxine (fT4), and its clinical significance is unclear. The purpose of this study is to investigate the prevalence of subclinical hypothyroidism in children and adolescents and determine the relationship between lipid profiles, insulin resistance and thyroid hormones. A retrospective, cross-sectional study was performed using data from a subset of the KNHANES VI. The subjects whose ages were in the range of 10-19 years were enrolled when their thyroid function tests were available (n = 1104), and their laboratory and anthropometric data were analysed. Subclinical hypothyroidism was more commonly identified in the obese group (27 of 111) compared to the other groups (127 of 993) (24.3 vs. 12.8%, P = 0.002). Total cholesterol and triglyceride levels were higher in a group with subclinical hypothyroidism. Body mass index (BMI) was positively correlated with serum concentrations of the TSH and negatively correlated with serum concentrations of fT4 after adjusting for age. The concentrations of total cholesterol and triglyceride were positively correlated with the TSH concentrations following adjustment for age and BMI standard deviation scores. The fT4 concentrations were negatively linked with total cholesterol after adjusting for age and BMI standard deviation scores. No significant correlation was found between insulin resistance index and TSH and fT4. Subclinical hypothyroidism was common in the obese group, and the concentrations of TSH were linked with the lipid profile. Subclinical hypothyroidism in obese children or adolescents should be closely monitored while also evaluating metabolic risk factors. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Walking mediates associations between neighborhood activity supportiveness and BMI in the Women’s Health Initiative San Diego cohort

PubMed Central

Remigio-Baker, Rosemay A.; Anderson, Cheryl A. M.; Adams, Marc A.; Norman, Gregory J.; Kerr, Jacqueline; Criqui, Michael H.; Allison, Matthew

2016-01-01

Objectives To investigate whether walking mediates neighborhood built environment associations with weight status in middle- and older-aged women. Methods Participants (N=5085; mean age=64±7.7; 75.4% White non-Hispanic) were from the Women’s Health Initiative San Diego cohort baseline visits. Body mass index (BMI) and waist circumference were measured objectively. Walking was assessed via survey. The geographic information system (GIS)-based home neighborhood activity supportiveness index included residential density, street connectivity, land use mix, and number of parks. Results BMI was 0.22 units higher and the odds ratio for being obese (vs. normal or overweight) was 8% higher for every standard deviation decrease in neighborhood activity supportiveness. Walking partially mediated these associations (22–23% attenuation). Findings were less robust for waist circumference. Conclusions Findings suggest women who lived in activity-supportive neighborhoods had a lower BMI than their counterparts, in part because they walked more. Improving neighborhood activity supportiveness has population-level implications for improving weight status and health. PMID:26798961

Walking mediates associations between neighborhood activity supportiveness and BMI in the Women's Health Initiative San Diego cohort.

PubMed

Carlson, Jordan A; Remigio-Baker, Rosemay A; Anderson, Cheryl A M; Adams, Marc A; Norman, Gregory J; Kerr, Jacqueline; Criqui, Michael H; Allison, Matthew

2016-03-01

To investigate whether walking mediates neighborhood built environment associations with weight status in middle- and older-aged women. Participants (N=5085; mean age=64 ± 7.7; 75.4% White non-Hispanic) were from the Women's Health Initiative San Diego cohort baseline visits. Body mass index (BMI) and waist circumference were measured objectively. Walking was assessed via survey. The geographic information system (GIS)-based home neighborhood activity supportiveness index included residential density, street connectivity, land use mix, and number of parks. BMI was 0.22 units higher and the odds ratio for being obese (vs. normal or overweight) was 8% higher for every standard deviation decrease in neighborhood activity supportiveness. Walking partially mediated these associations (22-23% attenuation). Findings were less robust for waist circumference. Findings suggest women who lived in activity-supportive neighborhoods had a lower BMI than their counterparts, in part because they walked more. Improving neighborhood activity supportiveness has population-level implications for improving weight status and health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influence of body mass index on the growth hormone response to provocative testing in short children without growth hormone deficiency.

PubMed

Lee, Jieun; Yoon, Juyoung; Kang, Min Jae; Lee, Young Ah; Lee, Seong Yong; Shin, Choong Ho; Yang, Sei Won

2013-09-01

Obesity and its related factors are known to suppress the secretion of growth hormone (GH). We aimed to evaluate the influence of body mass index (BMI) on the peak GH response to provocative testing in short children without GH deficiency. We conducted a retrospective review of medical records of 88 children (2-15 yr old) whose height was less than 3 percentile for one's age and sex, with normal results (peak GH level > 10 ng/mL) of GH provocative testing with clonidine and dopamine. Peak stimulated GH level, height, weight, pubertal status and serum IGF-1 level were measured. Univariate analysis showed that the BMI standard deviation score (SDS) correlated negatively with the natural log (ln) of the peak stimulated GH level (ln peak GH). BMI SDS did not correlate significantly with sex, age, pubertal status, or ln IGF-1 level. BMI SDS correlated negatively with ln peak GH level induced by clonidine but not by dopamine. In stepwise multivariate regression analysis, BMI SDS was the only significant predictor of ln peak GH level in the combination of tests and the clonidine test, but not in the dopamine test. In children without GH deficiency, BMI SDS correlates negatively with the peak GH level. BMI SDS should be included in the analysis of the results of GH provocation tests, especially tests with clonidine.

[Obesity in children and adolescents and their parents. Correlation of standardized body mass index between patients, their parents and siblings from the multicentre APS data].

PubMed

Röbl, M; Knerr, I; Keller, K M; Jaeschke, R; Hoffmeister, U; Reinehr, T; Holl, R W

2008-11-01

Obesity in children and adolescents is moving into the focus of public interest. Genetic as well as environmental factors are important in the etiology of obesity. The aim of this multicentre study was to correlate the weight of overweight or obese children and adolescents with that of their parents and siblings. Anthropometric and other data - comorbidities, various influencing factors and treatment - were collected from the adiposity data acquisition system for prospective surveillance (APS). Currently 125 medical centers and pediatric care clinics in Germany, Austria and Switzerland use the APS documentation. Until February 2008 data on a total of 37,062 children and adolescents had been collected. Data to calculate the Body Mass Index (BMI) were obtained from both parents of 11,074 (29,9%) children and adolescents. The mean BMI Standard Deviation Score (SDS) of these children and adolescents was 2.46. Their mean age was 11.9 years; 46% were males. The mean BMI-SDS of these children and adolescents correlated significantly with the BMI-SDS of both the mother (r=0.29 [Spearman's rank correlation coefficient]) and the father (r=018, both p<0.0001). The correlation with the father's BMI was closer in adolescents (15-20 years, r=0.20) than in young children (<10 years: r=0.12). The correlation with the mother's BMI was independent of age. A multivariate model including the BMI of the parents as well as age and sex of the children and adolescents explained 10.0% of the variance. Significant influencing factors were BMI of the mother, sex and the relationship between BMI of mother, age and sex. Data for the BMI of siblings were available of 3,933 (10.6 %) children and adolescents. The correlation of the BMI of the children and adolescents with that of their siblings was +0.17 (p<0.0001). This correlation was highest in adolescence (<10 years.: r=0.17, 15-20 years.: r=0.24, both p<0.0001). The patient's weight correlated more strongly with the mother's than the father's weight or that of the siblings.

UAE population reference standard charts for body mass index and skinfold thickness, at ages 0-18 years.

PubMed

Abdulrazzaq, Yousef M; Nagelkerke, Nico; Moussa, Mohamed A

2011-11-01

To determine a range of anthropometric measurements including skinfold thickness measurements in four different areas of the body, to construct population growth charts for body mass index (BMI), skinfolds, and to compare these with growth charts from other countries. One aim was also to validate body fat charts derived from skinfold thickness. A national cross-sectional growth survey of children, 0-18 years old, was conducted using multistage stratified random sampling. The sample size included at least 200 children in each age-sex group. Height, weight, biceps skinfold, triceps skinfold, subscapular skinfold, suprailiac skinfold, and mid-upper-arm circumference were measured in each child. We describe correlation, standard deviation scores relative to the other standards, and calculation of body density in the United Arab Emirates population. We determined whether any of the above is a good indicator of fatness in children. BMI, upper-arm circumference, sum of four skinfolds, and percentage body fat charts were constructed using the LMS method of smoothing. BMI was very significantly correlated with sum of skinfold thicknesses, and mid-upper-arm circumference. Prevalence of obesity and overweight in ages 13-17 years was respectively 9.94% and 15.16% in females and 6.08% and 14.16% in males. Derived body fat charts were found not to be accurate. A national BMI, upper-arm circumference, and sum of four skinfolds chart has been constructed that can be used as a reference standard for the United Arab Emirates. Sum of four skinfold thickness charts can be used as crude determinants of adiposity in children, but derived body fat charts were shown to be inaccurate.

Accuracy of body mass index in volunteer firefighters.

PubMed

Ode, J; Knous, J; Schlaff, R; Hemenway, J; Peterson, J; Lowry, J

2014-04-01

Obesity is prevalent among career firefighters and may contribute to heart attacks, a leading cause of on-duty fatalities. The US National Fire Protection Association estimates that 800 000 of 1.1 million firefighters are volunteers. Body mass index (BMI) is commonly used to assess obesity, but little is known about its accuracy in volunteer firefighters, in whom muscle mass may be higher, given firefighting's physical demands, reducing its accuracy in identifying obesity. To evaluate the accuracy of BMI in identifying obese volunteer firefighters. Height, weight and body composition were measured in 73 male volunteer firefighters (mean age 40±12). The proportions with BMI ≥ 25kg/m(2), ≥30kg/ m(2) and percent fat ≤ 20th percentile were determined. Using the age-specific 20th percentile for percent fat (Cooper Clinic) as the criterion for being over-fat, the accuracy of BMI was assessed using sensitivity and specificity calculations. The means ± standard deviation of BMI and percent fat were 32±6 and 25±5, respectively. The proportions with a BMI ≥ 25 and ≥30 were 90% and 60%, respectively. Fifty-one percent had a percent fat ≤ 20th percentile. The measure BMI ≥ 25 had a perfect sensitivity (1.0) and low specificity (0.19) and BMI ≥ 30 had a high sensitivity (0.89) and moderate specificity (0.69). Although BMI ≥ 30 accurately predicted being over-fat, it misclassified large and lean firefighters. Although BMI should be used cautiously, it can identify over-fat firefighters at risk of cardiovascular disease, and its measurement is cost-effective and simple.

[Motor Skills of Extremely Obese Children and Adolescents Based on the Multicentre Longitudinal Obesity Database (APV)].

PubMed

Koch, B; Graf, C; Hoffmeister, U; Platschek, A-M; Gruber, W; Holl, R

2016-03-01

Obese children and adolescents often exhibit progressively declining motor skills. To support young obese patients adequately, it is necessary to assess their individual physical and motor abilities, taking the degree of obesity into account. A total of 5 924 children and adolescents (mean age: 12.7±2.5 years, range 6.0-18.0 years, 3 195 girls) were examined in a standardised multicentre evaluation survey (APV). Fitness parameters were correlated with age- and gender-specific BMI-SDS (Standard Deviation Score) Methods: Anthropometric data were collected and patients performed the modified Munich fitness test (mMFT: maximal power, coordination, trunk flexibility) and a 6-min walk-test (aerobic endurance capacity). 33% of patients were extremely obese (BMI>99.5th percentile). Mean BMI-SDS was + 2.32±0.53 (♀-Δ=+ 0.06; p<0.001). The data indicated significant negative correlations between BMI-SDS and selected components of motor performance, especially maximal power (r=- 0,134), and particularly aerobic endurance capacity (r=- 0,214; all p<0.001). Motor performance was significantly below average (n=27 473, 6-18 years), especially among extremely obese patients. Performance in all motor tasks was lower in girls compared to boys, except for trunk flexibility (p<0.001). Correlations were found between BMI-SDS and motor performance. Extremely obese patients and obese girls showed the most pronounced motor deficits. These results emphasize the importance of standardized evaluation of individual motor performance in children and adolescents with obesity. © Georg Thieme Verlag KG Stuttgart · New York.

Prolonged elevated body mass index in preschool children after the Great East Japan Earthquake.

PubMed

Isojima, Tsuyoshi; Yokoya, Susumu; Ono, Atsushi; Kato, Noriko; Tanaka, Toshiaki; Yokomichi, Hiroshi; Yamagata, Zentaro; Tanaka, Soichiro; Matsubara, Hiroko; Ishikuro, Mami; Kikuya, Masahiro; Chida, Shoichi; Hosoya, Mitsuaki; Kuriyama, Shinichi; Kure, Shigeo

2017-09-01

The Great East Japan Earthquake followed by tsunamis and the Fukushima Daiichi Nuclear Power Plant (NPP) accident caused catastrophic damage. The effects of the disaster on the growth of affected children are of great concern but remain unknown. The subject group was derived from two Japanese nationwide retrospective cohorts (historical control and exposure groups, respectively). The exposure group experienced the disaster at 47-59 months of age. We analyzed longitudinal changes in standard deviation score (SDS) for height and body mass index (BMI) using normal Japanese children's standards. Moreover, we analyzed the details of the affected children in Fukushima using Fukushima-specific growth charts established with the historical control data to clarify any indirect effect of the disaster on growth. Affected children in Fukushima had significantly higher BMI SDS than the historical control group (difference, 0.13; 95% CI: 0.044-0.21, P = 0.0029) and the regional controls (difference, 0.14; 95% CI: 0.074-0.20, P < 0.0001) 1.5 years after the disaster. Similar sustained increases in BMI SDS were also found with Fukushima-specific growth charts, but the phenomenon was detected only in boys. Notably, the BMI SDS of affected children who lived near the NPP had been increasing after the disaster, whereas those in distant areas had not changed. In contrast, height SDS had not changed throughout the analysis. Prolonged elevated BMI SDS was detected only in affected children in Fukushima. This phenomenon may be explained by an indirect effect of the NPP accident. © 2017 Japan Pediatric Society.

Body mass index kinetics around adiposity rebound in Anorexia nervosa: A case-control study.

PubMed

Neveu, Rémi; Neveu, Dorine; Carrier, Edouard; Ourrad, Nadia; Perroud, Alain; Nicolas, Alain

2016-10-01

Anorexia nervosa (AN) is associated with parameters involved in body mass index (BMI) regulation. Contrary to obesity, BMI kinetics around the adiposity rebound is not documented in AN. This study aimed at investigating which characteristics of BMI kinetics around the adiposity rebound are associated with AN. Multicentre case-control study with 101 inpatient women with AN onset after 10 years of age, and 101 healthy women, all free of overweight history and matched for age, level of education and fathers' socio-professional status. Age at adiposity rebound, pre- and post-adiposity rebound BMI velocities and accelerations (change in velocity over time) were estimated with linear mixed models using data recorded between 2 and 10 years of age. Patients had an earlier adiposity rebound (mean (standard deviation (SD)): 5.3 (1.3) vs 5.7 (1.1) years), a larger BMI at adiposity rebound (mean (SD): 15.3 [1] vs 14.9 (0.9) kg/m 2 ) and 29% lower BMI acceleration after adiposity rebound than controls. After adjustment, only BMI at adiposity rebound and BMI acceleration after adiposity rebound were associated with a higher risk of AN (Odds ratio [95% confidence interval]: 2.15 [1.41-3.46] for an increase of 1 kg/m 2 and 2.44 [1.56-4.02] for an increase of 0.1 kg/(m 2 *years 2 ) respectively). These two factors were not correlated in patients (r = 0.007, p = 0.96). A flattened evolution of BMI after adiposity rebound and higher BMI at adiposity rebound were associated with AN. Further prospective study is needed to confirm these findings. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Longitudinal influences of neighbourhood built and social environment on children's weight status.

PubMed

Gose, Maria; Plachta-Danielzik, Sandra; Willié, Bianca; Johannsen, Maike; Landsberg, Beate; Müller, Manfred J

2013-10-15

The objective was to examine longitudinal 4-year-relationships between neighbourhood social environment and children's body mass index-standard deviation score (BMI-SDS) taking into account the built environment. Furthermore, we have analysed the influence of potential interactions between the social environment and family/social data on children's BMI-SDS. Between 2006-2008 and 2010-2012, anthropometric measurements were conducted among 485 children (age at baseline: 6.1 (5.8-6.4)). Socio-demographic characteristics and perception of residential environment were reported by parents. Geographic Information Systems were used to examine street length, number of food outlets and distance to the nearest playground and park/green space within an 800 m Euclidian buffer of each participant address point. Additional data on neighbourhood characteristics (e.g., traffic density, walkability, crime rates) were obtained from the State Capital of Kiel, Germany. In a multivariate model, walkability, street type, socioeconomic status of the district and perceived frequency of passing trucks/buses were associated with BMI-SDS over 4 years, but only neighbourhood SES had an effect on change in BMI-SDS. However, familial/social factors rather than neighbourhood environment (especially social environment) had an impact on children's BMI-SDS over 4 years. Thus, social inequalities in childhood overweight are only partially explained by social neighbourhood environment.

Interventions with children and parents to improve physical activity and body mass index: a meta-analysis.

PubMed

Dellert, Jane Cerruti; Johnson, Portia

2014-01-01

Examine the effect of interventions with parents and children on children's physical activity and body mass index (BMI). Computerized searches for intervention studies published between 1990 and 2011 used multiple ProQuest databases, including unpublished dissertations and theses to minimize publication bias. English-language, intervention-testing studies of children, parents, or families with outcomes of physical activity or BMI were retrieved from peer-reviewed journals, dissertations, and theses. Eliminated studies had no control or comparison group; had no continuous outcome variable; had no physical activity/exercise and/or BMI as outcomes; or had incomplete statistics necessary for meta-analysis (means, standard deviations, or confidence intervals). Twenty-one studies met inclusion criteria. Quality criteria were control group, objective outcome variable measure, clarity of variable definitions, and number and reason for subject withdrawal. Meta-analysis on the raw difference of means estimated mean weighted effect size (MWES) assessed dispersion of effects and computed a summary effect. MWES for interventions with parents and children on physical activity (Z = 2.92; confidence interval [CI] = .09 to .48; p = .002) and on BMI for interventions with children alone (Z = -2.10; CI = -.16 to -.01; p = .02) was significant. A significant effect on physical activity but not on BMI was found when interventions included both parents and their children.

Are you what your mother weighs? Evaluating the impact of maternal weight trajectories on youth overweight.

PubMed

Kowaleski-Jones, Lori; Brown, Barbara B; Fan, Jessie X; Smith, Ken R; Zick, Cathleen D

2010-09-01

In this study, we investigate how three alternative measures of maternal body mass index (BMI) relate to youth overweight. We contrast the typical cross-sectional measure of maternal BMI with a longitudinal mean and a standard deviation in maternal BMI. Using National Longitudinal Survey of Youth data, we estimate logistic regressions that relate maternal BMI to the risk of a youth being overweight while controlling for other familial characteristics. Participants in this study are 918 males and 841 females who were age 16-21 and either healthy weight or overweight in 2006. To be eligible for inclusion, teens were 15 years old by December 2006. After comparing several measures of maternal weight, we find that higher mean maternal BMI measured over the life of the adolescent has the strongest relationship with the odds of youth overweight for both male and female adolescents. For boys, a one unit increase in mother's mean BMI increases the odds of being overweight by 16% (OR = 1.16, 95% CI 1.11-1.20) while for girls the increase in the odds of being overweight is 13% (OR = 1.13, 95% CI 1.09-1.18). Our findings suggest that researchers should move beyond static measures of maternal weight when examining the correlates of youth BMI. Maternal weight histories offer additional insights about the youth's home environment that are associated with the risk of a youth being overweight.

Estimating the geographical distribution of the prevalence of the metabolic syndrome in young Mexicans.

PubMed

Murguía-Romero, Miguel; Jiménez-Flores, Rafael; Villalobos-Molina, Rafael; Méndez-Cruz, Adolfo René

2012-09-01

The geographical distribution of the metabolic syndrome (MetS) prevalence in young Mexicans (aged 17-24 years) was estimated stepwise starting from its prevalence based on the body mass index (BMI) in a study of 3,176 undergraduate students of this age group from Mexico City. To estimate the number of people with MetS by state, we multiplied its prevalence derived from the BMI range found in the Mexico City sample by the BMI proportions (range and state) obtained from the Mexico 2006 national survey on health and nutrition. Finally, to estimate the total number of young people with MetS in Mexico, its prevalence by state was multiplied by the share of young population in each state according to the National Population and Housing Census 2010. Based on these figures, we estimated the national prevalence of MetS at 15.8%, the average BMI at 24.1 (standard deviation = 4.2), and the prevalence of overweight people (BMI ≥25) of that age group at 39.0%. These results imply that 2,588,414 young Mexicans suffered from MetS in 2010. The Yucatan peninsula in the south and the Sonora state in the north showed the highest rates of MetS prevalence. The calculation of the MetS prevalence by BMI range in a sample of the population, and extrapolating it using the BMI proportions by range of the total population, was found to be a useful approach. We conclude that the BMI is a valuable public health tool to estimate MetS prevalence in the whole country, including its geographical distribution.

Is international or Asian criteria-based body mass index associated with maternal anaemia, low birthweight, and preterm births among Thai population? An observational study.

PubMed

Liabsuetrakul, Tippawan

2011-06-01

An observational study was conducted in the four southernmost provinces of Thailand aiming at determining the effect of international or Asian criteria-based body mass index (BMI) in predicting maternal anaemia, low birthweight (LBW), and preterm births among pregnant Thai women and the change in haemoglobin (Hb) level during pregnancy. Maternal anaemia was defined as a haemoglobin (Hb) level of <11 g/dL. Anaemia was detected in 27.4% and 26.9% of 1192 pregnant women at their first prenatal visit and the third trimester respectively. The proportions of overweight and obese women according to the Asian criteria-based pre-pregnancy BMI were higher than the international criteria-based BMI (22.4% and 10.1% vs 15.5% and 3.4% respectively). No significant difference between pre-pregnancy BMI and pregnancy BMI at the first prenatal visit was demonstrated (mean +/- standard deviation = 21.8 +/- 4.0 vs. 22.8 +/- 4.1). Underweight women had a significantly higher prevalence of maternal anaemia, LBW, and preterm birth compared to women with normal weight. Overweight and obese women at pre-pregnancy by the Asian criteria-based BMI had a lower prevalence of anaemia. The Hb levels did not change significantly over time. In addition to BMI, maternal age, parity, and late prenatal visit were independently associated with maternal anaemia, low birthweight, and preterm birth. Underweight pregnant women classified by international or Asian criteria-based BMI increased the risk of maternal anaemia, low birthweight, and preterm birth.

Body mass index and prevalence of skin diseases in adults with untreated coeliac disease.

PubMed

Zingone, F; Bucci, C; Tortora, R; Santonicola, A; Cappello, C; Franzese, M D; Passananti, V; Ciacci, C

2009-01-01

Coeliac disease (CD) is associated with immune-mediated skin diseases such as dermatitis herpetiformis and others. The objective of the study was to investigate the relation of body mass index (BMI), as an index of absorptive status, with the prevalence of skin diseases in adults with untreated CD. Anthropometry, gastro-intestinal symptoms, nutritional indices and immune-mediated skin diseases (dermatitis herpetiformis, psoriasis, aphthosis and alopecia) at diagnosis were analysed. 223 men and 924 women with untreated CD (aged 20-60 years) were included, the commonest skin disease was dermatitis herpetiformis (18.4 and 6.9%, respectively), the rarest one was alopecia (1.8 and 2.1%). The BMI was positively associated with male gender, age at diagnosis and nutritional indices, negatively with diarrhoea and dyspepsia (p < 0.001). A BMI difference of 3.5 (1 standard deviation) was related to an excess prevalence of dermatitis herpetiformis (odds ratio, OR = 1.46, 95% confidence interval, CI = 1.23-1.72) and of psoriasis (OR = 1.40, 95% CI = 1.10-1.79) but not of other immunological disorders. Findings were similar in analyses by gender or age group and controlled for gender and age. The relation of BMI to dermatitis herpetiformis was linear over the whole BMI range, also excluding overweight patients. The relation of BMI to psoriasis was flat for low-to-normal BMI and explained only by overweight patients. In CD at diagnosis, the BMI is positively related to the prevalence of dermatitis herpetiformis and psoriasis, not to that of other immune-mediated skin diseases. Copyright 2009 S. Karger AG, Basel.

Is International or Asian Criteria-based Body Mass Index Associated with Maternal Anaemia, Low Birthweight, and Preterm Births among Thai Population?—An Observational Study

PubMed Central

2011-01-01

An observational study was conducted in the four southernmost provinces of Thailand aiming at determining the effect of international or Asian criteria-based body mass index (BMI) in predicting maternal anaemia, low birthweight (LBW), and preterm births among pregnant Thai women and the change in haemoglobin (Hb) level during pregnancy. Maternal anaemia was defined as a haemoglobin (Hb) level of <11 g/dL. Anaemia was detected in 27.4% and 26.9% of 1,192 pregnant women at their first prenatal visit and the third trimester respectively. The proportions of overweight and obese women according to the Asian criteria-based pre-pregnancy BMI were higher than the international criteria-based BMI (22.4% and 10.1% vs 15.5% and 3.4% respectively). No significant difference between pre-pregnancy BMI and pregnancy BMI at the first prenatal visit was demonstrated (mean±standard deviation=21.8±4.0 vs 22.8±4.1). Underweight women had a significantly higher prevalence of maternal anaemia, LBW, and preterm birth compared to women with normal weight. Overweight and obese women at pre-pregnancy by the Asian criteria-based BMI had a lower prevalence of anaemia. The Hb levels did not change significantly over time. In addition to BMI, maternal age, parity, and late prenatal visit were independently associated with maternal anaemia, low birthweight, and preterm birth. Underweight pregnant women classified by international or Asian criteria-based BMI increased the risk of maternal anaemia, low birthweight, and preterm birth. PMID:21766557

Sleep Duration and Body Mass Index in Twins: A Gene-Environment Interaction

PubMed Central

Watson, Nathaniel F.; Harden, Kathryn Paige; Buchwald, Dedra; Vitiello, Michael V.; Pack, Allan I.; Weigle, David S.; Goldberg, Jack

2012-01-01

Study Objectives: To examine whether sleep duration modifies genetic and environmental influences on body mass index (BMI). Design: Genotype-environment interaction twin study. Setting: University of Washington Twin Registry. Patients or Participants: A population-based sample of US twins (1,088 pairs, 604 monozygotic, 484 dizygotic; 66% female; mean age = 36.6 yr, standard deviation (SD) = 15.9 yr). Interventions: N/A. Measurements and Results: Participants self-reported information on height, weight, and sleep. Mean BMI was calculated as 25.3 kg/m2 (SD = 5.4) and mean habitual sleep duration was 7.2 hr/night (SD = 1.2). Data were analyzed using biometric genetic interaction models. Overall the heritability of sleep duration was 34%. Longer sleep duration was associated with decreased BMI (P < 0.05). The heritability of BMI when sleep duration was < 7 hr (h2 = 70%) was more than twice as large as the heritability of BMI when sleep duration was ≥ 9 hr (h2 = 32%); this interaction was significant (P < 0.05). Conclusions: Shorter sleep duration is associated with increased BMI and increased genetic influences on BMI, suggesting that shorter sleep duration increases expression of genetic risks for high body weight. At the same time, longer sleep duration may suppress genetic influences on body weight. Future research aiming to identify specific genotypes for BMI may benefit by considering the moderating role of sleep duration. Citation: Watson NF; Harden KP; Buchwald D; Vitiello MV; Pack AI; Weigle DS; Goldberg J. Sleep duration and body mass index in twins: a gene-environment interaction. SLEEP 2012;35(5):597-603. PMID:22547885

Referrals for pediatric weight management: the importance of proximity.

PubMed

Ambler, Kathryn A; Hagedorn, Douglas W J; Ball, Geoff D C

2010-11-01

Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity. All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009. Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children. Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.

Measuring coronary calcium on CT images adjusted for attenuation differences.

PubMed

Nelson, Jennifer Clark; Kronmal, Richard A; Carr, J Jeffrey; McNitt-Gray, Michael F; Wong, Nathan D; Loria, Catherine M; Goldin, Jonathan G; Williams, O Dale; Detrano, Robert

2005-05-01

To quantify scanner and participant variability in attenuation values for computed tomographic (CT) images assessed for coronary calcium and define a method for standardizing attenuation values and calibrating calcium measurements. Institutional review board approval and participant informed consent were obtained at all study sites. An image attenuation adjustment method involving the use of available calibration phantom data to define standard attenuation values was developed. The method was applied to images from two population-based multicenter studies: the Coronary Artery Risk Development in Young Adults study (3041 participants) and the Multi-Ethnic Study of Atherosclerosis (6814 participants). To quantify the variability in attenuation, analysis of variance techniques were used to compare the CT numbers of standardized torso phantom regions across study sites, and multivariate linear regression models of participant-specific calibration phantom attenuation values that included participant age, race, sex, body mass index (BMI), smoking status, and site as covariates were developed. To assess the effect of the calibration method on calcium measurements, Pearson correlation coefficients between unadjusted and attenuation-adjusted calcium measurements were computed. Multivariate models were used to examine the effect of sex, race, BMI, smoking status, unadjusted score, and site on Agatston score adjustments. Mean attenuation values (CT numbers) of a standard calibration phantom scanned beneath participants varied significantly according to scanner and participant BMI (P < .001 for both). Values were lowest for Siemens multi-detector row CT scanners (110.0 HU), followed by GE-Imatron electron-beam (116.0 HU) and GE LightSpeed multi-detector row scanners (121.5 HU). Values were also lower for morbidly obese (BMI, > or =40.0 kg/m(2)) participants (108.9 HU), followed by obese (BMI, 30.0-39.9 kg/m(2)) (114.8 HU), overweight (BMI, 25.0-29.9 kg/m(2)) (118.5 HU), and normal-weight or underweight (BMI, <25.0 kg/m(2)) (120.1 HU) participants. Agatston score calibration adjustments ranged from -650 to 1071 (mean, -8 +/- 50 [standard deviation]) and increased with Agatston score (P < .001). The direction and magnitude of adjustment varied significantly according to scanner and BMI (P < .001 for both) and were consistent with phantom attenuation results in that calibration resulted in score decreases for images with higher phantom attenuation values. Image attenuation values vary by scanner and participant body size, producing calcium score differences that are not due to true calcium burden disparities. Use of calibration phantoms to adjust attenuation values and calibrate calcium measurements in research studies and clinical practice may improve the comparability of such measurements between persons scanned with different scanners and within persons over time.

Response to growth hormone treatment in Prader-Willi syndrome: auxological criteria versus genetic diagnosis.

PubMed

Scheermeyer, Elly; Hughes, Ian; Harris, Mark; Ambler, Geoff; Crock, Patricia; Verge, Charles F; Craig, Maria E; Bergman, Phil; Werther, George; van Driel, Mieke; Davies, Peter Sw; Choong, Catherine S Y

2013-12-01

The Australian Prader-Willi Syndrome (PWS) database was established to monitor the efficacy and safety of growth hormone (GH) treatment in PWS. This study aims to compare response to GH based on eligibility criteria. Comparative study: 72 children received GH on the basis of short stature or evidence of GH deficiency (pre-2009: PWS-SS) and 94 on a genetic diagnosis (post-2009: PWS-Dx). We report on mandatory patient data for GH prescription: median and standard deviation score (SDS) for height and body mass index (BMI), waist/height ratio, bone age/chronological age ratio and adverse events. Comparisons were made using non-parametric tests. At baseline, the PWS-SS cohort was shorter (height SDS: -2.6 vs. -1.1, P < 0.001), had a lower BMI (0.6 vs. 1.5 SDS, P < 0.05) and greater bone age delay (bone age/chronological age: 0.7 vs. 0.9, P < 0.05) than the PWS-Dx cohort. PWS-SS parents were shorter (mid-parental height SDS: -0.13 vs. 0.28, P < 0.005). Mean change in height over 2 years was 0.9 SDS and in BMI using PWS reference standards -0.3 SDSPWS (n = 106) (year 2, height SDS: PWS-SS = -1.7, PWS-Dx = 0.1; BMI SDSPWS : PWS-SS = -1.0, PWS-Dx = -0.6). The waist/height ratio reduced (PWS-Dx: 0.60 vs. 0.56, P < 0.05) and bone age delay was unchanged over this period. No serious adverse events were reported. The PWS-SS cohort represents a subgroup of the wider PWS-Dx population; however both cohorts improved height SDS with normalisation of height in the PWS-Dx cohort and lowering of BMI relative to PWS standards supporting the efficacy of treatment under the current Australian GH programme. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Physical Activity Levels in Chinese One-Year-Old Children and Their Parents, an Early STOPP China Study.

PubMed

Mei, Hong; Johansson, Elin; Hagströmer, Maria; Xiong, Yuelin; Zhang, Lanlan; Zhang, Jianduan; Marcus, Claude

2016-01-01

Physical activity (PA) is associated with health benefits, already in childhood. However, little is known about actual levels, patterns and gender differences in PA level in very young children. This study examines Chinese one-year-old children and their parents' PA levels and patterns, and assesses the correlations between children's PA level and gender, body mass index standard deviation score (BMI SDS), parental BMI and parental PA level. Data from 123 families participating in the Early STOPP China study were used. Families were recruited based on parental BMI and were classified as either high-risk or low-risk of obesity. Parents and children wore an ActiGraph GT3X+ to assess the average PA levels. PA levels and hourly patterns during weekdays and weekends were examined as were correlations with gender, BMI SDS, parental BMI and parental PA levels. There were no significant differences in children's averaged PA between risk groups, genders, or between weekdays and weekends. Children's peak average activity level was at 7 pm and they were least active at 3 pm (p<0.001). Both mothers and fathers demonstrated a similar PA pattern as their children, although paternal PA level was consistently lower than that of mothers and children. No significant association was found between children's PA and their gender, BMI SDS, parental BMI or paternal PA levels. Maternal PA was found positively associated with child PA (p<0.05). PA in one-year-old Chinese children vary over the day but weekdays and weekends are similar. At this age, children's PA is not related to gender, BMI SDS, parental BMI or paternal PA. Larger scale studies with more contextual information are needed to improve the understanding of our findings.

Triglyceride glucose-body mass index is effective in identifying nonalcoholic fatty liver disease in nonobese subjects.

PubMed

Zhang, Shujun; Du, Tingting; Li, Mengni; Jia, Jing; Lu, Huiming; Lin, Xuan; Yu, Xuefeng

2017-06-01

Nonalcoholic fatty liver disease (NAFLD) is an increasingly common condition that is highly correlated with obesity; however, it is not uncommon among nonobese individuals. Triglyceride (TG) and glucose index combined with body mass index (TyG-BMI) has been proposed as a favorable marker of insulin resistance. We sought to investigate the effectiveness of TyG-BMI in identifying NAFLD in nonobese subjects.We conducted a cross-sectional study in a nonobese (BMI <25.0 kg/m) Chinese population (N = 6809) of adults who underwent health examinations, including abdominal ultrasonography.The prevalence of ultrasonography-detected NAFLD was 23.9% in nonobese subjects. After adjusting for potential confounders, every 1-standard deviation increase in TyG-BMI had an odds ratio (OR) of 3.4 [95% confidence interval (95% CI), 3.0-3.9] for NAFLD. Compared with the lowest quartile of TyG-BMI, multivariable-adjusted ORs were 2.4 (1.6-3.6), 6.4 (4.2-9.7), and 15.3 (9.8-23.9) for those in the second, third, and fourth quartile, respectively. According to the receiver operating characteristic curve analysis, TyG-BMI was effective in diagnosing patients with NAFLD with an area under the curve of 0.835 (95% CI, 0.824-0.845). In comparison, TyG-BMI was superior to its components, including TyG, BMI, TG, and fasting plasma glucose, for identifying nonobese subjects at risk for NAFLD.In this study, the prevalence of NAFLD was over one-fifth in the nonobese population. TyG-BMI was an effective marker to detect NAFLD in nonobese subjects.

Triglyceride glucose-body mass index is effective in identifying nonalcoholic fatty liver disease in nonobese subjects

PubMed Central

Zhang, Shujun; Du, Tingting; Li, Mengni; Jia, Jing; Lu, Huiming; Lin, Xuan; Yu, Xuefeng

2017-01-01

Abstract Nonalcoholic fatty liver disease (NAFLD) is an increasingly common condition that is highly correlated with obesity; however, it is not uncommon among nonobese individuals. Triglyceride (TG) and glucose index combined with body mass index (TyG-BMI) has been proposed as a favorable marker of insulin resistance. We sought to investigate the effectiveness of TyG-BMI in identifying NAFLD in nonobese subjects. We conducted a cross-sectional study in a nonobese (BMI <25.0 kg/m2) Chinese population (N = 6809) of adults who underwent health examinations, including abdominal ultrasonography. The prevalence of ultrasonography-detected NAFLD was 23.9% in nonobese subjects. After adjusting for potential confounders, every 1-standard deviation increase in TyG-BMI had an odds ratio (OR) of 3.4 [95% confidence interval (95% CI), 3.0–3.9] for NAFLD. Compared with the lowest quartile of TyG-BMI, multivariable-adjusted ORs were 2.4 (1.6–3.6), 6.4 (4.2–9.7), and 15.3 (9.8–23.9) for those in the second, third, and fourth quartile, respectively. According to the receiver operating characteristic curve analysis, TyG-BMI was effective in diagnosing patients with NAFLD with an area under the curve of 0.835 (95% CI, 0.824–0.845). In comparison, TyG-BMI was superior to its components, including TyG, BMI, TG, and fasting plasma glucose, for identifying nonobese subjects at risk for NAFLD. In this study, the prevalence of NAFLD was over one-fifth in the nonobese population. TyG-BMI was an effective marker to detect NAFLD in nonobese subjects. PMID:28562560

[Correlation between percentage of body fat and simple anthropometric parameters in children aged 6-9 years in Guangzhou].

PubMed

Yan, H C; Hao, Y T; Guo, Y F; Wei, Y H; Zhang, J H; Huang, G P; Mao, L M; Zhang, Z Q

2017-11-10

Objective: To evaluate the accuracy of simple anthropometric parameters in diagnosing obesity in children in Guangzhou. Methods: A cross-sectional study, including 465 children aged 6-9 years, was carried out in Guangzhou. Their body height and weight, waist circumference (WC) and hip circumference were measured according to standard procedure. Body mass index (BMI), waist to hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Body fat percentage (BF%) was determined by dual-energy X-ray absorptiometry. Multiple regression analysis was applied to evaluate the correlations between age-adjusted physical indicators and BF%, after the adjustment for age. Obesity was defined by BF%. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic accuracy of the indicators for childhood obesity. Area under-ROC curves (AUCs) were calculated and the best cut-off point that maximizing 'sensitivity + specificity-1' was determined. Results: BMI showed the strongest association with BF% through multiple regression analysis. For 'per-standard deviation increase' of BMI, BF% increased by 5.3% ( t =23.1, P <0.01) in boys and 4.6% ( t =17.5, P <0.01) in girls, respectively. The ROC curve analysis indicated that BMI exhibited the largest AUC in both boys (AUC=0.908) and girls (AUC=0.895). The sensitivity was 80.8% in boys and 81.8% in girls, and the specificity was 88.2% in boys and 87.1% in girls. Both the AUCs for WHtR and WC were less than 0.8 in boys and girls. WHR had the smallest AUCs (<0.8) in both boys and girls. Conclusion: BMI appeared to be a good predicator for BF% in children aged 6-9 years in Guangzhou.

Impact of physical fitness and body composition on injury risk among active young adults: A study of Army trainees.

PubMed

Jones, Bruce H; Hauret, Keith G; Dye, Shamola K; Hauschild, Veronique D; Rossi, Stephen P; Richardson, Melissa D; Friedl, Karl E

2017-11-01

To determine the combined effects of physical fitness and body composition on risk of training-related musculoskeletal injuries among Army trainees. Retrospective cohort study. Rosters of soldiers entering Army basic combat training (BCT) from 2010 to 2012 were linked with data from multiple sources for age, sex, physical fitness (heights, weights (mass), body mass index (BMI), 2 mile run times, push-ups), and medical injury diagnoses. Analyses included descriptive means and standard deviations, comparative t-tests, risks of injury, and relative risks (RR) and 95% confidence intervals (CI). Fitness and BMI were divided into quintiles (groups of 20%) and stratified for chi-square (χ 2 ) comparisons and to determine trends. Data were obtained for 143,398 men and 41,727 women. As run times became slower, injury risks increased steadily (men=9.8-24.3%, women=26.5-56.0%; χ 2 trends (p<0.00001)). For both genders, the relationship of BMI to injury risk was bimodal, with the lowest risk in the average BMI group (middle quintile). Injury risks were highest in the slowest groups with lowest BMIs (male trainees=26.5%; female trainees=63.1%). Compared to lowest risk group (average BMI with fastest run-times), RRs were significant (male trainees=8.5%; RR 3.1, CI: 2.8-3.4; female trainees=24.6%; RR 2.6, CI: 2.3-2.8). Trainees with the lowest BMIs exhibited highest injury risks for both genders and across all fitness levels. While the most aerobically fit Army trainees experience lower risk of training-related injury, at any given aerobic fitness level those with the lowest BMIs are at highest risk. This has implications for recruitment and retention fitness standards. Copyright © 2017. Published by Elsevier Ltd.

Trajectories of growth in body mass index across childhood: Associations with maternal and paternal employment.

PubMed

Morrissey, Taryn W

2013-10-01

Research links mothers' employment to higher body mass index (BMI), a measure of weight-for-height, among their children. However, how maternal employment patterns relate to their children's BMI trajectories, and the role that fathers' employment plays in when and at what rate children grow, remain unclear. With data on children from 2 to 15 years of age living in two-parent families from the U.S. NICHD's Study of Early Child Care and Youth Development (N = 1107), individual growth models are used to describe American children's BMI trajectories as predicted by maternal and paternal employment characteristics. Results indicate that, by age 15, children's BMIs are, on average, nearly one-half of a standard deviation above recommended levels, and the majority of growth occurs during the preschool period. The duration of maternal employment, and combined measures of maternal and paternal employment duration, are both associated with higher child BMI across childhood. Associations are small but cumulative. Notably, the association between the duration of time children lived in dual-earner families and child BMI is larger than that between maternal employment duration alone and children's BMI, which is strongest during the preschool period. Combined measures of maternal and paternal employment intensity, defined as the number of periods both parents worked 35 or more hours per week, are associated with higher child BMI during the preschool period only. Findings highlight the importance of taking into account both parents' employment characteristics in investigating children's physical development. Copyright © 2012 Elsevier Ltd. All rights reserved.

Association between Dental Caries and BMI in Children: A Systematic Review and Meta-Analysis.

PubMed

Chen, Dongru; Zhi, Qinghui; Zhou, Yan; Tao, Ye; Wu, Liping; Lin, Huancai

2018-01-01

Research on the association between dental caries and body mass index (BMI) in children has shown contradictory results; thus we aimed to examine the association between dental caries and the full range of BMI classes among children. We comprehensively searched PubMed, Embase, and the Cochrane Library for studies published prior to March 2017. Articles comparing dental caries among the full range of BMI classes for children below 18 years of both genders were included. Fourteen studies were eligible for this study. Basic information - i.e., first author, published year, study design, country, sample size, age, type of dental caries index and BMI, main results and conclusions, and means and standard deviations of the dental caries indexes used - was pooled. The weighted mean differences and corresponding 95% confidence intervals for dental caries between children with abnormal weight and those with normal weight were analyzed. Generally, no significant differences in caries were found between any abnormal-weight group and the normal-weight group for both primary and permanent teeth. Sensitivity analyses showed that the obese group had more caries than the normal-weight group in their primary teeth. Significantly more caries was found among the overweight and obese children in both primary and permanent teeth in high-income countries, but not in low- and middle-income countries. We recommend that further studies use suitable sample sizes, unify the criteria for BMI categorization and the dental caries index, and investigate the confounding factors that might influence dental caries and BMI. © 2018 S. Karger AG, Basel.

The role of body mass in the response to growth hormone therapy.

PubMed

Martha, P M; Reiter, E O; Dávila, N; Shaw, M A; Holcombe, J H; Baumann, G

1992-12-01

Obesity is associated with normal or increased growth despite diminished GH secretion compared to lean children. The mechanism by which adequate growth is maintained in the presence of low GH levels is unknown, but is possibly mediated at the GH receptor level. To probe this hypothesis, we examined the relationship between GH responsivity, body mass index (BMI) and plasma GH-binding protein (GH-BP)/receptor level in 43 GH-deficient children during treatment with a fixed dose of GH (0.18 mg/kg.week). Before treatment, BMI [expressed as standard deviation score (SDS) for age (BMI-SDS)] did not correlate with either growth velocity or serum insulin-like growth factor-I (IGF-I). In contrast, after 12 months of GH therapy BMI-SDS correlated directly with plasma IGF-I (P < 10(-5)) and growth velocity (P < 10(-3)). These findings parallel those obtained for GH-BP vs. the response to GH, suggesting that BMI and GH-BP are covariants. The interrelationships among BMI, GH-BP, and response to GH were further probed by multiple regression analysis. Partial correlation coefficients vs. response to GH were consistently stronger for GH-BP than for BMI-SDS, indicating that GH-BP is the dominant factor between these two covariants in determining responsiveness to GH. The data suggest a primary role for GH-BP/receptor levels in determining GH action, with secondary but significant effects of nutrition and degree of adiposity. The latter may be mediated through the impact of nutrition and body mass on GH-BP/receptor levels.

Use of Fat Mass and Fat Free Mass Standard Deviation Scores Obtained Using Simple Measurement Methods in Healthy Children and Patients: Comparison with the Reference 4-Component Model

PubMed Central

Atherton, Rachel R.; Williams, Jane E.; Wells, Jonathan C. K.; Fewtrell, Mary S.

2013-01-01

Background Clinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data. Objectives (1) To compare fat mass (FM) and fat free mass (FFM) standard deviation scores (SDS) generated using new body composition reference data and obtained using simple measurement methods in healthy children and patients with those obtained using the reference 4-component (4-C) model; (2) To determine the extent to which scores from simple methods agree with those from the 4-C model in identification of abnormal body composition. Design FM SDS were calculated for 4-C model, dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy), BMI and skinfold thicknesses (SFT); and FFM SDS for 4CM, DXA and bioelectrical impedance analysis (BIA; height2/Z)) in 927 subjects aged 3.8–22.0 y (211 healthy, 716 patients). Results DXA was the most accurate method for both FM and FFM SDS in healthy subjects and patients (mean bias (limits of agreement) FM SDS 0.03 (±0.62); FFM SDS −0.04 (±0.72)), and provided best agreement with the 4-C model in identifying abnormal BC (SDS ≤−2 or ≥2). BMI and SFTs were reasonable predictors of abnormal FM SDS, but poor in providing an absolute value. BIA was comparable to DXA for FFM SDS and in identifying abnormal subjects. Conclusions DXA may be used both for research and clinically to determine FM and FFM SDS. BIA may be used to assess FFM SDS in place of DXA. BMI and SFTs can be used to measure adiposity for groups but not individuals. The performance of simpler techniques in monitoring longitudinal BC changes requires investigation. Ultimately, the most appropriate method should be determined by its predictive value for clinical outcome. PMID:23690932

Use of fat mass and fat free mass standard deviation scores obtained using simple measurement methods in healthy children and patients: comparison with the reference 4-component model.

PubMed

Atherton, Rachel R; Williams, Jane E; Wells, Jonathan C K; Fewtrell, Mary S

2013-01-01

Clinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data. (1) To compare fat mass (FM) and fat free mass (FFM) standard deviation scores (SDS) generated using new body composition reference data and obtained using simple measurement methods in healthy children and patients with those obtained using the reference 4-component (4-C) model; (2) To determine the extent to which scores from simple methods agree with those from the 4-C model in identification of abnormal body composition. FM SDS were calculated for 4-C model, dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy), BMI and skinfold thicknesses (SFT); and FFM SDS for 4CM, DXA and bioelectrical impedance analysis (BIA; height(2)/Z)) in 927 subjects aged 3.8-22.0 y (211 healthy, 716 patients). DXA was the most accurate method for both FM and FFM SDS in healthy subjects and patients (mean bias (limits of agreement) FM SDS 0.03 (± 0.62); FFM SDS -0.04 (± 0.72)), and provided best agreement with the 4-C model in identifying abnormal BC (SDS ≤-2 or ≥ 2). BMI and SFTs were reasonable predictors of abnormal FM SDS, but poor in providing an absolute value. BIA was comparable to DXA for FFM SDS and in identifying abnormal subjects. DXA may be used both for research and clinically to determine FM and FFM SDS. BIA may be used to assess FFM SDS in place of DXA. BMI and SFTs can be used to measure adiposity for groups but not individuals. The performance of simpler techniques in monitoring longitudinal BC changes requires investigation. Ultimately, the most appropriate method should be determined by its predictive value for clinical outcome.

Relationship between Soft Drink Consumption and Obesity in 9-11 Years Old Children in a Multi-National Study.

PubMed

Katzmarzyk, Peter T; Broyles, Stephanie T; Champagne, Catherine M; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V; Maia, Jose; Matsudo, Victor; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tremblay, Mark S; Tudor-Locke, Catrine; Zhao, Pei

2016-11-30

The purpose of this study was to determine the association between regular (sugar containing) and diet (artificially sweetened) soft drink consumption and obesity in children from 12 countries ranging in levels of economic and human development. The sample included 6162 children aged 9-11 years. Information on soft drink consumption was obtained using a food frequency questionnaire. Percentage body fat (%BF) was estimated by bio-electrical impedance analysis, body mass index (BMI) z -scores were computed using World Health Organization reference data, and obesity was defined as a BMI > +2 standard deviations (SD). Multi-level models were used to investigate trends in BMI z -scores, %BF and obesity across categories of soft drink consumption. Age, sex, study site, parental education and physical activity were included as covariates. There was a significant linear trend in BMI z -scores across categories of consumption of regular soft drinks in boys ( p = 0.049), but not in girls; there were no significant trends in %BF or obesity observed in either boys or girls. There was no significant linear trend across categories of diet soft drink consumption in boys, but there was a graded, positive association in girls for BMI z -score ( p = 0.0002) and %BF ( p = 0.0001). Further research is required to explore these associations using longitudinal research designs.

Relationship between Soft Drink Consumption and Obesity in 9–11 Years Old Children in a Multi-National Study

PubMed Central

Katzmarzyk, Peter T.; Broyles, Stephanie T.; Champagne, Catherine M.; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V.; Maia, Jose; Matsudo, Victor; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L.; Standage, Martyn; Tremblay, Mark S.; Tudor-Locke, Catrine; Zhao, Pei

2016-01-01

The purpose of this study was to determine the association between regular (sugar containing) and diet (artificially sweetened) soft drink consumption and obesity in children from 12 countries ranging in levels of economic and human development. The sample included 6162 children aged 9–11 years. Information on soft drink consumption was obtained using a food frequency questionnaire. Percentage body fat (%BF) was estimated by bio-electrical impedance analysis, body mass index (BMI) z-scores were computed using World Health Organization reference data, and obesity was defined as a BMI > +2 standard deviations (SD). Multi-level models were used to investigate trends in BMI z-scores, %BF and obesity across categories of soft drink consumption. Age, sex, study site, parental education and physical activity were included as covariates. There was a significant linear trend in BMI z-scores across categories of consumption of regular soft drinks in boys (p = 0.049), but not in girls; there were no significant trends in %BF or obesity observed in either boys or girls. There was no significant linear trend across categories of diet soft drink consumption in boys, but there was a graded, positive association in girls for BMI z-score (p = 0.0002) and %BF (p = 0.0001). Further research is required to explore these associations using longitudinal research designs. PMID:27916866

Descriptive epidemiology of pedometer-determined physical activity.

PubMed

Tudor-Locke, Catrine; Ham, Sandra A; Macera, Caroline A; Ainsworth, Barbara E; Kirtland, Karen A; Reis, Jared P; Kimsey, C Dexter

2004-09-01

The dual purposes of this study were: 1) to provide preliminary descriptive epidemiology data representing pedometer-determined physical activity (PA) and 2) to explore sources of intra-individual variability in steps per day. All participants (76 males, age = 48.4 +/- 16.3 yr, body mass index (BMI) = 27.1 +/- 5.1 kg x m(-2); 133 females, age = 47.4 +/- 17.5 yr, BMI = 26.9 +/- 5.7 kg x m(-2)) resided in Sumter County, SC, and were recruited by telephone to receive a mailed kit to self-monitor PA for 1 wk. Statistical analyses compared mean steps per day between sexes, races, age groups, education and income levels, and BMI categories. Mean steps per day were also compared between: 1) weekdays versus weekend days, 2) workdays versus nonworkdays, and 3) days of sport/exercise versus no participation. The entire sample took 5931 +/- 3664 steps x d(-1) (males = 7192 +/- 3596 vs females = 5210 +/- 3518 steps x d(-1), t = 7.88, P < 0.0001). Significant differences were also indicated by race, age, education, income, and BMI. In addition, weekdays were significantly higher than weekend days, workdays were higher than nonworkdays, and sport/exercise days were higher than nonsport/exercise days. The large standard deviations reflect a wide distribution of ambulatory behavior. Regardless, important differences are still evident by demographic characteristics, BMI categories, day of the week, and reported engagement in work or sport/exercise.

Longitudinal Influences of Neighbourhood Built and Social Environment on Children’s Weight Status

PubMed Central

Gose, Maria; Plachta-Danielzik, Sandra; Willié, Bianca; Johannsen, Maike; Landsberg, Beate; Müller, Manfred J.

2013-01-01

The objective was to examine longitudinal 4-year-relationships between neighbourhood social environment and children’s body mass index-standard deviation score (BMI-SDS) taking into account the built environment. Furthermore, we have analysed the influence of potential interactions between the social environment and family/social data on children’s BMI-SDS. Between 2006–2008 and 2010–2012, anthropometric measurements were conducted among 485 children (age at baseline: 6.1 (5.8–6.4)). Socio-demographic characteristics and perception of residential environment were reported by parents. Geographic Information Systems were used to examine street length, number of food outlets and distance to the nearest playground and park/green space within an 800 m Euclidian buffer of each participant address point. Additional data on neighbourhood characteristics (e.g., traffic density, walkability, crime rates) were obtained from the State Capital of Kiel, Germany. In a multivariate model, walkability, street type, socioeconomic status of the district and perceived frequency of passing trucks/busses were associated with BMI-SDS over 4 years, but only neighbourhood SES had an effect on change in BMI-SDS. However, familial/social factors rather than neighbourhood environment (especially social environment) had an impact on children’s BMI-SDS over 4 years. Thus, social inequalities in childhood overweight are only partially explained by social neighbourhood environment. PMID:24132135

Actigraphy-Derived Daily Rest-Activity Patterns and Body Mass Index in Community-Dwelling Adults.

PubMed

Cespedes Feliciano, Elizabeth M; Quante, Mirja; Weng, Jia; Mitchell, Jonathan A; James, Peter; Marinac, Catherine R; Mariani, Sara; Redline, Susan; Kerr, Jacqueline; Godbole, Suneeta; Manteiga, Alicia; Wang, Daniel; Hipp, J Aaron

2017-12-01

To examine associations between 24-hour rest-activity patterns and body mass index (BMI) among community-dwelling US adults. Rest-activity patterns provide a field method to study exposures related to circadian rhythms. Adults (N = 578) wore an actigraph on their nondominant wrist for 7 days. Intradaily variability and interdaily stability (IS), M10 (most active 10-hours), L5 (least active 5-hours), and relative amplitude (RA) were derived using nonparametric rhythm analysis. Mesor, acrophase, and amplitude were calculated from log-transformed count data using the parametric cosinor approach. Participants were 80% female and mean (standard deviation) age was 52 (15) years. Participants with higher BMI had lower values for magnitude, RA, IS, total sleep time (TST), and sleep efficiency. In multivariable analyses, less robust 24-hour rest-activity patterns as represented by lower RA were consistently associated with higher BMI: comparing the bottom quintile (least robust) to the top quintile (most robust 24-hour rest-activity pattern) of RA, BMI was 3-kg/m2 higher (p = .02). Associations were similar in magnitude to an hour less of TST (1-kg/m2 higher BMI) or a 10% decrease in sleep efficiency (2-kg/m2 higher BMI), and independent of age, sex, race, education, and the duration of rest and/or activity. Lower RA, reflecting both higher night activity and lower daytime activity, was associated with higher BMI. Independent of the duration of rest or activity during the day or night, 24-hour rest, and activity patterns from actigraphy provide aggregated measures of activity that associate with BMI in community-dwelling adults. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Pancreatic Fat Is Associated With Metabolic Syndrome and Visceral Fat but Not Beta-Cell Function or Body Mass Index in Pediatric Obesity.

PubMed

Staaf, Johan; Labmayr, Viktor; Paulmichl, Katharina; Manell, Hannes; Cen, Jing; Ciba, Iris; Dahlbom, Marie; Roomp, Kirsten; Anderwald, Christian-Heinz; Meissnitzer, Matthias; Schneider, Reinhard; Forslund, Anders; Widhalm, Kurt; Bergquist, Jonas; Ahlström, Håkan; Bergsten, Peter; Weghuber, Daniel; Kullberg, Joel

2017-03-01

Adolescents with obesity have increased risk of type 2 diabetes and metabolic syndrome (MetS). Pancreatic fat has been related to these conditions; however, little is known about associations in pediatric obesity. The present study was designed to explore these associations further. We examined 116 subjects, 90 with obesity. Anthropometry, MetS, blood samples, and oral glucose tolerance tests were assessed using standard techniques. Pancreatic fat fraction (PFF) and other fat depots were quantified using magnetic resonance imaging. The PFF was elevated in subjects with obesity. No association between PFF and body mass index-standard deviation score (BMI-SDS) was found in the obesity subcohort. Pancreatic fat fraction correlated to Insulin Secretion Sensitivity Index-2 and Homeostatic Model Assessment of Insulin Resistance in simple regression; however, when using adjusted regression and correcting for BMI-SDS and other fat compartments, PFF correlated only to visceral adipose tissue and fasting glucose. Highest levels of PFF were found in subjects with obesity and MetS. In adolescents with obesity, PFF is elevated and associated to MetS, fasting glucose, and visceral adipose tissue but not to beta-cell function, glucose tolerance, or BMI-SDS. This study demonstrates that conclusions regarding PFF and its associations depend on the body mass features of the cohort.

Dose assessment according to changes in algorithm in cardiac CT

NASA Astrophysics Data System (ADS)

Jang, H. C.; Cho, J. H.; Lee, H. K.; Hong, I. S.; Cho, M. S.; Park, C. S.; Lee, S. Y.; Dong, K. R.; Goo, E. H.; Chung, W. K.; Ryu, Y. H.; Lim, C. S.

2012-06-01

The principal objective of this study was to determine the effects of the application of the adaptive statistical iterative reconstruction (ASIR) technique in combination with another two factors (body mass index (BMI) and tube potential) on radiation dose in cardiac computed tomography (CT). For quantitative analysis, regions of interest were positioned on the central region of the great coronary artery, the right coronary artery, and the left anterior descending artery, after which the means and standard deviations of measured CT numbers were obtained. For qualitative analysis, images taken from the major coronary arteries (right coronary, left anterior descending, and left circumflex) were graded on a scale of 1-5, with 5 indicating the best image quality. Effective dose, which was calculated by multiplying the value of the dose length product by a standard conversion factor of 0.017 for the chest, was employed as a measure of radiation exposure dose. In cardiac CT in patients with BMI of less than 25 kg/m2, the use of 40% ASIR in combination with a low tube potential of 100 kVp resulted in a significant reduction in the radiation dose without compromising diagnostic quality. Additionally, the combination of the 120 kVp protocol and the application of 40% ASIR application for patients with BMI higher than 25 kg/m2 yielded similar results.

Food Environment and Weight Change: Does Residential Mobility Matter?

PubMed Central

Laraia, Barbara A.; Downing, Janelle M.; Zhang, Y. Tara; Dow, William H.; Kelly, Maggi; Blanchard, Samuel D.; Adler, Nancy; Schillinger, Dean; Moffet, Howard; Warton, E. Margaret; Karter, Andrew J.

2017-01-01

Abstract Associations between neighborhood food environment and adult body mass index (BMI; weight (kg)/height (m)2) derived using cross-sectional or longitudinal random-effects models may be biased due to unmeasured confounding and measurement and methodological limitations. In this study, we assessed the within-individual association between change in food environment from 2006 to 2011 and change in BMI among adults with type 2 diabetes using clinical data from the Kaiser Permanente Diabetes Registry collected from 2007 to 2011. Healthy food environment was measured using the kernel density of healthful food venues. Fixed-effects models with a 1-year-lagged BMI were estimated. Separate models were fitted for persons who moved and those who did not. Sensitivity analysis using different lag times and kernel density bandwidths were tested to establish the consistency of findings. On average, patients lost 1 pound (0.45 kg) for each standard-deviation improvement in their food environment. This relationship held for persons who remained in the same location throughout the 5-year study period but not among persons who moved. Proximity to food venues that promote nutritious foods alone may not translate into clinically meaningful diet-related health changes. Community-level policies for improving the food environment need multifaceted strategies to invoke clinically meaningful change in BMI among adult patients with diabetes. PMID:28387785

The effect of an automated clinical reminder on weight loss in primary care.

PubMed

O'Grady, Jason S; Thacher, Tom D; Chaudhry, Rajeev

2013-01-01

Overweight and obese individuals have increased health risks. Clinical reminders positively affect health outcomes in diabetes and osteoporosis, but the effect of automated prompts on weight loss in obesity has not been studied. Our objective was to determine whether an automatic prompt for the clinician to recommend lifestyle changes to patients with a body mass index (BMI) >25 kg/m(2) led to greater weight loss over a 3- to 6-month interval compared with the absence of a clinical reminder. We conducted a retrospective analysis of electronic medical records of obese adult patients with a BMI >25 kg/m(2) who were seen in 2009 and 2010, before and after implementation of an automated printed clinical reminder, respectively. We evaluated 1600 patients in each of the control and intervention groups. The primary outcome was the mean change in BMI between the control and intervention groups. Multiple linear regression was used to assess the effect of the clinical reminder on the change in BMI while adjusting for baseline BMI and potential confounding factors. The reduction in BMI (mean ± standard deviation) in the group with the clinical reminder (-0.084 ± 1.56 kg/m(2)) was not significantly greater than the control group (-0.053 ± 1.49 kg/m(2); P = .56). A regression model incorporating the clinical reminder, age, baseline BMI, obesity diagnosis, diabetes, and hyperlipidemia found that baseline BMI (P < .001), obesity diagnosis (P < .001), age (P = .001), and hyperlipidemia diagnosis (P = .02) were significant predictors of weight loss, but the clinical reminder was not (P = .78). There was a significant interaction between the clinical reminder and baseline BMI (P = .005), as the prompt increased weight loss more in those with lower baseline BMI. Automated clinical reminders alone do not improve weight loss in overweight and obese patients. Physician diagnoses of obesity or hyperlipidemia were associated with weight loss, suggesting that formally noting these diagnoses contributes to successful weight loss.

Psychostimulants: Influence on Body Mass Index and Height in a Pediatric Population with Attention-Deficit/Hyperactivity Disorder?

PubMed

Lentferink, Yvette E; van de Garde, Ewoudt M W; Knibbe, Catherijne A J; van der Vorst, Marja M J

2018-05-16

Attention-deficit/hyperactivity disorder (ADHD) is often treated with psychostimulants. Psychostimulants' adverse effects on body mass index standard deviation score (BMI-sds) and height in children/adolescents with ADHD have been reported. However, literature is inconsistent, and it is unclear whether the observed effects are dosage- and/or BMI-dependent. Therefore, the aim of this retrospective observational study is to evaluate the influence of psychostimulants on BMI-sds and height-sds in a pediatric cohort with ADHD from an outpatient clinic, and to study the correlation between psychostimulant dosage and BMI-sds and height-sds change. Participants ≤18 years of age diagnosed with ADHD who started with psychostimulants (methylphenidate) were studied. Changes in BMI-sds and height-sds over an 18-month treatment period were assessed in subgroups according to baseline BMI-sds, gender, and age. Furthermore, correlations between BMI-sds, height-sds, and psychostimulant dose were studied. In total, 298 participants [median age 9.8 years, height-sds 0.0, BMI-sds 0.5, psychostimulant dosage 0.5 (0.2-1.4) mg/kg/day] were analyzed, with an underweight, overweight, and obesity prevalence of 5%, 21%, and 7%, respectively. After 18 months of treatment a significant decline in BMI-sds (-0.4) and height-sds (-0.2) was observed. These effects were consistent in all subgroups except for no change in BMI-sds in the underweight subgroup and no change in height-sds in the overweight subgroup. Medication dosage was weakly correlated with change in BMI-sds [r = -0.3 (-0.9 to +0.5); p < 0.01] and height-sds [r = -0.2 (-0.4 to -0.1); p = 0.01]. After 18 months of psychostimulant treatment, a significant decline in BMI-sds and height-sds was observed. However, the correlation with psychostimulant dosage was weak, and the decline was not observed in all subgroups. Therefore, further studies on the etiology of BMI-change are warranted, particularly with regard to the ADHD symptoms.

Parental weight status and offspring cardiovascular disease risks: a cross-sectional study of Chinese children.

PubMed

McCarthy, Kayne; Ye, Yong-ling; Yuan, Shuai; He, Qi-qiang

2015-01-08

Prevalence of childhood obesity in China is increasing, and parental weight is a risk factor for the development of obesity in children. We examined the relationship of parental body weight status with risk of offspring cardiovascular disease (CVD) in Chinese children. We conducted a cross-sectional study in Wuhan, China, during May and June 2010. Parental body mass index (BMI) was calculated according to self-reported height and weight. Offspring CVD risk factors, including BMI, waist circumference, blood pressure, fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, cardiorespiratory fitness (CRF), and metabolic risk score (MRS), were assessed through anthropometric measures, blood samples, and a CRF test. Multiple linear regression and analysis of covariance were used to examine the effects of maternal and paternal weight status on offspring CVD risks. A total of 580 Chinese children (339 boys and 241 girls, mean [standard deviation] age, 9.6 [0.7] years) participated in the study. Maternal BMI was significantly associated with offspring elevated BMI (β = 0.134, P = .002), waist circumference (β = 0.253, P = .04), and decreased CRF (β = -0.134, P = .01). Paternal BMI was significantly associated with elevated offspring BMI (β = 0.161, P < .001), waist circumference (β = 0.404, P < .001), triglycerides (β = 0.017, P = .03), MRS (β = 0.084, P = .03), and decreased CRF (β = -0.174, P < .001). BMI (P < .001), waist circumference (P < .001), and MRS (P < .05) were positively associated with additional overweight/obese parents, whereas CRF was negatively associated (P < .001). Parental weight status was significantly associated with increased risk of CVD in their children, and the association was stronger for paternal weight status.

The role of obesity measures in the development and persistence of major depressive disorder.

PubMed

Gibson-Smith, Deborah; Bot, Mariska; Paans, Nadine Pg; Visser, Marjolein; Brouwer, Ingeborg; Penninx, Brenda Wjh

2016-07-01

The role of obesity with the development of major depressive disorder (MDD) requires conformation and whether obesity contributes to more chronic depression in persons with established (MDD) is unknown. This study examined the longitudinal relationship of body mass index (BMI) and waist circumference with the incidence and persistence of MDD over 2-year and 6-year periods. Data were sourced from the Netherlands Study of Depression and Anxiety. MDD was established with Composite International Diagnostic Interviews. The relationship of BMI and waist circumference with the development of depression two and six years later were estimated in the subsample with no current psychopathology at baseline. Associations with the persistence of depression was estimated in the subsample with current MDD. Higher BMI at baseline, but not waist circumference, slightly increased the odds of the development of MDD after two years (odds ratio (OR) per standard deviation increase: 1.11; p=0.03), This relationship was not significant after adjustment for health and lifestyle variables. Conversely, over a 6-year period both BMI and waist circumference moderately increased the odds of developing MDD even after adjustment (OR:1.17; p=0.05, OR:1.20; p=0.05). Persistence of MDD in currently depressed subjects, is not related with BMI or waist circumference (adjusted OR:0.93; p=0.2, OR:0.91; p=0.15). Development of depression may differ in participants lost to follow-up. Over a 6 year period, patients with higher BMI show a slightly increased risk of development of depression. However, in depressed patients there is no relationship between BMI and the persistence of depression. Copyright © 2016 Elsevier B.V. All rights reserved.

Psychosocial outcomes in a weight loss camp for overweight youth

PubMed Central

QUINLAN, NICOLE P.; KOLOTKIN, RONETTE L.; FUEMMELER, BERNARD F.; COSTANZO, PHILIP R.

2015-01-01

Objective There is good evidence that youth attending weight loss camps in the UK and US are successful at achieving weight loss. Limited research suggests improvement in body image and self-esteem as well. This study evaluated changes in eight psychosocial variables following participation in a weight loss camp and examined the role of gender, age, length of stay, and body mass index (BMI) in these changes. Methods This was an observational and self-report study of 130 participants (mean age=12.8; mean BMI=33.5; 70% female; 77% Caucasian). The program consisted of an 1 800 kcal/day diet, daily supervised physical activities, cooking/nutrition classes, and weekly psycho-educational/support groups led by psychology staff. Participants completed measures of anti-fat attitudes, values (e.g., value placed on appearance, athletic ability, popularity), body- and self-esteem, weight- and health-related quality of life, self-efficacy, and depressive symptoms. Results Participants experienced significant BMI reduction (average decrease of 7.5 kg [standard deviation, SD=4.2] and 2.9 BMI points [SD=1.4]). Participants also exhibited significant improvements in body esteem, self-esteem, self-efficacy, generic and weight-related quality of life, anti-fat attitudes, and the importance placed on appearance. Changes in self-efficacy, physical functioning and social functioning remained significant even after adjusting for initial zBMI, BMI change, and length of stay. Gender differences were found on changes in self-efficacy, depressive symptoms, and social functioning. Conclusion Participation in weight loss programs in a group setting, such as a camp, may have added benefit beyond BMI reduction. Greater attention to changes in psychosocial variables may be warranted when designing such programs for youth. PMID:19107660

Intake of water from foods, but not water from beverages, is related to lower body mass index and waist circumference in free-living humans [corrected].

PubMed

Murakami, Kentaro; Sasaki, Satoshi; Takahashi, Yoshiko; Uenishi, Kazuhiro

2008-10-01

Experimental trials using test meals suggest that water promotes satiety and decreases subsequent intake, thus possibly working to prevent obesity, when it is consumed as an integral component of a food, but not when consumed alone or alongside a food. We examined the associations of intake of water from beverages and intake of water from foods with body mass index (BMI) and waist circumference in free-living humans consuming self-selected diets. This observational cross-sectional study included 1136 female Japanese dietetic students 18-22 y of age. Dietary intake was assessed with a validated, self-administered, comprehensive, diet-history questionnaire. BMI was calculated using measured body height and weight. Waist circumference was measured at the level of the umbilicus. Means +/- standard deviations of BMI, waist circumference, intake of water from beverages, and intake of water from foods were 21.3 +/- 2.7 kg/m(2), 72.9 +/- 7.1 cm, 569 +/- 318 g/1000 kcal, and 476 +/- 110 g/1000 kcal, respectively. After adjustment for potential confounding factors, intake of water from beverages was not associated with BMI (P for trend = 0.25) or waist circumference (P for trend = 0.43). Conversely, intake of water from foods showed independent and negative associations with BMI (P for trend = 0.030) and waist circumference (P for trend = 0.0003). Intake of water from foods, but not water from beverages, was independently associated with lower BMI and waist circumference in free-living humans consuming self-selected diets.

Obesity and peripheral arterial disease: A Mendelian Randomization analysis.

PubMed

Huang, Ya; Xu, Min; Xie, Lan; Wang, Tiange; Huang, Xiaolin; Lv, Xiaofei; Chen, Ying; Ding, Lin; Lin, Lin; Wang, Weiqing; Bi, Yufang; Sun, Yimin; Zhang, Yifei; Ning, Guang

2016-04-01

Observational studies showed that obesity is a major risk factor for peripheral arterial disease (PAD). However, conventional epidemiology studies are vulnerable to residual bias from confounding factors. We aimed to explore the causality of obesity in development of PAD using Mendelian Randomization (MR) approach. A MR analysis was performed in 11,477 community-dwelling adults aged 40 years and above recruited from two nearby communities during 2011-2013 in Shanghai, China. We genotyped 14 body mass index (BMI) associated common variants identified and validated in East Asians. PAD was defined as ankle-to-brachial index (ABI) <0.90 or >1.40. Weighted BMI genetic risk score (GRS) was used as the Instrumental Variable (IV). After adjusted for confounding factors, we found that each standard deviation (SD, 2.76 points) increase in BMI-GRS was associated with 0.43 (95% confidence interval [CI]: 0.36-0.49) kg/m(2) increase in BMI (P < 0.0001) and an odds ratio (OR) for PAD of 1.17 (95% CI: 1.07-1.27; P = 0.0004). Compared with the lowest quartile of BMI-GRS, the second, third and highest quartile associated with 9%, 19% and 45% increment of PAD risk, respectively (P for trend = 0.002). In the MR analysis, we demonstrated a causal relationship between obesity and PAD (OR = 1.44 per BMI-unit, 95% CI: 1.18-1.75; P = 0.0003). This study suggested that obesity may be causally associated with PAD after controlling for the potential intermediate factors like hypertension, dyslipidemia and hyperglycemia. Copyright © 2016. Published by Elsevier Ireland Ltd.

Associations between body mass index-related genetic variants and adult body composition: the Fenland cohort study

PubMed Central

Clifton, Emma A D; Day, Felix R; De Lucia Rolfe, Emanuella; Forouhi, Nita G; Brage, Soren; Griffin, Simon J; Wareham, Nicholas J; Ong, Ken K

2016-01-01

Background/Objective Body mass index (BMI) is a surrogate measure of adiposity but does not distinguish fat from lean or bone mass. The genetic determinants of BMI are thought to predominantly influence adiposity but this has not been confirmed. Here we characterise the association between BMI-related genetic variants and body composition in adults. Subjects/Methods Among 9667 adults aged 29-64 years from the Fenland study, a genetic risk score for BMI (BMI-GRS) was calculated for each individual as the weighted sum of BMI-increasing alleles across 96 reported BMI-related variants. Associations between the BMI-GRS and body composition, estimated by DXA scans, were examined using age-adjusted linear regression models, separately by sex. Results The BMI-GRS was positively associated with all fat, lean and bone variables. Across body regions, associations of the greatest magnitude were observed for adiposity variables e.g. for each standard deviation (SD) increase in BMI-GRS predicted BMI, we observed a 0.90 SD (95% CI: 0.71, 1.09) increase in total fat mass for men (P=3.75×10−21) and a 0.96 SD (95% CI: 0.77, 1.16) increase for women (P=6.12×10−22). Associations of intermediate magnitude were observed with lean variables e.g. total lean mass: men: 0.68 SD (95% CI: 0.49, 0.86) (P=1.91×10−12); women: 0.85 SD (95% CI: 0.65, 1.04) (P=2.66×10−17) and of a lower magnitude with bone variables e.g. total bone mass: men: 0.39 SD (95% CI: 0.20, 0.58) (P=5.69×10−5); women: 0.45 SD (95% CI: 0.26, 0.65) (P=3.96×10−6). Nominally significant associations with BMI were observed for 28 SNPs. All 28 were positively associated with fat mass and 13 showed adipose-specific effects. Conclusion In adults, genetic susceptibility to elevated BMI influences adiposity more than lean or bone mass. This mirrors the association between BMI and body composition. The BMI-GRS can be used to model the effects of measured BMI and adiposity on health and other outcomes. PMID:28096530

The associations of anthropometric measurements with subsequent gestational diabetes in Aboriginal women.

PubMed

Sina, Maryam; Hoy, Wendy E; Callaway, Leonie; Wang, Zhiqiang

2015-01-01

To evaluate the associations of different anthropometric measurements on earlier exam with subsequent gestational diabetes mellitus (GDM) in Aboriginal women. This is a nested case-control study. Anthropometric measurements were conducted at baseline from 1992 to 1995 in a remote Aboriginal community. All subsequent pregnancies among the original participants were identified through review of hospital records of 20 years. Thirty-two women developed GDM and 99 women were hospitalised for pregnancy-related conditions other than GDM. The association between body mass index (BMI), weight, height, waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio with subsequent GDM was examined. Our results showed an increased risk of GDM with increase in one standard deviation of BMI (OR=2.0; 95% CI: 1.3, 3.1), weight (OR=1.7; 95% CI: 1.1, 2.7), waist circumference (OR=1.8; 95% CI: 1.1, 3.0) and waist-to-height ratio (OR=2.3; 95% CI: 1.4, 3.9). High BMI (BMI≥25kg/m(2)) was associated with subsequent GDM (OR=2.8; 95% CI: 1.0, 7.8). BMI and waist-to-height ratio are better predictors than other anthropometric indices of GDM in Aboriginal women. Given that these measures are associated with future GDM, interventions to reduce BMI, weight and waist circumference in young women need to be assessed for their potential to prevent GDM. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Somatic complaints and social competence predict success in childhood overweight treatment.

PubMed

de Niet, Judith; Timman, Reinier; Rokx, Casper; Jongejan, Mieke; Passchier, Jan; van Den Akker, Erica

2011-06-01

To determine baseline predictors of treatment success in terms of Body Mass Index-Standard Deviation Scores (BMI-SDS) in a multidisciplinary family-based behavioural lifestyle intervention for overweight and obese children. Overweight and obese children (N = 248; age 8-14 years) and their caregivers participated in a prospective study and attended a lifestyle intervention. Baseline data assessment included anthropometrics, demographics, breakfast behaviour, competence and behavioural problems (Child Behaviour Checklist [CBCL]), family functioning (Family Adaptability and Cohesion Evaluation Scales [FACES] III), and personality (Dutch Personality Questionnaire-Youth [NPV-J]). BMI-SDS was measured at start and after 3, 9, and 12 months of treatment. Mixed modelling was used for analysis. Greater BMI-SDS reductions over the course of one year were found in children with Caucasian parents, with lower baseline BMI-SDS, and higher CBCL-social competence scores. Furthermore, children with non-overweight parents, younger children, and children with lower CBCL-somatic scores were more successful in BMI-SDS reduction. No effects on treatment success were found for the number or position of siblings, having divorced parents or a working mother, educational level of the parents, breakfast behaviour, family functioning, and personality. These results suggest that screening for baseline characteristics in childhood obesity treatment could identify who will benefit most from a paediatric lifestyle intervention. Tailored programs should be developed and the treatment team should focus on children who are less successful in achieving weight reductions. Future research should study by which mechanisms somatic complaints and social competence influence treatment success.

Associations Between Adolescents' Weight and Maladjustment Differ With Deviation From Weight Norms in Social Contexts.

PubMed

Sutter, Carolyn; Nishina, Adrienne; Witkow, Melissa R; Bellmore, Amy

2016-09-01

In line with the reflected self-appraisal hypothesis, previous research finds associations between weight and maladjustment are strongest when there is a mismatch between individuals' weight and the weight norm of their social contexts. However, research has not considered associations in more proximal social contexts. We examined differences in associations between weight and maladjustment for 2 proximal social contexts: grade-level peers and friendship groups. We used sixth-graders (N = 565; Mage  = 12 years) self-reported height and weight (used to calculate body mass index (BMI) z-score), experiences of peer victimization, and depressive symptoms. Deviation from the normative weight was calculated as the students' BMI z-score minus the average BMI z-score for the context (grade-level peers or friendship group). Considering deviations from grade-level peers, greater BMI z-scores were associated with more self-reported peer victimization only for students above the weight norm. For the friendship group, greater weight was associated with more self-reported depressive symptoms only for those who were above the normative weight. Being heavier during adolescence may be especially problematic for students who differ from the norm in their proximal social contexts. Intervention efforts focused on weight and maladjustment may want to consider the contexts involved in adolescents' self-appraisals. © 2016, American School Health Association.

The effect of intraoperative administration of dexamethasone for PONV prophylaxis on perioperative blood glucose level in obese and normal weight children.

PubMed

Gnatzy, Richard; Hempel, Gunther; Kaisers, Udo X; Höhne, Claudia

2015-11-01

The incidence of postoperative nausea and vomiting (PONV) can be reduced by dexamethasone. Single-dose administration may cause elevated blood glucose levels in obese adults. No data are available for children. The aim was to evaluate perioperative blood glucose changes related to body weight in children who received dexamethasone. This prospective observational study included 62 children. All patients received total intravenous anesthesia and a single dose of dexamethasone (0.15 mg/kg, maximum 8 mg). Blood glucose levels were measured up to 6 h. Standard deviation scores (SDS) were calculated using age- and gender-specific body mass index (BMI) percentiles, p<0.05. A total of 62 children (11.5±2.9 years, median SDS 0.43, 29% overweight/obese) were included. Blood glucose levels increased from 5.52±0.52 to 6.74±0.84 mmol/L 6 h after dexamethasone without correlation to the BMI-SDS. This study showed an increase of perioperative blood glucose (normoglycemic ranges) after single dose of dexamethasone, but no BMI-dependent effect was observed in children. Therefore, low-dose dexamethasone may be used in obese children for PONV prophylaxis.

Increased augmentation index and central systolic arterial pressure are associated with lower school and motor performance in young adolescents.

PubMed

Vogrin, Bernarda; Slak Rupnik, Marjan; Mičetić-Turk, Dušanka

2017-12-01

Objective In adults, improper arterial function has been linked to cognitive impairment. The pulse wave velocity (PWV), augmentation index (AIx) and other vascular parameters are useful indicators of arterial health. In our study, we monitored arterial properties, body constitution, school success, and motor skills in young adolescents. We hypothesize that reduced cognitive and motor abilities have a vascular origin in children. Methods We analysed 81 healthy school children aged 11-16 years. Anthropometry central systolic arterial pressure, body mass index (BMI), standard deviation scores (SDS) BMI, general school performance grade, and eight motor tests were assessed. PWV, AIx, and central systolic arterial pressure (SBPao) were measured. Results AIx and SBPao correlated negatively with school performance grades. Extremely high AIx, PWV and SBPao values were observed in 5% of children and these children had average to low school performance. PWV correlated significantly with weight, height, and waist and hip circumference. AIx, PWV, school success, and BMI correlated strongly with certain motor functions. Conclusions Increased AIx and SBPao are associated with lower school and motor performance in children. PWV is influenced by the body's constitution.

Meal patterns among children and adolescents and their associations with weight status and parental characteristics.

PubMed

Würbach, Ariane; Zellner, Konrad; Kromeyer-Hauschild, Katrin

2009-08-01

To describe the meal patterns of Jena schoolchildren and their associations with children's weight status and parental characteristics. Cross-sectional study. Twenty schools in Jena (100,000 inhabitants), south-east Germany. A total of 2054 schoolchildren aged 7-14 years with information on BMI standard deviation score (BMI-SDS) and weight status (based on German reference values), of whom 1571 had additional information about their parents (parental education and employment status, weight status according to WHO guidelines) and meal patterns (school lunch participation rate, meal frequencies, breakfast consumption and frequency of family meals). Weight status of the children was associated with weight status, education and employment status of the parents. Meal patterns were strongly dependent on children's age and parental employment. As age increased, the frequency of meal consumption, participation rate in school lunches and the number of family meals decreased. Using linear regression analysis, a high inverse association between BMI-SDS and meal frequency was observed, in addition to relationships with parental weight status and paternal education. Age-specific prevention programmes should encourage greater meal frequency. The close involvement of parents is essential in any strategy for improving children's (families') diets.

Anthropometric data as predictors of Obstructive Sleep Apnea Severity.

PubMed

Pinto, José Antonio; Godoy, Luciana Ballester de Mello; Marquis, Valéria Wanderley Pinto Brandão; Sonego, Thiago Branco; Leal, Carolina de Farias Aires; Artico, Marina Spadari

2011-01-01

The Obstructive Sleep Apnea Syndrome is a chronic disease characterized by episodes upper airway collapse, and has been associated with increased cardiovascular morbidity. To correlate the neck, abdominal and pelvic circumference with the AHI and oxyhemoglobin saturation in OSA patients, and to correlate these values with disease severity. A prospective descriptive study of 82 patients evaluated complaints suggesting OSA, from July 2008 to March 2010. All patients underwent polysomnography, an ENT clinical exam, measures of the BMI, abdominal, pelvic, and cervical circumferences. The mean, standard deviations and Spearman's correlations were analyzed. The mean AHI in men was 39 events/hr; in women it was 21 events/hr in women. The mean neck circumference was 34. 5 cm in women and 41. 3 cm in men, the mean abdominal circumference was 94. 3 cm in women and 101. 5 cm in men, and the pelvic circumference was 105. 7 cm in men and 108. 7 cm in women. The neck circumference correlated more closely to the AHI in men (r = + 0. 389 p = 0. 001). The relationship between the abdominal circumference correlated more with AHI than with the BMI in men (AbC r = + 0. 358 p = 0. 003 BMI r = + 0. 321 p = 0. 009). The neck circumference is the best anthropometric measurement of respiratory disorder severity compared to the AbC or the BMI.

