90th Body Mass Index Percentile Research Articles

Urinary Sodium Excretion and Obesity Markers among Bangladeshi Adult Population: Pooled Data from Three Cohort Studies.

We evaluated the relationship of urinary sodium excretion with a conditional mean, 10th and 90th percentiles of body mass index (BMI), and waist circumference among 10,034 person-visits of Bangladeshi population. We fitted linear mixed models with participant-level random intercept and restricted maximum likelihood estimation for conditional mean models; and quantile mixed-effect models with participant-level random intercept and Laplace estimation for 10th and 90th percentiles models. For each 100 mmol/24 h increase in urinary sodium excretion, participants had a 0.10 kg/m2 (95% CI: 0.00, 0.10) increase in the mean; a 0.39 kg/m2 (95% CI: 0.23, 0.54) increase in the 10th percentile; and a 0.59 kg/m2 (95% CI: 0.39, 0.78) increase in the 90th percentile of BMI. For each 100 mmol/24 h increase in urinary sodium excretion, participants had a 0.20 cm (95% CI: 0.10, 0.30) increase in mean; a 0.18 cm (95% CI: −0.03, 0.40) change in the 10th percentile; and a 0.23 cm (95% CI: 0.03, 0.43) increase in the 90th percentile of waist circumference. We found a modest association between urine sodium and conditional mean of BMI and waist circumference. The magnitude of associations between urine sodium and the 10th and 90th percentile BMI distributions were higher compared to the conditional mean models, suggesting high sodium intake could be more detrimental to underweight and obese participants.

Trajectories of objectively measured physical activity and childhood overweight: longitudinal analysis of the IDEFICS/I.Family cohort

BackgroundSince only few longitudinal studies with appropriate study designs investigated the relationship between objectively measured physical activity (PA) and overweight, the degree PA can prevent excess weight gain in children, remains unclear. Moreover, evidence is limited on how childhood overweight determines PA during childhood. Therefore, we analyzed longitudinal trajectories of objectively measured PA and their bi-directional association with weight trajectories of children at 2- and 6-year follow-ups.MethodsLongitudinal data of three subsequent measurements from the IDEFICS/I.Family cohort study were used to analyze the bi-directional association between moderate-to-vigorous PA (MVPA) and weight status by means of multilevel regression models. Analyses comprised 3393 (2-year follow-up) and 1899 (6-year follow-up) children aged 2–15.9 years from eight European countries with valid accelerometer data and body mass index (BMI) measurements. For categorized analyses, children’s weight status was categorized as normal weight or overweight (cutoff: 90th percentile of BMI) and children’s PA as (in-) sufficiently active (cutoffs: 30, 45 and 60 min of MVPA per day).ResultsChildren engaging in at least 60 min MVPA daily at baseline and follow-ups had a lower odds of becoming overweight (odds ratio [OR] at 2-year follow-up: 0.546, 95% CI: 0.378, 0.789 and 6-year follow-up: 0.393, 95% CI: 0.242, 0.638), compared to less active children. Similar associations were found for 45 min MVPA daily. On the other side, children who became overweight had the lowest odds to achieve 45 or 60 min MVPA daily (ORs: 0.459 to 0.634), compared to normal weight children.ConclusionsBi-directional associations between MVPA and weight status were observed. In summary, at least 60 min MVPA are still recommended for the prevention of childhood overweight. To prevent excess weight gain, 45 min MVPA per day also showed preventive effects.

Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies

SummaryBackgroundSocioeconomic inequalities in childhood body-mass index (BMI) have been documented in high-income countries; however, uncertainty exists with regard to how they have changed over time, how inequalities in the composite parts (ie, weight and height) of BMI have changed, and whether inequalities differ in magnitude across the outcome distribution. Therefore, we aimed to investigate how socioeconomic inequalities in childhood and adolescent weight, height, and BMI have changed over time in Britain.MethodsWe used data from four British longitudinal, observational, birth cohort studies: the 1946 Medical Research Council National Survey of Health and Development (1946 NSHD), 1958 National Child Development Study (1958 NCDS), 1970 British Cohort Study (1970 BCS), and 2001 Millennium Cohort Study (2001 MCS). BMI (kg/m2) was derived in each study from measured weight and height. Childhood socioeconomic position was indicated by the father's occupational social class, measured at the ages of 10–11 years. We examined associations between childhood socioeconomic position and anthropometric outcomes at age 7 years, 11 years, and 15 years to assess socioeconomic inequalities in each cohort using gender-adjusted linear regression models. We also used multilevel models to examine whether these inequalities widened or narrowed from childhood to adolescence, and quantile regression was used to examine whether the magnitude of inequalities differed across the outcome distribution.FindingsIn England, Scotland, and Wales, 5362 singleton births were enrolled in 1946, 17 202 in 1958, 17 290 in 1970, and 16 404 in 2001. Low socioeconomic position was associated with lower weight at childhood and adolescent in the earlier-born cohorts (1946–70), but with higher weight in the 2001 MCS cohort. Weight disparities became larger from childhood to adolescence in the 2001 MCS but not the earlier-born cohorts (pinteraction=0·001). Low socioeconomic position was also associated with shorter height in all cohorts, yet the absolute magnitude of this difference narrowed across generations. These disparities widened with age in the 2001 MCS (pinteraction=0·002) but not in the earlier-born cohorts. There was little inequality in childhood BMI in the 1946–70 cohorts, whereas inequalities were present in the 2001 cohort and widened from childhood to adolescence in the 1958–2001 cohorts (pinteraction<0·05 in the later three cohorts but not the 1946 NSHD). BMI and weight disparities were larger in the 2001 cohort than in the earlier-born cohorts, and systematically larger at higher quantiles—eg, in the 2001 MCS at age 11 years, a difference of 0·98 kg/m2 (95% CI 0·63–1·33) in the 50th BMI percentile and 2·54 kg/m2 (1·85–3·22) difference at the 90th BMI percentile were observed.InterpretationOver the studied period (1953–2015), socioeconomic-associated inequalities in weight reversed and those in height narrowed, whereas differences in BMI and obesity emerged and widened. These substantial changes highlight the impact of societal changes on child and adolescent growth and the insufficiency of previous policies in preventing obesity and its socioeconomic inequality. As such, new and effective policies are required to reduce BMI inequalities in childhood and adolescence.FundingUK Economic and Social Research Council, Medical Research Council, and Academy of Medical Sciences/the Wellcome Trust.

Aggressive nutrition in extremely low birth weight infants: impact on parenteral nutrition associated cholestasis and growth

BackgroundParenteral nutrition associated cholestasis (PNAC) is a frequently observed pathology in extremely low birth weight (ELBW) infants. Its pathogenesis is determined by the composition and duration of parenteral nutrition (PN) as well as the tolerance of enteral feeds (EF). “Aggressive” nutrition is increasingly used in ELBW infants to improve postnatal growth. Little is known about the effect of “aggressive” nutrition on the incidence of PNAC. We analyzed the influence of implementing an “aggressive” nutritional regimen on the incidence of PNAC and growth in a cohort of ELBW infants.MethodsELBW infants were nourished using a “conservative” (2005–6; n = 77) or “aggressive” (2007–9; n = 85) nutritional regimen that differed in the composition of PN after birth as well as the composition and timing of advancement of EFs. We analyzed the incidence of PNAC (conjugated bilirubin > 1.5 mg/dl (25 µmol/l)) corrected for confounders of cholestasis (i.e., NEC and/or gastrointestinal surgery, sepsis, birth weight, Z-score of birth weight, time on PN and male sex), growth until discharge (as the most important secondary outcome) and neonatal morbidities.ResultsThe incidence of PNAC was significantly lower during the period of “aggressive” vs. “conservative “nutrition (27% vs. 46%, P < 0.05; adjusted OR 0.275 [0.116–0.651], P < 0.01). Body weight (+411g), head circumference (+1 cm) and length (+1 cm) at discharge were significantly higher. Extra-uterine growth failure (defined as a Z-score difference from birth to discharge lower than −1) was significantly reduced for body weight (85% vs. 35%), head circumference (77% vs. 45%) and length (85% vs. 65%) (P < 0.05). The body mass index (BMI) at discharge was significantly higher (11.1 vs. 12.4) using “aggressive” nutrition and growth became more proportionate with significantly less infants being discharged below the 10th BMI percentile (44% vs. 9%), while the percentage of infants discharged over the 90th BMI percentile (3% vs. 5%) did not significantly increase.Discussion“Aggressive” nutrition of ELBW infants was associated with a significant decrease of PNAC and marked improvement of postnatal growth.