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity.

PubMed

Trier, C; Fonvig, C E; Bøjsøe, C; Mollerup, P M; Gamborg, M; Pedersen, O; Hansen, T; Holm, J-C

2016-12-01

Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity. The aim of the present study was to assess whether the intake of sweetened beverages, candy, snacks or fast food at baseline in a multidisciplinary childhood obesity treatment program was associated with the baseline degree of obesity or the treatment effect. This prospective study included 1349 overweight and obese children (body mass index standard deviation scores (BMI SDS) ≥ 1.64) enrolled in treatment at The Children's Obesity Clinic, Copenhagen University Hospital Holbaek. The children were evaluated at baseline and after up to 5.9 years of treatment (median 1.3 years). Both boys and girls decreased their BMI SDS during treatment with a mean decrease in boys of 0.35 (p < 0.0001) and in girls of 0.22 (p < 0.0001) after 1 year of treatment. There were no associations between the baseline intake of sweetened beverages, candy, snacks, and/or fast food and BMI SDS at baseline or the change in BMI SDS during treatment. The intake of sweetened beverages, candy, snacks or fast food when entering a childhood obesity treatment program was not associated with the degree of obesity at baseline or the degree of weight loss during treatment. © 2016 World Obesity Federation.

Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism.

PubMed

Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C

2018-04-01

Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P  = 0.02; respectively). Systolic blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.

Effects of a Family-Based Childhood Obesity Treatment Program on Parental Weight Status.

PubMed

Trier, Cæcilie; Dahl, Maria; Stjernholm, Theresa; Nielsen, Tenna R H; Bøjsøe, Christine; Fonvig, Cilius E; Pedersen, Oluf; Hansen, Torben; Holm, Jens-Christian

2016-01-01

The aim of this study was to investigate the prevalence of overweight/obesity among parents of children entering childhood obesity treatment and to evaluate changes in the parents' weight statuses during their child's treatment. The study included parents of 1,125 children and adolescents aged 3-22 years, who were enrolled in a multidisciplinary childhood obesity treatment program. At baseline, weight and height of the parents were obtained by self-reported information and parental body mass index (BMI) was calculated. Weight and height of the children were measured in the clinic and BMI standard deviation scores were calculated. Furthermore, anthropometric data from parents of 664 children were obtained by telephone interview after a mean of 2.5 years of treatment (ranging 16 days to 7 years), and changes in parental BMI were analyzed. Data on changes in BMI were available in 606 mothers and 479 fathers. At baseline, the median BMI of the mothers was 28.1 kg/m2 (range: 16.9-66.6), and the median BMI of the fathers was 28.9 kg/m2 (range: 17.2-48.1). Seventy percent of the mothers and 80% of the fathers were overweight or obese at the time of their child's treatment initiation. Both the mothers and fathers lost weight during their child's treatment with a mean decrease in BMI in the mothers of 0.5 (95% CI: 0.2-0.8, p = 0.0006) and in the fathers of 0.4 (95% CI: 0.2-0.6, p = 0.0007). Of the overweight/obese parents, 60% of the mothers and 58% of the fathers lost weight during their child's treatment. There is a high prevalence of overweight/obesity among parents of children entering childhood obesity treatment. Family-based childhood obesity treatment with a focus on the child has a positive effect on parental BMI with both mothers and fathers losing weight. ClinicalTrials.gov NCT00928473.

Dental caries is negatively correlated with body mass index among 7-9 years old children in Guangzhou, China.

PubMed

Liang, Jing-Jing; Zhang, Zhe-Qing; Chen, Ya-Jun; Mai, Jin-Cheng; Ma, Jun; Yang, Wen-Han; Jing, Jin

2016-07-26

Evidence linking caries in primary dentition and children's anthropometric measures is contradictory. We aimed to evaluate the prevalence of primary dental caries and its relationship with body mass index (BMI) among 7-9 years old school children in urban Guangzhou, China. This cross-sectional study enrolled 32,461 pupils (14,778 girls and 17,683 boys) aged 7-9 years from 65 elementary schools in Guangzhou. Dental caries was detected according to criteria recommended by the World Health Organization (WHO). The total mean decayed, missing or filled teeth (dmft) of primary dentition were assessed. Weight and height were measured and BMI was calculated. Children were classified into underweight, normal weight, overweight and obesity groups by BMI based on Chinese criteria. Z-score of BMI-for-age (BAZ) was calculated by WHO standardized procedure. Multivariable odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using logistic regression. Restricted cubic spline regression was applied to evaluate the shape of the relationship between BAZ and primary dental caries. The prevalence of primary dental caries was 30.7 % in total sample. Regarding dmft values, the mean ± standard deviation (SD) in the combined sample were 1.03 ± 2.05 in boys and 0.93 ± 1.92 in girls. Both indices decreased by age. Compared with normal BMI group, children in overweight and obesity groups have 27 % (OR = 0.73, 95 % CI: 0.66-0.81, P < 0.0001) and 34 % (OR = 0.66, 95 % CI: 0.59-0.74, P < 0.0001) lower odds for the presence of primary dental caries after adjustment for age and gender, respectively. Although in general, increased BAZ was associated with decreased risk of dental caries, full-range BAZ was associated with dental caries in an A-shaped manner with a zenith at around -1.4. Higher BMI was associated with lower odds of caries; overweight and obese children were more likely to be primary dental caries free among 7-9 years in Guangzhou, China.

Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring's birth weight and subcutaneous fat: a population-based cohort study.

PubMed

Sommer, Christine; Sletner, Line; Mørkrid, Kjersti; Jenum, Anne Karen; Birkeland, Kåre Inge

2015-04-03

Maternal glucose and lipid levels are associated with neonatal anthropometry of the offspring, also independently of maternal body mass index (BMI). Gestational weight gain, however, is often not accounted for. The objective was to explore whether the effects of maternal glucose and lipid levels on offspring's birth weight and subcutaneous fat were independent of early pregnancy BMI and mid-gestational weight gain. In a population-based, multi-ethnic, prospective cohort of 699 women and their offspring, maternal anthropometrics were collected in gestational week 15 and 28. Maternal fasting plasma lipids, fasting and 2-hour glucose post 75 g glucose load, were collected in gestational week 28. Maternal risk factors were standardized using z-scores. Outcomes were neonatal birth weight and sum of skinfolds in four different regions. Mean (standard deviation) birth weight was 3491 ± 498 g and mean sum of skinfolds was 18.2 ± 3.9 mm. Maternal fasting glucose and HDL-cholesterol were predictors of birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain as well as early pregnancy BMI, gestational week at inclusion, maternal age, parity, smoking status, ethnic origin, gestational age and offspring's sex. However, weight gain was the strongest independent predictor of both birth weight and neonatal sum of skinfolds, with a 0.21 kg/week increased weight gain giving a 110.7 (95% confidence interval 76.6-144.9) g heavier neonate, and with 0.72 (0.38-1.06) mm larger sum of skinfolds. The effect size of mother's early pregnancy BMI on birth weight was higher in non-Europeans than in Europeans. Maternal fasting glucose and HDL-cholesterol were predictors of offspring's birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain. Mid-gestational weight gain was a stronger predictor of both birth weight and neonatal sum of skinfolds than early pregnancy BMI, maternal glucose and lipid levels.

Retarded head growth and neurocognitive development in infants of mothers with a history of eating disorders: longitudinal cohort study.

PubMed

Koubaa, S; Hällström, T; Hagenäs, L; Hirschberg, A L

2013-10-01

To characterise early growth and neurocognitive development in children of mothers with a history of eating disorders (ED). A longitudinal cohort study. Child-care centres in Stockholm, Sweden. Children born to mothers with previous ED (n = 47) (24 anorexia nervosa, 20 bulimia nervosa, 3 unspecified ED), and controls (n = 65). Mean values and standard deviation scores of weight and height from birth to 5 years of age and head circumference up to 18 months of age were compared between groups. Neurocognitive development was studied at the age of 5 years by the validated parent questionnaire Five to Fifteen. Head growth and neurocognitive development. We previously reported that mothers with a history of ED conceived infants with lower birthweight and head circumference than controls. At 3 months of age, body mass index (BMI) was no longer reduced but mean head circumferences of the children born to mothers with ED were smaller throughout the observation period. Similarly, the longitudinal results of the standard deviation scores of head circumference showed a significant overall group effect with lower levels in both subgroups of ED (anorexia nervosa and bulimia nervosa). The children of the ED mothers also had significantly higher Five to Fifteen scores than controls, reflecting difficulties in language skills. Head circumference at birth correlated with language skills in the children of mothers with ED. Children of mothers with previous ED demonstrated an early catch-up in BMI, but the average head circumference continued to be delayed until at least 18 months of age. The reduced head growth was related to delayed neurocognitive development. © 2013 RCOG.

Quality of life improves in children and adolescents during a community-based overweight and obesity treatment.

PubMed

Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine; Kloppenborg, Julie T; Baker, Jennifer L; Holm, Jens-Christian

2017-06-01

The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree of obesity. Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys) completed another PedsQL after a median of 13 months of treatment. Quality of life improved (p < 0.001), regardless of sex, age, and pubertal development stage upon entry (p ≥ 0.108). Greater reductions in BMI SDS and high socioeconomic status were associated with greater improvements in the quality of life (p ≤ 0.047). However, improvements also occurred in children and adolescents with low socioeconomic status or who increased their BMI SDS (p < 0.001). Improvements in quality of life occurred in children and adolescents during a community-based overweight and obesity treatment, even in children and adolescents who increased their BMI SDS. Thus, improvements may be due to the treatment itself and not exclusively to reductions in BMI SDS. Clinicaltrials.gov, ID-no.: NCT02013843.

Biologic Agents Are Associated with Excessive Weight Gain in Children with Inflammatory Bowel Disease.

PubMed

Haas, Leonard; Chevalier, Rachel; Major, Brittny T; Enders, Felicity; Kumar, Seema; Tung, Jeanne

2017-11-01

Children with active inflammatory bowel disease (IBD) are frequently underweight. Anti-tumor necrosis factor (anti-TNF) agents may induce remission and restore growth. However, its use in other autoimmune diseases has been associated with excess weight gain. Our aim was to examine whether children with IBD could experience excess weight gain. A centralized diagnostic index identified pediatric IBD patients evaluated at our institution who received anti-TNF therapy for at least 1 year between August 1998 and December 2013. Anthropometric data were collected at time of anti-TNF initiation and annually. Excess weight gain was defined as ΔBMI SDS (standard deviation score) where patients were (1) reclassified from "normal" to "overweight/obese," (2) "overweight" to "obese," or (2) a final BMI SDS >0 and ΔSDS >0.5. During the study period, 268 children received anti-TNF therapy. Of these, 69 had sufficient follow-up for a median of 29.3 months. Median age at first anti-TNF dose was 12.8 years. At baseline, mean weight SDS was -0.7 (SD 1.4), while mean BMI SDS was -0.6 (1.3). Using baseline BMI SDS, 11.6% were overweight/obese. At last follow-up (LFU), however, the mean ΔBMI SDS was 0.50 (p < 0.0001). However, 10 (17%) patients had excess weight gain at LFU; 3 patients were reclassified from "normal" to "obese," and 7 had a final BMI SDS >0 and ΔSDS >0.5. Pediatric patients with IBD may experience excess weight gain when treated with anti-TNF agents. Monitoring for this side effect is warranted.

Hair Cortisol Concentrations in Adolescent Girls with Anorexia Nervosa are Lower Compared to Healthy and Psychiatric Controls.

PubMed

Föcker, Manuel; Stalder, Tobias; Kirschbaum, Clemens; Albrecht, Muriel; Adams, Frederike; de Zwaan, Martina; Hebebrand, Johannes; Peters, Triinu; Albayrak, Özgür

2016-11-01

In anorexia nervosa (AN) hypercortisolism has been described using urine, plasma and saliva samples as short-term markers for the hypothalamic-pituitary-adrenal (HPA)-axis. Here, for the first time, we analyse hair cortisol concentration (HCC) as a marker for long-term integrated cortisol secretion in female patients with AN compared to female healthy controls (HC) and female psychiatric controls (PC). HCC was assessed in 22 female adolescent psychiatric inpatients with AN compared to 20 female HC and to 117 female PC of the same age range. For further analyses we examined the associations of age and body mass index (BMI) with HCC. Log HCC was lower in AN-patients compared to HC (p = 0.030). BMI-standard deviation scores (SDS) but not age correlated with log HCC (BMI-SDS: r = 0.19, bias corrected accelerated 95% confidence interval: [.04, .34], p = 0.015; age: r = 0.10, bias corrected accelerated 95% confidence interval: [-.07, .25], p = 0.213) when combining AN, HC and PC samples. We find lower HCC in AN, compared to HC and PC, respectively. Based on the relationship between HCC and BMI-SDS across AN, HC and PC, we argue that HCC might not capture endocrine alterations because of AN pathology-related processes but rather shows consistent relationships with BMI, which extent even to the very low range of BMI values, as present in AN patients. Alternatively, incorporation of cortisol into the hair follicle might have been compromised because of trophic hair follicle disturbances that had been reported in AN patients, previously. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

An Evaluation of a Smartphone–Assisted Behavioral Weight Control Intervention for Adolescents: Pilot Study

PubMed Central

Duncombe, Kristina M; Lott, Mark A; Hunsaker, Sanita L; Duraccio, Kara M; Woolford, Susan J

2016-01-01

Background The efficacy of adolescent weight control treatments is modest, and effective treatments are costly and are not widely available. Smartphones may be an effective method for delivering critical components of behavioral weight control treatment including behavioral self-monitoring. Objective To examine the efficacy and acceptability of a smartphone assisted adolescent behavioral weight control intervention. Methods A total of 16 overweight or obese adolescents (mean age=14.29 years, standard deviation=1.12) received 12 weeks of combined treatment that consisted of weekly in-person group behavioral weight control treatment sessions plus smartphone self-monitoring and daily text messaging. Subsequently they received 12 weeks of electronic-only intervention, totaling 24 weeks of intervention. Results On average, participants attained modest but significant reductions in body mass index standard score (zBMI: 0.08 standard deviation units, t (13)=2.22, P=.04, d=0.63) over the in-person plus electronic-only intervention period but did not maintain treatment gains over the electronic-only intervention period. Participants self-monitored on approximately half of combined intervention days but less than 20% of electronic-only intervention days. Conclusions Smartphones likely hold promise as a component of adolescent weight control interventions but they may be less effective in helping adolescents maintain treatment gains after intensive interventions. PMID:27554704

Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations.

PubMed

Nielsen, Tenna Ruest Haarmark; Fonvig, Cilius Esmann; Dahl, Maria; Mollerup, Pernille Maria; Lausten-Thomsen, Ulrik; Pedersen, Oluf; Hansen, Torben; Holm, Jens-Christian

2018-01-01

The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during childhood obesity treatment. 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6-21.7), and median BMI SDS 2.8 (range 1.3-5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0.4-7.4). Height and weight, body composition measured by dual-energy X-ray absorptiometry, and fasting plasma lipid concentrations were assessed at baseline and at follow-up. Lipid concentrations (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, and triglycerides (TG)) were available in 469 individuals (264 girls). Linear regressions were performed to investigate the associations between BMI SDS, body composition indices, and lipid concentrations. At baseline, BMI SDS was negatively associated with concentrations of HDL (p = 6.7*10-4) and positively with TG (p = 9.7*10-6). Reductions in BMI SDS were associated with reductions in total body fat percentage (p<2*10-16) and percent truncal body fat (p<2*10-16). Furthermore, reductions in BMI SDS were associated with improvements in concentrations of TC, LDL, HDL, non-HDL, LDL/HDL-ratio, and TG (all p <0.0001). Changes in body fat percentage seemed to mediate the changes in plasma concentrations of TC, LDL, and non-HDL, but could not alone explain the changes in HDL, LDL/HDL-ratio or TG. Among 81 individuals with available lipid concentrations, who increased their BMI SDS, 61% improved their body composition, and 80% improved their lipid concentrations. Reductions in the degree of obesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition and lipid concentrations may improve.

Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations

PubMed Central

Fonvig, Cilius Esmann; Dahl, Maria; Mollerup, Pernille Maria; Lausten-Thomsen, Ulrik; Pedersen, Oluf; Hansen, Torben; Holm, Jens-Christian

2018-01-01

Objective The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during childhood obesity treatment. Methods 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6–21.7), and median BMI SDS 2.8 (range 1.3–5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0.4–7.4). Height and weight, body composition measured by dual-energy X-ray absorptiometry, and fasting plasma lipid concentrations were assessed at baseline and at follow-up. Lipid concentrations (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, and triglycerides (TG)) were available in 469 individuals (264 girls). Linear regressions were performed to investigate the associations between BMI SDS, body composition indices, and lipid concentrations. Results At baseline, BMI SDS was negatively associated with concentrations of HDL (p = 6.7*10−4) and positively with TG (p = 9.7*10−6). Reductions in BMI SDS were associated with reductions in total body fat percentage (p<2*10−16) and percent truncal body fat (p<2*10−16). Furthermore, reductions in BMI SDS were associated with improvements in concentrations of TC, LDL, HDL, non-HDL, LDL/HDL-ratio, and TG (all p <0.0001). Changes in body fat percentage seemed to mediate the changes in plasma concentrations of TC, LDL, and non-HDL, but could not alone explain the changes in HDL, LDL/HDL-ratio or TG. Among 81 individuals with available lipid concentrations, who increased their BMI SDS, 61% improved their body composition, and 80% improved their lipid concentrations. Conclusion Reductions in the degree of obesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition and lipid concentrations may improve. PMID:29444114

A 52-Week Study of Olanzapine with a Randomized Behavioral Weight Counseling Intervention in Adolescents with Schizophrenia or Bipolar I Disorder.

PubMed

Detke, Holland C; DelBello, Melissa P; Landry, John; Hoffmann, Vicki Poole; Heinloth, Alexandra; Dittmann, Ralf W

2016-12-01

To evaluate the 52-week safety/tolerability of oral olanzapine for adolescents with schizophrenia or bipolar mania and compare effectiveness of a standard versus intense behavioral weight intervention in mitigating risk of weight gain. Patients 13-17 years old with schizophrenia (Brief Psychiatric Rating Scale for Children [BPRS-C] total score >30; item score ≥3 for hallucinations, delusions, or peculiar fantasies) or bipolar I disorder (manic or mixed episode; Young Mania Rating Scale [YMRS] total score ≥15) received open-label olanzapine (2.5-20 mg/day) and were randomized to standard (n = 102; a single weight counseling session) or intense (n = 101; weight counseling at each study visit) weight intervention. The primary outcome measure was mean change in body mass index (BMI) from baseline to 52 weeks using mixed-model repeated measures. Symptomatology was also assessed. No statistically significant differences between groups were observed in mean baseline-to-52-week change in BMI (standard: +3.6 kg/m 2 ; intense: +2.8 kg/m 2 ; p = 0.150) or weight (standard: +12.1 kg; intense: +9.6 kg; p = 0.148). Percentage of patients at endpoint who had gained ≥15% of their baseline weight was 40% for the standard group and 31% for the intense group (p = 0.187). Safety/tolerability results were generally consistent with those of previous olanzapine studies in adolescents, with the most notable exception being the finding of a mean decrease in prolactin. On symptomatology measures, patients with schizophrenia had a mean baseline-to-52-week change in BPRS-C of -32.5 (standard deviation [SD] = 10.8), and patients with bipolar disorder had a mean change in YMRS of -16.7 (SD = 8.9), with clinically and statistically significant improvement starting at 3-4 days for each. Long-term weight gain was high in both groups, with no statistically significant differences between the standard or intense behavioral weight interventions in BMI or weight. Safety, tolerability, and effectiveness findings were generally consistent with the known profile of olanzapine in adolescents.

Body mass index and body composition in adolescents treated with gonadotropin-releasing hormone analogue triptorelin depot for central precocious puberty: data at near final height.

PubMed

Chiocca, Elena; Dati, Eleonora; Baroncelli, Giampiero I; Mora, Stefano; Parrini, Donatella; Erba, Paola; Bertelloni, Silvano

2009-01-01

In children with central precocious puberty (CPP), gonadotropin-releasing hormone (GnRH) analogue treatment has been associated with an increase in body mass index (BMI). We evaluated BMI and body composition in adolescents treated with GnRH analogue at their near final height to assess the long-term effects of therapy on these parameters. We studied 20 patients (14.8 +/- 1.6 years; 17 females) previously treated with triptorelin depot for CPP (3.75 mg/28 days) from 8.1 +/- 0.8 to 11.5 +/- 0.8 years. 23 healthy adolescents with normal onset of puberty (14.7 +/- 2.1 years, 19 females) were the controls. BMI and body composition (dual-energy x-ray absorptiometry) were assessed. Patients reached their near adult height (-0.5 +/- 1.1 standard deviation score (SDS)); the girls were menstruating and the majority (15/17) had regular cycles, the boys showed normal testicular function. BMI was unchanged from the start of GnRH analogue therapy (0.4 +/- 1.0 SDS) to near adult height (0.2 +/- 1.0 SDS, p = NS vs. 0). Total fat mass (TFM) was significantly increased (16,144 +/- 8,065 g; controls 10,712.1 +/- 4,120.4 g, p < 0.02); glucose homeostasis and lipid profile corresponded to reference ranges. GnRH analogue therapy did not show long-term detrimental effects on BMI, but it may increase TFM, suggesting that body composition should be monitored till adulthood. Copyright 2009 S. Karger AG, Basel.

Causal Associations of Adiposity and Body Fat Distribution With Coronary Heart Disease, Stroke Subtypes, and Type 2 Diabetes Mellitus: A Mendelian Randomization Analysis.

PubMed

Dale, Caroline E; Fatemifar, Ghazaleh; Palmer, Tom M; White, Jon; Prieto-Merino, David; Zabaneh, Delilah; Engmann, Jorgen E L; Shah, Tina; Wong, Andrew; Warren, Helen R; McLachlan, Stela; Trompet, Stella; Moldovan, Max; Morris, Richard W; Sofat, Reecha; Kumari, Meena; Hyppönen, Elina; Jefferis, Barbara J; Gaunt, Tom R; Ben-Shlomo, Yoav; Zhou, Ang; Gentry-Maharaj, Aleksandra; Ryan, Andy; Mutsert, Renée de; Noordam, Raymond; Caulfield, Mark J; Jukema, J Wouter; Worrall, Bradford B; Munroe, Patricia B; Menon, Usha; Power, Chris; Kuh, Diana; Lawlor, Debbie A; Humphries, Steve E; Mook-Kanamori, Dennis O; Sattar, Naveed; Kivimaki, Mika; Price, Jacqueline F; Davey Smith, George; Dudbridge, Frank; Hingorani, Aroon D; Holmes, Michael V; Casas, Juan P

2017-06-13

The implications of different adiposity measures on cardiovascular disease etiology remain unclear. In this article, we quantify and contrast causal associations of central adiposity (waist-to-hip ratio adjusted for body mass index [WHRadjBMI]) and general adiposity (body mass index [BMI]) with cardiometabolic disease. Ninety-seven independent single-nucleotide polymorphisms for BMI and 49 single-nucleotide polymorphisms for WHRadjBMI were used to conduct Mendelian randomization analyses in 14 prospective studies supplemented with coronary heart disease (CHD) data from CARDIoGRAMplusC4D (Coronary Artery Disease Genome-wide Replication and Meta-analysis [CARDIoGRAM] plus The Coronary Artery Disease [C4D] Genetics; combined total 66 842 cases), stroke from METASTROKE (12 389 ischemic stroke cases), type 2 diabetes mellitus from DIAGRAM (Diabetes Genetics Replication and Meta-analysis; 34 840 cases), and lipids from GLGC (Global Lipids Genetic Consortium; 213 500 participants) consortia. Primary outcomes were CHD, type 2 diabetes mellitus, and major stroke subtypes; secondary analyses included 18 cardiometabolic traits. Each one standard deviation (SD) higher WHRadjBMI (1 SD≈0.08 U) associated with a 48% excess risk of CHD (odds ratio [OR] for CHD, 1.48; 95% confidence interval [CI], 1.28-1.71), similar to findings for BMI (1 SD≈4.6 kg/m 2 ; OR for CHD, 1.36; 95% CI, 1.22-1.52). Only WHRadjBMI increased risk of ischemic stroke (OR, 1.32; 95% CI, 1.03-1.70). For type 2 diabetes mellitus, both measures had large effects: OR, 1.82 (95% CI, 1.38-2.42) and OR, 1.98 (95% CI, 1.41-2.78) per 1 SD higher WHRadjBMI and BMI, respectively. Both WHRadjBMI and BMI were associated with higher left ventricular hypertrophy, glycemic traits, interleukin 6, and circulating lipids. WHRadjBMI was also associated with higher carotid intima-media thickness (39%; 95% CI, 9%-77% per 1 SD). Both general and central adiposity have causal effects on CHD and type 2 diabetes mellitus. Central adiposity may have a stronger effect on stroke risk. Future estimates of the burden of adiposity on health should include measures of central and general adiposity. © 2017 American Heart Association, Inc.

Use of BMI as the marker of adiposity in a metabolic syndrome severity score: Derivation and validation in predicting long-term disease outcomes.

PubMed

Gurka, Matthew J; Filipp, Stephanie L; Musani, Solomon K; Sims, Mario; DeBoer, Mark D

2018-06-01

Estimates of adiposity in evaluating the metabolic syndrome (MetS) have traditionally utilized measures of waist circumference (WC), whereas body mass index (BMI) is more commonly used clinically. Our objective was to determine if a MetS severity Z-score employing BMI as its measure of adiposity (MetS-Z-BMI) would perform similarly to a WC-based score (MetS-Z-WC) in predicting future disease. To formulate the MetS-Z-BMI, we performed confirmatory factor analysis on a sex- and race/ethnicity-specific basis on MetS-related data for 6870 adult participants of the National Health and Nutrition Survey 1999-2010. We then validated this score and compared it to MetS-Z-WC in assessing correlations with future coronary heart disease (CHD) and Type 2 diabetes mellitus (T2DM) using Cox proportional hazard analysis of 13,094 participants of the Atherosclerosis Risk in Communities study and Jackson Heart Study. Loading factors, which represent the relative contribution of each component to the latent MetS factor, were lower for BMI than for WC in formulating the two respective scores (MetS-Z-BMI and MetS-Z-WC). Nevertheless, MetS-Z-BMI and MetS-Z-WC exhibited similar hazard ratios (HR) toward future disease. For each one standard-deviation-unit increase in MetS-Z-BMI, HR for CHD was 1.76 (95% confidence interval [CI]: 1.65, 1.88) and HR for T2DM was 3.39 (CI 3.16, 3.63) (both p < 0.0001). There were no meaningful differences between the MetS-Z-WC and MetS-Z-BMI scores in their associations with future CHD and T2DM. A MetS severity Z-score utilizing BMI as its measure of adiposity operated similarly to a WC-based score in predicting future CHD and T2DM, suggesting overall similarity in MetS-based risk as estimated by both measures of adiposity. This indicates potential clinical usefulness of MetS-Z-BMI in assessing and following MetS-related risk over time. Copyright © 2018 Elsevier Inc. All rights reserved.

Body mass index and health-related quality of life among young Swiss men.

PubMed

Dey, Michelle; Gmel, Gerhard; Mohler-Kuo, Meichun

2013-10-30

Studies about the association between body mass index (BMI) and health-related quality of life (HRQOL) are often limited, because they 1) did not include a broad range of health-risk behaviors as covariates; 2) relied on clinical samples, which might lead to biased results; and 3) did not incorporate underweight individuals. Hence, this study aims to examine associations between BMI (from being underweight through obesity) and HRQOL in a population-based sample, while considering multiple health-risk behaviors (low physical activity, risky alcohol consumption, daily cigarette smoking, frequent cannabis use) as well as socio-demographic characteristics. A total of 5 387 young Swiss men (mean age = 19.99; standard deviation = 1.24) of a cross-sectional population-based study were included. BMI was calculated (kg/m²) based on self-reported height and weight and divided into 'underweight' (<18.5), 'normal weight' (18.5-24.9), 'overweight' (25.0-29.9) and 'obese' (≥30.0). Mental and physical HRQOL was assessed via the SF-12v2. Self-reported information on physical activity, substance use (alcohol, cigarettes, and cannabis) and socio-demographic characteristics also was collected. Logistic regression analyses were conducted to study the associations between BMI categories and below average mental or physical HRQOL. Substance use variables and socio-demographic variables were used as covariates. Altogether, 76.3% were normal weight, whereas 3.3% were underweight, 16.5% overweight and 3.9% obese. Being overweight or obese was associated with reduced physical HRQOL (adjusted OR [95% CI] = 1.58 [1.18-2.13] and 2.45 [1.57-3.83], respectively), whereas being underweight predicted reduced mental HRQOL (adjusted OR [95% CI] = 1.49 [1.08-2.05]). Surprisingly, obesity decreased the likelihood of experiencing below average mental HRQOL (adjusted OR [95% CI] = 0.66 [0.46-0.94]). Besides BMI, expressed as a categorical variable, all health-risk behaviors and socio-demographic variables were associated with reduced physical and/or mental HRQOL. Deviations from normal weight are, even after controlling for important health-risk behaviors and socio-demographic characteristics, associated with compromised physical or mental HRQOL among young men. Hence, preventive programs should aim to preserve or re-establish normal weight. The self-appraised positive mental well-being of obese men noted here, which possibly reflects a response shift, might complicate such efforts.

The effects of height and BMI on prostate cancer incidence and mortality: a Mendelian randomization study in 20,848 cases and 20,214 controls from the PRACTICAL consortium.

PubMed

Davies, Neil M; Gaunt, Tom R; Lewis, Sarah J; Holly, Jeff; Donovan, Jenny L; Hamdy, Freddie C; Kemp, John P; Eeles, Rosalind; Easton, Doug; Kote-Jarai, Zsofia; Al Olama, Ali Amin; Benlloch, Sara; Muir, Kenneth; Giles, Graham G; Wiklund, Fredrik; Gronberg, Henrik; Haiman, Christopher A; Schleutker, Johanna; Nordestgaard, Børge G; Travis, Ruth C; Neal, David; Pashayan, Nora; Khaw, Kay-Tee; Stanford, Janet L; Blot, William J; Thibodeau, Stephen; Maier, Christiane; Kibel, Adam S; Cybulski, Cezary; Cannon-Albright, Lisa; Brenner, Hermann; Park, Jong; Kaneva, Radka; Batra, Jyotsna; Teixeira, Manuel R; Pandha, Hardev; Lathrop, Mark; Smith, George Davey; Martin, Richard M

2015-11-01

Epidemiological studies suggest a potential role for obesity and determinants of adult stature in prostate cancer risk and mortality, but the relationships described in the literature are complex. To address uncertainty over the causal nature of previous observational findings, we investigated associations of height- and adiposity-related genetic variants with prostate cancer risk and mortality. We conducted a case-control study based on 20,848 prostate cancers and 20,214 controls of European ancestry from 22 studies in the PRACTICAL consortium. We constructed genetic risk scores that summed each man's number of height and BMI increasing alleles across multiple single nucleotide polymorphisms robustly associated with each phenotype from published genome-wide association studies. The genetic risk scores explained 6.31 and 1.46% of the variability in height and BMI, respectively. There was only weak evidence that genetic variants previously associated with increased BMI were associated with a lower prostate cancer risk (odds ratio per standard deviation increase in BMI genetic score 0.98; 95% CI 0.96, 1.00; p = 0.07). Genetic variants associated with increased height were not associated with prostate cancer incidence (OR 0.99; 95% CI 0.97, 1.01; p = 0.23), but were associated with an increase (OR 1.13; 95 % CI 1.08, 1.20) in prostate cancer mortality among low-grade disease (p heterogeneity, low vs. high grade <0.001). Genetic variants associated with increased BMI were associated with an increase (OR 1.08; 95 % CI 1.03, 1.14) in all-cause mortality among men with low-grade disease (p heterogeneity = 0.03). We found little evidence of a substantial effect of genetically elevated height or BMI on prostate cancer risk, suggesting that previously reported observational associations may reflect common environmental determinants of height or BMI and prostate cancer risk. Genetically elevated height and BMI were associated with increased mortality (prostate cancer-specific and all-cause, respectively) in men with low-grade disease, a potentially informative but novel finding that requires replication.

Skipping breakfast and 5‐year changes in body mass index and waist circumference in Japanese men and women

PubMed Central

Yoshita, K.; Nakamura, K.; Miura, K.; Takamura, T.; Nagasawa, S.Y.; Morikawa, Y.; Kido, T.; Naruse, Y.; Nogawa, K.; Suwazono, Y.; Sasaki, S.; Ishizaki, M.; Nakagawa, H.

2017-01-01

Summary Objective This study investigated the relationship between frequency of skipping breakfast and annual changes in body mass index (BMI) and waist circumference (WC). Methods The participants were 4,430 factory employees. BMI and WC were measured repeatedly at annual medical examinations over a 5‐year period. The association between frequency of skipping breakfast at the baseline examination and annual changes in anthropometric indices was evaluated using the generalized estimating equation method. Results The mean (standard deviation) BMI was 23.3 (3.0) kg m−2 for men and 21.9 (3.6) kg m−2 for women; and the mean WC was 82.6 (8.7) cm for men and 77.8 (9.8) cm for women. During the follow‐up period, mean BMI increased by 0.2 kg m−2 for men and women, and mean WC increased by 1.1 cm for men and 1.0 cm for women. The annual change in the BMI of men who skipped breakfast four to six times per week was 0.061 kg m−2 higher, and that of those who skipped breakfast seven times per week was 0.046 kg m−2 higher, compared with those who did not skip breakfast. Annual changes in the WC of male participants who skipped breakfast seven times per week was 0.248 cm higher than that of those who did not skip breakfast. Skipping breakfast was not associated with changes in BMI or WC in women. Conclusions Skipping breakfast was closely associated with annual changes in BMI and WC among men, and eating breakfast more than four times per week may prevent the excessive body weight gain associated with skipping breakfast. PMID:28702211

Physical Activity Producing Low, but Not Medium or Higher, Vertical Impacts Is Inversely Related to BMI in Older Adults: Findings From a Multicohort Study

PubMed Central

Elhakeem, Ahmed; Hannam, Kimberly; Deere, Kevin C; Hartley, April; Clark, Emma M; Moss, Charlotte; Edwards, Mark H; Dennison, Elaine; Gaysin, Tim; Kuh, Diana; Wong, Andrew; Cooper, Cyrus; Cooper, Rachel; Tobias, Jon H

2018-01-01

Abstract Background High impact physical activity (PA) is thought to improve skeletal health, but its relation to other health outcomes are unclear. We investigated associations between PA impact magnitude and body mass index (BMI) in older adults. Methods Data were taken from the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), Hertfordshire Cohort Study, and MRC National Survey of Health and Development. Vertical acceleration peaks from 7-day hip-worn accelerometer recordings were used to classify PA as low (0.5 < g < 1.0g), medium (1 < g < 1.5g), or higher (≥1.5g) impact. Cohort-specific associations of low, medium, and higher impact PA with BMI were examined using linear regressions and estimates combined using random-effects meta-analysis. Results A total of 1182 participants (mean age = 72.7 years, 68% female) were included. Low, medium, and higher impact PA were inversely related to BMI in initial models. After adjustment for confounders and other impacts, low, but not medium or higher, impacts were inversely related to BMI (−0.31, p < .001: overall combined standard deviation change in BMI per doubling in the number of low impacts). In adjusted analyses of body composition measured by dual-energy X-ray absorptiometry in COSHIBA, low, but not medium or higher, impacts were inversely related to total body fat mass (−0.19, p < .001) and android:gynoid fat mass ratio (−0.16, p = .01), whereas high impact PA was weakly and positively associated with lean mass (0.05, p = .06). Conclusions Greater exposure to PA producing low magnitude vertical impacts was associated with lower BMI and fat mass at older age. Low impact PA may help reduce obesity risk in older adults. PMID:29028919

Effect of a family-based cognitive behavioural intervention on body mass index, self-esteem and symptoms of depression in children with obesity (aged 7-13): a randomised waiting list controlled trial.

PubMed

Danielsen, Yngvild S; Nordhus, Inger H; Júlíusson, Petur B; Mæhle, Magne; Pallesen, Ståle

2013-01-01

We examined the effect of a 12-week family-based cognitive behavioural weight management programme developed for use in primary care settings. The sample consisted of 49 children with obesity (aged 7-13 years; mean ± SD: 10.68 ± 1.24). Families were randomly assigned to immediate start-up of treatment or to a 12-week waiting list condition. Outcome measures were body mass index standard deviation score (BMI SDS), self-esteem, symptoms of depression and blood parameters indicative of cardio-metabolic risk. Assessments were conducted at baseline, post-treatment, post-waiting list and 12 months after treatment termination. The mean reduction for the treatment group was -0.16 BMI SDS units compared with an increase of 0.04 units for the waiting list group (p = .001). For the entire sample, there was a significant post-treatment improvement on BMI SDS (p = .001), all self-esteem measures (p = .001-.041) and symptoms of depression (p = .004). The mean BMI SDS reduction was -0.18 units post-treatment, and it was maintained at 12-month follow-up. Significant reductions were found in blood lipid levels of total cholesterol (p = .03), LDL-cholesterol (p = .005) and HDL-cholesterol (p = .01) at 12-month follow-up. The favourable effect on most of the psychological measures waned from post-treatment to follow-up, but not approaching baseline levels. Boys demonstrated significantly greater reductions in BMI SDS than girls (p = .001), while baseline psychiatric co-morbidity did not influence BMI SDS outcome. The treatment shows significant and favourable effects on BMI SDS, self-esteem and symptoms of depression compared with a waiting list condition. © 2013 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.

PubMed

Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

2017-01-01

Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3-18), and the median BMI SDS was 2.85 (range: 1.26-8.96) in boys and 2.48 (range: 1.08-4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30-0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12-0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7-4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0-6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.

Sensitivity and Specificity of 50% Excess Weight Loss (50%EWL) and Twelve Other Bariatric Criteria for Weight Loss Success.

PubMed

van de Laar, Arnold W; van Rijswijk, A S; Kakar, H; Bruin, S C

2018-02-27

Criteria for bariatric weight loss success are numerous. Most of them are arbitrary. None of them is evidence-based. Our objective was to determine their sensitivity and specificity. Thirteen common bariatric weight loss criteria were compared to a benchmark reflecting the gold standard in bariatric surgery. We used an elaborate baseline BMI-independent weight loss percentile chart, based on retrospective data after laparoscopic Roux-en-Y gastric bypass (LRYGB), performed between 2007 and 2017. Percentile curves p31.6 (patients' expectation), p25 (interquartile range), p15.9 (1 standard deviation (SD) below median), and p10.9 (surgeons' goal) were used as possible cutoff for success to determine true or false positive and negative results beyond 1 year. We operated 4497 primary LRYGB patients, with mean follow-up 22 (± 1 SD 19; range 0-109) months, 3031 patients with last result ≥ 1 year, 518 ≥ 5 years. For all four cutoff percentile curves for success, specificities were low (2-72%) for criteria < 35 body mass index (BMI), ≥ 25percentage excess BMI loss (%EBMIL), ≥ 50%EBMIL, ≥ 15 percentage total weight loss (%TWL), ≥ 20%TWL, ≥ 25 percentage excess weight loss (%EWL), and high (83-96%) for < 30 BMI. No criterion had > 80% specificity and sensitivity for a cutoff above p15.9. For p15.9, they were both > 80% for criteria ≥ 10 BMI reduction and ≥ 50%EWL, both > 90% for ≥ 25%TWL and ≥ 35 percentage alterable weight loss (%AWL). All criteria had high sensitivities for all cutoff percentile curves (87-100%), except < 30 BMI (65-78%). For the first time, common bariatric criteria for weight loss success were systematically validated. Most criteria recognized success very well (high sensitivities), but ≥ 15%TWL, ≥ 20%TWL, < 35BMI, ≥ 25%EWL, ≥ 25%EBMIL, and ≥ 50%EBMIL left too many poor responders unnoticed (low specificities). Bariatric weight loss success is best assessed by comparing results to percentile curve 1 SD below median (p15.9) in a bariatric baseline BMI-independent weight loss percentile chart. Criteria ≥ 35%AWL and ≥ 25%TWL came close to that curve, both with > 90% sensitivity and specificity. Among others, criterion ≥ 50%EBMIL did not.

Accuracy of body mass index for age to diagnose obesity in Mexican schoolchildren.

PubMed

Mendoza Pablo, Pedro A; Valdés, Jesús; Ortiz-Hernández, Luis

2015-06-01

To compare the accuracy of three BMI-forage references (World Health Organization reference, WHO; the updated International Obesity Task Force reference, IOTF; and Centers for Disease Control and Prevention (CDC) growth charts) to diagnose obesity in Mexican children. A convenience sample of Mexican schoolchildren (n = 218) was assessed. The gold standard was the percentage of body fat estimated by deuterium dilution technique. Sensitivity and specificity of the classical cutoff point of BMI-for-age to identify obesity (i.e. > 2.00 standard deviation, SD) were estimated. The accuracy (i.e. area under the curve, AUC) of three BMI-for-age references for the diagnosis of obesity was estimated with the receiver operating characteristic (ROC) curves method. The optimal cutoff point (OCP) was determined. The cutoff points to identify obesity had low (WHO reference: 57.6%, CDC: 53.5%) to very low (IOTF reference: 40.4%) sensitivities, but adequate specificities (91.6%, 95.0%, and, 97.5%, respectively). The AUC of the three references were adequate (0.89). For the IOTF reference, the AUC was lower among the older children. The OCP for the CDC reference (1.24 SD) was lower than the OCP for WHO (1.53 SD) and IOTF charts (1.47 SD). The classical cutoff point for obesity has low sensitivity--especially for the IOTF reference. The accuracy of the three references was similar. However, to obtain comparable diagnosis of obesity different cutoff points should be used depending of the reference. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Stress Measured by Allostatic Load in Neurologically Impaired Children: The Importance of Nutritional Status.

PubMed

Calcaterra, Valeria; Cena, Hellas; de Silvestri, Annalisa; Albertini, Riccardo; De Amici, Mara; Valenza, Mario; Pelizzo, Gloria

2017-01-01

Allostatic load (AL) is the cumulative physiological wear and tear that results from repeated efforts to adapt to stressors over time. The life stress response is modified by nutritional status. We estimated AL scores among neurologically impaired (NI) children; the association with malnutrition was also evaluated. Forty-one patients with severe disabilities were included. Data based on 15 biomarkers were used to create the AL score. A dichotomous outcome of high AL was defined for those who had ≥6 dysregulated components. Body mass index (BMI)-standard deviation score (SDS) <-2 or SDS ≥2 and biochemical markers (≥4) defined malnutrition. High AL was noted in 17/41 of the whole sample (41.47%). Malnutrition occurred in 36.6% of the subjects. A significant correlation between high AL and malnutrition was observed (p = 0.01; ar ea under the receiver operating characteristic curve, 0.7457). High AL subjects had a significantly higher BMI (p = 0.009) and lower BMI-SDS (p = 0.003) than low AL subjects. AL score correlated with fat mass (p ≤ 0.01) and negatively correlated with fat-free mass (p ≤ 0.02). In NI children, high AL was associated with malnutrition. Body composition is a better indicator than BMI of allostatic adjustments. AL estimation should be considered a measure of health risk and be used to promote quality of life in at-risk disabled populations. © 2017 S. Karger AG, Basel.

Measures of Body Size and Composition and Risk of Incident Atrial Fibrillation in Older People

PubMed Central

Karas, Maria G.; Yee, Laura M.; Biggs, Mary L.; Djoussé, Luc; Mukamal, Kenneth J.; Ix, Joachim H.; Zieman, Susan J.; Siscovick, David S.; Gottdiener, John S.; Rosenberg, Michael A.; Kronmal, Richard A.; Heckbert, Susan R.; Kizer, Jorge R.

2016-01-01

Various anthropometric measures, including height, have been associated with atrial fibrillation (AF). This raises questions about the appropriateness of using ratio measures such as body mass index (BMI), which contains height squared in its denominator, in the evaluation of AF risk. Among older adults, the optimal anthropometric approach to risk stratification of AF remains uncertain. Anthropometric and bioelectrical impedance measures were obtained from 4,276 participants (mean age = 72.4 years) free of cardiovascular disease in the Cardiovascular Health Study. During follow-up (1989–2008), 1,050 cases of AF occurred. BMI showed a U-shaped association, whereas height, weight, waist circumference, hip circumference, fat mass, and fat-free mass were linearly related to incident AF. The strongest adjusted association occurred for height (per each 1-standard-deviation increment, hazard ratio = 1.38, 95% confidence interval: 1.25, 1.51), which exceeded all other measures, including weight (hazard ratio = 1.21, 95% confidence interval: 1.13, 1.29). Combined assessment of log-transformed weight and height showed regression coefficients that departed from the 1 to −2 ratio inherent in BMI, indicating a loss of predictive information. Risk estimates for AF tended to be stronger for hip circumference than for waist circumference and for fat-free mass than for fat mass, which was explained largely by height. These findings highlight the prominent role of body size and the inadequacy of BMI as determinants of AF in older adults. PMID:27188936

The effects of body mass index on graft survival in adult recipients transplanted with single pediatric kidneys.

PubMed

Balamuthusamy, Saravanan; Paramesh, Anil; Zhang, Rubin; Florman, Sander; Shenava, Rajesh; Islam, Tareq; Wagner, Janis; Killackey, Mary; Alper, Brent; Simon, Eric E; Slakey, Douglas

2009-01-01

There is insufficient data on the impact of recipient body mass index (BMI) on the long-term graft survival of adult patients transplanted with single pediatric kidneys. We performed a retrospective analysis of adult patients transplanted with single pediatric kidneys at our center. The recipients were classified into 2 groups: group 1 (BMI > or =30) and group 2 (BMI <30). Donor/recipient demographics, postoperative outcomes and survival rates were compared between the 2 groups. There was no significant difference in donor/recipient demographics between the 2 groups. In group 1, the death-censored graft survival (DCGS) at 1, 3 and 5 years was 90% at all 3 time points, and in group 2 it was 86, 68 and 60%, respectively (p = 0.05). The mean glomerular filtration rate (with standard deviation in parentheses) at 1, 3 and 5 years was, respectively, 55 (15), 59 (19) and 55 (28) ml/min for group 1, compared to 65 (28), 69 (23) and 67 (20) ml/min in group 2 (p = NS). Multivariate analysis revealed a hazard ratio of 5.12 (95% confidence interval 1.06-24.7; p = 0.04) for graft loss in nonobese patients when compared to obese patients. Obese patients had an increased risk for acute rejections within the first month of transplant (p = 0.02). Patients with a BMI > or =30 transplanted with single pediatric kidneys have better DCGS rates when compared to nonobese patients. Copyright (c) 2008 S. Karger AG, Basel.

Growth reference centiles and secular changes in Turkish children and adolescents.

PubMed

Ozer, Başak Koca

2007-07-01

The purpose of the study is to develop current reference growth centiles for Turkish children and adolescents. A cross-sectional growth survey was conducted on 1.427 (709 boys and 718 girls) healthy schoolchildren aged 6-17 years in Ankara, the capital city of Turkey. As an indicator of socio-economic status, the occupation of the parents was recorded. Growth references of height, weight, body mass index (BMI), sitting height, iliospinal height, relative iliospinal height and relative sitting height were constructed by the LMS method. Sex differences, association of parental occupation with height and BMI standard deviation scores were assessed by analyses of variance. Results showed significant sexual dimorphism for height, weight, sitting height and iliospinal height (p<0.001). Significant effect of socio-economic background was found on height and BMI. The prevalence of overweight and obesity was found using the International Obesity Task Force (IOTF) reference criteria 22.4% and 5.6% in boys and 21.2% and 3% in girls. Present results demonstrated an increment during the last three decades in height, leg length and weight curves which is more prominent in boys, but not in the sitting height. This positive secular change appears to be a logical outcome of the gradual changes in nutrition, health care and education, and environmental and economic conditions.

Head Start Wellness Policy Intervention in Hawaii: A Project of the Children's Healthy Living Program.

PubMed

Esquivel, Monica; Nigg, Claudio R; Fialkowski, Marie K; Braun, Kathryn L; Li, Fenfang; Novotny, Rachel

2016-02-01

The increased prevalence of childhood overweight and obesity across the United States and the Pacific has become a serious public health concern, with especially high prevalence among Native Hawaiian and Pacific Islander (NHPI) children. This study aimed to measure the effect of a Head Start (HS) policy intervention for childhood obesity prevention. Twenty-three HS classrooms located in Hawaii participated in the trial of a 7-month policy intervention with HS teachers. Classroom- and child-level outcome assessments were conducted, including: the Environment and Policy Assessment and Observations (EPAO) of the classroom environment; plate waste observations to assess child intake of fruit and vegetables; and child growth. The intervention showed a positive and significant effect on classroom EPAO physical activity (PA) and EPAO total scores. Although mean BMI z-score (zBMI) increased at postintervention for both intervention (mean = 0.60; standard deviation [SD], 1.16; n = 114) and delayed-intervention groups (mean = 0.35; SD, 1.17; n = 132), change in zBMI was not significantly different between the groups (p = 0.50; p = 0.48). These findings contribute evidence on the potential for HS wellness policy to improve the PA environment of HS classrooms. More research is needed to link these policy changes to other child outcomes.

Nutritively Sweetened Beverage Consumption and Body Weight: A Systematic Review and Meta-Analysis of Randomized Experiments

PubMed Central

Mattes, Richard D; Shikany, James M; Kaiser, Kathryn A; Allison, David B

2010-01-01

Nutritively sweetened beverages (NSBs) may play a role in the obesity epidemic. We abstracted data from randomized controlled trials (RCTs) and evidence-based reviews through January 2009 concerning effects of consumption of NSBs on changes in body weight and adiposity. Studies included were those 1) conducted in humans; 2) lasting at least 3 weeks; 3) incorporating random assignment of subjects to conditions that differed only in the consumption of NSBs; and 4) including an adiposity indicator as an outcome. Twelve studies met the inclusion criteria. Meta-analysis of 6 studies that added NSBs to persons’ diets showed dose-dependent increases in weight. Contrarily, meta-analysis of studies that attempted to reduce NSB consumption consistently showed no effect on BMI when all subjects were considered. Meta-analysis of studies providing access to results separately for subjects overweight at baseline showed a significant effect of a roughly 0.35 standard deviations lesser BMI change (i.e., more weight loss or less weight gain) relative to controls. The current evidence does not demonstrate conclusively that NSB consumption has uniquely contributed to obesity or that reducing NSB consumption will reduce BMI levels in general. We recommend an adequately powered RCT among overweight persons, among whom there is suggestive evidence of an effect. PMID:20524996

Serum omentin levels in adolescent girls with anorexia nervosa and obesity.

PubMed

Oświęcimska, J; Suwała, A; Świętochowska, E; Ostrowska, Z; Gorczyca, P; Ziora-Jakutowicz, K; Machura, E; Szczepańska, M; Kukla, M; Stojewska, M; Ziora, D; Ziora, K

2015-01-01

It is believed that omentin is secreted by stromal cells of adipose tissue and modulates insulin sensitivity. Data from a few studies have shown lower serum omentin in obese children and higher in anorexia nervosa. However, to date, there is lack of research on serum omentin concentrations in adolescent patients in a wide range of body mass index (BMI) and insulin resistance. In this cross-sectional study omentin-1 serum concentrations were evaluated using commercially available ELISA kit in 47 Polish girls with restrictive anorexia nervosa (AN), 50 with simple obesity (OB) and 39 healthy controls (C). The mean serum omentin-1 concentration in girls with AN was statistically significantly higher than that of C and OB girls. Statistically significant (P<0.0001) negative correlations between the serum concentrations of omentin-1 and body weight (r=-0.73), BMI (r=-0.75), standard deviation score for body mass index (BMI-SDS) (r=-0.75), insulin (r=-0.81) and HOMA-IR index (r=-0.82) were seen in the entire examined population. We conclude, that omentin-1 is the nutritional marker reflecting body weight and insulin resistance. Our findings support the hypothesized role of omentin in maintenance of body weight and regulation of appetite and suggest the adaptation of its secretion to body weight and glucose metabolism.

A Novel Home-Based Intervention for Child and Adolescent Obesity: The Results of the Whānau Pakari Randomized Controlled Trial.

PubMed

Anderson, Yvonne C; Wynter, Lisa E; Grant, Cameron C; Cave, Tami L; Derraik, José G B; Cutfield, Wayne S; Hofman, Paul L

2017-11-01

To report 12-month outcomes from a multidisciplinary child obesity intervention program, targeting high-risk groups. In this unblinded randomized controlled trial, participants (recruited January 2012-August 2014) were aged 5 to 16 years, resided in Taranaki, Aotearoa/New Zealand, and had BMI ≥ 98th percentile or BMI > 91st percentile with weight-related comorbidities. Randomization was by minimization (age and ethnicity), with participants assigned to an intense intervention group (home-based assessments at 6-month intervals and a 12-month multidisciplinary program with weekly group sessions) or to a minimal-intensity control group with home-based assessments and advice at each 6-month follow-up. The primary outcome was the change in BMI standard deviation score (SDS) at 12 months from baseline. A mixed model analysis was undertaken, incorporating all 6- and 12-month data. Two hundred and three children were randomly assigned (47% Māori, 43% New Zealand European, 53% female, 28% from the most deprived quintile, mean age 10.7 years, mean BMI SDS 3.12). Both groups displayed a change in BMI SDS at 12 months from baseline (-0.12 control, -0.10 intervention), improvements in cardiovascular fitness (P < 0.0001), and improvements in quality of life (P < 0.001). Achieving ≥ 70% attendance in the intense intervention group resulted in a change in BMI SDS of -0.22. This program achieved a high recruitment of target groups and a high rate of BMI SDS reduction, irrespective of intervention intensity. If retention is optimized, the intensive program doubles its effect. © 2017 The Obesity Society.

The relationship between dietary patterns, body mass index percentile, and household food security in young urban children.

PubMed

Trapp, Christine M; Burke, Georgine; Gorin, Amy A; Wiley, James F; Hernandez, Dominica; Crowell, Rebecca E; Grant, Autherene; Beaulieu, Annamarie; Cloutier, Michelle M

2015-04-01

The relationship between food insecurity and child obesity is unclear. Few studies have examined dietary patterns in children with regard to household food security and weight status. The aim of this study was to examine the association between household food security, dietary intake, and BMI percentile in low-income, preschool children. Low-income caregivers (n=222) with children ages 2-4 years were enrolled in a primary-care-based obesity prevention/reversal study (Steps to Growing Up Healthy) between October 2010 and December 2011. At baseline, demographic data, household food security status (US Household Food Security Instrument) and dietary intake (Children's Dietary Questionnaire; CDQ) were collected. BMI percentile was calculated from anthropometric data. Participating children were primarily Hispanic (90%), Medicaid insured (95%), 50% female, 35±8.7 months of age (mean±standard deviation), 19% overweight (BMI 85th-94th percentile), and 29% obese (≥95th percentile). Thirty-eight percent of interviews were conducted in Spanish. Twenty-five percent of households reported food insecurity. There was no association between household food insecurity and child BMI percentile. Dietary patterns of the children based on the CDQ did not differ by household food security status. Food group subscale scores (fruit and vegetable, fat from dairy, sweetened beverages, and noncore foods) on the CDQ did not differ between normal weight and overweight/obese children. Maternal depression and stress did not mediate the relationship between household food insecurity and child weight status. Hispanic children were more likely to be overweight or obese in both food-secure and food-insecure households. Household food insecurity was not associated with child BMI percentile in this study. Dietary intake patterns of children from food-insecure households were not different compared to those from food-secure households.

Comparison of anthropometric measures as predictors of cancer incidence: A pooled collaborative analysis of 11 Australian cohorts.

PubMed

Harding, Jessica L; Shaw, Jonathan E; Anstey, Kaarin J; Adams, Robert; Balkau, Beverley; Brennan-Olsen, Sharon L; Briffa, Tom; Davis, Timothy M E; Davis, Wendy A; Dobson, Annette; Flicker, Leon; Giles, Graham; Grant, Janet; Huxley, Rachel; Knuiman, Matthew; Luszcz, Mary; MacInnis, Robert J; Mitchell, Paul; Pasco, Julie A; Reid, Christopher; Simmons, David; Simons, Leon; Tonkin, Andrew; Woodward, Mark; Peeters, Anna; Magliano, Dianna J

2015-10-01

Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an individuals' risk of cancer. © 2015 UICC.

Diagnostic performance of body mass index to identify excess body fat in children with cerebral palsy.

PubMed

Duran, Ibrahim; Schulze, Josefa; Martakis, KyriakoS; Stark, Christina; Schoenau, Eckhard

2018-03-07

To assess the diagnostic performance of body mass index (BMI) cut-off values according to recommendations of the World Health Organization (WHO), the World Obesity Federation (WOF), and the German Society for Adiposity (DAG) to identify excess body fat in children with cerebral palsy (CP). The present study was a monocentric retrospective analysis of prospectively collected data among children and adolescents with CP participating in a rehabilitation programme. Excess body fat was defined as a body fat percentage above the 85th centile assessed by dual-energy X-ray absorptiometry. In total, 329 children (181 males, 148 females) with CP were eligible for analysis. The mean age was 12 years 4 months (standard deviation 2y 9mo). The BMI cut-off values for 'overweight' according to the WHO, WOF, and DAG showed the following sensitivities and specificities for the prediction of excess body fat in our population: WHO: sensitivity 0.768 (95% confidence interval [CI] 0.636-0.870), specificity 0.894 (95% CI 0.851-0.928); WOF: sensitivity 0.696 (95% CI 0.559-0.812), specificity 0.934 (95% CI 0.898-0.960); DAG: sensitivity 0.411 (95% CI 0.281-0.550), specificity 0.993 (95% CI 0.974-0.999). Body mass index showed high specificity, but low sensitivity in children with CP. Thus, 'normal-weight obese' children with CP were overlooked, when assessing excess body fat only using BMI. Excess body fat in children with cerebral palsy (CP) is less common than previously reported. Body mass index (BMI) had high specificity but low sensitivity in detecting excess body fat in children with CP. BMI evaluation criteria of the German Society for Adiposity could be improved in children with CP. © 2018 Mac Keith Press.

Perceived and Police-Reported Neighborhood Crime: Linkages to Adolescent Activity Behaviors and Weight Status.

PubMed

Forsyth, Ann; Wall, Melanie; Choo, Tse; Larson, Nicole; Van Riper, David; Neumark-Sztainer, Dianne

2015-08-01

Inadequate physical activity and obesity during adolescence are areas of public health concern. Questions exist about the role of neighborhoods in the etiology of these problems. This research addressed the relationships of perceived and objective reports of neighborhood crime to adolescent physical activity, screen media use, and body mass index (BMI). Socioeconomically and racially/ethnically diverse adolescents (N = 2,455, 53.4% female) from 20 urban, public middle and high schools in Minneapolis/St. Paul, Minnesota responded to a classroom survey in the Eating and Activity in Teens 2010 study. BMI was measured by research staff. Participants' mean age was 14.6 (standard deviation = 2.0); 82.7% represented racial/ethnic groups other than non-Hispanic white. Linear regressions examined associations between crime perceived by adolescents and crime reported to police and the outcomes of interest (BMI z-scores, physical activity, and screen time). Models were stratified by gender and adjusted for age, race/ethnicity, socioeconomic status, and school. BMI was positively associated with perceived crime among girls and boys and with reported crime in girls. For girls, there was an association between higher perceived crime and increased screen time; for boys, between higher reported property crime and reduced physical activity. Perceived crime was associated with reported crime, both property and personal, in both genders. Few prior studies of adolescents have studied the association between both perceived and reported crime and BMI. Community-based programs for youth should consider addressing adolescents' safety concerns along with other perceived barriers to physical activity. Interventions targeting actual crime rates are also important. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Disease associated malnutrition correlates with length of hospital stay in children.

PubMed

Hecht, Christina; Weber, Martina; Grote, Veit; Daskalou, Efstratia; Dell'Era, Laura; Flynn, Diana; Gerasimidis, Konstantinos; Gottrand, Frederic; Hartman, Corina; Hulst, Jessie; Joosten, Koen; Karagiozoglou-Lampoudi, Thomais; Koetse, Harma A; Kolaček, Sanja; Książyk, Janusz; Niseteo, Tena; Olszewska, Katarzyna; Pavesi, Paola; Piwowarczyk, Anna; Rousseaux, Julien; Shamir, Raanan; Sullivan, Peter B; Szajewska, Hania; Vernon-Roberts, Angharad; Koletzko, Berthold

2015-02-01

Previous studies reported a wide range of estimated malnutrition prevalence (6-30%) in paediatric inpatients based on various anthropometric criteria. We performed anthropometry in hospitalised children and assessed the relationship between malnutrition and length of hospital stay (LOS) and complication rates. In a prospective multi-centre European study, 2567 patients aged 1 month to 18 years were assessed in 14 centres in 12 countries by standardised anthropometry within the first 24 h after admission. Body mass index (BMI) and height/length <-2 standard deviation scores (SDS, WHO reference) were related to LOS (primary outcome), frequency of gastrointestinal (diarrhoea and vomiting) and infectious complications (antibiotic use), weight change during stay (secondary outcomes) and quality of life. A BMI <-2 SDS was present in 7.0% of the patients at hospital admission (range 4.0-9.3% across countries) with a higher prevalence in infants (10.8%) and toddlers aged 1-2 years (8.3%). A BMI <-2 to ≥-3 SDS (moderate malnutrition) and a BMI <-3 SDS (severe malnutrition) was associated with a 1.3 (CI95: 1.01, 1.55) and 1.6 (CI95: 1.27, 2.10) days longer LOS, respectively (p = 0.04 and p < 0.001). Reduced BMI <-2 SDS was also associated to lower quality of life, and more frequent occurrence of diarrhoea (22% vs 12%, p < 0.001) and vomiting (26% vs 14%, p < 0.001). Disease associated malnutrition in hospitalised children in Europe is common and is associated with significantly prolonged LOS and increased complications, with possible major cost implications, and reduced quality of life. This study was registered at clinicaltrials.gov as NCT01132742. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Associations of Maternal Material Hardships During Childhood and Adulthood with Prepregnancy Weight, Gestational Weight Gain, and Postpartum Weight Retention

PubMed Central

Provenzano, Audrey M.; Rifas-Shiman, Sheryl L.; Herring, Sharon J.; Rich-Edwards, Janet W.

2015-01-01

Background: We examined associations of material hardship with prepregnancy body mass index (BMI), gestational weight gain (GWG), and substantial postpartum weight retention (SPPWR; ≥5 kg at 1 year). Methods: We studied 2128 women in Project Viva, a Boston-area cohort with recruitment during1999–2002. At recruitment, women reported whether they experienced material hardship, defined as having ever received public assistance, welfare, or lacked basic necessities (food, rent, or medical care) during childhood, in adulthood before pregnancy, and/or in pregnancy. We used multivariable logistic models adjusted for age, race/ethnicity, and parity (and prepregnancy BMI for GWG and SPPWR) to examine associations of material hardship with the three weight-related outcomes (BMI, GWG, and SPPWR). Results: Mean age was 31.8 (standard deviation, 5.2) years; 66% of women were white, 16% were obese (prepregnancy BMI ≥30.0 kg/m2), 50% experienced excessive GWG, and 17% experienced SPPWR. Material hardship was most common during childhood (n=192, 9%), followed by adulthood (102, 5%), and pregnancy (41, 2%). Hardship in adulthood was associated with prepregnancy obesity (BMI ≥30 kg/m2 vs. 18.5 to <25.0 kg/m2), odds ratio ([OR] 2.35, 95% confidence interval [CI] 1.29, 4.31), but hardship in childhood was not (OR 1.26, 95% CI 0.80, 1.98). Hardship in childhood was associated with excess GWG (OR 1.45, 95% CI 0.99, 2.14), but hardship in adulthood or during pregnancy was not. We saw trends among hardship in each of the periods and associations with SPPWR, but all confidence intervals included the null. Conclusion: The timing of hardship exposure may differently influence weight before, during, and after pregnancy. PMID:25902486

Longitudinal evaluation of the prevalence of overweight/obesity in children with congenital heart disease.

PubMed

Tamayo, Catalina; Manlhiot, Cedric; Patterson, Katie; Lalani, Sheliza; McCrindle, Brian W

2015-02-01

Regarding long-term cardiovascular health, obesity may have greater implications for children with congenital heart disease (CHD). We sought to determine trends in anthropometry over time and its association with exercise capacity. Medical records of pediatric patients with CHD were randomly sampled. Serial measurements of weight and height were abstracted, body mass index (BMI) was calculated, and measurements were converted to percentiles and z scores. Analyses of trends were performed using regression models adjusted for repeated measures. Median follow-up after diagnosis for 725 patients was 7.1 years (interquartile range, 1.9-12.8 years). The median initial weight z score was -1.1 (fifth/95th percentile, -3.6/+1.1) and increased over time (+0.103 [0.007] standard deviations [SD]/y; P < 0.001). BMI and height z scores could only be calculated for patients > 2 years old; at that age, the median BMI z score was -0.2 (fifth/95th percentile, -2.6/+1.9) and increased over time (+0.042 [0.007] SD/y; P < 0.001), whereas the median height z score was -0.3 (fifth/95th percentile, -2.7/+1.4) with no change over time (-0.007 [0.006] SD/y; P = 0.18). Using standard BMI percentile cut points to define overweight and obesity, 28% of patients had at least 1 BMI measurement indicating overweight and 17% indicating obesity. Available exercise test results (n = 153) showed that overweight/obese patients had lower percent predicted maximum oxygen consumption (-16 [2]%; P < 0.001), higher peak systolic blood pressure (+11 [4] mm Hg; P = 0.002), and higher systolic blood pressure response (+7 [3] mm Hg; P = 0.01) than normal weight patients. In conclusion, children with repaired CHD have an important risk of overweight/obesity over time that may increase their cardiovascular risk and impair their exercise capacity. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Effects of a Family-Based Childhood Obesity Treatment Program on Parental Weight Status

PubMed Central

Trier, Cæcilie; Dahl, Maria; Stjernholm, Theresa; Nielsen, Tenna R. H.; Bøjsøe, Christine; Fonvig, Cilius E.; Pedersen, Oluf; Hansen, Torben; Holm, Jens-Christian

2016-01-01

Objective The aim of this study was to investigate the prevalence of overweight/obesity among parents of children entering childhood obesity treatment and to evaluate changes in the parents’ weight statuses during their child’s treatment. Methods The study included parents of 1,125 children and adolescents aged 3–22 years, who were enrolled in a multidisciplinary childhood obesity treatment program. At baseline, weight and height of the parents were obtained by self-reported information and parental body mass index (BMI) was calculated. Weight and height of the children were measured in the clinic and BMI standard deviation scores were calculated. Furthermore, anthropometric data from parents of 664 children were obtained by telephone interview after a mean of 2.5 years of treatment (ranging 16 days to 7 years), and changes in parental BMI were analyzed. Results Data on changes in BMI were available in 606 mothers and 479 fathers. At baseline, the median BMI of the mothers was 28.1 kg/m2 (range: 16.9–66.6), and the median BMI of the fathers was 28.9 kg/m2 (range: 17.2–48.1). Seventy percent of the mothers and 80% of the fathers were overweight or obese at the time of their child’s treatment initiation. Both the mothers and fathers lost weight during their child’s treatment with a mean decrease in BMI in the mothers of 0.5 (95% CI: 0.2–0.8, p = 0.0006) and in the fathers of 0.4 (95% CI: 0.2–0.6, p = 0.0007). Of the overweight/obese parents, 60% of the mothers and 58% of the fathers lost weight during their child’s treatment. Conclusion There is a high prevalence of overweight/obesity among parents of children entering childhood obesity treatment. Family-based childhood obesity treatment with a focus on the child has a positive effect on parental BMI with both mothers and fathers losing weight. Trial Registration ClinicalTrials.gov NCT00928473 PMID:27560141

Blood pressure in relation to general and central adiposity among 500 000 adult Chinese men and women.

PubMed

Chen, Zhengming; Smith, Margaret; Du, Huaidong; Guo, Yu; Clarke, Robert; Bian, Zheng; Collins, Rory; Chen, Junshi; Qian, Yijian; Wang, Xiaoping; Chen, Xiaofang; Tian, Xiaocao; Wang, Xiaohuan; Peto, Richard; Li, Liming

2015-08-01

Greater adiposity is associated with higher blood pressure. Substantial uncertainty remains, however, about which measures of adiposity most strongly predict blood pressure and whether these associations differ materially between populations. We examined cross-sectional data on 500 000 adults recruited from 10 diverse localities across China during 2004-08. Multiple linear regression was used to estimate the effects on systolic blood pressure (SBP) of general adiposity [e.g. body mass index (BMI), body fat percentage, height-adjusted weight] vs central adiposity [e.g. waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR)], before and after adjustment for each other. The main analyses excluded those reported taking any antihypertensive medication, and were adjusted for age, region and education. The overall mean [standard deviation (SD)] BMI was 23.6 (3.3) kg/m(2) and mean WC was 80.0 (9.5) cm. The differences in SBP (men/women, mmHg) per 1SD higher general adiposity (height-adjusted weight: 6.6/5.6; BMI: 5.5/4.9; body fat percentage: 5.5/5.0) were greater than for central adiposity (WC: 5.0/4.3; HC: 4.8/4.1; WHR: 3.7/3.2), with a 10 kg/m(2) greater BMI being associated on average with 16 (men/women: 17/14) mmHg higher SBP. The associations of blood pressure with measures of general adiposity were not materially altered by adjusting for WC and HC, but those for central adiposity were significantly attenuated after adjusting for BMI (WC: 1.1/0.7; HC: 0.3/-0.2; WHR: 0.6/0.6). In adult Chinese, blood pressure is more strongly associated with general adiposity than with central adiposity, and the associations with BMI were about 50% stronger than those observed in Western populations. © The Author 2015. Published by Oxford University Press on behalf of the International Epidemiological Association.

Effect of Body Mass Index on Intrafraction Prostate Displacement Monitored by Real-Time Electromagnetic Tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Butler, Wayne M., E-mail: wbutler@wheelinghospital.org; Wheeling Jesuit University, Wheeling, West Virginia; Morris, Mallory N.

2012-10-01

Purpose: To evaluate, using real-time monitoring of implanted radiofrequency transponders, the intrafraction prostate displacement of patients as a function of body mass index (BMI). Methods and Materials: The motions of Beacon radiofrequency transponders (Calypso Medical Technologies, Seattle, WA) implanted in the prostate glands of 66 men were monitored throughout the course of intensity modulated radiation therapy. Data were acquired at 10 Hz from setup to the end of treatment, but only the 1.7 million data points with a 'beam on' tag were used in the analysis. There were 21 obese patients, with BMI {>=}30 and 45 nonobese patients in themore » study. Results: Mean displacements were least in the left-right lateral direction (0.56 {+-} 0.24 mm) and approximately twice that magnitude in the superior-inferior and anterior-posterior directions. The net vector displacement was larger still, 1.95 {+-} 0.47 mm. Stratified by BMI cohort, the mean displacements per patient in the 3 Cartesian axes as well as the net vector for patients with BMI {>=}30 were slightly less (<0.2 mm) but not significantly different than the corresponding values for patients with lower BMIs. As a surrogate for the magnitude of oscillatory noise, the standard deviation for displacements in all measured planes showed no significant differences in the prostate positional variability between the lower and higher BMI groups. Histograms of prostate displacements showed a lower frequency of large displacements in obese patients, and there were no significant differences in short-term and long-term velocity distributions. Conclusions: After patients were positioned accurately using implanted radiofrequency transponders, the intrafractional displacements in the lateral, superior-inferior, and anterior-posterior directions as well as the net vector displacements were smaller, but not significantly so, for obese men than for those with lower BMI.« less

Visceral adiposity is significantly associated with type 2 diabetes in middle-aged and elderly Chinese women: A cross-sectional study.

PubMed

Lv, Xiaofei; Zhou, Weiwei; Sun, Jichao; Lin, Ruhai; Ding, Lin; Xu, Min; Xu, Yu; Zhao, Zhiyun; Chen, Yuhong; Bi, Yufang; Lu, Jieli; Wang, Weiqing; Ning, Guang

2017-10-01

Previous studies suggest that visceral fat is associated with type 2 diabetes (T2D) independent of body mass index (BMI). However, epidemiological data about the relationship between visceral fat and T2D are rare in Chinese. The aim of the present study was to investigate whether visceral fat area (VFA) is associated with T2D beyond and above BMI in the Chinese population. The present community-based cross-sectional study was conducted in 2013 on 4126 individuals (2545 women, 1581 men) aged ≥ 40 years, with T2D diagnosed according to 1999 World Health Organization criteria. The VFA was measured by a fat area analyzer using bioelectrical impedance analysis. Participants were categorized into normal weight and overweight/obese groups according to BMI. Within each group, compared with women with below-median VFA, women with above-median VFA had a significantly increased risk of diabetes (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.31-2.69 in the normal weight group; OR 2.10, 95% CI 1.54-2.85 in the overweight/obese group), whereas among men the corresponding associations were not significant in either group. Among women, after multivariable adjustment including BMI, each one standard deviation increase in VFA was significantly associated with a 45% higher risk of having T2D (OR 1.45, 95% CI 1.26-1.67), whereas among men BMI, not VFA, was independently associated with T2D (OR 1.18, 95% CI 1.02-1.37). Visceral fat was independently associated with T2D in women regardless of obesity status, whereas in men BMI may have a more important effect on T2D than visceral fat. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Does Family History of Obesity, Cardiovascular, and Metabolic Diseases Influence Onset and Severity of Childhood Obesity?

PubMed

Corica, Domenico; Aversa, Tommaso; Valenzise, Mariella; Messina, Maria Francesca; Alibrandi, Angela; De Luca, Filippo; Wasniewska, Malgorzata

2018-01-01

The objectives were to evaluate (1) the metabolic profile and cardiometabolic risk in overweight/obese children at first assessment, stratifying patients according to severity of overweight and age; and (2) to investigate the relationship between family history (FH) for obesity and cardiometabolic diseases and severity of childhood obesity. In this cross-sectional, retrospective, observational study, 260 children (139 female), aged between 2.4 and 17.2 years, with overweight and obesity were recruited. Data regarding FH for obesity and cardiometabolic diseases were collected. Each patient underwent clinical and auxological examination and fasting blood sampling for metabolic profile. Homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-to-high-density lipoprotein cholesterol ratio, and atherogenic index of plasma were calculated. To evaluate the severity of obesity, children were divided into two groups for BMI standard deviation (SD) ≤2.5 and BMI SD >2.5. Moreover, study population was analyzed, dividing it into three groups based on the chronological age of patient (<8, 8-11, >11 years). BMI SD was negatively correlated with chronological age ( p  < 0.005) and significantly higher in the group of children <8 years. BMI SD was positively associated with FH for obesity. Patients with more severe obesity (BMI SD >2.5) were younger ( p  < 0.005), mostly prepubertal, presented a significantly higher HOMA-IR ( p  = 0.04), and had a significantly higher prevalence of FH for arterial hypertension, type 2 diabetes mellitus, and coronary heart disease than the other group. (1) Family history of obesity and cardiometabolic diseases are important risk factors for precocious obesity onset in childhood and are related to the severity of obesity. (2) Metabolic profile, especially HOMA-IR, is altered even among the youngest obese children at first evaluation. (3) Stratification of obesity severity, using BMI SD, is effective to estimate the cardiometabolic risk of patients.

[Nutritional status and risk in hospitalized children].

PubMed

Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

2001-11-01

A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was < -2 SD, > +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

Assessment of nutritional status and serum leptin in children with inflammatory bowel disease.

PubMed

Aurangzeb, Brekhna; Leach, Steven T; Lemberg, Daniel A; Day, Andrew S

2011-05-01

Children with inflammatory bowel disease (IBD) commonly have altered nutrition and growth. Measurement of serum leptin may enhance other modalities to assess the nutritional state of children with IBD. The aim of the present study was to define the nutritional status of children with newly diagnosed IBD by measuring anthropometry and serum leptin levels. Twenty-eight children newly diagnosed with IBD and 56 age- and sex-matched controls were enrolled prospectively. Anthropometry (weight, height, and body mass index [BMI] expressed as z scores) and serum leptin levels were measured. The children with IBD had lower mean BMI z scores and weight-for-age percentiles than controls (P = 0.05 and P = 0.01, respectively). The mean (standard deviation) serum leptin levels of the children with IBD were 2.4 (± 1.9) pg/mL, compared with 5.2 (± 4.6) pg/mL for controls (P = 0.01). The BMI percentile correlated positively with leptin levels in both groups. Following adjustment for BMI percentiles, serum leptin levels were lower in children with IBD than in controls (P = 0.02). Leptin levels did not correlate with serum markers of inflammation or disease activity scores. Detailed and focused nutritional assessment should be an integral part of the management of all children with IBD. Children at the time of diagnosis of IBD have significant undernutrition and have lower serum leptin levels than controls. The inflammatory state in IBD appears not to alter leptin metabolism. Further study of the effect of leptin in IBD is required.

S219. RISK FACTORS FOR LOW BONE MINERAL DENSITY IN PATIENTS TAKING ANTIPSYCHOTICS

PubMed Central

Jhon, Min; Hong, Ji-Eun; Park, Cheol; Lee, Ju-Yeon; Jo, Anna; Kim, Jae-Min; Shin, Il-Seon; Williams, Lana; Berk, Michael; Yoon, Jin-Sang; Kim, Sung-Wan

2018-01-01

Abstract Background The aim of this study is to explore potentially modifiable risk factors for low bone mineral density (BMD) in adults with psychotic disorders. Furthermore, we sought to identify gender-specific risk factors. Methods The study included 285 community-dwelling patients with psychotic disorders. Dual-energy x-ray absorptiometry was used to measure BMD. Laboratory examinations included vitamin D and prolactin levels. Low BMD was defined as<1 standard deviation below the mean for young adults. Clinical characteristics associated with low BMD were identified with logistic regression analysis in total population and each gender. Results Fifty-eight (20.4%) subjects had low BMD. Low BMD was more common in men and in patients with low body mass indices (BMIs), as well as in those with shorter treatment durations, those on Medicaid, and patients using serotonergic antidepressants. Logistic regression analysis revealed that low BMD was negatively associated with BMI and treatment duration and positively with gender (male) and serotonergic antidepressants use in the overall population. In men, low BMD was associated with treatment duration and BMI; in women, low BMD was associated with BMI, prolactin level, vitamin D, and serotonergic antidepressant use. Discussion Low BMI was risk factor for reduced BMD in both genders. Shorter treatment duration was associated with low BMD in men, whereas higher prolactin levels, lower vitamin D, and the use of serotonergic antidepressants were associated with low BMD in women. Psychotropic agents should be prescribed mindful of their effects on bone, as use of these medications is a modifiable risk factor for osteoporosis in women with psychotic disorders.

Influence of weight and body fat distribution on bone density in postmenopausal women.

PubMed

Murillo-Uribe, A; Carranza-Lira, S; Martínez-Trejo, N; Santos-González, J

2000-01-01

To determine whether obesity or body fat distribution induces a greater modification on bone remodeling biochemistry (BRB) and bone density in postmenopausal women. One hundred and thirteen postmenopausal patients were studied. They were initially divided according to body mass index (BMI), and afterwards by waist-hip ratio (WHR) as well as combinations of the two factors. Hormone measurements and assessments of BRB were also done. Dual-emission X-ray absorptiometry from the lumbar column and hip was performed with Lunar DPXL equipment, and the standard deviation in relation to young adult (T) and age-matched subjects (Z) was calculated. Statistical analysis was done by the Mann-Whitney U test. The relation of BMI and WHR with the variables was calculated by simple regression analysis. When divided according to BMI, there was greater bone density in the femoral neck in those with normal weight. After dividing according to WHR, the Z scores had a trend to a lesser decrease in those with upper level body fat distribution. Divided according to BMI and WHR, obese patients with upper-level body fat distribution had greater bone density in the lumbar column than those with normal weight and lower-level body fat distribution. With the same WHR, those with normal weight had greater bone density than those who were obese. A beneficial effect of upper-level body fat distribution on bone density was found. It is greater than that from obesity alone, and obesity and upper-level body fat distribution have an additive effect on bone density.

Food Environment and Weight Change: Does Residential Mobility Matter?: The Diabetes Study of Northern California (DISTANCE).

PubMed

Laraia, Barbara A; Downing, Janelle M; Zhang, Y Tara; Dow, William H; Kelly, Maggi; Blanchard, Samuel D; Adler, Nancy; Schillinger, Dean; Moffet, Howard; Warton, E Margaret; Karter, Andrew J

2017-05-01

Associations between neighborhood food environment and adult body mass index (BMI; weight (kg)/height (m)2) derived using cross-sectional or longitudinal random-effects models may be biased due to unmeasured confounding and measurement and methodological limitations. In this study, we assessed the within-individual association between change in food environment from 2006 to 2011 and change in BMI among adults with type 2 diabetes using clinical data from the Kaiser Permanente Diabetes Registry collected from 2007 to 2011. Healthy food environment was measured using the kernel density of healthful food venues. Fixed-effects models with a 1-year-lagged BMI were estimated. Separate models were fitted for persons who moved and those who did not. Sensitivity analysis using different lag times and kernel density bandwidths were tested to establish the consistency of findings. On average, patients lost 1 pound (0.45 kg) for each standard-deviation improvement in their food environment. This relationship held for persons who remained in the same location throughout the 5-year study period but not among persons who moved. Proximity to food venues that promote nutritious foods alone may not translate into clinically meaningful diet-related health changes. Community-level policies for improving the food environment need multifaceted strategies to invoke clinically meaningful change in BMI among adult patients with diabetes. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Metabolic signatures of adiposity in young adults: Mendelian randomization analysis and effects of weight change.

PubMed

Würtz, Peter; Wang, Qin; Kangas, Antti J; Richmond, Rebecca C; Skarp, Joni; Tiainen, Mika; Tynkkynen, Tuulia; Soininen, Pasi; Havulinna, Aki S; Kaakinen, Marika; Viikari, Jorma S; Savolainen, Markku J; Kähönen, Mika; Lehtimäki, Terho; Männistö, Satu; Blankenberg, Stefan; Zeller, Tanja; Laitinen, Jaana; Pouta, Anneli; Mäntyselkä, Pekka; Vanhala, Mauno; Elliott, Paul; Pietiläinen, Kirsi H; Ripatti, Samuli; Salomaa, Veikko; Raitakari, Olli T; Järvelin, Marjo-Riitta; Smith, George Davey; Ala-Korpela, Mika

2014-12-01

Increased adiposity is linked with higher risk for cardiometabolic diseases. We aimed to determine to what extent elevated body mass index (BMI) within the normal weight range has causal effects on the detailed systemic metabolite profile in early adulthood. We used Mendelian randomization to estimate causal effects of BMI on 82 metabolic measures in 12,664 adolescents and young adults from four population-based cohorts in Finland (mean age 26 y, range 16-39 y; 51% women; mean ± standard deviation BMI 24 ± 4 kg/m(2)). Circulating metabolites were quantified by high-throughput nuclear magnetic resonance metabolomics and biochemical assays. In cross-sectional analyses, elevated BMI was adversely associated with cardiometabolic risk markers throughout the systemic metabolite profile, including lipoprotein subclasses, fatty acid composition, amino acids, inflammatory markers, and various hormones (p<0.0005 for 68 measures). Metabolite associations with BMI were generally stronger for men than for women (median 136%, interquartile range 125%-183%). A gene score for predisposition to elevated BMI, composed of 32 established genetic correlates, was used as the instrument to assess causality. Causal effects of elevated BMI closely matched observational estimates (correspondence 87% ± 3%; R(2)= 0.89), suggesting causative influences of adiposity on the levels of numerous metabolites (p<0.0005 for 24 measures), including lipoprotein lipid subclasses and particle size, branched-chain and aromatic amino acids, and inflammation-related glycoprotein acetyls. Causal analyses of certain metabolites and potential sex differences warrant stronger statistical power. Metabolite changes associated with change in BMI during 6 y of follow-up were examined for 1,488 individuals. Change in BMI was accompanied by widespread metabolite changes, which had an association pattern similar to that of the cross-sectional observations, yet with greater metabolic effects (correspondence 160% ± 2%; R(2) = 0.92). Mendelian randomization indicates causal adverse effects of increased adiposity with multiple cardiometabolic risk markers across the metabolite profile in adolescents and young adults within the non-obese weight range. Consistent with the causal influences of adiposity, weight changes were paralleled by extensive metabolic changes, suggesting a broadly modifiable systemic metabolite profile in early adulthood. Please see later in the article for the Editors' Summary.

Does waist circumference uncorrelated with BMI add valuable information?

PubMed

Ngueta, Gerard; Laouan-Sidi, Elhadji A; Lucas, Michel

2014-09-01

Estimation of relative contribution of Body Mass Index (BMI) and waist circumference (WC) on health outcomes requires a regression model that includes both obesity metrics. But, multicollinearity could yield biased estimates. To address the multicollinearity issue between BMI and WC, we used the residual model approach. The standard WC (Y-axis) was regressed on the BMI (X-axis) to obtain residual WC. Data from two adult population surveys (Nunavik Inuit and James Bay Cree) were analysed to evaluate relative effect of BMI and WC on four cardiometabolic risk factors: insulin, triglycerides, systolic blood pressure and high-density lipoprotein levels. In multivariate models, standard WC and BMI were significantly associated with cardiometabolic outcomes. Residual WC was not linked with any outcomes. The BMI effect was weakened by including standard WC in the model, but its effect remained unchanged if residual WC was considered. The strong correlation between standard WC and BMI does not allow assessment of their relative contributions to health in the same model without a risk of making erroneous estimations. By contrast with BMI, fat distribution (residual WC) does not add valuable information to a model that already contains overall adiposity (BMI) in Inuit and Cree. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Triptorelin therapy in girls with central precocious puberty increases body mass index].

PubMed

Martín Díaz, M J; Soriano Guillén, L; Muñoz Calvo, M T; Pozo Román, J; Argente Oliver, J

2006-11-01

The most important complications of central precocious puberty (CPP) in girls are loss of height and multiple psychosocial problems. To study the effect of triptorelin therapy in a cohort of girls with CPP. Thirty-four girls diagnosed with organic or idiopathic CPP and treated with monthly triptorelin were studied. Age, height in standard deviation (SD), bone age (Greulich and Pyle), height prediction (Bayle-Pinneau), body mass index (BMI) in SD, uterine size (pelvic ultrasound), target height, cranial magnetic resonance imaging, triptorelin dose, and treatment duration were studied. Triptorelin produced a statistically significant reduction in growth velocity and an increase in BMI after 1 year of therapy and these changes were maintained after discontinuation of therapy. Adult height in these patients was in accordance with their target genetic height, as well as with their predicted height according to the method of Bayley-Pinneau. No significant differences were found between age of menarche in our patients and in controls. Adult height in patients with organic CPP was significantly lower than that in patients with idiopathic CPP. 1. Triptorelin can increase BMI in girls with CPP. 2. The presence of an organic cause in patients with CPP worsens the prognosis for adult height. 3. The Bayley-Pinneau prediction method for "average" bone age is useful for establishing a prognosis of adult height in girls with CPP treated with triptorelin.

Weight gain in children on oxcarbazepine monotherapy.

PubMed

Garoufi, Anastasia; Vartzelis, George; Tsentidis, Charalambos; Attilakos, Achilleas; Koemtzidou, Evangelia; Kossiva, Lydia; Katsarou, Eustathia; Soldatou, Alexandra

2016-05-01

Studies of the effect of oxcarbazepine (OXC) on body growth of children with epilepsy are rare and their results are controversial. To the contrary, many studies have shown significant weight gain following valproate (VPA) treatment. To prospectively evaluate the effect of OXC monotherapy on growth patterns of children with epilepsy and compare it with the effect of VPA monotherapy. Fifty-nine otherwise healthy children, aged 3.7-15.9 years, with primary generalized, partial or partial with secondary generalization seizure disorder, were included in the study. Twenty six children were placed on OXC and thirty three on VPA monotherapy. Body weight (BW), height and body mass index (BMI) as well as their standard deviation scores (SDS), were evaluated prior to as well as 8 months post initiation of OXC or VPA therapy. Eight months post OXC-treatment, BW, SDS-BW, BMI and SDS-BMI increased significantly. The increase was similar to that observed in the VPA group. An additional 15.4% of children in the OXC group and 21.2% in the VPA group became overweight or obese. The effect of both OXC and VPA therapy on linear growth did not reach statistical significance. Similarly to VPA, OXC monotherapy resulted in a significant weight gain in children with epilepsy. Careful monitoring for excess weight gain along with counseling on adapting a healthy lifestyle should be offered to children on OXC therapy. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical Manifestations Associated with Overweight/Obesity in Puerto Ricans with Fibromyalgia Syndrome.

PubMed

Fred-Jiménez, Ruth M; Arroyo-Ávila, Mariangelí; Mayor, Ángel M; Ríos, Grissel; Vilá, Luis M

2016-01-01

Objective. To determine the clinical manifestations associated with overweight/obesity in Hispanics from Puerto Rico with fibromyalgia syndrome (FMS). Methods. A cross-sectional study was performed in 144 patients with FMS (per American College of Rheumatology (ACR) classification criteria). Sociodemographic features, FMS-related symptoms, tender points (per ACR criteria), comorbidities, and FMS treatment were examined. BMI was calculated and patients were grouped into two categories: BMI ≤ 24.9 kg/m(2) (nonoverweight/obese) and BMI ≥ 25 kg/m(2) (overweight/obese). Bivariate and multivariate analyses were used to evaluate differences between the study groups. Results. The mean (standard deviation (SD)) age of patients was 50.2 (9.9) years; 95.1% were females and 75.7% were overweight/obese. In the bivariate analysis, overweight/obese patients were more likely to have self-reported memory impairment, anxiety, shortness of breath, and urinary frequency than nonoverweight/obese patients. In addition, the tender point count was higher in the overweight/obese group. In the logistic regression analyses, self-reported memory impairment and urinary frequency differences remained significant after adjusting for confounding variables. Conclusion. In this population of Puerto Ricans with FMS, overweight/obese patients experienced more FMS-related manifestations than nonoverweight/obese individuals. However, prospective studies are needed to confirm these associations and to elucidate if weight reduction interventions could favorably impact the severity of FMS.

Clinical Manifestations Associated with Overweight/Obesity in Puerto Ricans with Fibromyalgia Syndrome

PubMed Central

Fred-Jiménez, Ruth M.; Arroyo-Ávila, Mariangelí; Mayor, Ángel M.; Ríos, Grissel; Vilá, Luis M.

2016-01-01

Objective. To determine the clinical manifestations associated with overweight/obesity in Hispanics from Puerto Rico with fibromyalgia syndrome (FMS). Methods. A cross-sectional study was performed in 144 patients with FMS (per American College of Rheumatology (ACR) classification criteria). Sociodemographic features, FMS-related symptoms, tender points (per ACR criteria), comorbidities, and FMS treatment were examined. BMI was calculated and patients were grouped into two categories: BMI ≤ 24.9 kg/m2 (nonoverweight/obese) and BMI ≥ 25 kg/m2 (overweight/obese). Bivariate and multivariate analyses were used to evaluate differences between the study groups. Results. The mean (standard deviation (SD)) age of patients was 50.2 (9.9) years; 95.1% were females and 75.7% were overweight/obese. In the bivariate analysis, overweight/obese patients were more likely to have self-reported memory impairment, anxiety, shortness of breath, and urinary frequency than nonoverweight/obese patients. In addition, the tender point count was higher in the overweight/obese group. In the logistic regression analyses, self-reported memory impairment and urinary frequency differences remained significant after adjusting for confounding variables. Conclusion. In this population of Puerto Ricans with FMS, overweight/obese patients experienced more FMS-related manifestations than nonoverweight/obese individuals. However, prospective studies are needed to confirm these associations and to elucidate if weight reduction interventions could favorably impact the severity of FMS. PMID:26885384

Age plays an important role in the relationship between smoking status and obesity risk: a large scale cross-sectional study of Chinese adults

PubMed Central

Su, Pu; Hong, Liu; Sun, Hang; Zhao, Yi Fan; Li, Liang

2015-01-01

Objective: To study the role of age plays in the relationship between smoking status and obesity in both Chinese men and women. Methods: From Chinese Physical and Psychological Database, participants were divided into non-smokers, current smokers, and former smokers. Body mass index (BMI), waist circumference (WC), fat percentage, fat mass, and fat free mass were measured. The mean, standard deviation and frequency of these indicators were calculated for each age bracket. One-way ANOVA and post-hoc test analyses were used to detect the difference among these three groups. Results: In men, from 19 to 24 years old, BMI, WC and fat free mass of current smokers were higher than that of non-smokers (P<0.01). However, fat mass and fat percentage of current smokers were lower than that of non-smokers but higher than that of former smokers (P<0.01). From 25 to 34 years old, BMI and fat mass of former smokers were higher than non-smokers and current smokers (P<0.01). In addition, WC and fat free mass of non-smokers were lower than that of current smokers and former smokers (P<0.01). From 45 to older, BMI, WC, fat mass, fat free mass and fat percentage of former smokers were higher than that of current smokers (P<0.01). From 55 to older, BMI, WC, fat mass, fat free mass and fat percentage of current smokers were lower than that of non-smokers (P<0.01). In women, smoking status might not be significantly related to obesity (P>0.05). Conclusion: For young men, smoking might have an effect on increasing fat free mass, BMI and WC, and decreasing fat mass and fat percentage. For middle and older men, smoking might have an effect on decreasing fat free mass, fat mass, BMI, WC, and fat percentage. Obesity risk should be paid more attention in smoking cessation programs for those former smokers. PMID:26770514

Gender-assortative waist circumference in mother-daughter and father-son pairs, and its implications. An 11-year longitudinal study in children (EarlyBird 59).

PubMed

Mostazir, M; Jeffery, A; Voss, L; Wilkin, T

2014-06-01

Body mass index (BMI) is reportedly gender assortative (mother-daughter, father-son) in contemporary children. We investigated the corresponding transmission of waist circumference (WC) and its implications. We measured parental WC at baseline and WC, height, weight and para-umbilical skin-fold (USF) annually in their offspring from 5 to 15 years (n = 223 trios). Parents were deemed normal metabolic risk (NR) or high risk (HR) according to World Health Organization (WHO) cut-points for WC (mothers 80 cm, fathers 94 cm). The residual from WC adjusted for BMI (WC|BMI ) was used as a surrogate for excess intra-abdominal fat, and its association with insulin resistance (HOMA2-IR) was sought. WC and USF were both gender assortative, while WC|BMI was not. WC was greater by 1.62 cm (P < 0.05, confidence interval [CI]: 0.09-3.16) and USF by 0.37 cm (P < 0.01, CI: 0.19-0.56) among the daughters (but not the sons) of HR compared with those of NR mothers, and by 1.32 cm (P < 0.05, CI: 0.09-2.55) and 0.18 cm (P < 0.05, CI: 0.04-0.32), respectively in the corresponding father-son (but not father-daughter) pairings. No such differences could be demonstrated for WC|BMI . A standard deviation score 1(SDS) change in WC|BMI , independent of BMI, was associated with a 7.14% change in IR in girls (P < 0.01, CI: 1.76-12.80) and 8.02% in boys (P < 0.001, CI: 2.93-13.36), but there was no relationship between IR and USF. The relationship of offspring WC to metabolic health and to parental size is complex. Subcutaneous abdominal fat is gender assortative but harmless, while intra-abdominal fat (its surrogate in this analysis) is unrelated to parental waist circumference, but metabolically harmful. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Mendelian randomisation analysis provides no evidence for a relationship between adult height and testicular cancer risk.

PubMed

Levy, M; Hall, D; Sud, A; Law, P; Litchfield, K; Dudakia, D; Haugen, T B; Karlsson, R; Reid, A; Huddart, R A; Grotmol, T; Wiklund, F; Houlston, R S; Turnbull, C

2017-09-01

Observational studies have suggested anthropometric traits, particularly increased height are associated with an elevated risk of testicular cancer (testicular germ cell tumour). However, there is an inconsistency between study findings, suggesting the possibility of the influence of confounding factors. To examine the association between anthropometric traits and testicular germ cell tumour using an unbiased approach, we performed a Mendelian randomisation study. We used genotype data from genome wide association studies of testicular germ cell tumour totalling 5518 cases and 19,055 controls. Externally weighted polygenic risk scores were created and used to evaluate associations with testicular germ cell tumour risk per one standard deviation (s.d) increase in genetically-defined adult height, adult BMI, adult waist hip ratio adjusted for BMI (WHRadjBMI), adult hip circumference adjusted for BMI (HIPadjBMI), adult waist circumference adjusted for BMI (WCadjBMI), birth weight (BW) and childhood obesity. Mendelian randomisation analysis did not demonstrate an association between any anthropometric trait and testicular germ cell tumour risk. In particular, despite good power, there was no global evidence for association between height and testicular germ cell tumour. However, three SNPs for adult height individually showed association with testicular germ cell tumour (rs4624820: OR = 1.47, 95% CI: 1.41-1.55, p = 2.7 × 10 -57 ; rs12228415: OR = 1.17, 95% CI: 1.11-1.22, p = 3.1 × 10 -10 ; rs7568069: OR = 1.13, 95% CI: 1.07-1.18, p = 1.1 × 10 -6 ). This Mendelian randomisation analysis, based on the largest testicular germ cell tumour genome wide association dataset to date, does not support a causal etiological association between anthropometric traits and testicular germ cell tumour aetiology. Our findings are more compatible with confounding by shared environmental factors, possibly related to prenatal growth with exposure to these risk factors occurring in utero. © 2017 American Society of Andrology and European Academy of Andrology.

Predictors of blood pressure at 7-13 years: The "new millennium baby" study.

PubMed

Brambilla, P; Bedogni, G; Pietrobelli, A; Cianfarani, S; Agostoni, C

2016-08-01

The purpose of this study is to evaluate the association between blood pressure (BP) at 7-13 years of age and body mass index (BMI), early feeding, lifestyle indicators, and parental characteristics. Retrospective plus cross-sectional cohort study was started in 1294 children born in 2000-2004, right from their birth in primary care settings. Early feeding was estimated by measuring breast-feeding (BF) duration, complementary feeding (CF) introduction time, and lifestyle indicators such as daily screen time and weekly extracurricular sports activity time. Parental education, smoking, and obesity-related diseases were also considered. Multivariable linear regression and mediation analysis were used. CF introduction at 5-6 months of age was a negative predictor of systolic and diastolic BP (mean systolic BP-standard deviation score (SDS) -0.38 [95% CI: -0.47, -0.29] (p < 0.001); mean diastolic BP-SDS -0.32 [95% CI: -0.40, -0.24]) (p < 0.001); BMI was a positive predictor of systolic and diastolic BP (p < 0.001); and parental hypertension was a positive predictor of diastolic BP (p < 0.05). Predictors of mean BMI-SDS at 7-13 years of age were birth weight, screen time, and parental obesity and smoking (p < 0.001). BF had no effect on BP or BMI. Mediation analysis showed virtually no indication of the effect of CF on BP mediated by BMI. CF introduction between 5 and 6 months of age could be associated with low BP at 7-13 years. The effect of CF on BP seems to be independent of BMI. Low screen time is associated with low BMI. CF time may play a role in the occurrence of surrogates of noncommunicable disorders in future. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Urinary Triclosan Concentrations Are Inversely Associated with Body Mass Index and Waist Circumference in the US General Population: Experience in NHANES 2003-2010

PubMed Central

Li, Shengxu; Zhao, Jinying; Wang, Guangdi; Zhu, Yun; Rabito, Felicia; Krousel-Wood, Marie; Chen, Wei; Whelton, Paul K

2015-01-01

Background Humans are extensively exposed to triclosan, an antibacterial and antifungal agent. Triclosan’s effects on human health, however, have not been carefully investigated. Objective To examine whether triclosan exposure is associated with obesity traits. Methods This study included 2,898 children (6-19 years old) and 5,066 adults (20 years or older) who participated in the National Health and Nutrition Examination Surveys (NHANES) 2003-2010 and had a detectable level of urinary triclosan. Multiple linear regression models were used to examine the association between urinary triclosan and both body mass index (BMI) and waist circumference. Results Each standard deviation increase in urinary triclosan was associated with a 0.34 (95% confidence interval, CI: 0.05, 0.64) kg/m2 lower level of BMI (p=0.02) and 0.92 (95% CI: 0.09, 1.74) cm smaller waist circumference (p=0.03) in boys, and a 0.62 (95% CI: 0.31, 0.94) kg/m2 lower level of BMI (p=0.0002) and 1.32 (95% CI: 0.54, 2.09) cm smaller waist circumference in girls (P=0.001); a 0.42 (95% CI: 0.06, 0.77) kg/m2 lower level of BMI (P=0.02) and 1.35 (95% CI: 0.48, 2.22) cm smaller waist circumference (P=0.003) in men, and a 0.71 (95% CI: 0.34, 1.07) kg/m2 lower level of BMI (P=0.0002) and 1.68 (95% CI: 0.86, 2.50) cm smaller waist circumference (P=0.0001) in women. In both children and adults, there was a consistent trend for lower levels of BMI and smaller waist circumference with increasing levels of urinary triclosan, from the lowest to the highest quartile of urinary triclosan (P≤0.001 in all cases). Conclusion Triclosan exposure is inversely associated with BMI and waist circumference. The biological mechanisms linking triclosan exposure to obesity await further investigation. PMID:25823951

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

PubMed Central

Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

2017-01-01

Background Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. Methods In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. Results From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. Conclusion BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility. PMID:28264043

Impact of Masked Replacement of Sugar-Sweetened with Sugar-Free Beverages on Body Weight Increases with Initial BMI: Secondary Analysis of Data from an 18 Month Double-Blind Trial in Children.

PubMed

Katan, Martijn B; de Ruyter, Janne C; Kuijper, Lothar D J; Chow, Carson C; Hall, Kevin D; Olthof, Margreet R

2016-01-01

Substituting sugar-free for sugar-sweetened beverages reduces weight gain. This effect may be more pronounced in children with a high body mass index (BMI) because their sensing of kilocalories might be compromised. We investigated the impact of sugar-free versus sugary drinks separately in children with a higher and a lower initial BMI z score, and predicted caloric intakes and degree of compensation in the two groups. This is a secondary, explorative analysis of our double-blind randomized controlled trial (RCT) which showed that replacement of one 250-mL sugary drink per day by a sugar-free drink for 18 months significantly reduced weight gain. In the 477 children who completed the trial, mean initial weights were close to the Dutch average. Only 16% were overweight and 3% obese. Weight changes were expressed as BMI z-score, i.e. as standard deviations of the BMI distribution per age and sex group. We designated the 239 children with an initial BMI z-score below the median as 'lower BMI' and the 238 children above the median as 'higher BMI'. The difference in caloric intake from experimental beverages between treatments was 86 kcal/day both in the lower and in the higher BMI group. We used a multiple linear regression and the coefficient of the interaction term (initial BMI group times treatment), indicated whether children with a lower BMI responded differently from children with a higher BMI. Statistical significance was defined as p ≤ 0.05. Relative to the sugar sweetened beverage, consumption of the sugar-free beverage for 18 months reduced the BMI z-score by 0.05 SD units within the lower BMI group and by 0.21 SD within the higher BMI group. Body weight gain was reduced by 0.62 kg in the lower BMI group and by 1.53 kg in the higher BMI group. Thus the treatment reduced the BMI z-score by 0.16 SD units more in the higher BMI group than in the lower BMI group (p = 0.04; 95% CI -0.31 to -0.01). The impact of the intervention on body weight gain differed by 0.90 kg between BMI groups (p = 0.09; 95% CI -1.95 to 0.14). In addition, we used a physiologically-based model of growth and energy balance to estimate the degree to which children had compensated for the covertly removed sugar kilocalories by increasing their intake of other foods. The model predicts that children with a lower BMI had compensated 65% (95% CI 28 to 102) of the covertly removed sugar kilocalories, whereas children with a higher BMI compensated only 13% (95% CI -37 to 63). The children with a BMI above the median might have a reduced tendency to compensate for changes in caloric intake. Differences in these subconscious compensatory mechanisms may be an important cause of differences in the tendency to gain weight. If further research bears this out, cutting down on the intake of sugar-sweetened drinks may benefit a large proportion of children, especially those who show a tendency to become overweight. ClinicalTrials.gov NCT00893529.

Impact of Masked Replacement of Sugar-Sweetened with Sugar-Free Beverages on Body Weight Increases with Initial BMI: Secondary Analysis of Data from an 18 Month Double–Blind Trial in Children

PubMed Central

Katan, Martijn B.; de Ruyter, Janne C.; Kuijper, Lothar D. J.; Chow, Carson C.; Hall, Kevin D.; Olthof, Margreet R.

2016-01-01

Background Substituting sugar-free for sugar-sweetened beverages reduces weight gain. This effect may be more pronounced in children with a high body mass index (BMI) because their sensing of kilocalories might be compromised. We investigated the impact of sugar-free versus sugary drinks separately in children with a higher and a lower initial BMI z score, and predicted caloric intakes and degree of compensation in the two groups. Methods and Findings This is a secondary, explorative analysis of our double-blind randomized controlled trial (RCT) which showed that replacement of one 250-mL sugary drink per day by a sugar—free drink for 18 months significantly reduced weight gain. In the 477 children who completed the trial, mean initial weights were close to the Dutch average. Only 16% were overweight and 3% obese. Weight changes were expressed as BMI z-score, i.e. as standard deviations of the BMI distribution per age and sex group. We designated the 239 children with an initial BMI z-score below the median as ‘lower BMI’ and the 238 children above the median as ‘higher BMI’. The difference in caloric intake from experimental beverages between treatments was 86 kcal/day both in the lower and in the higher BMI group. We used a multiple linear regression and the coefficient of the interaction term (initial BMI group times treatment), indicated whether children with a lower BMI responded differently from children with a higher BMI. Statistical significance was defined as p ≤ 0.05. Relative to the sugar sweetened beverage, consumption of the sugar—free beverage for 18 months reduced the BMI z-score by 0.05 SD units within the lower BMI group and by 0.21 SD within the higher BMI group. Body weight gain was reduced by 0.62 kg in the lower BMI group and by 1.53 kg in the higher BMI group. Thus the treatment reduced the BMI z-score by 0.16 SD units more in the higher BMI group than in the lower BMI group (p = 0.04; 95% CI -0.31 to -0.01). The impact of the intervention on body weight gain differed by 0.90 kg between BMI groups (p = 0.09; 95% CI -1.95 to 0.14). In addition, we used a physiologically-based model of growth and energy balance to estimate the degree to which children had compensated for the covertly removed sugar kilocalories by increasing their intake of other foods. The model predicts that children with a lower BMI had compensated 65% (95% CI 28 to 102) of the covertly removed sugar kilocalories, whereas children with a higher BMI compensated only 13% (95% CI -37 to 63). Conclusions The children with a BMI above the median might have a reduced tendency to compensate for changes in caloric intake. Differences in these subconscious compensatory mechanisms may be an important cause of differences in the tendency to gain weight. If further research bears this out, cutting down on the intake of sugar-sweetened drinks may benefit a large proportion of children, especially those who show a tendency to become overweight. Trial Registration ClinicalTrials.gov NCT00893529 PMID:27447721

The tracking of active travel and its relationship with body composition in UK adolescents.

PubMed

Falconer, Catherine L; Leary, Sam D; Page, Angie S; Cooper, Ashley R

2015-12-01

To examine the tracking of active travel through adolescence, and its association with body mass index (BMI) and fat mass at age 17 in a UK cohort. We analysed data collected from the Avon Longitudinal Study of Parents and Children (ALSPAC). The analyses include all participants with self-reported travel mode to school at ages 12, 14 and 16 years, and measured height, weight and body composition at age 17 ( n =2,026). Tracking coefficients were calculated for individual travel behaviours (including walking and cycling) through adolescence using Generalised Estimating Equations. Linear regression analyses examined associations between travel pattern (consistently passive, consistently active, active at two time points or active at one time point), BMI, and DXA-measured fat mass (expressed as internally derived standard deviation scores) at 17 years. Analyses were adjusted for height (where appropriate), sex, age, parental social class, and maternal education with interaction terms to assess sex differences. There was substantial tracking in active travel through adolescence, with 38.5% of males and 32.3% of females consistently walking or cycling to school. In males, a consistently or predominantly active travel pattern was associated with a lower BMI SD score at age 17 (consistently active: adjusted β =-0.23; 95% CI -0.40, -0.06; active at two time points: adjusted β -0.30; 95% CI -0.50, -0.10) compared to those with a consistently passive pattern. No associations were seen in females. Maintenance of active travel behaviours throughout adolescence may help to protect against the development of excess BMI in males. In addition to encouraging the adoption of active travel to school, public health messages should aim to prevent drop out from active travel to promote good health in youth.

Fat distribution and insulin resistance in young adult nonobese Asian Indian women.

PubMed

Szuszkiewicz-Garcia, Magdalene; Li, Rong; Grundy, Scott M; Abate, Nicola; Chandalia, Manisha

2012-10-01

Although Asian Indian (people of Indian subcontinent descent) men are shown to have higher total and truncal body fat as well as greater insulin resistance compared to white men matched for total body fat and age, data in women are not conclusive. The objective of this study was to compare total and regional fat distribution and insulin sensitivity between healthy young premenopausal Asian Indian and white women of similar body mass index (BMI). Twenty Asian Indian women (65% immigrants and 35% first generation living in Dallas) and 31 white women of similar age and BMI [age 24±3 vs. 25±4; BMI 22±4 vs. 23±5; mean±standard deviation (SD) in Asian Indian and white, respectively] without diabetes were evaluated with anthropometric measurements, underwater weighing for percentage of total body fat mass, magnetic resonance imaging of whole abdomen for measurement of abdominal subcutaneous and intraperitoneal fat mass, and euglycemic-hyperinsulinemic clamp study for measurement of insulin sensitivity. There were no differences in waist or hip circumference, total body subcutaneous abdominal or intraperitoneal fat mass, fasting plasma glucose, and insulin levels between Asian Indian women and white women. The peripheral glucose disposal rate (Rd) during hyperinsulinemic-euglycemic clamp was found to be almost identical in the two study groups (median value of 6.9 and 6.8 mg/min per kg of body weight, for Asian Indians and whites, respectively). For similar total or regional fat content, the glucose disposal rate was comparable in the two study groups. In conclusion, we demonstrate that young Asian Indian women do not have excess abdominal or intraperitoneal fat or insulin resistance for similar BMI compared to white women of European descent.

Fat Distribution and Insulin Resistance in Young Adult Nonobese Asian Indian Women

PubMed Central

Szuszkiewicz-Garcia, Magdalene; Li, Rong; Grundy, Scott M.; Abate, Nicola

2012-01-01

Abstract Although Asian Indian (people of Indian subcontinent descent) men are shown to have higher total and truncal body fat as well as greater insulin resistance compared to white men matched for total body fat and age, data in women are not conclusive. The objective of this study was to compare total and regional fat distribution and insulin sensitivity between healthy young premenopausal Asian Indian and white women of similar body mass index (BMI). Twenty Asian Indian women (65% immigrants and 35% first generation living in Dallas) and 31 white women of similar age and BMI [age 24±3 vs. 25±4; BMI 22±4 vs. 23±5; mean±standard deviation (SD) in Asian Indian and white, respectively] without diabetes were evaluated with anthropometric measurements, underwater weighing for percentage of total body fat mass, magnetic resonance imaging of whole abdomen for measurement of abdominal subcutaneous and intraperitoneal fat mass, and euglycemic–hyperinsulinemic clamp study for measurement of insulin sensitivity. There were no differences in waist or hip circumference, total body subcutaneous abdominal or intraperitoneal fat mass, fasting plasma glucose, and insulin levels between Asian Indian women and white women. The peripheral glucose disposal rate (Rd) during hyperinsulinemic–euglycemic clamp was found to be almost identical in the two study groups (median value of 6.9 and 6.8 mg/min per kg of body weight, for Asian Indians and whites, respectively). For similar total or regional fat content, the glucose disposal rate was comparable in the two study groups. In conclusion, we demonstrate that young Asian Indian women do not have excess abdominal or intraperitoneal fat or insulin resistance for similar BMI compared to white women of European descent. PMID:22746275

Body mass index and the development of amiodarone-induced thyrotoxicosis in adults with congenital heart disease--a cohort study.

PubMed

Stan, Marius N; Ammash, Naser M; Warnes, Carole A; Brennan, Michael D; Thapa, Prabin; Nannenga, Michael R; Bahn, Rebecca S

2013-08-10

Amiodarone-induced thyrotoxicosis (AIT) is a recognized complication of amiodarone treatment with limited management options. Its predisposing factors are incompletely defined yet a higher prevalence was reported in adults with congenital heart disease (CHD). Therefore we sought to determine the incidence and risk factors for AIT in adults with CHD. At a tertiary care center we followed a historical cohort of amiodarone-treated CHD patients for the period 1987-2009. Follow-up concluded at AIT diagnosis or with last thyroid assessment on amiodarone. Cumulative incidence of AIT was calculated. AIT association with nutritional status was hypothesized a priori. AIT developed in 23/169 patients or 13.6%. The AIT incidence peaked in the 3rd year at 7.7%. AIT patients had a lower body mass index (BMI) at AMIO initiation compared with the rest of the cohort (mean ± standard deviation: 21.9 ± 2.9 vs. 25.1 ± 5.0; p<0.001). Patients with BMI<21 were more likely to develop thyrotoxicosis (RR=6.1) compared to those with BMI>25 (p<0.001). Presence of goiter was strongly associated with AIT (RR 3.6, p=0.002). Affected patients had a trend for higher cyanotic heart disease prevalence (34.8% vs. 17.8%, p=0.059). On multivariate analysis body mass index and goiter remained independent predictors of outcome. BMI<21 at initiation of amiodarone therapy and presence of goiter are strong predictors of AIT in this population. Its incidence is time dependent. These predictors can be used clinically in assessing overall impact of amiodarone therapy in congenital heart disease patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Higher Maternal Protectiveness Is Associated with Higher Odds of Child Overweight and Obesity: A Longitudinal Australian Study

PubMed Central

Hancock, Kirsten J.; Lawrence, David; Zubrick, Stephen R.

2014-01-01

In recent years there has been an increasing interest in overprotective parenting and the potential role it plays in child development. While some have argued that a trend towards increased parental fear and reduced opportunity for independent mobility may be linked to increasing rates of child overweight and obesity, there is limited empirical information available to support this claim. Using data from the Longitudinal Study of Australian Children, this study aimed to examine the longitudinal relationships between maternal protectiveness and child overweight and obesity. A cohort of 4–5 year old children was followed up at 6–7, 8–9 and 10–11 years of age (n  =  2596). Measures included a protective parenting scale administered when children were 6–7 and 8–9 years of age, child body mass index (BMI), family characteristics including household income, neighbourhood disadvantage, child's position amongst siblings, and maternal BMI, education, employment, mental health and age at first birth. International Obesity Taskforce age- and sex-specific BMI cut points were used to determine if children were in the normal, overweight or obese BMI range. There was no association between maternal protectiveness and the odds of children being overweight or obese at age 4–5, 6–7 or 8–9 years. However at age 10–11 years, a 1 standard deviation increase in maternal protectiveness was associated with a 13% increase in the odds of children being overweight or obese. The results provide evidence of a relationship between maternal protectiveness and child overweight and obesity, however further research is required to understand the mechanism(s) that links the two concepts. PMID:24955586

Self-reported versus measured height and weight in Hispanic and non-Hispanic menopausal women.

PubMed

Griebeler, Marcio L; Levis, Silvina; Beringer, Laura Muñoz; Chacra, Walid; Gómez-Marín, Orlando

2011-04-01

Height and weight information is commonly used in clinical trials and in making therapeutic decisions in medical practice. In both settings, the data are often obtained by self-report. If erroneous, this practice could lead to inaccuracies in estimating renal function and medication doses or to inaccurate outcomes of research studies. Previous publications have reported lack of reliability of self-reported weight and height in the general population but have not addressed age-specific and ethnicity-specific subgroups in the U.S. population. The inaccuracy of self-reported weight and height could be particularly significant in times of considerable changes in body weight, such as at menopause, which is often associated with weight gain. We assessed the validity of self-reported height and weight in 428 women within the first 5 years of menopause, 70.6% of whom were Hispanic. Participants overestimated their height by 2.2±3.5 cm (mean±standard deviation [SD]) and underestimated their weight by 1.5±2.9 kg. As a group, based on self-reported measures, 33.3% were misclassified with respect to body mass index (BMI) category, and the difference between measured BMI and self-reported BMI was similar between Hispanic white and non-Hispanic white women, positively related to measured weight, and inversely related to measured height, years from menopause, and multiple parity. From the public health perspective, inaccurate self-report could lead to a considerable underestimation of the current obesity prevalence rates. In our study population, the prevalence of obesity (BMI ≥30 kg/m(2)) was 6.3% based on self-reported values and 18% based on measured height and weight, representing a 3-fold underestimation.

Self-Reported Versus Measured Height and Weight in Hispanic and Non-Hispanic Menopausal Women

PubMed Central

Griebeler, Marcio L.; Beringer, Laura Muñoz; Chacra, Walid; Gómez-Marín, Orlando

2011-01-01

Abstract Background Height and weight information is commonly used in clinical trials and in making therapeutic decisions in medical practice. In both settings, the data are often obtained by self-report. If erroneous, this practice could lead to inaccuracies in estimating renal function and medication doses or to inaccurate outcomes of research studies. Previous publications have reported lack of reliability of self-reported weight and height in the general population but have not addressed age-specific and ethnicity-specific subgroups in the U.S. population. The inaccuracy of self-reported weight and height could be particularly significant in times of considerable changes in body weight, such as at menopause, which is often associated with weight gain. Methods We assessed the validity of self-reported height and weight in 428 women within the first 5 years of menopause, 70.6% of whom were Hispanic. Results Participants overestimated their height by 2.2±3.5 cm (mean±standard deviation [SD]) and underestimated their weight by 1.5±2.9 kg. As a group, based on self-reported measures, 33.3% were misclassified with respect to body mass index (BMI) category, and the difference between measured BMI and self-reported BMI was similar between Hispanic white and non-Hispanic white women, positively related to measured weight, and inversely related to measured height, years from menopause, and multiple parity. Conclusions From the public health perspective, inaccurate self-report could lead to a considerable underestimation of the current obesity prevalence rates. In our study population, the prevalence of obesity (BMI ≥30 kg/m2) was 6.3% based on self-reported values and 18% based on measured height and weight, representing a 3-fold underestimation. PMID:21413893

Energy expenditure and enjoyment of common children's games in a simulated free-play environment.

PubMed

Howe, Cheryl A; Freedson, Patty S; Feldman, Henry A; Osganian, Stavroula K

2010-12-01

To measure the energy expenditure and enjoyment of children's games to be used in developing a school-based intervention for preventing excessive weight gain. Healthy weight (body mass index [BMI] < 85th percentile) and overweight or obese (BMI ≥ 85th percentile) third-grade children (15 boys; 13 girls) were recruited. In a large gymnasium, children performed 10 games randomly selected from 30 games used in previous interventions. Total energy expenditure was measured with a portable metabolic unit and perceived enjoyment was assessed using a 9-point Likert scale of facial expressions. Mean physical activity energy expenditure (PAEE = total energy expenditure minus resting metabolism) and enjoyment of the games were adjusted for sex and BMI classification. PAEE and enjoyment were compared using a repeated-measures ANOVA with sex, BMI classification, and games as main effects. The games elicited a moderate intensity effort (mean ± standard deviation = 5.0 ± 1.3 metabolic equivalents, 123 ± 36 kcal/30 min). PAEE was higher for boys than for girls (0.12 ± 0.04 versus 0.11 ± 0.04 kcal/kg/min) and for healthy weight compared with overweight children (0.13 ± 0.04 versus 0.11 ± 0.03 kcal/kg/min). Twenty-two of the 30 games elicited a sufficiently high PAEE (≥ 100 kcal/30 min) and enjoyment (≥ neutral expression) for inclusion in future school-based interventions. Not all children's games are perceived as enjoyable or resulted in an energy expenditure that was sufficiently high for inclusion in future physical activity interventions to prevent the excess weight gain associated with childhood obesity. Copyright © 2010 Mosby, Inc. All rights reserved.

Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery.

PubMed

Ewang-Emukowhate, M; Harrington, D J; Botha, A; McGowan, B; Wierzbicki, A S

2015-06-01

Micronutrient deficiencies occur in morbidly obese patients. The aim of this study was to assess vitamin deficiencies prior to bariatric surgery including vitamin K about which there is little data in this population. A prospective assessment of 118 consecutive patients was performed. Clinical allied with haematological and biochemical variables were measured. Micronutrients measured included vitamins K1 , PIVKA-II (protein-induced in vitamin K absence factor II), vitamin D, vitamin B12 (holotranscobalamin), iron, transferrin and folate. Patients were aged 49 ± 11 [mean (SD, standard deviation)] years, body mass index (BMI) 50 ± 8 kg/m(2), 66% female and 78% Caucasian. Hypertension was present in 47% and type 2 diabetes in 32%. Vitamin D supplements had been prescribed in 8%. Micronutrient insufficiencies were found for vitamin K (40%), vitamin D (92%) and vitamin B12 (25%), and also iron (44%) and folate (18%). Normocalcaemic vitamin D insufficiency with secondary hyperparathyroidism was present in 18%. Iron and transferrin levels were associated with age, sex and estimated glomerular filtration rate. Vitamin K levels were associated with age, and inversely with BMI and diabetes mellitus; and PIVKA-II with smoking, triglycerides and liver function markers. Vitamin D levels were associated with statin use and prescription of supplements and inversely with BMI. Vitamin B12 levels were associated with ethnicity and HbA1c. Micronutrient status shows differing relationships with age, gender and BMI. Vitamin K insufficiency was present in 40% and not related to deficiencies in other vitamins or micronutrients. Vitamin D and vitamin K supplementation should be considered prebariatric surgery in patients with diabetes or severe insulin resistance. © 2014 John Wiley & Sons Ltd.

Relationship between body mass index, fat mass and lean mass with SF-36 quality of life scores in a group of fibromyalgia patients.

PubMed

Arranz, Laura; Canela, Miguel Angel; Rafecas, Magda

2012-11-01

Patients suffering from fibromyalgia (FM) had widespread musculoskeletal pain and stiffness, fatigue, sleep disorders, cognitive impairment and other symptoms, which seriously affects their quality of life (QoL), making it difficult to perform normal activities. Moreover, FM has been associated with a higher prevalence of overweight and obesity than in the general population. Weight reduction has been beneficial in both FM and other rheumatic patients. Obesity and overweight have been pointed as playing a relevant role in FM symptoms; however, it is necessary to find out more about this relationship. The objective of this study was to evaluate the relationship between body mass index (BMI), fat mass (fM) and lean mass (lM) with quality of life in a group of FM patients. 103 women, with a mean age of 53.74 ± 7.81, and members of different FM patient associations from Spain participated in our study. Some anthropometric measures were taken like weight, height, BMI, body fat mass and lean mass. FM patients QoL was assessed by the Short-Form Health Survey, SF-36 questionnaire. Statistical reports were based on mean, standard deviation and correlation, but significance was tested by nonparametric methods. BMI, fM and lM correlated differently with the specific SF-36 scores. BMI had a high negative correlation with emotional role, fM with bodily pain and lM almost with all scores but specially with emotional role, vitality and physical role. The outcome of this study reveals some interesting relationships, which need to be further investigated to improve the management of FM patients.

[Association between dietary calcium/dairy intakes and overweight/obesity].

PubMed

Chen, Yanrong; Liu, Yan; Xue, Hongmei; Bao, Yuxin; Luo, Jiao; Tian, Guo; Cheng, Guo

2016-05-01

To investigate the intakes of dietary calcium/dairy and the current prevalence of overweight and obesity among children and adolescents aged 7-15 in Longquanyi District, Chengdu, and to explore the association of dietary calcium and dairy intake with overweight/obesity. 1738 children and adolescents were recruited in the cross-sectional study using cluster random sampling method. Information on dietary calcium and dairy intakes was collected using 24-hour dietary recall and food frequency questionnaire (FFQ). Height, weight and waist circumference were measured to calculate body mass index (BMI)/waist-to-height ratio (WHtR) and body mass index standard deviation (BMI SDS). Overweight/obesity was defined based on the criteria of Working Group on Obesity in China (WGOC). Participants were grouped into 3 categories indicating lower, moderate and higher intakes of dietary calcium and dairy, respectively. The association of dietary calcium and dairy consumption with (BMI SDS) /WHtR and the prevalence of overweight/obesity was analyzed after being stratified by gender and age. The prevalence of overweight/obesity in boys and girls were 11.92%/7.04% and 8.04%/6.30%, respectively. The intake of dietary calcium and dairy in girls were much higher than that in boys (P < 0.0001). Among boys aged 7-9 years, those with higher consumption of dairy had the higher BMI SDS (P = 0.01). Among boys aged 10-12 years, those with higher consumption of dietary calcium had the lowest prevalence of overweight (P = 0.03). However, similar results were not observed among girls. Dietary calcium and dairy intakes seemed to be related to overweight/ obesity in boys, however the associations were inconsistent among different age groups. Associations between consumption of calcium, dairy and overweight/obesity were not found among girls.

Higher maternal protectiveness is associated with higher odds of child overweight and obesity: a longitudinal Australian study.

PubMed

Hancock, Kirsten J; Lawrence, David; Zubrick, Stephen R

2014-01-01

In recent years there has been an increasing interest in overprotective parenting and the potential role it plays in child development. While some have argued that a trend towards increased parental fear and reduced opportunity for independent mobility may be linked to increasing rates of child overweight and obesity, there is limited empirical information available to support this claim. Using data from the Longitudinal Study of Australian Children, this study aimed to examine the longitudinal relationships between maternal protectiveness and child overweight and obesity. A cohort of 4-5 year old children was followed up at 6-7, 8-9 and 10-11 years of age (n  =  2596). Measures included a protective parenting scale administered when children were 6-7 and 8-9 years of age, child body mass index (BMI), family characteristics including household income, neighbourhood disadvantage, child's position amongst siblings, and maternal BMI, education, employment, mental health and age at first birth. International Obesity Taskforce age- and sex-specific BMI cut points were used to determine if children were in the normal, overweight or obese BMI range. There was no association between maternal protectiveness and the odds of children being overweight or obese at age 4-5, 6-7 or 8-9 years. However at age 10-11 years, a 1 standard deviation increase in maternal protectiveness was associated with a 13% increase in the odds of children being overweight or obese. The results provide evidence of a relationship between maternal protectiveness and child overweight and obesity, however further research is required to understand the mechanism(s) that links the two concepts.

Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives

PubMed Central

Wong, Matthew; Katzman, Debra K.; Akseer, Nadia; Steinegger, Cathleen; Hancock-Howard, Rebecca L.; Coyte, Peter C.

2015-01-01

Background Admission to hospital is the treatment of choice for anorexia nervosa in adolescent patients who are medically unstable; however, stays are often prolonged and frequently disrupt normal adolescent development, family functioning, school and work productivity. We sought to determine the costs of inpatient treatment in this population from a hospital and caregiver perspective, and to identify determinants of such costs. Methods We used micro-costing methods for this cohort study involving all adolescent patients (age 12–18 yr) admitted for treatment of anorexia nervosa at a tertiary care child and adolescent eating disorder program in Toronto, between Sept. 1, 2011, and Mar. 31, 2013. We used hospital administrative data and Canadian census data to calculate hospital and caregiver costs. Results We included 73 adolescents in our cohort for cost-analysis. We determined a mean total hospital cost in 2013 Canadian dollars of $51 349 (standard deviation [SD] $26 598) and a mean total societal cost of $54 932 (SD $27 864) per admission, based on a mean length of stay of 37.9 days (SD 19.7 d). We found patient body mass index (BMI) to be the only significant negative predictor of hospital cost (p < 0.001). For every unit increase in BMI, we saw a 15.7% decrease in hospital cost. In addition, we found higher BMI (p < 0.001) and younger age (p < 0.05) to be significant negative predictors of caregiver costs. Interpretation The economic burden of inpatient treatment for adolescents with anorexia nervosa on hospitals and caregivers is substantial, especially among younger patients and those with lower BMI. Recognizing the symptoms of eating disorders early may preclude the need for admission to hospital altogether or result in admissions at higher BMIs, thereby potentially reducing these costs. PMID:26389097

Rapid weight gain during infancy and early childhood is related to higher anthropometric measurements in preadolescence.

PubMed

Nanri, H; Shirasawa, T; Ochiai, H; Nomoto, S; Hoshino, H; Kokaze, A

2017-05-01

This study examined the relationship between rapid weight gain during infancy and/or early childhood and anthropometric measurements [body mass index (BMI), percent body fat (%BF), waist circumference (WC) and waist-to-height ratio (WHtR)] in preadolescence by sex. Subjects were fourth-grade school children (aged 9 to 10 years) from elementary schools in Ina-town, Japan, in 2010. Measurements of height, weight, %BF and WC were conducted for each subject. We obtained data on height and weight of subjects at birth, age 1.5 years and age 3 years from the Maternal and Child Health handbook. Rapid weight gain was defined as a change in weight-for-age standard deviation score greater than 0.67 from birth to age 1.5 years (infancy) or from age 1.5 to 3 years (early childhood). All anthropometric variables (BMI, %BF, WC and WHtR) at age 9 to 10 years were significantly higher in the rapid weight gain during both infancy and early childhood period group than in the no rapid weight gain group, regardless of sex. When compared with the no rapid weight gain group, rapid weight gain during early childhood period had significantly higher BMI and WC in boys and BMI, %BF and WC in girls. Compared with the no rapid weight gain group, the rapid weight gain during infancy group had a significantly higher WC in boys and significantly higher BMI and WC in girls. Rapid weight gain during both infancy and early childhood was related to higher anthropometric measurements, including WHtR, among Japanese preadolescents, regardless of sex. This study suggests that rapid weight gain during infancy and early childhood may be a risk factor for general/abdominal obesity later in life. © 2017 The Authors. Child: Care, Health and Development Published by John Wiley & Sons Ltd.

Mid-arm and calf circumferences are stronger mortality predictors than body mass index for patients with chronic obstructive pulmonary disease.

PubMed

Ho, Shu-Chuan; Wang, Jiun-Yi; Kuo, Han-Pin; Huang, Chien-Da; Lee, Kang-Yun; Chuang, Hsiao-Chi; Feng, Po-Hao; Chen, Tzu-Tao; Hsu, Min-Fang

2016-01-01

Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death in the world. Patients with COPD experience airflow obstruction, weight loss, skeletal muscle dysfunction, and comorbidities. Anthropometric indicators are risk factors for mortality in geriatric assessment. This study examined and compared the associations of anthropometric indicators, such as low body mass index (BMI), low mid-arm circumference (MAC), and low calf circumference (CC), with the prediction of a 3-year follow-up mortality risk in patients with COPD. We recruited nonhospitalized patients with COPD without acute conditions from a general hospital in Taiwan. The BMI, MAC, and CC of all patients were measured, and they were followed for 3 years through telephone interviews and chart reviews. The Kaplan-Meier survival curves stratified by BMI, MAC, and CC were analyzed. Variables univariately associated with survival were entered into a multivariate Cox regression model. The Bayesian information criterion was used to compare the predictive ability of the three anthropometric indicators to predict mortality rate. In total, 104 patients were included (mean ± standard deviation age, 74.2±6.9 years; forced expiratory volume in 1 second [%], 58.4±20.4 predicted; males, 94.2%); 22 patients (21.2%) died during the 36-month follow-up. During this long-term follow-up, the three anthropometric indicators could predict mortality risk in patients with COPD (low BMI [<21 kg/m(2)], hazard ratio [HR] =2.78, 95% confidence interval [CI] =1.10-7.10; low MAC [<23.5 cm], HR =3.09, 95% CI =1.30-7.38; low CC [<30 cm], HR =4.40, 95% CI =1.82-10.63). CC showed the strongest potential in predicting the mortality risk, followed by MAC and BMI. Among the three anthropometric variables examined, CC can be considered a strong predictor of mortality risk in patients with COPD.

Body configuration as a predictor of mortality: comparison of five anthropometric measures in a 12 year follow-up of the Norwegian HUNT 2 study.

PubMed

Petursson, Halfdan; Sigurdsson, Johann A; Bengtsson, Calle; Nilsen, Tom I L; Getz, Linn

2011-01-01

Distribution of body fat is more important than the amount of fat as a prognostic factor for life expectancy. Despite that, body mass index (BMI) still holds its status as the most used indicator of obesity in clinical work. We assessed the association of five different anthropometric measures with mortality in general and cardiovascular disease (CVD) mortality in particular using Cox proportional hazards models. Predictive properties were compared by computing integrated discrimination improvement and net reclassification improvement for two different prediction models. The measures studied were BMI, waist circumference, hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). The study population was a prospective cohort of 62,223 Norwegians, age 20-79, followed up for mortality from 1995-1997 to the end of 2008 (mean follow-up 12.0 years) in the Nord-Trøndelag Health Study (HUNT 2). After adjusting for age, smoking and physical activity WHR and WHtR were found to be the strongest predictors of death. Hazard ratios (HRs) for CVD mortality per increase in WHR of one standard deviation were 1.23 for men and 1.27 for women. For WHtR, these HRs were 1.24 for men and 1.23 for women. WHR offered the greatest integrated discrimination improvement to the prediction models studied, followed by WHtR and waist circumference. Hip circumference was in strong inverse association with mortality when adjusting for waist circumference. In all analyses, BMI had weaker association with mortality than three of the other four measures studied. Our study adds further knowledge to the evidence that BMI is not the most appropriate measure of obesity in everyday clinical practice. WHR can reliably be measured and is as easy to calculate as BMI and is currently better documented than WHtR. It appears reasonable to recommend WHR as the primary measure of body composition and obesity.

Quantifying the extent to which index event biases influence large genetic association studies.

PubMed

Yaghootkar, Hanieh; Bancks, Michael P; Jones, Sam E; McDaid, Aaron; Beaumont, Robin; Donnelly, Louise; Wood, Andrew R; Campbell, Archie; Tyrrell, Jessica; Hocking, Lynne J; Tuke, Marcus A; Ruth, Katherine S; Pearson, Ewan R; Murray, Anna; Freathy, Rachel M; Munroe, Patricia B; Hayward, Caroline; Palmer, Colin; Weedon, Michael N; Pankow, James S; Frayling, Timothy M; Kutalik, Zoltán

2017-03-01

As genetic association studies increase in size to 100 000s of individuals, subtle biases may influence conclusions. One possible bias is 'index event bias' (IEB) that appears due to the stratification by, or enrichment for, disease status when testing associations between genetic variants and a disease-associated trait. We aimed to test the extent to which IEB influences some known trait associations in a range of study designs and provide a statistical framework for assessing future associations. Analyzing data from 113 203 non-diabetic UK Biobank participants, we observed three (near TCF7L2, CDKN2AB and CDKAL1) overestimated (body mass index (BMI) decreasing) and one (near MTNR1B) underestimated (BMI increasing) associations among 11 type 2 diabetes risk alleles (at P  <  0.05). IEB became even stronger when we tested a type 2 diabetes genetic risk score composed of these 11 variants (-0.010 standard deviations BMI per allele, P  =  5 × 10- 4), which was confirmed in four additional independent studies. Similar results emerged when examining the effect of blood pressure increasing alleles on BMI in normotensive UK Biobank samples. Furthermore, we demonstrated that, under realistic scenarios, common disease alleles would become associated at P <  5 × 10- 8 with disease-related traits through IEB alone, if disease prevalence in the sample differs appreciably from the background population prevalence. For example, some hypertension and type 2 diabetes alleles will be associated with BMI in sample sizes of  >500 000 if the prevalence of those diseases differs by >10% from the background population. In conclusion, IEB may result in false positive or negative genetic associations in very large studies stratified or strongly enriched for/against disease cases. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Dysfunction of autonomic nervous system in childhood obesity: a cross-sectional study.

PubMed

Baum, Petra; Petroff, David; Classen, Joseph; Kiess, Wieland; Blüher, Susann

2013-01-01

To assess the distribution of autonomic nervous system (ANS) dysfunction in overweight and obese children. Parasympathetic and sympathetic ANS function was assessed in children and adolescents with no evidence of impaired glucose metabolism by analysis of heart rate variability (low frequency power ln(LF), high frequency power, ln(HF); ln(LF/HF) ratio, ratio of longest RR interval during expiration to shortest interval during inspiration (E/I ratio), root mean square of successive differences (RMSSD); sympathetic skin response (SSR); and quantitative pupillography (pupil diameter in darkness, light reflex amplitude, latency, constriction velocity, re-dilation velocity). The relationship of each ANS variable to the standard deviation score of body mass index (BMI-SDS) was assessed in a linear model considering age, gender and pubertal stage as co-variates and employing an F-statistic to compare the fit of nested models. Group comparisons between normal weight and obese children as well as an analysis of dependence on insulin resistance (as indexed by the Homeostasis Model Assessment of Insulin Resistance, HOMA-IR) were performed for parameters shown to correlate with BMI-SDS. Statistical significance was set at 5%. Measurements were performed in 149 individuals (mean age 12.0 y; 90 obese 45 boys; 59 normal weight, 34 boys). E/I ratio (p = 0.003), ln(HF) (p = 0.03), pupil diameter in darkness (p = 0.01) were negatively correlated with BMI-SDS, whereas ln(LF/HF) was positively correlated (p = 0.05). Early re-dilation velocity was in trend negatively correlated to BMI-SDS (p = 0.08). None of the parameters that depended significantly on BMI-SDS was found to be significantly correlated with HOMA-IR. These findings demonstrate extended ANS dysfunction in obese children and adolescents, affecting several organ systems. Both parasympathetic activity and sympathetic activity are reduced. The conspicuous pattern of ANS dysfunction raises the possibility that obesity may give rise to dysfunction of the peripheral autonomic nerves resembling that observed in normal-weight diabetic children and adolescents.

The Interaction of Obstructive Sleep Apnea and Obesity on the Inflammatory Markers C-Reactive Protein and Interleukin-6: The Icelandic Sleep Apnea Cohort

PubMed Central

Arnardottir, Erna S.; Maislin, Greg; Schwab, Richard J.; Staley, Bethany; Benediktsdottir, Bryndis; Olafsson, Isleifur; Juliusson, Sigurdur; Romer, Micah; Gislason, Thorarinn; Pack, Allan I.

2012-01-01

Study Objectives: To assess the relative roles and interaction of obstructive sleep apnea (OSA) severity and obesity on interleukin-6 (IL-6) and C-reactive protein (CRP) levels. Design: Cross-sectional cohort. Setting: The Icelandic Sleep Apnea Cohort. Participants: 454 untreated OSA patients (380 males and 74 females), mean ± standard deviation age 54.4 ± 10.6 yr. Interventions: N/A. Measurements and Results: Participants underwent a sleep study, abdominal magnetic resonance imaging to measure total abdominal and visceral fat volume, and had fasting morning IL-6 and CRP levels measured in serum. A significantly higher correlation was found for BMI than visceral fat volume with CRP and IL-6 levels. Oxygen desaturation index, hypoxia time, and minimum oxygen saturation (SaO2) significantly correlated with IL-6 and CRP levels, but apnea-hypopnea index did not. When stratified by body mass index (BMI) category, OSA severity was associated with IL-6 levels in obese participants only (BMI > 30 kg/m2). A multiple linear regression model with interaction terms showed an independent association of OSA severity with IL-6 levels and an interaction between OSA severity and BMI, i.e., degree of obesity altered the relationship between OSA and IL-6 levels. An independent association of OSA severity with CRP levels was found for minimum SaO2 only. A similar interaction of OSA severity and BMI on CRP levels was found for males and postmenopausal women. Conclusions: OSA severity is an independent predictor of levels of IL-6 and CRP but interacts with obesity such that this association is found only in obese patients. Citation: Arnardottir ES; Maislin G; Schwab RJ; Staley B; Benediktsdottir B; Olafsson I; Juliusson S; Romer M; Gislason T; Pack AI. The interaction of obstructive sleep apnea and obesity on the inflammatory markers c-reactive protein and interleukin-6: the Icelandic Sleep Apnea Cohort. SLEEP 2012;35(7):921-932. PMID:22754038

Body mass index predicts selected physical fitness attributes but is not associated with performance on military relevant tasks in U.S. Army Soldiers.

PubMed

Pierce, Joseph R; DeGroot, David W; Grier, Tyson L; Hauret, Keith G; Nindl, Bradley C; East, Whitfield B; McGurk, Michael S; Jones, Bruce H

2017-11-01

Army body composition standards are based upon validated criteria; however, certain field-expedient methodologies (e.g., weight-for-height, body mass index [BMI]) may disqualify individuals from service who may otherwise excel on physical performance and military-relevant tasks. The purpose was to assess soldier physical performance and military-specific task/fitness performance stratified by BMI. Cross-sectional observational study. Male (n=275) and female (n=46) soldiers performed a wide-array of physical fitness tests and military-specific tasks, including the Army physical fitness test (APFT). Within-sex performance data were analyzed by BMI tertile stratification or by Army Body Composition Program (ABCP) weight-for-height (calculated BMI) screening standards using ANOVA/Tukey post-hoc or independent t-tests, respectively. BMI stratification (higher vs. lower BMI) was associated with significant improvements in muscular strength and power, but also with decrements in speed/agility in male and female soldiers. Within the military specific tasks, a higher BMI was associated with an increased APFT 2-Mile Run time; however, performance on a 1600-m Loaded March or a Warrior Task and Battle Drill obstacle course was not related to BMI in either sex. Male and Female soldiers who did not meet ABCP screening standards demonstrated a slower 2-Mile Run time; however, not meeting the ABCP BMI standard only affected a minimal number (∼6%) of soldiers' ability to pass the APFT. Military body composition standards require a careful balance between physical performance, health, and military readiness. Allowances should be considered where tradeoffs exist between body composition classifications and performance on physical tasks with high military relevance. Published by Elsevier Ltd.

The Predisposing Factors between Dental Caries and Deviations from Normal Weight.

PubMed

Chopra, Amandeep; Rao, Nanak Chand; Gupta, Nidhi; Vashisth, Shelja; Lakhanpal, Manav

2015-04-01

Dental caries and deviations from normal weight are two conditions which share several broadly predisposing factors. So it's important to understand any relationship between dental state and body weight if either is to be managed appropriately. The study was done to find out the correlation between body mass index (BMI), diet, and dental caries among 12-15-year-old schoolgoing children in Panchkula District. A multistage sample of 12-15-year-old school children (n = 810) in Panchkula district, Haryana was considered. Child demographic details and diet history for 5 days was recorded. Data regarding dental caries status was collected using World Health Organization (1997) format. BMI was calculated and categorized according to the World Health Organization classification system for BMI. The data were subjected to statistical analysis using chi-square test and binomial regression developed using the Statistical Package for Social Sciences (SPSS) 20.0. The mean Decayed Missing Filled Teeth (DMFT) score was found to be 1.72 with decayed, missing, and filled teeth to be 1.22, 0.04, and 0.44, respectively. When the sample was assessed based on type of diet, it was found that vegetarians had higher mean DMFT (1.72) as compared to children having mixed diet. Overweight children had highest DMFT (3.21) which was followed by underweight (2.31) and obese children (2.23). Binomial regression revealed that females were 1.293 times at risk of developing caries as compared to males. Fair and poor Simplified-Oral Hygiene Index (OHI-S) showed 3.920 and 4.297 times risk of developing caries as compared to good oral hygiene, respectively. Upper high socioeconomic status (SES) is at most risk of developing caries. Underweight, overweight, and obese are at 2.7, 2.5, and 3 times risk of developing caries as compared to children with normal BMI, respectively. Dental caries and deviations from normal weight are two conditions which share several broadly predisposing factors such as diet, SES, lifestyle and other environmental factors.

A descriptive study of adherence to lifestyle modificationfactors among hypertensive patients.

PubMed

Alhalaiqa, Fadwa; Al-Nawafleh, Ahmad; Batiha, Abdul-Monim; Masa'deh, Rami; Abd Al-Razek, Aida

2017-02-27

Healthy life style recommendations (e.g., physical activity, healthy diet, and decreased cholesterol levels) play an important role in controlling blood pressure (BP). This study aimed to assess lifestyle modification factors among patients diagnosed with hypertension. A descriptive-survey design was used. Data were collected using four questionnaires; one was the Beliefs about Medication questionnaire (BMQ) and the rest were developed to collect data about demographic and clinical characteristics and lifestyle modification factors. In total 312 questionnaires were completed. The results revealed that our participants did not follow the healthy lifestyle recommendations; for example, the mean blood sugar (BS) level, body mass index (BMI), and cholesterol levels were 155 mg/dL (standard deviation (SD) = 71.9), 29 kg/m2 (SD = 5.4), and 197 mg/dL (SD = 86.6), respectively. A significant correlation was shown between age and BP (P = 0.000). Increase in diastolic BP (DBP) correlated with a significant increase in cholesterol level (P = 0.002) and BMI (P = 0.006). Our study showed that somewhat hypertensive patients in Jordan did not follow a healthy lifestyle. Therefore, urgent action by addressing behavioral risk factors has a positive impact on preventing and controlling hypertension.

Evolution of GH secretion in urine during an in-patient slimming course in obese children.

PubMed

Lehingue, Y; Locard, E; Vivant, J F; Mounier, A; Serban, A; Remontet, L; Porquet, D; Joly, M O; Mamelle, N

2000-03-01

To estimate the change in GH excretion in urine (GH-U) during a slimming course, and if increased, to assess the components of the course related to the increase in obese children. Observational follow-up study of patients admitted for primary obesity to an in-patient slimming course lasting at least 10 weeks. 48 complete observations out of 54 consecutive pre-pubertal patients admitted to a paediatric centre for treatment of primary obesity (BMI greater than the 90th percentile of the national reference curves). GH excretion in urine by immunoradiometric assay, at entry and after 10 weeks, various anthropometric measurements, nutritional intake and departure from the prescribed diet, time spent in physical activity, sleep duration. A mean decrease of 0.90 standard deviations for BMI was accompanied by a 34% increase of GH-U. Time spent in physical activity was the only component of the course found to be related to the magnitude of GH-U increase. The results of this observational study confirm that GH-U is increased after a slimming course in children, and suggest that physical activity is a major contributor to the restoration of normal GH-U levels.

Resistance Training Increases the Variability of Strength Test Scores

DTIC Science & Technology

2009-06-08

standard deviations for pretest and posttest strength measurements. This information was recorded for every strength test used in a total of 377 samples...significant if the posttest standard deviation consistently was larger than the pretest standard deviation. This condition could be satisfied even if...the difference in the standard deviations was small. For example, the posttest standard deviation might be 1% larger than the pretest standard

Associations between macrolevel economic factors and weight distributions in low- and middle-income countries: a multilevel analysis of 200,000 adults in 40 countries.

PubMed

Nandi, Arijit; Sweet, Elizabeth; Kawachi, Ichiro; Heymann, Jody; Galea, Sandro

2014-02-01

We examined associations between macrolevel economic factors hypothesized to drive changes in distributions of weight and body mass index (BMI) in a representative sample of 200,796 men and women from 40 low- and middle-income countries. We used meta-regressions to describe ecological associations between macrolevel factors and mean BMIs across countries. Multilevel regression was used to assess the relation between macrolevel economic characteristics and individual odds of underweight and overweight relative to normal weight. In multilevel analyses adjusting for individual-level characteristics, a 1-standard-deviation increase in trade liberalization was associated with 13% (95% confidence interval [CI] = 0.76, 0.99), 17% (95% CI = 0.71, 0.96), 13% (95% CI = 0.76, 1.00), and 14% (95% CI = 0.75, 0.99) lower odds of underweight relative to normal weight among rural men, rural women, urban men, and urban women, respectively. Economic development was consistently associated with higher odds of overweight relative to normal weight. Among rural men, a 1-standard-deviation increase in foreign direct investment was associated with 17% (95% CI = 1.02, 1.35) higher odds of overweight relative to normal weight. Macrolevel economic factors may be implicated in global shifts in epidemiological patterns of weight.

Associations Between Macrolevel Economic Factors and Weight Distributions in Low- and Middle-Income Countries: A Multilevel Analysis of 200 000 Adults in 40 Countries

PubMed Central

Sweet, Elizabeth; Kawachi, Ichiro; Heymann, Jody; Galea, Sandro

2014-01-01

Objectives. We examined associations between macrolevel economic factors hypothesized to drive changes in distributions of weight and body mass index (BMI) in a representative sample of 200 796 men and women from 40 low- and middle-income countries. Methods. We used meta-regressions to describe ecological associations between macrolevel factors and mean BMIs across countries. Multilevel regression was used to assess the relation between macrolevel economic characteristics and individual odds of underweight and overweight relative to normal weight. Results. In multilevel analyses adjusting for individual-level characteristics, a 1–standard-deviation increase in trade liberalization was associated with 13% (95% confidence interval [CI] = 0.76, 0.99), 17% (95% CI = 0.71, 0.96), 13% (95% CI = 0.76, 1.00), and 14% (95% CI = 0.75, 0.99) lower odds of underweight relative to normal weight among rural men, rural women, urban men, and urban women, respectively. Economic development was consistently associated with higher odds of overweight relative to normal weight. Among rural men, a 1–standard-deviation increase in foreign direct investment was associated with 17% (95% CI = 1.02, 1.35) higher odds of overweight relative to normal weight. Conclusions. Macrolevel economic factors may be implicated in global shifts in epidemiological patterns of weight. PMID:24228649

A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis.

PubMed

Chirita-Emandi, Adela; Shepherd, Sheila; Kyriakou, Andreas; McNeilly, Jane D; Dryden, Carol; Corrigan, Donna; Devenny, Anne; Ahmed, Syed Faisal

2017-08-28

We aimed to describe the longitudinal changes in bone mineral content and influencing factors, in children with cystic fibrosis (CF). One hundred children (50 females) had dual X-ray absorptiometry (DXA) performed. Of these, 48 and 24 children had two to three scans, respectively over 10 years of follow-up. DXA data were expressed as lumbar spine bone mineral content standard deviation score (LSBMCSDS) adjusted for age, gender, ethnicity and bone area. Markers of disease, anthropometry and bone biochemistry were collected retrospectively. Baseline LSBMCSDS was >0.5 SDS in 13% children, between -0.5; 0.5 SDS, in 50% and ≤-0.5 in the remainder. Seventy-eight percent of the children who had baseline LSBMCSDS >-0.5, and 35% of the children with poor baseline (LSBMCSDS<-0.5), showed decreasing values in subsequent assessments. However, mean LS BMC SDS did not show a significant decline in subsequent assessments (-0.51; -0.64; -0.56; p=0.178). Lower forced expiratory volume in 1 s percent (FEV1%) low body mass index standard deviation scores (BMI SDS) and vitamin D were associated with reduction in BMC. Bone mineral content as assessed by DXA is sub-optimal and decreases with time in most children with CF and this study has highlighted parameters that can be addressed to improve bone health.

Estimate of standard deviation for a log-transformed variable using arithmetic means and standard deviations.

PubMed

Quan, Hui; Zhang, Ji

2003-09-15

Analyses of study variables are frequently based on log transformations. To calculate the power for detecting the between-treatment difference in the log scale, we need an estimate of the standard deviation of the log-transformed variable. However, in many situations a literature search only provides the arithmetic means and the corresponding standard deviations. Without individual log-transformed data to directly calculate the sample standard deviation, we need alternative methods to estimate it. This paper presents methods for estimating and constructing confidence intervals for the standard deviation of a log-transformed variable given the mean and standard deviation of the untransformed variable. It also presents methods for estimating the standard deviation of change from baseline in the log scale given the means and standard deviations of the untransformed baseline value, on-treatment value and change from baseline. Simulations and examples are provided to assess the performance of these estimates. Copyright 2003 John Wiley & Sons, Ltd.

Establishment of reference intervals of clinical chemistry analytes for the adult population in Saudi Arabia: a study conducted as a part of the IFCC global study on reference values.

PubMed

Borai, Anwar; Ichihara, Kiyoshi; Al Masaud, Abdulaziz; Tamimi, Waleed; Bahijri, Suhad; Armbuster, David; Bawazeer, Ali; Nawajha, Mustafa; Otaibi, Nawaf; Khalil, Haitham; Kawano, Reo; Kaddam, Ibrahim; Abdelaal, Mohamed

2016-05-01

This study is a part of the IFCC-global study to derive reference intervals (RIs) for 28 chemistry analytes in Saudis. Healthy individuals (n=826) aged ≥18 years were recruited using the global study protocol. All specimens were measured using an Architect analyzer. RIs were derived by both parametric and non-parametric methods for comparative purpose. The need for secondary exclusion of reference values based on latent abnormal values exclusion (LAVE) method was examined. The magnitude of variation attributable to gender, ages and regions was calculated by the standard deviation ratio (SDR). Sources of variations: age, BMI, physical exercise and smoking levels were investigated by using the multiple regression analysis. SDRs for gender, age and regional differences were significant for 14, 8 and 2 analytes, respectively. BMI-related changes in test results were noted conspicuously for CRP. For some metabolic related parameters the ranges of RIs by non-parametric method were wider than by the parametric method and RIs derived using the LAVE method were significantly different than those without it. RIs were derived with and without gender partition (BMI, drugs and supplements were considered). RIs applicable to Saudis were established for the majority of chemistry analytes, whereas gender, regional and age RI partitioning was required for some analytes. The elevated upper limits of metabolic analytes reflects the existence of high prevalence of metabolic syndrome in Saudi population.

Personality and diabetes mellitus incidence in a national sample.

PubMed

Cukić, Iva; Weiss, Alexander

2014-09-01

To test whether personality traits were prospectively associated with type 2 diabetes incidence. The sample (n=6798) was derived from the National Health and Nutrition Examination Survey Epidemiological Follow-up Study cohort. We fit four logistic regression models to test whether neuroticism, extraversion, openness to experience, or the Type A behavior pattern predicted type 2 diabetes incidence. Model 1 included sex, age, and race/ethnicity. Model 2 added personality traits, Model 3 added depressive symptoms, and Model 4 added body mass index (BMI), hypertension, and cigarette smoking status as predictors. In Model 1 age was associated with increased risk of diabetes (2% per year); being black as opposed to white was associated with a three-fold increase in risk. In Model 2 age and being black were still significant and extraversion was associated with decreased risk (17% per standard deviation [SD]). In Model 3 age, being black, and extraversion were still significant. In addition, neuroticism was associated with decreased risk (26% per SD) and depressive symptoms were associated with increased risk (28% per SD). In Model 4 age, being black, neuroticism, and depressive symptoms were still significant. BMI was associated with increased risk (14% per SD) and extraversion was no longer significant. Higher neuroticism was associated with reduced type 2 diabetes risk even after controlling for race/ethnicity, age, depressive symptoms, and BMI. Extraversion and Type A behavior were not significant after including covariates. Copyright © 2014 Elsevier Inc. All rights reserved.

Spontaneous growth in growth hormone deficiency from birth until 7 years of age: development of disease-specific growth curves.

PubMed

Mayer, M; Schmitt, K; Kapelari, K; Frisch, H; Köstl, G; Voigt, M

2010-01-01

Little is known about spontaneous growth of growth hormone (GH)-deficient children during infancy and childhood. Retrospectively, we calculated disease-specific pretreatment percentiles for height, weight, BMI and growth velocity of 113 GH-deficient boys and 41 GH-deficient girls from birth until 7 years of age, by mean and standard deviation. Infants with idiopathic GH deficiency (GHD) grow in disease-specific percentile channels. There is a significant difference in length and weight from birth onward compared to regional reference (p<0.001). Boys' birth length was 48.7+/-2.9 cm (p<0.001; -1.31+/-1.11 SDS), birth weight was 3.09+/-0.61 kg (p<0.01; -0.92+/-1.19 SDS), and BMI at birth was 12.9+/-1.7. Girls' birth length was 48.1+/-3.4 cm (p<0.05; -1.17+/-1.51 SDS), birth weight was 2.92+/-0.60 kg (p=0.05; -1.08+/-1.19 SDS), and BMI at birth was 12.6+/-2.2. There was a continuous loss of growth velocity, despite a wide variance in the first years, so height deficit became more evident with increasing age. GHD is a congenital disease no matter when height deficit becomes clinically evident, because GH-deficient children grow in disease-specific percentile channels with a highly significantly reduced length and weight, which demonstrates that GH is essential for adequate growth in infancy and early childhood. Copyright (c) 2010 S. Karger AG, Basel.

Correlation of cephalometric and anthropometric measures with obstructive sleep apnea severity

PubMed Central

Borges, Paulo de Tarso M; Filho, Edson Santos Ferreira; Araujo, Telma Maria Evangelista de; Neto, Jose Machado Moita; Borges, Nubia Evangelista de Sa; Neto, Baltasar Melo; Campelo, Viriato; Paschoal, Jorge Rizzato; Li, Li M

2013-01-01

Summary Introduction: Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) often have associated changes in craniofacial morphology and distribution of body fat, either alone or in combination. Aim: To correlate cephalometric and anthropometric measures with OSAHS severity by using the apnea-hypopnea index (AHI). Method: A retrospective cephalometry study of 93 patients with OSAHS was conducted from July 2010 to July 2012. The following measurements were evaluated: body mass index (BMI), neck circumference (NC), waist circumference (WC), hip circumference (HC), the angles formed by the cranial base and the maxilla (SNA) and the mandible (SNB), the difference between SNA and SNB (ANB), the distance from the mandibular plane to the hyoid bone (MP-H), the space between the base of the tongue and the posterior pharyngeal wall (PAS), and the distance between the posterior nasal spine and the tip of the uvula (PNS-P). Means, standard deviations, and Pearson's correlation coefficients were calculated and analyzed. Results: AHI correlated significantly with BMI (r = 0.207, p = 0.047), NC (r = 0.365, p = 0.000), WC (r = 0.337, p = 0.001), PNS-P (r = 0.282, p = 0.006), and MP-H (r = 0.235, p = 0.023). Conclusion: Anthropometric measurements (BMI, NC, and WC) and cephalometric measurements (MP-H and PNS-P) can be used as predictors of OSAHS severity. PMID:25992029

Neighborhood environment and children's physical activity and body mass index: evidence from military personnel installation assignments.

PubMed

Datar, Ashlesha; Nicosia, Nancy; Wong, Elizabeth; Shier, Victoria

2015-04-01

The majority of existing studies use observed, rather than experimental or quasi-experimental, variation in individuals' neighborhood environments to study their influence on body weight and related behaviors. This study leverages the periodic relocation of military personnel to examine the relationship between neighborhood environment and children's physical activity (PA) and BMI in military families. This study utilizes data on 12- and 13-year-old children from the Military Teenagers Environments, Exercise, and Nutrition Study (N=903). Multivariate regression models are estimated, separately for families living on- and off-post, to examine the relationship between parents' perceptions of the neighborhood environment, measured using the Neighborhood Environment Walkability Scale-Youth Version (NEWS-Y), and children's self-reported PA and BMI. Different features of the neighborhood environment were significant for off- versus on-post families. For children living off-post, a 1 standard deviation (SD) increase in the proximity-to-recreational-facilities subscale was associated with 16.5 additional minutes per week (p<0.05) of moderate PA (MPA), but street connectivity had a significant negative association with vigorous activity. For children living on-post, a 1 SD increase on the crime safety subscale was associated with 22.9 additional minutes per week (p<0.05) of MPA. None of the NEWS-Y subscales were associated with children's BMI. Efforts to increase children's PA in military families should take into account that different aspects of the neighborhood environment matter for children living on- versus off-post.

Association between anthropometric measures of obesity and subclinical atherosclerosis in Bangladesh.

PubMed

Ge, Wenzhen; Parvez, Faruque; Wu, Fen; Islam, Tariqul; Ahmed, Alauddin; Shaheen, Ishrat; Sarwar, Golam; Demmer, Ryan T; Desvarieux, Moise; Ahsan, Habibul; Chen, Yu

2014-01-01

Anthropometric measures such as waist-hip-ratio (WHR), waist-height-ratio (WHtR), waist circumference, Mid-upper arm circumference (MUAC), and upper thigh circumference, have been linked to the risk of cardiovascular disease (CVD). However, their relationships with subclinical atherosclerosis are unclear. Studies in normal-weight populations, especially in Asian countries where leanness is prevalent, are lacking. We conducted a cross-sectional study to assess the associations of WHR, WHtR, waist circumference, hip circumference, body mass index (BMI), MUAC and upper thigh circumference with carotid intima-media thickness (cIMT) among 562 middle-aged participants free of CVD in rural Bangladesh. After adjusting for age and sex, WHR and waist circumference but not BMI showed a positive significant association with cIMT. In multivariate analysis, each standard deviation (SD) increase of WHR (0.08) or WHtR (0.07) was associated with an 8.96 μm (95% CI, 1.12-16.81) or 11.45 μm (95%CI, 0.86-22.04) difference in cIMT, respectively, after controlling for age, sex, BMI, smoking status, education level, and systolic blood pressure (SBP). The associations of WHR and WHtR with cIMT were independent of the influence of other anthropometric measures. The associations of other anthropometric measures and cIMT were not apparent. In our relatively lean, healthy Asian population, WHR and WHtR appear to be better predictors of early atherosclerosis than other common surrogates of adiposity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Selected anthropometric indices of maritime university students.

PubMed

Rębacz-Maron, Ewa

2015-01-01

Overweight and obesity during working life are becoming an increasingly serious challenge to various professional groups where recruits and personnel must be healthy and fit. Marine recruitment, even at the training stage, should be open to applicants who meet health and fitness criteria. The objective of the study is to determine the overweight and adiposity rates among seafarer candidates (n = 368). Based on anthropometric measurements and somatic indices the extent of obesity among marine students/ /future seafarers was investigated. In the groups identified according to the year of study, arithmetic averages (SD - standard deviation) were calculated for somatometric characteristics, and were then used to analyse the phenomena of overweight and obesity. The comparison was performed using the Kruskal-Wallis test, one-way analysis of variance (ANOVA) by ranks. The highest average body mass index (BMI) score was found in fourth-year students (mean BMI 25.7 ± 2.8). The average BMI for years one and two was in the upper range of 'healthy' weight. In 24.0% of first-year students and 32.2% of second-year students, the waist circumference was higher than half of the body height. Body fat percentage results indicate that this feature is highly variable, with a strong upward trend. Findings regarding overweight among future seamen give cause for concern. The participants of the study were characterised by excessive weight and adiposity. Recruitment criteria for uniformed services are not as restrictive as they used to be, as it is getting increasingly more difficult to find sufficiently slim and fit applicants.

Tracking of overweight and obesity from early childhood to adolescence in a population-based cohort - the Tromsø Study, Fit Futures.

PubMed

Evensen, Elin; Wilsgaard, Tom; Furberg, Anne-Sofie; Skeie, Guri

2016-05-10

Obesity is a serious childhood health problem today. Studies have shown that overweight and obesity tend to be stable (track) from birth, through childhood and adolescence, to adulthood. However, existing studies are heterogeneous; there is still no consensus on the strength of the association between high birth weight or high body mass index (BMI) early in life and overweight and obesity later in life, nor on the appropriate age or target group for intervention and prevention efforts. This study aimed to determine the presence and degree of tracking of overweight and obesity and development in BMI and BMI standard deviation scores (SDS) from childhood to adolescence in the Fit Futures cohort from North Norway. Using a retrospective cohort design, data on 532 adolescents from the Fit Futures cohort were supplemented with height and weight data from childhood health records, and BMI was calculated at 2-4, 5-7, and 15-17 years of age. Participants were categorized into weight classes by BMI according to the International Obesity Taskforce's age- and sex-specific cut-off values for children 2-18 years of age (thinness: adult BMI <18.5 kg/m(2), normal weight: adult BMI ≥18.5- < 25 kg/m(2), overweight: adult BMI ≥25- < 30 kg/m(2), obesity: adult BMI ≥30 kg/m(2)). Non-parametric tests, Cohen's weighted Kappa statistic and logistic regression were used in the analyses. The prevalence of overweight and obesity combined, increased from 11.5 % at 2-4 years of age and 13.7 % at 5-7 years of age, to 20.1 % at 15-17 years of age. Children who were overweight/obese at 5-7 years of age had increased odds of being overweight/obese at 15-17 years of age, compared to thin/normal weight children (crude odds ratio: 11.1, 95 % confidence interval: 6.4-19.2). Six out of 10 children who were overweight/obese at 5-7 years of age were overweight/obese at 15-17 years of age. The prevalence of overweight and obesity increased with age. We found a moderate indication of tracking of overweight/obesity from childhood to adolescence. Preventive and treatment initiatives among children at high risk of overweight and obesity should start before 5-7 years of age, but general preventive efforts targeting all children are most important.

Mendelian randomization study of adiposity-related traits and risk of breast, ovarian, prostate, lung and colorectal cancer.

PubMed

Gao, Chi; Patel, Chirag J; Michailidou, Kyriaki; Peters, Ulrike; Gong, Jian; Schildkraut, Joellen; Schumacher, Fredrick R; Zheng, Wei; Boffetta, Paolo; Stucker, Isabelle; Willett, Walter; Gruber, Stephen; Easton, Douglas F; Hunter, David J; Sellers, Thomas A; Haiman, Christopher; Henderson, Brian E; Hung, Rayjean J; Amos, Christopher; Pierce, Brandon L; Lindström, Sara; Kraft, Peter

2016-06-01

Adiposity traits have been associated with risk of many cancers in observational studies, but whether these associations are causal is unclear. Mendelian randomization (MR) uses genetic predictors of risk factors as instrumental variables to eliminate reverse causation and reduce confounding bias. We performed MR analyses to assess the possible causal relationship of birthweight, childhood and adult body mass index (BMI), and waist-hip ratio (WHR) on the risks of breast, ovarian, prostate, colorectal and lung cancers. We tested the association between genetic risk scores and each trait using summary statistics from published genome-wide association studies (GWAS) and from 51 537 cancer cases and 61 600 controls in the Genetic Associations and Mechanisms in Oncology (GAME-ON) Consortium. We found an inverse association between the genetic score for childhood BMI and risk of breast cancer [odds ratio (OR) = 0.71 per standard deviation (s.d.) increase in childhood BMI; 95% confidence interval (CI): 0.60, 0.80; P = 6.5 × 10(-5)). We also found the genetic score for adult BMI to be inversely associated with breast cancer risk (OR = 0.66 per s.d. increase in BMI; 95% CI: 0.57, 0.77; P = 2.5 × 10(-7)), and positively associated with ovarian cancer (OR = 1.35; 95% CI: 1.05, 1.72; P = 0.017), lung cancer (OR = 1.27; 95% CI: 1.09, 1.49; P = 2.9 × 10(-3)) and colorectal cancer (OR = 1.39; 95% CI: 1.06, 1.82, P = 0.016). The inverse association between genetically predicted adult BMI and breast cancer risk remained even after adjusting for directional pleiotropy via MR-Egger regression. Findings from this study provide additional understandings of the complex relationship between adiposity and cancer risks. Our results for breast and lung cancer are particularly interesting, given previous reports of effect heterogeneity by menopausal status and smoking status. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Salivary alpha amylase diurnal pattern and stress response are associated with body mass index in low-income preschool-aged children.

PubMed

Miller, Alison L; Sturza, Julie; Rosenblum, Katherine; Vazquez, Delia M; Kaciroti, Niko; Lumeng, Julie C

2015-03-01

Physiological stress responses are proposed as a pathway through which stress can "get under the skin" and lead to health problems, specifically obesity. We tested associations of salivary alpha amylase (sAA) diurnal patterns and stress responses with body mass index (BMI) in young, low-income children (51% male; 54% non-Hispanic white). Diurnal saliva samples were collected three times per day across three days for 269 children (M age 50.8 months, SD 6.3). Individual sAA intercept and slope values were calculated using random effect models to represent morning sAA levels and rate of sAA change across the day. A subset of children (n=195; M age 56.6 months, SD 6.9) participated in a lab-based behavioral stress protocol. Area under the curve increase (AUCI) across four timepoints was calculated to represent increase in sAA output during stress elicitation. Children were weighed and height measured and BMI z-score was calculated. Linear regression was used to evaluate associations of sAA intercept, sAA slope, and sAA AUCI with BMI z-score, controlling for child age, sex, and race/ethnicity; maternal weight status; and family income-to-needs ratio. Diurnal and stress-response sAA patterns were related to child adiposity: for each 1-standard deviation unit (SDU) decrease in morning sAA level, the child's BMI z-score increased by 0.11 (SE 0.05) SDU's (p<.04); for each 1-SDU increase in sAA slope across the day, the child's BMI z-score increased by 0.12 (SE 0.05) SDU's (p<.03); and for each 1-SDU decrease in sAA AUCI during the stress elicitation, the child's BMI z-score increased by 0.14 (SE 0.06) SDU's (p<.03). Blunted stress responses and atypical diurnal patterns of sAA have been found following exposure to chronic life stressors such as poverty. Findings suggest that associations of stress, sAA, and elevated body mass index may develop very early in the lifespan. Copyright © 2014 Elsevier Ltd. All rights reserved.