Can Changing Economic Factors Explain the Rise in Obesity?

A growing literature examines the effects of economic variables on obesity, typically focusing on only one or a few factors at a time. We build a more comprehensive economic model of body weight, combining the 1990–2010 Behavioral Risk Factor Surveillance System with 27 state-level variables related to general economic conditions, labor supply, and the monetary or time costs of calorie intake, physical activity, and cigarette smoking. Controlling for demographic characteristics and state and year fixed effects, changes in these economic variables collectively explain 37% of the rise in body mass index (BMI), 43% of the rise in obesity, and 59% of the rise in Class II/III obesity. Quantile regressions also point to large effects among the heaviest individuals, with half the rise in the 90th percentile of BMI explained by economic factors. Variables related to calorie intake—particularly restaurant and supercenter/warehouse club densities—are the primary drivers of the results.

Habitual sleep patterns and the distribution of body mass index: cross-sectional findings among Swedish men and women

ObjectiveTo compare distributions of body mass index (BMI) between individuals with different habitual sleep patterns. MethodsWe performed cross-sectional analyses of 40,197 Swedish adults (64% women), who reported sleep duration and quality, weight, height, and possible confounding factors in 1997. Using quantile regression, we estimated associations between sleep patterns and selected percentiles of the distribution of BMI. ResultsWhile the medians were similar, larger adjusted values of BMI were estimated in the upper part of the distribution among men and women with short sleep (≤5 h) compared with medium-length sleep (6–8 h). For example, in men, the 90th percentile of BMI was 0.80 kg/m2 (95% confidence interval: 0.17–1.43 kg/m2) higher among short sleepers. In women, long sleepers (≥9 h) also showed larger values in the upper part of the BMI distribution; the 90th percentile was 1.23 kg/m2 (0.42–2.04 kg/m2) higher than in medium-length sleepers. In male long sleepers, smaller values were estimated in the lower part of the BMI distribution; the 10th percentile was 0.84 kg/m2 lower (0.35–1.32 kg/m2) than in medium-length sleepers. The 90th percentile of BMI in women with poor-quality compared with good-quality sleep was larger by 0.82 kg/m2 (0.47–1.16 kg/m2); the 10th percentile was smaller by 0.17 kg/m2 (0.02–0.32 kg/m2). ConclusionsShort, long or poor-quality sleepers showed larger, or smaller, values at the tails of the BMI distribution, but similar medians. Hence, unfavorable sleep patterns and BMI were associated only in a subset of this study population.

Greater screen time is associated with adolescent obesity: A longitudinal study of the BMI distribution from Ages 14 to 18

Previous research has examined the association between screen time and average changes in adolescent body mass index (BMI). Until now, no study has evaluated the longitudinal relationship between screen time and changes in the BMI distribution across mid to late adolescence. Participants (n=1,336) were adolescents who were followed from age 14 to age 18 and surveyed every six months. Time spent watching television/videos and playing video games was self-reported (<1hr/d, 1hr/d, 2hrs/d, 3hrs/d, 4hrs/d, or 5+hrs/d). BMI (kg/m2) was calculated from self-reported height and weight. Longitudinal quantile regression was used to model the 10th, 25th, 50th, 75th and 90th BMI percentiles as dependent variables. Study wave and screen time were the main predictors, and adjustment was made for gender, race, maternal education, hours of sleep and physical activity. We observed increases at all the BMI percentiles over time, with the greatest increase at the 90th BMI percentile. Screen time was positively associated with changes in BMI at the 50th (0.17, 95% CI: 0.06, 0.27), 75th (0.31, 95% CI: 0.10, 0.52) and 90th BMI percentiles (0.56, 95% CI: 0.27, 0.82). No associations were observed between screen time and changes at the 10th and 25th BMI percentiles. We observed positive associations between screen time and changes in the BMI at the upper tail of the BMI distribution. Therefore lowering screen time, especially among overweight and obese adolescents, could contribute to reducing the prevalence of adolescent obesity.

Moderate‐To‐vigorous physical activity is associated with decreases in body mass index from ages 9 to 15 years

The purpose of this study is to determine whether time spent in objectively measured physical activity is associated with change in body mass index (BMI) from ages 9 to 15. The participants were enrolled in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 938). At ages 9, 11, 12, and 15 the time spent in moderate-to-vigorous physical activity (MVPA) was objectively measured, and BMI was calculated (kg/m(2) ). Longitudinal quantile regression was used to analyze the data. The 10th, 25th, 50th, 75th, and 90th BMI percentiles were modeled as the dependent variables with age and MVPA (h/day) modeled as predictors. Adjustment was also made for gender, race, sleep, healthy eating score, maternal education, and sedentary behavior. A negative association between MVPA and change in BMI was observed at the 90th BMI percentile (-3.57, 95% CI -5.15 to -1.99 kg/m(2) per hour of MVPA). The negative association between time spent in MVPA and change in BMI was progressively weaker toward the 10th BMI percentile (-0.27, 95% CI -0.62 to 0.07 kg/m(2) per hour of MVPA). The associations remained similar after adjusting for the covariates, and when the analyses were stratified by gender. Time spent in MVPA was negatively associated with change in BMI from age 9 to 15. The association was strongest at the upper tail of the BMI distribution, and increasing time spent in MVPA could help reduce the prevalence of childhood obesity.

Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years

To determine if time spent in objectively measured sedentary behavior is associated with a change in body mass index (BMI) between ages 9 and 15 years, adjusting for moderate-to-vigorous physical activity (MVPA). Prospective observational study of children at ages 9 (2000), 11 (2002), 12 (2003) and 15 years (2006). Longitudinal quantile regression was used to model the influence of predictors on changes at the 10th, 25th, 50th, 75th and 90th BMI percentiles over time. Participants were enrolled in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development and include both boys and girls (n=789). Objectively measured BMI (kg m(-2)) was the outcome variable and objectively measured sedentary behavior was the main predictor. Adjustment was also made for MVPA, gender, race, maternal education, hours of sleep and healthy eating index. Increases in BMI were observed at all percentiles, with the greatest increase observed at the 90th BMI percentile. Spending more time in sedentary behavior (h per day) was associated with additional increases in BMI at the 90th, 75th and 50th BMI percentiles, independent of MVPA and the other covariates (90th percentile=0.59, 95% confidence interval (95% CI): 0.19-0.98 kg m(-2); 75th percentile=0.48, 95% CI: 0.25-0.72 kg m(-2); and 50th percentile=0.19, 95% CI: 0.05-0.33 kg m(-2)). No associations were observed between sedentary behavior and changes at the 25th and 10th BMI percentiles. Sedentary behavior was associated with greater increases in BMI at the 90th, 75th and 50th BMI percentiles between ages 9 and 15 years, independent of MVPA. Preventing an increase in sedentary behavior from childhood to adolescence may contribute to reducing the number of children classified as obese.

Association between walking distance and percentiles of body mass index in older and younger men

Objective:To assess the association of weekly walking distance to body weight and waist circumference in elderly (age ⩾75 years), senior (55⩽ age <75 years), middle-aged (35⩽ age <55 years), and...