Do body mass index trajectories affect the risk of type 2 diabetes? A case-control study.

PubMed

Mano, Yoshihiko; Yokomichi, Hiroshi; Suzuki, Kohta; Takahashi, Atsunori; Yoda, Yoshioki; Tsuji, Masahiro; Sato, Miri; Shinohara, Ryoji; Mizorogi, Sonoko; Mochizuki, Mie; Yamagata, Zentaro

2015-07-28

Although obesity is a well-studied risk factor for diabetes, there remains an interest in whether "increasing body mass index (BMI)," "high BMI per se," or both are the actual risk factors for diabetes. The present study aimed to retrospectively compare BMI trajectories of individuals with and without diabetes in a case-control design and to assess whether increasing BMI alone would be a risk factor. Using comprehensive health check-up data measured over ten years, we conducted a case-control study and graphically drew the trajectories of BMIs among diabetic patients and healthy subjects, based on coefficients in fitted linear mixed-effects models. Patient group was matched with healthy control group at the onset of diabetes with an optimal matching method in a 1:10 ratio. Simple fixed-effects models assessed the differences in increasing BMIs over 10 years between patient and control groups. At the time of matching, the mean ages in male patients and controls were 59.3 years [standard deviation (SD) = 9.2] and 57.7 years (SD = 11.2), whereas the mean BMIs were 25.0 kg/m(2) (SD = 3.1) and 25.2 kg/m(2) (SD = 2.9), respectively. In female patients and controls, the mean ages were 61.4 years (SD = 7.9) and 60.1 years (SD = 9.6), whereas the mean BMIs were 24.8 kg/m(2) (SD = 3.5) and 24.9 kg/m(2) (SD = 3.4), respectively. The simple fixed-effects models detected no statistical significance for the differences of increasing BMIs between patient and control groups in males (P = 0.19) and females (P = 0.67). Sudden increases in BMI were observed in both male and female patients when compared with BMIs 1 year prior to diabetes onset. The present study suggested that the pace of increasing BMIs is similar between Japanese diabetic patients and healthy individuals. The increasing BMI was not detected to independently affect the onset of type 2 diabetes.

Obesity classification in military personnel: a comparison of body fat, waist circumference, and body mass index measurements.

PubMed

Heinrich, Katie M; Jitnarin, Nattinee; Suminski, Richard R; Berkel, LaVerne; Hunter, Christine M; Alvarez, Lisa; Brundige, Antionette R; Peterson, Alan L; Foreyt, John P; Haddock, C Keith; Poston, Walker S C

2008-01-01

The purpose of this study was to evaluate obesity classifications from body fat percentage (BF%), body mass index (BMI), and waist circumference (WC). A total of 451 overweight/obese active duty military personnel completed all three assessments. Most were obese (men, 81%; women, 98%) using National Institutes of Health (NIH) BF% standards (men, >25%; women, >30%). Using the higher World Health Organization (WHO) BF >35% standard, 86% of women were obese. BMI (55.5% and 51.4%) and WC (21.4% and 31.9%) obesity rates were substantially lower for men and women, respectively (p < 0.05). BMI/WC were accurate discriminators for BF% obesity (theta for all comparisons >0.75, p < 0.001). Optimal cutoff points were lower than NIH/WHO standards; WC = 100 cm and BMI = 29 maximized sensitivity and specificity for men, and WC = 79 cm and BMI = 25.5 (NIH) or WC = 83 cm and BMI = 26 (WHO) maximized sensitivity and specificity for women. Both WC and BMI measures had high rates of false negatives compared to BF%. However, at a population level, WC/BMI are useful obesity measures, demonstrating fair-to-high discriminatory power.

Densely calculated facial soft tissue thickness for craniofacial reconstruction in Chinese adults.

PubMed

Shui, Wuyang; Zhou, Mingquan; Deng, Qingqiong; Wu, Zhongke; Ji, Yuan; Li, Kang; He, Taiping; Jiang, Haiyan

2016-09-01

Craniofacial reconstruction (CFR) is used to recreate a likeness of original facial appearance for an unidentified skull; this technique has been applied in both forensics and archeology. Many CFR techniques rely on the average facial soft tissue thickness (FSTT) of anatomical landmarks, related to ethnicity, age, sex, body mass index (BMI), etc. Previous studies typically employed FSTT at sparsely distributed anatomical landmarks, where different landmark definitions may affect the contrasting results. In the present study, a total of 90,198 one-to-one correspondence skull vertices are established on 171 head CT-scans and the FSTT of each corresponding vertex is calculated (hereafter referred to as densely calculated FSTT) for statistical analysis and CFR. Basic descriptive statistics (i.e., mean and standard deviation) for densely calculated FSTT are reported separately according to sex and age. Results show that 76.12% of overall vertices indicate that the FSTT is greater in males than females, with the exception of vertices around the zygoma, zygomatic arch and mid-lateral orbit. These sex-related significant differences are found at 55.12% of all vertices and the statistically age-related significant differences are depicted between the three age groups at a majority of all vertices (73.31% for males and 63.43% for females). Five non-overlapping categories are given and the descriptive statistics (i.e., mean, standard deviation, local standard deviation and percentage) are reported. Multiple appearances are produced using the densely calculated FSTT of various age and sex groups, and a quantitative assessment is provided to examine how relevant the choice of FSTT is to increasing the accuracy of CFR. In conclusion, this study provides a new perspective in understanding the distribution of FSTT and the construction of a new densely calculated FSTT database for craniofacial reconstruction. Copyright © 2016. Published by Elsevier Ireland Ltd.

Construction of a New Growth References for China Based on Urban Chinese Children: Comparison with the WHO Growth Standards

PubMed Central

Zong, Xin-Nan; Li, Hui

2013-01-01

Introduction Growth references for Chinese children should be updated due to the positive secular growth trends and the progress of the smoothing techniques. Human growth differs among the various ethnic groups, so comparison of the China references with the WHO standards helps to understand such differences. Methods The China references, including weight, length/height, head circumference, weight-for-length/height and body mass index (BMI) aged 0–18 years, were constructed based on 69,760 urban infants and preschool children under 7 years and 24,542 urban school children aged 6–20 years derived from two cross-sectional national surveys. The Cole’s LMS method is employed for smoothing the growth curves. Results The merged data sets resulted in a smooth transition at age 6–7 years and continuity of curves from 0 to 18 years. Varying differences were found on the empirical standard deviation (SD) curves in each indicator at nearly all ages between China and WHO. The most noticeable differences occurred in genders, final height and boundary centiles curves. Chinese boys’ weight is strikingly heavier than that of the WHO at age 6–10 years. The height is taller than that of the WHO for boys below 15 years and for girls below 13, but is significantly lower when boys over 15 years and girls over 13. BMI is generally higher than that of the WHO for boys at age 6–16 years but appreciably lower for girls at 3–18 years. Conclusions The differences between China and WHO are mainly caused by the reference populations of different ethnic backgrounds. For practitioners, the choices of the standards/references depend on the population to be assessed and the purpose of the study. The new China references could be applied to facilitate the standardization assessment of growth and nutrition for Chinese children and adolescents in clinical pediatric and public health. PMID:23527219

7 CFR 400.204 - Notification of deviation from standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Notification of deviation from standards. 400.204... Contract-Standards for Approval § 400.204 Notification of deviation from standards. A Contractor shall advise the Corporation immediately if the Contractor deviates from the requirements of these standards...

Assessing Causality in the Association between Child Adiposity and Physical Activity Levels: A Mendelian Randomization Analysis

PubMed Central

Richmond, Rebecca C.; Davey Smith, George; Ness, Andy R.; den Hoed, Marcel; McMahon, George; Timpson, Nicholas J.

2014-01-01

Background Cross-sectional studies have shown that objectively measured physical activity is associated with childhood adiposity, and a strong inverse dose–response association with body mass index (BMI) has been found. However, few studies have explored the extent to which this association reflects reverse causation. We aimed to determine whether childhood adiposity causally influences levels of physical activity using genetic variants reliably associated with adiposity to estimate causal effects. Methods and Findings The Avon Longitudinal Study of Parents and Children collected data on objectively assessed activity levels of 4,296 children at age 11 y with recorded BMI and genotypic data. We used 32 established genetic correlates of BMI combined in a weighted allelic score as an instrumental variable for adiposity to estimate the causal effect of adiposity on activity. In observational analysis, a 3.3 kg/m2 (one standard deviation) higher BMI was associated with 22.3 (95% CI, 17.0, 27.6) movement counts/min less total physical activity (p = 1.6×10−16), 2.6 (2.1, 3.1) min/d less moderate-to-vigorous-intensity activity (p = 3.7×10−29), and 3.5 (1.5, 5.5) min/d more sedentary time (p = 5.0×10−4). In Mendelian randomization analyses, the same difference in BMI was associated with 32.4 (0.9, 63.9) movement counts/min less total physical activity (p = 0.04) (∼5.3% of the mean counts/minute), 2.8 (0.1, 5.5) min/d less moderate-to-vigorous-intensity activity (p = 0.04), and 13.2 (1.3, 25.2) min/d more sedentary time (p = 0.03). There was no strong evidence for a difference between variable estimates from observational estimates. Similar results were obtained using fat mass index. Low power and poor instrumentation of activity limited causal analysis of the influence of physical activity on BMI. Conclusions Our results suggest that increased adiposity causes a reduction in physical activity in children and support research into the targeting of BMI in efforts to increase childhood activity levels. Importantly, this does not exclude lower physical activity also leading to increased adiposity, i.e., bidirectional causation. Please see later in the article for the Editors' Summary PMID:24642734

Secular trends of body mass index in North Indian children with Type 1 diabetes do not support the Accelerator Hypothesis.

PubMed

Dayal, Devi; Samprathi, Madhusudan; Jayaraman, Dhaarani; Kohat, Dilesh; Bhalla, Anil Kumar

2016-03-01

The accelerator hypothesis, which proposes a link between Type 1 diabetes (T1D) and Type 2 diabetes (T2D) through weight-related insulin resistance, remains untested in developing countries with increasing rates of childhood obesity and T1D, and different ethnicities. We aimed to test the accelerator hypothesis in the context of a significant increase in T1D at our centre. Medical records of children diagnosed with T1D between January 2005 and December 2014 were retrospectively reviewed. The body mass index (BMI) standard deviation scores (SDSs) were calculated using height and weight measurements recorded 1-2 months after diagnosis of T1D and compared with age-matched anthropometric data. The rate of change in BMI SDSs over time was calculated. Analysis of BMI data was undertaken for the three age categories: <5, 5 to <10 and >10 years. The mean age at diagnosis of 467 children with T1D was 7·27 ± 0·32 years and showed no change over the study period. There was a yearly increase of 14·11% in patient numbers; this increase was similar in the three age categories (22·7%, 17·0%, 16·3%, respectively, P = 1·0). Comparison of patient numbers between the two time periods of 5 years each showed a marked increase during 2010-2014 (148 vs 319, % increase 115·5%). The mean BMI SDSs at diagnosis in the three age categories were similar (P = 1·0) and showed a yearly change of -0·36; the mean change in the three age categories was also similar (-0·35, -0·27, -0·46, respectively, P = 1·0). No correlation was found between age at diagnosis and BMI SDSs (correlation coefficient 0·010, P = 0·82). The mean BMI SDS in patients was significantly lower compared to controls (-0·54 vs -0·02, P = 0·001). There was no association between BMI SDS and age at diagnosis in children with new onset T1D. Further studies are needed to test whether the accelerator hypothesis is relevant in developing countries. © 2015 John Wiley & Sons Ltd.

Risk factors for mortality caused by hypothalamic obesity in children with hypothalamic tumours.

PubMed

Haliloglu, B; Atay, Z; Guran, T; Abalı, S; Bas, S; Turan, S; Bereket, A

2016-10-01

Hypothalamic obesity (HyOb) is a common complication of childhood hypothalamic tumours. Patients with HyOb probably have a higher mortality rate than those with other types of obesity due in many cases to obstructive sleep apnoea/hypoventilation. To identify predictive factors for mortality caused by HyOb in children. Twenty children with HyOb secondary to hypothalamic tumours that were followed-up for ≥3 years and aged <15 years at diagnosis, and received supraphysiological glucocorticoid treatment for ≤1 month. Mean age at diagnosis was 6.36 ± 3.60 years. Mean body mass index (BMI) Standard deviation of the samples (SDS) increased from 0.77 ± 1.26 to 2.66 ± 1.45 during the first 6 months, but slowed from month 6-12 (2.73 ± 1.35). ΔBMI SDS at 0-6 months was significantly higher in patients aged <6 years at diagnosis than in those aged >6 years at diagnosis (3.71 ± 1.96 vs. 0.83 ± 0.73, P < 0.001). Maximum BMI SDS was also significantly higher in the younger group (3.88 ± 1.39 vs. 2.79 ± 0.64, P < 0.05). In all, four patients died and the mortality rate was significantly higher in the patients with a further increase in BMI SDS > 1 SDS after 6 months of therapy (RR: 8.4, P < 0.05). Both overall mortality and obesity-related mortality rates were higher in the patients aged <6 years at diagnosis (4.5-fold, 7.2-fold higher, respectively, P > 0.05). The mortality rate was also 3.7-fold higher in the patients with a maximum BMI SDS ≥ 3 at any time during the first 3 years after therapy(P > 0.05). An increase in BMI SDS after 6 months of therapy was observed to be a risk factor for mortality caused by HyOb. In addition, age <6 years at diagnosis and a maximum BMI SDS ≥ 3 were associated with a higher mortality rate, indicating that earlier and more aggressive treatment of obesity is required. © 2015 World Obesity.

The Standard Deviation of Launch Vehicle Environments

NASA Technical Reports Server (NTRS)

Yunis, Isam

2005-01-01

Statistical analysis is used in the development of the launch vehicle environments of acoustics, vibrations, and shock. The standard deviation of these environments is critical to accurate statistical extrema. However, often very little data exists to define the standard deviation and it is better to use a typical standard deviation than one derived from a few measurements. This paper uses Space Shuttle and expendable launch vehicle flight data to define a typical standard deviation for acoustics and vibrations. The results suggest that 3dB is a conservative and reasonable standard deviation for the source environment and the payload environment.

The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013-2015.

PubMed

Zoellner, Jamie M; Hill, Jennie; You, Wen; Brock, Donna; Frisard, Madlyn; Alexander, Ramine; Silva, Fabiana; Price, Bryan; Marshall, Ruby; Estabrooks, Paul A

2017-09-28

Few interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose). This pre-post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes. No significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001). By incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.

Using Genetic Variation to Explore the Causal Effect of Maternal Pregnancy Adiposity on Future Offspring Adiposity: A Mendelian Randomisation Study

PubMed Central

Felix, Janine F.; Gaillard, Romy; McMahon, George

2017-01-01

Background It has been suggested that greater maternal adiposity during pregnancy affects lifelong risk of offspring fatness via intrauterine mechanisms. Our aim was to use Mendelian randomisation (MR) to investigate the causal effect of intrauterine exposure to greater maternal body mass index (BMI) on offspring BMI and fat mass from childhood to early adulthood. Methods and Findings We used maternal genetic variants as instrumental variables (IVs) to test the causal effect of maternal BMI in pregnancy on offspring fatness (BMI and dual-energy X-ray absorptiometry [DXA] determined fat mass index [FMI]) in a MR approach. This was investigated, with repeat measurements, from ages 7 to 18 in the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 2,521 to 3,720 for different ages). We then sought to replicate findings with results for BMI at age 6 in Generation R (n = 2,337 for replication sample; n = 6,057 for total pooled sample). In confounder-adjusted multivariable regression in ALSPAC, a 1 standard deviation (SD, equivalent of 3.7 kg/m2) increase in maternal BMI was associated with a 0.25 SD (95% CI 0.21–0.29) increase in offspring BMI at age 7, with similar results at later ages and when FMI was used as the outcome. A weighted genetic risk score was generated from 32 genetic variants robustly associated with BMI (minimum F-statistic = 45 in ALSPAC). The MR results using this genetic risk score as an IV in ALSPAC were close to the null at all ages (e.g., 0.04 SD (95% CI -0.21–0.30) at age 7 and 0.03 SD (95% CI -0.26–0.32) at age 18 per SD increase in maternal BMI), which was similar when a 97 variant generic risk score was used in ALSPAC. When findings from age 7 in ALSPAC were meta-analysed with those from age 6 in Generation R, the pooled confounder-adjusted multivariable regression association was 0.22 SD (95% CI 0.19–0.25) per SD increase in maternal BMI and the pooled MR effect (pooling the 97 variant score results from ALSPAC with the 32 variant score results from Generation R) was 0.05 SD (95%CI -0.11–0.21) per SD increase in maternal BMI (p-value for difference between the two results = 0.05). A number of sensitivity analyses exploring violation of the MR results supported our main findings. However, power was limited for some of the sensitivity tests and further studies with relevant data on maternal, offspring, and paternal genotype are required to obtain more precise (and unbiased) causal estimates. Conclusions Our findings provide little evidence to support a strong causal intrauterine effect of incrementally greater maternal BMI resulting in greater offspring adiposity. PMID:28118352

Low aerobic fitness and obesity are associated with lower standardized test scores in children.

PubMed

Roberts, Christian K; Freed, Benjamin; McCarthy, William J

2010-05-01

To investigate whether aerobic fitness and obesity in school children are associated with standardized test performance. Ethnically diverse (n = 1989) 5th, 7th, and 9th graders attending California schools comprised the sample. Aerobic fitness was determined by a 1-mile run/walk test; body mass index (BMI) was obtained from state-mandated measurements. California standardized test scores were obtained from the school district. Students whose mile run/walk times exceeded California Fitnessgram standards or whose BMI exceeded Centers for Disease Control sex- and age-specific body weight standards scored lower on California standardized math, reading, and language tests than students with desirable BMI status or fitness level, even after controlling for parent education among other covariates. Ethnic differences in standardized test scores were consistent with ethnic differences in obesity status and aerobic fitness. BMI-for-age was no longer a significant multivariate predictor when covariates included fitness level. Low aerobic fitness is common among youth and varies among ethnic groups, and aerobic fitness level predicts performance on standardized tests across ethnic groups. More research is needed to uncover the physiological mechanisms by which aerobic fitness may contribute to performance on standardized academic tests.

Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.

PubMed

James, Peter; Kioumourtzoglou, Marianthi-Anna; Hart, Jaime E; Banay, Rachel F; Kloog, Itai; Laden, Francine

2017-11-01

Recent studies have linked urban environmental factors and body mass index (BMI); however, such factors are often examined in isolation, ignoring correlations across exposures. Using data on Nurses' Health Study participants living in the Northeastern United States in 2006, we estimated associations between neighborhood walkability (a composite of population density, street connectivity, and business access), greenness (from satellite imagery), and ambient air pollution (from satellite-based spatiotemporally resolved PM2.5 predictions and weighted monthly average concentrations of NO2 from up to five nearest monitors) and self-reported BMI using generalized additive models, allowing for deviations from linearity using penalized splines. Among 23,435 women aged 60-87 years, we observed nonlinear associations between walkability and BMI and between PM2.5 and BMI in single-exposure models adjusted for age, race, and individual- and area-level socioeconomic status. When modeling all exposures simultaneously, only the association between walkability and BMI remained nonlinear and nonmonotonic. Increasing walkability was associated with increasing BMI at lower levels of walkability (walkability index <1.8), while increasing walkability was linked to lower BMI in areas of higher walkability (walkability index >1.8). A 10 percentile increase in walkability, right above 1.8 was associated with a 0.84% decrease in log BMI. The relationship between walkability and BMI existed only among younger participants (<71 years old). Neighborhood walkability was nonlinearly linked to lower BMI independent of air pollution and greenness. Our findings highlight the importance of accounting for nonlinear confounding by interrelated urban environmental factors when investigating associations between the environment and BMI.

Clinical Evaluation of the Root Tear of the Posterior Horn of the Medial Meniscus in Total Knee Arthroplasty for Osteoarthritis.

PubMed

Choi, Eui-Sung; Park, Sang-Jun

2015-06-01

To investigate the incidence of root tears of the posterior horn of the medial meniscus in total knee replacement arthroplasty for knee osteoarthritis and retrospectively analyze clinical results and factors associated with root tears. There were 197 knees of 140 enrolled patients who had undergone total knee replacement arthroplasty between September 2010 and May 2014. The presence of a root tear of the posterior horn of the medial meniscus was confirmed in all patients. Statistical analysis was performed to investigate the correlation between root tears and the possible factors of meniscal tears including gender, age, severity of symptoms (visual analogue scale [VAS] score and medial joint line tenderness), grade of osteoarthritis (Kellgren-Lawrence grading scale), body mass index (BMI), varus deformity, and mechanical axis deviation. Meniscal tears were observed in 154 knees (78.17%). The root tear had correlation with the severity of osteoarthritis (p<0.05), varus deformity (p<0.05), mechanical axis deviation (p<0.05), and BMI (p<0.05). Factors considered to represent the severity of osteoarthritis were found to be associated with root tears of the medial meniscus posterior horn. Increased BMI seemed to be associated with the increased incidence of root tears of the medial meniscus posterior horn.

Overweight children with type 1 diabetes have a more favourable lipid profile than overweight non-diabetic children.

PubMed

van Vliet, Mariska; van der Heyden, Josine C; Diamant, Michaela; von Rosenstiel, Inès A; Schindhelm, Roger K; Heymans, Martijn W; Brandjes, Desiderius P M; Beijnen, Jos H; Aanstoot, Henk J; Veeze, Henk J

2012-03-01

In the present article, we aimed to compare the cardiometabolic risk between overweight children with and without type 1 diabetes (T1DM). Therefore, data with regard to cardiometabolic risk parameters of 44 overweight Caucasian children (3-18 years) with T1DM were matched with 44 overweight peers without T1DM for sex, ethnicity, age and standard deviation score of BMI (Z-BMI). Detailed history was taken, information regarding anthropometrics and family history were collected and blood pressure was measured. Blood samples were collected for evaluation of lipid profiles (fasting in controls, non-fasting in T1DM children), alanine aminotransferase and HbA1c (in children with T1DM). It was found that overweight children with T1DM had lower median standard deviation score of waist circumference (Z-WC) as compared to the overweight control group [median, 2.0 (interquartile range, IQR, 1.5-2.3) vs. 2.6 (IQR, 2.0-2.9), P < 0.001]. After adjustment for Z-WC, in children with T1DM, median high-density lipoprotein cholesterol levels were significantly higher and median low-density lipoprotein cholesterol lower in T1DM children, as compared to their peers without T1DM [1.40 (IQR, 1.2-1.5) vs. 1.2 (IQR, 1.0-1.3) and 2.7 (IQR, 2.5-3.2) vs. 3.0 (IQR, 2.5-3.4), respectively, all P < 0.01]. When dividing children according to glycaemic status, children with suboptimal glycaemic control had higher values of triglycerides as compared to well-controlled children [1.3 (IQR, 1.0-1.8) vs. 0.96 (IQR, 0.80-1.2), P = 0.036]. In conclusion, overweight children with T1DM have a more favourable lipid profile, as compared to non-diabetic overweight controls, in spite of a higher frequency of a positive family history of CVD, T2DM and hypertension. Still, paediatricians should give extra attention to cardiometabolic risk factors within this vulnerable group, taking into account the already high cardiometabolic risk.

Comparison of Body Mass Index (BMI) Categories Based on Asian and Universal Standards and Language Spoken at Home among Asian American University Students

ERIC Educational Resources Information Center

Ng, Tiffany; McMahan, Shari; Mouttapa, Michele; Tanjasiri, Sora Park; Beam, William

2009-01-01

Background: The World Health Organization released lower Body Mass Index (BMI) cutoff points for Asian individuals to account for increased body fat percentage (BF%) and risk of obesity-related conditions at a lower body mass index. Purpose: This preliminary study: (1) explores the impact of utilizing Asian BMI standards (compared to universal…

Defining overweight and obesity among Greek children living in Thessaloniki: International versus local reference standards.

PubMed

Christoforidis, A; Dimitriadou, M; Papadopolou, E; Stilpnopoulou, D; Katzos, G; Athanassiou-Metaxa, M

2011-04-01

Body Mass Index (BMI) offers a simple and reasonable measure of obesity that, with the use of the appropriate reference, can help in the early detection of children with weight problems. Our aim was to compare the two most commonly used international BMI references and the national Greek BMI reference in identifying Greek children being overweight and obese. A group of 1557 children (820 girls and 737 boys, mean age: 11.42 ± 3.51 years) were studied. Weight and height was measured using standard methods, and BMI was calculated. Overweight and obesity were determined using the International Obesity Task Force (IOTF) standards, the Centers for Disease Control and Prevention (CDC) BMI-forage curves and the most recent Greek BMI-for-age curves. RESULTS showed that the IOTF's cut-off limits identifies a significantly higher prevalence of overweight (22.4%) compared with both the CDC's (11.8%, p=0.03) and the Greek's (7.4%, p=0.002) cut-off limits. However, the prevalence of obesity was generally increased when it was determined using the CDC's cut-off limits (13.9%) compared to the prevalence calculated with both the IOTF's (6.5%, p=0.05) and the Greek's (6.9%, n.s.) cut off limits. The use of the national Greek reference standards for BMI underestimates the true prevalence of overweight and obesity. On the contrary, both the IOTF and the CDC standards, although independently, detect an increased number of overweight and obese children and thus they should be adopted in the clinical practice for an earlier identification and a timelier intervention.

7 CFR 400.174 - Notification of deviation from financial standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Notification of deviation from financial standards... Agreement-Standards for Approval; Regulations for the 1997 and Subsequent Reinsurance Years § 400.174 Notification of deviation from financial standards. An insurer must immediately advise FCIC if it deviates from...

Degrees of Freedom for Allan Deviation Estimates of Multiple Clocks

DTIC Science & Technology

2016-04-01

Allan deviation . Allan deviation will be represented by σ and standard deviation will be represented by δ. In practice, when the Allan deviation of a...the Allan deviation of standard noise types. Once the number of degrees of freedom is known, an approximate confidence interval can be assigned by...measurement errors from paired difference data. We extend this approach by using the Allan deviation to estimate the error in a frequency standard

Beyond Body Mass Index: Using Anthropometric Measures and Body Composition Indicators to Assess Odds of an Endometriosis Diagnosis.

PubMed

Backonja, Uba; Hediger, Mary L; Chen, Zhen; Lauver, Diane R; Sun, Liping; Peterson, C Matthew; Buck Louis, Germaine M

2017-09-01

Body mass index (BMI) and endometriosis have been inversely associated. To address gaps in this research, we examined associations among body composition, endometriosis, and physical activity. Women from 14 clinical sites in the Salt Lake City, Utah and San Francisco, California areas and scheduled for laparoscopy/laparotomy were recruited during 2007-2009. Participants (N = 473) underwent standardized anthropometric assessments to estimate body composition before surgery. Using a cross-sectional design, odds of an endometriosis diagnosis (adjusted odds ratio [aOR]; 95% confidence interval [CI]) were calculated for anthropometric and body composition measures (weight in kg; height in cm; mid upper arm, waist, hip, and chest circumferences in cm; subscapular, suprailiac, and triceps skinfold thicknesses in mm; arm muscle and fat areas in cm 2 ; centripetal fat, chest-to-waist, chest-to-hip, waist-to-hip, and waist-to-height ratios; arm fat index; and BMI in kg/m 2 ). Physical activity (metabolic equivalent of task-minutes/week) and sedentariness (average minutes sitting on a weekday) were assessed using the International Physical Activity Questionnaire-Short Form. Measures were modeled continuously and in quartiles based on sample estimates. Adjusted models were controlled for age (years, continuous), site (Utah/California), smoking history (never, former, or current smoker), and income (below, within 180%, and above of the poverty line). Findings were standardized by dividing variables by their respective standard deviations. We used adjusted models to examine whether odds of an endometriosis diagnosis were moderated by physical activity or sedentariness. Inverse relationships were observed between endometriosis and standardized: weight (aOR = 0.71, 95% CI 0.57-0.88); subscapular skinfold thickness (aOR = 0.79, 95% CI 0.65-0.98); waist and hip circumferences (aOR = 0.79, 95% CI 0.64-0.98 and aOR = 0.76, 95% CI 0.61-0.94, respectively); total upper arm and upper arm muscle areas (aOR = 0.76, 95% CI 0.61-0.94 and aOR = 0.74, 95% CI 0.59-0.93, respectively); and BMI (aOR = 0.75, 95% CI 0.60-0.93), despite similar heights. Women in the highest versus lowest quartile had lower adjusted odds of an endometriosis diagnosis for: weight; mid-upper arm, hip, and waist circumferences; total upper arm and upper arm muscle areas; BMI; and centripetal fat ratio. There was no evidence of a main effect or moderation of physical activity or sedentariness. In a surgical cohort, endometriosis was inversely associated with anthropometric measures and body composition indicators.

Cross-sectional study of height and weight in the population of Andalusia from age 3 to adulthood

PubMed Central

López-Siguero, Juan Pedro; García, Juan Manuel Fernández; Castillo, Juan de Dios Luna; Molina, Jose Antonio Moreno; Cosano, Carlos Ruiz; Ortiz, Antonio Jurado

2008-01-01

Background and objectives In Andalusia there were no studies including a representative sample of children and adolescent population assessing growth and weight increase. Our objectives were to develop reference standards for weight, height and BMI for the Andalusian pediatric population, from 3 to 18 years of age for both genders, and to identify the final adult height in Andalusia. Subjects and methods Two samples were collected. The first included individuals from 3 to 18 years of age (3592 girls and 3605 boys). They were stratified according type of study center, size of population of origin, age (32 categories of 0.5 years) and gender, using cluster sampling. Subjects from >18 to 23 years of age (947 women and 921 men) were sampled in 6 non-university educational centers and several university centers in Granada. Exclusion criteria included sons of non-Spanish mother or father, and individuals with chronic conditions and/or therapies affecting growth. Two trained fellows collected the data through February to December 2004, for the first sample, and through January to May 2005, for the second. Reference curves were adjusted using Cole's LMS method, and the quality of the adjustment was assessed using the tests proposed by Royston. In addition, a sensitivity analysis was applied to the final models obtained. Results Data for 9065 cases (4539 women and 4526 men) were obtained; 79.39% (n = 7197) in the up to 18 years of age group. In the first sampling only 0.07% (3 girls and 2 boys) refused to participate in the study. In addition, 327 students (4.5%) were absent when sampling was done. We present mean and standard deviation fort height, weight and BMI at 0.5 years intervals, from 3 to 23 years of age, for both genders. After adjustment with the different models, percentiles for height, weight (percentiles 3, 5, 10, 25, 50, 75, 90, 95, and 97) and BMI (percentiles 3, 5, 50, 85, 95, and 97) are presented for both genders. Conclusion This is the first study in Andalusia with a representative sample from the child-juvenile population to investigate weight, height and BMI in subjects from 3 to 23 years of age. The great variability observed in the values from sample of 18 to 23 years of age individuals, ensures the inclusion of extreme values, although random sampling was not used. There still is a lack of standard reference values for the Andalusian population younger done 3 years of age. PMID:18673524

Does body mass index misclassify physically active young men.

PubMed

Grier, Tyson; Canham-Chervak, Michelle; Sharp, Marilyn; Jones, Bruce H

2015-01-01

The purpose of this analysis was to determine the accuracy of age and gender adjusted BMI as a measure of body fat (BF) in U.S. Army Soldiers. BMI was calculated through measured height and weight (kg/m(2)) and body composition was determined by dual energy X-ray absorptiometry (DEXA). Linear regression was used to determine a BF prediction equation and examine the correlation between %BF and BMI. The sensitivity and specificity of BMI compared to %BF as measured by DEXA was calculated. Soldiers (n = 110) were on average 23 years old, with a BMI of 26.4, and approximately 18% BF. The correlation between BMI and %BF (R = 0.86) was strong (p < 0.01). A sensitivity of 77% and specificity of 100% were calculated when using Army age adjusted BMI thresholds. The overall accuracy in determining if a Soldier met Army BMI standards and were within the maximum allowable BF or exceeded BMI standards and were over the maximum allowable BF was 83%. Using adjusted BMI thresholds in populations where physical fitness and training are requirements of the job provides better accuracy in identifying those who are overweight or obese due to high BF.

Development of bioelectrical impedance-derived indices of fat and fat-free mass for assessment of nutritional status in childhood.

PubMed

Wright, C M; Sherriff, A; Ward, S C G; McColl, J H; Reilly, J J; Ness, A R

2008-02-01

(1) To develop a method of manipulating bioelectrical impedance (BIA) that gives indices of lean and fat adjusted for body size, using a large normative cohort of children. (2) To assess the discriminant validity of the method in a group of children likely to have abnormal body composition. Two prospective cohort studies. Normative data: Avon Longitudinal Study of Parents and Children (ALSPAC), population based cohort; proof of concept study: tertiary feeding clinic and special needs schools. Normative data: 7576 children measured aged between 7.25 and 8.25 (mean 7.5) (s.d.=0.2) years; proof of concept study: 29 children with either major neurodisability or receiving artificial feeding, or both, mean age 7.6 (s.d.=2) years. Leg-to-leg (Z (T)) and arm-to-leg (Z (B)) BIA, weight and height. Total body water (TBW) was estimated from the resistance index (RI=height(2)/Z), and fat-free mass was linearly related to TBW. Fat mass was obtained by subtracting fat-free mass from total weight. Fat-free mass was log-transformed and the reciprocal transform was taken for fat mass to satisfy parametric model assumptions. Lean and fat mass were then adjusted for height and age using multiple linear regression models. The resulting standardized residuals gave the lean index and fat index, respectively. In the normative cohort, the lean index was higher and fat index lower in boys. The lean index rose steeply to the middle of the normal range of body mass index (BMI) and then slowly for higher BMI values, whereas the fat index rose linearly through and above the normal range. In the proof of concept study, the children as a group had low lean indices (mean (s.d.) -1.5 (1.7)) with average fat indices (+0.21 (2.0)) despite relatively low BMI standard deviation scores (-0.60 (2.3)), but for any given BMI, individual children had extremely wide ranges of fat indices. The lean index proved more stable and repeatable than BMI. This clinical method of handling BIA reveals important variations in nutritional status that would not be detected using anthropometry alone. BIA used in this way would allow more accurate assessment of energy sufficiency in children with neurodisability and may provide a more valid identification of children at risk of underweight or obesity in field and clinical settings.

Prevalences of overweight and obesity among children in remote Aboriginal communities in central Australia.

PubMed

Schultz, Rosalie

2012-01-01

The chronic diseases associated with overweight and obesity are major contributors to the excess disease burden of Aboriginal Australians. Surveillance of overweight and obesity is required to monitor these conditions, and to develop and evaluate interventions to improve health and wellbeing. Remote Aboriginal communities in Australia's Northern Territory (NT) are where approximately two-thirds of the NT Aboriginal people live, a proportion which has been stable over many years. However the remote communities suffer significant socioeconomic disadvantage including limited education and employment opportunities, and poor quality and overcrowded housing. Approximately one-third of Aboriginal people in NT live in central Australia, which consists of the Alice Springs and Barkly districts. The Healthy School-Aged Kids Program includes health promotion and child health screening, and is run in remote Aboriginal communities of NT. This report provides estimates of prevalences of overweight and obesity among children in central Australia who participated in health checks as part of Healthy School-Aged Kids Program in 2010. All children in remote central Australian Aboriginal communities were invited to participate in health checks. Children who attended were weighed and measured. Date of birth, sex, height and weight for each child were used to determine prevalence of overweight (≥+1 standard deviation [SD] BMI-for-age) and obesity (≥+2 SD BMI-for-age) according to WHO Growth standards. Differences in proportions of overweight and obesity by age group and sex, and their statistical significance were calculated. Weight, height, sex and age data were available for 996 children from a population of 1764. It was found that 22.1% of girls and 20.7% of boys were overweight; and 5.1% of girls and 5.8% of boys were obese as defined by BMI-for-age. Prevalence of overweight but not obesity increased with age (for overweight z=3.28, p=0.0011; for obesity z=0.68; p=0.50). The prevalences of overweight and obesity as estimated by BMI-for-age among children in remote central Australian Aboriginal communities were compared with those in other Australian surveys. They appear unlikely to reflect future relative risk of the chronic diseases with which overweight and obesity are associated. Routine collection of data on BMI-for-age may not provide adequate estimation of future risk of chronic disease burden attributable to overweight and obesity among these children. Alternative measures for surveillance for overweight such as waist circumference may prove more useful. Appropriate interventions to reduce risk of chronic disease are required, including interventions to reduce prevalences of overweight and obesity.

1 CFR 21.14 - Deviations from standard organization of the Code of Federal Regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Deviations from standard organization of the... CODIFICATION General Numbering § 21.14 Deviations from standard organization of the Code of Federal Regulations. (a) Any deviation from standard Code of Federal Regulations designations must be approved in advance...

Malnutrition in pediatric patients with cancer at diagnosis and throughout therapy: A multicenter cohort study.

PubMed

Zimmermann, Karin; Ammann, Roland A; Kuehni, Claudia E; De Geest, Sabina; Cignacco, Eva

2013-04-01

Malnutrition is a common problem in pediatric patients with cancer. Reported prevalence varies widely and has often been assessed only in a subset of childhood types of cancer. This study aimed to describe the prevalence of malnutrition among pediatric patients newly diagnosed with cancer, to describe the occurrence and course of malnutrition during therapy and to identify factors associated with malnutrition during therapy. In a retrospective cohort study of 327 patients diagnosed from 2003 to 2006 in three Swiss tertiary care hospitals, weight and height measures together with patient-, disease-, and treatment-related characteristics were assessed. Malnutrition was defined as body mass index (BMI) below -2 standard deviation scores (SDS) or a weight loss >10% from diagnosis. Malnutrition was assessed at diagnosis and continuously during anticancer therapy. At diagnosis, 5.8% of the patients (19) were malnourished based on BMI. During anticancer therapy, the cumulative incidence of malnutrition rose to 22% (70 patients) after 30 days, to 36% (116 patients) after 60 days, and finally to 47% (155 patients). In these 155 patients, the median duration of malnutrition was 60 days (interquartile range, 21-122). Age above 10 years at diagnosis, BMI ≤ -1.0 SDS at diagnosis, and a diagnosis of medulloblastoma were positively associated with a higher proportion of malnutrition time during therapy. The rapid increase of malnutrition after the start of treatment underlines the need to develop evidence-based and efficient methods to provide nutritional support for children with cancer. Copyright © 2012 Wiley Periodicals, Inc.

Neighborhood Environment and Children's Physical Activity and Body Mass Index: Evidence from Military Personnel Installation Assignments

PubMed Central

Nicosia, Nancy; Wong, Elizabeth; Shier, Victoria

2015-01-01

Abstract Background: The majority of existing studies use observed, rather than experimental or quasi-experimental, variation in individuals' neighborhood environments to study their influence on body weight and related behaviors. Purpose: This study leverages the periodic relocation of military personnel to examine the relationship between neighborhood environment and children's physical activity (PA) and BMI in military families. Methods: This study utilizes data on 12- and 13-year-old children from the Military Teenagers Environments, Exercise, and Nutrition Study (N=903). Multivariate regression models are estimated, separately for families living on- and off-post, to examine the relationship between parents' perceptions of the neighborhood environment, measured using the Neighborhood Environment Walkability Scale–Youth Version (NEWS-Y), and children's self-reported PA and BMI. Results: Different features of the neighborhood environment were significant for off- versus on-post families. For children living off-post, a 1 standard deviation (SD) increase in the proximity-to-recreational-facilities subscale was associated with 16.5 additional minutes per week (p<0.05) of moderate PA (MPA), but street connectivity had a significant negative association with vigorous activity. For children living on-post, a 1 SD increase on the crime safety subscale was associated with 22.9 additional minutes per week (p<0.05) of MPA. None of the NEWS-Y subscales were associated with children's BMI. Conclusions: Efforts to increase children's PA in military families should take into account that different aspects of the neighborhood environment matter for children living on- versus off-post. PMID:25658385

Candida spp. and gingivitis in children with nephrotic syndrome or type 1 diabetes.

PubMed

Olczak-Kowalczyk, Dorota; Pyrżak, Beata; Dąbkowska, Maria; Pańczyk-Tomaszewska, Małgorzata; Miszkurka, Grażyna; Rogozińska, Izabela; Swoboda-Kopeć, Ewa; Gozdowski, Dariusz; Kalińska, Angelika; Piróg, Anna; Mizerska-Wasiak, Małgorzata; Roszkowska-Blaim, Maria

2015-05-08

Diabetes and Nephrotic syndrome (NS) promote plaque-related gingivitis and yeast-like fungal infections. The study assesses the impact of Candida spp. and general disease- or treatment-related factors on plaque-related gingivitis severity in children and adolescents with Nephrotic syndrome /diabetes. Body mass index (BMI), BMI standard deviation score, and oral cavity (Plaque Index--PLI, Gingival Index--GI, mucosa status, presence and Candida enzymatic activity) were assessed in 96 patients (32 with NS: 30- immunosuppressive treatment, 35--type 1 diabetes, and 29 generally healthy), aged; 3-18 years. Laboratory included cholesterol and triglyceride measurements; in diabetic subjects- glycated haemoglobin, in NS: total protein, albumin, creatinine, haemoglobin, haematocrit, white cell count, urinary protein excretion. Medical records supplied information on disease duration and treatment. A statistical analysis was performed; Kendall Tau coefficient, chi-square test, t-test, and multiple regression analysis ( P < 0.05). Candida spp. often occurred in healthy patients, but oral candidiasis was found only in the NS and diabetes groups (9.37% and 11.43%). Gingivitis occurred more frequently in patients with NS/diabetes. Gingivitis severity was correlated with PLI, age, and yeast enzyme activity in NS--to with immunosuppressive treatment with >1 drug, drug doses, treatment duration, lipid disorders, and BMI; in diabetes, with blood glucose and glycated haemoglobin >8%. Poor hygiene control is the main cause of gingivitis. Gingivitis severity is most likely related to age, lipid disorders and increase in body mass. Candida spp., in uncompensated diabetes and in those using immunosuppressive treatment, might intensify plaque-related gingivitis.

Perceived stress, behavior, and body mass index among adults participating in a worksite obesity prevention program, Seattle, 2005-2007.

PubMed

Barrington, Wendy E; Ceballos, Rachel M; Bishop, Sonia K; McGregor, Bonnie A; Beresford, Shirley A A

2012-01-01

Stress in numerous contexts may affect the risk for obesity through biobehavioral processes. Acute stress has been associated with diet and physical activity in some studies; the relationship between everyday stress and such behavior is not clear. The objective of this study was to examine associations between perceived stress, dietary behavior, physical activity, eating awareness, self-efficacy, and body mass index (BMI) among healthy working adults. Secondary objectives were to explore whether eating awareness modified the relationship between perceived stress and dietary behavior and perceived stress and BMI. Promoting Activity and Changes in Eating (PACE) was a group-randomized worksite intervention to prevent weight gain in the Seattle metropolitan area from 2005 through 2007. A subset of 621 participants at 33 worksites provided complete information on perceived stress at baseline. Linear mixed models evaluated cross-sectional associations. The mean (standard deviation [SD]) Perceived Stress Scale-10 score among all participants was 12.7 (6.4), and the mean (SD) BMI was 29.2 kg/m2 (6.3 kg/m2). Higher levels of perceived stress were associated with lower levels of eating awareness, physical activity, and walking. Among participants who had low levels of eating awareness, higher levels of perceived stress were associated with fewer servings of fruit and vegetables and greater consumption of fast food meals. Dietary and physical activity behaviors of workers may be associated with average levels of perceived stress. Longitudinal studies are needed, however, to support inclusion of stress management or mindfulness techniques in workplace obesity prevention efforts.

Laparoscopic sleeve gastrectomy improves renal transplant candidacy and posttransplant outcomes in morbidly obese patients.

PubMed

Kim, Y; Jung, A D; Dhar, V K; Tadros, J S; Schauer, D P; Smith, E P; Hanseman, D J; Cuffy, M C; Alloway, R R; Shields, A R; Shah, S A; Woodle, E S; Diwan, T S

2018-02-01

Morbid obesity is a barrier to kidney transplantation due to inferior outcomes, including higher rates of new-onset diabetes after transplantation (NODAT), delayed graft function (DGF), and graft failure. Laparoscopic sleeve gastrectomy (LSG) increases transplant eligibility by reducing BMI in kidney transplant candidates, but the effect of surgical weight loss on posttransplantation outcomes is unknown. Reviewing single-center medical records, we identified all patients who underwent LSG before kidney transplantation from 2011-2016 (n = 20). Post-LSG kidney recipients were compared with similar-BMI recipients who did not undergo LSG, using 2:1 direct matching for patient factors. McNemar's test and signed-rank test were used to compare groups. Among post-LSG patients, mean BMI ± standard deviation (SD) was 41.5 ± 4.4 kg/m 2 at initial encounter, which decreased to 32.3 ± 2.9 kg/m 2 prior to transplantation (P < .01). No complications, readmissions, or mortality occurred following LSG. After transplantation, one patient (5%) experienced DGF, and no patients experienced NODAT. Allograft and patient survival at 1-year posttransplantation was 100%. Compared with non-LSG patients, post-LSG recipients had lower rates of DGF (5% vs 20%) and renal dysfunction-related readmissions (10% vs 27.5%) (P < .05 each). Perioperative complications, allograft survival, and patient survival were similar between groups. These data suggest that morbidly obese patients with end-stage renal disease who undergo LSG to improve transplant candidacy, achieve excellent posttransplantation outcomes. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters.

PubMed

Horák, Stanislav; Sovová, Eliška; Pastucha, Dalibor; Konečný, Petr; Radová, Lenka; Calabová, Naděžda; Janoutová, Jana; Janout, Vladimír

2017-12-01

Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions). Copyright© by the National Institute of Public Health, Prague 2017

The effects of Nigella sativa L. on obesity: A systematic review and meta-analysis.

PubMed

Namazi, Nazli; Larijani, Bagher; Ayati, Mohammad Hossein; Abdollahi, Mohammad

2018-06-12

Nigella sativa L. (N.sativa) is a traditional herbal medicine that has been used for centuries to treat rheumatoid arthritis, diabetes, asthma, and other metabolic disorders. Recently, anti-obesity characteristics of N.sativa have been indicated. The effects of N. sativa as a complementary therapy in obesity management remains controversial. We aimed to perform a meta-analysis on the effects of supplementation with N. sativa on some anthropometric indices in adult subjects. We searched PubMed/Medline, Cochrane Library, ISI Web of Science, and Scopus databases until June 2017 to identify relevant placebo-controlled clinical trials. Data was reported as weighted mean differences and standard deviations to show the magnitude of effects for N. sativa on body weight, body mass index (BMI) and waist circumference (WC). Findings of 11 studies revealed that N. sativa supplement reduced body weight (-2.11 kg, 95% CI: -3.61, -0.61, I 2 :72.4%), BMI (-1.16 kg/m 2 ; 95%CI: -1.81, -0.51; I 2 : 40.1%) and WC (-3.52 cm, 95%CI: -4.10, -2.92, I 2 =0%) significantly compared to placebo groups. Supplementation with N. sativa exerts a moderate effect on reduction in body weight, BMI and WC. However, due to the high heterogeneity for body weight and limited high quality studies, the findings should be declared by caution. No serious side effects were also reported following N. sativa supplementation. Further studies are needed to clarify the effects of N. sativa on other anthropometric indices. Copyright © 2018 Elsevier B.V. All rights reserved.

Association Study of Three Gene Polymorphisms Recently Identified by a Genome-Wide Association Study with Obesity-Related Phenotypes in Chinese Children.

PubMed

Song, Qi-Ying; Song, Jie-Yun; Wang, Yang; Wang, Shuo; Yang, Yi-De; Meng, Xiang-Rui; Ma, Jun; Wang, Hai-Jun; Wang, Yan

2017-01-01

This study aimed to examine associations of three single-nucleotide polymorphisms (SNPs) with obesity-related phenotypes in Chinese children. These SNPs were identified by a recent genome-wide association (GWA) study among European children. Given that varied genetic backgrounds across different ethnicity may result in different association, it is necessary to study these associations in a different ethnic population. A total of 3,922 children, including 2,191 normal-weight, 873 overweight and 858 obese children, from three independent studies were included in the study. Logistic and linear regressions were performed, and meta-analyses were conducted to assess the associations between the SNPs and obesity-related phenotypes. The pooled odds ratios of the A-allele of rs564343 in PACS1 for obesity and severe obesity were 1.180 (p = 0.03) and 1.312 (p = 0.004), respectively. We also found that rs564343 was nominally associated with BMI, BMI standard deviation score (BMI-SDS), waist circumference, and waist-to-height ratio (p < 0.05). We showed for the first time that the rs564343 in PACS1 was associated with risk of severe obesity in a non-European population. This SNP was also found to be associated with common obesity and various obesity-related phenotypes in Chinese children, which had not been reported in the original study. The results demonstrated the value of conducting genetic researches in populations with different ethnicity. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Circulating insulin-like growth factor-binding protein 3 levels, independent of insulin-like growth factor 1, associate with truncal fat and systolic blood pressure in South Asian and white European preschool children.

PubMed

Patel, Leena; Whatmore, Andrew; Davies, Jill; Bansal, Narinder; Vyas, Avni; Gemmell, Isla; Oldroyd, John; Cruickshank, J Kennedy; Clayton, Peter

2014-01-01

To study the effect of the insulin-like growth factor (IGF) system on growth, adiposity and systolic blood pressure (SBP) in early life in British-born South Asian (SA) and White European (WE) children. The effect of IGF-1 and insulin-like growth factor-binding protein 3 (IGFBP-3) over the first 4 years in 204 healthy SA and WE children was investigated by mixed linear regression modelling. This enabled inclusion of all follow-up observations and adjustment for repeated measures. At birth, SA babies were shorter and lighter than WE babies. Over 4 years, SA ethnicity was associated with lower height, weight and body mass index (BMI) standard deviation score (SDS), higher subscapular/triceps skinfold thickness (Ss/Tr SFT) and lower SBP (all p < 0.01). IGF-1 was associated with greater height (p = 0.03), weight (p < 0.001) and BMI SDS (p < 0.001), and IGFBP-3 with greater weight SDS (p < 0.001), BMI SDS (p = 0.001), Ss/Tr SFT (p = 0.003) and SBP (p = 0.023). Over this first 4-year period of life, SA ethnicity was associated with being shorter, lighter, having more superficial truncal adiposity and lower SBP. IGFBP-3 (and not IGF-1) was independently associated with both superficial truncal adiposity and SBP, suggesting that IGFBP-3 is a potential metabolic and cardiovascular marker in healthy children in the early years of life.

Feeding choice has a gender-associated effect on infant growth.

PubMed

Nagahara, Keiko; Dobashi, Kazushige; Itabashi, Kazuo

2013-08-01

Appropriate nutrition during childhood is important for preventing future development of lifestyle-related diseases. The effect of feeding choice on infant growth in Japan is not known. Data from 204 healthy schoolchildren (age, 6-9 years) were obtained retrospectively from their parents by questionnaires. Breast-fed (BF) and formula-fed (FF) groups were defined as those fed only breast milk or formula milk at 4 months of age, respectively. There were 71 children (M/F, 31/40) in BF and 30 (M/F, 19/11) in FF. Anthropometric data at birth, and at 1, 4, 7, 10, 18, and 36 months of age in male and female infants were compared between the groups. In male infants, height was significantly lower at 4 months, bodyweight was lower from 4 to 18 months, and body mass index (BMI) was lower from 10 to 36 months in BF than in FF. The standard deviation scores (SDS) for height, weight and BMI had a similar pattern. No significant differences were observed for these variables for female infants in BF compared with FF. Multiple regression analysis showed that birthweight, mother's pre-pregnancy weight, and infant feeding choice were significant factors associated with weight-SDS at 18 and 36 months. Feeding choice was the only factor associated with BMI-SDS at 18 months. Infant feeding choice had a gender-associated effect on growth during infancy. When evaluating infant growth, not only birthweight and mother's pre-pregnancy weight, but also infant feeding choice and gender should be considered. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Defining overweight and obesity among Greek children living in Thessaloniki: International versus local reference standards

PubMed Central

Christoforidis, A; Dimitriadou, M; Papadopolou, E; Stilpnopoulou, D; Katzos, G; Athanassiou-Metaxa, M

2011-01-01

Background: Body Mass Index (BMI) offers a simple and reasonable measure of obesity that, with the use of the appropriate reference, can help in the early detection of children with weight problems. Our aim was to compare the two most commonly used international BMI references and the national Greek BMI reference in identifying Greek children being overweight and obese. Methods: A group of 1557 children (820 girls and 737 boys, mean age: 11.42 ± 3.51 years) were studied. Weight and height was measured using standard methods, and BMI was calculated. Overweight and obesity were determined using the International Obesity Task Force (IOTF) standards, the Centers for Disease Control and Prevention (CDC) BMI-forage curves and the most recent Greek BMI-for-age curves. Results: Results showed that the IOTF's cut-off limits identifies a significantly higher prevalence of overweight (22.4%) compared with both the CDC's (11.8%, p=0.03) and the Greek's (7.4%, p=0.002) cut-off limits. However, the prevalence of obesity was generally increased when it was determined using the CDC's cut-off limits (13.9%) compared to the prevalence calculated with both the IOTF's (6.5%, p=0.05) and the Greek's (6.9%, n.s.) cut off limits. Conclusions: The use of the national Greek reference standards for BMI underestimates the true prevalence of overweight and obesity. On the contrary, both the IOTF and the CDC standards, although independently, detect an increased number of overweight and obese children and thus they should be adopted in the clinical practice for an earlier identification and a timelier intervention. PMID:22110296

Upgraded FAA Airfield Capacity Model. Volume 1. Supplemental User’s Guide

DTIC Science & Technology

1981-02-01

SIGMAR (P4.0) cc 1-4 -standard deviation, in seconds, of arrival runway occupancy time (R.O.T.). SIGMAA (F4.0) cc 5-8 -standard deviation, in seconds...iI SI GMAC - The standard deviation of the time from departure clearance to start of roll. SIGMAR - The standard deviation of the arrival runway

The impact of long-term growth hormone treatment on metabolic parameters in Japanese patients with short stature born small for gestational age.

PubMed

Kappelgaard, Anne-Marie; Kiyomi, Fumiaki; Horikawa, Reiko; Yokoya, Susumu; Tanaka, Toshiaki

2014-01-01

An examination of the effects of up to 260 weeks of growth hormone (GH) therapy on metabolic parameters in Japanese children born small for gestational age (SGA). Data were analysed from a 156-week extension of a 104-week multicentre, randomised, double-blind, parallel-group trial. Sixty-five children born SGA (age 3-<8 years) received 33 μg/kg/day (n = 31, 64.5% male) or 67 μg/kg/day (n = 34, 58.8% male) GH for 260 weeks. Changes in metabolic parameters - glucose, insulin, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol - were recorded. Alterations in weight, body mass index standard deviation score (BMI SDS) and vital signs were also evaluated. Over 260 weeks of GH treatment, a positive correlation between Δheight SDS and Δinsulin-like growth factor-I SDS was observed. Insulin and glucose levels were generally unaffected. Favourable changes in lipid profiles were recorded, which were maintained for the study duration. No adverse alterations in weight, BMI SDS or vital signs were noted. Long-term, continuous GH treatment in children born SGA appears to be efficacious, associated with potential benefits for several metabolic parameters and associated with no long-term safety concerns.

A method comparison of total and HMW adiponectin: HMW/total adiponectin ratio varies versus total adiponectin, independent of clinical condition.

PubMed

van Andel, Merel; Drent, Madeleine L; van Herwaarden, Antonius E; Ackermans, Mariëtte T; Heijboer, Annemieke C

2017-02-01

Total and high-molecular-weight (HMW) adiponectin have been associated with endocrine and cardiovascular pathology. As no gold standard is available, the discussion about biological relevance of isoforms is complicated. In our study we perform a method comparison between two commercially available assays measuring HMW and total adiponectin, in various patient groups, thus contributing further to this discussion. We determined levels of HMW and total adiponectin using assays by Lumipulse® and Millipore® respectively, in 126 patients with different clinical characteristics (n=29 healthy volunteers, n=22 dialysis patients, n=25 elderly with body mass index (BMI) <21kg/m 2 , n=25 elderly with BMI 30-35kg/m 2 , n=26 children). The Passing & Bablock regression analysis resulted in HMW adiponectin LUMIPULSE ∗0.5-0.9=total adiponectin MILLIPORE , albeit with significant deviation from linearity (p<0.001). Pearson's correlation was R=0.987 (p=0.000). No significant differences between patient groups were observed (p=0.190). The HMW/total adiponectin ratio varies with total adiponectin concentration independent of clinical conditions studied. Our results imply that total and HMW adiponectin have similar utility when assessing adiponectin levels in blood, as the ratio is independent of clinical condition. Copyright © 2016 Elsevier B.V. All rights reserved.

Associations of Fast Food Restaurant Availability With Dietary Intake and Weight Among African Americans in the Jackson Heart Study, 2000–2004

PubMed Central

Diez Roux, Ana V.; Smith, Adam E.; Tucker, Katherine L.; Gore, Larry D.; Zhang, Lei; Wyatt, Sharon B.

2011-01-01

Objectives. We examined the associations of fast food restaurant (FFR) availability with dietary intake and weight among African Americans in the southeastern United States. Methods. We investigated cross-sectional associations of FFR availability with dietary intake and body mass index (BMI) and waist circumference in 4740 African American Jackson Heart Study participants (55.2 ±12.6 years, 63.3% women). We estimated FFR availability using circular buffers with differing radii centered at each participant's geocoded residential location. Results. We observed no consistent associations between FFR availability and BMI or waist circumference. Greater FFR availability was associated with higher energy intake among men and women younger than 55 years, even after adjustment for individual socioeconomic status. For each standard deviation increase in 5-mile FFR availability, the energy intake increased by 138 kilocalories (confidence interval [CI] = 70.53, 204.75) for men and 58 kilocalories (CI = 8.55, 105.97) for women. We observed similar associations for the 2-mile FFR availability, especially in men. FFR availability was also unexpectedly positively associated with total fiber intake. Conclusions. FFR availability may contribute to greater energy intake in younger African Americans who are also more likely to consume fast food. PMID:21551382

Growth Patterns in the Irish Pyridoxine Nonresponsive Homocystinuria Population and the Influence of Metabolic Control and Protein Intake

PubMed Central

Coughlan, Aoife; Grant, Tim; McNulty, Jenny; Clark, Anne; Deverell, Deirdre; Mayne, Philip; Hughes, Joanne; Monavari, Ahmad; Knerr, Ina; Crushell, Ellen

2017-01-01

A low methionine diet is the mainstay of treatment for pyridoxine nonresponsive homocystinuria (HCU). There are various guidelines for recommended protein intakes for HCU and clinical practice varies. Poor growth has been associated with low cystine levels. This retrospective review of 48 Irish pyridoxine nonresponsive HCU patients assessed weight, height, body mass index (BMI), protein intake, and metabolic control up to 18 years at nine set time points. Patients diagnosed through newborn screening (NBS) were compared to late diagnosed (LD) patients. At 18 years the LD group (n = 12, mean age at diagnosis 5.09 years) were heavier (estimated effect +4.97 Kg, P = 0.0058) and taller (estimated effect +7.97 cm P = 0.0204) than the NBS group (n = 36). There was no difference in growth rate between the groups after 10 years of age. The HCU population were heavier and taller than the general population by one standard deviation with no difference in BMI. There was no association between intermittently low cystine levels and height. Three protein intake guidelines were compared; there was no difference in adult height between those who met the lowest of the guidelines (Genetic Metabolic Dietitians International) and those with a higher protein intake. PMID:29270317

Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults †.

PubMed

Frames, Christopher W; Soangra, Rahul; Lockhart, Thurmon E; Lach, John; Ha, Dong Sam; Roberto, Karen A; Lieberman, Abraham

2018-05-24

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m², using a force plate and an inertial measurement unit affixed at the sternum. Participants' fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

The transition between the phenotypes of Prader-Willi syndrome during infancy and early childhood.

PubMed

Butler, Jill V; Whittington, Joyce E; Holland, Anthony J; McAllister, Catherine J; Goldstone, Anthony P

2010-06-01

Prader-Willi syndrome (PWS) is a genetic disorder historically characterized by two phenotypic stages. The early phenotype in infants is associated with hypotonia, poor suck, and failure to thrive. In later childhood, PWS is associated with intellectual disability, hyperphagia, as well as growth and sex hormone deficiency. Little is known about the transition between phenotypes. This study investigates the nature of the change in infancy and childhood PWS. Forty-six children (22 females, 24 males; mean age 2 y 9 mo, SD 18.9 mo; range 7 mo-5 y) with genetically confirmed PWS participated. Information was obtained on childhood height and weight, and eating behaviour from case notes and by parental interview. Weight standard deviation scores (SDS) started to exceed height by the end of the first year. Height SDS appeared to fall from near normal at birth until stabilizing below normal around 2 years. Half of the children whose body mass index (BMI) was higher than normal at interview had food interests greater than that of their peers, and the age at which increased age-appropriate eating was first noted was later than the increase of BMI SDS. Obesity may develop before the increased interest in food, suggesting underlying physiological factors independent of appetite control may be important.

A Visual Model for the Variance and Standard Deviation

ERIC Educational Resources Information Center

Orris, J. B.

2011-01-01

This paper shows how the variance and standard deviation can be represented graphically by looking at each squared deviation as a graphical object--in particular, as a square. A series of displays show how the standard deviation is the size of the average square.

Effect of child labour on growth of children.

PubMed

Ambadekar, N N; Wahab, S N; Zodpey, S P; Khandait, D W

1999-11-01

This community based group comparison study was undertaken to assess the effect of child labour on the growth of children. The study subjects were 223 child labourers aged between 8-15 y who were matched by age to an equal number of controls and pair matched for gender. The mean weight of the male child labourers and the controls increased from 23.8 (+/-5.9) to 41.2 (+/-9.7) kg and 23.9 (+/-4.8) to 44.4 (+/-10.3) kg respectively, while mean height increased from 121.5 (+/-12.6) to 151.9 (+/-10.6) cm and 122.0 (+/-8.4) to 154.8 (+/-10.8) cm respectively from 8-15 y. At older ages (12 y and above for weight and 14 y and above for height) the difference was statistically significant. The same was not observed for the female study subjects. Similarly standard deviation (s.d.) scores for weight for age and height for age of male comparison subjects was significantly (P<0.01) nearer to National Centre for Health Statistics (NCHS) standard than that of the child labourers. Body mass index (BMI) below normal value, that is, 18.5 was observed in significantly (P=0.0261) more child labourers 180 (80.7%) than controls 160 (71.1%). With increasing duration of employment BMI decreased from 18.1 (+/-3.5) to 17.3 (+/-2.2). Genital development was observed to be delayed significantly in male child labourers. Therefore, it can be concluded that labouring at a young age has a deleterious effect on the growth of the child.

World and Olympic mountain bike champions' anthropometry, body composition and somatotype.

PubMed

Sánchez-Muñoz, Cristóbal; Muros, José J; Zabala, Mikel

2018-06-01

The aim of the study was to describe the anthropometric profile of male Olympic cross country (XCO) mountain bikers. Fifty one XCO bikers participated in this study, divided into an elite group who competed in top level international competitions, and a non-elite group who competed at a national level. The elite group was further classified according to whether they had been world or Olympic champion mountain bikers (WOC) or not (NWOC). The anthropometric profiles included the measurements of height, weight, arm span, skinfolds, girths, and breadths. Body Mass Index (BMI), body composition and somatotype were also calculated. Variables was described as mean, standard deviation and range. The standardizing of the variables was carried out using the Shapiro-Wilk with Lillieforts correction and homoscedasticity was analyzed using the Levene Test. After verifying that the variables were normal, the data were analyzed using non-paired t-tests (elite vs. non-elite and WOC vs. NWOC). Elite riders had significantly lower BMI, lower percentage of fat, total thigh area and larger thigh muscle area than the sub-elite riders, and presented significantly lower values for the endomorphic component and higher values for the ectomorphic component. The mean somatotype of the elite riders could be defined as ecto-mesomorphic (1.7-4.6-3.1). Comparisons between of WOC riders and NWOC, showed that the WOC bikers had a significantly higher value for weight, arm span, upper arm girth relaxed and upper arm girth flexed and tensed, calf girth, total upper arm area, and upper arm muscle area than the NWOC riders group.

Variability of pesticide detections and concentrations in field replicate water samples collected for the National Water-Quality Assessment Program, 1992-97

USGS Publications Warehouse

Martin, Jeffrey D.

2002-01-01

Correlation analysis indicates that for most pesticides and concentrations, pooled estimates of relative standard deviation rather than pooled estimates of standard deviation should be used to estimate variability because pooled estimates of relative standard deviation are less affected by heteroscedasticity. The 2 Variability of Pesticide Detections and Concentrations in Field Replicate Water Samples, 1992–97 median pooled relative standard deviation was calculated for all pesticides to summarize the typical variability for pesticide data collected for the NAWQA Program. The median pooled relative standard deviation was 15 percent at concentrations less than 0.01 micrograms per liter (µg/L), 13 percent at concentrations near 0.01 µg/L, 12 percent at concentrations near 0.1 µg/L, 7.9 percent at concentrations near 1 µg/L, and 2.7 percent at concentrations greater than 5 µg/L. Pooled estimates of standard deviation or relative standard deviation presented in this report are larger than estimates based on averages, medians, smooths, or regression of the individual measurements of standard deviation or relative standard deviation from field replicates. Pooled estimates, however, are the preferred method for characterizing variability because they provide unbiased estimates of the variability of the population. Assessments of variability based on standard deviation (rather than variance) underestimate the true variability of the population. Because pooled estimates of variability are larger than estimates based on other approaches, users of estimates of variability must be cognizant of the approach used to obtain the estimate and must use caution in the comparison of estimates based on different approaches.

Basic life support: evaluation of learning using simulation and immediate feedback devices1.

PubMed

Tobase, Lucia; Peres, Heloisa Helena Ciqueto; Tomazini, Edenir Aparecida Sartorelli; Teodoro, Simone Valentim; Ramos, Meire Bruna; Polastri, Thatiane Facholi

2017-10-30

to evaluate students' learning in an online course on basic life support with immediate feedback devices, during a simulation of care during cardiorespiratory arrest. a quasi-experimental study, using a before-and-after design. An online course on basic life support was developed and administered to participants, as an educational intervention. Theoretical learning was evaluated by means of a pre- and post-test and, to verify the practice, simulation with immediate feedback devices was used. there were 62 participants, 87% female, 90% in the first and second year of college, with a mean age of 21.47 (standard deviation 2.39). With a 95% confidence level, the mean scores in the pre-test were 6.4 (standard deviation 1.61), and 9.3 in the post-test (standard deviation 0.82, p <0.001); in practice, 9.1 (standard deviation 0.95) with performance equivalent to basic cardiopulmonary resuscitation, according to the feedback device; 43.7 (standard deviation 26.86) mean duration of the compression cycle by second of 20.5 (standard deviation 9.47); number of compressions 167.2 (standard deviation 57.06); depth of compressions of 48.1 millimeter (standard deviation 10.49); volume of ventilation 742.7 (standard deviation 301.12); flow fraction percentage of 40.3 (standard deviation 10.03). the online course contributed to learning of basic life support. In view of the need for technological innovations in teaching and systematization of cardiopulmonary resuscitation, simulation and feedback devices are resources that favor learning and performance awareness in performing the maneuvers.

[Evaluation of weight, height and BMI in children, adolescents and young adults from the Community of Madrid].

PubMed

López de Lara, D; Santiago Paniagua, P; Tapia Ruiz, M; Rodríguez Mesa, M D; Gracia Bouthelier, R; Carrascosa Lezcano, A

2010-12-01

The data of four growth studies involving populations from Andalusia, Barcelona, Bilbao and Zaragoza have recently been reported as part of the Spanish Cross-sectional Growth Study 2008 (SCGS). With the aim of detecting possible differences between the population of the Madrid region and those of the SCGS, and by so-doing assess the applicability of the conclusions of this reference work to the Madrid region, a cross-sectional study of the latter was undertaken, recording the weight, height and body mass index (BMI). We have analyzed 6463 subjects (3055 females and 3408 males) aged 3-24 years. All subjects were healthy, Caucasian, and of Spanish origin. Differences between the results of the Madrid and SCGS studies were sought by multiple linear regression analysis of the log of the height, weight and BMI data adjusted for age and geographical area. The Tukey multiple comparisons test was used to analyse differences in age ranges. All calculations were performed using SAS v. 8.2 software. Means and standard deviations are provided for the weight, height and BMI of women and men; distributions by percentiles are also provided. No differences of clinical importance were seen in the weight, height or BMI between the subjects of the Madrid region and those of the SCGS. However, comparisons with the results of other studies performed more than 20 years ago revealed an increase in the weight and height values in all percentiles. In summary, the official Spanish SCGS reference data for 2008 are similar to those recorded for the Madrid region. Bearing in mind that recent cross-sectional studies undertaken in Andalusia, Aragon, Catalonia, the Basque Country and the present work show no significant differences in mean weights, heights or BMIs in any age group, nor in the final height attained by adults, the Spanish population would appear to be anthropometrically homogeneous. The conclusions of the SCGS may therefore be applicable to the entire country. Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Obesity, metabolic factors and risk of different histological types of lung cancer: A Mendelian randomization study

PubMed Central

Carreras-Torres, Robert; Johansson, Mattias; Haycock, Philip C.; Wade, Kaitlin H.; Relton, Caroline L.; Martin, Richard M.; Davey Smith, George; Albanes, Demetrius; Aldrich, Melinda C.; Andrew, Angeline; Bickeböller, Heike; Bojesen, Stig E.; Brunnström, Hans; Manjer, Jonas; Brüske, Irene; Caporaso, Neil E.; Chen, Chu; Christiani, David C.; Christian, W. Jay; Doherty, Jennifer A.; Duell, Eric J.; Goodman, Gary E.; Grankvist, Kjell; Haugen, Aage; Hong, Yun-Chul; Johansson, Mikael B.; Lam, Stephen; Landi, Maria Teresa; Lazarus, Philip; Le Marchand, Loïc; Liu, Geoffrey; Melander, Olle; Rennert, Gad; Risch, Angela; Haura, Eric B.; Scelo, Ghislaine; Zaridze, David; Mukeriya, Anush; Savić, Milan; Lissowska, Jolanta; Swiatkowska, Beata; Janout, Vladimir; Holcatova, Ivana; Mates, Dana; Shen, Hongbing; Tardon, Adonina; Woll, Penella; Tsao, Ming-Sound; Wu, Xifeng; Yuan, Jian-Min; Hung, Rayjean J.; Amos, Christopher I.; Brennan, Paul

2017-01-01

Background Assessing the relationship between lung cancer and metabolic conditions is challenging because of the confounding effect of tobacco. Mendelian randomization (MR), or the use of genetic instrumental variables to assess causality, may help to identify the metabolic drivers of lung cancer. Methods and findings We identified genetic instruments for potential metabolic risk factors and evaluated these in relation to risk using 29,266 lung cancer cases (including 11,273 adenocarcinomas, 7,426 squamous cell and 2,664 small cell cases) and 56,450 controls. The MR risk analysis suggested a causal effect of body mass index (BMI) on lung cancer risk for two of the three major histological subtypes, with evidence of a risk increase for squamous cell carcinoma (odds ratio (OR) [95% confidence interval (CI)] = 1.20 [1.01–1.43] and for small cell lung cancer (OR [95%CI] = 1.52 [1.15–2.00]) for each standard deviation (SD) increase in BMI [4.6 kg/m2]), but not for adenocarcinoma (OR [95%CI] = 0.93 [0.79–1.08]) (Pheterogeneity = 4.3x10-3). Additional analysis using a genetic instrument for BMI showed that each SD increase in BMI increased cigarette consumption by 1.27 cigarettes per day (P = 2.1x10-3), providing novel evidence that a genetic susceptibility to obesity influences smoking patterns. There was also evidence that low-density lipoprotein cholesterol was inversely associated with lung cancer overall risk (OR [95%CI] = 0.90 [0.84–0.97] per SD of 38 mg/dl), while fasting insulin was positively associated (OR [95%CI] = 1.63 [1.25–2.13] per SD of 44.4 pmol/l). Sensitivity analyses including a weighted-median approach and MR-Egger test did not detect other pleiotropic effects biasing the main results. Conclusions Our results are consistent with a causal role of fasting insulin and low-density lipoprotein cholesterol in lung cancer etiology, as well as for BMI in squamous cell and small cell carcinoma. The latter relation may be mediated by a previously unrecognized effect of obesity on smoking behavior. PMID:28594918

Body Configuration as a Predictor of Mortality: Comparison of Five Anthropometric Measures in a 12 Year Follow-Up of the Norwegian HUNT 2 Study

PubMed Central

Petursson, Halfdan; Sigurdsson, Johann A.; Bengtsson, Calle; Nilsen, Tom I. L.; Getz, Linn

2011-01-01

Background Distribution of body fat is more important than the amount of fat as a prognostic factor for life expectancy. Despite that, body mass index (BMI) still holds its status as the most used indicator of obesity in clinical work. Methods We assessed the association of five different anthropometric measures with mortality in general and cardiovascular disease (CVD) mortality in particular using Cox proportional hazards models. Predictive properties were compared by computing integrated discrimination improvement and net reclassification improvement for two different prediction models. The measures studied were BMI, waist circumference, hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). The study population was a prospective cohort of 62,223 Norwegians, age 20–79, followed up for mortality from 1995–1997 to the end of 2008 (mean follow-up 12.0 years) in the Nord-Trøndelag Health Study (HUNT 2). Results After adjusting for age, smoking and physical activity WHR and WHtR were found to be the strongest predictors of death. Hazard ratios (HRs) for CVD mortality per increase in WHR of one standard deviation were 1.23 for men and 1.27 for women. For WHtR, these HRs were 1.24 for men and 1.23 for women. WHR offered the greatest integrated discrimination improvement to the prediction models studied, followed by WHtR and waist circumference. Hip circumference was in strong inverse association with mortality when adjusting for waist circumference. In all analyses, BMI had weaker association with mortality than three of the other four measures studied. Conclusions Our study adds further knowledge to the evidence that BMI is not the most appropriate measure of obesity in everyday clinical practice. WHR can reliably be measured and is as easy to calculate as BMI and is currently better documented than WHtR. It appears reasonable to recommend WHR as the primary measure of body composition and obesity. PMID:22028926

Compliance with regulations on weight gain 6 months after delivery in active duty military women.

PubMed

Chauhan, Suneet P; Johnson, Traci L; Magann, Everett F; Woods, Janine Y; Chen, Han-Yang; Sheldon, Ingrid V; Morrison, John C

2013-04-01

To determine factors associated with active duty military women being within Navy weight standards 6 months following childbirth. Inclusion criteria for this study were active duty women who delivered a nonanomalous fetus at a Naval Hospital and who remained in the area and their weight was recorded 6 months following childbirth. Multivariate logistic regressions, adjusted for 14 covariates, determined the factors for achieving acceptable weight. Among 1,009 women who participated in this prospective cohort study, 68% began within Navy body weight standards and 52% had a normal body mass index (BMI) (<25). Six months after childbirth, 48% were within Navy body weight standards and 32% had a BMI <25. Only 2 factors, BMI at first visit and cesarean delivery, significantly influenced the percentage of women who met the weight standards at 6 months. Lowering the prepregnancy BMI and avoiding a cesarean delivery may improve the percentage of active duty women who meet weight standards 6 months after childbirth. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Clinical Evaluation of the Root Tear of the Posterior Horn of the Medial Meniscus in Total Knee Arthroplasty for Osteoarthritis

PubMed Central

Park, Sang-Jun

2015-01-01

Purpose To investigate the incidence of root tears of the posterior horn of the medial meniscus in total knee replacement arthroplasty for knee osteoarthritis and retrospectively analyze clinical results and factors associated with root tears. Materials and Methods There were 197 knees of 140 enrolled patients who had undergone total knee replacement arthroplasty between September 2010 and May 2014. The presence of a root tear of the posterior horn of the medial meniscus was confirmed in all patients. Statistical analysis was performed to investigate the correlation between root tears and the possible factors of meniscal tears including gender, age, severity of symptoms (visual analogue scale [VAS] score and medial joint line tenderness), grade of osteoarthritis (Kellgren-Lawrence grading scale), body mass index (BMI), varus deformity, and mechanical axis deviation. Results Meniscal tears were observed in 154 knees (78.17%). The root tear had correlation with the severity of osteoarthritis (p<0.05), varus deformity (p<0.05), mechanical axis deviation (p<0.05), and BMI (p<0.05). Conclusions Factors considered to represent the severity of osteoarthritis were found to be associated with root tears of the medial meniscus posterior horn. Increased BMI seemed to be associated with the increased incidence of root tears of the medial meniscus posterior horn. PMID:26060607

The Influence of Familial Predisposition to Cardiovascular Complications upon Childhood Obesity Treatment

PubMed Central

Nielsen, Louise A.; Bøjsøe, Christine; Kloppenborg, Julie T.; Trier, Cæcilie; Gamborg, Michael; Holm, Jens-Christian

2015-01-01

Introduction The aim was to investigate whether a familial predisposition to obesity related cardiovascular complications was associated with the degree of obesity at baseline and/or changes in the degree of obesity during a multidisciplinary childhood obesity treatment program. Methods The study included 1421 obese children (634 boys) with a median age of 11.5 years (range 3.1–17.9 years), enrolled in treatment for 0.04 to 5.90 years (median 1.3 years) at the Children's Obesity Clinic, Denmark. At baseline, weight and height were measured, body mass index (BMI) standard deviation score (SDS) calculated, and self-reported information on familial predisposition to obesity, hypertension, type 2 diabetes mellitus (T2DM), thromboembolic events, and dyslipidaemia were obtained. A familial predisposition included events in biological parents, siblings, grandparents, uncles, and aunts. The treatment outcomes were categorically analysed according to the prevalence of familial predispositions. Results The median BMI SDS at enrolment was 3.2 in boys and 2.8 in girls. One-thousand-and-forty-one children had obesity in their family, 773 had hypertension, 551 had T2DM, 568 had thromboembolic events, and 583 had dyslipidaemia. Altogether, 733 had three or more predispositions. At baseline, familial T2DM was associated with a higher mean BMI SDS (p = 0.03), but no associations were found between the other predispositions and the children's degree of obesity. During treatment, girls with familial obesity lost more weight, compared to girls without familial obesity (p = 0.04). No other familial predispositions were associated with changes in BMI SDS during treatment. Conclusion Obese children with a familial predisposition to T2DM showed a significantly higher degree of obesity at baseline and girls with familial obesity responded better to treatment. Besides these findings, no other associations were found between the occurrence of familial predispositions and the degree of obesity or changes herein during multidisciplinary childhood obesity treatment. PMID:25756875

Peripheral blood mononuclear cell gene expression profile in obese boys who followed a moderate energy-restricted diet: differences between high and low responders at baseline and after the intervention.

PubMed

Rendo-Urteaga, Tara; García-Calzón, Sonia; González-Muniesa, Pedro; Milagro, Fermín I; Chueca, María; Oyarzabal, Mirentxu; Azcona-Sanjulián, M Cristina; Martínez, J Alfredo; Marti, Amelia

2015-01-28

The present study analyses the gene expression profile of peripheral blood mononuclear cells (PBMC) from obese boys. The aims of the present study were to identify baseline differences between low responders (LR) and high responders (HR) after 10 weeks of a moderate energy-restricted dietary intervention, and to compare the gene expression profile between the baseline and the endpoint of the nutritional intervention. Spanish obese boys (age 10-14 years) were advised to follow a 10-week moderate energy-restricted diet. Participants were classified into two groups based on the association between the response to the nutritional intervention and the changes in BMI standard deviation score (BMI-SDS): HR group (n 6), who had a more decreased BMI-SDS; LR group (n 6), who either maintained or had an even increased BMI-SDS. The expression of 28,869 genes was analysed in PBMC from both groups at baseline and after the nutritional intervention, using the Affymetrix Human Gene 1.1 ST 24-Array plate microarray. At baseline, the HR group showed a lower expression of inflammation and immune response-related pathways, which suggests that the LR group could have a more developed pro-inflammatory phenotype. Concomitantly, LEPR and SIRPB1 genes were highly expressed in the LR group, indicating a tendency towards an impaired immune response and leptin resistance. Moreover, the moderate energy-restricted diet was able to down-regulate the inflammatory 'mitogen-activated protein kinase signalling pathway' in the HR group, as well as some inflammatory genes (AREG and TNFAIP3). The present study confirms that changes in the gene expression profile of PBMC in obese boys may help to understand the weight-loss response. However, further research is required to confirm these findings.

Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study.

PubMed

Santos, Maria Inês; Limbert, Catarina; Marques, Filipa Carlota; Rosário, Frederico; Lopes, Lurdes

2015-05-01

Serum thyroid stimulating hormone (TSH) levels are frequently elevated in obese children and are most likely to be associated with insulin resistance. However, clinical relevance of this association remains unclear. To assess the prevalence of hyperthyrotropinemia; to analyze the relationship between TSH and homeostasis model assessment - insulin resistance (HOMA-IR); and to verify whether TSH levels and HOMA-IR vary with weight loss in obese children. Retrospective longitudinal study with data from baseline and 1 year after lifestyle intervention in a pediatric obese group (344 children were recruited and 100 among them completed follow-up). For postintervention analysis, three groups were considered according to body mass index-standard deviation score (BMI-SDS) variations: ≤-0.5 (significant weight loss); 0.5-0 (weight loss); and >0 (weight gain). Statistical analysis was performed using SPSS 19.0®. The prevalence of increased TSH levels was 9.3%. At baseline TSH (p=0.007), fT4 (p=0.006), and HOMA-IR (p<0.001) were positively correlated to BMI-SDS (n=344). Weight reduction was verified in 67 out of 100 cases but significant loss was present in only 21 cases. Decreases in both TSH and BMI-SDS were independently associated with decreases in HOMA-IR (p=0.005 and p=0.016, respectively). There was no correlation between TSH and BMI-SDS variation. Significant decreases in the HOMA-IR (p=0.006) were only achieved in the significant weight loss group. The prevalence of hyperthyrotropinemia was lower than previously reported. However, cutoff values were adjusted to pubertal stage, suggesting an over report in other studies. Insulin resistance and TSH were positively correlated, independent of body status. Although weight loss was not associated with TSH variation, a decrease in TSH levels was independently associated with decreases in HOMA-IR.

Risk of bladder cancer by disease severity in relation to metabolic factors and smoking; a prospective pooled cohort study of 800,000 men and women.

PubMed

Teleka, Stanley; Häggström, Christel; Nagel, Gabriele; Bjørge, Tone; Manjer, Jonas; Ulmer, Hanno; Liedberg, Fredrik; Ghaderi, Sara; Lang, Alois; Jonsson, Håkan; Jahnson, Staffan; Orho-Melander, Marju; Tretli, Steinar; Stattin, Pär; Stocks, Tanja

2018-05-14

Previous studies on metabolic factors and bladder cancer (BC) risk have shown inconsistent results and have commonly not investigated associations separately by sex, smoking, and tumor invasiveness. Among 811 633 participants in six European cohorts, we investigated sex-specific associations between body mass index (BMI), mid-blood pressure (BP, [systolic+diastolic]/2), plasma glucose, triglycerides, total cholesterol and risk of BC overall, non-muscle invasive BC (NMIBC) and muscle invasive BC (MIBC). Among men, we additionally assessed additive interactions between metabolic factors and smoking on BC risk. During follow-up, 2 983 men and 754 women were diagnosed with BC. Among men, triglycerides and BP were positively associated with BC risk overall (hazard ratio [HR] per standard deviation [SD]: 1.17 [95% CI 1.06-1.27] and 1.09 [1.02-1.17], respectively), and among women, BMI was inversely associated with risk (HR: 0.90 [0.82-0.99]). The associations for BMI and BP differed between men and women (P interaction ≤0.005). Among men, BMI, cholesterol and triglycerides were positively associated with risk for NMIBC (HRs: 1.09 [95% CI 1.01-1.18], 1.14 [1.02-1.25], and 1.30 [1.12-1.48] respectively), and BP was positively associated with MIBC (HR: 1.23 [1.02-1.49]). Among women, glucose was positively associated with MIBC (HR: 1.99 [1.04-3.81]). Apart from cholesterol, HRs for metabolic factors did not significantly differ between MIBC and NMIBC, and there were no interactions between smoking and metabolic factors on BC. This study supports an involvement of metabolic aberrations in BC risk. Whilst some associations were significant only in certain sub-groups, there were generally no significant differences in associations by smoking or tumor invasiveness. This article is protected by copyright. All rights reserved. © 2018 UICC.