Association of K121Q polymorphism in ENPP1 (PC-1) with BMI in Caucasian and African-American adults

To test for association of the ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) K121Q polymorphism with body mass index (BMI) and diabetes in a large sample of Caucasians and African-Americans by selectively genotyping individuals at the extremes of the phenotypic distribution. Subsets comprising the extremes of the BMI distribution (10th-20th and above the 90th BMI percentile for Caucasians and between the 10th-30th and above the 80th percentile for African-Americans) from a group of 10,260 Caucasian and 2268 African-American adults participating in New York Cancer Project were studied. Subjects were genotyped for the ENPP1 K121Q polymorphism by pyrosequencing and tested for association with BMI and diabetes by regression analysis. Regression analysis with BMI as the dependent variable demonstrated a significant association (P = 0.02) of genotype at K121Q with BMI, with no significant race-by-genotype interaction (P = 0.30). Compared with Q/Q or Q/K individuals, the K/K individuals had a BMI approximately 1.3 kg/m2 higher, without effects of age, gender or race. By logistic regression analysis, the K121Q alleles had no significant effect on diabetes status (P = 0.37) in obese subjects. In both Caucasians and African-Americans, the K121 polymorphism in ENPP1 was associated with increased BMI, but not with diabetes.

High prevalence of metabolic risk factors for cardiovascular diseases among Saudi population, aged 30–64 years

Objective: Study the prevalence of metabolic risk factors for cardiovascular diseases, obesity, diabetes mellitus, hypercholesterolemia and other cholesterol related risk factors among Saudi population, aged 30–64 years. Design: Cross sectional national epidemiological randomized household survey. Subject: 2059 Saudi subjects, aged 30–64 years. Sample was representative and in accordance with the national population distribution with respect to age, gender, regional and residency, urban vs. rural, population distribution. Measurement: Height and weight with calculation of body mass index, blood samples were drawn and assayed for glucose, total cholesterol, triglyceride and high density lipoprotein. Low density lipoprotein and cholesterol/high density lipoprotein ratio were calculated. Oral glucose tolerance test was done for subjects with borderline random glucose concentration. The overall prevalence of diabetes mellitus was calculated. Results: Mean body mass index (BMI) was significantly higher among female subjects 28.3(6) vs. 26.6(4.6), P=0.0001. The 90th percentile of BMI was higher among female subjects across all age groups. The 90th percentile of BMI for Saudi subjects were higher across all age group than sex and age matched European subjects. Mean serum total cholesterol (TC) concentration was higher, however, not significant among female, compared with male subjects. The 90th percentile of serum TC concentration was higher among female, compared with male subjects for all age groups after the age of 40 years. The 90th percentile of serum TC concentration for Saudi subjects was lower across all age groups than sex and age matched European subjects. The prevalence of overweight was significantly higher among male subjects whereas the prevalence of obesity was significantly higher among female subjects. The prevalence of diabetes mellitus was significantly higher among female subjects whereas the prevalence of impaired glucose tolerance was significantly higher among male subjects. The prevalence of hypercholesterolemia, whether using cut-off levels of >5.2 mmol/l or >6.2 mmol/l. were similar between male and female subjects. They were lower than the prevalence of hypercholesterolemia among sex and age matched subjects whether from developed or from some developing countries. The prevalence of hypo HDL cholesterolemia, <0.9 mmol/l, was significantly higher among male subjects. The prevalence of total cholesterol/high density lipoprotein ratio, >6.5, for Saudi subjects was higher than some other developing countries. Conclusion: This study has shown high prevalence of metabolic risk factors for CVD. As atherosclerosis is ongoing process and considering the young nature of this country with 60% of population are <30 years old, one would expect the magnitude of CVD to multiply in the future especially with the continuous exposure to metabolic and non-metabolic risk factors. Several of the metabolic risk factors are modifiable either through change of lifestyle or medical treatment. There is a need to address such risk factors at national and regional level with aim of early identification and prevention. There is a need to monitor the trend of CVD and the risk factors which can be used to assess the efficacy of control programs.