Feasibility Study of Using Gemstone Spectral Imaging (GSI) and Adaptive Statistical Iterative Reconstruction (ASIR) for Reducing Radiation and Iodine Contrast Dose in Abdominal CT Patients with High BMI Values.

PubMed

Zhu, Zheng; Zhao, Xin-ming; Zhao, Yan-feng; Wang, Xiao-yi; Zhou, Chun-wu

2015-01-01

To prospectively investigate the effect of using Gemstone Spectral Imaging (GSI) and adaptive statistical iterative reconstruction (ASIR) for reducing radiation and iodine contrast dose in abdominal CT patients with high BMI values. 26 patients (weight > 65kg and BMI ≥ 22) underwent abdominal CT using GSI mode with 300mgI/kg contrast material as study group (group A). Another 21 patients (weight ≤ 65kg and BMI ≥ 22) were scanned with a conventional 120 kVp tube voltage for noise index (NI) of 11 with 450mgI/kg contrast material as control group (group B). GSI images were reconstructed at 60keV with 50%ASIR and the conventional 120kVp images were reconstructed with FBP reconstruction. The CT values, standard deviation (SD), signal-noise-ratio (SNR), contrast-noise-ratio (CNR) of 26 landmarks were quantitatively measured and image quality qualitatively assessed using statistical analysis. As for the quantitative analysis, the difference of CNR between groups A and B was all significant except for the mesenteric vein. The SNR in group A was higher than B except the mesenteric artery and splenic artery. As for the qualitative analysis, all images had diagnostic quality and the agreement for image quality assessment between the reviewers was substantial (kappa = 0.684). CT dose index (CTDI) values for non-enhanced, arterial phase and portal phase in group A were decreased by 49.04%, 40.51% and 40.54% compared with group B (P = 0.000), respectively. The total dose and the injection rate for the contrast material were reduced by 14.40% and 14.95% in A compared with B. The use of GSI and ASIR provides similar enhancement in vessels and image quality with reduced radiation dose and contrast dose, compared with the use of conventional scan protocol.

Long-term BMI and growth profiles in offspring of women with gestational diabetes.

PubMed

Hammoud, Nurah M; Visser, Gerard H A; van Rossem, Lenie; Biesma, Douwe H; Wit, Jan M; de Valk, Harold W

2018-05-01

Gestational diabetes mellitus (GDM) is reported to be associated with childhood obesity, however the magnitude of this association and relation to intrauterine growth is uncertain. We, therefore, aimed to assess whether the growth trajectories of large for gestational age (LGA) and non-LGA offspring of mothers with GDM (OGDM) are different until early adolescence. We also aimed to explore whether growth trajectories of OGDM differ from those of offspring of mothers with type 1 or 2 diabetes (ODM1, ODM2). We studied height and BMI standard deviation score (SDS) of the OGDM group, up to the age of 14 years, with subgroup analysis comparing LGA with non-LGA at birth as a reflection of the intrauterine environment. All mothers with GDM who delivered at the University Medical Center Utrecht between 1990 and 2006 were contacted to participate; informed consent was received for 104 OGDM of 93 mothers. Offspring data were collected through Dutch infant welfare centres. Recorded height and weight were converted to BMI and age- and sex-specific SDS values for Dutch children. Additionally, we compared the OGDM group with ODM1 and ODM2 groups in order to identify those offspring with the highest risk of becoming overweight. Growth trajectories were compared between non-LGA and LGA OGDM and between OGDM, ODM1 and ODM2, using a random-effects model. In the longitudinal follow-up a mean of 7.4 ± 2 measurements per infant were available. Mothers had a prepregnancy BMI of 25.8 kg/m 2 and 24% of their infants were LGA at birth. Heights of OGDM were no different from those of the Dutch Growth Study. Non-LGA OGDM showed a BMI SDS comparable with that of the reference population, with a slight increase in early adolescence. LGA OGDM had a higher BMI SDS trajectory than non-LGA OGDM and the reference population, which plateaued at around 10 years of age. Comparison of growth trajectories of OGDM, ODM1 and ODM2 showed ODM2 to have the highest trajectory followed by ODM1 and OGDM, with the LGA counterparts of all three offspring groups in the highest BMI SDS ranges. Until early adolescence, OGDM have a BMI that is 0.5 SDS higher than that of the Dutch background population. LGA OGDM appear to be at particularly higher risk of being overweight in adolescence compared with non-LGA OGDM, putting them also at a higher lifetime risk of being overweight and developing obesity. ODM2 showed the highest BMI SDS values and had an average BMI SDS of +1.6 until the age of 14, when it became +2 SD. These results emphasize the importance of adequate recognition and timely treatment of maternal gestational diabetes to prevent fetal macrosomia in obstetrics.

Diagnostic performance of BMI percentiles to identify adolescents with metabolic syndrome.

PubMed

Laurson, Kelly R; Welk, Gregory J; Eisenmann, Joey C

2014-02-01

To compare the diagnostic performance of the Centers for Disease Control and Prevention (CDC) and FITNESSGRAM (FGram) BMI standards for quantifying metabolic risk in youth. Adolescents in the NHANES (n = 3385) were measured for anthropometric variables and metabolic risk factors. BMI percentiles were calculated, and youth were categorized by weight status (using CDC and FGram thresholds). Participants were also categorized by presence or absence of metabolic syndrome. The CDC and FGram standards were compared by prevalence of metabolic abnormalities, various diagnostic criteria, and odds of metabolic syndrome. Receiver operating characteristic curves were also created to identify optimal BMI percentiles to detect metabolic syndrome. The prevalence of metabolic syndrome in obese youth was 19% to 35%, compared with <2% in the normal-weight groups. The odds of metabolic syndrome for obese boys and girls were 46 to 67 and 19 to 22 times greater, respectively, than for normal-weight youth. The receiver operating characteristic analyses identified optimal thresholds similar to the CDC standards for boys and the FGram standards for girls. Overall, BMI thresholds were more strongly associated with metabolic syndrome in boys than in girls. Both the CDC and FGram standards are predictive of metabolic syndrome. The diagnostic utility of the CDC thresholds outperformed the FGram values for boys, whereas FGram standards were slightly better thresholds for girls. The use of a common set of thresholds for school and clinical applications would provide advantages for public health and clinical research and practice.

How do we assign punishment? The impact of minimal and maximal standards on the evaluation of deviants.

PubMed

Kessler, Thomas; Neumann, Jörg; Mummendey, Amélie; Berthold, Anne; Schubert, Thomas; Waldzus, Sven

2010-09-01

To explain the determinants of negative behavior toward deviants (e.g., punishment), this article examines how people evaluate others on the basis of two types of standards: minimal and maximal. Minimal standards focus on an absolute cutoff point for appropriate behavior; accordingly, the evaluation of others varies dichotomously between acceptable or unacceptable. Maximal standards focus on the degree of deviation from that standard; accordingly, the evaluation of others varies gradually from positive to less positive. This framework leads to the prediction that violation of minimal standards should elicit punishment regardless of the degree of deviation, whereas punishment in response to violations of maximal standards should depend on the degree of deviation. Four studies assessed or manipulated the type of standard and degree of deviation displayed by a target. Results consistently showed the expected interaction between type of standard (minimal and maximal) and degree of deviation on punishment behavior.

Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank

PubMed Central

Tyrrell, Jessica; Jones, Samuel E; Beaumont, Robin; Astley, Christina M; Lovell, Rebecca; Yaghootkar, Hanieh; Tuke, Marcus; Ruth, Katherine S; Freathy, Rachel M; Hirschhorn, Joel N; Wood, Andrew R; Murray, Anna; Weedon, Michael N

2016-01-01

Objective To determine whether height and body mass index (BMI) have a causal role in five measures of socioeconomic status. Design Mendelian randomisation study to test for causal effects of differences in stature and BMI on five measures of socioeconomic status. Mendelian randomisation exploits the fact that genotypes are randomly assigned at conception and thus not confounded by non-genetic factors. Setting UK Biobank. Participants 119 669 men and women of British ancestry, aged between 37 and 73 years. Main outcome measures Age completed full time education, degree level education, job class, annual household income, and Townsend deprivation index. Results In the UK Biobank study, shorter stature and higher BMI were observationally associated with several measures of lower socioeconomic status. The associations between shorter stature and lower socioeconomic status tended to be stronger in men, and the associations between higher BMI and lower socioeconomic status tended to be stronger in women. For example, a 1 standard deviation (SD) higher BMI was associated with a £210 (€276; $300; 95% confidence interval £84 to £420; P=6×10−3) lower annual household income in men and a £1890 (£1680 to £2100; P=6×10−15) lower annual household income in women. Genetic analysis provided evidence that these associations were partly causal. A genetically determined 1 SD (6.3 cm) taller stature caused a 0.06 (0.02 to 0.09) year older age of completing full time education (P=0.01), a 1.12 (1.07 to 1.18) times higher odds of working in a skilled profession (P=6×10−7), and a £1130 (£680 to £1580) higher annual household income (P=4×10−8). Associations were stronger in men. A genetically determined 1 SD higher BMI (4.6 kg/m2) caused a £2940 (£1680 to £4200; P=1×10−5) lower annual household income and a 0.10 (0.04 to 0.16) SD (P=0.001) higher level of deprivation in women only. Conclusions These data support evidence that height and BMI play an important partial role in determining several aspects of a person’s socioeconomic status, especially women’s BMI for income and deprivation and men’s height for education, income, and job class. These findings have important social and health implications, supporting evidence that overweight people, especially women, are at a disadvantage and that taller people, especially men, are at an advantage. PMID:26956984

Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank.

PubMed

Tyrrell, Jessica; Jones, Samuel E; Beaumont, Robin; Astley, Christina M; Lovell, Rebecca; Yaghootkar, Hanieh; Tuke, Marcus; Ruth, Katherine S; Freathy, Rachel M; Hirschhorn, Joel N; Wood, Andrew R; Murray, Anna; Weedon, Michael N; Frayling, Timothy M

2016-03-08

To determine whether height and body mass index (BMI) have a causal role in five measures of socioeconomic status. Mendelian randomisation study to test for causal effects of differences in stature and BMI on five measures of socioeconomic status. Mendelian randomisation exploits the fact that genotypes are randomly assigned at conception and thus not confounded by non-genetic factors. UK Biobank. 119,669 men and women of British ancestry, aged between 37 and 73 years. Age completed full time education, degree level education, job class, annual household income, and Townsend deprivation index. In the UK Biobank study, shorter stature and higher BMI were observationally associated with several measures of lower socioeconomic status. The associations between shorter stature and lower socioeconomic status tended to be stronger in men, and the associations between higher BMI and lower socioeconomic status tended to be stronger in women. For example, a 1 standard deviation (SD) higher BMI was associated with a £210 (€276; $300; 95% confidence interval £84 to £420; P=6 × 10(-3)) lower annual household income in men and a £1890 (£1680 to £2100; P=6 × 10(-15)) lower annual household income in women. Genetic analysis provided evidence that these associations were partly causal. A genetically determined 1 SD (6.3 cm) taller stature caused a 0.06 (0.02 to 0.09) year older age of completing full time education (P=0.01), a 1.12 (1.07 to 1.18) times higher odds of working in a skilled profession (P=6 × 10(-7)), and a £1130 (£680 to £1580) higher annual household income (P=4 × 10(-8)). Associations were stronger in men. A genetically determined 1 SD higher BMI (4.6 kg/m(2)) caused a £2940 (£1680 to £4200; P=1 × 10(-5)) lower annual household income and a 0.10 (0.04 to 0.16) SD (P=0.001) higher level of deprivation in women only. These data support evidence that height and BMI play an important partial role in determining several aspects of a person's socioeconomic status, especially women's BMI for income and deprivation and men's height for education, income, and job class. These findings have important social and health implications, supporting evidence that overweight people, especially women, are at a disadvantage and that taller people, especially men, are at an advantage. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

TESTOSTERONE LEVELS ACHIEVED BY MEDICALLY TREATED TRANSGENDER WOMEN IN A UNITED STATES ENDOCRINOLOGY CLINIC COHORT.

PubMed

Liang, Jennifer J; Jolly, Divya; Chan, Kelly J; Safer, Joshua D

2018-02-01

Most transgender women depend on medical treatment alone to lower testosterone levels in order to align physical appearance with gender identity. The medical regimen in the United States typically includes spironolactone and estrogens. The purpose of this cross-sectional study was to assess the testosterone suppression achieved among transgender women treated with spironolactone and estrogens. Testosterone and estradiol levels were extracted from the electronic medical records of 98 anonymized transgender women treated with oral spironolactone and oral estrogen therapy at the Endocrinology Clinic at Boston Medical Center. Patients starting therapy required about 9 months to reach a steady-state testosterone, with significant heterogeneity of levels achieved among patients. Patients with normal body mass index (BMI) had higher testosterone levels, whereas patients with obese BMI had lower testosterone levels throughout treatment. Stratification of patients by age or spironolactone dosage revealed no significant difference in testosterone levels achieved. At steady state, patients in the highest suppressing quartile were able to achieve testosterone levels of 27 ng/dL, with a standard deviation of 21 ng/dL. Measured serum estradiol levels did not change over time and did not correlate with dosage of estradiol administered. Among a cohort of transgender women treated with spironolactone and estrogen, the highest suppressing quartile could reliably achieve testosterone levels in the female range at virtually all times. The second highest suppressing quartile could not achieve female levels but remained below the male range virtually all of the time. One quartile was unable to achieve any significant suppression. BMC = Boston Medical Center BMI = body mass index CPY = cyproterone acetate LC-MS/MS = liquid chromatography-tandem mass spectrometry Q = quartile.

Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? A retrospective case-control study.

PubMed

Brorsson, Anna Lena; Viklund, Gunnel; Örtqvist, Eva; Lindholm Olinder, Anna

2015-11-01

To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI). This retrospective case-control study compares 216 patients starting CSII with a control group on MDI (n = 215), matched for glycated hemoglobin (HbA1c), sex, and age during a 2-yr period. Variables collected were gender, age, HbA1c, insulin requirement, BMI, BMI-SDS, ketoacidosis, and serious hypoglycaemic events. In the CSII group there was an improvement in HbA1c after 6 and 12 months compared with the MDI group. For boys and girls separately the same effect was detected after 6 months, but only for boys after 12 months. The incidence of ketoacidosis was higher in the CSII group compared with the MDI group (2.8 vs. 0.5/100 person-yr). The incidences of severe hypoglycaemic episodes per 100 person-yr were three in the CSII group and six in the MDI group (p < 0.05). After 6, 12, and 24 months, the insulin requirement was higher in the MDI group. This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Association of Pericardial Fat with Coronary Artery Plaque Index at MR Imaging: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Miao, Cuilian; Chen, Shaoguang; Ding, Jingzhong; Liu, Kiang; Li, Debiao; Macedo, Robson; Lai, Shenghan; Vogel-Claussen, Jens; Brown, Elizabeth R.; Lima, João A. C.

2011-01-01

Purpose: To determine the relationship of pericardial fat, which secretes proinflammatory markers that have been implicated in coronary atherosclerosis, with atherosclerotic plaque in an asymptomatic population–based cohort. Materials and Methods: In this institutional review board–approved study, all participants supplied written informed consent. One hundred eighty-three participants (89 women, 94 men; mean age, 61 years ± 9 [standard deviation]) from the community-based Multi-Ethnic Study of Atherosclerosis (MESA) were included. The coronary artery eccentricity (ratio of maximal to minimal coronary artery wall thickness) was determined by using magnetic resonance (MR) imaging and served as an index of plaque burden. The pericardial fat volume was determined by using computed tomography. Linear regression coefficient analysis was used to correlate pericardial fat volume with coronary artery wall thickness and plaque eccentricity. Results: Pericardial fat volume correlated significantly with degree of plaque eccentricity (P < .05) in both men and women. After adjustments for body mass index (BMI) and waist circumference, traditional risk factors, C-reactive protein level, and coronary artery calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men (P < .01) but not in women. BMI and waist circumference correlated with degree of plaque eccentricity in the univariate model (P < .05) but not after adjustment for pericardial fat volume or traditional risk factors. Conclusion: Pericardial fat volume, rather than BMI and waist circumference, was more strongly related to plaque eccentricity as a measure of coronary atherosclerotic plaque burden. The results support the proposed role of pericardial fat in association with atherosclerosis. © RSNA, 2011 PMID:21846753

Changes in whole-body fat distribution, intrahepatic lipids, and insulin resistance of obese adolescents during a low-level lifestyle intervention.

PubMed

Springer, Fabian; Ballweg, Verena; Schweizer, Roland; Schick, Fritz; Ranke, Michael B; Binder, Gerhard; Ehehalt, Stefan

2015-12-01

The aim of this study was to analyze changes in adipose tissue (AT) distribution, intrahepatic lipids (IHL), and insulin resistance (IR) among a group of obese adolescents undergoing a 7-months low-level lifestyle intervention. Thirty-nine obese Caucasian adolescents (mean age 13.9 years, body mass index standard deviation score (BMI-SDSLMS) 2.14) were included. AT and IHL were determined by T1-weighted magnetic resonance (MR) imaging and single-voxel MR spectroscopy; IR was estimated using the homeostatic model assessment (HOMA-IR). The lifestyle intervention led to a reduction of both BMI-SDSLMS (boys 2.27 to 2.17; girls 2.00 to 1.82) and HOMA-IR (boys 6.1 to 4.4 (p = 0.008); girls 6.2 to 4.7 (p = 0.030)). IHL dropped in both genders (boys 7.5 to 4.3 %; girls 4.6 to 3.4 %) positively correlating with HOMA-IR (boys r = 0.52; girls r = 0.68), while in contrast visceral AT did not change significantly. Although the lifestyle intervention only slightly reduced BMI-SDSLMS, insulin sensitivity improved in both genders and came along with a marked reduction of IHL. This suggests that IHL might play the dominant role regarding insulin resistance in the youth, especially if compared to other AT compartments such as visceral AT. • MR imaging/spectroscopy can be used to evaluate body fat distribution and intrahepatic lipids in the youth. • The strength of associations between body fat compartments and insulin resistance is under scientific debate. • The study emphasizes that even a low-level lifestyle intervention has a beneficial effect. • The study suggests that intrahepatic lipids are an important factor in the development of insulin resistance.

Anthropometric predictors of gestational hypertensive disorders in a remote aboriginal community: a nested case-control study.

PubMed

Sina, Maryam; Hoy, Wendy; Wang, Zhiqiang

2014-03-05

Australian Aboriginal women tend to have body shape and pregnancy risk profiles different from other Australian women. This study aims to examine the associations of anthropometric indices with gestational hypertensive disorders (GHD), and to determine the index that can best predict the risk of this condition occurring during pregnancy. This is a nested case-control study. Baseline body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were measured as part of a broader health screening program between 1992 and 1995 in a remote Aboriginal community. All subsequent pregnancies among the original participants were identified during 20 year follow-up period through hospital records (up to May 2012). Twenty eight women were diagnosed as having GHD, each of whom were individually matched by age at baseline with five women who were hospitalised for other pregnancy-related conditions and were free from GHD (n = 140). The associations of the baseline anthropometric measurements with GHD were assessed using conditional logistic regression. The best predictor of GHD was WC (OR = 1.8; (95% CI, 1.1-2.9) for one standard deviation increase in WC), followed by BMI with the corresponding OR = 1.7 (95% CI, 1.1- 2.6). Other measurements, HC, WHR, and WHtR, were also positively associated with GHD, but those associations were not statistically significant. WC and BMI prior to pregnancy are anthropometric predictors of GHD in Aboriginal women, and WC is the best predictor. These findings imply the importance of early weight control in preventing GHD in Aboriginal women.

Varus thrust and knee frontal plane dynamic motion in persons with knee osteoarthritis.

PubMed

Chang, A H; Chmiel, J S; Moisio, K C; Almagor, O; Zhang, Y; Cahue, S; Sharma, L

2013-11-01

Varus thrust visualized during walking is associated with a greater medial knee load and an increased risk of medial knee osteoarthritis (OA) progression. Little is known about how varus thrust presence determined by visual observation relates to quantitative gait kinematic data. We hypothesized that varus thrust presence is associated with greater knee frontal plane dynamic movement during the stance phase of gait. Participants had knee OA in at least one knee. Trained examiners assessed participants for varus thrust presence during ambulation. Frontal plane knee motion during ambulation was captured using external passive reflective markers and an 8-camera motion analysis system. To examine the cross-sectional relationship between varus thrust and frontal plane knee motion, we used multivariable regression models with the quantitative motion measures as dependent variables and varus thrust (present/absent) as predictor; models were adjusted for age, gender, body mass index (BMI), gait speed, and knee static alignment. 236 persons [mean BMI: 28.5 kg/m(2) (standard deviation (SD) 5.5), mean age: 64.9 years (SD 10.4), 75.8% women] contributing 440 knees comprised the study sample. 82 knees (18.6%) had definite varus thrust. Knees with varus thrust had greater peak varus angle and greater peak varus angular velocity during stance than knees without varus thrust (mean differences 0.90° and 6.65°/s, respectively). These patterns remained significant after adjusting for age, gender, BMI, gait speed, and knee static alignment. Visualized varus thrust during walking was associated with a greater peak knee varus angular velocity and a greater peak knee varus angle during stance phase of gait. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Early childhood growth patterns and school-age respiratory resistance, fractional exhaled nitric oxide and asthma.

PubMed

Casas, Maribel; den Dekker, Herman T; Kruithof, Claudia J; Reiss, Irwin K; Vrijheid, Martine; de Jongste, Johan C; Jaddoe, Vincent W V; Duijts, Liesbeth

2016-12-01

Greater infant weight gain is associated with lower lung function and increased risk of childhood asthma. The role of early childhood peak growth patterns is unclear. We assessed the associations of individually derived early childhood peak growth patterns with respiratory resistance, fractional exhaled nitric oxide, wheezing patterns, and asthma until school-age. We performed a population-based prospective cohort study among 5364 children. Repeated growth measurements between 0 and 3 years of age were used to derive standard deviation scores (s.d.s) of peak height and weight velocities (PHV and PWV, respectively), and body mass index (BMI) and age at adiposity peak. Respiratory resistance and fractional exhaled nitric oxide were measured at 6 years of age. Wheezing patterns and asthma were prospectively assessed by annual questionnaires. We also assessed whether any association was explained by childhood weight status. Greater PHV was associated with lower respiratory resistance [Z-score (95% CI): -0.03 (-0.04, -0.01) per s.d.s increase] (n = 3382). Greater PWV and BMI at adiposity peak were associated with increased risks of early wheezing [relative risk ratio (95% CI): 1.11 (1.06, 1.16), 1.26 (1.11, 1.43), respectively] and persistent wheezing [relative risk ratio (95% CI): 1.09 (1.03, 1.16), 1.37 (1.17, 1.60), respectively] (n = 3189 and n = 3005, respectively). Childhood weight status partly explained these associations. No other associations were observed. PWV and BMI at adiposity peak are critical for lung developmental and risk of school-age wheezing. Follow-up studies at older ages are needed to elucidate whether these effects persist at later ages. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of early life factors on body mass index trajectory during childhood: a population-based longitudinal analysis in the Western Brazilian Amazon.

PubMed

Lourenço, Barbara H; Villamor, Eduardo; Augusto, Rosângela A; Cardoso, Marly A

2015-04-01

Low- to middle-income countries may experience the occurrence of a dual burden of under and overnutrition. To better understand the overall progression of body mass index (BMI) during childhood, we estimated average BMI-for-age z-score (BAZ) growth curves in a population-based longitudinal study of 255 children living in the Brazilian Amazon. Children were aged 0.1-5.5 years at recruitment (2003). We collected data on socio-economic and maternal characteristics, children's birthweight and infant feeding practices. Child anthropometric measurements were taken in 2003, 2007 and 2009. BAZ differences among categories of exposure variables were calculated at 6 and 12 months, and 2, 7 and 10 years. At baseline, the mean (standard deviation) age was 2.6 (1.4) years; 12.9% were overweight and 3.9% thin. After adjustment, mean BAZ estimates were mostly negative. Boys were close to the median value for BAZ until 12 months, whereas girls were below the median (P=0.05). Children from households above the wealth median were 0.36 z- and 0.49 z-less underweight than poorer children at 7 and 10 years, respectively (P<0.01). Maternal BMI was positively associated with children's BAZ since 12 months old; BAZ in children from overweight mothers was higher by 0.69 compared with their counterparts at 10 years (P<0.01). Birthweight was positively related to BAZ up until 2 years (P=0.01). Socio-economic background and maternal nutritional status are important predictors of BAZ throughout childhood. Although excessive weight gain is a public health concern, it is critical to restrict inequities, while promoting healthier growth in developing countries. © 2012 Blackwell Publishing Ltd.

The association of reproductive and lifestyle factors with a score of multiple endogenous hormones

PubMed Central

Shafrir, Amy L.; Zhang, Xuehong; Poole, Elizabeth M.; Hankinson, Susan E.; Tworoger, Shelley S.

2014-01-01

Introduction We recently reported that high levels of multiple sex and growth hormones were associated with increased postmenopausal breast cancer risk. Limited research has explored the relationship between reproductive, anthropometric, and lifestyle factors and levels of multiple hormones simultaneously. Methods This cross-sectional analysis included 738 postmenopausal Nurses' Health Study participants who were controls in a breast cancer nested case-control study and had measured levels of estrone, estradiol, estrone sulfate, testosterone, androstenedione, dehydroepiandrosterone sulfate, prolactin and sex hormone binding globulin (SHBG). A score was created by summing the number of hormones a woman had above (below for SHBG) each hormone's age-adjusted geometric mean. The association between lifestyle, anthropometric, and reproductive exposures and the score was assessed using generalized linear models. Results The hormone score ranged from 0 to 8 with a mean of 4.0 (standard deviation=2.2). Body mass index (BMI) and alcohol consumption at blood draw were positively associated with the hormone score: a 5 unit increase in BMI was associated with a 0.79 (95%CI: 0.63, 0.95) unit increase in the score (p<0.0001) and each 15 grams/day increase in alcohol consumption was associated with a 0.41 (95%CI: 0.18, 0.63) unit increase in the score (p=0.0004). Family history of breast cancer, age at menarche, and physical activity were not associated with the score. Conclusions Reproductive breast cancer risk factors were not associated with elevated levels of multiple endogenous hormones, whereas anthropometric and lifestyle factors, particularly BMI and alcohol consumption, tended to be associated with higher levels of multiple hormones. PMID:25048255

Obesity related factors in school-aged children.

PubMed

Soltani, Parvaneh Reza; Ghanbari, Atefeh; Rad, Afagh Hasanzadeh

2013-05-01

Overweight and obesity is becoming an increasingly prevalent problem in both developed and developing world, and is one of the most serious public health challenges of the 21(st) century. Although various studies demonstrated pediatric obesity-related factors, but, due to its ongoing hazardous effects, researchers aimed to assess obesity-related factors in school-aged children in Rasht, Iran. This was a case-control study which was performed in eight primary schools of Rasht. A cluster sampling method was used to select 320 students including 80 in case (BMI ≥85(th) percentile for age and gender) and 240 in control group (BMI = 5(th)-85(th) percentile for age and gender). Data were collected by a scale, a tape meter, and a form which consisted of obesity-related factors, and were analyzed by Chi-square, Mann-Whitney, and stepwise multivariate regression tests in SPSS 19. Findings showed that the mean and standard deviation of birth weight (g) in case and control groups were 3671 ± 5.64 and 190 ± 5.46, respectively (P = 0.000). 82.5% of case and 92.9% of control group had exclusive breastfeeding for 4-6 months (P = 0.024). Also, multivariate regression analysis indicated that birth weight, age, exclusive breastfeeding, and frequency of meals have significant effects on body mass index (BMI). It seems that more accurate interventions for primordial prevention are essential to reduce childhood obesity risk factors, including promotion of pre-pregnancy and prenatal care to have neonates who are appropriate for gestational age and also improving exclusive breastfeeding in the first 6 months of life. In addition, identifying children at risk for adolescent obesity provides physicians and midwives with an opportunity for earlier intervention with the goal of limiting the progression of abnormal weight gain.

Relationship between adult height and body weight and risk of carotid atherosclerosis assessed in terms of carotid intima-media thickness: The Nagasaki Islands study

PubMed Central

2013-01-01

Background Previous studies have reported an inverse association between height and risk of cardiovascular disease. However, evidence is limited for the association between risk of atherosclerosis and height. Further, although the association between atherosclerosis and body mass index (BMI) is reportedly positive, there have been no reports of studies on associations between height and atherosclerosis in relation to BMI. Methods We conducted a cross-sectional study of Japanese men aged 30 to 89 years undergoing general health check-ups. Results Of the 1,337 men, 312 were diagnosed with carotid atherosclerosis (carotid intima-media thickness (CIMT) ≥ 1.1 mm), but no significant association was found between height and carotid atherosclerosis for the entire study group. Stratification by BMI status of those analytical findings disclosed a significant inverse association between height and carotid atherosclerosis among overweight (BMI ≥ 25 kg/m2) but not among non-overweight (BMI < 25 kg/m2) men. The classical cardiovascular risk factors-adjusted odds ratio (OR) and 95% confidence interval (CI) of carotid atherosclerosis for an increment of one SD (standard deviation) in height (6.70 cm) were 0.71 (0.54 to 0.94) for overweight (BMI ≥ 25 kg/m2) and 1.05 (0.87 to 1.27) for non-overweight (BMI < 25 kg/m2) men. Conclusion Independent from classical cardiovascular risk factors, height was found to be inversely associated with carotid atherosclerosis for overweight but not for non-overweight men. PMID:24180493

Effects of bariatric surgery on urinary incontinence

PubMed Central

Bulbuller, Nurullah; Habibi, Mani; Yuksel, Mustafa; Ozener, Onur; Oruc, Mehmet Tahir; Oner, Osman Zekai; Kazak, Mehmet Altug

2017-01-01

Introduction Obesity is an important modifiable etiological factor associated with several diseases. There is strong evidence that urinary incontinence (UI) is positively correlated with body mass index (BMI). Aim One of the many benefits experienced by obese patients after bariatric surgery is decrease in UI. To investigate this correlation, we aimed to examine the effects of weight loss on UI in female patients who had undergone laparoscopic sleeve gastrectomy (LSG). Materials and methods Obese female patients (n=120), ≥18 years of age, and planning to undergo LSG were included in this prospective study. We administered the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and Incontinence Impact Questionnaire (IIQ-7) to the patients prior to surgery and 6 months after the surgery. Using the collected data, we determined the incidence of UI and examined the relationship between the preoperative and postoperative BMI and UI values. Results The mean age of the patients was 39.19 (standard deviation [SD] =9.94) years and the mean preoperative BMI was 46.17 (SD =5.35). Of the 120 patients, 72 (60%) complained of UI preoperatively. Among these 72 patients, 23 (31.95%) described urge incontinence, 18 (25%) stress incontinence, and 31 (43.05%) mixed-type incontinence. At 6 months postoperatively, the percentage of excess weight loss was 70.33% (SD =14.84%). For all three UI subtypes, the 6-month postoperative ICIQ-UI-SF and IIQ-7 scores decreased significantly compared to the preoperative scores (P<0.05). Conclusion LSG results in a clinically significant improvement in most common types of UI, regardless of patient reproductive history, existence of comorbid conditions, and smoking status. PMID:28176911

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 1: January

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analyses produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of January. Included are global analyses of: (1) Mean temperature standard deviation; (2) Mean geopotential height standard deviation; (3) Mean density standard deviation; (4) Mean density standard deviation (all for 13 levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation for the 13 levels; and (6) Jet stream at levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Potential for Higher Treatment Failure in Obese Patients: Correlation of Elevated Body Mass Index and Increased Daily Prostate Deviations From the Radiation Beam Isocenters in an Analysis of 1,465 Computed Tomographic Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wong, James R.; Gao Zhanrong; Merrick, Scott

2009-09-01

Purpose: Recent clinical outcome studies on prostate cancer have reported the influence of patient's obesity on the biochemical failure rates after various treatment modalities. In this study, we investigated the effect of patient's physical characteristics on prostate shift in external beam radiotherapy (EBRT) and hypothesized that there maybe a correlation between patient physique and tumor shift. Methods and Materials: A retrospective analysis was performed using data for 117 patients who received image-guided radiation therapy (IGRT) for prostate cancer between January 2005 and April 2007. A total of 1,465 CT scans were analyzed. The standard deviations (SDs) of prostate shifts formore » all patients, along with patient weight, body mass index (BMI), and subcutaneous adipose-tissue thickness (SAT), were determined. Spearman rank correlation analysis was performed. Results: Of the 117 patients, 26.5% were considered normal weight, 48.7% were overweight, 17.9% were mildly obese, and 6.9% were moderately to severely obese. Notably 1.3%, 1.5%, 2.0%, and 21.2% of the respective shifts were greater than 10 mm in the left-right (LR) direction for the four patient groups, whereas in the anterior-posterior direction the shifts are 18.2%, 12.6%, 6.7%, and 21.0%, respectively. Strong correlations were observed between SAT, BMI, patient weight, and SDs of daily shifts in the LR direction (p < 0.01). Conclusions: The strong correlation between obesity and shift indicates that without image-guided radiation therapy, the target volume (prostate with or without seminal vesicles) may not receive the intended dose for patients who are moderate to severely obese. This may explain the higher recurrence rate with conventional external beam radiation therapy.« less

Comparing Standard Deviation Effects across Contexts

ERIC Educational Resources Information Center

Ost, Ben; Gangopadhyaya, Anuj; Schiman, Jeffrey C.

2017-01-01

Studies using tests scores as the dependent variable often report point estimates in student standard deviation units. We note that a standard deviation is not a standard unit of measurement since the distribution of test scores can vary across contexts. As such, researchers should be cautious when interpreting differences in the numerical size of…

Bidirectional association between parental child-feeding practices and body mass index at 4 and 7 y of age.

PubMed

Afonso, Lisa; Lopes, Carla; Severo, Milton; Santos, Susana; Real, Helena; Durão, Catarina; Moreira, Pedro; Oliveira, Andreia

2016-03-01

Evidence of the association between parental child-feeding practices and the child's body mass index (BMI) is controversial, and bidirectional effects have been poorly studied. We aimed to examine bidirectional associations between parental child-feeding practices and BMI at 4 and 7 y of age. This study included 3708 singleton children from the Generation XXI birth cohort with data on parental child-feeding practices and BMI at 4 and 7 y old. Feeding practices were assessed through a self-administered questionnaire by combining the Child Feeding Questionnaire and the Overt/Covert Control scale and then adapting it to Portuguese preschool children. Weight and height were measured according to standardized procedures, and age- and sex-specific BMI z scores were computed based on the WHO Growth References. Linear regression models were used to estimate the bidirectional associations between each practice and BMI z score. Crosslagged analyses were performed to compare the directions of those associations (the mean score of each practice and BMI z score at both ages were standardized to enable effect size comparisons). After adjustments, pressure to eat and overt control at 4 y of age were associated with a lower BMI z score 3 y later (β: -0.05; 95% CI: -0.08, -0.03 and β: -0.05; 95% CI: -0.09, -0.01, respectively). Regarding the opposite direction of association, a higher BMI z score at 4 y of age was significantly associated with higher levels of restriction and covert control at 7 y of age (β: 0.06; 95% CI: 0.03, 0.08 and β: 0.06; 95% CI: 0.04, 0.08, respectively) and with lower levels of pressure to eat (β: -0.17; 95% CI: -0.20, -0.15). The only bidirectional practice, pressure to eat, was more strongly influenced by the BMI z score than the reverse (βstandardized: -0.17 compared with βstandardized: -0.04; likelihood ratio test: P < 0.001). We found that parents both respond to and influence the child's weight; thus, this child-parent interaction should be considered in future research. © 2016 American Society for Nutrition.

Overweight and obesity in 4-5-year-old children in New Zealand: results from the first 4 years (2009-2012) of the B4School Check programme.

PubMed

Rajput, Nitin; Tuohy, Pat; Mishra, Suryaprakash; Smith, Ash; Taylor, Barry

2015-03-01

We describe the prevalence of overweight and obesity in four-year-old children in New Zealand, variations with ethnicity and socio-economic status, and changes over the study duration using body mass index (BMI) measurements collected as part of the B4School Check programme. Demographic and BMI data were extracted for all children measured between 2009 and 2012. Overweight and obesity rates were estimated using International Obesity Task Force (IOTF) 2012 standards and the 85th (overweight) and 95th (obese) percentiles for BMI-for-age of the World Health Organization (WHO) 2006, Centers for Disease Control and Prevention 2000 and UK 1990 reference standards. A total of 168,744 BMI measurements were included in the analysis with a coverage rate of 66.5%. Mean BMI was 16.30 kg/m(2) in girls and 16.44 kg/m(2) in boys. Mean BMI z-score (WHO 2006 standards) was 0.601 in girls and 0.785 in boys. Using WHO 2006 standards, 16.9% of girls and 19.6% of boys were overweight and 13.8% of girls and 18.7% of boys were obese. Using IOTF standards, 18.3% of girls and 16.2% of boys were overweight and 5.7% of girls and 4.7% of boys were found obese. Prevalence of overweight and obesity was higher in Pacific and Maori children and those living in more socio-economically deprived areas than other children. No definite time-trends were observed over the study duration. The study reaffirms the high prevalence of overweight and obesity in pre-school children in New Zealand, and demonstrates the variations in prevalence when using different reference standards. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Blood pressure variability in man: its relation to high blood pressure, age and baroreflex sensitivity.

PubMed

Mancia, G; Ferrari, A; Gregorini, L; Parati, G; Pomidossi, G; Bertinieri, G; Grassi, G; Zanchetti, A

1980-12-01

1. Intra-arterial blood pressure and heart rate were recorded for 24 h in ambulant hospitalized patients of variable age who had normal blood pressure or essential hypertension. Mean 24 h values, standard deviations and variation coefficient were obtained as the averages of values separately analysed for 48 consecutive half-hour periods. 2. In older subjects standard deviation and variation coefficient for mean arterial pressure were greater than in younger subjects with similar pressure values, whereas standard deviation and variation coefficient for mean arterial pressure were greater than in younger subjects with similar pressure values, whereas standard deviation aations and variation coefficient were obtained as the averages of values separately analysed for 48 consecurive half-hour periods. 2. In older subjects standard deviation and variation coefficient for mean arterial pressure were greater than in younger subjects with similar pressure values, whereas standard deviation and variation coefficient for heart rate were smaller. 3. In hypertensive subjects standard deviation for mean arterial pressure was greater than in normotensive subjects of similar ages, but this was not the case for variation coefficient, which was slightly smaller in the former than in the latter group. Normotensive and hypertensive subjects showed no difference in standard deviation and variation coefficient for heart rate. 4. In both normotensive and hypertensive subjects standard deviation and even more so variation coefficient were slightly or not related to arterial baroreflex sensitivity as measured by various methods (phenylephrine, neck suction etc.). 5. It is concluded that blood pressure variability increases and heart rate variability decreases with age, but that changes in variability are not so obvious in hypertension. Also, differences in variability among subjects are only marginally explained by differences in baroreflex function.

Diagnostic performance of body mass index using the Western Pacific Regional Office of World Health Organization reference standards for body fat percentage.

PubMed

Yoon, Jong Lull; Cho, Jung Jin; Park, Kyung Mi; Noh, Hye Mi; Park, Yong Soon

2015-02-01

Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic performance of BMI using the Western Pacific Regional Office of World Health Organization reference standard for BF%-defined obesity by sex and age and identified the optimal BMI cut-off for BF%-defined obesity using receiver operating characteristic curve analysis. BMI-defined obesity (≥25 kg/m(2)) was observed in 38.7% of men and 28.1% of women, with a high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72% women) for BF%-defined obesity (25.2%, men; 31.1%, women). The optimal BMI cut-off (24.2 kg/m(2)) had 78% sensitivity and 71% specificity. BMI demonstrated limited diagnostic accuracy for adiposity in Korea. There was a -1.3 kg/m(2) difference in optimal BMI cut-offs between Korea and America, smaller than the 5-unit difference between the Western Pacific Regional Office and global World Health Organization obesity criteria.

Factors influencing endometrial thickness in postmenopausal women.

PubMed

Hebbar, S; Chaya, V; Rai, L; Ramachandran, A

2014-07-01

Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. To study the various factors influencing the ET in postmenopausal women. This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. This study suggests that parity, BMI, presence of myoma, tamoxifen usage, uterine volume, ovarian volume and serum estradiol influence the ET in postmenopausal women.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 7: July

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analysis produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of July. Included are global analyses of: (1) Mean temperature/standard deviation; (2) Mean geopotential height/standard deviation; (3) Mean density/standard deviation; (4) Height and vector standard deviation (all at 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation at levels 1000 through 30 mb; and (6) Jet stream at levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 10: October

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analysis produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of October. Included are global analyses of: (1) Mean temperature/standard deviation; (2) Mean geopotential height/standard deviation; (3) Mean density/standard deviation; (4) Height and vector standard deviation (all at 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point/standard deviation at levels 1000 through 30 mb; and (6) Jet stream at levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 3: March

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-11-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analysis produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of March. Included are global analyses of: (1) Mean Temperature Standard Deviation; (2) Mean Geopotential Height Standard Deviation; (3) Mean Density Standard Deviation; (4) Height and Vector Standard Deviation (all for 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean Dew Point Standard Deviation for levels 1000 through 30 mb; and (6) Jet stream for levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 2: February

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-09-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analyses produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of February. Included are global analyses of: (1) Mean temperature standard deviation; (2) Mean geopotential height standard deviation; (3) Mean density standard deviation; (4) Height and vector standard deviation (all for 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation for the 13 levels; and (6) Jet stream for levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 4: April

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analyses produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of April. Included are global analyses of: (1) Mean temperature standard deviation; (2) Mean geopotential height standard deviation; (3) Mean density standard deviation; (4) Height and vector standard deviation (all for 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation for the 13 levels; and (6) Jet stream for levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Precision analysis for standard deviation measurements of immobile single fluorescent molecule images.

PubMed

DeSantis, Michael C; DeCenzo, Shawn H; Li, Je-Luen; Wang, Y M

2010-03-29

Standard deviation measurements of intensity profiles of stationary single fluorescent molecules are useful for studying axial localization, molecular orientation, and a fluorescence imaging system's spatial resolution. Here we report on the analysis of the precision of standard deviation measurements of intensity profiles of single fluorescent molecules imaged using an EMCCD camera.We have developed an analytical expression for the standard deviation measurement error of a single image which is a function of the total number of detected photons, the background photon noise, and the camera pixel size. The theoretical results agree well with the experimental, simulation, and numerical integration results. Using this expression, we show that single-molecule standard deviation measurements offer nanometer precision for a large range of experimental parameters.

Identifying Overweight and Obesity in Brazilian Schoolchildren, 2014.

PubMed

Pozza, Fernanda Seyr; Nucci, Luciana Bertoldi; Enes, Carla Cristina

For any intervention in a population, we need to understand population characteristics and needs. The School Health Program (PSE) is a Brazilian national proposal for the improvement of schoolchildren's quality of life by integrating health and education areas to address vulnerabilities that affect the development of students from public schools. To describe the prevalence of overweight and obesity in school-aged children and adolescents and to expound methods to evaluate the nutritional status deviation. Cross-sectional study. Schools in Itatiba, Sao Paulo, Brazil, participating in PSE. A total of 6829 schoolchildren aged 6 month to 15 years. Nutritional status and standard percentile curves for body mass index (BMI) for gender. In children younger than 5 years, the prevalence of being overweight was 13.9%; for those between 5 years or older and younger than 10 years, it was 33.9%; and for those 10 years or older, it was 34.0%. In males, obesity and severe obesity were more present (10.7% and 3.7%, respectively) than in girls (9.5% and 1.9%, respectively). Regarding location, it was found that the region with the highest income showed a higher prevalence of overweight children. Compared with the World Health Organization reference BMI curves, our reference percentile curve showed a higher standard for the cutoff points between normal range and overweight. From our results, we found that age and measures of weight and height in schoolchildren could contribute, in a cheap and simple way, to the assessment of nutritional status in a region. This is helpful in providing health monitoring and assisting in making public health decisions, as well as serving in comparison with other scientific studies. Partnership between education and health systems can facilitate and improve the quality of health management among schoolchildren.

Mammographic density defined by higher than conventional brightness thresholds better predicts breast cancer risk

PubMed Central

Nguyen, Tuong L; Aung, Ye K; Evans, Christopher F; Dite, Gillian S; Stone, Jennifer; MacInnis, Robert J; Dowty, James G; Bickerstaffe, Adrian; Aujard, Kelly; Rommens, Johanna M; Song, Yun-Mi; Sung, Joohon; Jenkins, Mark A; Southey, Melissa C; Giles, Graham G; Apicella, Carmel; Hopper, John L

2017-01-01

Abstract Background: Mammographic density defined by the conventional pixel brightness threshold, and adjusted for age and body mass index (BMI), is a well-established risk factor for breast cancer. We asked if higher thresholds better separate women with and without breast cancer. Methods: We studied Australian women, 354 with breast cancer over-sampled for early-onset and family history, and 944 unaffected controls frequency-matched for age at mammogram. We measured mammographic dense area and percent density using the CUMULUS software at the conventional threshold, which we call Cumulus, and at two increasingly higher thresholds, which we call Altocumulus and Cirrocumulus, respectively. All measures were Box–Cox transformed and adjusted for age and BMI. We estimated the odds per adjusted standard deviation (OPERA) using logistic regression and the area under the receiver operating characteristic curve (AUC). Results: Altocumulus and Cirrocumulus were correlated with Cumulus (r ∼ 0.8 and 0.6, respectively). For dense area, the OPERA was 1.62, 1.74 and 1.73 for Cumulus, Altocumulus and Cirrocumulus, respectively (all P < 0.001). After adjusting for Altocumulus and Cirrocumulus, Cumulus was not significant (P > 0.6). The OPERAs for percent density were less but gave similar findings. The mean of the standardized adjusted Altocumulus and Cirrocumulus dense area measures was the best predictor; OPERA = 1.87 [95% confidence interval (CI): 1.64–2.14] and AUC = 0.68 (0.65–0.71). Conclusions: The areas of higher mammographically dense regions are associated with almost 30% stronger breast cancer risk gradient, explain the risk association of the conventional measure and might be more aetiologically important. This has substantial implications for clinical translation and molecular, genetic and epidemiological research. PMID:28338721

Higher maternal education is associated with favourable growth of young children in different countries

PubMed Central

Lakshman, Rajalakshmi; Zhang, Jing; Zhang, Jianduan; Koch, Felix S; Marcus, Claude; Ludvigsson, Johnny; Ong, Ken K; Sobko, Tanja

2013-01-01

Background Childhood growth affects long-term health and could contribute to health inequalities that persist throughout life. Methods We compared growth data of 4-6 year old children born 1997-2002 in UK (n=15,168), Sweden (n=6,749) and rural China (n=10,327). Standard deviation scores (SDS) were calculated against the WHO Standard. Obesity and overweight were defined by International Obesity Taskforce cut-offs, and stunting, underweight and thinness by height, weight or BMI < −2 SDS. Associations with maternal education were standardised by calculating the Slope Index of Inequality (SII). Results Mean SDS height, weight and BMI in UK (−0.01; 0.42; 0.62, respectively) and Sweden (0.45; 0.59; 0.45) were higher than in China (−0.98, −0.82, −0.29). Higher maternal education was consistently associated with taller offspring height SDS (SII: UK 0.25; Sweden 0.17; China 1.06). Underweight and stunting were less common in UK (prevalence: 0.6% and 2.2%, respectively) and Sweden (0.3% and 0.6%) than in China (9.5% and 16.4%), where these outcomes were inversely associated with maternal education (SII: −25.8% and −12.7%). Obesity prevalence in UK, Sweden and China was 4.8%, 3.7% and 0.4%, respectively. Maternal education was inversely associated with offspring obesity in UK (SII: −3.3%) and Sweden (−2.8%), but not in China (+0.3%). Conclusions Higher maternal education was associated with more favourable growth in young children: lower obesity and overweight in UK and Sweden, and lower stunting and underweight in rural China. Public health strategies to optimize growth in early childhood need to acknowledge socioeconomic factors, but possibly with a different emphasis in different settings. PMID:23450064

Mammographic density defined by higher than conventional brightness thresholds better predicts breast cancer risk.

PubMed

Nguyen, Tuong L; Aung, Ye K; Evans, Christopher F; Dite, Gillian S; Stone, Jennifer; MacInnis, Robert J; Dowty, James G; Bickerstaffe, Adrian; Aujard, Kelly; Rommens, Johanna M; Song, Yun-Mi; Sung, Joohon; Jenkins, Mark A; Southey, Melissa C; Giles, Graham G; Apicella, Carmel; Hopper, John L

2017-04-01

Mammographic density defined by the conventional pixel brightness threshold, and adjusted for age and body mass index (BMI), is a well-established risk factor for breast cancer. We asked if higher thresholds better separate women with and without breast cancer. We studied Australian women, 354 with breast cancer over-sampled for early-onset and family history, and 944 unaffected controls frequency-matched for age at mammogram. We measured mammographic dense area and percent density using the CUMULUS software at the conventional threshold, which we call Cumulus , and at two increasingly higher thresholds, which we call Altocumulus and Cirrocumulus , respectively. All measures were Box-Cox transformed and adjusted for age and BMI. We estimated the odds per adjusted standard deviation (OPERA) using logistic regression and the area under the receiver operating characteristic curve (AUC). Altocumulus and Cirrocumulus were correlated with Cumulus (r ∼ 0.8 and 0.6 , respectively) . For dense area, the OPERA was 1.62, 1.74 and 1.73 for Cumulus, Altocumulus and Cirrocumulus , respectively (all P  < 0.001). After adjusting for Altocumulus and Cirrocumulus , Cumulus was not significant ( P  > 0.6). The OPERAs for percent density were less but gave similar findings. The mean of the standardized adjusted Altocumulus and Cirrocumulus dense area measures was the best predictor; OPERA = 1.87 [95% confidence interval (CI): 1.64-2.14] and AUC = 0.68 (0.65-0.71). The areas of higher mammographically dense regions are associated with almost 30% stronger breast cancer risk gradient, explain the risk association of the conventional measure and might be more aetiologically important. This has substantial implications for clinical translation and molecular, genetic and epidemiological research. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association

Efficacy of Healing meditation in reducing anxiety of individuals at the phase of weight loss maintenance: A randomized blinded clinical trial.

PubMed

Sampaio, Cynthia Vieira Sanches; Lima, Manuela Garcia; Ladeia, Ana Marice

2016-12-01

To verify the efficacy of Healing Meditation in reducing anxiety levels in individuals on a weight loss maintenance program. A randomized, controlled, evaluator-blinded clinical trial, conducted between January and October 2014, with a follow-up of 12 weeks. A weight loss secondary care facility in Salvador, Brazil., of 41 patients at the weight maintenance phase (Mean initial BMI 33.6±4.7kg/m 2 , who had attained a mean BMI of 24.5±1.6kg/m 2 in a median period of 7 months). An 8-week Healing Meditation program (n=20), consisting of a 1h weekly meeting, or for a control group on the waiting list (n=21), in addition to the standard clinical program. Total anxiety was measured by the Hamilton Anxiety Scale (HAM-A), before and after the intervention. Secondary analyses included comparison of the effect of meditation on the somatic and psychic components of the scale. Through an intention to treat analysis, we detected a difference in the mean variation between the intervention and control groups in the total anxiety scores of 7.7 (95% CI 6.3-9.2; Cohen's d=3.41). Means and standard deviations for pre and post intervention anxiety scores were 15.5 (3.4) and 7.8 (2.0) for the intervention group and 14.8 (3.4) and 14.9 (3.4) for the control. Healing meditation significantly reduced the anxiety of obese individuals, in the phase of weight maintenance, suggesting this to be an effective auxiliary resource for weight loss maintenance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nutritional status of children with inflammatory bowel disease in Saudi Arabia.

PubMed

El Mouzan, Mohammad Issa; Al Edreesi, Mohammed Hadi; Al-Hussaini, Abdulrahman Abdullah; Saadah, Omar Ibrahim; Al Qourain, Abdulaziz Abdullatif; Al Mofarreh, Mohammad Abdullah; Al Saleem, Khalid Abdulrahman

2016-02-07

To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia. The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn's disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height(2) (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and < -2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older. There were 374 children from 0.33 to 17 years of age, including 119 (32%) children with UC and 255 (68%) with CD. All of the children were Saudi nationals, and 68 (57%) of the UC and 150 (59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020). A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.

Nutritional status of children with inflammatory bowel disease in Saudi Arabia

PubMed Central

El Mouzan, Mohammad Issa; Al Edreesi, Mohammed Hadi; Al-Hussaini, Abdulrahman Abdullah; Saadah, Omar Ibrahim; Al Qourain, Abdulaziz Abdullatif; Al Mofarreh, Mohammad Abdullah; Al Saleem, Khalid Abdulrahman

2016-01-01

AIM: To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia. METHODS: The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn’s disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height2 (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and < -2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older. RESULTS: There were 374 children from 0.33 to 17 years of age, including 119 (32%) children with UC and 255 (68%) with CD. All of the children were Saudi nationals, and 68 (57%) of the UC and 150 (59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020). CONCLUSION: A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care. PMID:26855544

Obesity prevalence and accuracy of BMI-defined obesity in Russian firefighters.

PubMed

Gurevich, K G; Poston, W S C; Anders, B; Ivkina, M A; Archangelskaya, A; Jitnarin, N; Starodubov, V I

2017-01-01

No data exist on obesity or the accuracy of body mass index (BMI) in Russian Federation firefighters. To determine the prevalence of obesity and rates of misclassification of BMI-based obesity status. Career firefighters in the Moscow region completed anthropometric assessments including height, weight, BMI, body fat per cent (BF%) and waist circumference (WC). Using these three methods, we defined obesity as BMI ≥30, BF% >25 and WC >102, respectively. The study group consisted of 167 male firefighters. Obesity prevalence was 22% for BMI [95% confidence interval (CI) 16.9-28.5], 60% for BF% (95% CI 52.5-67.3) and 28% for WC (95% CI 21.3-34.9). False positive rates for BMI-based obesity status were low, with 3% (95% CI -1.1 to 7.1) and 6% (95% CI 1.6-9.9) of non-obese participants defined by BF% and WC standards misidentified as obese using BMI. However, 65% (95% CI 55.7-77.4) of BF%-defined obese participants and 36% (95% CI 22.5-49.9) of WC-defined obese participants were misclassified as non-obese using BMI (i.e. false negatives). Rates of BMI-based obesity in Russian male firefighters were similar to that of males in the general Russian adult male population. Compared with BF% or WC standards, BMI-based obesity classi- fication produced low rates of false positives but demonstrated high rates of false negatives. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Body composition in childhood inflammatory bowel disease.

PubMed

Wiskin, Anthony E; Wootton, Stephen A; Hunt, Toby M; Cornelius, Victoria R; Afzal, Nadeem A; Jackson, Alan A; Beattie, R Mark

2011-02-01

Little is known about the impact of disease and treatment on the pattern of growth in children with Inflammatory Bowel Disease (IBD). Significant deficits in height and weight in children with Crohn's disease have been reported but changes in fat and fat free mass are less well defined. This study aims to describe the height, weight and body composition of a cohort of children with IBD. Height, weight, skinfold thicknesses and bioelectrical impedance analysis was performed. Disease activity was assessed with clinical scoring systems. 55 children, median age 13.7 years (range 6.5-17.7) were studied. Median (25th, 75th percentile) Standard Deviation Score for BMI, Height and Weight were - 0.3 (- 0.97, 0.65), - 0.56 (- 1.42, 0.06), - 0.62 (- 1.43, 0.19). In Crohn's disease, using multiple regression analysis disease activity measured by PCDAI was significantly inversely related to fat free mass (β - 0.2, 95% CI -0.17, -0.03, p 0.005). Children with IBD were both under and overweight. Nutritional deficits were more common in Crohn's disease. Fat free mass was related to disease activity in children with Crohn's disease regardless of changes in weight. Weight or BMI may mask deficits in lean tissue in the presence of normal or increased proportions of body fat. Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

[Nutritional status and food intake of populations from high altitude regions of the Northwest of Argentia].

PubMed

Bassett, Maria Natalia; Gimenez, Maria Alejandra; Romaguera, Dora; Sammán, Norma

2013-06-01

The purpose of this work was to study the nutritional status and food intake of Andean populations of Northwest ofArgentine. A cross-sectional nutritional survey was carried out in representative samples of populations of highland from Argentine. Also anthropometric measurements, a food intake, a semi-quantitative food frequency questionnaire were performed and recorded. Stunting (height-for-age Z-score < -2 standard deviations) was the main nutritional problem in children and adolescents in the area of Puna and Quebrada regions. While overweight and obesity, evaluated by BMI> 85th and 95th percentile respectively, were the main nutritional problems among adolescents in the Valleys. Adult populations showed higher prevalence of overweight and obesity according to BMI determined. These are important risk factors for cardiovascular and chronic diseases.Usually the typical composition of the main food dish of regions has a base of rice, pasta, flour or corn, accompanied by tubers or eggs, or a few vegetables and beef. This dish varies little from one day to another, constituting a monotonous diet with a high intake of sugar (sugary drinks and sweets) and refined grains. Results suggest that these populations would be in early stages of nutritional transition and could be the starting point to promote them healthier food consumption and a diet less monotonous. It would be recommendable reincorporate native products of the region.

An analysis of malar fat volume in two age groups: implications for craniofacial surgery.

PubMed

Corey, Christina L; Popelka, Gerald R; Barrera, Jose E; Most, Sam P

2012-12-01

Objective To evaluate how malar fat pad (MFP) volumes vary with age, after controlling for gender and body mass index (BMI). Study Design A prospective case-control study evaluating volume of the MFP in women of two age groups. Methods Soft tissue dimensions were measured in eight subjects using magnetic resonance imaging. A multiplanar localizing sequence, followed in sagittal and coronal orientations using a turbo spin echo sequence, was performed to define the MFP. Volumetric calculations were then performed using a 3D image analysis application (Dextroscope, Volume Interactions, Republic of Singapore) to circumscribe areas, orient dimensions, and calculate volumes of the MFP. Results These data reveal no significant difference in the mean (standard deviation) right MFP (p = 0.50), left MFP (p = 0.41), or total MFP (p = 0.45) volumes when comparing the two age groups. In addition, these data indicate that there was no correlation between age and total MFP volume (Pearson correlation coefficient 0.27). Moreover, there was no correlation between age and the ratio of total volume/BMI (Pearson correlation coefficient -0.18). Conclusions Although the sample size of this study was small, these data indicate that ptosis of midfacial fat is more important than volume loss in midfacial aging. These data would suggest repositioning as the primary modality for craniofacial reconstruction.

The one year exercise and lifestyle intervention program KLAKS: Effects on anthropometric parameters, cardiometabolic risk factors and glycemic control in childhood obesity.

PubMed

Blüher, Susann; Petroff, David; Wagner, Antje; Warich, Katja; Gausche, Ruth; Klemm, Thorsten; Wagner, Mario; Keller, Alexandra

2014-03-01

Regular physical exercise within structured lifestyle programs may improve weight status and minimize metabolic risk factors in childhood obesity. The aim of this study was to evaluate the effect of the one-year combined physical exercise/lifestyle program KLAKS on anthropometric and metabolic parameters and glycemic control in childhood obesity. 142 overweight/obese (BMI>90th percentile) candidates (7-18years) were enrolled, 115 participants completed the program. Anthropometrics and biochemical parameters were obtained at beginning and completion. An oral glucose tolerance test (OGTT) was performed in a subgroup of participants. Course of glucose and insulin levels within OGTT was correlated with several parameters and is reported here for those who completed the program. The mean standard deviation scores (SDS) decreased significantly for BMI, waist circumference, waist-to-height ratio (WHtR) and percentage body fat (all p≤0.01). Improved metabolic risk markers included mean glucose levels within an OGTT at follow-up compared to baseline (p<0.0001) and HbA1c (p=0.05) as well as indications of improvement for gamma-glutamyl-transferase and free fatty acids. The one-year combined exercise/lifestyle program KLAKS significantly improves markers of obesity and glycemic control. Impaired cardiometabolic risk markers, even subclinical, are also favorably influenced by program participation. Copyright © 2014 Elsevier Inc. All rights reserved.

Cardio-pulmonary fitness test by ultra-short heart rate variability.

PubMed

Aslani, Arsalan; Aslani, Amir; Kheirkhah, Jalal; Sobhani, Vahid

2011-10-01

It is known that exercise induces cardio-respiratory autonomic modulation. The aim of this study was to assess the cardio-pulmonary fitness by ultra-short heart rate variability. Study population was divided into 3 groups: Group-1 (n = 40) consisted of military sports man. Group-2 (n = 40) were healthy age-matched sedentary male subjects with normal body mass index [BMI = 19 - 25 kg/m(2)). Group-3 (n = 40) were healthy age-matched obese male subjects [BMI > 29 kg/m(2)). Standard deviation of normal-to-normal QRS intervals (SDNN) was recorded over 15 minutes. Bruce protocol treadmill test was used; and, maximum oxygen consumption (VO(2)max) was calculated. WHEN THE STUDY POPULATION WAS DIVIDED INTO QUARTILES OF SDNN (FIRST QUARTILE: < 60 msec; second quartile: > 60 and < 100 msec; third quartile: > 100 and <140 msec; and fourth quartile: >140 msec), progressive increase was found in VO(2)max; and, SDNN was significantly linked with estimated VO(2)max. In conclusion, the results of this study demonstrate that exercise training improves cardio-respiratory autonomic function (and increases heart rate variability). Improvement in cardio-respiratory autonomic function seems to translate into a lower rate of long term mortality. Ultra-short heart rate variability is a simple cardio-pulmonary fitness test which just requires 15 minutes, and involves no exercise such as in the treadmill or cycle test.

Associations of Maternal Dietary Patterns during Pregnancy with Offspring Adiposity from Birth Until 54 Months of Age

PubMed Central

Chen, Ling-Wei; Aris, Izzuddin M.; Bernard, Jonathan Y.; Tint, Mya-Thway; Chia, Airu; Colega, Marjorelee; Gluckman, Peter D.; Shek, Lynette Pei-Chi; Saw, Seang-Mei; Chong, Yap-Seng; Yap, Fabian; Godfrey, Keith M.; van Dam, Rob M.; Chong, Mary Foong-Fong; Lee, Yung Seng

2016-01-01

Most studies linking maternal diet with offspring adiposity have focused on single nutrients or foods, but a dietary pattern approach is more representative of the overall diet. We thus aimed to investigate the relations between maternal dietary patterns and offspring adiposity in a multi-ethnic Asian mother–offspring cohort in Singapore. We derived maternal dietary patterns using maternal dietary intake information at 26–28 weeks of gestation, of which associations with offspring body mass index (BMI), abdominal circumference (AC), subscapular skinfold (SS), and triceps skinfold (TS) were assessed using longitudinal data analysis (linear mixed effects (LME)) and multiple linear regression at ages 0, 3, 6, 9, 12, 15, 18, 24, 36, 48, and 54 months. Three dietary patterns were derived: (1) vegetables-fruit-and-white rice (VFR); (2) seafood-and-noodles (SfN); and (3) pasta-cheese-and-bread (PCB). In the LME model adjusting for potential confounders, each standard deviation (SD) increase in maternal VFR pattern score was associated with 0.09 mm lower offspring TS. Individual time-point analysis additionally revealed that higher VFR score was generally associated with lower postnatal offspring BMI z-score, TS, SS, and sum of skinfolds (SS + TS) at ages 18 months and older. Maternal adherence to a dietary pattern characterized by higher intakes of fruit and vegetables and lower intakes of fast food was associated with lower offspring adiposity. PMID:28025503

Underweight, Obesity and Exercise among Adults with Intellectual Disabilities in Supported Accommodation in Northern England

ERIC Educational Resources Information Center

Emerson, E.

2005-01-01

Significant deviation from normal weight (obesity and underweight) and lack of physical exercise have been identified as three of the most significant global behavioural risks to health. Body mass index (BMI) and levels of physical activity were measured in a sample of 1542 adults with intellectual disabilities (ID) receiving supported…

Exploring Students' Conceptions of the Standard Deviation

ERIC Educational Resources Information Center

delMas, Robert; Liu, Yan

2005-01-01

This study investigated introductory statistics students' conceptual understanding of the standard deviation. A computer environment was designed to promote students' ability to coordinate characteristics of variation of values about the mean with the size of the standard deviation as a measure of that variation. Twelve students participated in an…

7 CFR 801.4 - Tolerances for dockage testers.

Code of Federal Regulations, 2012 CFR

2012-01-01

....10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Riddle separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Sieve separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Total...

7 CFR 801.4 - Tolerances for dockage testers.

Code of Federal Regulations, 2014 CFR

2014-01-01

....10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Riddle separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Sieve separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Total...

7 CFR 801.4 - Tolerances for dockage testers.

Code of Federal Regulations, 2011 CFR

2011-01-01

....10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Riddle separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Sieve separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Total...

7 CFR 801.4 - Tolerances for dockage testers.

Code of Federal Regulations, 2013 CFR

2013-01-01

....10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Riddle separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Sieve separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Total...

Statistics as Unbiased Estimators: Exploring the Teaching of Standard Deviation

ERIC Educational Resources Information Center

Wasserman, Nicholas H.; Casey, Stephanie; Champion, Joe; Huey, Maryann

2017-01-01

This manuscript presents findings from a study about the knowledge for and planned teaching of standard deviation. We investigate how understanding variance as an unbiased (inferential) estimator--not just a descriptive statistic for the variation (spread) in data--is related to teachers' instruction regarding standard deviation, particularly…

7 CFR 801.4 - Tolerances for dockage testers.

Code of Federal Regulations, 2010 CFR

2010-01-01

....10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Riddle separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Sieve separation ±0.10 percent, mean deviation from standard dockage tester using Hard Red Winter wheat Total...

7 CFR 801.6 - Tolerances for moisture meters.

Code of Federal Regulations, 2010 CFR

2010-01-01

... moisture, mean deviation from National standard moisture meter using Hard Red Winter wheat Mid ±0.05 percent moisture, mean deviation from National standard moisture meter using Hard Red Winter wheat High ±0.05 percent moisture, mean deviation from National standard moisture meter using Hard Red Winter wheat...

Impacts of biological and procedural factors on semiquantification uptake value of liver in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging.

PubMed

Mahmud, Mohd Hafizi; Nordin, Abdul Jalil; Ahmad Saad, Fathinul Fikri; Azman, Ahmad Zaid Fattah

2015-10-01

Increased metabolic activity of fluorodeoxyglucose (FDG) in tissue is not only resulting of pathological uptake, but due to physiological uptake as well. This study aimed to determine the impacts of biological and procedural factors on FDG uptake of liver in whole body positron emission tomography/computed tomography (PET/CT) imaging. Whole body fluorine-18 ((18)F) FDG PET/CT scans of 51 oncology patients have been reviewed. Maximum standardized uptake value (SUVmax) of lesion-free liver was quantified in each patient. Pearson correlation was performed to determine the association between the factors of age, body mass index (BMI), blood glucose level, FDG dose and incubation period and liver SUVmax. Multivariate regression analysis was established to determine the significant factors that best predicted the liver SUVmax. Then the subjects were dichotomised into four BMI groups. Analysis of variance (ANOVA) was established for mean difference of SUVmax of liver between those BMI groups. BMI and incubation period were significantly associated with liver SUVmax. These factors were accounted for 29.6% of the liver SUVmax variance. Statistically significant differences were observed in the mean SUVmax of liver among those BMI groups (P<0.05). BMI and incubation period are significant factors affecting physiological FDG uptake of liver. It would be recommended to employ different cut-off value for physiological liver SUVmax as a reference standard for different BMI of patients in PET/CT interpretation and use a standard protocol for incubation period of patient to reduce variation in physiological FDG uptake of liver in PET/CT study.

Relations of nutritional intake to age, sex and body mass index in Japanese elderly patients with type 2 diabetes: the Japanese Elderly Diabetes Intervention Trial.

PubMed

Yoshimura, Yukio; Kamada, Chiemi; Takahashi, Keiko; Kaimoto, Tae; Iimuro, Satoshi; Ohashi, Yasuo; Araki, Atsushi; Umegaki, Hiroyuki; Sakurai, Takashi; Ito, Hideki

2012-04-01

To determine the status of nutritional intake in elderly Japanese patients with type 2 diabetes aged 65 years or older, and to clarify relations of nutritional intake to age, sex and body mass index (BMI). Clinical parameters and nutritional intake were investigated and compared in 912 (417 men, 495 women) elderly Japanese patients with type 2 diabetes registered to the Japanese Elderly Diabetes Intervention Trial. The mean daily energy intake of patients was 1802 kcal in men and 1661 kcal in women, respectively. The energy intakes per kilogram of standard bodyweight in both sexes and the energy intakes per kilogram of present bodyweight in men increased significantly with age. The protein : fat : carbohydrate (PFC) energy ratio (%E) was 15.2:25.4:59.5 in men, and 15.7:25.8:58.6 in women, respectively. Grain, oil, alcohol and soft drink intakes were higher in men than in women. Potato, fruit and green vegetable intakes were higher in women than in men. Fruit intake showed a significant age-related increase in men. In women, there was an age-related significant decrease of meat intake. An increase of BMI correlated with a significant increase in bodyweight, waist circumference, hip circumference, waist-to-hip ratio, triglycerides and diastolic blood pressure. The mean energy intake of three BMI groups, lean (BMI < 18.5 kg/m(2)), normal (18.5 kg/m(2)

Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES).

PubMed

Bidulescu, Aurelian; Din-Dzietham, Rebecca; Coverson, Dorothy L; Chen, Zhimin; Meng, Yuan-Xiang; Buxbaum, Sarah G; Gibbons, Gary H; Welch, Verna L

2010-09-28

Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA). Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI) and obesity and test whether these associations are modified by psychosocial stress, known to influence sleep quality. A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m²) continuously and categorically (BMI ≥ 30 versus BMI < 30). Global sleep quality (GSQ) score was computed as the sum of response values for the seven components of the Pittsburgh Sleep Quality Index (PSQI) scale. GSQ score was defined as a continuous variable (range 0-21) and as tertiles. The general perceived stress (GPS), derived from the validated Cohen scale, was categorized into tertiles to test the interaction. Chi-square tests, correlation coefficients and weighted multiple linear and logistic regression were used to assess the associations of GSQ, GPS and obesity. The mean (standard deviation) age was 47.5 (17.0) years, and 1,096 (72%) were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.): 1.08 (1.03 - 1.12)], and with a worse sleep disturbance subcomponent score [OR (95% C.I.): 1.48 (1.16 - 1.89)]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.): 1.09 (1.02 - 1.17). Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.

Agreement and Diagnostic Performance of FITNESSGRAM®, International Obesity Task Force, and Hungarian National BMI Standards

ERIC Educational Resources Information Center

Laurson, Kelly R.; Welk, Gregory J.; Marton, Orsolya; Kaj, Mónika; Csányi, Tamás

2015-01-01

Purpose: This study examined agreement between all 3 standards (as well as relative diagnostic associations with metabolic syndrome) using a representative sample of youth from the Hungarian National Youth Fitness Study. Method: Body mass index (BMI) was assessed in a field sample of 2,352 adolescents (ages 10-18.5 years) and metabolic syndrome…

Genetic evidence for causal relationships between maternal obesity-related traits and birth weight

PubMed Central

Tyrrell, Jessica; Richmond, Rebecca C.; Palmer, Tom M.; Feenstra, Bjarke; Rangarajan, Janani; Metrustry, Sarah; Cavadino, Alana; Paternoster, Lavinia; Armstrong, Loren L.; De Silva, N. Maneka G.; Wood, Andrew R.; Horikoshi, Momoko; Geller, Frank; Myhre, Ronny; Bradfield, Jonathan P.; Kreiner-Møller, Eskil; Huikari, Ville; Painter, Jodie N.; Hottenga, Jouke-Jan; Allard, Catherine; Berry, Diane J.; Bouchard, Luigi; Das, Shikta; Evans, David M.; Hakonarson, Hakon; Hayes, M. Geoffrey; Heikkinen, Jani; Hofman, Albert; Knight, Bridget; Lind, Penelope A.; McCarthy, Mark I.; McMahon, George; Medland, Sarah E.; Melbye, Mads; Morris, Andrew P.; Nodzenski, Michael; Reichetzeder, Christoph; Ring, Susan M.; Sebert, Sylvain; Sengpiel, Verena; Sørensen, Thorkild I.A.; Willemsen, Gonneke; de Geus, Eco J. C.; Martin, Nicholas G.; Spector, Tim D.; Power, Christine; Järvelin, Marjo-Riitta; Bisgaard, Hans; Grant, Struan F.A.; Nohr, Ellen A.; Jaddoe, Vincent W.; Jacobsson, Bo; Murray, Jeffrey C.; Hocher, Berthold; Hattersley, Andrew T.; Scholtens, Denise M.; Smith, George Davey; Hivert, Marie-France; Felix, Janine F.; Hyppönen, Elina; Lowe, William L.; Frayling, Timothy M.; Lawlor, Debbie A.; Freathy, Rachel M.

2016-01-01

Structured abstract Importance Neonates born to overweight/obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. Objective To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. Design, Setting and Participants We used Mendelian randomization to test whether maternal BMI and obesity-related traits are causally related to offspring birth weight. Mendelian randomization makes use of the fact that genotypes are randomly determined at conception and are thus not confounded by non-genetic factors. Data were analysed on 30,487 women from 18 studies. Participants were of European ancestry from population- or community-based studies located in Europe, North America or Australia and participating in the Early Growth Genetics (EGG) Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. We tested associations between a genetic score of 30 BMI-associated single nucleotide polymorphisms (SNPs) and (i) maternal BMI and (ii) birth weight, to estimate the causal relationship between BMI and birth weight. Analyses were repeated for other obesity-related traits. Exposures Genetic scores for BMI, fasting glucose level, type 2 diabetes, systolic blood pressure (SBP), triglyceride level, HDL-cholesterol level, vitamin D status and adiponectin level. Main Outcome(s) and Measure(s) Offspring birth weight measured by trained study personnel (n=2 studies), from medical records (n= 10 studies) or from maternal report (n=6 studies). Results Among the 30,487 newborns the mean birth weight in the various cohorts ranged from 3325 g to 3679 g. The genetic score for BMI was associated with a 2g (95%CI: 0, 3g) higher offspring birth weight per maternal BMI-raising allele (P=0.008). The maternal genetic scores for fasting glucose and SBP were also associated with birth weight with effect sizes of 8g (95%CI: 6, 10g) per glucose-raising allele (P=7×10−14) and −4g (95%CI: −6, −2g) per SBP-raising allele (P=1×10−5), respectively. A 1 standard deviation (1 SD ≈ 4kg/m2) genetically higher maternal BMI was associated with a 55g (95% CI: 17, 93g) higher birth weight. A 1-SD genetically higher maternal fasting glucose (≈ 0.4mmol/L) or SBP (10mmHg) were associated with a 114g (95%CI: 80, 147g) higher or −208g (95% CI: −394, −21g) lower birth weight, respectively. For BMI and fasting glucose these genetic associations were consistent with the observational associations, but for SBP, the genetic and observational associations were in opposite directions. Conclusions and Relevance In this Mendelian randomization study of more than 30,000 women with singleton offspring from 18 studies, genetically elevated maternal BMI and blood glucose levels were potentially causally associated with higher offspring birth weight, whereas genetically elevated maternal systolic blood pressure was shown to be potentially causally related to lower birth weight. If replicated, these findings may have implications for counseling and managing pregnancies to avoid adverse weight-related birth outcomes. PMID:26978208

Visualizing the Sample Standard Deviation

ERIC Educational Resources Information Center

Sarkar, Jyotirmoy; Rashid, Mamunur

2017-01-01

The standard deviation (SD) of a random sample is defined as the square-root of the sample variance, which is the "mean" squared deviation of the sample observations from the sample mean. Here, we interpret the sample SD as the square-root of twice the mean square of all pairwise half deviations between any two sample observations. This…

The academic penalty for gaining weight: a longitudinal, change-in-change analysis of BMI and perceived academic ability in middle school students.

PubMed

Kenney, E L; Gortmaker, S L; Davison, K K; Bryn Austin, S

2015-09-01

Worse educational outcomes for obese children regardless of academic ability may begin early in the life course. This study tested whether an increase in children's relative weight predicted lower teacher- and child-perceived academic ability even after adjusting for standardized test scores. Three thousand three hundred and sixty-two children participating in the Early Childhood Longitudinal Study-Kindergarten Cohort were studied longitudinally from fifth to eighth grade. Heights, weights, standardized test scores in maths and reading, and teacher and self-ratings of ability in maths and reading were measured at each wave. Longitudinal, within-child linear regression models estimated the impact of a change in body mass index (BMI) z-score on change in normalized teacher and student ratings of ability in reading and maths, adjusting for test score. A change in BMI z-score from fifth to eighth grade was not independently associated with a change in standardized test scores. However, adjusting for standardized test scores, an increasing BMI z-score was associated with significant reductions in teacher's perceptions of girls' ability in reading (-0.12, 95% confidence interval (CI): -0.23, -0.03, P=0.03) and boys' ability in math (-0.30, 95% CI: -0.43, -0.17, P<0.001). Among children who were overweight at fifth grade and increased in BMI z-score, there were even larger reductions in teacher ratings for boys' reading ability (-0.37, 95% CI: -0.71, -0.03, P=0.03) and in girls' self-ratings of maths ability (-0.47, 95% CI: -0.83, -0.11, P=0.01). From fifth to eighth grade, increase in BMI z-score was significantly associated with worsening teacher perceptions of academic ability for both boys and girls, regardless of objectively measured ability (standardized test scores). Future research should examine potential interventions to reduce bias and promote positive school climate.

Variation in the standard deviation of the lure rating distribution: Implications for estimates of recollection probability.

PubMed

Dopkins, Stephen; Varner, Kaitlin; Hoyer, Darin

2017-10-01

In word recognition semantic priming of test words increased the false-alarm rate and the mean of confidence ratings to lures. Such priming also increased the standard deviation of confidence ratings to lures and the slope of the z-ROC function, suggesting that the priming increased the standard deviation of the lure evidence distribution. The Unequal Variance Signal Detection (UVSD) model interpreted the priming as increasing the standard deviation of the lure evidence distribution. Without additional parameters the Dual Process Signal Detection (DPSD) model could only accommodate the results by fitting the data for related and unrelated primes separately, interpreting the priming, implausibly, as decreasing the probability of target recollection (DPSD). With an additional parameter, for the probability of false (lure) recollection the model could fit the data for related and unrelated primes together, interpreting the priming as increasing the probability of false recollection. These results suggest that DPSD estimates of target recollection probability will decrease with increases in the lure confidence/evidence standard deviation unless a parameter is included for false recollection. Unfortunately the size of a given lure confidence/evidence standard deviation relative to other possible lure confidence/evidence standard deviations is often unspecified by context. Hence the model often has no way of estimating false recollection probability and thereby correcting its estimates of target recollection probability.

The relationship between 19th century BMIs and family size: Economies of scale and positive externalities.

PubMed

Carson, Scott Alan

2015-04-01

The use of body mass index values (BMI) to measure living standards is now a well-accepted method in economics. Nevertheless, a neglected area in historical studies is the relationship between 19th century BMI and family size, and this relationship is documented here to be positive. Material inequality and BMI are the subject of considerable debate, and there was a positive relationship between BMI and wealth and an inverse relationship with inequality. After controlling for family size and wealth, BMI values were related with occupations, and farmers and laborers had greater BMI values than workers in other occupations. Copyright © 2014 Elsevier GmbH. All rights reserved.

Down-Looking Interferometer Study II, Volume I,

DTIC Science & Technology

1980-03-01

g(standard deviation of AN )(standard deviation of(3) where T’rm is the "reference spectrum", an estimate of the actual spectrum v gv T ’V Cgv . If jpj...spectrum T V . cgv . According to Eq. (2), Z is the standard deviation of the observed contrast spectral radiance AN divided by the effective rms system

40 CFR 61.207 - Radium-226 sampling and measurement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... B, Method 114. (3) Calculate the mean, x 1, and the standard deviation, s 1, of the n 1 radium-226... owner or operator of a phosphogypsum stack shall report the mean, standard deviation, 95th percentile..., Method 114. (4) Recalculate the mean and standard deviation of the entire set of n 2 radium-226...

BMI and Heath-Carter somatotypes of female students in Ljubljana.

PubMed

Zerbo, D; Flezar, M; Stefancic, M

1998-12-01

Measurements of 22 anthropometric and two spirometric variables were taken from 86 healthy female students of the University of Ljubljana who were not actively engaged in sports. The BMI and Heath-Carter somatotypes were calculated according to the anthropometric method. The average value of FEVC (Forced Expiratory Vital Capacity) amounted to 4.2 liters, and that of FEV 1 (Forced Expiratory Volume 1) to 3.7 liters and they exceeded the European standards for the corresponding age and height. Central and mesomorph-endomorph somatotypes predominated, and the majority of students were classified into the second group of BMI with a normal body weight. The values of FEVC, FEV 1 and the Tiffeneau index increased in line with the ectomorphic component. No differences in the average FEVC and FEV 1 were found between BMI groups. The Tiffeneau index increased from the third to the first group. It was concluded that the ventilation measures were higher in ectomorphic students, who actually exhaled values that exceeded the requirements of standards the least of all groups. Due to rare statistically significant differences in FEVC and FEV 1 between somatotypes and BMI groups it would be necessary to repeat the analysis on a larger sample. There also appeared to be a need for new Slovenian standards.

Height, adiposity and body fat distribution and breast density in young women.

PubMed

Dorgan, Joanne F; Klifa, Catherine; Shepherd, John A; Egleston, Brian L; Kwiterovich, Peter O; Himes, John H; Gabriel, Kelley; Horn, Linda; Snetselaar, Linda G; Stevens, Victor J; Barton, Bruce A; Robson, Alan M; Lasser, Norman L; Deshmukh, Snehal; Hylton, Nola M

2012-07-13

Breast density is one of the strongest risk factors for breast cancer, but determinants of breast density in young women remain largely unknown. Associations of height, adiposity and body fat distribution with percentage dense breast volume (%DBV) and absolute dense breast volume (ADBV) were evaluated in a cross-sectional study of 174 healthy women, 25 to 29 years old. Adiposity and body fat distribution were measured by anthropometry and dual-energy X-ray absorptiometry (DXA), while %DBV and ADBV were measured by magnetic resonance imaging. Associations were evaluated using linear mixed-effects models. All tests of statistical significance are two-sided. Height was significantly positively associated with %DBV but not ADBV; for each standard deviation (SD) increase in height, %DBV increased by 18.7% in adjusted models. In contrast, all measures of adiposity and body fat distribution were significantly inversely associated with %DBV; a SD increase in body mass index (BMI), percentage fat mass, waist circumference and the android:gynoid fat mass ratio (A:G ratio) was each associated significantly with a 44.4 to 47.0% decrease in %DBV after adjustment for childhood BMI and other covariates. Although associations were weaker than for %DBV, all measures of adiposity and body fat distribution also were significantly inversely associated with ADBV before adjustment for childhood BMI. After adjustment for childhood BMI, however, only the DXA measures of percentage fat mass and A:G ratio remained significant; a SD increase in each was associated with a 13.8 to 19.6% decrease in ADBV. In mutually adjusted analysis, the percentage fat mass and the A:G ratio remained significantly inversely associated with %DBV, but only the A:G ratio was significantly associated with ADBV; a SD increase in the A:G ratio was associated with an 18.5% decrease in ADBV. Total adiposity and body fat distribution are independently inversely associated with %DBV, whereas in mutually adjusted analysis only body fat distribution (A:G ratio) remained significantly inversely associated with ADBV in young women. Research is needed to identify biological mechanisms underlying these associations.

Image quality and radiation reduction of 320-row area detector CT coronary angiography with optimal tube voltage selection and an automatic exposure control system: comparison with body mass index-adapted protocol.

PubMed

Lim, Jiyeon; Park, Eun-Ah; Lee, Whal; Shim, Hackjoon; Chung, Jin Wook

2015-06-01

To assess the image quality and radiation exposure of 320-row area detector computed tomography (320-ADCT) coronary angiography with optimal tube voltage selection with the guidance of an automatic exposure control system in comparison with a body mass index (BMI)-adapted protocol. Twenty-two patients (study group) underwent 320-ADCT coronary angiography using an automatic exposure control system with the target standard deviation value of 33 as the image quality index and the lowest possible tube voltage. For comparison, a sex- and BMI-matched group (control group, n = 22) using a BMI-adapted protocol was established. Images of both groups were reconstructed by an iterative reconstruction algorithm. For objective evaluation of the image quality, image noise, vessel density, signal to noise ratio (SNR), and contrast to noise ratio (CNR) were measured. Two blinded readers then subjectively graded the image quality using a four-point scale (1: nondiagnostic to 4: excellent). Radiation exposure was also measured. Although the study group tended to show higher image noise (14.1 ± 3.6 vs. 9.3 ± 2.2 HU, P = 0.111) and higher vessel density (665.5 ± 161 vs. 498 ± 143 HU, P = 0.430) than the control group, the differences were not significant. There was no significant difference between the two groups for SNR (52.5 ± 19.2 vs. 60.6 ± 21.8, P = 0.729), CNR (57.0 ± 19.8 vs. 67.8 ± 23.3, P = 0.531), or subjective image quality scores (3.47 ± 0.55 vs. 3.59 ± 0.56, P = 0.960). However, radiation exposure was significantly reduced by 42 % in the study group (1.9 ± 0.8 vs. 3.6 ± 0.4 mSv, P = 0.003). Optimal tube voltage selection with the guidance of an automatic exposure control system in 320-ADCT coronary angiography allows substantial radiation reduction without significant impairment of image quality, compared to the results obtained using a BMI-based protocol.

Measuring perceived exercise capability and investigating its relationship with childhood obesity: a feasibility study.

PubMed

Taylor, M J; Arriscado, D; Vlaev, I; Taylor, D; Gately, P; Darzi, A

2016-01-01

According to the COM-B ('Capability', 'Opportunity', 'Motivation' and 'Behaviour') model of behaviour, three factors are essential for behaviour to occur: capability, opportunity and motivation. Obese children are less likely to feel capable of exercising. The implementation of a new methodological approach to investigate the relationship between perceived exercise capability (PEC) and childhood obesity was conducted, which involved creating a new instrument, and demonstrating how it can be used to measure obesity intervention outcomes. A questionnaire aiming to measure perceived exercise capability, opportunity and motivation was systematically constructed using the COM-B model and administered to 71 obese children (aged 9-17 years (12.24±0.2.01), body mass index (BMI) standard deviation scores (SDS) 2.80±0.660) at a weight-management camp in northern England. Scale validity and reliability was assessed. Relationships between PEC, as measured by the questionnaire, and BMI SDS were investigated for the children at the weight-management camp, and for 45 Spanish schoolchildren (aged 9-13 years, (10.52±1.23), BMI SDS 0.80±0.99). A pilot study, demonstrating how the questionnaire can be used to measure the effectiveness of an intervention aiming to bring about improved PEC for weight-management camp attendees, was conducted. No participants withdrew from these studies. The questionnaire domain (exercise capability, opportunity and motivation) composite scales were found to have adequate internal consistency (a=0.712-0.796) and construct validity (χ(2)/degrees of freedom=1.55, root mean square error of approximation=0.072, comparative fit index=0.92). Linear regression revealed that low PEC was associated with higher baseline BMI SDS for both UK (b=-0.289, P=0.010) and Spanish (b=-0.446, P=0.047) participants. Pilot study findings provide preliminary evidence for PEC improvements through intervention being achievable, and measurable using the questionnaire. Evidence is presented for reliability and validity of the questionnaire, and for feasibility of its use in the context of a childhood obesity intervention. Future research could investigate the link between PEC and childhood obesity further.

Effect of weight loss on sympatho-vagal balance in subjects with grade-3 obesity: restrictive surgery versus hypocaloric diet.

PubMed

Pontiroli, Antonio E; Merlotti, Claudia; Veronelli, Annamaria; Lombardi, Federico

2013-12-01

Few and mostly uncontrolled studies indicate that weight loss improves heart rate variability (HRV) in grade-3 obesity. The aim of this study was to compare in grade-3 obesity surgery and hypocaloric diet on clinical and metabolic variables and on autonomic indices of HRV. Twenty-four subjects (body mass index, BMI 45.5 ± 9.13 kg/m(2)) underwent surgery (n = 12, gastric banding, LAGB) or received hypocaloric diet (n = 12, 1,000-1,200 kg/day). Clinical [BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate] and metabolic variables [glucose, cholesterol, HDL- and LDL-cholesterol, triglycerides, AST and ALT transaminases] and 24-h Holter electrocardiographic-derived HRV parameters [R-R interval, standard deviation of R-R intervals (SDNN); low/high-frequency (LF/HF) ratio, and QT interval] were measured at baseline and after 6 months. The two groups were identical at baseline. BMI (-7.5 ± 3.57 kg/m(2), mean ± SD), glucose (-24.1 ± 26.77 mg/dL), SBP (-16.7 ± 22.19 mmHg) and DBP (-6.2 ± 8.56 mmHg) decreased in LAGB subjects (p < 0.05) and remained unchanged in controls. At 6 months, SDNN increased in LAGB subjects (+25.0 ± 37.19 ms, p < 0.05) and LF/HF ratio diminished (2.9 ± 1.84 vs. 4.9 ± 2.78; p = 0.01), with no change in controls; LF (daytime) and HF (24 h and daytime) increased in LAGB subjects, with no change in controls. Decrease in BMI correlated with SBP and DBP decrease (p < 0.05), and DBP decrease correlated with HR decrease (p < 0.05) and QT shortening (p < 0.05). Weight loss is associated with improvement of glucose metabolism, of blood pressure, and with changes in time and frequency domain parameters of HRV; all these changes indicate recovery of a more physiological autonomic control, with increase in parasympathetic and reduction in sympathetic indices of HRV.

Flexner 2.0-Longitudinal Study of Student Participation in a Campus-Wide General Pathology Course for Graduate Students at The University of Arizona.

PubMed

Briehl, Margaret M; Nelson, Mark A; Krupinski, Elizabeth A; Erps, Kristine A; Holcomb, Michael J; Weinstein, John B; Weinstein, Ronald S

2016-01-01

Faculty members from the Department of Pathology at The University of Arizona College of Medicine-Tucson have offered a 4-credit course on enhanced general pathology for graduate students since 1996. The course is titled, "Mechanisms of Human Disease." Between 1997 and 2016, 270 graduate students completed Mechanisms of Human Disease. The students came from 21 programs of study. Analysis of Variance, using course grade as the dependent and degree, program, gender, and year (1997-2016) as independent variables, indicated that there was no significant difference in final grade (F = 0.112; P = .8856) as a function of degree (doctorate: mean = 89.60, standard deviation = 5.75; master's: mean = 89.34, standard deviation = 6.00; certificate program: mean = 88.64, standard deviation = 8.25), specific type of degree program (F = 2.066, P = .1316; life sciences: mean = 89.95, standard deviation = 6.40; pharmaceutical sciences: mean = 90.71, standard deviation = 4.57; physical sciences: mean = 87.79, standard deviation = 5.17), or as a function of gender (F = 2.96, P = .0865; males: mean = 88.09, standard deviation = 8.36; females: mean = 89.58, standard deviation = 5.82). Students in the physical and life sciences performed equally well. Mechanisms of Human Disease is a popular course that provides students enrolled in a variety of graduate programs with a medical school-based course on mechanisms of diseases. The addition of 2 new medically oriented Master of Science degree programs has nearly tripled enrollment. This graduate level course also potentially expands the interdisciplinary diversity of participants in our interprofessional education and collaborative practice exercises.

Flexner 2.0—Longitudinal Study of Student Participation in a Campus-Wide General Pathology Course for Graduate Students at The University of Arizona

PubMed Central

Briehl, Margaret M.; Nelson, Mark A.; Krupinski, Elizabeth A.; Erps, Kristine A.; Holcomb, Michael J.; Weinstein, John B.

2016-01-01

Faculty members from the Department of Pathology at The University of Arizona College of Medicine-Tucson have offered a 4-credit course on enhanced general pathology for graduate students since 1996. The course is titled, “Mechanisms of Human Disease.” Between 1997 and 2016, 270 graduate students completed Mechanisms of Human Disease. The students came from 21 programs of study. Analysis of Variance, using course grade as the dependent and degree, program, gender, and year (1997-2016) as independent variables, indicated that there was no significant difference in final grade (F = 0.112; P = .8856) as a function of degree (doctorate: mean = 89.60, standard deviation = 5.75; master’s: mean = 89.34, standard deviation = 6.00; certificate program: mean = 88.64, standard deviation = 8.25), specific type of degree program (F = 2.066, P = .1316; life sciences: mean = 89.95, standard deviation = 6.40; pharmaceutical sciences: mean = 90.71, standard deviation = 4.57; physical sciences: mean = 87.79, standard deviation = 5.17), or as a function of gender (F = 2.96, P = .0865; males: mean = 88.09, standard deviation = 8.36; females: mean = 89.58, standard deviation = 5.82). Students in the physical and life sciences performed equally well. Mechanisms of Human Disease is a popular course that provides students enrolled in a variety of graduate programs with a medical school-based course on mechanisms of diseases. The addition of 2 new medically oriented Master of Science degree programs has nearly tripled enrollment. This graduate level course also potentially expands the interdisciplinary diversity of participants in our interprofessional education and collaborative practice exercises. PMID:28725783

Trends in the Prevalence of Overweight and Obesity among Chinese Preschool Children from 2006 to 2014.

PubMed

Xiao, Yanyu; Qiao, Yijuan; Pan, Lei; Liu, Jin; Zhang, Tao; Li, Nan; Liu, Enqing; Wang, Yue; Liu, Hongyan; Liu, Gongshu; Huang, Guowei; Hu, Gang

2015-01-01

To examine the trends in the prevalence of overweight and obesity among preschool children from 2006 to 2014. A total of 145,078 children aged 3-6 years from 46 kindergartens finished the annual health examination in Tianjin, China. Height, weight and other information were obtained using standardized methods. Z-scores for weight, height, and BMI were calculated based on the standards for the World Health Organization (WHO) child growth standards. From 2006 to 2014, mean values of height z-scores significantly increased from 0.34 to 0.54, mean values of weight z-scores kept constant, and mean values of BMI z-scores significantly decreased from 0.40 to 0.23. Mean values of height z-scores, weight z-scores, and BMI z-scores slightly decreased among children from 3 to 4 years old, and then increased among children from 4 to 6 years old. Between 2006 and 2014, there were no significant changes in prevalence of overweight (BMI z-scores >2 SD) and obesity (BMI z-scores >3 SD) among 3-4 years children. However, prevalence of obesity (BMI z-scores >2 SD) increased from 8.8% in 2006 to 10.1% in 2010, and then kept stable until 2014 among 5-6 years children. Boys had higher prevalence of obesity than girls. Mean values of BMI z-scores decreased from 2006 to 2014 among Chinese children aged 3-6 years old due to the significant increase of height z-scores. Prevalence of obesity increased from 2006 to 2010, and then kept stable until 2014 among children aged 5-6 years. The prevalence of obesity was higher in boys than in girls.

[Challenges in building a surgical obesity center].

PubMed

Fischer, L; El Zein, Z; Bruckner, T; Hünnemeyer, K; Rudofsky, G; Reichenberger, M; Schommer, K; Gutt, C N; Büchler, M W; Müller-Stich, B P

2014-04-01

It is estimated that approximately 1 million adults in Germany suffer from grade III obesity. The aim of this article is to describe the challenges faced when constructing an operative obesity center. The inflow of patients as well as personnel and infrastructure of the interdisciplinary Diabetes and Obesity Center in Heidelberg were analyzed. The distribution of continuous data was described by mean values and standard deviation and analyzed using variance analysis. The interdisciplinary Diabetes and Obesity Center in Heidelberg was founded in 2006 and offers conservative therapeutic treatment and all currently available operative procedures. For every operative intervention carried out an average of 1.7 expert reports and 0.3 counter expertises were necessary. The time period from the initial presentation of patients in the department of surgery to an operation was on average 12.8 months (standard deviation SD ± 4.5 months). The 47 patients for whom remuneration for treatment was initially refused had an average body mass index (BMI) of 49.2 kg/m(2) and of these 39 had at least the necessity for treatment of a comorbidity. Of the 45 patients for whom the reason for the refusal of treatment costs was given as a lack of conservative treatment, 30 had undertaken a medically supervised attempt at losing weight over at least 6 months. Additionally, 19 of these patients could document participation in a course at a rehabilitation center, a Xenical® or Reduktil® therapy or had undertaken the Optifast® program. For the 20 patients who supposedly lacked a psychosomatic evaluation, an adequate psychosomatic evaluation was carried out in all cases. The establishment of an operative obesity center can last for several years. A essential prerequisite for success seems to be the constructive and targeted cooperation with the health insurance companies.

Body Composition, Nutritional Profile and Muscular Fitness Affect Bone Health in a Sample of Schoolchildren from Colombia: The Fuprecol Study

PubMed Central

Forero-Bogotá, Mónica Adriana; Ojeda-Pardo, Mónica Liliana; García-Hermoso, Antonio; Correa-Bautista, Jorge Enrique; González-Jiménez, Emilio; Schmidt-RíoValle, Jacqueline; Navarro-Pérez, Carmen Flores; Gracia-Marco, Luis; Vlachopoulos, Dimitris; Martínez-Torres, Javier; Ramírez-Vélez, Robinson

2017-01-01

The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤−1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤−1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life. PMID:28165360

Body Composition, Nutritional Profile and Muscular Fitness Affect Bone Health in a Sample of Schoolchildren from Colombia: The Fuprecol Study.

PubMed

Forero-Bogotá, Mónica Adriana; Ojeda-Pardo, Mónica Liliana; García-Hermoso, Antonio; Correa-Bautista, Jorge Enrique; González-Jiménez, Emilio; Schmidt-RíoValle, Jacqueline; Navarro-Pérez, Carmen Flores; Gracia-Marco, Luis; Vlachopoulos, Dimitris; Martínez-Torres, Javier; Ramírez-Vélez, Robinson

2017-02-03

The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z -score cut off of ≤-1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤-1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life.

Fracture predictive ability of physical performance tests and history of falls in elderly women: a 10-year prospective study.

PubMed

Wihlborg, A; Englund, M; Åkesson, K; Gerdhem, P

2015-08-01

In a large cohort of elderly women followed for 10 years, we found that balance, gait speed, and self-reported history of fall independently predicted fracture. These clinical risk factors are easily evaluated and therefore advantageous in a clinical setting. They would improve fracture risk assessment and thereby also fracture prevention. The aim of this study was to identify additional risk factors for osteoporosis-related fracture by investigating the fracture predictive ability of physical performance tests and self-reported history of falls. In the population-based Osteoporosis Prospective Risk Assessment study (OPRA), 1044 women were recruited at the age of 75 and followed for 10 years. At inclusion, knee extension force, standing balance, gait speed, and bone mineral density (BMD) were examined. Falls the year before investigation was assessed by questionnaire. Cox proportional hazards regression analysis was used to determine fracture hazard ratios (HR) with BMD, history of fracture, BMI, smoking habits, bisphosphonate, vitamin D, glucocorticoid, and alcohol use as covariates. Continuous variables were standardized and HR shown for each standard deviation change. Of all women, 427 (41%) sustained at least one fracture during the 10-year follow-up. Failing the balance test had an HR of 1.98 (1.18-3.32) for hip fracture. Each standard deviation decrease in gait speed was associated with an HR of 1.37 (1.14-1.64) for hip fracture. Previous fall had an HR of 1.30 (1.03-1.65) for any fracture; 1.39 (1.08-1.79) for any osteoporosis-related fracture; and 1.60 (1.03-2.48) for distal forearm fracture. Knee extension force did not show fracture predictability. The balance test, gait speed test, and self-reported history of fall all hold independent fracture predictability. Consideration of these clinical risk factors for fracture would improve the fracture risk assessment and subsequently also fracture prevention.

Increasing variability of body mass and health correlates in Swiss conscripts, a possible role of relaxed natural selection?

PubMed Central

Staub, Kaspar; Henneberg, Maciej; Galassi, Francesco M; Eppenberger, Patrick; Haeusler, Martin; Morozova, Irina; Rühli, Frank J; Bender, Nicole

2018-01-01

Abstract Background and objectives The body mass index (BMI) is an established anthropometric index for the development of obesity-related conditions. However, little is known about the distribution of BMI within a population, especially about this distribution’s temporal change. Here, we analysed changes in the distribution of height, weight and BMI over the past 140 years based on data of Swiss conscripts and tested for correlations between anthropometric data and standard blood parameters. Methods Height and weight were measured in 59 504 young Swiss males aged 18–19 years during conscription in 1875–79, 1932–36, 1994 and 2010–12. For 65% of conscripts in 2010–12, results of standard blood analysis were available. We calculated descriptive statistics of the distribution of height, weight and BMI over the four time periods and tested for associations between BMI and metabolic parameters. Results Average and median body height, body weight and BMI increased over time. Height did no longer increase between 1994 and 2010–12, while weight and BMI still increased over these two decades. Variability ranges of weight and BMI increased over time, while variation of body height remained constant. Elevated levels of metabolic and inflammatory blood parameters were found at both ends of BMI distribution. Conclusions and implications Both overweight and underweight subgroups showed similar changes in inflammation parameters, pointing toward related metabolic deficiencies in both conditions. In addition to environmental influences, our results indicate a potential role of relaxed natural selection on genes affecting metabolism and body composition.

Body mass index trajectory classes and incident asthma in childhood: results from 8 European Birth Cohorts--a Global Allergy and Asthma European Network initiative.

PubMed

Rzehak, Peter; Wijga, Alet H; Keil, Thomas; Eller, Esben; Bindslev-Jensen, Carsten; Smit, Henriette A; Weyler, Joost; Dom, Sandra; Sunyer, Jordi; Mendez, Michelle; Torrent, Maties; Vall, Oriol; Bauer, Carl-Peter; Berdel, Dietrich; Schaaf, Beate; Chen, Chih-Mei; Bergström, Anna; Fantini, Maria P; Mommers, Monique; Wahn, Ulrich; Lau, Susanne; Heinrich, Joachim

2013-06-01

The causal link between body mass index (BMI) or obesity and asthma in children is still being debated. Analyses of large longitudinal studies with a sufficient number of incident cases and in which the time-dependent processes of both excess weight and asthma development can be validly analyzed are lacking. We sought to investigate whether the course of BMI predicts incident asthma in childhood. Data from 12,050 subjects of 8 European birth cohorts on asthma and allergies were combined. BMI and doctor-diagnosed asthma were modeled during the first 6 years of life with latent growth mixture modeling and discrete time hazard models. Subpopulations of children were identified with similar standardized BMI trajectories according to age- and sex-specific "World Health Organization (WHO) child growth standards" and "WHO growth standards for school aged children and adolescents" for children up to age 5 years and older than 5 years, respectively (BMI-SDS). These types of growth profiles were analyzed as predictors for incident asthma. Children with a rapid BMI-SDS gain in the first 2 years of life had a higher risk for incident asthma up to age 6 years than children with a less pronounced weight gain slope in early childhood. The hazard ratio was 1.3 (95% CI, 1.1-1.5) after adjustment for birth weight, weight-for-length at birth, gestational age, sex, maternal smoking in pregnancy, breast-feeding, and family history of asthma or allergies. A rapid BMI gain at 2 to 6 years of age in addition to rapid gain in the first 2 years of life did not significantly enhance the risk of asthma. Rapid growth in BMI during the first 2 years of life increases the risk of asthma up to age 6 years. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

A Note on Standard Deviation and Standard Error

ERIC Educational Resources Information Center

Hassani, Hossein; Ghodsi, Mansoureh; Howell, Gareth

2010-01-01

Many students confuse the standard deviation and standard error of the mean and are unsure which, if either, to use in presenting data. In this article, we endeavour to address these questions and cover some related ambiguities about these quantities.

Analytical quality goals derived from the total deviation from patients' homeostatic set points, with a margin for analytical errors.

PubMed

Bolann, B J; Asberg, A

2004-01-01

The deviation of test results from patients' homeostatic set points in steady-state conditions may complicate interpretation of the results and the comparison of results with clinical decision limits. In this study the total deviation from the homeostatic set point is defined as the maximum absolute deviation for 95% of measurements, and we present analytical quality requirements that prevent analytical error from increasing this deviation to more than about 12% above the value caused by biology alone. These quality requirements are: 1) The stable systematic error should be approximately 0, and 2) a systematic error that will be detected by the control program with 90% probability, should not be larger than half the value of the combined analytical and intra-individual standard deviation. As a result, when the most common control rules are used, the analytical standard deviation may be up to 0.15 times the intra-individual standard deviation. Analytical improvements beyond these requirements have little impact on the interpretability of measurement results.

Effects of women's body mass index on in vitro fertilization success: a retrospective cohort study.

PubMed

Haghighi, Zahra; Rezaei, Zahra; Es-Haghi Ashtiani, Somayyeh

2012-07-01

The purpose of this study is to evaluate the influence of body mass index (BMI) on the reproductive outcomes and clinical pregnancy rate after in vitro fertilization (IVF). This retrospective study was performed on 230 women undergoing first cycle of standard IVF between October 2008 and February 2010. The patients were classified into three groups according to their BMI (BMI < 20 kg/m², 20 kg/m² < BMI < 27.9 kg/m² and BMI > 28 kg/m²). Information regarding clinical pregnancy was compared within these three groups. There was no significant relation between BMI and age, the number of aspirated follicles, transferred embryos, mature oocytes, days of taking human menopausal gonadotropin (HMG) ampules and the total number of HMG ampules among three BMI studied groups. Statistically significant difference was detected between BMI and endometrial thickness. BMI has no effect on IVF outcomes and clinical pregnancy after IVF. However, losing weight in obese women seems reasonable to prevent possible obstetrics complications.

Effects of parenting style and parent-related weight and diet on adolescent weight status.

PubMed

Alia, Kassandra A; Wilson, Dawn K; St George, Sara M; Schneider, Elizabeth; Kitzman-Ulrich, Heather

2013-04-01

This study examined the interaction between parental limit setting of sedentary behaviors and health factors (weight status, physical activity [PA], fruit and vegetable [FV] intake) on standardized body mass index (zBMI) in African American adolescents. Data were from 67 parent-adolescent dyads. Parental limit setting, PA and FV intake were assessed via self-report, and objective height and weight measurements were collected. Regressions examined the interaction between parental limit setting and BMI, PA, FV intake on adolescent zBMI. The model for parent BMI and FV intake accounted for 31% of the variance in adolescent zBMI. A significant interaction for parent BMI by limit setting showed that as parental BMI increased, higher (vs. lower) limit setting was associated with lower adolescent zBMI. Higher parent FV consumption was associated with lower adolescent zBMI. Future interventions should integrate parent limit setting and target parent fruit and vegetable intake for obesity prevention in underserved adolescents.

14 CFR Appendix C to Part 91 - Operations in the North Atlantic (NAT) Minimum Navigation Performance Specifications (MNPS) Airspace

Code of Federal Regulations, 2010 CFR

2010-01-01

... defined in section 1 of this appendix is as follows: (a) The standard deviation of lateral track errors shall be less than 6.3 NM (11.7 Km). Standard deviation is a statistical measure of data about a mean... standard deviation about the mean encompasses approximately 68 percent of the data and plus or minus 2...

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index.

PubMed

García-Solís, Pablo; Solís-S, Juan Carlos; García-Gaytán, Ana Cristina; Reyes-Mendoza, Vanessa A; Robles-Osorio, Ludivina; Villarreal-Ríos, Enrique; Leal-García, Luisa; Hernández-Montiel, Hebert Luis

2013-08-01

To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

Carbohydrate-lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngioma treatment in children: single institution experience.

PubMed

Kalina, Maria Aleksandra; Wilczek, Marta; Kalina-Faska, Barbara; Skała-Zamorowska, Eliza; Mandera, Marek; Małecka Tendera, Ewa

2015-01-01

To evaluate auxology and metabolic disturbances in children with craniopharyngioma, and to present observational results of treatment of metabolic sequels with metformin and micronized fenofibrate. The studied group comprised 22 children [median age at diagnosis 10.5 (0.17-16.75) years; median follow-up 5.1 years]. Assessment included height standard deviations (SDS), body mass index (BMI) SDS, concentrations of lipids, glucose and insulin (fasting or oral glucose tolerance test) and homeostatic model assessment of insulin resistance (HOMA-IR) index. Ten adolescents with hyperinsulinemia and dyslipidemia received therapy with metformin (500-1500 mg/daily) and micronized fenofibrate (160 mg/daily). At diagnosis, median hSDS was -1.66 (range: -4.08; +0.1). Nine (40.9%) children were growth hormone-treated. There was gradual increase of BMI SDS, 18 (81.8%) patients being overweight at the final assessment. Dyslipidaemia was found in 19 patients (86.4%), hyperinsulinaemia in 11 patients (50%) and elevated HOMA-IR in 15 patients (68.2%). Decrease of triglycerides [median 263.5 (171-362) mg/dL vs. 154 (102-183) mg/dL] and HOMA-IR [8.64 (5.08-12.65) vs. 4.68 (0.7-7.9)] was significant in the group treated with metformin and fenofibrate for 6 months. Significant auxologic changes and metabolic abnormalities were found in children treated for craniopharyngioma. The use of metformin and fenofibrate seemed to attenuate these disturbances in a short-term observation.

Determination of pain intensity risk factors among school children with nonspecific low back pain.

PubMed

Akdag, Beyza; Cavlak, Ugur; Cimbiz, Ali; Camdeviren, Handan

2011-02-01

Low back pain (LBP) is a common disease among people under the age of 20. To the best of our knowledge few studies have been carried out on LBP among school children in Turkey, and none of them studied the correlation between pain intensity and related variables with LBP. This cross-sectional study was carried out to investigate the risk factors and their correlations with pain intensity among 222 school children (106 girls and 116 boys) aged 10-18 years in the city of Denizli. A self-reported questionnaire was used to collect the data. The regression tree method (RTM) was used to determine the risk factors by using the STATISTICA program package. Pain intensity was the outcome variable, and 8 independent variables (body mass index (BMI), sex, regular exercise habit, studying posture, transportation to/from school, duration of studying, bag handling, and type of bed) were used to detect their effect on pain intensity. The results showed that pain intensity is significantly affected by 4 independent variables: duration of studying, type of bed, transportation to/from school, and BMI. The overall mean and standard deviation of pain intensity was 2.58 ± 0.86 (minimum=1, maximum=5). Results from the literature, as well as our study, show that taking parents' and teachers' concerns seriously is of vital importance. Our results indicate that parents and teachers should be informed about duration of studying, type of bed, transportation and obesity as risk factors predicting NLBP in school children.

Maternal postnatal depression and child growth: a European cohort study

PubMed Central

2010-01-01

Background Previous studies have reported postpartum depression to be associated with both positive and negative effects on early infant growth. This study examined the hypothesis that maternal postnatal depression may be a risk factor for later child growth faltering or overweight. Methods A total of 929 women and their children participating in a European multicenter study were included at a median age of 14 days. Mothers completed the Edinburgh postnatal depression scale (EPDS) at 2, 3 and 6 months after delivery. EPDS scores of 13 and above at any time were defined as maternal depression. Weight, length, triceps and subscapular skinfold thicknesses were measured, and body mass index (BMI) were calculated when the children were two years old and converted to standard deviation scores based on the WHO Multicentre Growth Reference Study (MGRS). Results Z-scores for weight-for-length at inclusion of infants of mothers with high EPDS scores (-0.55, SD 0.74) were lower than of those with normal scores (-0.36, SD 0.74; p = 0.013). BMI at age 24 months did not differ in the high (16.3 kg/m2, SD 1.3) and in the normal EPDS groups (16.2 kg/m2, SD 1.3; p = 0.48). All other anthropometric indices also did not differ between groups, with no change by multivariate adjustment. Conclusions We conclude that a high maternal postnatal depression score does not have any major effects on offspring growth in high income countries. PMID:20226021

Nutrient Patterns and Their Association with Socio-Demographic, Lifestyle Factors and Obesity Risk in Rural South African Adolescents

PubMed Central

Pisa, Pedro T.; Pedro, Titilola M.; Kahn, Kathleen; Tollman, Stephen M.; Pettifor, John M.; Norris, Shane A.

2015-01-01

The aim of this study was to identify and describe the diversity of nutrient patterns and how they associate with socio-demographic and lifestyle factors including body mass index in rural black South African adolescents. Nutrient patterns were identified from quantified food frequency questionnaires (QFFQ) in 388 rural South African adolescents between the ages of 11–15 years from the Agincourt Health and Socio-demographic Surveillance System (AHDSS). Principle Component Analysis (PCA) was applied to 25 nutrients derived from QFFQs. Multiple linear regression and partial R2 models were fitted and computed respectively for each of the retained principal component (PC) scores on socio-demographic and lifestyle characteristics including body mass index (BMI) for age Z scores. Four nutrient patterns explaining 79% of the total variance were identified: PCI (26%) was characterized by animal derived nutrients; PC2 (21%) by vitamins, fibre and vegetable oil nutrients; PC3 (19%) by both animal and plant derived nutrients (mixed diet driven nutrients); and PC4 (13%) by starch and folate. A positive and significant association was observed with BMI for age Z scores per 1 standard deviation (SD) increase in PC1 (0.13 (0.02; 0.24); p = 0.02) and PC4 (0.10 (−0.01; 0.21); p = 0.05) scores only. We confirmed variability in nutrient patterns that were significantly associated with various lifestyle factors including obesity. PMID:25984738

Constitutional Delay Influences the Auxological Response to Growth Hormone Treatment in Children with Short Stature and Growth Hormone Sufficiency

PubMed Central

Gunn, Katherine C.; Cutfield, Wayne S.; Hofman, Paul L.; Jefferies, Craig A.; Albert, Benjamin B.; Gunn, Alistair J.

2014-01-01

In a retrospective, population based cohort study, we examined whether constitutional delay was associated with the growth response to growth hormone (GH) in children with short stature and normal GH responses. 70 patients were treated with 21 GH iu/m2/week from 1975 to 2013 throughout New Zealand. Demographic and auxological data were prospectively collected and standard deviation scores (SDS) were calculated for height (HtSDS), yearly growth velocity (GV-SDS), body mass index (BMI-SDS) and predicted adult height (PAH-SDS) at time of the last available bone age. In the first year, GH was associated with marked increase in HtSDS (+0.46 (0.19, 0.76), p < 0.001) and GV-SDS (from −1.9 (−3.6, −0.7) to +2.7 (0.45, 4.2), p < 0.001). The increase in HtSDS but not in GV-SDS was greatest with younger patients and greater bone age delay, with no effect of sex, BMI-SDS or baseline HtSDS. PAH-SDS increased with treatment (+0.94 (0.18, 1.5)); increased PAH-SDS was associated with less bone age delay and greater initial increase in HtSDS. This study shows that greater bone age delay was associated with greater initial improvement in height but less improvement in predicted adult heights, suggesting that children with very delayed bone ages may show accelerated maturation during GH treatment. PMID:25317732

Metabolic syndrome in Turner syndrome and relation between body composition and clinical, genetic, and ultrasonographic characteristics.

PubMed

Calcaterra, Valeria; Brambilla, Paola; Maffè, Gabriella Carnevale; Klersy, Catherine; Albertini, Riccardo; Introzzi, Francesca; Bozzola, Elena; Bozzola, Mauro; Larizza, Daniela

2014-04-01

An increased relative risk of diabetes, ischemic heart disease, atherosclerosis, and hypertension have been reported in Turner syndrome (TS) patients. No data are currently available on the prevalence of metabolic syndrome in TS subjects. We evaluated the frequency of metabolic syndrome in obese and nonobese patients with TS. We evaluated 85 TS patients (27.05 ± 11.17 years). Obesity was defined as standard deviation score body mass index (SDS-BMI) ≥ 2 or BMI ≥ 30 kg/m(2) in adult patients. We classified metabolic syndrome according to the International Diabetes Federation (IDF). Hepatic ultrasound was performed in all girls. The prevalence of metabolic syndrome was 4.7% (12.5% obese and 4.3% nonobese, P=0.16) and associated with visceral adiposity (P=0.008). Abnormalities in glucose metabolism and hypertension were not associated with genetic or therapeutic factors. The karyotype 45,X was associated with atherogenic profile. Pathological waist circumference was more frequent in girls treated with estro-progestin (P=0.03). Evidence of fatty liver was associated with metabolic syndrome (P=0.03) and insulin resistance (P=0.05). Elevated liver enzymes were found in 15 subjects and were not related to treatment or ultrasound abnormalities. Prevalence of each component of metabolic syndrome in TS patients is partially influenced by genetic makeup and treatment. Hepatosteatosis was associated with metabolic syndrome and insulin resistance, but not to elevated liver enzymes.

Personnel's health surveillance at work: effect of age, body mass index, and shift work on mental workload and work ability index.

PubMed

Safari, Shahram; Akbari, Jafar; Kazemi, Meghdad; Mououdi, Mohammad Amin; Mahaki, Behzad

2013-01-01

Two great changes in developed countries are taking place: populations are ageing and becoming increasingly overweight. Combination of these factors with shift work is a risk factor for work ability and mental workload that are dynamic processes which change greatly throughout an individual's work life. The aim of this study was to investigate mental workload and work ability in textile workers and to identify factors which affect work ability and mental workload. This cross-sectional study was carried out among 194 male workers in textile industry. Employees based on their job group and work conditions have been divided into 6 categories. They completed work ability index and mental workload questionnaires during three work shifts. Body mass index (BMI) and demographic details were recorded. All of the participants rated their work ability as moderate with high mental workload. The mean WAI and mental workload in age group were significant. The mean BMI was 25.5 kg/m(2) (standard deviation 4.1) and the mean age was 40.22 years. There was a statistically significant correlation between work ability index and shift work. Unlike the previous study, a decrease point in WAI started in early age that may be due to life-style work and another psychological factor; on the other hand, NASA-TLX revealed high score in six subscales that can be another reason for low WAI.

Constitutional delay influences the auxological response to growth hormone treatment in children with short stature and growth hormone sufficiency.

PubMed

Gunn, Katherine C; Cutfield, Wayne S; Hofman, Paul L; Jefferies, Craig A; Albert, Benjamin B; Gunn, Alistair J

2014-08-14

In a retrospective, population based cohort study, we examined whether constitutional delay was associated with the growth response to growth hormone (GH) in children with short stature and normal GH responses. 70 patients were treated with 21 GH iu/m2/week from 1975 to 2013 throughout New Zealand. Demographic and auxological data were prospectively collected and standard deviation scores (SDS) were calculated for height (HtSDS), yearly growth velocity (GV-SDS), body mass index (BMI-SDS) and predicted adult height (PAH-SDS) at time of the last available bone age. In the first year, GH was associated with marked increase in HtSDS (+0.46 (0.19, 0.76), p < 0.001) and GV-SDS (from -1.9 (-3.6, -0.7) to +2.7 (0.45, 4.2), p < 0.001). The increase in HtSDS but not in GV-SDS was greatest with younger patients and greater bone age delay, with no effect of sex, BMI-SDS or baseline HtSDS. PAH-SDS increased with treatment (+0.94 (0.18, 1.5)); increased PAH-SDS was associated with less bone age delay and greater initial increase in HtSDS. This study shows that greater bone age delay was associated with greater initial improvement in height but less improvement in predicted adult heights, suggesting that children with very delayed bone ages may show accelerated maturation during GH treatment.

Personnel's Health Surveillance at Work: Effect of Age, Body Mass Index, and Shift Work on Mental Workload and Work Ability Index

PubMed Central

Safari, Shahram; Akbari, Jafar; Kazemi, Meghdad; Mououdi, Mohammad Amin; Mahaki, Behzad

2013-01-01

Introduction. Two great changes in developed countries are taking place: populations are ageing and becoming increasingly overweight. Combination of these factors with shift work is a risk factor for work ability and mental workload that are dynamic processes which change greatly throughout an individual's work life. The aim of this study was to investigate mental workload and work ability in textile workers and to identify factors which affect work ability and mental workload. Methods. This cross-sectional study was carried out among 194 male workers in textile industry. Employees based on their job group and work conditions have been divided into 6 categories. They completed work ability index and mental workload questionnaires during three work shifts. Body mass index (BMI) and demographic details were recorded. Results. All of the participants rated their work ability as moderate with high mental workload. The mean WAI and mental workload in age group were significant. The mean BMI was 25.5 kg/m2 (standard deviation 4.1) and the mean age was 40.22 years. There was a statistically significant correlation between work ability index and shift work. Conclusions. Unlike the previous study, a decrease point in WAI started in early age that may be due to life-style work and another psychological factor; on the other hand, NASA-TLX revealed high score in six subscales that can be another reason for low WAI. PMID:23956756

Repeatable source, site, and path effects on the standard deviation for empirical ground-motion prediction models

USGS Publications Warehouse

Lin, P.-S.; Chiou, B.; Abrahamson, N.; Walling, M.; Lee, C.-T.; Cheng, C.-T.

2011-01-01

In this study, we quantify the reduction in the standard deviation for empirical ground-motion prediction models by removing ergodic assumption.We partition the modeling error (residual) into five components, three of which represent the repeatable source-location-specific, site-specific, and path-specific deviations from the population mean. A variance estimation procedure of these error components is developed for use with a set of recordings from earthquakes not heavily clustered in space.With most source locations and propagation paths sampled only once, we opt to exploit the spatial correlation of residuals to estimate the variances associated with the path-specific and the source-location-specific deviations. The estimation procedure is applied to ground-motion amplitudes from 64 shallow earthquakes in Taiwan recorded at 285 sites with at least 10 recordings per site. The estimated variance components are used to quantify the reduction in aleatory variability that can be used in hazard analysis for a single site and for a single path. For peak ground acceleration and spectral accelerations at periods of 0.1, 0.3, 0.5, 1.0, and 3.0 s, we find that the singlesite standard deviations are 9%-14% smaller than the total standard deviation, whereas the single-path standard deviations are 39%-47% smaller.

A better norm-referenced grading using the standard deviation criterion.

PubMed

Chan, Wing-shing

2014-01-01

The commonly used norm-referenced grading assigns grades to rank-ordered students in fixed percentiles. It has the disadvantage of ignoring the actual distance of scores among students. A simple norm-referenced grading via standard deviation is suggested for routine educational grading. The number of standard deviation of a student's score from the class mean was used as the common yardstick to measure achievement level. Cumulative probability of a normal distribution was referenced to help decide the amount of students included within a grade. RESULTS of the foremost 12 students from a medical examination were used for illustrating this grading method. Grading by standard deviation seemed to produce better cutoffs in allocating an appropriate grade to students more according to their differential achievements and had less chance in creating arbitrary cutoffs in between two similarly scored students than grading by fixed percentile. Grading by standard deviation has more advantages and is more flexible than grading by fixed percentile for norm-referenced grading.

Personal Background Preparation Survey for early identification of nursing students at risk for attrition.

PubMed

Johnson, Craig W; Johnson, Ronald; Kim, Mira; McKee, John C

2009-11-01

During 2004 and 2005 orientations, all 187 and 188 new matriculates, respectively, in two southwestern U.S. nursing schools completed Personal Background and Preparation Surveys (PBPS) in the first predictive validity study of a diagnostic and prescriptive instrument for averting adverse academic status events (AASE) among nursing or health science professional students. One standard deviation increases in PBPS risks (p < 0.05) multiplied odds of first-year or second-year AASE by approximately 150%, controlling for school affiliation and underrepresented minority student (URMS) status. AASE odds one standard deviation above mean were 216% to 250% those one standard deviation below mean. Odds of first-year or second-year AASE for URMS one standard deviation above the 2004 PBPS mean were 587% those for non-URMS one standard deviation below mean. The PBPS consistently and significantly facilitated early identification of nursing students at risk for AASE, enabling proactive targeting of interventions for risk amelioration and AASE or attrition prevention. Copyright 2009, SLACK Incorporated.

Impact of BMI on clinical outcomes of NOAC therapy in daily care - Results of the prospective Dresden NOAC Registry (NCT01588119).

PubMed

Tittl, L; Endig, S; Marten, S; Reitter, A; Beyer-Westendorf, I; Beyer-Westendorf, J

2018-07-01

Direct acting non-Vitamin K antagonist oral anticoagulants (NOAC) are characterized by a fixed dosing regimen. Despite the potential for relative underdosing due to large distribution volumes, dose adjustments for patients with high body mass index (BMI) are not recommended. Since efficacy and safety data in obese patients are scarce, we evaluated the impact of BMI on clinical outcomes in daily care patients treated with NOAC for stroke prevention in atrial fibrillation or venous thromboembolism. Using prospectively collected data from a non-interventional registry, cardiovascular (CV), major bleeding events (MB) and all-cause mortality were evaluated according to BMI classes. All outcome events were centrally adjudicated using standard scientific definitions. Between November 1st 2011 and December 31st 2016, 3432 patients were enrolled into the registry (61.3% rivaroxaban; 20% apixaban; 10.1% dabigatran, 8.6% edoxaban; mean follow-up 998.1 ± 542.9 days; median 1004 days). With increasing BMI (range 13.7-57.2 kg/m 2 ), the proportion of patients receiving standard (vs. reduced) NOAC dose increased from 64.7% (underweight) to 78.9% (obesity). Although obese patients had more cardiovascular risk factors compared to normal weight patients, on-treatment rates of clinical outcomes (CV, MB, all-cause-mortality) were lowest in overweight and obese patients. In a large set of real-life NOAC recipients we found no indication that high BMI is associated with inferior NOAC effectiveness or safety, which is in line with recent epidemiological data of a "BMI paradox" that indicates a somewhat protective effect of higher BMI regarding unfavourable outcomes also in patients receiving fixed dose NOAC anticoagulation without dose adjustment for higher BMI. Copyright © 2018 Elsevier B.V. All rights reserved.

Demonstration of the Gore Module for Passive Ground Water Sampling

DTIC Science & Technology

2014-06-01

ix ACRONYMS AND ABBREVIATIONS % RSD percent relative standard deviation 12DCA 1,2-dichloroethane 112TCA 1,1,2-trichloroethane 1122TetCA...Analysis of Variance ROD Record of Decision RSD relative standard deviation SBR Southern Bush River SVOC semi-volatile organic compound...replicate samples had a relative standard deviation ( RSD ) that was 20% or less. For the remaining analytes (PCE, cDCE, and chloroform), at least 70

Impact of baseline systolic blood pressure on visit-to-visit blood pressure variability: the Kailuan study.

PubMed

Wang, Anxin; Li, Zhifang; Yang, Yuling; Chen, Guojuan; Wang, Chunxue; Wu, Yuntao; Ruan, Chunyu; Liu, Yan; Wang, Yilong; Wu, Shouling

2016-01-01

To investigate the relationship between baseline systolic blood pressure (SBP) and visit-to-visit blood pressure variability in a general population. This is a prospective longitudinal cohort study on cardiovascular risk factors and cardiovascular or cerebrovascular events. Study participants attended a face-to-face interview every 2 years. Blood pressure variability was defined using the standard deviation and coefficient of variation of all SBP values at baseline and follow-up visits. The coefficient of variation is the ratio of the standard deviation to the mean SBP. We used multivariate linear regression models to test the relationships between SBP and standard deviation, and between SBP and coefficient of variation. Approximately 43,360 participants (mean age: 48.2±11.5 years) were selected. In multivariate analysis, after adjustment for potential confounders, baseline SBPs <120 mmHg were inversely related to standard deviation (P<0.001) and coefficient of variation (P<0.001). In contrast, baseline SBPs ≥140 mmHg were significantly positively associated with standard deviation (P<0.001) and coefficient of variation (P<0.001). Baseline SBPs of 120-140 mmHg were associated with the lowest standard deviation and coefficient of variation. The associations between baseline SBP and standard deviation, and between SBP and coefficient of variation during follow-ups showed a U curve. Both lower and higher baseline SBPs were associated with increased blood pressure variability. To control blood pressure variability, a good target SBP range for a general population might be 120-139 mmHg.

Flexner 3.0-Democratization of Medical Knowledge for the 21st Century: Teaching Medical Science Using K-12 General Pathology as a Gateway Course.

PubMed

Weinstein, Ronald S; Krupinski, Elizabeth A; Weinstein, John B; Graham, Anna R; Barker, Gail P; Erps, Kristine A; Holtrust, Angelette L; Holcomb, Michael J

2016-01-01

A medical school general pathology course has been reformatted into a K-12 general pathology course. This new course has been implemented at a series of 7 to 12 grade levels and the student outcomes compared. Typically, topics covered mirrored those in a medical school general pathology course serving as an introduction to the mechanisms of diseases. Assessment of student performance was based on their score on a multiple-choice final examination modeled after an examination given to medical students. Two Tucson area schools, in a charter school network, participated in the study. Statistical analysis of examination performances showed that there were no significant differences as a function of school ( F = 0.258, P = .6128), with students at school A having an average test scores of 87.03 (standard deviation = 8.99) and school B 86.00 (standard deviation = 8.18; F = 0.258, P = .6128). Analysis of variance was also conducted on the test scores as a function of gender and class grade. There were no significant differences as a function of gender ( F = 0.608, P = .4382), with females having an average score of 87.18 (standard deviation = 7.24) and males 85.61 (standard deviation = 9.85). There were also no significant differences as a function of grade level ( F = 0.627, P = .6003), with 7th graders having an average of 85.10 (standard deviation = 8.90), 8th graders 86.00 (standard deviation = 9.95), 9th graders 89.67 (standard deviation = 5.52), and 12th graders 86.90 (standard deviation = 7.52). The results demonstrated that middle and upper school students performed equally well in K-12 general pathology. Student course evaluations showed that the course met the student's expectations. One class voted K-12 general pathology their "elective course-of-the-year."

Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range.

PubMed

Wan, Xiang; Wang, Wenqian; Liu, Jiming; Tong, Tiejun

2014-12-19

In systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials. A number of the trials, however, reported the study using the median, the minimum and maximum values, and/or the first and third quartiles. Hence, in order to combine results, one may have to estimate the sample mean and standard deviation for such trials. In this paper, we propose to improve the existing literature in several directions. First, we show that the sample standard deviation estimation in Hozo et al.'s method (BMC Med Res Methodol 5:13, 2005) has some serious limitations and is always less satisfactory in practice. Inspired by this, we propose a new estimation method by incorporating the sample size. Second, we systematically study the sample mean and standard deviation estimation problem under several other interesting settings where the interquartile range is also available for the trials. We demonstrate the performance of the proposed methods through simulation studies for the three frequently encountered scenarios, respectively. For the first two scenarios, our method greatly improves existing methods and provides a nearly unbiased estimate of the true sample standard deviation for normal data and a slightly biased estimate for skewed data. For the third scenario, our method still performs very well for both normal data and skewed data. Furthermore, we compare the estimators of the sample mean and standard deviation under all three scenarios and present some suggestions on which scenario is preferred in real-world applications. In this paper, we discuss different approximation methods in the estimation of the sample mean and standard deviation and propose some new estimation methods to improve the existing literature. We conclude our work with a summary table (an Excel spread sheet including all formulas) that serves as a comprehensive guidance for performing meta-analysis in different situations.

Flexner 3.0—Democratization of Medical Knowledge for the 21st Century

PubMed Central

Krupinski, Elizabeth A.; Weinstein, John B.; Graham, Anna R.; Barker, Gail P.; Erps, Kristine A.; Holtrust, Angelette L.; Holcomb, Michael J.

2016-01-01

A medical school general pathology course has been reformatted into a K-12 general pathology course. This new course has been implemented at a series of 7 to 12 grade levels and the student outcomes compared. Typically, topics covered mirrored those in a medical school general pathology course serving as an introduction to the mechanisms of diseases. Assessment of student performance was based on their score on a multiple-choice final examination modeled after an examination given to medical students. Two Tucson area schools, in a charter school network, participated in the study. Statistical analysis of examination performances showed that there were no significant differences as a function of school (F = 0.258, P = .6128), with students at school A having an average test scores of 87.03 (standard deviation = 8.99) and school B 86.00 (standard deviation = 8.18; F = 0.258, P = .6128). Analysis of variance was also conducted on the test scores as a function of gender and class grade. There were no significant differences as a function of gender (F = 0.608, P = .4382), with females having an average score of 87.18 (standard deviation = 7.24) and males 85.61 (standard deviation = 9.85). There were also no significant differences as a function of grade level (F = 0.627, P = .6003), with 7th graders having an average of 85.10 (standard deviation = 8.90), 8th graders 86.00 (standard deviation = 9.95), 9th graders 89.67 (standard deviation = 5.52), and 12th graders 86.90 (standard deviation = 7.52). The results demonstrated that middle and upper school students performed equally well in K-12 general pathology. Student course evaluations showed that the course met the student’s expectations. One class voted K-12 general pathology their “elective course-of-the-year.” PMID:28725762

Estimation of the neural drive to the muscle from surface electromyograms

NASA Astrophysics Data System (ADS)

Hofmann, David

Muscle force is highly correlated with the standard deviation of the surface electromyogram (sEMG) produced by the active muscle. Correctly estimating this quantity of non-stationary sEMG and understanding its relation to neural drive and muscle force is of paramount importance. The single constituents of the sEMG are called motor unit action potentials whose biphasic amplitude can interfere (named amplitude cancellation), potentially affecting the standard deviation (Keenan etal. 2005). However, when certain conditions are met the Campbell-Hardy theorem suggests that amplitude cancellation does not affect the standard deviation. By simulation of the sEMG, we verify the applicability of this theorem to myoelectric signals and investigate deviations from its conditions to obtain a more realistic setting. We find no difference in estimated standard deviation with and without interference, standing in stark contrast to previous results (Keenan etal. 2008, Farina etal. 2010). Furthermore, since the theorem provides us with the functional relationship between standard deviation and neural drive we conclude that complex methods based on high density electrode arrays and blind source separation might not bear substantial advantages for neural drive estimation (Farina and Holobar 2016). Funded by NIH Grant Number 1 R01 EB022872 and NSF Grant Number 1208126.

Calculate Your Body Mass Index

MedlinePlus

... Professional Resources Calculate Your Body Mass Index Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women. Enter your weight and height using standard or metric measures. Select "Compute BMI" and your ...

Comparison of a novel fixation device with standard suturing methods for spinal cord stimulators.

PubMed

Bowman, Richard G; Caraway, David; Bentley, Ishmael

2013-01-01

Spinal cord stimulation is a well-established treatment for chronic neuropathic pain of the trunk or limbs. Currently, the standard method of fixation is to affix the leads of the neuromodulation device to soft tissue, fascia or ligament, through the use of manually tying general suture. A novel semiautomated device is proposed that may be advantageous to the current standard. Comparison testing in an excised caprine spine and simulated bench top model was performed. Three tests were performed: 1) perpendicular pull from fascia of caprine spine; 2) axial pull from fascia of caprine spine; and 3) axial pull from Mylar film. Six samples of each configuration were tested for each scenario. Standard 2-0 Ethibond was compared with a novel semiautomated device (Anulex fiXate). Upon completion of testing statistical analysis was performed for each scenario. For perpendicular pull in the caprine spine, the failure load for standard suture was 8.95 lbs with a standard deviation of 1.39 whereas for fiXate the load was 15.93 lbs with a standard deviation of 2.09. For axial pull in the caprine spine, the failure load for standard suture was 6.79 lbs with a standard deviation of 1.55 whereas for fiXate the load was 12.31 lbs with a standard deviation of 4.26. For axial pull in Mylar film, the failure load for standard suture was 10.87 lbs with a standard deviation of 1.56 whereas for fiXate the load was 19.54 lbs with a standard deviation of 2.24. These data suggest a novel semiautomated device offers a method of fixation that may be utilized in lieu of standard suturing methods as a means of securing neuromodulation devices. Data suggest the novel semiautomated device in fact may provide a more secure fixation than standard suturing methods. © 2012 International Neuromodulation Society.

Explaining the Positive Relationship between Fourth-Grade Children’s Body Mass Index and Energy Intake at School-Provided Meals (Breakfast and Lunch)

PubMed Central

Baxter, Suzanne Domel; Royer, Julie A.; Hitchcock, David B.

2013-01-01

BACKGROUND A positive relationship exists between children’s body mass index (BMI) and energy intake at school-provided meals. To help explain this relationship, we investigated 7 outcome variables concerning aspects of school-provided meals—energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. METHODS We observed children in grade 4 (N=465) eating school-provided breakfast and lunch on one to 4 days per child. We measured children’s weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). RESULTS BMI was positively related to amounts eaten of standardized school-meal portions (p < .0001) and increased 8.45 kg/m2 per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m2 for every 100-kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m2 for every 100-kcal received. BMI was not significantly related to 4 outcome variables. CONCLUSIONS Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions. PMID:23517000

Using appropriate body mass index cut points for overweight and obesity among Asian Americans

PubMed Central

Jih, Jane; Mukherjea, Arnab; Vittinghoff, Eric; Nguyen, Tung T.; Tsoh, Janice Y.; Fukuoka, Yoshimi; Bender, Melinda S.; Tseng, Winston; Kanaya, Alka M.

2014-01-01

Objective Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California. Method Secondary analysis of the 2009 adult California Health Interview Survey (n = 45,946) of non-Hispanic Whites (NHW), African Americans, Hispanics and Asians (Vietnamese, Chinese, Korean, Filipino, South Asian and Japanese). WHO Asian BMI cut points (overweight = 23–27.5 kg/m2; obese ≥ 27.5 kg/m2) were used for Asian subgroups. Standard BMI cut points (overweight = 25–29.9 kg/m2; obese ≥ 30 kg/m2) were applied for other groups. Results Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p < 0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI = 23–24.9 kg/m2 and Koreans, Filipinos and Japanese with BMI = 27.5–29.9 kg/m2, the ranges WHO recommends as overweight or obese for Asians but not for other groups. Conclusions Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans. PMID:24736092

Using appropriate body mass index cut points for overweight and obesity among Asian Americans.

PubMed

Jih, Jane; Mukherjea, Arnab; Vittinghoff, Eric; Nguyen, Tung T; Tsoh, Janice Y; Fukuoka, Yoshimi; Bender, Melinda S; Tseng, Winston; Kanaya, Alka M

2014-08-01

Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California. Secondary analysis of the 2009 adult California Health Interview Survey (n=45,946) of non-Hispanic Whites (NHW), African Americans, Hispanics and Asians (Vietnamese, Chinese, Korean, Filipino, South Asian and Japanese). WHO Asian BMI cut points (overweight=23-27.5kg/m(2); obese≥27.5kg/m(2)) were used for Asian subgroups. Standard BMI cut points (overweight=25-29.9kg/m(2); obese≥30kg/m(2)) were applied for other groups. Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p<0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI=23-24.9kg/m(2) and Koreans, Filipinos and Japanese with BMI=27.5-29.9kg/m(2), the ranges WHO recommends as overweight or obese for Asians but not for other groups. Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans. Copyright © 2014 Elsevier Inc. All rights reserved.

Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial.

PubMed

Melville, Craig A; Mitchell, Fiona; Stalker, Kirsten; Matthews, Lynsay; McConnachie, Alex; Murray, Heather M; Melling, Chris; Mutrie, Nanette

2015-09-29

Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. One hundred two participants in 50 clusters were randomised. 82 (80.4%) participants completed the primary outcome. 66.7% of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5% (standard deviation 10.9) of time sedentary and 59% percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95% confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6% (95% CI -2.984 to 6.102), percentage time in MVPA 0.3% (95% CI -0.7 to 1.3), BMI -0.2 kg/m(2) (95% CI -0.8 to 0.4) or subjective well-being 0.3 (95% CI -0.9 to 1.5). This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach. Current Controlled Trials ISRCTN50494254.

Identification of Patients With Diabetes Who Benefit Most From a Health Coaching Program in Chronic Disease Management, Sydney, Australia, 2013.

PubMed

Delaney, Grace; Newlyn, Neroli; Pamplona, Elline; Hocking, Samantha L; Glastras, Sarah J; McGrath, Rachel T; Fulcher, Gregory R

2017-03-02

Chronic disease management programs (CDMPs) that include health coaching can facilitate and coordinate diabetes management. The aim of this study was to assess changes in patients' general knowledge of diabetes, self-reported health status, diabetes distress, body mass index (BMI), and glycemic control after enrollment in a face-to-face CDMP group health coaching session (with telephone follow-up) compared with participation in telephone-only health coaching, during a 12-month period. Patients with diabetes were enrolled in a health coaching program at Royal North Shore Hospital, Sydney, Australia, in 2013. Questionnaires were administered at baseline and at 3, 6, and 12 months, and the results were compared with baseline. Glycemic control, measured with glycated hemoglobin A 1c (HbA 1c ) and BMI, were measured at baseline and 12 months. Overall, 238 patients attended a face-to-face CDMP session with telephone follow-up (n = 178) or participated in telephone-only health coaching (n = 60). We found no change in BMI in either group; however, HbA 1c levels in patients with baseline above the current recommended target (>7%) decreased significantly from 8.5% (standard deviation [SD], 1.0%) to 7.9% (SD, 1.0%) (P = .03). Patients with the lowest self-reported health status at baseline improved from 4.4 (SD, 0.5) to 3.7 (SD, 0.9) (P = .001). Diabetes knowledge improved in all patients (24.4 [SD, 2.4] to 25.2 [SD, 2.4]; P < .001), and diabetes distress decreased among those with the highest levels of distress at baseline (3.0 [SD, 0.4] vs 3.8 [SD, 0.6]; P = .003). Diabetes health coaching programs can improve glycemic control and reduce diabetes distress in patients with high levels of these at baseline.

Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents.

PubMed

Rothermel, Juliane; Lass, Nina; Bosse, Christina; Reinehr, Thomas

2017-07-26

While the main role of growth hormone (GH) replacement therapy in children is to promote linear growth, GH has also an effect on lipids and body composition. There is an ongoing discussion whether discontinuation of GH treatment is associated with deterioration of lipids. We analyzed weight status [as body mass index-standard deviation score (BMI-SDS)], insulin like growth factor (IGF)-1, triglycerides, total, low-density liporptoein (LDL)- and high-density lipoprotein (HDL)-cholesterol at the end of GH treatment and in mean 6 months later in 90 adolescents (53 with GH deficiency, 16 with Turner syndrome [TS] and 21 born small-for-gestational age [SGA]). After stopping GH treatment, total cholesterol (+10±24 mg/dL vs. -4±13 mg/dL) and LDL-cholesterol (+15±20 mg/dL vs. -6±12 mg/dL) increased significantly higher in severe (defined by GH peak in stimulation test <3 ng/mL) compared to moderate GHD. In patients with TS, total cholesterol (+19±9 mg/dL), LDL-cholesterol (+9±12 mg/dL) and HDL-cholesterol (+4.3±3.5 mg/dL) increased significantly. In adolescents born SGA, triglycerides increased (+34±51 mg/dL) and HDL-cholesterol decreased significantly (-3.8±7.1 mg/dL). In multiple linear regression analyses, changes of total and LDL-cholesterol were significantly negatively related to peak GH in stimulation tests, but not to gender, age at GH start, duration of GH treatment, observation time, changes of BMI-SDS or IGF-1 after the end of GH treatment. The BMI-SDS did not change after the end of GH treatment. Discontinuation of GH treatment leads to a deterioration of lipids in TS, SGA and severe but not moderate GHD.

Diffusion tensor imaging of the human calf: Variation of inter- and intramuscle-specific diffusion parameters.

PubMed

Schlaffke, Lara; Rehmann, Robert; Froeling, Martijn; Kley, Rudolf; Tegenthoff, Martin; Vorgerd, Matthias; Schmidt-Wilcke, Tobias

2017-10-01

To investigate to what extent inter- and intramuscular variations of diffusion parameters of human calf muscles can be explained by age, gender, muscle location, and body mass index (BMI) in a specific age group (20-35 years). Whole calf muscles of 18 healthy volunteers were evaluated. Magnetic resonance imaging (MRI) was performed using a 3T scanner and a 16-channel Torso XL coil. Diffusion-weighted images were acquired to perform fiber tractography and diffusion tensor imaging (DTI) analysis for each muscle of both legs. Fiber tractography was used to separate seven lower leg muscles. Associations between DTI parameters and confounds were evaluated. All muscles were additionally separated in seven identical segments along the z-axis to evaluate intramuscular differences in diffusion parameters. Fractional anisotropy (FA) and mean diffusivity (MD) were obtained for each muscle with low standard deviations (SDs) (SD FA : 0.01-0.02; SD MD : 0.07-0.14(10 -3 )). We found significant differences in FA values of the tibialis anterior muscle (AT) and extensor digitorum longus (EDL) muscles between men and women for whole muscle FA (two-sample t-tests; AT: P = 0.0014; EDL: P = 0.0004). We showed significant intramuscular differences in diffusion parameters between adjacent segments in most calf muscles (P < 0.001). Whereas muscle insertions showed higher (SD 0.03-0.06) than muscle bellies (SD 0.01-0.03), no relationships between FA or MD with age or BMI were found. Inter- and intramuscular variations in diffusion parameters of the calf were shown, which are not related to age or BMI in this age group. Differences between muscle belly and insertion should be considered when interpreting datasets not including whole muscles. 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1137-1148. © 2017 International Society for Magnetic Resonance in Medicine.

Fast food, fruits and vegetables' prices’ association with dietary intakes among US adults: Is there modification by family income?

PubMed Central

Beydoun, May A.; Powell, Lisa; Wang, Youfa

2016-01-01

We examined effects of prices of fast foods (FF) and fruits and vegetables (FV) on dietary intake, body mass index (BMI) and obesity risks and whether the associations varied across groups according to their family income. Data from the US Department of Agriculture Continuing Survey of Food Intakes by Individuals (CSFII, 1994–96) for 7,331 individuals aged 20–65 years with complete data on two 24-hr recalls were used. We computed two food price indices (FFPI and FVPI) which were linked to individuals through geocoded identifiers. Main outcomes included dietary intakes of energy, selected nutrients and food groups, fast food consumption, and diet quality measured using two indices (HEI and aMED), BMI and obesity. Interaction terms between key variables were tested in regression analyses and in further stratified analysis by family income. Higher fast food prices (FFPI) were associated with higher, fiber intake, low saturated fat, and better overall diet quality as measured by aMED. FVPI was positively associated with improved dietary quality as well in terms of lower cholesterol and sodium intakes, improved HEI and lower BMI. Most of these associations showed homogeneous strengths across income groups as evidenced by a non-significant FFPI*PIR or FVPI*PIR interaction term (p<0.10). While increasing FFPI by one standard deviation was only borderline protective against FF consumption (OR=0.89; 95% CI: 0.78, 1.02), its association with other binary outcomes that were considered was non-significant. In contrast, FVPI was protective against obesity, particularly among the near poor. It was also associated with improved aMED score (OR: 2.22; 95% CI: 1.22, 4.03). Analyses of these national data suggest that changing fast food and fruit and vegetable prices may affect people’s dietary quality and to some extent their adiposity, although the present study is limited by the available food price data. PMID:18313824

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.

PubMed

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years ( P <0.001), body mass index (BMI) <23.5 ( P =0.007), Mini-Mental State Examination <20 ( P =0.004), Barthel Index <65 ( P =0.002), hemoglobin <7.69 mmol/L ( P =0.017), serum protein <70 g/L ( P =0.008), albumin <32 g/L ( P =0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P <0.001), history of falls (OR =2.55; 95% CI =1.05-6.19; P =0.039), age (OR =1.14; 95% CI =1.05-1.23; P =0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P =0.034). Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

Gestational weight gain and obesity, adiposity and body size in African-American and Dominican children in the Bronx and Northern Manhattan.

PubMed

Widen, Elizabeth M; Whyatt, Robin M; Hoepner, Lori A; Mueller, Noel T; Ramirez-Carvey, Judyth; Oberfield, Sharon E; Hassoun, Abeer; Perera, Frederica P; Gallagher, Dympna; Rundle, Andrew G

2016-10-01

Gestational weight gain (GWG) is potentially modifiable and is associated with infant size and body composition; however, long-term effects on childhood obesity have not been reported among multi-ethnic urban populations. We examined the association between GWG and child anthropometric measures and body composition at 7 years [waist circumference (WC), body mass index z-score (BMIZ), obesity (BMIZ ≥95%ile) and bioelectrical impedance analysis estimates of percentage body fat (%fat)] in African-American and Dominican dyads (n = 323) in the Columbia Center for Children's Environmental Health prospective birth cohort study from 1998 to 2013. Linear and logistic regression evaluated associations between excessive GWG [>Institute of Medicine (IOM) 2009 guidelines] and outcomes, adjusting for pre-pregnancy BMI and covariates. Pre-pregnancy BMI (mean ± standard deviation, all such values) and total GWG were 25.8 ± 6.2 kg m(-2) (45% overweight/obese) and 16.4 ± 7.9 kg (64% > IOM guidelines), respectively. Excessive GWG was associated with higher BMIZ {0.44 [95% confidence interval (CI): 0.2, 0.7], P < 0.001}, WC [β: 2.9 cm (95% CI: 1.1, 4.6), P = 0.002], %fat at 7 years [β: 2.2% (95% CI: 1.0, 3.5), P = 0.001)] and obesity [odds ratio: 2.93 (95% CI: 1.5, 5.8), P = 0.002]. Pre-pregnancy BMI was positively associated with child size, adiposity and obesity (all P < 0.05). Excessive GWG was highly prevalent and was associated with child obesity, greater percentage body fat and abdominal adiposity. Strategies to support healthy GWG are warranted to promote healthy growth and prevent childhood obesity. © 2015 John Wiley & Sons Ltd.

Polycystic ovary syndrome: clinical presentation in normal-weight compared with overweight adolescents.

PubMed

McManus, Shilpa S; Levitsky, Lynne L; Misra, Madhusmita

2013-01-01

To characterize polycystic ovary syndrome (PCOS) in adolescents and determine whether a distinct clinical presentation differentiates normal-weight (NW) from overweight (OW) PCOS. Retrospective chart review of patients seen in a tertiary care center from 1998-2008 who met the National Institutes of Health and/or Rotterdam criteria for PCOS (N = 211; NW = 43, OW = 168). We collected data on clinical features, biochemical markers, and ultrasound findings. Patient age ranged from 11.3 to 20.3 years (mean, 15.7 ± 1.7 years), and body mass index (BMI) from 17.4 to 64.2 kg/m2 (mean, 31.7 ± 7.7 kg/m2). Seventy-one percent of patients were Caucasian, 85% had irregular menses, 69% reported hirsutism, 18% had moderate to severe acne, 91% had a high free androgen index (FAI), and 8% had abnormal thyroid-stimulating hormone (TSH) levels. The BMI-standard deviation (SD) score was 0.1 ± 0.5 in NW and 3.4 ± 1.8 in OW girls. NW girls were older at diagnosis (16.4 ± 1.4 years vs. 15.5 ± 1.7 years; P = .0006) than OW girls, less likely to have a family history of obesity (22% vs. 65%; P<.0001), and less likely to have acanthosis nigricans (11% vs. 68%; P<.0001). NW girls were more likely to have polycystic ovaries on ultrasound (88% vs. 52%; P = .01) and a lower FAI (7.3 ± 4.5 vs. 17.4 ± 12.9; P<.0001). The BMI-SD score was negatively associated with sex hormone binding globulin (r(s) = -0.52; P<.0001) and positively associated with FAI (r(s) = 0.42; P<.0001). NW girls are more likely to be older at diagnosis and have polycystic ovaries. Other differences in presentation between groups were attributable to differences in weight. NW PCOS is likely part of a continuous spectrum of clinical PCOS rather than a distinct entity.

Multidisciplinary care of obese children and adolescents for one year reduces ectopic fat content in liver and skeletal muscle.

PubMed

Fonvig, Cilius Esmann; Chabanova, Elizaveta; Ohrt, Johanne Dam; Nielsen, Louise Aas; Pedersen, Oluf; Hansen, Torben; Thomsen, Henrik S; Holm, Jens-Christian

2015-12-30

Ectopic fat deposition in liver and skeletal muscle tissue is related to cardiovascular disease risk and is a common metabolic complication in obese children. We evaluated the hypotheses of ectopic fat in these organs could be diminished following 1 year of multidisciplinary care specialized in childhood obesity, and whether this reduction would associate with changes in other markers of metabolic function. This observational longitudinal study evaluated 40 overweight children and adolescents enrolled in a multidisciplinary treatment protocol at the Children's Obesity Clinic, Holbæk, Denmark. The participants were assessed by anthropometry, fasting blood samples (HbA1c, glucose, insulin, lipids, and biochemical variables of liver function), and liver and muscle fat content assessed by magnetic resonance spectroscopy at enrollment and following an average of 12.2 months of care. Univariate linear regression models adjusted for age, sex, treatment duration, baseline degree of obesity, and pubertal developmental stage were used for investigating possible associations. The standard deviation score (SDS) of baseline median body mass index (BMI) was 2.80 (range: 1.49-3.85) and the median age was 14 years (10-17). At the end of the observational period, the 40 children and adolescents (21 girls) significantly decreased their BMI SDS, liver fat, muscle fat, and visceral adipose tissue volume. The prevalence of hepatic steatosis changed from 28 to 20 % (p = 0.26) and the prevalence of muscular steatosis decreased from 75 to 45 % (p = 0.007). Changes in liver and muscle fat were independent of changes in BMI SDS, baseline degree of obesity, duration of treatment, age, sex, and pubertal developmental stage. A 1-year multidisciplinary intervention program in the setting of a childhood obesity outpatient clinic confers a biologically important reduction in liver and muscle fat; metabolic improvements that are independent of the magnitude of concurrent weight loss. ClinicalTrials.gov registration number: NCT00928473 , the Danish Childhood Obesity Biobank. Registered June 25, 2009.

Y2 receptor gene variants reduce the risk of hypertension in obese children and adolescents.

PubMed

Santoro, Nicola; Del Giudice, Emanuele Miraglia; Grandone, Anna; Marzuillo, Pierluigi; Cozzolino, Domenico; Di Salvo, Giovanni; Pacileo, Giuseppe; Calabrò, Raffaele; Perrone, Laura

2008-08-01

To verify whether peptide YY (PYY) and its Y2 receptor (Y2R) gene variants can be associated with obesity or hypertension or both in a cohort of obese children and adolescents. Two hundred and twenty-nine obese children (105 girls, mean z-score BMI 5.1 +/- 2.4; mean age 10.5 +/- 2.9 years) and 250 age and sex-matched lean controls (130 women, mean z-score BMI 0.5 +/- 1.1; mean age 10.3 +/- 2.8) were enrolled in the study. Height, weight, BMI, waist circumference and 24-h systolic and diastolic blood pressure were measured. Night-time, day-time and 24-h systolic and diastolic blood pressures were evaluated by 24 h ambulatory blood pressure measurement, and appropriate standard deviation scores according to sex, age and height were calculated. Molecular screening of the PYY and Y2R genes was performed. No new mutations were found. We observed three previously described polymorphisms: G767C on PYY and T585C and T936C on Y2R. An association study was carried out in obese patients. No associations were found between the PYY genotypes and the studied phenotypes. The Y2R gene variants, T585C and T936C, which are in almost complete linkage disequilibrium, were found to be associated with night-time, day-time and 24-h systolic and diastolic blood pressures. In particular, subject homozygotes for the T allele showed lower systolic and diastolic blood pressure values compared with the other genotypes. Moreover, obese children homozygous for the T585 allele showed a lower risk of developing hypertension than patients carrying the CC and CT genotypes (chi 6.9; df = 1, P = 0.03; odds ratio = 0.5, 95% confidence interval: 0.27-0.88). Our results suggest that Y2R gene variants are involved in blood pressure regulation in obese children and adolescents.

The Influence of Health Behaviors During Childhood on Adolescent Health Behaviors, Health Indicators, and Academic Outcomes Among Participants from Hawaii.

PubMed

Nigg, Claudio R; Amato, Katie

2015-08-01

Health behaviors during childhood may influence adolescent health behaviors and be related to other important outcomes, but no longitudinal research has examined this in a multicultural population in Hawaii to date. This study investigated if childhood moderate to vigorous physical activity (MVPA), fruit and vegetable consumption, and sedentary behavior influence adolescent (1) MVPA, fruit and vegetable consumption, and sedentary behavior; (2) body mass index (BMI) percentile, general health, and stress; and (3) school marks and school absenteeism. Three cohorts of public elementary school children (fourth to sixth graders) who participated in a state-mandated after-school program in 2004, 2005, and 2006 completed baseline (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior) and 5-year follow-up surveys (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior; BMI, general health, stress, school marks, and absenteeism; combined follow-up n = 334; 14.76 ± 0.87 years old; 55.1% female; 53% Asian, 19.8% Native Hawaiian/other Pacific Islander, 15.3% White, and 11.9% other). Regressions found that childhood MVPA (mean [m] = 45.42, standard deviation [SD] = 31.2 min/day) and fruit and vegetable consumption (m = 6.96, SD = 4.54 servings/day) predicted these behaviors in adolescence (m = 47.22, SD = 27.04 min/day and m = 4.63, SD = 3.03 servings/day, respectively, p < 0.05). Childhood sedentary behavior (m = 3.85, SD = 2.85 h/day)) predicted adolescent BMI percentile (m = 60.93, SD = 28.75, p < 0.05). Childhood fruit and vegetable consumption and sedentary behavior negatively predicted adolescent marks (B average, p < 0.05). Childhood health behaviors do influence adolescent health behaviors, some health outcomes, and some academic indicators in this population, especially childhood sedentary behavior, which underlines the importance of sedentary behavior interventions.

PREDICTORS OF QUALITY OF LIFE IN 165 PATIENTS WITH ACROMEGALY: RESULTS FROM A SINGLE-CENTER STUDY.

PubMed

Kreitschmann-Andermahr, Ilonka; Buchfelder, Michael; Kleist, Bernadette; Kohlmann, Johannes; Menzel, Christa; Buslei, Rolf; Kołtowska-Häggsträm, Maria; Strasburger, Christian; Siegel, Sonja

2017-01-01

Even if treated, acromegaly has a considerable impact on patient quality of life (QoL); despite this, the exact clinical determinants of QoL in acromegaly are unknown. This study retrospectively examines a cohort of treated patients with acromegaly, with the aim of identifying these determinants. Retrospective survey analysis, with 165 patients included in the study. All patients completed a survey, which included demographic data and the clinical details of their disease, the Short Form-36 Health Survey (SF-36), the revised Beck Depression Inventory (BDI-II), and the Bern Embitterment Inventory (BEI). Stepwise regression was used to identify predictors of QoL. The strongest predictors of the physical component score of the SF-36 were (in order of declining strength of association): Delay between first presentation of the disease and diagnosis, body mass index (BMI), number of doctors visited before the diagnosis of acromegaly, and age at diagnosis. For the mental component score, the strongest predictors were: number of doctors visited, previous radiotherapy, and age at study entry; and, for the BDI-II score: number of doctors visited, previous radiotherapy, age at study entry, and employment status at the time of diagnosis. The following were predictors of the BEI score: number of doctors visited, and age at study entry. Diagnostic delay and lack of diagnostic acumen in medical care provision are strong predictors of poor QoL in patients with acromegaly. Other identified parameters are radiotherapy, age, BMI, and employment status. An efficient acromegaly service should address these aspects when devising disease management plans. BDI-II = Beck Depression Inventory II BEI = Bern Embitterment Inventory BMI = body mass index IGF-1 = insulin-like growth factor 1 MCS = mental component summary (score) PCS = physical component summary (score) QoL = quality of life SDS = standard deviation score SF-36 = Short Form-36 Health Survey.

Cardiovascular fitness in young males and risk of unprovoked venous thromboembolism in adulthood.

PubMed

Zöller, Bengt; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

2017-03-01

Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. The present study aims to determine whether high cardiovascular fitness reduces the risk of VTE. A Swedish cohort of male conscripts (n = 773,925) born in 1954-1970 with no history of previous VTE were followed from enlistment (1972-1990) until 2010. Data on cardiovascular fitness using a cycle ergonometric test (maximal aerobic workload in Watt [W max ]) at conscription were linked with national hospital register data and the Multi-Generation Register. We identified all full-siblings and first-cousin pairs discordant for maximal aerobic workload. This co-relative design allows for adjustment for familial resemblance. In total, 3005 (0.39%) males were affected by VTE. Cardiovascular fitness estimated with W max was not associated with VTE risk when adjusted for body mass index (BMI). However, cardiovascular fitness estimated with W max /kg and adjusted for BMI was associated with reduced risk for VTE (Hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.78-0.85 per standard deviation compared with mean W max /kg). The association was weaker over time and also when examining discordant first cousins and full-sibling pairs. These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk. Key messages Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. A Swedish cohort of male conscripts (n = 773,925) tested with a cycle ergometric test with no history of previous VTE were followed from enlistment (1972-1990) until 2010. Cardiovascular fitness estimated with W max /kg and adjusted for BMI was associated with reduced risk for VTE (HR 0.81, 95% CI 0.78-0.85). These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk.

Betatrophin: no relation to glucose metabolism or weight status in obese children before and after lifestyle intervention.

PubMed

Roth, Christian L; Elfers, Clinton; Lass, Nina; Reinehr, Thomas

2017-09-01

The influences of obesity, glucose metabolism, gender, and puberty on betatrophin levels and the longitudinal relationships between weight loss, metabolic changes and betatrophin have not yet been studied in childhood. Cross-sectional and longitudinal analysis of weight status (standard deviation score-body mass index (SDS-BMI)), homeostasis model assessment insulin resistance (HOMA-IR), gender, and pubertal stage were evaluated in 69 obese children (51% female, age 11.9 ± 2.0 years) participating in lifestyle intervention over a 1-year period. An oral glucose tolerance test was performed in 53 of the 69 children. Twenty normal weight children (50% female, age 12.3 ± 3.0 years) served as controls. Circulating betatrophin did not differ significantly between obese and lean children (1.99 ± 0.90 vs 2.35 ± 0.28, mean ± SD, P = .155). At baseline, betatrophin did not differ in obese patients with vs without glucose intolerance (1.89 ± 0.96 vs 2.031 ± 0.91 ng/mL; P = .591) and obese with (delta SDS-BMI >0.4) vs without successful obesity intervention (1.89 ± 0.94 vs. 2.07 ± 0.87 ng/mL; P = 0.396). In multiple linear regression analyses, pubertal stage was associated with betatrophin (b: 0.48, P = .027), while gender, age, BMI, blood pressure, fasting glucose, HOMA-IR, triglycerides, LDL- and HDL-cholesterol were not related to betatrophin at baseline. At the end of the 1-year intervention, changes of betatrophin were not significantly associated with any parameter after controlling for multiple covariates including age and changes of pubertal stages. Our data do not support a relationship between betatrophin and weight status or glucose tolerance, insulin resistance, and lipid metabolism in children. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association between low lean mass and low bone mineral density in 653 women with hip fracture: does the definition of low lean mass matter?

PubMed

Di Monaco, Marco; Castiglioni, Carlotta; Di Monaco, Roberto; Tappero, Rosa

2017-12-01

Loss of both muscle and bone mass results in fragility fractures with increased risk of disability, poor quality of life, and death. Our aim was to assess the association between low appendicular lean mass (aLM) defined according to different criteria and low bone mineral density (BMD) in hip-fracture women. Six hundred fifty-three women admitted to our rehabilitation hospital underwent dual energy X-ray absorptiometry 19.1 ± 4.1 (mean ± SD) days after hip-fracture occurrence. Low aLM was identified according to either Baumgartner's definition (aLM/height 2 less than two standard deviations below the mean of the young reference group) or FNIH criteria: aLM <15.02 kg, or aLM adjusted for body mass index (BMI) <0.512. Low BMD was diagnosed with a T-score <-2.5 at the unfractured femoral neck. Using Baumgartner's definition, the association between low aLM/height 2 and low BMD was significant: χ 2 (1, n = 653) = 8.52 (p = 0.004), but it was erased by adjustments for age and fat mass. Using the FNIH definition the association between low aLM and low BMD was significant: χ 2 (1, n = 653) = 42.5 (p < 0.001), and it was confirmed after adjustment for age and fat mass (p < 0.001). With the FNIH definition based on aLM/BMI ratio the association between low aLM/BMI ratio and low BMD was nonsignificant: χ 2 (1, n = 653) = 0.003 (p = 0.957). The association between low aLM and low BMD in women with hip fracture dramatically depends on the adopted definition of low aLM. FNIH threshold for aLM (<15.02 kg) emerges as a useful tool to capture women with damage of the muscle-bone unit.

Differences in gestational weight gain between pregnancies before and after maternal bariatric surgery correlate with differences in birth weight but not with scores on the body mass index in early childhood.

PubMed

Berglind, D; Willmer, M; Näslund, E; Tynelius, P; Sørensen, T I A; Rasmussen, F

2014-12-01

Large maternal gestational weight gain (GWG) is associated with increased birth weight and increased risk of obesity in offspring, but these associations may be confounded by genetic and environmental factors. The aim was to investigate the effects of differences in GWG in all three trimesters on differences in birth weight and in body mass index (BMI) scores at 4 and 6 years of age, within siblings born before and after bariatric surgery. Women with at least one child born before and one after bariatric surgery were identified in national Swedish registers. Series of weight (and height) measurements were collected from antenatal medical records, with data on the nearest pregnancies before and after bariatric surgery. The age-adjusted means of pre- and post-operative GWG of 124 women were 11.3 (standard deviation [SD] 7.2) and 8.3 (SD 6.4) kg, respectively (P = 0.01). Adjusted fixed effects regression models showed positive associations of differences in mean total GWG with differences in siblings' birth weight, 0.023 kg per 1-kg greater weight gain (95% confidence interval [CI]: 0.014-0.069) and for second trimester 0.53 kg for each 1-kg greater weight per week (95% CI: 0.32-1.61), whereas no associations were found with BMI in pre-school age. This study showed positive associations between differences in total and second trimester maternal GWG and differences in children's birth weight, but no association with BMI scores in pre-school age. Maternal genetic, social and lifestyle factors fixed from one pregnancy to the next were taken into account in the analyses by the study design. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

The prevalence of obesity among clinical students in a Malaysian medical school.

PubMed

Boo, N Y; Chia, G J Q; Wong, L C; Chew, R M; Chong, W; Loo, R C N

2010-02-01

This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities. This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake. The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors. Obesity remains a common problem among medical students in their clinical years.

Education and screening for chronic kidney disease in Indian youth: pilot program results.

PubMed

Rao, Panduranga S; Wright Nunes, Julie A; Gillespie, Brenda W; Perlman, Rachel L; Ravichandran, Rajan

2017-01-01

There is a paucity of information on kidney education and screening programs in Indian youth. Participants (n=2,158) from Chennai colleges were educated about the kidneys and chronic kidney disease (CKD) and screened in a pilot program from April to May 2013. This entailed: 1) a presentation and educational video and 2) an on-site assessment of weight, blood pressure, and demographic information. Urinalysis (UA) kits were distributed and returned in ≤48 hours. We examined participant characteristics and their association with dipstick proteinuria using logistic regression. The mean (standard deviation [SD]) age was 18.9 (1.6) years, and 1,451 (68%) were men. Mean (SD) body mass index (BMI) was 21.9 (4.3) kg/m 2 ; 745 (36%) had a BMI consistent with being overweight or obese. Mean (SD) systolic blood pressure (SBP) was 118.7 (13.1) mm Hg, and 94 (5%) of the participants had SBP ≥140. Mean (SD) diastolic blood pressure (DBP) was 70.9 (11.4) mm Hg, with 119 participants (6%) having ≥90 mm Hg. A total of 136 participants had glycosuria (UA≥1+) and 120 (6%) had proteinuria (UA≥1+). In unadjusted analyses, sex (odds ratio [OR]=1.64 [confidence interval, CI 1.06-2.55]; p =0.026 men vs. women) and age (OR=1.13 per year [CI 1.01-1.26]; p =0.032) were significantly associated with proteinuria. In the analysis adjusted for age, sex, SBP, DBP, glycosuria, and BMI, age remained independently associated with higher odds for proteinuria (OR=1.14 per year [1.02-1.29]; p =0.026). Males showed a trend of higher risk compared with women (OR=1.57 [CI 1.00-2.50]; p =0.051). This education and screening pilot program in a population of college students offers unique opportunities for identification, education, and early intervention for CKD.

Early results after laparoscopic Roux-en-Y gastric bypass: effect of the learning curve

PubMed Central

Andrew, Christopher G.; Hanna, Wael; Look, Didier; McLean, Alexander P.H.; Christou, Nicolas V.

2006-01-01

Introduction This study was performed to evaluate the safety and short-term efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity and to describe the relation between learning curve and short-term outcomes. Methods We collected a prospective database on the first 201 consecutive patients who underwent LRYGB by a single university-based, experienced bariatric surgeon over 24 months. We divided patients into 3 consecutive groups of 67 patients for analysis (Group 1, Group 2 and Group 3). Results The mean patient age was 37 (standard deviation [SD] 9) years; mean body mass index (BMI) was 49.2 (SD 8.3) kg/m2. BMI was similar in Groups 1 and 2 (mean 47.1, SD 5.9 and mean 48.7, SD 8.9 kg/m2) but increased in Group 3 (mean 52, SD 9.7 kg/m2, p < 0.01). Operative time decreased from 145 (SD 30) minutes in Group 1 to 114 (SD 24) minutes in Group 2 (p < 0.01) and was maintained at 119 (SD 23) minutes in Group 3. Early and late complication rates were 14.9% and 12.4%, respectively. Leak rates decreased from 6.0% in the first group to 1.5% in Groups 2 and 3, but they did not reach statistical significance. Anastomotic stricture rates decreased from 11.9% in Group 1 to 3.0% in Group 2 (p < 0.01). Overall excess weight loss for the entire series was 31.5% (SD 11.9%), 54.5% (SD 14.1%), 77.1% (SD 18.5%) and 82.1% (SD 17.5%) at 3, 6, 12 and 18 months, respectively. Conclusion LRYGB can be performed with acceptable morbidity and short-term results during the learning curve. In our series, operative time and anastomotic stricture rates decreased with experience, despite an increase in mean BMI. PMID:17234071

Spinal Implant Density and Postoperative Lumbar Lordosis as Predictors for the Development of Proximal Junctional Kyphosis in Adult Spinal Deformity.

PubMed

McClendon, Jamal; Smith, Timothy R; Sugrue, Patrick A; Thompson, Sara E; O'Shaughnessy, Brian A; Koski, Tyler R

2016-11-01

To evaluate spinal implant density and proximal junctional kyphosis (PJK) in adult spinal deformity (ASD). Consecutive patients with ASD receiving ≥5 level fusions were retrospectively analyzed between 2007 and 2010. ASD, elective fusions, minimum 2-year follow-up. age <18 years, neuromuscular or congenital scoliosis, cervical or cervicothoracic fusions, nonelective conditions (infection, tumor, trauma). Instrumented fusions were classified by the Scoliosis Research Society-Schwab ASD classification. Statistical analysis consisted of descriptives (measures of central tendency, dispersion, frequencies), independent Student t tests, χ 2 , analysis of variance, and logistic regression to determine association of implant density [(number of screws + number of hooks)/surgical levels of fusion] and PJK. Mean and median follow-up was 2.8 and 2.7 years, respectively. Eighty-three patients (17 male, 66 female) with a mean age of 59.7 years (standard deviation, 10.3) were analyzed. Mean body mass index (BMI) was 29.5 kg/m 2 (range, 18-56 kg/m 2 ) with mean preoperative Oswestry Disability Index of 48.67 (range, 6-86) and mean preoperative sagittal vertical axis of 8.42. The mean levels fused were 9.95 where 54 surgeries had interbody fusion. PJK prevalence was 21.7%, and pseudoarthrosis was 19.3%. Mean postoperative Oswestry Disability Index was 27.4 (range, 0-74). Independent Student t tests showed that PJK was not significant for age, gender, BMI, rod type, mean postoperative sagittal vertical axis, or Scoliosis Research Society-Schwab ASD classification; but iliac fixation approached significance (P = 0.077). Implant density and postoperative lumbar lordosis (LL) were predictors for PJK (P = 0.018 and 0.045, respectively). Controlling for age, BMI, and gender, postoperative LL (not implant density) continued to show significance in multivariate logistic regression model. PJK, although influenced by a multitude of factors, may be statistically related to implant density and LL. Copyright © 2016. Published by Elsevier Inc.

Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis.

PubMed

Koo, Bo Kyung; Kim, Donghee; Joo, Sae Kyung; Kim, Jung Ho; Chang, Mee Soo; Kim, Byeong Gwan; Lee, Kook Lae; Kim, Won

2017-01-01

We explored whether sarcopenia is associated with the histological severity of non-alcoholic fatty liver disease (NAFLD), especially non-alcoholic steatohepatitis (NASH) and significant fibrosis. In a biopsy-proven NAFLD cohort, the appendicular skeletal muscle mass (ASM) was measured. Sarcopenia was defined as a ASM/body weight (ASM%) value beyond two standard deviations below the mean for healthy young adults. Among the entire set of 309 subjects, the prevalence of sarcopenia in subjects without NAFLD, with non-alcoholic fatty liver (NAFL), and with NASH were 8.7%, 17.9%, and 35.0%, respectively (p<0.001). ASM% was inversely correlated with the severity of fibrosis (p<0.001), and the prevalence of significant fibrosis (⩾F2) was higher in subjects with sarcopenia than in those without (45.7% vs. 24.7%; p<0.001). A crude analysis revealed that sarcopenia was associated with NAFLD (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.58-9.25), which became insignificant after adjustment for body mass index (BMI), diabetes, and hypertension. Among NAFLD subjects, subjects with sarcopenia were more likely to have NASH than those without sarcopenia through a multivariate analysis adjusted for age, gender, BMI, hypertension, diabetes, and smoking status (OR, 2.28; 95% CI, 1.21-4.30), and this finding was obtained even after adjustment for insulin resistance (OR, 2.30; 95% CI, 1.08-4.93). Sarcopenia was also associated with significant fibrosis independent of BMI and insulin resistance (OR, 2.05; 95% CI, 1.01-4.16). In this large biopsy-proven NAFLD cohort, sarcopenia was significantly associated with NASH and significant fibrosis. Low muscle mass was found to be associated with histological severity in non-alcoholic fatty liver disease, and sarcopenia was significantly associated with non-alcoholic steatohepatitis and significant fibrosis, independent of obesity, inflammation, and insulin resistance. Clinical trial number: NCT 02206841. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Epicardial Adipose Tissue Thickness Independently Predicts Severe Aortic Valve Stenosis.

PubMed

Mahabadi, Amir A; Kahlert, Heike A; Dykun, Iryna; Balcer, Bastian; Kahlert, Philipp; Rassaf, Tienush

2017-05-01

Epicardial fat tissue (EAT) is associated with coronary as well as aortic valve calcification. The study aim was to determine whether EAT thickness is different in patients with and without aortic valve stenosis (AVS). A cohort of 200 consecutive patients with severe AVS and 200 matched patients without AVS were included retrospectively in the study. EAT thickness was quantified, using transthoracic echocardiography, as the space between the epicardial wall of the myocardium and the visceral layer of the pericardium. Unadjusted and risk factor-adjusted logistic regression analysis was used to determine the association of EAT thickness with the presence of AVS. Overall, 400 patients (182 males, 218 females; mean age 79.6 ± 6.5 years) were included in the study. EAT thickness was significantly higher in patients with severe AVS (7.4 ± 0.3 mm versus 5.8 ± 0.2 mm; p <0.0001 for patients with and without AVS, respectively). In logistic regression analysis, an increase in EAT by one standard deviation was associated with a two-fold increased occurrence of AVS (OR [95%CI]: 2.10 [1.65-2.68]; p <0.0001). Associations remained stable upon adjustment for age, gender and traditional cardiovascular risk factors (2.08 [1.59-2.72]; p <0.0001). Body mass index (BMI) -specific subgroup analysis showed that the link between EAT and AVS was independent of BMI (1.78 [1.15-2.75], 2.62 [1.71- 4.02], and 2.22 [1.36- 3.62], for BMI <25 kg/m2, 25-30 kg/m2, and >30kg/ m2, respectively). EAT, in addition to traditional cardiovascular risk factors, significantly improved the area under the receiver operating characteristic curve (from 0.70 to 0.76; p = 0.003). EAT thickness is significantly associated with severe AVS, independent of traditional risk factors. While further studies are needed to confirm these results, the present findings support the hypothesis that EAT may influence sclerosis of the aortic valve.

Study Protocol: A randomized controlled trial evaluating the effect of family-based behavioral treatment of childhood and adolescent obesity-The FABO-study.

PubMed

Skjåkødegård, Hanna F; Danielsen, Yngvild S; Morken, Mette; Linde, Sara-Rebekka F; Kolko, Rachel P; Balantekin, Katherine N; Wilfley, Denise E; Júlíusson, Pétur B

2016-10-21

The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children's family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. Randomized controlled trial (RCT), in which families (n = 120) are recruited from the children and adolescents (ages 6-18 years) referred to the Obesity Outpatient Clinic (OOC), Haukeland University Hospital, Norway. Criteria for admission to the OOC are BMI above the International Obesity Task Force (IOTF) cut-off ≥ 35, or IOTF ≥ 30 with obesity related co-morbidity. Families are randomized to receive FBSFT immediately or following one year of TAU. All participants receive a multidisciplinary assessment. For TAU this assessment results in a plan and a contract for chancing specific lifestyle behaviors. Thereafter each family participates in monthly counselling sessions with their primary health care nurse to work on implementing these goals, including measuring their weight change, and also meet every third month for sessions at the OOC. In FBSFT, following assessment, families participate in 17 weekly sessions at the OOC, in which each family works on changing lifestyle behaviors using a structured cognitive-behavioral, socio-ecological approach targeting both parents and children with strategies for behavioral maintenance and sustainable weight change. Outcome variables include body mass index (BMI; kg/m 2 ), BMI standard deviation score (SDS) and percentage above the IOTF definition of overweight, waist-circumference, body composition (bioelectric impedance (BIA) and dual-X-ray-absorptiometry (DXA)), blood tests, blood pressure, activity/inactivity and sleep pattern (measured by accelerometer), as well as questionnaires measuring depression, general psychological symptomatology, self-esteem, disturbed eating and eating disorder symptoms. Finally, barriers to treatment and parenting styles are measured via questionnaires. This is the first systematic application of FBSFT in the treatment of obesity among youth in Norway. The study gives an opportunity to evaluate the effect of FBSFT implemented in routine clinical practice across a range of youth with severe obesity. ClinicalTrails.gov NCT02687516 . Registered 16th of February, 2016.

Standard and Amputation-Adjusted Body Mass Index Measures: Comparison and Relevance to Functional Measures, Weight-Related Comorbidities, and Dieting.

PubMed

Wong, Christopher Kevin; Wong, Ryan J

2017-12-01

People with limb loss may misjudge weight-related health when not adjusting body mass index (BMI) for amputation level. This cross-sectional, community-based study compared BMI and amputation-adjusted BMI (A-BMI) and evaluated relationships among BMI categories, function, and dieting. Subjects provided self-reported demographic, functional, and medical/prosthetic data including height and weight and completed performance-based balance and gait measures. A Web-based A-BMI calculator adjusted for amputation levels. Results for 294 subjects from 11 states (68.4% men; 76.5% white; average age, 55.6 [15.1] y) were reported, with vascular (49.7%) and unilateral transtibial (40.8%) amputations as the most common. Body mass index and A-BMI were closely correlated (Pearson r = 0.99), but a BMI of 28.6 (6.7) was less than an A-BMI of 30.3 (6.2) (t test, P < 0.001). Agreement among Centers for Disease Control BMI categories was moderate (κ = 0.48); 39.7% of BMI categories were underestimated without adjusting for amputations. Functional measures did not differ among BMI/A-BMI categories (P > 0.05). A larger than random proportion categorized as overweight by BMI dieted (χ, P < 0.05), and people categorized as overweight by A-BMI did not (38.3% classified as normal BMI). Functional abilities did not differ among BMI categories (Kruskal-Wallis and analysis of variance, P > 0.05). People with limb loss using BMI may underestimate weight-related health; a Web-based A-BMI calculator may help monitor weight to make dieting decisions.

Metabolic signatures of birthweight in 18 288 adolescents and adults

PubMed Central

Würtz, Peter; Wang, Qin; Niironen, Marjo; Tynkkynen, Tuulia; Tiainen, Mika; Drenos, Fotios; Kangas, Antti J; Soininen, Pasi; Skilton, Michael R; Heikkilä, Kauko; Pouta, Anneli; Kähönen, Mika; Lehtimäki, Terho; Rose, Richard J; Kajantie, Eero; Perola, Markus; Kaprio, Jaakko; Eriksson, Johan G; Raitakari, Olli T; Lawlor, Debbie A; Davey Smith, George; Järvelin, Marjo-Riitta; Ala-Korpela, Mika; Auro, Kirsi

2016-01-01

Background: Lower birthweight is associated with increased susceptibility to cardiometabolic diseases in adulthood, but the underlying molecular pathways are incompletely understood. We examined associations of birthweight with a comprehensive metabolic profile measured in adolescents and adults. Methods: High-throughput nuclear magnetic resonance metabolomics and biochemical assays were used to quantify 87 circulating metabolic measures in seven cohorts from Finland and the UK, comprising altogether 18 288 individuals (mean age 26 years, range 15–75). Metabolic associations with birthweight were assessed by linear regression models adjusted for sex, gestational age and age at blood sampling. The metabolic associations with birthweight were compared with the corresponding associations with adult body mass index (BMI). Results: Lower birthweight adjusted for gestational age was adversely associated with cardiometabolic biomarkers, including lipoprotein subclasses, fatty acids, amino acids and markers of inflammation and impaired liver function (P < 0.0015 for 46 measures). Associations were consistent across cohorts with different ages at metabolic profiling, but the magnitudes were weak. The pattern of metabolic deviations associated with lower birthweight resembled the metabolic signature of higher adult BMI (R2 = 0.77) assessed at the same time as the metabolic profiling. The resemblance indicated that 1 kg lower birthweight is associated with similar metabolic aberrations as caused by 0.92 units higher BMI in adulthood. Conclusions: Lower birthweight adjusted for gestational age is associated with adverse biomarker aberrations across multiple metabolic pathways. Coherent metabolic signatures between lower birthweight and higher adult adiposity suggest that shared molecular pathways may potentially underpin the metabolic deviations. However, the magnitudes of metabolic associations with birthweight are modest in comparison to the effects of adiposity, implying that birthweight is only a weak indicator of the metabolic risk profile in adulthood. PMID:27892411

Computer Programs for the Semantic Differential: Further Modifications.

ERIC Educational Resources Information Center

Lawson, Edwin D.; And Others

The original nine programs for semantic differential analysis have been condensed into three programs which have been further refined and augmented. They yield: (1) means, standard deviations, and standard errors for each subscale on each concept; (2) Evaluation, Potency, and Activity (EPA) means, standard deviations, and standard errors; (3)…

Determining a one-tailed upper limit for future sample relative reproducibility standard deviations.

PubMed

McClure, Foster D; Lee, Jung K

2006-01-01

A formula was developed to determine a one-tailed 100p% upper limit for future sample percent relative reproducibility standard deviations (RSD(R),%= 100s(R)/y), where S(R) is the sample reproducibility standard deviation, which is the square root of a linear combination of the sample repeatability variance (s(r)2) plus the sample laboratory-to-laboratory variance (s(L)2), i.e., S(R) = s(L)2, and y is the sample mean. The future RSD(R),% is expected to arise from a population of potential RSD(R),% values whose true mean is zeta(R),% = 100sigmaR, where sigmaR and mu are the population reproducibility standard deviation and mean, respectively.

Does physical activity influence the relationship between low back pain and obesity?

PubMed

Smuck, Matthew; Kao, Ming-Chih J; Brar, Nikhraj; Martinez-Ith, Agnes; Choi, Jongwoo; Tomkins-Lane, Christy C

2014-02-01

Evidence supporting an association between obesity and low back pain (LBP) continues to grow; yet little is known about the cause and effect of this relationship. Even less is known about the mechanisms linking the two. Physical activity is a logical suspect, but no study has demonstrated its role. This study was designed to examine the interrelationship between physical activity, obesity, and LBP. The specific aims were to determine if obesity is a risk factor for LBP in the U.S. population, measure the strength of any observed association, and evaluate the role of physical activity in modulating this association. A cross-sectional U.S. population-based study. A cohort of 6,796 adults from the 2003-2004 National Health and Nutrition Examination Survey. Demographic information, an in-depth health questionnaire, physical examination details, and 7-day free-living physical activity monitoring using accelerometry (ActiGraph AM-7164; ActiGraph, Pensacola, FL, USA). LBP status was determined by questionnaire response. Body mass index (BMI) was calculated during physical examination and divided here into four groups (normal weight <25, overweight 25-30, obese 31-35, and ultraobese 36+). Summary measures of physical activity were computed based on intensity cutoffs, percentile intensities, and bout. Demographics, social history, and comorbid health conditions were used to build adjusted weighted logistic regression models constructed using Akaike Information Criterion. All displayed estimates are significant at level <.05. No external funding was received to support this study. None of the authors report conflicts of interest directly related to the specific subject matter of this manuscript. In the U.S. population, the risk of low LBP increases in step with BMI from 2.9% for normal BMI (20-25) to 5.2% for overweight (26-30), 7.7% for obese (31-35), and 11.6% for ultraobese (36+). Smoking is consistently the strongest predictor of LBP across the BMI spectrum (odds ratio 1.6-2.9). Physical activity also modulates these risks. In the overall model, the best physical activity predictors of LBP are in the moderate and high intensity ranges with small effects (odds ratio 0.98 and 0.996 per standard deviation increase, respectively). When broken down by BMI, time spent in sedentary and moderate activity ranges demonstrate more robust influences on LBP status in the overweight, obese, and ultraobese groups. Increased BMI is a risk factor for back pain in Americans. More important, the role of physical activity in mitigating back pain risk is shown to be of greater consequence in the overweight and obese populations. Copyright © 2014 Elsevier Inc. All rights reserved.

Analysis of Body Mass Index and First-Term Attrition of Navy Enlisted Personnel

DTIC Science & Technology

2017-06-01

due to health and physical appearance issues (Feeney, 2014). One study reports that, within the last few years, over one-third of the United States...individual within acceptable physical health . This difference is more restrictive for BUMED. For example, a male with a BMI of 28 would be within...acceptable physical health under the nationwide standard (“Calculate Your BMI,” 2014). Under the BUMED standard, however, this male would not be within

Predictors of weight loss in Mexican American adolescents

USDA-ARS?s Scientific Manuscript database

This study examined predictors of weight change in Mexican American adolescents. Eighty overweight Mexican American children were randomized to receive either the intensive intervention or self help program. Physiological (e.g. standardized BMI (zBMI), percent body fat, and tanner stage), psychologi...

The correlation between body mass index, limb circumferences and blood pressure cuff fit in bariatric surgical patients.

PubMed

Schumann, R; Alyamani, O; Viswanath, A; Bonney, I

2016-01-01

The purpose of this study was to determine the correlation between body mass index (BMI) and upper and lower arm as well as lower leg circumferences and the frequency of correct blood pressure (BP) cuff fit. We explored recommendations for the most likely BP cuff size and location for the three BMI categories. Following IRB approval we retrospectively analyzed a research database of bariatric surgical patients with a BMI of ≥40 kg/m(2). Data included patients' characteristics, upper and lower arm as well as lower leg circumferences. Patients were divided into three groups based on BMI (kg/m(2), Group I: <45, Group II: 45-55, and Group III: >55). Appropriate cuff fit using a standard or large adult BP cuff (CRITIKON(®), GE Healthcare, Waukesha, Wisconsin, USA) on the upper and lower arm, and lower leg was determined. We analyzed the percent proportion of proper cuff fit for cuff sizes and locations between groups using appropriate nonparametric testing. Limb circumference correlated significantly with BMI (P = 0.01), and the upper arm correlated most closely (r = 0.76). A standard adult BP cuff on the lower arm fit properly in >90% and >80% and in Groups I and II, respectively. A large cuff on the lower arm was appropriate in 87% of Group III. In two participants, a large cuff fit properly on the lower leg. Limb circumference significantly correlated with BMI. Recommendations for proper cuff fit in different BMI categories can be made.

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis.

PubMed

Yoo, S; Lee, S-Y; Kim, K-N; Sung, E

2006-07-01

To examine the relationships between body mass index (BMI), percentage-weight-for-height (PWH) and percentage body fat (PBF), and to compare their validity based on PBF with the BMI criteria of International Obesity Task Force (IOTF) for childhood obesity in Korean pre-adolescent school children. Statistical comparative analysis for anthropometric measures. Korean pre-adolescent children (438 boys and 454 girls, aged 8-12 years, mean BMI 19.5+/-3.4 kg/m2). Body mass index and PWH were calculated as body size indices from height and weight. Hand-to-foot bioelectrical impedance analysis (BIA) was performed to obtain PBF values, with obese children defined as PBF above 35%. Sensitivity and specificity were displayed with the gold standard of PBF, and receiver operating characteristic (ROC) curves were used to assess the performance of BMI and PWH in detecting obesity. The prevalence of obesity varied by the criteria: 18.8% by Korean BMI standards for 95 percentile, 11% by the IOTF-BMI 30 kg/m2 and 29.4% by Korean PWH cutoffs. Body mass index and PWH were significantly correlated with PBF after adjusting for age, 0.910 (P<0.01) and 0.915 (P<0.01), respectively. The sensitivity and specificity of the PWH cutoffs were 0.909 and 0.882, respectively. The local BMI 95 percentiles had lower sensitivity (0.714) and specificity (0.790). The IOTF-BMI definition showed much lower sensitivity (0.457) and higher specificity (0.990). The BMI cutoffs corresponding with the highest accuracy were smaller than IOTF-BMI 30 kg/m2 for all age groups in both boys and girls. The prevalence of obesity among Korean pre-adolescent children widely varied according to the diagnostic criteria applied. Universally recommended cutoffs for children by IOTF showed the lowest sensitivity among the criteria used, and may therefore underestimate obesity in this population.

Secondary analyses of data from four studies with fourth-grade children show that sex, race, amounts eaten of standardized portions, and energy content given in trades explain the positive relationship between BMI and energy intake at school-provided meals

PubMed Central

Baxter, Suzanne Domel; Paxton-Aiken, Amy E.; Tebbs, Joshua M.; Royer, Julie A.; Guinn, Caroline H.; Finney, Christopher J.

2012-01-01

Results from a 2012 article showed a positive relationship between children’s body mass index (BMI) and energy intake at school-provided meals. To help explain that positive relationship, secondary analyses investigated 1) whether the relationship differed by sex and race, and 2) the relationship between BMI and six aspects of school-provided meals—amounts eaten of standardized portions, energy content given in trades, energy intake received in trades, energy intake from flavored milk, energy intake from a la carte ice cream, and breakfast type. Data were from four studies conducted one per school year (1999–2000 to 2002–2003). Fourth-grade children (n=328; 50% female; 54% Black) from 13 schools total were observed eating school-provided breakfast and lunch on one to three days per child for 1,178 total meals (50% breakfast). Children were weighed and measured. Marginal regression models were fit using BMI as the dependent variable. For Purpose One, independent variables were energy intake at school-provided meals, sex, race, age, and study; additional models included interaction terms involving energy intake and sex/race. For Purpose Two, independent variables were the six aspects of school-provided meals, sex, race, age, and study. The relationship between BMI and energy intake at school-provided meals differed by sex (p<0.0001; stronger for females) and race (p=0.0063; stronger for Black children). BMI was positively related to amounts eaten of standardized portions (p<0.0001) and negatively related to energy content given in trades (p=0.0052). Explaining the positive relationship between BMI and energy intake at school-provided meals may contribute to school-based obesity prevention efforts. PMID:23084638

Packing Fraction of a Two-dimensional Eden Model with Random-Sized Particles

NASA Astrophysics Data System (ADS)

Kobayashi, Naoki; Yamazaki, Hiroshi

2018-01-01

We have performed a numerical simulation of a two-dimensional Eden model with random-size particles. In the present model, the particle radii are generated from a Gaussian distribution with mean μ and standard deviation σ. First, we have examined the bulk packing fraction for the Eden cluster and investigated the effects of the standard deviation and the total number of particles NT. We show that the bulk packing fraction depends on the number of particles and the standard deviation. In particular, for the dependence on the standard deviation, we have determined the asymptotic value of the bulk packing fraction in the limit of the dimensionless standard deviation. This value is larger than the packing fraction obtained in a previous study of the Eden model with uniform-size particles. Secondly, we have investigated the packing fraction of the entire Eden cluster including the effect of the interface fluctuation. We find that the entire packing fraction depends on the number of particles while it is independent of the standard deviation, in contrast to the bulk packing fraction. In a similar way to the bulk packing fraction, we have obtained the asymptotic value of the entire packing fraction in the limit NT → ∞. The obtained value of the entire packing fraction is smaller than that of the bulk value. This fact suggests that the interface fluctuation of the Eden cluster influences the packing fraction.

SPIDER ® sleeve gastrectomy--a new concept in single-trocar bariatric surgery: initial experience and technical details.

PubMed

Noel, P; Nedelcu, M; Gagner, M

2014-04-01

Single port instrument delivery extended reach (SPIDER(®)) surgical system is a revolutionary surgical platform that allows triangulation of the surgical instruments while eliminating the crossing of instruments, the problematic characteristic of single access laparoscopic surgery. The purpose of this study was to analyze our initial experience with SPIDER(®) sleeve gastrectomy and to present the technical details of this new minimally invasive approach, performed in ten patients at the La Casamance Private Hospital between November 2012 and April 2013. All patients were reviewed at scheduled post-operative consultations at 1, 3 and 6 months. In addition to clinical examination, the post-operative consultation at one month also included a satisfaction survey using the Moorehead-Ardelt questionnaire. An initial series of ten sleeve gastrectomies were performed in female patients with a mean age of 41.5 years (range: 2-52). The mean BMI was 40.11 (range: 37.25-44.3). The intervention was performed through a single trocar in all patients with no "conversion" to classic laparoscopy or open surgery. The mean operative time was 61 ± 15.22 minutes (SD=standard deviation) (range: 43-96 min). The mean BMI at one month was 35.5 (SD:± 3.58, SEM: ± 1.13) (SEM=standard error of mean) with an average percentage of excess weight loss (%EWL) of 32.9% (SD:± 8.56%, SEM:± 2.71%). The mean BMI at three months was 32.4 (SD: ± 2.78, SEM: ± 0.88) with an average %EWL of 52.7% (SD: ± 8.64%, SEM: ± 2.73%). The mean BMI at six months was 29.9 (SD:± 2.60, SEM: ± 0.98) with a mean %EWL of 68.8% (SD: ± 8.38%, SEM:± 3.17%). Complete remission of co-morbid conditions was observed in four patients, improvement in three others, and no change in a single patient. The mean duration of hospitalization was 3.1 days. The mean follow-up period was 161 days (SD:± 57.4 days, range: 90-243 days). There was no mortality and no intra-operative and post-operative complications were noted. The SPIDER(®) surgical platform seems to be a usable and effective method for performance of minimally invasive single-access sleeve gastrectomy, offering an easy and efficient operative procedure compared to other single-port systems. Prospective long-term studies are recommended before this approach can be validated to be of comparable efficiency to conventional multi-port laparoscopic surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

[Diet and polymer standard vs. standard in the nutritional status of elderly patients with fragility].

PubMed

Luna-Ramos, Gissel Karelly; Pedraza-Zárate, Miguel Ángel; Franco-Álvarez, Nubia; González-Velázquez, Felipe

2016-01-01

The elderly patients with fragility show different physiological changes, so they are given polymeric diets to maintain and/or alter their nutritional status. The aim of this paper is to demonstrate the effect of changing a standard polymeric diet and a standard diet on nutritional status in elderly patients with fragility. Clinical randomized controlled trial in 23 elderly patients, 70 years of age or older, with fragility, hospitalized in a Internal Medicine Unity in a period from July to December 2014. Nutritional status was determined through Minimum Nutritional Consulting (MNA) and body mass index (BMI). Descriptive statistics, Chi square, Student t test and McNemar. In the G1: 12 patients were in the G2 and 11, a positive change was observed in the nutritional status G1 initially being 14.00 (malnutrition) and end 22.75 (risk of malnutrition). According to BMI (kg/m2) was evident at the beginning 25 % of patients (3) with mild malnutrition, but the final results show figures with a zero percentage of malnourished patients. The use of standard polymeric diet increases body weight, BMI and nutritional status in elderly patients with fragility.

Complexities of follicle deviation during selection of a dominant follicle in Bos taurus heifers.

PubMed

Ginther, O J; Baldrighi, J M; Siddiqui, M A R; Araujo, E R

2016-11-01

Follicle deviation during a follicular wave is a continuation in growth rate of the dominant follicle (F1) and decreased growth rate of the largest subordinate follicle (F2). The reliability of using an F1 of 8.5 mm to represent the beginning of expected deviation for experimental purposes during waves 1 and 2 (n = 26 per wave) was studied daily in heifers. Each wave was subgrouped as follows: standard subgroup (F1 larger than F2 for 2 days preceding deviation and F2 > 7.0 mm on the day of deviation), undersized subgroup (F2 did not attain 7.0 mm by the day of deviation), and switched subgroup (F2 larger than F1 at least once on the 2 days before or on the day of deviation). For each wave, mean differences in diameter between F1 and F2 changed abruptly at expected deviation in the standard subgroup but began 1 day before expected deviation in the undersized and switched subgroups. Concentrations of FSH in the wave-stimulating FSH surge and an increase in LH centered on expected deviation did not differ among subgroups. Results for each wave indicated that (1) expected deviation (F1, 8.5 mm) was a reliable representation of actual deviation in the standard subgroup but not in the undersized and switched subgroups; (2) concentrations of the gonadotropins normalized to expected deviation were similar among the three subgroups, indicating that the day of deviation was related to diameter of F1 and not F2; and (3) defining an expected day of deviation for experimental use should consider both diameter of F1 and the characteristics of deviation. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 90.708 - Cumulative Sum (CumSum) procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... is 5.0×σ, and is a function of the standard deviation, σ. σ=is the sample standard deviation and is... individual engine. FEL=Family Emission Limit (the standard if no FEL). F=.25×σ. (2) After each test pursuant...

Acoustic Correlates of Compensatory Adjustments to the Glottic and Supraglottic Structures in Patients with Unilateral Vocal Fold Paralysis

PubMed Central

2015-01-01

The goal of this study was to analyse perceptually and acoustically the voices of patients with Unilateral Vocal Fold Paralysis (UVFP) and compare them to the voices of normal subjects. These voices were analysed perceptually with the GRBAS scale and acoustically using the following parameters: mean fundamental frequency (F0), standard-deviation of F0, jitter (ppq5), shimmer (apq11), mean harmonics-to-noise ratio (HNR), mean first (F1) and second (F2) formants frequency, and standard-deviation of F1 and F2 frequencies. Statistically significant differences were found in all of the perceptual parameters. Also the jitter, shimmer, HNR, standard-deviation of F0, and standard-deviation of the frequency of F2 were statistically different between groups, for both genders. In the male data differences were also found in F1 and F2 frequencies values and in the standard-deviation of the frequency of F1. This study allowed the documentation of the alterations resulting from UVFP and addressed the exploration of parameters with limited information for this pathology. PMID:26557690

Dynamics of the standard deviations of three wind velocity components from the data of acoustic sounding

NASA Astrophysics Data System (ADS)

Krasnenko, N. P.; Kapegesheva, O. F.; Shamanaeva, L. G.

2017-11-01

Spatiotemporal dynamics of the standard deviations of three wind velocity components measured with a mini-sodar in the atmospheric boundary layer is analyzed. During the day on September 16 and at night on September 12 values of the standard deviation changed for the x- and y-components from 0.5 to 4 m/s, and for the z-component from 0.2 to 1.2 m/s. An analysis of the vertical profiles of the standard deviations of three wind velocity components for a 6-day measurement period has shown that the increase of σx and σy with altitude is well described by a power law dependence with exponent changing from 0.22 to 1.3 depending on the time of day, and σz depends linearly on the altitude. The approximation constants have been found and their errors have been estimated. The established physical regularities and the approximation constants allow the spatiotemporal dynamics of the standard deviation of three wind velocity components in the atmospheric boundary layer to be described and can be recommended for application in ABL models.

BMI and depressive symptoms: the role of media pressures.

PubMed

Jeffers, Amy J; Cotter, Elizabeth W; Snipes, Daniel J; Benotsch, Eric G

2013-12-01

Obese and overweight individuals experience higher risk for depression and emotional distress. One factor that may contribute to depression in obese or overweight individuals is exposure to unrealistic images in the media. Indeed, overall media consumption is associated with body image dissatisfaction in adolescents and young adults. Despite these compelling links, prior work has not examined the mediating effect of media pressures on the link between BMI and depression. In the present study, young adults (N = 743) completed an online survey assessing demographic information, perceived pressure from the media to conform to a certain body standard, and symptoms of depression. Structural equation modeling analyses indicated a direct effect of BMI on media pressure, a direct effect of media pressure on depressive symptoms, and an indirect effect of BMI on depressive symptoms mediated by media pressures. Findings indicate that higher BMI levels are associated with greater depressive symptoms when there is greater perceived media pressure on body image. Results suggest the need for clinicians to assess media consumption and perceived pressure to conform to physical appearance standards in individuals who are obese or overweight as well as individuals at risk for eating disorders. © 2013.

A proof for Rhiel's range estimator of the coefficient of variation for skewed distributions.

PubMed

Rhiel, G Steven

2007-02-01

In this research study is proof that the coefficient of variation (CV(high-low)) calculated from the highest and lowest values in a set of data is applicable to specific skewed distributions with varying means and standard deviations. Earlier Rhiel provided values for d(n), the standardized mean range, and a(n), an adjustment for bias in the range estimator of micro. These values are used in estimating the coefficient of variation from the range for skewed distributions. The d(n) and an values were specified for specific skewed distributions with a fixed mean and standard deviation. In this proof it is shown that the d(n) and an values are applicable for the specific skewed distributions when the mean and standard deviation can take on differing values. This will give the researcher confidence in using this statistic for skewed distributions regardless of the mean and standard deviation.

Random errors in interferometry with the least-squares method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang Qi

2011-01-20

This investigation analyzes random errors in interferometric surface profilers using the least-squares method when random noises are present. Two types of random noise are considered here: intensity noise and position noise. Two formulas have been derived for estimating the standard deviations of the surface height measurements: one is for estimating the standard deviation when only intensity noise is present, and the other is for estimating the standard deviation when only position noise is present. Measurements on simulated noisy interferometric data have been performed, and standard deviations of the simulated measurements have been compared with those theoretically derived. The relationships havemore » also been discussed between random error and the wavelength of the light source and between random error and the amplitude of the interference fringe.« less

The association between Polycystic Ovary Syndrome (PCOS) and metabolic syndrome: a statistical modelling approach.

PubMed

Ranasinha, S; Joham, A E; Norman, R J; Shaw, J E; Zoungas, S; Boyle, J; Moran, L; Teede, H J

2015-12-01

Polycystic ovary syndrome (PCOS) affects 12-21% of women. Women with PCOS exhibit clustering of metabolic features. We applied rigorous statistical methods to further understand the interplay between PCOS and metabolic features including insulin resistance, obesity and androgen status. Retrospective cross-sectional analysis. Women with PCOS attending reproductive endocrine clinics in South Australia for the treatment of PCOS (n = 172). Women without PCOS (controls) in the same Australian region (n = 335) from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), a national population-based study (age- and BMI-matched within one standard deviation of the PCOS cohort). The factor structure for metabolic syndrome for women with PCOS and control groups was examined, specifically, the contribution of individual factors to metabolic syndrome and the association of hyperandrogenism with other metabolic factors. Women with PCOS demonstrated clustering of metabolic features that was not observed in the control group. Metabolic syndrome in the PCOS cohort was strongly represented by obesity (standardized factor loading = 0·95, P < 0·001) and insulin resistance factors (loading = 0·92, P < 0·001) and moderately by blood pressure (loading = 0·62, P < 0·001) and lipid factors (loading = 0·67, P = 0·002). On further analysis, the insulin resistance factor strongly correlated with the obesity (r = 0·70, P < 0·001) and lipid factors (r = 0·68, P < 0·001) and moderately with the blood pressure factor (loading = 0·43, P = 0·002). The hyperandrogenism factor was moderately correlated with the insulin resistance factor (r = 0·38, P < 0·003), but did not correlate with any other metabolic factors. PCOS women are more likely to display metabolic clustering in comparison with age- and BMI-matched control women. Obesity and insulin resistance, but not androgens, are independently and most strongly associated with metabolic syndrome in PCOS. © 2015 John Wiley & Sons Ltd.

Cardiovascular Disease Risk Factors in Ghana during the Rural-to-Urban Transition: A Cross-Sectional Study

PubMed Central

Kodaman, Nuri; Aldrich, Melinda C.; Sobota, Rafal; Asselbergs, Folkert W.; Poku, Kwabena A.; Brown, Nancy J.; Moore, Jason H.; Williams, Scott M.

2016-01-01

Populations in sub-Saharan Africa are shifting from rural to increasingly urban. Although the burden of cardiovascular disease is expected to increase with this changing landscape, few large studies have assessed a wide range of risk factors in urban and rural populations, particularly in West Africa. We conducted a cross-sectional, population-based survey of 3317 participants from Ghana (≥18 years old), of whom 2265 (57% female) were from a mid-sized city (Sunyani, population ~250,000) and 1052 (55% female) were from surrounding villages (populations <5000). We measured canonical cardiovascular disease risk factors (BMI, blood pressure, fasting glucose, lipids) and fibrinolytic markers (PAI-1 and t-PA), and assessed how their distributions and related clinical outcomes (including obesity, hypertension and diabetes) varied with urban residence and sex. Urban residence was strongly associated with obesity (OR: 7.8, 95% CI: 5.3–11.3), diabetes (OR 3.6, 95% CI: 2.3–5.7), and hypertension (OR 3.2, 95% CI: 2.6–4.0). Among the quantitative measures, most affected were total cholesterol (+0.81 standard deviations, 95% CI 0.73–0.88), LDL cholesterol (+0.89, 95% CI: 0.79–0.99), and t-PA (+0.56, 95% CI: 0.48–0.63). Triglycerides and HDL cholesterol profiles were similarly poor in both urban and rural environments, but significantly worse among rural participants after BMI-adjustment. For most of the risk factors, the strength of the association with urban residence did not vary with sex. Obesity was a major exception, with urban women at particularly high risk (26% age-standardized prevalence) compared to urban men (7%). Overall, urban residents had substantially worse cardiovascular risk profiles, with some risk factors at levels typically seen in the developed world. PMID:27732601

Erect penile dimensions in a cohort of 778 Middle Eastern men: establishment of a nomogram.

PubMed

Habous, Mohamad; Tealab, Alaa; Williamson, Ben; Binsaleh, Saleh; El Dawy, Sherif; Mahmoud, Saad; Abdelwahab, Osama; Nassar, Mohammed; Mulhall, John P; Veale, David; Muir, Gordon

2015-06-01

Accurate data regarding the size of the erect penis are of great importance to several disciplines working with male patients, but little high-quality research exists on the subject, particularly in different ethnic groups and for erect penis size. The aim of this study was to create a nomogram of erect penile dimensions in a large sample of Middle Eastern men. A retrospective cohort study of 778 men (mean age 43.7; range 20-82) attending urological outpatient clinics in Saudi Arabia was conducted. Exclusion criteria were age under 18 years, a presenting complaint of small or short penis, Peyronie's disease or complaint of congenital curvature, clinical hypogonadism, and previous penile surgery or trauma. Three erect penile dimensions following induction of erection using intracavernosal injection of Quadrimix. Mean patient body mass index (BMI) was 29.09 (standard deviation [SD] 5.76). The mean suprapubic skin-to-penile tip erect length was 12.53 cm (SD 1.93); the mean erect length from the symphysis pubis to the penile tip was 14.34 cm (SD 1.86); and the mean erect shaft circumference was 11.50 cm (SD 1.74). A nomogram was constructed and statistical analysis performed, demonstrating a weak negative correlation between BMI and erect penile length measured from the suprapubic skin (r = -0.283, P < 0.000) but not from bone to tip, and a weak negative correlation between age and both erect penile length measurements (skin to tip r = -0.177, P < 0.0005; bone to tip r = -0.099, P = 0.006). A nomogram for Middle Eastern men can be used as a standard when advising men with small penis anxiety. The importance of measuring erect size and allowing for infra-pubic fat interference in measurement is emphasized. We envisage that this tool can be used to educate and reassure concerned men about the size of their penises. © 2015 International Society for Sexual Medicine.

The Effect of Metformin and Standard Therapy Versus Standard Therapy Alone in Nondiabetic Patients with Insulin Resistance and Nonalcoholic Steatohepatitis (NASH): A Pilot Trial

DTIC Science & Technology

2009-01-01

histology in nondiabetic patients with insulin resistance and NASH. Decrease in BMI through diet and exercise significantly improved HOMA - IR scores, serum...BMI through diet and exercise significantly improved HOMA - IR scores, serum aminotransferases and liver histology. 15. SUBJECT TERMS 16. SECURITY...insulin resistance (or HOMA - IR ) score was calculated using the formula: fasting insulin (mIU/ml) fasting glu- cose (mg/dl)/405 [Matthews et al. 1985

Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity.

PubMed

Cole, T J; Lobstein, T

2012-08-01

The international (International Obesity Task Force; IOTF) body mass index (BMI) cut-offs are widely used to assess the prevalence of child overweight, obesity and thinness. Based on data from six countries fitted by the LMS method, they link BMI values at 18 years (16, 17, 18.5, 25 and 30 kg m(-2)) to child centiles, which are averaged across the countries. Unlike other BMI references, e.g. the World Health Organization (WHO) standard, these cut-offs cannot be expressed as centiles (e.g. 85th). To address this, we averaged the previously unpublished L, M and S curves for the six countries, and used them to derive new cut-offs defined in terms of the centiles at 18 years corresponding to each BMI value. These new cut-offs were compared with the originals, and with the WHO standard and reference, by measuring their prevalence rates based on US and Chinese data. The new cut-offs were virtually identical to the originals, giving prevalence rates differing by < 0.2% on average. The discrepancies were smaller for overweight and obesity than for thinness. The international and WHO prevalences were systematically different before/after age 5. Defining the international cut-offs in terms of the underlying LMS curves has several benefits. New cut-offs are easy to derive (e.g. BMI 35 for morbid obesity), and they can be expressed as BMI centiles (e.g. boys obesity = 98.9th centile), allowing them to be compared with other BMI references. For WHO, median BMI is relatively low in early life and high at older ages, probably due to its method of construction. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

Explaining the positive relationship between fourth-grade children's body mass index and energy intake at school-provided meals (breakfast and lunch).

PubMed

Guinn, Caroline H; Baxter, Suzanne D; Royer, Julie A; Hitchcock, David B

2013-05-01

A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school-provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. Fourth-grade children (N = 465) from Columbia, SC, were observed eating school-provided breakfast and lunch on 1 to 4 days per child. Researchers measured children's weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). BMI was positively related to amounts eaten of standardized school-meal portions (p < .0001) and increased 8.45 kg/m(2) per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m(2) for every 100 kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m(2) for every 100 kcal received. BMI was not significantly related to 4 outcome variables. Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions. © 2013, American School Health Association.

RCT of a high-protein diet on hunger motivation and weight-loss in obese children: an extension and replication.

PubMed

Duckworth, Lauren C; Gately, Paul J; Radley, Duncan; Cooke, Carlton B; King, Roderick F G J; Hill, Andrew J

2009-09-01

This study aimed to evaluate the weight loss and hunger motivation effects of an energy-restricted high-protein (HP) diet in overweight and obese children. In total, 95 overweight and obese children attended an 8-week (maximum) program of physical activity, reduced-energy intake, and behavior change education. Children were randomly assigned to one of two isoenergetic diets (standard (SP): 15% protein; HP: 25% protein), based on individually estimated energy requirements. Anthropometry and body composition were assessed at the start and end of the program and appetite and mood ratings completed on the first 3 consecutive weekdays of each week children attended camp. The HP diet had no greater effect on weight loss, body composition, or changes in appetite or mood when compared to the SP diet. Overall, campers lost 5.2 +/- 3.0 kg in body weight and reduced their BMI standard deviation score (sds) by 0.25. Ratings of desire to eat increased significantly over the duration of the intervention, irrespective of diet. This is the third time we have reported an increase in hunger motivation in weight-loss campers and replicates our previous failure to block this with a higher protein diet. Further work is warranted into the management of hunger motivation as a result of negative energy balance.

N2/O2/H2 Dual-Pump Cars: Validation Experiments

NASA Technical Reports Server (NTRS)

OByrne, S.; Danehy, P. M.; Cutler, A. D.

2003-01-01

The dual-pump coherent anti-Stokes Raman spectroscopy (CARS) method is used to measure temperature and the relative species densities of N2, O2 and H2 in two experiments. Average values and root-mean-square (RMS) deviations are determined. Mean temperature measurements in a furnace containing air between 300 and 1800 K agreed with thermocouple measurements within 26 K on average, while mean mole fractions agree to within 1.6 % of the expected value. The temperature measurement standard deviation averaged 64 K while the standard deviation of the species mole fractions averaged 7.8% for O2 and 3.8% for N2, based on 200 single-shot measurements. Preliminary measurements have also been performed in a flat-flame burner for fuel-lean and fuel-rich flames. Temperature standard deviations of 77 K were measured, and the ratios of H2 to N2 and O2 to N2 respectively had standard deviations from the mean value of 12.3% and 10% of the measured ratio.

Comparative study of navigated versus freehand osteochondral graft transplantation of the knee.

PubMed

Koulalis, Dimitrios; Di Benedetto, Paolo; Citak, Mustafa; O'Loughlin, Padhraig; Pearle, Andrew D; Kendoff, Daniel O

2009-04-01

Osteochondral lesions are a common sports-related injury for which osteochondral grafting, including mosaicplasty, is an established treatment. Computer navigation has been gaining popularity in orthopaedic surgery to improve accuracy and precision. Navigation improves angle and depth matching during harvest and placement of osteochondral grafts compared with conventional freehand open technique. Controlled laboratory study. Three cadaveric knees were used. Reference markers were attached to the femur, tibia, and donor/recipient site guides. Fifteen osteochondral grafts were harvested and inserted into recipient sites with computer navigation, and 15 similar grafts were inserted freehand. The angles of graft removal and placement as well as surface congruity (graft depth) were calculated for each surgical group. The mean harvesting angle at the donor site using navigation was 4 degrees (standard deviation, 2.3 degrees ; range, 1 degrees -9 degrees ) versus 12 degrees (standard deviation, 5.5 degrees ; range, 5 degrees -24 degrees ) using freehand technique (P < .0001). The recipient plug removal angle using the navigated technique was 3.3 degrees (standard deviation, 2.1 degrees ; range, 0 degrees -9 degrees ) versus 10.7 degrees (standard deviation, 4.9 degrees ; range, 2 degrees -17 degrees ) in freehand (P < .0001). The mean navigated recipient plug placement angle was 3.6 degrees (standard deviation, 2.0 degrees ; range, 1 degrees -9 degrees ) versus 10.6 degrees (standard deviation, 4.4 degrees ; range, 3 degrees -17 degrees ) with freehand technique (P = .0001). The mean height of plug protrusion under navigation was 0.3 mm (standard deviation, 0.2 mm; range, 0-0.6 mm) versus 0.5 mm (standard deviation, 0.3 mm; range, 0.2-1.1 mm) using a freehand technique (P = .0034). Significantly greater accuracy and precision were observed in harvesting and placement of the osteochondral grafts in the navigated procedures. Clinical studies are needed to establish a benefit in vivo. Improvement in the osteochondral harvest and placement is desirable to optimize clinical outcomes. Navigation shows great potential to improve both harvest and placement precision and accuracy, thus optimizing ultimate surface congruity.

Familial risk moderates the association between sleep and zBMI in children.

PubMed

Bagley, Erika J; El-Sheikh, Mona

2013-08-01

A cumulative risk approach was used to examine the moderating effect of familial risk factors on relations between actigraphy-based sleep quantity (minutes) and quality (efficiency) and sex- and age-standardized body mass index (zBMI). The sample included 124 boys and 104 girls with a mean age of 10.41 years (SD = 0.67). Children wore actigraphs for 1 week, and their height and weight were assessed in the lab. After controlling for potential confounds, multiple regression analyses indicated that sleep minutes predicted children's zBMI and that both sleep minutes and efficiency interacted with family risk in the prediction of zBMI. The association between poor sleep and zBMI was especially evident for children exposed to higher levels of family risk. Findings suggest that not all children who exhibit poor sleep are at equal risk for higher zBMI and that familial and contextual conditions need to be considered in this link.

Body mass index and the risk of postoperative cerebrospinal fluid leak following trans-sphenoidal surgery in an Asian population.

PubMed

Sun, Ira; Lim, Jia Xu; Goh, Chun Peng; Low, Shiong Wen; Kirollos, Ramez W; Tan, Chuen Seng; Lwin, Sein; Yeo, Tseng Tsai

2016-09-22

Postoperative cerebrospinal fluid (CSF) leak is a serious complication following trans-sphenoidal surgery for which elevated body mass index (BMI) has been implicated as a risk factor, albeit only in two recent North American studies. Given the paucity of evidence, we sought to determine if this association held true in an Asian population, where BMI criteria for obesity differ from the international standard. A retrospective study of 119 patients who underwent 123 trans-sphenoidal procedures for sellar lesions between May 2000 and May 2012 was conducted. Univariate and multivariate logistic regression analyses were performed to investigate the impact of elevated BMI and other risk factors on postoperative CSF leak. We found 10 (8.1%) procedures in ten patients that were complicated by postoperative CSF leak. The median BMI of patients with postoperative leak following trans-sphenoidal procedures was significantly higher than that of patients without postoperative CSF leak (27.0 kg/m2 vs. 24.6 kg/m2; p = 0.018). Patients categorised as either moderate or high risk under the Asian BMI classification were more likely to suffer from a postoperative leak (p = 0.030). Repeat procedures were also found to be significantly associated with postoperative CSF leak (p = 0.041). Elevated BMI predicts for postoperative CSF leak following trans-sphenoidal procedures, even in an Asian population, where the definition of obesity differs from international standards. Thus, BMI should be borne in mind during local and regional management decision-making processes prior to such procedures.

Matrix Summaries Improve Research Reports: Secondary Analyses Using Published Literature

ERIC Educational Resources Information Center

Zientek, Linda Reichwein; Thompson, Bruce

2009-01-01

Correlation matrices and standard deviations are the building blocks of many of the commonly conducted analyses in published research, and AERA and APA reporting standards recommend their inclusion when reporting research results. The authors argue that the inclusion of correlation/covariance matrices, standard deviations, and means can enhance…

30 CFR 74.8 - Measurement, accuracy, and reliability requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... concentration, as defined by the relative standard deviation of the distribution of measurements. The relative standard deviation shall be less than 0.1275 without bias for both full-shift measurements of 8 hours or... Standards, Regulations, and Variances, 1100 Wilson Boulevard, Room 2350, Arlington, Virginia 22209-3939...

Electronic health technology for the assessment of physical activity and eating habits in children and adolescents with overweight and obesity IDA.

PubMed

Schiel, Ralf; Kaps, Alexander; Bieber, Gerald

2012-04-01

It was the goal of the trial to study the impact of electronic healthcare technology into treatment. One hundred and twenty-four children/adolescents (females 56%, age 13.5±2.8 years, height 1.64±0.13 m, weight 85.4±23.0 kg, body-mass index (BMI) 31.3±5.2 kg/m(2), BMI-standard deviation score (SDS) 2.50±0.5) were included. To assess physical activity and eating habits, a mobile motion sensor integrated into a mobile phone with digital camera was used. The children/adolescents had a significant weight reduction of 7.1±3.0 kg. BMI/BMI-SDS decreased (p<0.01). Intensity (14.1±6.4 activity units) and duration of physical activity (290.4±92.6 min/day) were assessed with sensors. Time walking: median 45.5 (range, 2.5-206.5), running 8.0 (range, 0-39.5), cycling 27.7 (range, 0-72.5), car driving 23.7 (range, 0-83.0) min/day. Comparing self-reported physical activity (walking 292.9 (range, 9.6-496.1), running 84.8 (range, 8.4-130.2) min/day) with assessment with sensors there were significant differences (p<0.01). Duration of physical activity documented by children/adolescents was higher than the assessment with motion sensors (walking 292.9 vs 45.5 min, p<0.01, running 84.8 vs 8.0 min, p<0.01). Sensor derived energy intake was higher than recommended (469.14±88.75 kcal vs 489.03±108.25 kcal, p=0.09). Performing multivariate analysis the following parameters showed associations with weight reduction (R-square=0.75): body weight (β=-0.95, p<0.01), C-reactive protein (CRP, β=0.15, p=0.07), physical activity, time spent in activities measured with sensors (β=-0.18, p=0.04), stress management (β=0.16, p=0.06), body fat mass at onset of the trial (β=0.45, p<0.01) and body shape (β=-0.25, p=0.01). The innovative mobile movement detection system is highly accepted by children and adolescents. The system is able to augment existing weight reduction and stabilization strategies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Gestational Weight Gain, Body Mass Index, and Risk of Hypertensive Disorders of Pregnancy in a Predominantly Puerto Rican Population.

PubMed

Chasan-Taber, Lisa; Silveira, Marushka; Waring, Molly E; Pekow, Penelope; Braun, Barry; Manson, JoAnn E; Solomon, Caren G; Markenson, Glenn

2016-09-01

Objectives To prospectively evaluate the association between gestational weight gain (GWG), prepregnancy body mass index (BMI), and hypertensive disorders of pregnancy using the revised Institute of Medicine (IOM) Guidelines. Methods We examined these associations among 1359 participants in Proyecto Buena Salud, a prospective cohort study conducted from 2006 to 2011 among women from the Caribbean Islands. Information on prepregnancy BMI, GWG, and incident diagnoses of hypertension in pregnancy were based on medical record abstraction. Results Four percent (n = 54) of women were diagnosed with hypertension in pregnancy, including 2.6 % (n = 36) with preeclampsia. As compared to women who gained within IOM GWG guidelines (22.8 %), those who gained above guidelines (52.5 %) had an odds ratio of 3.82 for hypertensive disorders (95 % CI 1.46-10.00; ptrend = 0.003) and an odds ratio of 2.94 for preeclampsia (95 % CI 1.00-8.71, ptrend = 0.03) after adjusting for important risk factors. Each one standard deviation (0.45 lbs/week) increase in rate of GWG was associated with a 1.74 odds of total hypertensive disorders (95 % CI 1.34-2.27) and 1.86 odds of preeclampsia (95 % CI 1.37-2.52). Conclusions for Practice Findings from this prospective study suggest that excessive GWG is associated with hypertension in pregnancy and could be a potentially modifiable risk factor in this high-risk ethnic group.

Association Between Mobility Mode and C-Reactive Protein Levels in Men With Chronic Spinal Cord Injury

PubMed Central

Morse, Leslie R.; Stolzmann, Kelly; Nguyen, Hiep P.; Jain, Nitin B.; Zayac, Cara; Gagnon, David R.; Tun, Carlos G.; Garshick, Eric

2008-01-01

Objective To assess clinical determinants of systemic inflammation in persons with chronic spinal cord injury (SCI). Design Cross-sectional survey. Setting Veterans Affairs medical center. Participants As part of an epidemiologic study assessing SCI-related health conditions, 63 men with chronic SCI provided a blood sample and information regarding locomotive mode and personal habits. Interventions Not applicable. Main Outcome Measure Plasma high-sensitivity C-reactive protein (CRP). Results The mean ± standard deviation age was 56±14y, and participants were assessed 21±13y after injury. Adjusting for heart disease, hypertension, and body mass index (BMI), the mean CRP in 12 motorized wheelchair users (5.11mg/L) was not significantly greater than 23 participants who used a manual wheelchair (2.19mg/L) (P=.085) but was significantly greater than the 17 who walked with an assistive device (1.41mg/L) (P=.005) and the 12 who walked independently (1.63mg/L) (P=.027). CRP was significantly greater in participants with obesity but was not related to age, smoking, or SCI level and severity. CRP was elevated in participants reporting a urinary tract infection (UTI) or pressure ulcer within a year, but adjustment for this did not account for the elevated CRP in motorized wheelchair users. Conclusions These results suggest that CRP in chronic SCI is independently related to locomotive mode, BMI, and a history of pressure ulcers and UTI. It is suggested that future studies in SCI investigate whether modifying these factors influence systemic inflammation and cardiovascular health. PMID:18374004

DNA methylation of miRNA coding sequences putatively associated with childhood obesity.

PubMed

Mansego, M L; Garcia-Lacarte, M; Milagro, F I; Marti, A; Martinez, J A

2017-02-01

Epigenetic mechanisms may be involved in obesity onset and its consequences. The aim of the present study was to evaluate whether DNA methylation status in microRNA (miRNA) coding regions is associated with childhood obesity. DNA isolated from white blood cells of 24 children (identification sample: 12 obese and 12 non-obese) from the Grupo Navarro de Obesidad Infantil study was hybridized in a 450 K methylation microarray. Several CpGs whose DNA methylation levels were statistically different between obese and non-obese were validated by MassArray® in 95 children (validation sample) from the same study. Microarray analysis identified 16 differentially methylated CpGs between both groups (6 hypermethylated and 10 hypomethylated). DNA methylation levels in miR-1203, miR-412 and miR-216A coding regions significantly correlated with body mass index standard deviation score (BMI-SDS) and explained up to 40% of the variation of BMI-SDS. The network analysis identified 19 well-defined obesity-relevant biological pathways from the KEGG database. MassArray® validation identified three regions located in or near miR-1203, miR-412 and miR-216A coding regions differentially methylated between obese and non-obese children. The current work identified three CpG sites located in coding regions of three miRNAs (miR-1203, miR-412 and miR-216A) that were differentially methylated between obese and non-obese children, suggesting a role of miRNA epigenetic regulation in childhood obesity. © 2016 World Obesity Federation.

Foot-to-foot bioelectrical impedance analysis: a valuable tool for the measurement of body composition in children.

PubMed

Tyrrell, V J; Richards, G; Hofman, P; Gillies, G F; Robinson, E; Cutfield, W S

2001-02-01

To determine the accuracy of foot-to-foot bioelectrical impedance analysis (BIA) and anthropometric indices as measures of body composition in children. Comparison of foot-to-foot BIA and anthropometry to dual-energy X-ray absorptiometry (DEXA)-derived body composition in a multi-ethnic group of children. : Eighty-two European, NZ Maori and Pacific Island children aged 4.9-10.9 y. DEXA body composition, foot-to-foot bioelectrical impedance, height, weight, hip and waist measurements. Using a BIA prediction equation derived from our study population we found a high correlation between DEXA and BIA in the estimation of fat-free mass (FFM), fat mass (FM) and percentage body fat (PBF) (r=0.98, 0.98 and 0.94, respectively). BIA-FFM underestimated DEXA-FFM by a mean of 0.75 kg, BIA-FM overestimated DEXA-FM by a mean of 1.02 kg and BIA-PBF overestimated DEXA-PBF by a mean of 2.53%. The correlation between six anthropometric indices (body mass index (BMI), ponderal index, Chinn's weight-for-height index, BMI standard deviation score, weight-for-length index and Cole's weight-for-height index) and DEXA were also examined. The correlation of these indices with PBF was remarkably similar (r=0.85-0.87), more variable with FM (r=0.77-0.94) and poor with FFM (r=0.41-0.75). BIA correlated better than anthropometric indices in the estimation of FFM, FM and PBF. Foot-to-foot BIA is an accurate technique in the measurement of body composition.

Gamma Knife radiosurgery for hypothalamic hamartoma preserves endocrine functions.

PubMed

Castinetti, Frederic; Brue, Thierry; Morange, Isabelle; Carron, Romain; Régis, Jean

2017-06-01

Gamma Knife radiosurgery (GK) is an effective treatment for hypothalamic hamartoma. No precise data are available on the risk of endocrine side effects of this treatment. In this study, 34 patients with hypothalamic hamartoma (HH) were followed prospectively at the Department of Endocrinology, La Timone Hospital, Marseille, France, for a mean follow-up of >2 years (mean ± standard deviation [SD] 3.6 ± 2 years). Initial pre- and post-GK radiosurgery evaluations were performed, including weight, body mass index (BMI), and a complete endocrinological workup. At diagnosis, eight patients presented with central precocious puberty at a mean age of 5.4 ± 2.4 years. At the time of GK (mean age 18.2 ± 11.1 years), two patients previously treated with surgery presented with luteinizing hormone/follicle-stimulating hormone (LH/FSH) deficiency. After GK, only one patient presented with a new thyrotropin-stimulating hormone (TSH) deficiency, 2 years after the procedure. The other pituitary axes remained normal in all but two patients (who had LH/FSH deficiency prior to GK). There was no significant difference between pre- and post-GK mean BMI (26.9 vs. 25.1 kg/m 2 , p = 0.59). To conclude, in this group of 34 patients, GK did not induce major endocrinologic side effects reported with all the other surgical techniques in the literature. It is, thus, a safe and effective procedure in the treatment of hypothalamic hamartoma. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Ambulatory blood pressure monitoring in healthy children with parental hypertension.

PubMed

Alpay, Harika; Ozdemir, Nihal; Wühl, Elke; Topuzoğlu, Ahmet

2009-01-01

The aim of this study was to compare ambulatory blood pressure monitoring (ABPM) parameters in offspring with at least one hypertensive parent (HP) to offspring with normotensive parents (NP) and to determine whether gender of parent or child might influence the association between parental hypertension and blood pressure (BP). Eighty-nine healthy children (mean age 11.1 +/- 3.9 years) with HP and 90 controls (mean age 10.5 +/- 3.1 years) with NP were recruited. Age, gender, and height did not differ between the two groups, whereas children of HP had higher weight, body mass index (BMI), and waist circumference compared with healthy controls. No difference was found in casual BP between the two groups. In contrast, during ABPM daytime and nighttime mean systolic and diastolic BP and mean arterial pressure (MAP) standard deviation scores (SDS) were significantly elevated in children with HP. The mean percentage of nocturnal BP decline (dipping) was not significantly different between the two groups. Children with hypertensive mothers had higher daytime systolic and MAP SDS than controls; no such difference was detected for children with hypertensive fathers. Daytime systolic and MAP SDS were significantly elevated in boys with HP compared with boys with NP but failed to be significant in girls. Multiple linear regression analysis showed that parental history of hypertension (B = 0.29) and BMI (B = 0.03) were independently correlated with increase of daytime MAP SDS. Early changes in ambulatory BP parameters were present in healthy children of HP. BP in HP offspring was influenced by the gender of the affected parent and the offspring.

Chronic disease prevalence among elderly Saudi men.

PubMed

Saquib, Nazmus; Saquib, Juliann; Alhadlag, Abdulrahman; Albakour, Mohamad Anas; Aljumah, Bader; Sughayyir, Mohammed; Alhomidan, Ziad; Alminderej, Omar; Aljaser, Mohamed; Al-Mazrou, Abdulrahman

2017-01-01

Saudi demographic composition has changed because of increased life expectancy and decreased fertility rates. Little data are available about health conditions among older adults in Saudi Arabia, who are expected to represent 20% of the population by 2050. The study aim was to assess the prevalence and risk factors for chronic conditions among older Saudi men. The sample pertained to 400 men (age ≥55 years) from Buraidah, Al-Qassim. Research assistants recruited participants in all the mosques from the randomly selected neighborhoods (16 of 95). They administered a structured questionnaire that assessed self-reported disease history (heart disease, hypertension, diabetes, asthma, gastric/peptic ulcer, and cancer), and medication use; participants' height, weight, blood pressure, and random blood glucose (glucometer) were measured. Multinomial logistic regressions were employed to assess correlates of number of chronic diseases. The mean and standard deviation for age and body mass index (BMI) were 63.0 ± 7.5 years and 28.9 ± 4.8 (kg/m 2 ), respectively. 78% (77.8%) were overweight or obese, 35.0% were employed, 54.5% walked daily, 9.3% were current smokers, and 85.0% belonged to the middle class. The prevalence of hypertension, diabetes, heart disease, asthma, ulcer, and cancer were: 71.3% 27.3%, 16.4%, 9.7%, 8.9%, and 2.0%, respectively. Of the participants, 31.0% had one, 34.5% had two or more, and 34.5% did not have any chronic diseases. The likelihood of chronic diseases increased with increased age, higher BMI, and current smoking. The chronic disease prevalence among the Saudi elderly men is substantial.

Prevalence of obstructive sleep apnea among obese toddlers and preschool children.

PubMed

Bin-Hasan, Saadoun; Katz, Sherri; Nugent, Zoe; Nehme, Joy; Lu, Zihang; Khayat, Abdullah; Al-Saleh, Suhail; Amin, Reshma; Narang, Indra

2018-05-01

Obstructive sleep apnea (OSA) is a common disorder estimated at 1-5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4-5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA. A retrospective study involving children ≤6 years, identified from two Canadian pediatric tertiary care centers who had an in-lab polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age and gender or a z-score of > 2. OSA was diagnosed if the obstructive apnea-hypopnea index (OAHI) was greater than 2 events per hour. There were 60 participants included; the mean age was 4.4 years (standard deviation [SD] ± 1.7), mean BMI z-score was 3.0 (SD ± 1.2). Of these, 22/60 (36.6%) had OSA. Compared with the non-OSA group, the OSA group had a higher Epworth sleepiness score (p = 0.03) and were more likely to snore (p = 0.01). Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness may be useful indicators to facilitate triage for a PSG, especially in resource-limited settings.

Association of diet with acne vulgaris among adolescents in Ibadan, southwest Nigeria.

PubMed

Okoro, Emeka O; Ogunbiyi, Adebola O; George, Adekunle O; Subulade, Mobolaji O

2016-09-01

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous units that affects 85% of the world's population aged 11-30 years. Diet is believed to affect the severity of acne vulgaris. This study was designed to identify possible associations of diet with acne vulgaris in Nigeria. A cross-sectional study was conducted among adolescents in Ibadan in 2011. Students were interviewed for demographic data, history of acne, and frequency of intake of specific foods in the previous 12 months. Each participant was examined for facial acne. Body mass index (BMI) was calculated for each participant. Data for 464 students were analyzed. The mean ± standard deviation age of all subjects was 13.6 ± 3.6 years, and the mean BMI was 17.8 kg/m(2) . A total of 299 (64.4%) students were found to have acne vulgaris. Frequencies of intake of various foods varied widely. Prevalences of acne were higher among those who reported an at least daily intake of milk as beverage (72.6% vs. 62.0%; P = 0.035), corn (76.6% vs. 62.3%; P = 0.016), fried beef (75.0% vs. 62.1%; P = 0.042), and cake (77.8% vs. 62.3%; P = 0.012), and less common among those students who reported an at least daily intake of bananas (55.3% vs. 67.6%; P = 0.032). The present findings suggest associations between some foods and acne in the Nigerian context. An interventional dietary study will be required to further ascertain the effects of these foods on acne vulgaris. © 2016 The International Society of Dermatology.

A suggested approach for imputation of missing dietary data for young children in daycare.

PubMed

Stevens, June; Ou, Fang-Shu; Truesdale, Kimberly P; Zeng, Donglin; Vaughn, Amber E; Pratt, Charlotte; Ward, Dianne S

2015-01-01

Parent-reported 24-h diet recalls are an accepted method of estimating intake in young children. However, many children eat while at childcare making accurate proxy reports by parents difficult. The goal of this study was to demonstrate a method to impute missing weekday lunch and daytime snack nutrient data for daycare children and to explore the concurrent predictive and criterion validity of the method. Data were from children aged 2-5 years in the My Parenting SOS project (n=308; 870 24-h diet recalls). Mixed models were used to simultaneously predict breakfast, dinner, and evening snacks (B+D+ES); lunch; and daytime snacks for all children after adjusting for age, sex, and body mass index (BMI). From these models, we imputed the missing weekday daycare lunches by interpolation using the mean lunch to B+D+ES [L/(B+D+ES)] ratio among non-daycare children on weekdays and the L/(B+D+ES) ratio for all children on weekends. Daytime snack data were used to impute snacks. The reported mean (± standard deviation) weekday intake was lower for daycare children [725 (±324) kcal] compared to non-daycare children [1,048 (±463) kcal]. Weekend intake for all children was 1,173 (±427) kcal. After imputation, weekday caloric intake for daycare children was 1,230 (±409) kcal. Daily intakes that included imputed data were associated with age and sex but not with BMI. This work indicates that imputation is a promising method for improving the precision of daily nutrient data from young children.

Anorexia: an early sign of fourth ventricle astrocytoma in children.

PubMed

Leroy, Henri-Arthur; Baroncini, Marc; Delestret, Isabelle; Florent, Vincent; Vinchon, Matthieu

2014-12-01

Paediatric low-grade astrocytomas of the fourth ventricle are rare tumours, generally revealed by hydrocephalus. However, some patients present with a history of severe anorexia. It might be a harbinger, which if recognized, could lead to earlier diagnosis. We decided to examine our database in order to evaluate the incidence and signification of anorexia in this context. Retrospective monocentric study of cases of low-grade astrocytomas of the fourth ventricle operated between 1991 and 2012 in our paediatric neurosurgery department. We particularly observed the clinical presentation and long-term clinical, oncological and radiological evolution. Non-parametrical tests were used (Mann-Whitney, Fisher). We reviewed 34 cases, 31 pilocytic astrocytomas and 3 diffuse astrocytomas, 16 boys and 18 girls, (M/F ratio 0.89). Mean age at diagnosis was 8 years old. Seven presented with notable anorexia, the average BMI in this group was ≤2 standard deviation (SD); with clinical signs evolving for 11.5 months. Twenty-seven children had no anorexia; average BMI in this group was +1 SD, with clinical evolution for 6 months on an average of p < 0.05. We found no significant difference regarding hydrocephalus or tumour location. In all children with anorexia, body mass index improved markedly in the postoperative follow-up, which lasted, on average, for 6 years. Anorexia with stunted body weight curve is a non-exceptional presentation in children with low-grade astrocytomas of the fourth ventricle. Unexplained or atypical anorexia with negative etiologic assessment should prompt cerebral imaging. Clinical improvement after surgical resection, could suggest a possible interaction between tumour tissue and appetite-suppressing peptide secretion.

A parent-based intervention to promote healthy eating and active behaviours in pre-school children: evaluation of the MEND 2-4 randomized controlled trial.

PubMed

Skouteris, H; Hill, B; McCabe, M; Swinburn, B; Busija, L

2016-02-01

There is a paucity of studies evaluating targeted obesity prevention interventions in pre-school children. We conducted a randomized controlled trial to evaluate the efficacy of a parent-based obesity prevention intervention for pre-schoolers - MEND (Mind, Exercise, Nutrition … Do It!) 2-4 on child diet, eating habits, physical activity/sedentary behaviours, and body mass index (BMI). Parent-child dyads attended 10 weekly 90-min workshops relating to nutrition, physical activity and behaviours, including guided active play and healthy snack time. Assessments were conducted at baseline, immediately post-intervention, and 6 and 12 months post-intervention; child intake of vegetables, fruit, beverages, processed snack foods, fussiness, satiety responsiveness, physical activity, sedentary behaviour and neophobia were assessed via parent proxy report. Parent and child height and weight were measured. Two hundred one parent-child dyads were randomized to intervention (n = 104) and control (n = 97). Baseline mean child age was 2.7 (standard deviation [SD] 0.6) years, and child BMI-for-age z-score (World Health Organization) was 0.66 (SD 0.88). We found significant positive group effects for vegetable (P = 0.01) and snack food (P = 0.03) intake, and satiety responsiveness (P = 0.047) immediately post-intervention. At 12 months follow-up, intervention children exhibited less neophobia (P = 0.03) than controls. Future research should focus on additional strategies to support parents to continue positive behaviour change. ACTRN12610000200088. © 2015 World Obesity.

The effects of auditory stimulation with music on heart rate variability in healthy women.

PubMed

Roque, Adriano L; Valenti, Vitor E; Guida, Heraldo L; Campos, Mônica F; Knap, André; Vanderlei, Luiz Carlos M; Ferreira, Lucas L; Ferreira, Celso; Abreu, Luiz Carlos de

2013-07-01

There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women. We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21), who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19), who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB). A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB). The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio), low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes. The triangular index and the standard deviation of the long-term RR interval indices were reduced during exposure to both music styles in the first group and tended to decrease in the second group whereas the white noise exposure decreased the high frequency index. We observed no changes regarding the triangular interpolation of RR intervals, standard deviation of instantaneous beat-by-beat variability and standard deviation of instantaneous beat-by-beat variability/standard deviation in the long-term RR interval ratio. We suggest that relaxant baroque and excitatory heavy metal music slightly decrease global heart rate variability because of the equivalent sound level.

The effects of auditory stimulation with music on heart rate variability in healthy women

PubMed Central

Roque, Adriano L.; Valenti, Vitor E.; Guida, Heraldo L.; Campos, Mônica F.; Knap, André; Vanderlei, Luiz Carlos M.; Ferreira, Lucas L.; Ferreira, Celso; de Abreu, Luiz Carlos

2013-01-01

OBJECTIVES: There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women. METHODS: We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21), who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19), who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB). A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB). The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio), low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes. RESULTS: The triangular index and the standard deviation of the long-term RR interval indices were reduced during exposure to both music styles in the first group and tended to decrease in the second group whereas the white noise exposure decreased the high frequency index. We observed no changes regarding the triangular interpolation of RR intervals, standard deviation of instantaneous beat-by-beat variability and standard deviation of instantaneous beat-by-beat variability/standard deviation in the long-term RR interval ratio. CONCLUSION: We suggest that relaxant baroque and excitatory heavy metal music slightly decrease global heart rate variability because of the equivalent sound level. PMID:23917660

Superfluid and Insulating Phases of Fermion Mixtures in Optical Lattices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iskin, M.; Sa de Melo, C. A. R.

2007-08-24

The ground state phase diagram of fermion mixtures in optical lattices is analyzed as a function of interaction strength, fermion filling factor, and tunneling parameters. In addition to standard superfluid, phase-separated or coexisting superfluid-excess-fermion phases found in homogeneous or harmonically trapped systems, fermions in optical lattices have several insulating phases, including a molecular Bose-Mott insulator (BMI), a Fermi-Pauli (band) insulator (FPI), a phase-separated BMI-FPI mixture or a Bose-Fermi checkerboard (BFC). The molecular BMI phase is the fermion mixture counterpart of the atomic BMI found in atomic Bose systems, the BFC or BMI-FPI phases exist in Bose-Fermi mixtures, and lastly themore » FPI phase is particular to the Fermi nature of the constituent atoms of the mixture.« less

USL/DBMS NASA/PC R and D project C programming standards

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Moreau, Dennis R.

1984-01-01

A set of programming standards intended to promote reliability, readability, and portability of C programs written for PC research and development projects is established. These standards must be adhered to except where reasons for deviation are clearly identified and approved by the PC team. Any approved deviation from these standards must also be clearly documented in the pertinent source code.

Standard deviation index for stimulated Brillouin scattering suppression with different homogeneities.

PubMed

Ran, Yang; Su, Rongtao; Ma, Pengfei; Wang, Xiaolin; Zhou, Pu; Si, Lei

2016-05-10

We present a new quantitative index of standard deviation to measure the homogeneity of spectral lines in a fiber amplifier system so as to find the relation between the stimulated Brillouin scattering (SBS) threshold and the homogeneity of the corresponding spectral lines. A theoretical model is built and a simulation framework has been established to estimate the SBS threshold when input spectra with different homogeneities are set. In our experiment, by setting the phase modulation voltage to a constant value and the modulation frequency to different values, spectral lines with different homogeneities can be obtained. The experimental results show that the SBS threshold increases negatively with the standard deviation of the modulated spectrum, which is in good agreement with the theoretical results. When the phase modulation voltage is confined to 10 V and the modulation frequency is set to 80 MHz, the standard deviation of the modulated spectrum equals 0.0051, which is the lowest value in our experiment. Thus, at this time, the highest SBS threshold has been achieved. This standard deviation can be a good quantitative index in evaluating the power scaling potential in a fiber amplifier system, which is also a design guideline in suppressing the SBS to a better degree.

figure1.nc

EPA Pesticide Factsheets

NetCDF file of the SREF standard deviation of wind speed and direction that was used to inject variability in the FDDA input.variable U_NDG_OLD contains standard deviation of wind speed (m/s)variable V_NDG_OLD contains the standard deviation of wind direction (deg)This dataset is associated with the following publication:Gilliam , R., C. Hogrefe , J. Godowitch, S. Napelenok , R. Mathur , and S.T. Rao. Impact of inherent meteorology uncertainty on air quality model predictions. JOURNAL OF GEOPHYSICAL RESEARCH-ATMOSPHERES. American Geophysical Union, Washington, DC, USA, 120(23): 12,259–12,280, (2015).

Air displacement plethysmography versus dual-energy x-ray absorptiometry in underweight, normal-weight, and overweight/obese individuals.

PubMed

Lowry, David W; Tomiyama, A Janet

2015-01-01

Accurately estimating fat percentage is important for assessing health and determining treatment course. Methods of estimating body composition such as hydrostatic weighing or dual-energy x-ray absorptiometry (DXA), however, can be expensive, require extensive operator training, and, in the case of hydrostatic weighing, be highly burdensome for patients. Our objective was to evaluate air displacement plethysmography via the Bod Pod, a less burdensome method of estimating body fat percentage. In particular, we filled a gap in the literature by testing the Bod Pod at the lower extreme of the Body Mass Index (BMI) distribution. Three BMI groups were recruited and underwent both air displacement plethysmography and dual-energy x-ray absorptiometry. We recruited 30 healthy adults at the lower BMI distribution from the Calorie Restriction (CR) Society and followers of the CR Way. We also recruited 15 normal weight and 19 overweight/obese healthy adults from the general population. Both Siri and Brozek equations derived body fat percentage from the Bod Pod, and Bland-Altman analyses assessed agreement between the Bod Pod and DXA. Compared to DXA, the Bod Pod overestimated body fat percentage in thinner participants and underestimated body fat percentage in heavier participants, and the magnitude of difference was larger for underweight BMI participants, reaching 13% in some. The Bod Pod and DXA had smaller discrepancies in normal weight and overweight/obese participants. While less burdensome, clinicians should be aware that Bod Pod estimates may deviate from DXA estimates particularly at the lower end of the BMI distribution.

Air Displacement Plethysmography versus Dual-Energy X-Ray Absorptiometry in Underweight, Normal-Weight, and Overweight/Obese Individuals

PubMed Central

Lowry, David W.; Tomiyama, A. Janet

2015-01-01

Background Accurately estimating fat percentage is important for assessing health and determining treatment course. Methods of estimating body composition such as hydrostatic weighing or dual-energy x-ray absorptiometry (DXA), however, can be expensive, require extensive operator training, and, in the case of hydrostatic weighing, be highly burdensome for patients. Our objective was to evaluate air displacement plethysmography via the Bod Pod, a less burdensome method of estimating body fat percentage. In particular, we filled a gap in the literature by testing the Bod Pod at the lower extreme of the Body Mass Index (BMI) distribution. Findings Three BMI groups were recruited and underwent both air displacement plethysmography and dual-energy x-ray absorptiometry. We recruited 30 healthy adults at the lower BMI distribution from the Calorie Restriction (CR) Society and followers of the CR Way. We also recruited 15 normal weight and 19 overweight/obese healthy adults from the general population. Both Siri and Brozek equations derived body fat percentage from the Bod Pod, and Bland-Altman analyses assessed agreement between the Bod Pod and DXA. Compared to DXA, the Bod Pod overestimated body fat percentage in thinner participants and underestimated body fat percentage in heavier participants, and the magnitude of difference was larger for underweight BMI participants, reaching 13% in some. The Bod Pod and DXA had smaller discrepancies in normal weight and overweight/obese participants. Conclusions While less burdensome, clinicians should be aware that Bod Pod estimates may deviate from DXA estimates particularly at the lower end of the BMI distribution. PMID:25607661

Prevalence of Overweight and Obesity among Chinese Adults: Role of Adiposity Indicators and Age.

PubMed

Xu, Weili; Zhang, Hua; Paillard-Borg, Stephanie; Zhu, Hong; Qi, Xiuying; Rizzuto, Debora

2016-01-01

The role of different body fat indicators and age in assessing the prevalence of obesity is unclear. We aimed to examine to what extent different body fat indicators including BMI, waist circumference (WC) and waist-to-hip ratio (WHR) affect the prevalence of overweight and obesity among Chinese adults taking age into account. This population-based cross-sectional study included a random sample of 7,603 adults aged 20-79 years across entire Tianjin, China. BMI, WC, and WHR were used to define overweight and obesity following standard criteria. Prevalence rates were calculated and standardized using local age- and gender-specific census data. Logistic regression was used in data analysis. Using the combination of BMI, WC, and WHR, the prevalence of overweight and obesity was 69.8%, and increased with age till the age of 60 and a decline thereafter. The prevalence of overweight assessed by BMI was higher than that assessed by WC and WHR, while the prevalence of obesity defined by BMI was much lower than that defined by WC or WHR. The prevalence of overweight and obesity is about 70% among Chinese adults. Adiposity indicators and age play an important role in the prevalence of overweight and obesity. © 2016 S. Karger GmbH, Freiburg.

Trends in adult overweight and obesity prevalence in Mongolia, 2005-2013.

PubMed

Chimeddamba, Oyun; Gearon, Emma; Stevenson, Christopher; Liviya Ng, Winda; Baasai, Bulganchimeg; Peeters, Anna

2016-10-01

To analyze trends in the prevalence of overweight and obesity among Mongolian adults during the past decade as measured by body mass index (BMI) and waist circumference (WC). Data from the repeated cross-sectional surveys on the prevalence of noncommunicable disease risk factors conducted in 2005, 2009, and 2013 in Mongolia were used. Linear regression was used to quantify trends in mean BMI and WC, adjusted for age group, sex, and survey year. The age-standardized prevalence of obesity, denoted by the international BMI cutoff values, in men and women between 2005 and 2013 increased from 10.8% to 17.6% and from 18.9% to 26.4%, respectively. Using Asian-specific BMI cutoff values for men and women, the age-standardized prevalence of obesity between 2005 and 2013 increased from 20.0% to 32.8% and 33.4% to 43.7%, respectively. The prevalence of overweight and obesity has increased markedly between 2005 and 2013 similarly across all age groups and sexes. It is important to consider the use of Asian-specific cut-offs as the burden of obesity is twice as high as when using international BMI cutoffs. These data demonstrate the urgent need for obesity treatment, prevention, and monitoring in Mongolia. © 2016 The Obesity Society.

Markers of adiposity in HIV/AIDS patients: Agreement between waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index

PubMed Central

Ngu, Roland Cheofor; Kadia, Benjamin Momo; Tianyi, Frank-Leonel; Choukem, Simeon Pierre

2018-01-01

Background Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are all independent predictors of cardio-metabolic risk and therefore important in HIV/AIDS patients on antiretroviral therapy at risk of increased visceral adiposity. This study aimed to assess the extent of agreement between these parameters and the body mass index (BMI), as anthropometric parameters and in classifying cardio-metabolic risk in HIV/AIDS patients. Methods A secondary analysis of data from a cross-sectional study involving 200 HIV/AIDS patients was done. Anthropometric parameters were measured from participants using standard guidelines and central obesity defined according to recommended criteria. Increased cardio-metabolic risk was defined according to the standard cut-off values for all four parameters. Data were analyzed using STATA version 14.1. Results The prevalence of WC-defined central obesity, WHR-defined central obesity and WHtR > 0.50 were 33.5%, 44.5% and 36.5%, respectively. The prevalence of BMI-defined overweight and obesity was 40.5%. After adjusting for gender and HAART status, there was a significant linear association and correlation between WC and BMI (regression equation: WC (cm) = 37.184 + 1.756 BMI (Kg/m2) + 0.825 Male + 1.002 HAART, (p < 0.001, r = 0.65)), and between WHtR and BMI (regression equation: WHtR = 0.223 + 0.011 BMI (Kg/m2)– 0.0153 Male + 0.003 HAART, (p < 0.001, r = 0.65)), but not between WHR and BMI (p = 0.097, r = 0.13). There was no agreement between the WC, WHtR and BMI, and minimal agreement between the WHR and BMI, in identifying patients with an increased cardio-metabolic risk. Conclusion Despite the observed linear association and correlation between these anthropometric parameters, the routine use of WC, WHR and WHtR as better predictors of cardio-metabolic risk should be encouraged in these patients, due to their minimal agreement with BMI in identifying HIV/AIDS patients with increased cardio-metabolic risk. HAART status does not appear to significantly affect the association between these anthropometric parameters. PMID:29566089

75 FR 67093 - Iceberg Water Deviating From Identity Standard; Temporary Permit for Market Testing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-P-0517] Iceberg Water Deviating From Identity Standard; Temporary Permit for Market Testing AGENCY: Food and Drug... from the requirements of the standards of identity issued under section 401 of the Federal Food, Drug...

78 FR 2273 - Canned Tuna Deviating From Identity Standard; Temporary Permit for Market Testing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-P-1189] Canned Tuna Deviating From Identity Standard; Temporary Permit for Market Testing AGENCY: Food and Drug... interstate shipment of experimental packs of food varying from the requirements of standards of identity...

Upgraded FAA Airfield Capacity Model. Volume 2. Technical Description of Revisions

DTIC Science & Technology

1981-02-01

the threshold t k a the time at which departure k is released FIGURE 3-1 TIME AXIS DIAGRAM OF SINGLE RUNWAY OPERATIONS 3-2 J"- SIGMAR the standard...standard deviation of the interarrival time. SIGMAR - the standard deviation of the arrival runway occupancy time. A-5 SINGLE - program subroutine for

Methods of editing cloud and atmospheric layer affected pixels from satellite data

NASA Technical Reports Server (NTRS)

Nixon, P. R.; Wiegand, C. L.; Richardson, A. J.; Johnson, M. P. (Principal Investigator)

1982-01-01

Subvisible cirrus clouds (SCi) were easily distinguished in mid-infrared (MIR) TIROS-N daytime data from south Texas and northeast Mexico. The MIR (3.55-3.93 micrometer) pixel digital count means of the SCi affected areas were more than 3.5 standard deviations on the cold side of the scene means. (These standard deviations were made free of the effects of unusual instrument error by factoring out the Ch 3 MIR noise on the basis of detailed examination of noisy and noise-free pixels). SCi affected areas in the IR Ch 4 (10.5-11.5 micrometer) appeared cooler than the general scene, but were not as prominent as in Ch 3, being less than 2 standard deviations from the scene mean. Ch 3 and 4 standard deviations and coefficients of variation are not reliable indicators, by themselves, of the presence of SCi because land features can have similar statistical properties.

The relationship between body mass index and uric acid: a study on Japanese adult twins.

PubMed

Tanaka, Kentaro; Ogata, Soshiro; Tanaka, Haruka; Omura, Kayoko; Honda, Chika; Hayakawa, Kazuo

2015-09-01

The present study aimed to investigate the association between body mass index (BMI) and uric acid (UA) using the twin study methodology to adjust for genetic factors. The association between BMI and UA was investigated in a cross-sectional study using data from both monozygotic and dizygotic twins registered at the Osaka University Center for Twin Research and the Osaka University Graduate School of Medicine. From January 2011 to March 2014, 422 individuals participated in the health examination. We measured height, weight, age, BMI, lifestyle habits (Breslow's Health Practice Index), serum UA, and serum creatinine. To investigate the association between UA and BMI with adjustment for the clustering of a twin within a pair, individual-level analyses were performed using generalized linear mixed models (GLMMs). To investigate an association with adjustment for genetic and family environmental factors, twin-pair difference values analyses were performed. In all analysis, BMI was associated with UA in men and women. Using the GLMMs, standardized regression coefficients were 0.194 (95 % confidence interval: 0.016-0.373) in men and 0.186 (95 % confidence interval: 0.071-0.302) in women. Considering twin-pair difference value analyses, standardized regression coefficients were 0.333 (95 % confidence interval: 0.072-0.594) in men and 0.314 (95 % confidence interval: 0.151-0.477) in women. The present study shows that BMI was significantly associated with UA, after adjusting for both genetic and familial environment factors in both men and women.

A Taxonomy of Delivery and Documentation Deviations During Delivery of High-Fidelity Simulations.

PubMed

McIvor, William R; Banerjee, Arna; Boulet, John R; Bekhuis, Tanja; Tseytlin, Eugene; Torsher, Laurence; DeMaria, Samuel; Rask, John P; Shotwell, Matthew S; Burden, Amanda; Cooper, Jeffrey B; Gaba, David M; Levine, Adam; Park, Christine; Sinz, Elizabeth; Steadman, Randolph H; Weinger, Matthew B

2017-02-01

We developed a taxonomy of simulation delivery and documentation deviations noted during a multicenter, high-fidelity simulation trial that was conducted to assess practicing physicians' performance. Eight simulation centers sought to implement standardized scenarios over 2 years. Rules, guidelines, and detailed scenario scripts were established to facilitate reproducible scenario delivery; however, pilot trials revealed deviations from those rubrics. A taxonomy with hierarchically arranged terms that define a lack of standardization of simulation scenario delivery was then created to aid educators and researchers in assessing and describing their ability to reproducibly conduct simulations. Thirty-six types of delivery or documentation deviations were identified from the scenario scripts and study rules. Using a Delphi technique and open card sorting, simulation experts formulated a taxonomy of high-fidelity simulation execution and documentation deviations. The taxonomy was iteratively refined and then tested by 2 investigators not involved with its development. The taxonomy has 2 main classes, simulation center deviation and participant deviation, which are further subdivided into as many as 6 subclasses. Inter-rater classification agreement using the taxonomy was 74% or greater for each of the 7 levels of its hierarchy. Cohen kappa calculations confirmed substantial agreement beyond that expected by chance. All deviations were classified within the taxonomy. This is a useful taxonomy that standardizes terms for simulation delivery and documentation deviations, facilitates quality assurance in scenario delivery, and enables quantification of the impact of deviations upon simulation-based performance assessment.

The impact of maternal body mass index on external cephalic version success.

PubMed

Chaudhary, Shahrukh; Contag, Stephen; Yao, Ruofan

2018-01-21

The purpose of this study is to determine the association between body mass index (BMI) and success of ECV. This is a cross-sectional analysis of singleton live births in the USA from 2010 to 2014 using birth certificate data. Patients were assigned a BMI category according to standard WHO classification. Comparisons of success of ECV between the BMI categories were made using chi-square analysis with normal BMI as the reference group. Cochran-Armitage test was performed to look for a trend of decreasing success of ECV as BMI increased. The odds for successful ECV were estimated using multivariate logistic regression analysis, adjusting for possible confounders. A total of 51,002 patients with documented ECV were available for analysis. There was a decreased success rate for ECV as BMI increased (p < .01). Women with a BMI of 40 kg/m 2 or greater had a 58.5% success rate of ECV; women with a normal BMI had 65.0% success rate of ECV. Multivariate analyses demonstrated significant decrease in success of ECV in women with BMI of 40 kg/m 2 or greater (OR 0.621, CI 0.542-0.712). Among women with BMI of 40 kg/m 2 or greater with successful ECV, 59.5% delivered vaginally. In contrast, 81.0% of women with normal BMI and successful ECV delivered vaginally. Morbidly obese women have decreased success rate of ECV as BMI increases and decreased vaginal delivery rates after successful ECV.

Body Mass Index, the Most Widely Used but also Widely Criticized Index: Would a Gold-Standard Measure of Total Body Fat be a Better Predictor of Cardiovascular Disease Mortality?

PubMed Central

Ortega, Francisco B; Sui, Xuemei; Lavie, Carl J; Blair, Steven N

2016-01-01

Objectives To examine whether an accurate measure (using a gold-standard method) of total body fat (BF) would be a better predictor of cardiovascular disease (CVD) mortality than body mass index (BMI). Participants and Methods A total of 60,335 participants were examined between January 1, 1979, and December 31, 2003, and then followed-up for mean of 15.2 years. BMI was estimated by standard procedures. Indices of body composition [i.e. BF%, fat mass index (FMI), fat-free mass (FFM) and FFM index (FFMI)] were derived from either skinfold thicknesses or hydrostatic weighing. For exact comparisons, the indices studied were categorized identically using sex-specific percentiles. Results Compared with a medium BMI, a very high BMI was associated with hazard ratios (HR) of 2.7 (confidence interval, CI:2.1-3.3) for CVD mortality, a stronger association than for BF% or FMI; i.e. HR=1.6(CI:1.3-1.9) and 2.2(CI:1.8-2.7), respectively. Compared with a medium FFMI, a very high FFMI was associated with a HR of 2.2 (CI:1.7-2.7) for CVD mortality, with these estimates being markedly smaller for FFM, i.e. HR=1.2(CI:0.9-1.6). When the analyses were restricted only to the sample with hydrostatic assessments (N=29,959), the results were nearly identical, with even slightly larger differences in favor of BMI, i.e. HR=3.0 (CI:2.2-4.0) compared with BF% and FMI, i.e. HR=1.5(CI:1.2-1.9) and 2.1(CI:1.6-2.7) respectively. We estimated Harrell c-index as an indicator of discriminant/predictive ability for these models and observed that the c-index in models including BMI was significantly higher than that in models including BF% or FMI (all P values <.005). Conclusions The simple and inexpensive measure of BMI can be as clinically important or even more than total adiposity measures assessed by accurate and expensive methods. Physiological explanations for these findings are discussed. PMID:26948431

Simulation-based estimation of mean and standard deviation for meta-analysis via Approximate Bayesian Computation (ABC).

PubMed

Kwon, Deukwoo; Reis, Isildinha M

2015-08-12

When conducting a meta-analysis of a continuous outcome, estimated means and standard deviations from the selected studies are required in order to obtain an overall estimate of the mean effect and its confidence interval. If these quantities are not directly reported in the publications, they must be estimated from other reported summary statistics, such as the median, the minimum, the maximum, and quartiles. We propose a simulation-based estimation approach using the Approximate Bayesian Computation (ABC) technique for estimating mean and standard deviation based on various sets of summary statistics found in published studies. We conduct a simulation study to compare the proposed ABC method with the existing methods of Hozo et al. (2005), Bland (2015), and Wan et al. (2014). In the estimation of the standard deviation, our ABC method performs better than the other methods when data are generated from skewed or heavy-tailed distributions. The corresponding average relative error (ARE) approaches zero as sample size increases. In data generated from the normal distribution, our ABC performs well. However, the Wan et al. method is best for estimating standard deviation under normal distribution. In the estimation of the mean, our ABC method is best regardless of assumed distribution. ABC is a flexible method for estimating the study-specific mean and standard deviation for meta-analysis, especially with underlying skewed or heavy-tailed distributions. The ABC method can be applied using other reported summary statistics such as the posterior mean and 95 % credible interval when Bayesian analysis has been employed.

On Teaching about the Coefficient of Variation in Introductory Statistics Courses

ERIC Educational Resources Information Center

Trafimow, David

2014-01-01

The standard deviation is related to the mean by virtue of the coefficient of variation. Teachers of statistics courses can make use of that fact to make the standard deviation more comprehensible for statistics students.

Secondary analyses of data from 4 studies with fourth-grade children show that sex, race, amounts eaten of standardized portions, and energy content given in trades explain the positive relationship between body mass index and energy intake at school-provided meals.

PubMed

Baxter, Suzanne Domel; Paxton-Aiken, Amy E; Tebbs, Joshua M; Royer, Julie A; Guinn, Caroline H; Finney, Christopher J

2012-09-01

Results from a 2012 article showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals. To help explain that positive relationship, secondary analyses investigated (1) whether the relationship differed by sex and race and (2) the relationship between BMI and 6 aspects of school-provided meals--amounts eaten of standardized portions, energy content given in trades, energy intake received in trades, energy intake from flavored milk, energy intake from a la carte ice cream, and breakfast type. Data were from 4 studies conducted 1 per school year (1999-2000 to 2002-2003). Fourth-grade children (n = 328; 50% female; 54% black) from 13 schools total were observed eating school-provided breakfast and lunch on 1 to 3 days per child for 1178 total meals (50% breakfast). Children were weighed and measured. Marginal regression models were fit using BMI as the dependent variable. For purpose 1, independent variables were energy intake at school-provided meals, sex, race, age, and study; additional models included interaction terms involving energy intake and sex/race. For purpose 2, independent variables were the 6 aspects of school-provided meals, sex, race, age, and study. The relationship between BMI and energy intake at school-provided meals differed by sex (P < .0001; stronger for females) and race (P = .0063; stronger for black children). BMI was positively related to amounts eaten of standardized portions (P < .0001) and negatively related to energy content given in trades (P = .0052). Explaining the positive relationship between BMI and energy intake at school-provided meals may contribute to school-based obesity prevention efforts. Copyright © 2012 Elsevier Inc. All rights reserved.

High degree of BMI misclassification of malnutrition among Swedish elderly population: Age-adjusted height estimation using knee height and demispan

PubMed Central

Gavriilidou, N N; Pihlsgård, M; Elmståhl, S

2015-01-01

Background/Objectives: The degree of misclassification of obesity and undernutrition among elders owing to inaccurate height measurements is investigated using height predicted by knee height (KH) and demispan equations. Subjects/Methods: Cross-sectional investigation was done among a random heterogeneous sample from five municipalities in Southern Sweden from a general population study ‘Good Aging in Skåne' (GÅS). The sample comprised two groups: group 1 (KH) including 2839 GÅS baseline participants aged 60–93 years with a valid KH measurement and group 2 (demispan) including 2871 GÅS follow-up examination participants (1573 baseline; 1298 new), aged 60–99 years, with a valid demispan measurement. Participation rate was 80%. Height, weight, KH and demispan were measured. KH and demispan equations were formulated using linear regression analysis among participants aged 60–64 years as reference. Body mass index (BMI) was calculated in kg/m2. Results: Undernutrition prevalences in men and women were 3.9 and 8.6% by KH, compared with 2.4 and 5.4% by standard BMI, and more pronounced for all women aged 85+ years (21% vs 11.3%). The corresponding value in women aged 85+ years by demispan was 16.5% vs 10% by standard BMI. Obesity prevalences in men and women were 17.5 and 14.6% by KH, compared with 19.0 and 20.03% by standard BMI. Values among women aged 85+ years were 3.7% vs 10.4% by KH and 6.5% vs 12.7% by demispan compared with the standard. Conclusions: There is an age-related misclassification of undernutrition and obesity attributed to inaccurate height estimation among the elderly. This could affect the management of patients at true risk. We therefore propose using KH- and demispan-based formulae to address this issue. PMID:25205322

How well does the standard body mass index or variations with a different exponent predict human lifespan?

PubMed

Foster, Dean; Karloff, Howard; Shirley, Kenneth E

2016-02-01

The objective was twofold: (1) to estimate for each individual the body mass index (BMI) which is associated with the lowest risk of death, and (2) to study variants of the BMI formula to determine which gives the best predictions of death. Treating BMI = mass/height(2) as a continuous variable and estimating its interaction effects with several other variables, this study analyzed the NIH-AARP study data set of approximately 566,000 individuals and fit Cox proportional hazards models to the survival times. For each individual, a "personalized optimal BMI," the BMI for that individual which, according to the model, is associated with the lowest risk of death, is estimated. The average personalized optimal BMI is approximately 26, which is in the current "overweight" category. In fact, mass/height is a better predictor of death on the data set than BMI itself. The model suggests that an individual's "optimal" BMI depends on his or her features; "one-size-fits-all" recommendations may be not best. © 2016 The Obesity Society.

Big drinkers: how BMI, gender and rules of thumb influence the free pouring of wine.

PubMed

Smarandescu, Laura; Walker, Doug; Wansink, Brian

2014-11-01

This research examines free pouring behavior and provides an account of how Body Mass Index (BMI) and gender might lead to the overpouring, and consequently the overconsumption of wine. An observational study with young adults investigated how BMI and gender affect free-pouring of wine over a variety of pouring scenarios, and how rules-of-thumb in pouring affect the quantities of alcohol poured by men and women across BMI categories. For men, the amount poured was positively related to BMI. However, BMI did not affect pours by women. The use of the "half glass" rule-of-thumb in pouring reduced the volume of wine poured by over 20% for both men and women. Importantly, this rule-of-thumb substantially attenuated the pours by men at high BMI levels. Increasing awareness of pouring biases represents an early and effective step toward curbing alcohol consumption among men, and especially those who are overweight. Additionally, using a simple "half glass" rule-of-thumb may be an effective way to curb overpouring, despite non-standard glass sizes. Copyright © 2014. Published by Elsevier B.V.

Body mass index and body fat percentage in assessment of obesity prevalence in saudi adults.

PubMed

Habib, Syed Shahid

2013-02-01

To assess the obesity prevalence in Saudi adults according to the international standards of body mass index (BMI) and body fat percentage (BF%). Five hundred and thirty healthy Saudi adults aged 18-72 years (mean 36.91 ± 15.22 years) were enrolled in this study. Their body composition was assessed by bioelectrical impendence analysis with a commercially available body composition analyzer. Standard BMI and BF% values were used to define obesity. The prevalence of underweight, normal underweight, overweight and obesity in Saudi adults according to the BMI criteria (<18.5 kg/m², 18.5-24.4 kg/m², 25-29.9 kg/m², 30 kg/m² and above, respectively) was 2.5%, 30.2%, 33.6%, and 33.8%, respectively, whereas the obesity prevalence was 60% (n=318) in Saudi adults according to the BF% criteria (25% for males and 30% for females), which was significantly higher than that according to BMI criteria. However, it was 50.6% (n=268) when the BMI cutoff point was 27.5 kg/m², proposed by WHO for the Asian population. Kappa analysis showed that the obesity prevalence defined by BMI and BF% was higher in females than in males (k=0.530 vs k=0.418, P<0.0001). The sensitivity and specificity of BMI (30 kg/m² and 27.5 kg/m²) were 54.1% and 96.7% and 76.4% and 88.2%, respectively, for obesity. A lower BMI cutoff point (26.60 kg/m²) was proposed in this study, which gave the maximum sensitivity (84.3%) and specificity (85.4%), with a moderate kappa agreement (k=0.686). Moreover, the obesity prevalence at this cutoff point (56.4%) was significantly higher than that recommended by WHO. The specificity of BMI for obesity is high and its sensitivity is low in both sexes. Its sensitivity can be increased by changing BMI cutoff to a lower value. The choice of BF% reference is of great influence for the assessment of obesity prevalence according to the BMI. Copyright © 2013 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Evaluating relationship in cytokines level, Fibromyalgia Impact Questionnaire and Body Mass Index in women with Fibromyalgia syndrome.

PubMed

Ghizal, Fatima; Das, Siddharth Kumar; Verma, Narsingh; Mahdi, Abbas Ali

2016-01-01

Cytokines (TNF-α and IL-6) levels are reported to be perturbed in Fibromyalgia syndrome (FMS) patients. Moreover, Body Mass Index (BMI) may also be related to disturbed cytokines level. Therefore, the present study was planned to evaluate the levels of cytokines and to correlate them with BMI and Fibromyalgia Impact Questionnaire Revised (FIQR) in female FMS patients (n= 60) and control group (n= 60). 4 ml of blood samples were taken from both the group of patients and controls to measure the levels of IL-6 and TNF-α . Symptoms of FMS were assessed by FIQR. BMI was calculated by a standard formula of weight in kilograms divided by height in meter square. There were significant differences in BMI levels in FMS patients than in control group. However, no significant association was found between BMI and TNF-α levels, and BMI and IL-6 levels in patient and control groups. However, a significant association was found between FIQR and BMI in patients group. On the basis of the results we conclude that the levels of IL-6 and TNF-alpha are not associated with BMI in FMS patients. Furthermore, patients with higher BMI may fall at the risk of FMS. Therefore, weight management may be an important aspect for treatment of FMS patients.

HYDROCORTISONE THERAPY AND GROWTH TRAJECTORY IN CHILDREN WITH CLASSICAL CONGENITAL ADRENAL HYPERPLASIA.

PubMed

Bizzarri, Carla; Improda, Nicola; Maggioli, Chiara; Capalbo, Donatella; Roma, Silvia; Porzio, Ottavia; Salerno, Mariacarolina; Cappa, Marco

2017-05-01

Poor linear growth is one of the main concerns in children with congenital adrenal hyperplasia (CAH). We aimed to analyze factors affecting growth trajectory in children with classical CAH. Clinical records of children followed from infancy up to the end of growth at two Italian tertiary referral hospitals were reviewed. Fifty-seven patients (31 males), treated with hydrocortisone and fludrocortisone only, were included. Clinical observations were divided into three groups: 0 to 2 years, 172 observations; from 2 years to puberty onset, 813 observations; after puberty onset, 527 observations. Height velocity, pubertal growth spurt, and final height were evaluated as outcomes. Final height standard deviation score (SDS) was lower than target height SDS (-0.74 ± 1.1 versus -0.31 ± 1.01; P<.001). Target-adjusted final height SDS was -0.44 ± 1.8 in males and -0.13 ± 1.1 in females (P = .001). Total pubertal growth was 21.9 ± 7.3 cm in males and 19.2 ± 8.2 cm in females (P = .19). Hydrocortisone dose increased and height-velocity SDS decreased during puberty. At multivariable analysis, height-velocity SDS was adversely affected by hydrocortisone dose (P = .038) and directly related to adrenocorticotropic hormone (ACTH) levels (P = .023). Target-adjusted final-height SDS was adversely affected by hydrocortisone dose (P<.001) and positively related to mineralocorticoid therapy (P = .001) and ACTH levels (P = .02). Total pubertal growth (cm) was positively related to ACTH levels (P = .01). Height outcome of CAH patients is now better than previously reported. During puberty, the lowest effective dose of hydrocortisone should be used to optimize pubertal growth spurt and final height. 17-OHP = 17-alpha-hydroxyprogesterone ACTH = adrenocorticotropic hormone BMI = body mass index CAH = congenital adrenal hyperplasia GH = growth hormone HPA = hypothalamus-pituitary-adrenal PRA = plasma renin activity SDS = standard deviation score SV = simple virilizing SW = salt-wasting.

Postprandial Glucose Surges after Extremely Low Carbohydrate Diet in Healthy Adults.

PubMed

Kanamori, Koji; Ihana-Sugiyama, Noriko; Yamamoto-Honda, Ritsuko; Nakamura, Tomoka; Sobe, Chie; Kamiya, Shigemi; Kishimoto, Miyako; Kajio, Hiroshi; Kawano, Kimiko; Noda, Mitsuhiko

2017-09-01

Carbohydrate-restricted diets are prevalent not only in obese people but also in the general population to maintain appropriate body weight. Here, we report that extreme carbohydrate restriction for one day affects the subsequent blood glucose levels in healthy adults. Ten subjects (median age 30.5 years, BMI 21.1 kg/m 2 , and HbA1c 5.5%), wearing with a continuous glucose monitoring device, were given isoenergetic test meals for 4 consecutive days. On day 1, day 2 (D2), and day 4 (D4), they consumed normal-carbohydrate (63-66% carbohydrate) diet, while on day 3, they took low-carbohydrate/high-fat (5% carbohydrate) diet. The daily energy intake was 2,200 kcal for males and 1,700 kcal for females. On D2 and D4, we calculated the mean 24-hr blood glucose level (MEAN/24h) and its standard deviation (SD/24h), the area under the curve (AUC) for glucose over 140 mg/dL within 4 hours after each meal (AUC/4h/140), the mean amplitude of the glycemic excursions (MAGE), the incremental AUC of 24-hr blood glucose level above the mean plus one standard deviation (iAUC/MEAN+SD). Indexes for glucose fluctuation on D4 were significantly greater than those on D2 (SD/24h; p = 0.009, MAGE; p = 0.013, AUC/4h/140 after breakfast and dinner; p = 0.006 and 0.005, and iAUC/MEAN+SD; p = 0.007). The value of MEAN/24h and AUC/4h/140 after lunch on D4 were greater than those on D2, but those differences were not statistically significant. In conclusion, consumption of low-carbohydrate/high-fat diet appears to cause higher postprandial blood glucose on subsequent normal-carbohydrate diet particularly after breakfast and dinner in healthy adults.

Quantitative signal intensity alteration in infrapatellar fat pad predict incident radiographic osteoarthritis: the Osteoarthritis Initiative.

PubMed

Wang, Kang; Ding, Changhai; Hannon, Michael J; Chen, Zhongshan; Kwoh, C Kent; Hunter, David J

2018-04-12

To determine if infrapatellar fat pad (IPFP) signal intensity (SI) measures are predictive of incident radiographic osteoarthritis (iROA) over 4 years in the OA Initiative (OAI) study. Case knees (n=355) defined by iROA were matched one-to-one by gender, age and radiographic status with control knees. T2-weighted MR images were assessed at P0 (the visit when iROA was found on radiograph), P-1 (1 year prior to P0) and baseline, and utilized to assess IPFP SI semi-automatically using MATLAB. Conditional logistic regression analyses were used to assess risk of iROA associated with IPFP SI alteration after adjustment for covariates. Participants were on average 60.2 years old, predominantly female (66.7%) and overweight (mean BMI: 28.3). Baseline IPFP measures including mean value and standard deviation of IPFP SI [Mean(IPFP), sDev(IPFP)] (HR, 95%CI: 5.2, 1.1 to 23.6 and 5.7, 2.2 to 14.5, respectively), mean value and standard deviation of IPFP high SI [Mean(H), sDev(H)] (HR, 95%CI: 3.3, 1.7 to 6.4 and 3.1, 1.3 to 7.7, respectively), median value and upper quartile value of IPFP high SI [Median(H), UQ(H)], and clustering effect of high SI [Clustering factor(H)] were associated with iROA during 4 years. All P-1 IPFP measures were associated with iROA after 12 months. P-0 IPFP SI measures were all associated with ROA. The quantitative segmentation of high signal in IPFP is confirming previous work based on semiquantitative assessment suggesting its predictive validity. The IPFP high SI alteration could be an important imaging biomarker to predict the occurrence of radiographic OA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Body mass index standard deviation score and obesity in children with type 1 diabetes in the Nordic countries. HbA1c and other predictors of increasing BMISDS.

PubMed

Birkebaek, N H; Kahlert, J; Bjarnason, R; Drivvoll, A K; Johansen, A; Konradsdottir, E; Pundziute-Lyckå, A; Samuelsson, U; Skrivarhaug, T; Svensson, J

2018-05-21

Intensified insulin therapy may increase body weight and cause obesity. This study compared body mass index standard deviation score (BMISDS) and obesity rate in children with type 1 diabetes (T1D) in Denmark, Iceland, Norway and Sweden, and uncovered predictors for increasing BMISDS. Data registered in the Nordic national childhood diabetes databases during the period 2008-2012 on children below 15 years with T1D for more than 3 months were compiled, including information on gender, age, diabetes duration, hemoglobin A 1c (HbA 1c ), insulin dose, severe hypoglycemia (SH), treatment modality, height and weight. The Swedish reference chart for BMI was used for calculating BMISDS. Totally, 11 025 children (48% females) (30 994 registrations) were included. Medians by the last recorded examination were: age, 13.5 years; diabetes duration, 4.3 years; HbA 1c , 7.9% (63 mmol/mol); insulin dose, 0.8 IU/kg/d and BMISDS, 0.70. Obesity rate was 18.5%. Adjusted mean BMISDS (BMISDS adj) was inversely related to HbA 1c and directly to diabetes duration. Higher BMISDS adj was found in those with an insulin dose above 0.6 IU/kg/d, and in girls above 10 years. Pump users had higher BMISDS adj than pen users, and patients with registered SH had higher BMISDS adj than patients without SH (both P < .001). Obesity rate in children with T1D in the Nordic countries is high, however, with country differences. Low HbA 1c , long diabetes duration, higher insulin dose, pump treatment and experiencing a SH predicted higher BMISDS. Diabetes caregivers should balance the risk of obesity and the benefit of a very low HbA 1c. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A SIMPLE METHOD FOR EVALUATING DATA FROM AN INTERLABORATORY STUDY

EPA Science Inventory

Large-scale laboratory-and method-performance studies involving more than about 30 laboratories may be evaluated by calculating the HORRAT ratio for each test sample (HORRAT=[experimentally found among-laboratories relative standard deviation] divided by [relative standard deviat...

Histogram-based quantitative evaluation of endobronchial ultrasonography images of peripheral pulmonary lesion.

PubMed

Morikawa, Kei; Kurimoto, Noriaki; Inoue, Takeo; Mineshita, Masamichi; Miyazawa, Teruomi

2015-01-01

Endobronchial ultrasonography using a guide sheath (EBUS-GS) is an increasingly common bronchoscopic technique, but currently, no methods have been established to quantitatively evaluate EBUS images of peripheral pulmonary lesions. The purpose of this study was to evaluate whether histogram data collected from EBUS-GS images can contribute to the diagnosis of lung cancer. Histogram-based analyses focusing on the brightness of EBUS images were retrospectively conducted: 60 patients (38 lung cancer; 22 inflammatory diseases), with clear EBUS images were included. For each patient, a 400-pixel region of interest was selected, typically located at a 3- to 5-mm radius from the probe, from recorded EBUS images during bronchoscopy. Histogram height, width, height/width ratio, standard deviation, kurtosis and skewness were investigated as diagnostic indicators. Median histogram height, width, height/width ratio and standard deviation were significantly different between lung cancer and benign lesions (all p < 0.01). With a cutoff value for standard deviation of 10.5, lung cancer could be diagnosed with an accuracy of 81.7%. Other characteristics investigated were inferior when compared to histogram standard deviation. Histogram standard deviation appears to be the most useful characteristic for diagnosing lung cancer using EBUS images. © 2015 S. Karger AG, Basel.

Role of the standard deviation in the estimation of benchmark doses with continuous data.

PubMed

Gaylor, David W; Slikker, William

2004-12-01

For continuous data, risk is defined here as the proportion of animals with values above a large percentile, e.g., the 99th percentile or below the 1st percentile, for the distribution of values among control animals. It is known that reducing the standard deviation of measurements through improved experimental techniques will result in less stringent (higher) doses for the lower confidence limit on the benchmark dose that is estimated to produce a specified risk of animals with abnormal levels for a biological effect. Thus, a somewhat larger (less stringent) lower confidence limit is obtained that may be used as a point of departure for low-dose risk assessment. It is shown in this article that it is important for the benchmark dose to be based primarily on the standard deviation among animals, s(a), apart from the standard deviation of measurement errors, s(m), within animals. If the benchmark dose is incorrectly based on the overall standard deviation among average values for animals, which includes measurement error variation, the benchmark dose will be overestimated and the risk will be underestimated. The bias increases as s(m) increases relative to s(a). The bias is relatively small if s(m) is less than one-third of s(a), a condition achieved in most experimental designs.

Statistical models for estimating daily streamflow in Michigan

USGS Publications Warehouse

Holtschlag, D.J.; Salehi, Habib

1992-01-01

Statistical models for estimating daily streamflow were analyzed for 25 pairs of streamflow-gaging stations in Michigan. Stations were paired by randomly choosing a station operated in 1989 at which 10 or more years of continuous flow data had been collected and at which flow is virtually unregulated; a nearby station was chosen where flow characteristics are similar. Streamflow data from the 25 randomly selected stations were used as the response variables; streamflow data at the nearby stations were used to generate a set of explanatory variables. Ordinary-least squares regression (OLSR) equations, autoregressive integrated moving-average (ARIMA) equations, and transfer function-noise (TFN) equations were developed to estimate the log transform of flow for the 25 randomly selected stations. The precision of each type of equation was evaluated on the basis of the standard deviation of the estimation errors. OLSR equations produce one set of estimation errors; ARIMA and TFN models each produce l sets of estimation errors corresponding to the forecast lead. The lead-l forecast is the estimate of flow l days ahead of the most recent streamflow used as a response variable in the estimation. In this analysis, the standard deviation of lead l ARIMA and TFN forecast errors were generally lower than the standard deviation of OLSR errors for l < 2 days and l < 9 days, respectively. Composite estimates were computed as a weighted average of forecasts based on TFN equations and backcasts (forecasts of the reverse-ordered series) based on ARIMA equations. The standard deviation of composite errors varied throughout the length of the estimation interval and generally was at maximum near the center of the interval. For comparison with OLSR errors, the mean standard deviation of composite errors were computed for intervals of length 1 to 40 days. The mean standard deviation of length-l composite errors were generally less than the standard deviation of the OLSR errors for l < 32 days. In addition, the composite estimates ensure a gradual transition between periods of estimated and measured flows. Model performance among stations of differing model error magnitudes were compared by computing ratios of the mean standard deviation of the length l composite errors to the standard deviation of OLSR errors. The mean error ratio for the set of 25 selected stations was less than 1 for intervals l < 32 days. Considering the frequency characteristics of the length of intervals of estimated record in Michigan, the effective mean error ratio for intervals < 30 days was 0.52. Thus, for intervals of estimation of 1 month or less, the error of the composite estimate is substantially lower than error of the OLSR estimate.

Familial Risk Moderates the Association Between Sleep and zBMI in Children

PubMed Central

El-Sheikh, Mona

2013-01-01

Objective A cumulative risk approach was used to examine the moderating effect of familial risk factors on relations between actigraphy-based sleep quantity (minutes) and quality (efficiency) and sex- and age-standardized body mass index (zBMI). Methods The sample included 124 boys and 104 girls with a mean age of 10.41 years (SD = 0.67). Children wore actigraphs for 1 week, and their height and weight were assessed in the lab. Results After controlling for potential confounds, multiple regression analyses indicated that sleep minutes predicted children’s zBMI and that both sleep minutes and efficiency interacted with family risk in the prediction of zBMI. The association between poor sleep and zBMI was especially evident for children exposed to higher levels of family risk. Conclusions Findings suggest that not all children who exhibit poor sleep are at equal risk for higher zBMI and that familial and contextual conditions need to be considered in this link. PMID:23699749

"A Body Shape Index" in middle-age and older Indonesian population: scaling exponents and association with incident hypertension.

PubMed

Cheung, Yin Bun

2014-01-01

"A Body Shape Index" (ABSI) is a recently proposed index that standardizes waist circumference for body mass index (BMI) and height. This study aims to: (a) examine if the ABSI scaling exponents for standardizing waist circumference for BMI and height are valid in middle-aged and older Indonesian population, and (b) compare the association between incident hypertension and ABSI and other anthropometric measures. The Indonesian Family Life Survey Wave 3 measured anthropometric variables and blood pressure of 8255 adults aged between 40 to 85 years in 2000. The relationship between two anthropometric quantities, e.g. weight (w) and height (h), can be expressed as the power law-equivalent [Formula: see text], where p = 2 is the scaling exponent in the derivation of the BMI and can be estimated by linear regression analysis. This was extended to the regression analysis of the log-transformed waist circumference, weight and height to establish the scaling exponents in the ABSI. The values for men were similar to those developed by the previous American study, which were 2/3 (BMI) and 1/2 (height). Those for women were somewhat smaller, at 3/5 (BMI) and 1/5 (height). The original (American) ABSI leads to mild negative correlation with BMI (-0.14) and height (-0.12) in the female population. Analysis of the development of hypertension between Waves 3 and 4 (average interval 7.5 years) in relation to ABSI measured at Wave 3 showed stronger association if the locally derived (Indonesian) scaling exponents were used. However, both versions of the ABSI were less associated with incident hypertension than waist circumference and BMI. The values for the scaling exponents for ABSI are roughly similar between the American population and the middle-aged and older Indonesian population, although larger discrepancy was found in women. The ABSI is less associated with incident hypertension than waist circumference and BMI.

SURVIVORS OF STANDARD RISK ACUTE LYMPHOBLASTIC LEUKEMIA DO NOT HAVE INCREASED RISK FOR OVERWEIGHT AND OBESITY COMPARED TO NON-CANCER PEERS: A REPORT FROM THE CHILDREN’S ONCOLOGY GROUP

PubMed Central

Lindemulder, Susan J; Stork, Linda C; Bostrom, Bruce; Lu, Xiaomin; Devidas, Meenakshi; Hunger, Stephen; Neglia, Joseph P; Kadan-Lottick, Nina S

2015-01-01

Background We sought to determine whether survivors of standard risk ALL (SR-ALL) treated without cranial radiation have increased risk for obesity by assessing changes in body mass index (BMI) during and after treatment; identifying contributing patient and treatment factors; comparing rates of overweight/obese to national health data. Procedure Eligibility for this retrospective cohort study included 1) previous enrollment on legacy therapy trials CCG1922 or CCG1952; 2) continuous first remission; and 3) age at follow-up evaluation of 6-16.99 years. Height and weight from diagnosis, consolidation, start of maintenance, last cycle of maintenance, and off-therapy were analyzed. Results The 269 subjects were a median age of 3.5 years at diagnosis and 13.3 years at follow-up. BMI% significantly increased from induction to consolidation (+17.6 ± 1.6%), start of maintenance to end-of-treatment (+3.3 ± 1.6%) and decreased from end-of-treatment to follow-up (−3.5 ± 1.6%,). Higher BMI% at follow-up was associated with higher BMI% at diagnosis (p < 0.0001), but not age at diagnosis, gender, or race. Patients previously randomized to dexamethasone had a stronger association between BMI% at diagnosis and BMI% at follow-up than those who received prednisone (p=0.0005). At follow-up, 39% of survivors were overweight or obese; the relative risk of overweight/obese was 1.028 (p=0.738) compared to the general population. Conclusions Our study of patients with SR-ALL found a significant increase in BMI% largely during the first month of therapy that is greater with dexamethasone than prednisone. However, after therapy, there was no increased risk of overweight/obese BMI compared to non-cancer peers. PMID:25663378

10 CFR 961.4 - Deviations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Deviations. 961.4 Section 961.4 Energy DEPARTMENT OF ENERGY STANDARD CONTRACT FOR DISPOSAL OF SPENT NUCLEAR FUEL AND/OR HIGH-LEVEL RADIOACTIVE WASTE General § 961.4 Deviations. Requests for authority to deviate from this part shall be submitted in writing to...

10 CFR 961.4 - Deviations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Deviations. 961.4 Section 961.4 Energy DEPARTMENT OF ENERGY STANDARD CONTRACT FOR DISPOSAL OF SPENT NUCLEAR FUEL AND/OR HIGH-LEVEL RADIOACTIVE WASTE General § 961.4 Deviations. Requests for authority to deviate from this part shall be submitted in writing to...

10 CFR 961.4 - Deviations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Deviations. 961.4 Section 961.4 Energy DEPARTMENT OF ENERGY STANDARD CONTRACT FOR DISPOSAL OF SPENT NUCLEAR FUEL AND/OR HIGH-LEVEL RADIOACTIVE WASTE General § 961.4 Deviations. Requests for authority to deviate from this part shall be submitted in writing to...

10 CFR 961.4 - Deviations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Deviations. 961.4 Section 961.4 Energy DEPARTMENT OF ENERGY STANDARD CONTRACT FOR DISPOSAL OF SPENT NUCLEAR FUEL AND/OR HIGH-LEVEL RADIOACTIVE WASTE General § 961.4 Deviations. Requests for authority to deviate from this part shall be submitted in writing to...

10 CFR 961.4 - Deviations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Deviations. 961.4 Section 961.4 Energy DEPARTMENT OF ENERGY STANDARD CONTRACT FOR DISPOSAL OF SPENT NUCLEAR FUEL AND/OR HIGH-LEVEL RADIOACTIVE WASTE General § 961.4 Deviations. Requests for authority to deviate from this part shall be submitted in writing to...

Effects of calisthenics and Pilates exercises on coordination and proprioception in adult women: a randomized controlled trial.

PubMed

Ozer Kaya, Derya; Duzgun, Irem; Baltaci, Gul; Karacan, Selma; Colakoglu, Filiz

2012-08-01

To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training. Randomized, controlled, assessor-blinded, repeated-measures. University research laboratory. Healthy, sedentary, female participants age 25-50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training. Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training. For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05). It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.

Do health care workforce, population, and service provision significantly contribute to the total health expenditure? An econometric analysis of Serbia.

PubMed

Santric-Milicevic, M; Vasic, V; Terzic-Supic, Z

2016-08-15

In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P < 0.05. The regression model captures 90 % of all variations of observed dependent variables (adjusted R square), and the model is significant (P < 0.001). Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001). Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.

Deviation between self-reported and measured occupational physical activity levels in office employees: effects of age and body composition.

PubMed

Wick, Katharina; Faude, Oliver; Schwager, Susanne; Zahner, Lukas; Donath, Lars

2016-05-01

Whether occupational physical activity (PA) will be assessed via questionnaires or accelerometry depends on available resources. Although self-reported data collection seems feasible and inexpensive, obtained information could be biased by demographic determinants. Thus, we aimed at comparing self-reported and objectively measured occupational sitting, standing, and walking times adjusted for socio-demographic variables. Thirty-eight office employees (eight males, 30 females, age 40.8 ± 11.4 years, BMI 23.9 ± 4.2 kg/m(2)) supplied with height-adjustable working desks were asked to report sitting, standing, and walking times using the Occupational Sitting and Physical Activity Questionnaire during one working week. The ActiGraph wGT3X-BT was used to objectively measure occupational PA during the same week. Subjectively and objectively measured data were compared computing the intra-class correlation coefficients, paired t tests and Bland-Altman plots. Furthermore, repeated-measurement ANOVAs for measurement (subjective vs. objective) and socio-demographic variables were calculated. Self-reported data yielded a significant underestimation of standing time (13.3 vs. 17.9%) and an overestimation of walking time (12.7 vs. 5.0%). Significant interaction effects of age and measurement of standing time (F = 6.0, p = .02, ηp(2) = .14) and BMI group and measurement of walking time were found (F = 3.7, p = .04, ηp(2) = .17). Older employees (>39 years) underestimated their standing time, while underweight workers (BMI < 20 kg/m(2)) overestimated their walking time. Self-reported PA data differ from objective data. Demographic variables (age, BMI) affect the amount of self-reported misjudging of PA. In order to improve the validity of self-reported data, a correction formula for the economic assessment of PA by subjective measures is needed, considering age and BMI.

The Body and the Beautiful: Health, Attractiveness and Body Composition in Men’s and Women’s Bodies

PubMed Central

Brierley, Mary-Ellen; Brooks, Kevin R.; Mond, Jonathan; Stevenson, Richard J.

2016-01-01

The dominant evolutionary theory of physical attraction posits that attractiveness reflects physiological health, and attraction is a mechanism for identifying a healthy mate. Previous studies have found that perceptions of the healthiest body mass index (weight scaled for height; BMI) for women are close to healthy BMI guidelines, while the most attractive BMI is significantly lower, possibly pointing to an influence of sociocultural factors in determining attractive BMI. However, less is known about ideal body size for men. Further, research has not addressed the role of body fat and muscle, which have distinct relationships with health and are conflated in BMI, in determining perceived health and attractiveness. Here, we hypothesised that, if attractiveness reflects physiological health, the most attractive and healthy appearing body composition should be in line with physiologically healthy body composition. Thirty female and 33 male observers were instructed to manipulate 15 female and 15 male body images in terms of their fat and muscle to optimise perceived health and, separately, attractiveness. Observers were unaware that they were manipulating the muscle and fat content of bodies. The most attractive apparent fat mass for female bodies was significantly lower than the healthiest appearing fat mass (and was lower than the physiologically healthy range), with no significant difference for muscle mass. The optimal fat and muscle mass for men’s bodies was in line with the healthy range. Male observers preferred a significantly lower overall male body mass than did female observers. While the body fat and muscle associated with healthy and attractive appearance is broadly in line with physiologically healthy values, deviations from this pattern suggest that future research should examine a possible role for internalization of body ideals in influencing perceptions of attractive body composition, particularly in women. PMID:27257677

The Influence of Body Mass Index on Outcomes in Ureteroscopy: Results from the Clinical Research Office of Endourological Society URS Global Study.

PubMed

Krambeck, Amy; Wijnstok, Nienke; Olbert, Peter; Mitroi, George; Bariol, Simon; Shah, Hemendra N; El-Abd, Ahmed S; Onal, Bulent; de la Rosette, Jean

2017-01-01

Although ureteroscopy (URS) has been established as a viable treatment for stones in obese patients, its safety and success has not been fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety, and efficacy. This study utilized the Clinical Research Office of the Endourological Society (CROES) URS Global Study, which was a prospective, multicenter study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries. The relationship between body mass index (BMI), diabetes, and creatinine, with retreatment, stone-free rates, complications, and long hospital stay, was examined with a multivariate logistic regression analyses. Of the 10,099 URS patients with BMI data, 17.4% were obese and 2.2% were super obese. Overall, 86.7% patients were stone free and 16.8% required retreatment. Higher BMI was associated with lower stone-free rates, and any deviation from normal weight was associated with higher retreatment rates. In multivariate analysis controlling for several variables including stone size, the association between BMI and lower stone-free rates with higher retreatment rates persisted. Intraoperative complications occurred in 518 (5.1%) patients, and 343 (3.4%) experienced a postoperative complication. Postoperative complications were more frequent in the underweight and super obese subjects, and there was no relationship between BMI and intraoperative complications. Although URS for stone disease was found to be an overall safe procedure for obese and super obese patients, efficacy of the procedure may be lower compared with normal-weight subjects and higher retreatment rates may be necessary.

The Body and the Beautiful: Health, Attractiveness and Body Composition in Men's and Women's Bodies.

PubMed

Brierley, Mary-Ellen; Brooks, Kevin R; Mond, Jonathan; Stevenson, Richard J; Stephen, Ian D

2016-01-01

The dominant evolutionary theory of physical attraction posits that attractiveness reflects physiological health, and attraction is a mechanism for identifying a healthy mate. Previous studies have found that perceptions of the healthiest body mass index (weight scaled for height; BMI) for women are close to healthy BMI guidelines, while the most attractive BMI is significantly lower, possibly pointing to an influence of sociocultural factors in determining attractive BMI. However, less is known about ideal body size for men. Further, research has not addressed the role of body fat and muscle, which have distinct relationships with health and are conflated in BMI, in determining perceived health and attractiveness. Here, we hypothesised that, if attractiveness reflects physiological health, the most attractive and healthy appearing body composition should be in line with physiologically healthy body composition. Thirty female and 33 male observers were instructed to manipulate 15 female and 15 male body images in terms of their fat and muscle to optimise perceived health and, separately, attractiveness. Observers were unaware that they were manipulating the muscle and fat content of bodies. The most attractive apparent fat mass for female bodies was significantly lower than the healthiest appearing fat mass (and was lower than the physiologically healthy range), with no significant difference for muscle mass. The optimal fat and muscle mass for men's bodies was in line with the healthy range. Male observers preferred a significantly lower overall male body mass than did female observers. While the body fat and muscle associated with healthy and attractive appearance is broadly in line with physiologically healthy values, deviations from this pattern suggest that future research should examine a possible role for internalization of body ideals in influencing perceptions of attractive body composition, particularly in women.

The truly remarkable universality of half a standard deviation: confirmation through another look.

PubMed

Norman, Geoffrey R; Sloan, Jeff A; Wyrwich, Kathleen W

2004-10-01

In this issue of Expert Review of Pharmacoeconomics and Outcomes Research, Farivar, Liu, and Hays present their findings in 'Another look at the half standard deviation estimate of the minimally important difference in health-related quality of life scores (hereafter referred to as 'Another look') . These researchers have re-examined the May 2003 Medical Care article 'Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation' (hereafter referred to as 'Remarkable') in the hope of supporting their hypothesis that the minimally important difference in health-related quality of life measures is undoubtedly closer to 0.3 standard deviations than 0.5. Nonetheless, despite their extensive wranglings with the exclusion of many articles that we included in our review; the inclusion of articles that we did not include in our review; and the recalculation of effect sizes using the absolute value of the mean differences, in our opinion, the results of the 'Another look' article confirm the same findings in the 'Remarkable' paper.

Static Scene Statistical Non-Uniformity Correction

DTIC Science & Technology

2015-03-01

Error NUC Non-Uniformity Correction RMSE Root Mean Squared Error RSD Relative Standard Deviation S3NUC Static Scene Statistical Non-Uniformity...Deviation ( RSD ) which normalizes the standard deviation, σ, to the mean estimated value, µ using the equation RS D = σ µ × 100. The RSD plot of the gain...estimates is shown in Figure 4.1(b). The RSD plot shows that after a sample size of approximately 10, the different photocount values and the inclusion

Effect of multizone refractive multifocal contact lenses on standard automated perimetry.

PubMed

Madrid-Costa, David; Ruiz-Alcocer, Javier; García-Lázaro, Santiago; Albarrán-Diego, César; Ferrer-Blasco, Teresa

2012-09-01

The aim of this study was to evaluate whether the creation of 2 foci (distance and near) provided by multizone refractive multifocal contact lenses (CLs) for presbyopia correction affects the measurements on Humphreys 24-2 Swedish interactive threshold algorithm (SITA) standard automated perimetry (SAP). In this crossover study, 30 subjects were fitted in random order with either a multifocal CL or a monofocal CL. After 1 month, a Humphrey 24-2 SITA standard strategy was performed. The visual field global indices (the mean deviation [MD] and pattern standard deviation [PSD]), reliability indices, test duration, and number of depressed points deviating at P<5%, P<2%, P<1%, and P<0.5% on pattern deviation probability plots were determined and compared between multifocal and monofocal CLs. Thirty eyes of 30 subjects were included in this study. There were no statistically significant differences in reliability indices or test duration. There was a statistically significant reduction in the MD with the multifocal CL compared with monfocal CL (P=0.001). Differences were not found in PSD nor in the number of depressed points deviating at P<5%, P<2%, P<1%, and P<0.5% in the pattern deviation probability maps studied. The results of this study suggest that the multizone refractive lens produces a generalized depression in threshold sensitivity as measured by the Humphreys 24-2 SITA SAP.

Discrepancies between leg-to-leg bioelectrical Impedance analysis and computerized tomography in abdominal visceral fat measurement.

PubMed

Lu, Hsueh-Kuan; Chen, Yu-Yawn; Yeh, Chinagwen; Chuang, Chih-Lin; Chiang, Li-Ming; Lai, Chung-Liang; Casebolt, Kevin M; Huang, Ai-Chun; Lin, Wen-Long; Hsieh, Kuen-Chang

2017-08-22

The aim of this study was to evaluate leg-to-leg bioelectrical impedance analysis (LBIA) using a four-contact electrode system for measuring abdominal visceral fat area (VFA). The present study recruited 381 (240 male and 141 female) Chinese participants to compare VFA measurements estimated by a standing LBIA system (VFALBIA) with computerized tomography (CT) scanned at the L4-L5 vertebrae (VFA CT ). The total mean body mass index (BMI) was 24.7 ± 4.2 kg/m 2 . Correlation analysis, regression analysis, Bland-Altman plot, and paired sample t-tests were used to analyze the accuracy of the VFA LBIA . For the total subjects, the regression line was VFA LBIA  = 0.698 VFA CT  + 29.521, (correlation coefficient (r) = 0.789, standard estimate of error (SEE) = 24.470 cm 2 , p < 0.001), Lin's correlation coefficient (CCC) was 0.785; and the limit of agreement (LOA; mean difference ±2 standard deviation) ranged from -43.950 to 67.951 cm 2 , LOA% (given as a percentage of mean value measured by the CT) was 48.2%. VFA LBIA and VFA CT showed significant difference (p < 0.001). Collectively, the current study indicates that LBIA has limited potential to accurately estimate visceral fat in a clinical setting.

Association between Body Mass Index and Dental Caries among Anganwadi Children of Belgaum City, India.

PubMed

Aluckal, Eby; Anzil, Ksa; Baby, Mathews; George, Eldhose K; Lakshmanan, Sanju; Chikkanna, Shilpa

2016-10-01

Body mass index (BMI) is an index that measures height for weight, which is commonly used to categorize underweight, overweight, and obese individuals. Deviation from normal weight results from an imbalance between caloric consumption and energy expenditure. Childhood obesity and childhood dental caries are coincidental in many populations, probably due to common confounding risk factors, such as intake frequency, cariogenic diet, and poor oral hygiene. So the aim of the present study was to assess the BMI status and to corelate between dental caries and BMI among the Anganwadi children of Belgaum city, Karnataka, India. Four hundred and thirty three children from 20 Anganwadi's belonging to the age group of 2 to 6 years of both sexes were measured for BMI and dental caries status. The caries index was measured as the number of decayed (d) and filled (f) teeth (t) (dft). The BMI in units of kg/m 2 was determined and children were categorized according to age-and gender-specific criteria as underweight (<5th percentile), normal (5th-85th percentile), at risk for overweight (85th- 95th percentile), and overweight (>95th percentile). The data were subjected to statistical analysis using Student's t-test, analysis of variance (ANOVA), and Karl Pearson's correlation coefficient test with the help of Statistical Package for the Social Sciences (SPSS) version 18.0. The proportion of subjects in Centre for Disease Control (CDC) weight categories was: 5% underweight, 79% normal, 9% under the risk for overweight, and 6% overweight. A significant association was found between children with normal BMI and those who were underweight, overweight, and under the risk for overweight. Children with overweight/obese or underweight/malnourished children had higher decayed and filled surfaces compared to children with normal weight. Nutritional status has a profound effect on dental caries. Both underweight/malnutrition and overweight/ obesity have significant adverse implications for health. Childhood obesity and childhood dental caries are coincidental in many populations.

Incidence rates, correlates, and prognosis of electrocardiographic P-wave abnormalities - a nationwide population-based study.

PubMed

Lehtonen, Arttu O; Langén, Ville L; Puukka, Pauli J; Kähönen, Mika; Nieminen, Markku S; Jula, Antti M; Niiranen, Teemu J

Scant data exist on incidence rates, correlates, and prognosis of electrocardiographic P-wave abnormalities in the general population. We recorded ECG and measured conventional cardiovascular risk factors in 5667 Finns who were followed up for incident atrial fibrillation (AF). We obtained repeat ECGs from 3089 individuals 11years later. The incidence rates of prolonged P-wave duration, abnormal P terminal force (PTF), left P-wave axis deviation, and right P-wave axis deviation were 16.0%, 7.4%, 3.4%, and 2.2%, respectively. Older age and higher BMI were associated with incident prolonged P-wave duration and abnormal PTF (P≤0.01). Higher blood pressure was associated with incident prolonged P-wave duration and right P-wave axis deviation (P≤0.01). During follow-up, only prolonged P-wave duration predicted AF (multivariable-adjusted hazard ratio, 1.38; P=0.001). Modifiable risk factors associate with P-wave abnormalities that are common and may represent intermediate steps of atrial cardiomyopathy on a pathway leading to AF. Copyright © 2017 Elsevier Inc. All rights reserved.

Overweight Kidney Transplant Recipients Are at Risk of Being Overdosed Following Standard Bodyweight-Based Tacrolimus Starting Dose.

PubMed

Andrews, Louise M; de Winter, Brenda C M; Tang, Jiang-Tao; Shuker, Nauras; Bouamar, Rachida; van Schaik, Ron H N; Koch, Birgit C P; van Gelder, Teun; Hesselink, Dennis A

2017-02-01

Bodyweight-based dosing of tacrolimus (Tac) is considered standard care, even though the available evidence is thin. An increasing proportion of transplant recipients is overweight, prompting the question if the starting dose should always be based on bodyweight. For this analysis, data were used from a randomized-controlled trial in which patients received either a standard Tac starting dose or a dose that was based on CYP3A5 genotype. The hypothesis was that overweight patients would have Tac overexposure following standard bodyweight-based dosing. Data were available for 203 kidney transplant recipients, with a median body mass index (BMI) of 25.6 (range, 17.2-42.2). More than 50% of the overweight or obese patients had a Tac predose concentration above the target range. The CYP3A5 nonexpressers tended to be above target when they weighed more than 67.5 kg or had a BMI of 24.5 or higher. Dosing guidelines were proposed with a decrease up to 40% in Tac starting doses for different BMI groups. The dosing guideline for patients with an unknown genotype was validated using the fixed-dose versus concentration controlled data set. This study demonstrates that dosing Tac solely on bodyweight results in overexposure in more than half of overweight or obese patients.

Replacing Non-Active Video Gaming by Active Video Gaming to Prevent Excessive Weight Gain in Adolescents.

PubMed

Simons, Monique; Brug, Johannes; Chinapaw, Mai J M; de Boer, Michiel; Seidell, Jaap; de Vet, Emely

2015-01-01

The aim of the current study was to evaluate the effects of and adherence to an active video game promotion intervention on anthropometrics, sedentary screen time and consumption of sugar-sweetened beverages and snacks among non-active video gaming adolescents who primarily were of healthy weight. We assigned 270 gaming (i.e. ≥ 2 hours/week non-active video game time) adolescents randomly to an intervention group (n = 140) (receiving active video games and encouragement to play) or a waiting-list control group (n = 130). BMI-SDS (SDS = adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds were measured at baseline, at four and ten months follow-up (primary outcomes). Sedentary screen time, physical activity, consumption of sugar-sweetened beverages and snacks, and process measures (not at baseline) were assessed with self-reports at baseline, one, four and ten months follow-up. Multi-level-intention to treat-regression analyses were conducted. The control group decreased significantly more than the intervention group on BMI-SDS (β = 0.074, 95%CI: 0.008;0.14), and sum of skinfolds (β = 3.22, 95%CI: 0.27;6.17) (overall effects). The intervention group had a significantly higher decrease in self-reported non-active video game time (β = -1.76, 95%CI: -3.20;-0.32) and total sedentary screen time (Exp (β = 0.81, 95%CI: 0.74;0.88) than the control group (overall effects). The process evaluation showed that 14% of the adolescents played the Move video games every week ≥ 1 hour/week during the whole intervention period. The active video game intervention did not result in lower values on anthropometrics in a group of 'excessive' non-active video gamers (mean ~ 14 hours/week) who primarily were of healthy weight compared to a control group throughout a ten-month-period. Even some effects in the unexpected direction were found, with the control group showing lower BMI-SDS and skin folds than the intervention group. The intervention did result in less self-reported sedentary screen time, although these results are likely biased by social desirability. Dutch Trial Register NTR3228.

Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children.

PubMed

Farpour-Lambert, Nathalie J; Aggoun, Yacine; Marchand, Laetitia M; Martin, Xavier E; Herrmann, François R; Beghetti, Maurice

2009-12-15

The aim of this study was to determine the effects of physical activity on systemic blood pressure (BP) and early markers of atherosclerosis in pre-pubertal obese children. Hypertension and endothelial dysfunction are premature complications of obesity. We performed a 3-month randomized controlled trial with a modified crossover design: 44 pre-pubertal obese children (age 8.9 + or - 1.5 years) were randomly assigned (1:1) to an exercise (n = 22) or a control group (n = 22). We recruited 22 lean children (age 8.5 + or - 1.5 years) for baseline comparison. The exercise group trained 60 min 3 times/week during 3 months, whereas control subjects remained relatively inactive. Then, both groups trained twice/week during 3 months. We assessed changes at 3 and 6 months in office and 24-h BP, arterial intima-media thickness (IMT) and stiffness, endothelial function (flow-mediated dilation), body mass index (BMI), body fat, cardiorespiratory fitness (maximal oxygen consumption [VO(2)max]), physical activity, and biological markers. Obese children had higher BP, arterial stiffness, body weight, BMI, abdominal fat, insulin resistance indexes, and C-reactive protein levels, and lower flow-mediated dilation, VO(2)max, physical activity, and high-density lipoprotein cholesterol levels than lean subjects. At 3 months, we observed significant changes in 24-h systolic BP (exercise -6.9 + or - 13.5 mm Hg vs. control 3.8 + or - 7.9 mm Hg, -0.8 + or - 1.5 standard deviation score [SDS] vs. 0.4 + or - 0.8 SDS), diastolic BP (-0.5 + or - 1.0 SDS vs. 0 + or - 1.4 SDS), hypertension rate (-12% vs. -1%), office BP, BMI z-score, abdominal fat, and VO(2)max. At 6 months, change differences in arterial stiffness and IMT were significant. A regular physical activity program reduces BP, arterial stiffness, and abdominal fat; increases cardiorespiratory fitness; and delays arterial wall remodeling in pre-pubertal obese children. (Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children: A Randomized Controlled Trial; NCT00801645).

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors

PubMed Central

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Background Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Objective Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Methods Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( χ¯ ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. Results About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (P<0.001), body mass index (BMI) <23.5 (P=0.007), Mini-Mental State Examination <20 (P=0.004), Barthel Index <65 (P=0.002), hemoglobin <7.69 mmol/L (P=0.017), serum protein <70 g/L (P=0.008), albumin <32 g/L (P=0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76–19.49; P<0.001), history of falls (OR =2.55; 95% CI =1.05–6.19; P=0.039), age (OR =1.14; 95% CI =1.05–1.23; P=0.001), and BMI (OR =0.91; 95% CI =0.83–0.99; P=0.034). Conclusion Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls. PMID:27695303

Dipeptidyl Peptidase-4 Inhibitor Sitagliptin Prevented Weight Regain in Obese Women with Polycystic Ovary Syndrome Previously Treated with Liraglutide: A Pilot Randomized Study.

PubMed

Ferjan, Simona; Janez, Andrej; Jensterle, Mojca

2017-12-01

Weight loss is often nonsustainable after liraglutide cessation. The present study is the first insight into the potential prevention of weight regain in obese subjects who have been withdrawn from liraglutide. We evaluated whether dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin in adjunct to metformin prevents body weight regain more effectively than metformin alone in obese polycystic ovary syndrome (PCOS) previously treated with liraglutide. A 12-week prospective randomized open-label study was conducted with 24 obese women with PCOS who had been pretreated with liraglutide 3.0 mg due to antiobesity management (aged 34.3 ± 6.8 years, body mass index [BMI] 36.3 ± 5.2 kg/m 2 , mean ± standard deviation). They were randomized to combined treatment (COMBO) with sitagliptin 100 mg per day (QD) and metformin (MET) 1000 mg twice daily (BID) (n = 12) or MET 1000 mg BID (n = 12). Lifestyle intervention was promoted in both groups. The primary outcome was change in anthropometric measures of obesity. Women treated with MET regain 4.7 ± 2.7 kg (P = 0.002) compared with a 0.9 ± 2.5 kg in COMBO (P = 0.147). BMI increased for 1.7 ± 0.9 kg/m 2 in MET (P = 0.002) compared with 0.3 ± 0.8 kg/m 2 increase in COMBO (P = 0.136). MET group regain 4.5% ± 2.5% of body weight as opposed to 0.8% ± 2.6% in COMBO. The between-treatment differences were significant for weight change (P < 0.001), percentage of weight change (P < 0.001), and BMI change (P < 0.001). Greater ability to resist emotional eating was demonstrated in COMBO. Sitagliptin in adjunct to metformin prevented weight regain in obese women with PCOS previously treated with liraglutide.

The impact of height during childhood on the national prevalence rates of overweight.

PubMed

van Dommelen, Paula; de Kroon, Marlou L A; Cameron, Noël; Schönbeck, Yvonne; van Buuren, Stef

2014-01-01

It is known that height and body mass index (BMI) are correlated in childhood. However, its impact on the (trend of) national prevalence rates of overweight and obesity has never been investigated. The aim of our study is to investigate the relation between height and national prevalence rates of overweight and obesity in childhood between 1980, 1997, and 2009, and to calculate which fixed value of p (2.0,2.1, …,3.0) in kg/m(p) during childhood is most accurate in predicting adult overweight. Cross-sectional growth data of children from three Dutch nationwide surveys in 1980, 1997, and 2009, and longitudinal data from the Terneuzen Birth Cohort and the Harpenden Growth Study were used. Relative risks (RR) and 95% confidence intervals (CI) were calculated. Our study showed that tall (>1 standard deviation (SD)) girls aged 5.0-13.9 y were more often overweight (RR = 3.5,95%CI:2.8-4.4) and obese (RR = 3.9,95%CI:2.1-7.4) than short girls (<-1 SD). Similar results were found in boys aged 5.0-14.9 y (RR = 4.4,95%CI:3.4-5.7 and RR = 5.3,95%CI:2.6-11.0). No large differences were found in the other age groups and in comparison with children with an average stature. Tall boys aged 2.0-4.9 y had a significantly higher positive trend in overweight between 1980 and 1997 compared to short boys (RR = 4.0,95%CI:1.38-11.9). For other age groups and in girls, no significant trends were found. The optimal Area Under the Curve (AUC) to predict adult overweight was found for p = 2.0. Tall girls aged 5.0-13.9y and tall boys aged 5.0-14.9y have much higher prevalence rates of overweight and obesity than their shorter peers. We suggest taking into account the impact of height when evaluating trends and variations of BMI distributions in childhood, and to use BMI to predict adult overweight.

Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging

PubMed Central

Alhurani, Rabe E.; Vassilaki, Maria; Aakre, Jeremiah; Mielke, Michelle M.; Kremers, Walter K.; Machulda, Mary M.; Geda, Yonas E.; Knopman, David S.; Peterson, Ronald C.; Roberts, Rosebud O.

2016-01-01

IMPORTANCE Unintentional weight loss has been associated with risk of dementia. Since mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI. OBJECTIVE To investigate the association of change in weight and BMI with risk of MCI. DESIGN, SETTING, AND PARTICIPANTS A population-based, prospective study of participants aged 70 years and older from the Mayo Clinic Study of Aging. Maximum weight and height in midlife (aged 40 to 65 years old) were retrospectively ascertained from the medical records of participants using a medical records linkage system. MAIN OUTCOMES MEASURES Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and body mass index with risk of MCI was investigated using proportional hazards models. RESULTS Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI. The mean (standard deviation) rate of weight change per decade from midlife to study entry was greater for individuals who developed incident MCI vs. those who remained cognitively normal (−2.0 (5.1) vs. −1.2 (4.9) kg; p = 0.006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR] 95% confidence interval [CI], 1.04 [1.02, 1.06], p < 0.001) after adjusting for sex, education and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg/decade corresponds to a 24% increase in risk of MCI (HR=1.24). Higher decline in BMI per decade was also associated with incident MCI (HR, 1.08, 95% CI = [1.03, 1.13], p = 0.003). CONCLUSIONS AND RELEVANCE These findings suggest that declining weight from midlife to late-life is a marker for MCI and may help identify persons at increased risk for MCI. PMID:26831542

Relevance of the triglyceride-to-high-density lipoprotein cholesterol ratio as an important lipid fraction in apparently healthy, young, and middle-aged Indian men

PubMed Central

Kohli, Aparna; Siddhu, Anupa; Pandey, Ravindra M.; Reddy, K. Srinath

2017-01-01

Context: Cardiovascular disease (CVD) is the largest cause of mortality in Indians. Insulin resistance and related dyslipidemia of increased triglyceride (TG), small dense low-density lipoprotein (sd-LDL) particles, and decreased high-density lipoprotein-cholesterol (HDL-C) are associated with increased risk of CVD. TG/HDL-C ratio could be a potential surrogate marker for this South Asian phenotype. Data are scarce on the relevance of TG/HDL-C ratio as a useful lipid marker among Indians. Aims: To study the prevalence of TG/HDL-C ratio among healthy, young, and middle-aged Indian men (25–44 years) and its relationship with other lipid and nonlipid factors. Subjects and Methods: In this cross-sectional analysis, fasting blood samples from 236 healthy participants recruited from an urban community setting were tested for TG/HDL-C ratio, HDL-C, TG, total cholesterol (TC), non-HDL-C, TC/HDL-C, high-sensitivity C-reactive protein, body mass index (BMI), and body fat. Results: Mean (standard deviation) age of participants was 34.7 (7.7) years; median (interquartile range) TG/HDL-C ratio was 4 (2.85-5.2). More than half (51.3%) the participants (n = 121) recorded abnormal TG/HDL-C ratio (≥4.0). Across tertiles of TG/HDL-C ratio, there was a significant trend of higher conventional lipid parameters such as non-HDL-C*, TC/HDL-C ratio*, TG*, HDL-C*, TC**; and non-lipid parameters body-fat* and BMI*** (*P < 0.001, **P = 0.015, ***P = 0.002). LDL-C showed moderate and nonsignificant (P = 0.646) increase across tertiles. Conclusion: In a sample of apparently healthy, young, and middle-aged Indian men abnormal TG/HDL-C ratio levels were observed among more than half the participants. The TG/HDL-C ratio was closely associated with other lipid parameters and measures of adiposity, such as BMI and body fat, apart from its previously documented unique association with sd-LDL particles. TG/HDL-C ratio should be evaluated in future for risk prediction of incident CVD among Indians. PMID:28217509

Relevance of the triglyceride-to-high-density lipoprotein cholesterol ratio as an important lipid fraction in apparently healthy, young, and middle-aged Indian men.

PubMed

Kohli, Aparna; Siddhu, Anupa; Pandey, Ravindra M; Reddy, K Srinath

2017-01-01

Cardiovascular disease (CVD) is the largest cause of mortality in Indians. Insulin resistance and related dyslipidemia of increased triglyceride (TG), small dense low-density lipoprotein (sd-LDL) particles, and decreased high-density lipoprotein-cholesterol (HDL-C) are associated with increased risk of CVD. TG/HDL-C ratio could be a potential surrogate marker for this South Asian phenotype. Data are scarce on the relevance of TG/HDL-C ratio as a useful lipid marker among Indians. To study the prevalence of TG/HDL-C ratio among healthy, young, and middle-aged Indian men (25-44 years) and its relationship with other lipid and nonlipid factors. In this cross-sectional analysis, fasting blood samples from 236 healthy participants recruited from an urban community setting were tested for TG/HDL-C ratio, HDL-C, TG, total cholesterol (TC), non-HDL-C, TC/HDL-C, high-sensitivity C-reactive protein, body mass index (BMI), and body fat. Mean (standard deviation) age of participants was 34.7 (7.7) years; median (interquartile range) TG/HDL-C ratio was 4 (2.85-5.2). More than half (51.3%) the participants ( n = 121) recorded abnormal TG/HDL-C ratio (≥4.0). Across tertiles of TG/HDL-C ratio, there was a significant trend of higher conventional lipid parameters such as non-HDL-C*, TC/HDL-C ratio*, TG*, HDL-C*, TC**; and non-lipid parameters body-fat* and BMI*** (* P < 0.001, ** P = 0.015, *** P = 0.002). LDL-C showed moderate and nonsignificant ( P = 0.646) increase across tertiles. In a sample of apparently healthy, young, and middle-aged Indian men abnormal TG/HDL-C ratio levels were observed among more than half the participants. The TG/HDL-C ratio was closely associated with other lipid parameters and measures of adiposity, such as BMI and body fat, apart from its previously documented unique association with sd-LDL particles. TG/HDL-C ratio should be evaluated in future for risk prediction of incident CVD among Indians.

Risk factors for lower extremity injuries in elite female soccer players.

PubMed

Nilstad, Agnethe; Andersen, Thor Einar; Bahr, Roald; Holme, Ingar; Steffen, Kathrin

2014-04-01

The incidence of lower extremity injuries in female soccer players is high, but the risk factors for injuries are unknown. To investigate risk factors for lower extremity injuries in elite female soccer players. Cohort study; Level of evidence, 3. Players in the Norwegian elite female soccer league (N = 12 teams) participated in baseline screening tests before the 2009 competitive soccer season. The screening included tests assessing maximal lower extremity strength, dynamic balance, knee valgus angles in a drop-jump landing, knee joint laxity, generalized joint laxity, and foot pronation. Also included was a questionnaire to collect information on demographic data, elite-level experience, and injury history. Time-loss injuries and exposure in training and matches were recorded prospectively in the subsequent soccer season using weekly text messaging. Players reporting an injury were contacted to collect data regarding injury circumstances. Univariate and multivariate regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for ±1 standard deviation of change. In total, 173 players underwent complete screening tests and registration of injuries and exposure throughout the season. A total of 171 injuries in 107 players (62%) were recorded; ligament and muscle injuries were the most frequent. Multivariate analyses showed that a greater body mass index (BMI) (OR, 1.51; 95% CI, 1.21-1.90; P = .001) was the only factor significantly associated with new lower extremity injuries. A greater BMI was associated with new thigh injuries (OR, 1.51; 95% CI, 1.08-2.11; P = .01), a lower knee valgus angle in a drop-jump landing was associated with new ankle injuries (OR, 0.64; 95% CI, 0.41-1.00; P = .04), and a previous knee injury was associated with new lower leg and foot injuries (OR, 3.57; 95% CI, 1.27-9.99; P = .02), whereas none of the factors investigated influenced the risk of new knee injuries. A greater BMI was associated with lower extremity injuries in elite female soccer players. Increased knowledge on risk factors for lower extremity injuries enables more targeted prevention strategies with the aim of reducing injury rates in female soccer players.

Investigation of the refractive index repeatability for tantalum pentoxide coatings, prepared by physical vapor film deposition techniques.

PubMed

Stenzel, O; Wilbrandt, S; Wolf, J; Schürmann, M; Kaiser, N; Ristau, D; Ehlers, H; Carstens, F; Schippel, S; Mechold, L; Rauhut, R; Kennedy, M; Bischoff, M; Nowitzki, T; Zöller, A; Hagedorn, H; Reus, H; Hegemann, T; Starke, K; Harhausen, J; Foest, R; Schumacher, J

2017-02-01

Random effects in the repeatability of refractive index and absorption edge position of tantalum pentoxide layers prepared by plasma-ion-assisted electron-beam evaporation, ion beam sputtering, and magnetron sputtering are investigated and quantified. Standard deviations in refractive index between 4*10^-4 and 4*10^-3 have been obtained. Here, lowest standard deviations in refractive index close to our detection threshold could be achieved by both ion beam sputtering and plasma-ion-assisted deposition. In relation to the corresponding mean values, the standard deviations in band-edge position and refractive index are of similar order.

Closed-form confidence intervals for functions of the normal mean and standard deviation.

PubMed

Donner, Allan; Zou, G Y

2012-08-01

Confidence interval methods for a normal mean and standard deviation are well known and simple to apply. However, the same cannot be said for important functions of these parameters. These functions include the normal distribution percentiles, the Bland-Altman limits of agreement, the coefficient of variation and Cohen's effect size. We present a simple approach to this problem by using variance estimates recovered from confidence limits computed for the mean and standard deviation separately. All resulting confidence intervals have closed forms. Simulation results demonstrate that this approach performs very well for limits of agreement, coefficients of variation and their differences.

Sample sizes needed for specified margins of relative error in the estimates of the repeatability and reproducibility standard deviations.

PubMed

McClure, Foster D; Lee, Jung K

2005-01-01

Sample size formulas are developed to estimate the repeatability and reproducibility standard deviations (Sr and S(R)) such that the actual error in (Sr and S(R)) relative to their respective true values, sigmar and sigmaR, are at predefined levels. The statistical consequences associated with AOAC INTERNATIONAL required sample size to validate an analytical method are discussed. In addition, formulas to estimate the uncertainties of (Sr and S(R)) were derived and are provided as supporting documentation. Formula for the Number of Replicates Required for a Specified Margin of Relative Error in the Estimate of the Repeatability Standard Deviation.

Changes in Weight over the School Year and Summer Vacation: Results of a 5-Year Longitudinal Study

ERIC Educational Resources Information Center

Moreno, Jennette P.; Johnston, Craig A.; Woehler, Deborah

2013-01-01

Background: Evidence suggests that children gain more weight during the summer months compared with the school year. To examine the impact of the school and summer environment on children's weight further, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students entering kindergarten. Methods: Heights and…

Validity of body mass index as a measurement of adiposity in infancy

USDA-ARS?s Scientific Manuscript database

To assess the validity of body mass index (BMI) and age- and sex-standardized BMI z-score (BMIZ) as surrogates for adiposity (body fat percentage [BF%], fat mass, and fat mass index [kg/m2]) at 3 time points in infancy (1, 4, and 7 months) and to assess the extent to which the change in BMIZ represe...

BMI-Referenced Cut-Points for Recommended Daily Pedometer-Determined Steps in Australian Children and Adolescents

ERIC Educational Resources Information Center

McCormack, Gavin R.; Rutherford, Jack; Giles-Corti, Billie; Tudor-Locke, Catrine; Bull, Fiona

2011-01-01

The purpose of this study was to establish sex-specific criterion-referenced standards for pedometer-determined physical activity related to body mass index (BMI)-defined weight status among youth. We analyzed data from 7-16-year-old boys (n = 338) and girls (n = 337) and used pedometer-assessed physical activity and anthropometric data to derive…

Comparing biomarker measurements to a normal range: when to use standard error of the mean (SEM) or standard deviation (SD) confidence intervals tests.

PubMed

Pleil, Joachim D

2016-01-01

This commentary is the second of a series outlining one specific concept in interpreting biomarkers data. In the first, an observational method was presented for assessing the distribution of measurements before making parametric calculations. Here, the discussion revolves around the next step, the choice of using standard error of the mean or the calculated standard deviation to compare or predict measurement results.

Italian Multicenter Study on Accuracy of 18F-FDG PET/CT in Assessing Bone Marrow Involvement in Pediatric Hodgkin Lymphoma.

PubMed

Cistaro, Angelina; Cassalia, Laura; Ferrara, Cinzia; Quartuccio, Natale; Evangelista, Laura; Bianchi, Maurizio; Fagioli, Franca; Bisi, Gianni; Baldari, Sergio; Zanella, Alessandro; Pillon, Marta; Zucchetta, Pietro; Burei, Marta; Sala, Alessandra; Guerra, Luca; Guglielmo, Priscilla; Burnelli, Roberta; Panareo, Stefano; Scalorbi, Federica; Rambaldi, Ilaria; Piccardo, Arnoldo; Garaventa, Alberto; Familiari, Demetrio; Fornito, Maria Concetta; Lopci, Egesta; Mascarin, Maurizio; Altini, Corinna; Ferrari, Cristina; Perillo, Teresa; Santoro, Nicola; Borsatti, Eugenio; Rubini, Giuseppe

2018-06-01

The present study investigated the utility of fluorine-18 ( 18 F) fluoro-2-deoxy-d-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in newly diagnosed pediatric Hodgkin lymphoma (HL). A total of 224 pediatric patients with HL underwent 18 F-FDG PET/CT at staging. BMB or follow-up imaging was used as the standard of reference for the evaluation of BMI. 18 F-FDG PET/CT was negative for BMI in 193 cases. Of the 193 patients, the findings for 16 were originally reported as doubtful and later interpreted as negative for BMI, with negative findings on follow-up imaging and BMB. At BMB, 1 of the 16 patients (6.25%) had BMI. Of the 193 patients, 192 (99.48%) had negative BMB findings. Thus, the 18 F-FDG PET/CT findings were truly negative for 192 patients and falsely negative for 1 patient for BMI. 18 F-FDG PET/CT showed high diagnostic performance in the evaluation of BMI in pediatric HL. Thus, BMB should be ideally reserved for patients presenting with doubtful 18 F-FDG PET/CT findings for BMI. Copyright © 2018 Elsevier Inc. All rights reserved.

Introducing the Mean Absolute Deviation "Effect" Size

ERIC Educational Resources Information Center

Gorard, Stephen

2015-01-01

This paper revisits the use of effect sizes in the analysis of experimental and similar results, and reminds readers of the relative advantages of the mean absolute deviation as a measure of variation, as opposed to the more complex standard deviation. The mean absolute deviation is easier to use and understand, and more tolerant of extreme…

The association between pre-pregnancy overweight/obesity and offspring's behavioral problems and executive functioning.

PubMed

Menting, Malou D; van de Beek, Cornelieke; de Rooij, Susanne R; Painter, Rebecca C; Vrijkotte, Tanja G M; Roseboom, Tessa J

2018-06-01

The prevalence of obesity among women of childbearing age has been rising dramatically over the last decades. Pre-pregnancy obesity may have negative neurodevelopmental consequences for the offspring. The present study examined the association of maternal pre-pregnancy overweight and obesity with child behavior problems and executive functioning at age 5 years. Data of 4094 mother-child pairs of the Amsterdam Born Children and their Development birth cohort study was used. Child behavioral problems were assessed with the maternal and teacher version of the Strengths and Difficulties Questionnaire. Two executive functioning constructs, inhibitory control and cognitive flexibility, were measured with the Response Organization Objects task of the Amsterdam Neuropsychological Tasks test battery. Increased maternal pre-pregnancy BMI was associated with an increase in children's behavioral problems (OR total behavioral problems reported by mothers pre-pregnancy obesity versus normal weight: 1.78 [95% CI 1.17 to 2.69] and reported by teachers for pre-pregnancy overweight versus normal weight: 1.32 [1.00 to 1.74]). Maternal pre-pregnancy obesity was associated with an increase in peer relationship problems reported by teachers (OR: 1.77 [1.18 to 2.64]). It was also associated with a small decrease in cognitive flexibility (increased Reaction Time in ms: B = 67.59 [5.88 to 129.30] and Within Subject Standard Deviation in ms: B = 76.46 [32.00 to 120.92]), but not with inhibitory control. Cognitive flexibility did not mediate the association between maternal pre-pregnancy BMI and children's behavioral problems. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Midline posterior glossectomy and lingual tonsillectomy in obese and nonobese children with down syndrome: Biomarkers for success.

PubMed

Propst, Evan J; Amin, Reshma; Talwar, Natasha; Zaman, Michele; Zweerink, Allison; Blaser, Susan; Zaarour, Christian; Luginbuehl, Igor; Karsli, Cengiz; Aziza, Albert; Forrest, Christopher; Drake, James; Narang, Indra

2017-03-01

To examine outcomes following midline posterior glossectomy (MPG) plus lingual tonsillectomy (LT) for the treatment of significant obstructive sleep apnea (OSA) in children with Down syndrome (DS). Patients with DS who had persistent OSA following tonsillectomy and adenoidectomy (TA) and were relatively intolerant of positive airway pressure (PAP) therapy were evaluated by physical examination and sleep/CINE magnetic resonance imaging to determine the etiology of upper airway obstruction. Patients with relative macroglossia underwent MPG plus LT if required. Successful surgical outcome was defined as the resolution of OSA or the ability to tolerate PAP. Thirteen children (8 male, 5 female), mean (standard deviation) age 14.2 (4.0) years underwent MPG plus LT. Fifty-four percent of patients were obese (Body mass index [BMI] > 95th centile) and 8% were overweight (BMI 85th-95th centile) preoperatively. All patients underwent pre- and postoperative polysomnography. Postoperatively, the obstructive apnea-hypopnea index fell significantly from 47.0/hour to 5.6/hour (P <.05) in normal weight individuals who did not become obese, but not in obese patients or those who became obese postoperatively. Successful surgical outcome was seen in all (N = 6) children who were normal weight or overweight preoperatively compared with none who were obese preoperatively (N = 7). Midline posterior glossectomy and LT are beneficial in normal weight and overweight children with DS who have persistent OSA following TA and are intolerant of PAP therapy. Obesity pre- or postoperatively portends a worse prognosis following MPG, suggesting that aggressive weight loss initiatives should be considered as an adjunct to surgery in this population. 4. Laryngoscope, 127:757-763, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

The quality of life of adolescents with menstrual problems.

PubMed

Nur Azurah, Abdul Ghani; Sanci, Lena; Moore, Elya; Grover, Sonia

2013-04-01

To date, very few publications have examined the health related quality of life (HRQL) in the younger population with menstrual problems, despite their high prevalence in adolescent girls. We describe the health-related quality of life (HRQL) among adolescents with menstrual problems and identified factors that have an impact on it. The study was a questionnaire study (using PedsQL 4.0) of adolescents aged 13-18 referred to a tertiary gynecology center for menstrual problems between June 2009 and August 2010. One hundred eighty-four adolescents completed the questionnaires. The mean age was 15.10 ± 1.49 with the mean body mass index (BMI) of 22.83 ± 4.82 kg/m(2). The most common menstrual problems seen in the clinic were dysmenorrhea (38.6%) followed by heavy bleeding (33.6%), oligomenorrhea (19.6%), and amenorrhea (8.2%). The mean overall score was 70.40 ± 16.36 with 42.3% having a score below 1 standard deviation (SD) from the norms. Adolescents with dysmenorrhea had the poorest score in physical function, whereas those with amenorrhea had the lowest score in psychosocial function. Maternal parenting style, parental anxiety, adolescents' ill-health behavior, and BMI have been found to have impact on the girls' quality of life (QoL). Although menstrual problems are not life threatening, they can pose a significant impact on the quality of life of these patients. Identification of these impacts might lead to the recognition of potential services or education to improve this. Understanding the characteristics that predict QoL may help a clinician identify patients who are risk for poor QoL. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. All rights reserved.