BMI Data Research Articles

Healthy lifestyle and life expectancy at age 30 years in the Chinese population: an observational study

The improvement of life expectancy is one of the aims of the Healthy China 2030 blueprint. We aimed to investigate the extent to which healthy lifestyles are associated with life expectancy in Chinese adults. We used the prospective China Kadoorie Biobank (CKB) study to examine the relative risk of mortality associated with individual and combined lifestyle factors (never smoking or quitting not for illness, no excessive alcohol use, being physically active, healthy eating habits, and healthy body shape). Participants with coronary heart disease, stroke, cancer, or missing values for body-mass index were excluded. For analysis of chronic respiratory diseases, participants with chronic obstructive pulmonary disease or asthma were excluded. We estimated the national prevalence of lifestyle factors using data from the China Nutrition and Health Surveillance (CNHS; 2015) and derived mortality rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (2015). All three data sources were combined to estimate the life expectancy of individuals at age 30 years following different levels of lifestyle factors by using the life table method. The cause-specific decomposition of the life expectancy differences was analysed using Arriaga's method. After the exclusion of CKB participants with coronary heart disease, stroke, cancer, or missing BMI data at baseline, 487 209 were included in the primary analysis. Participants with COPD or asthma at baseline were additionally excluded for chronic respiratory disease-related analysis, leaving 451 233 participants with data available for analysis. Data from 171 127 adults aged 30-84 years from the CNHS 2015 were used to estimate the sex-specific and age-specific prevalence of lifestyle-related factors. There were 42 496 deaths documented over a median follow-up of 11·1 years (IQR 10·2-12·1) in CKB. The adjusted hazard ratios (aHRs) of participants adopting five versus 0-1 low-risk factors was 0·38 (95% CI 0·34-0·43) for all-cause mortality, aHR 0·37 (0·30-0·46) for cardiovascular disease mortality, aHR 0·47 (0·39-0·56) for cancer mortality, and aHR 0·30 (0·14-0·64) for chronic respiratory disease mortality. The life expectancy at age 30 years for individuals with 0-1 low-risk factors was on average 41·7 years (95% CI 41·5-42·0) for men and 47·3 years (46·6-48·0) for women. For individuals with all five low-risk factors, the life expectancy at age 30 was 50·5 years (95% CI 48·5-52·4) for men and 55·4 years (53·5-57·4) for women; meaning a difference of 8·8 years (95% CI 6·8-10·7) for men and 8·1 years (6·5-9·9) for women. The estimated extended life expectancy for men and women was mainly attributable to reduced death from cardiovascular disease (2·4 years [27% of the total extended life expectancy] for men and 3·7 years [46%] for women), cancer (2·6 years [30%] for men and 0·9 years [11%] for women), and chronic respiratory disease (0·6 years [7%] for men and 1·2 years [15%] for women). Our findings suggest that increasing the adoption of these five healthy lifestyle factors through public health interventions could be associated with substantial gains in life expectancy in the Chinese population. National Natural Science Foundation of China, National Key Research and Development Program of China, Kadoorie Charitable Foundation, UK Wellcome Trust.

Illness stigma, body image dissatisfaction, thwarted belongingness and depressive symptoms in youth with inflammatory bowel disease.

Elevated depressive symptoms are observed in a significant number of youth with inflammatory bowel disease (IBD) and have been linked to illness stigma and social isolation. Body image dissatisfaction is an understudied variable in the pediatric IBD literature that may be related to both stigma and social difficulties. It is suspected that, due to the stigmatizing nature of IBD, some youth may feel self-conscious about their body image, which contributes to decreased feelings of social belongingness and ultimately depressive symptoms. The current study tested an illness stigma→ body image dissatisfaction→ thwarted belongingness→ depressive symptoms serial mediation model, in which IBD stigma was hypothesized to indirectly influence youth depressive symptoms through the sequential effects of stigma on body image dissatisfaction and thwarted social belongingness. Youth with IBD (N = 75) between 10 and 18 years old were recruited from a pediatric gastroenterology clinic and completed psychosocial measures. Disease severity was assessed by a physician global assessment. Current medications and BMI data were collected. Analyses revealed significant direct effects among the modeled variables and a significant serial indirect path for illness stigma→ body image dissatisfaction→ thwarted belongingness→ depressive symptoms, controlling for sex, BMI and prednisone medication. Youth who perceive greater IBD stigma are more likely to experience increased body image dissatisfaction due to their IBD, which may engender feelings of social estrangement and ultimately elevated depressive symptoms. Depressive symptoms and the psychosocial challenges faced by youth should be routinely monitored as part of comprehensive IBD management.

Use of the Complete Airway Repositioning and Expansion (CARE) approach in 220 patients with Obstructive Sleep Apnea (OSA): A retrospective cohort study

Objective/BackgroundObstructive sleep apnea (OSA) is a prevalent disease with significant health repercussions. While many effective OSA treatment modalities exist, Complete Airway Repositioning and Expansion (CARE) represents an emerging approach that leverages gradual airway expansion, with or without mandibular advancement. We conducted a retrospective study of patients who underwent CARE with a dental provider and examined how their sleep study data changed, with a focus on apnea hypopnea index (AHI). Patients/MethodsA retrospective database of 220 adult patients was examined. Demographic data and radiographic and sleep study data were compared in patients before and following at least 6 months of treatment with one of two possible dental devices. ResultsThe median age of patients in this cohort was 50 years, and evenly split by gender. The median decrease in AHI was 49.0%, with a median pre-treatment AHI of 17.3 and median post-treatment AHI of 9.6 (p<0.001). Most participants (63.6%) demonstrated an improvement in their OSA severity class. Fifty-seven (25.9%) participants had complete resolution of their OSA. Post-treatment, 151 (68.6%) of patients had OSA severities of none or mild. Thirty-four (15.5%) of patients had in increase in AHI and 13 (6.0%) of these patients demonstrated an increase in OSA classification. One patient experienced an adverse event in the form of a loose molar tooth requiring repair. Overall findings were limited by missingness of BMI and clinical co-morbidity data, as well as quality of life measures. ConclusionsIn this large, but data limited retrospective series, CARE seems to be an effective and safe approach to OSA management that may be a useful alternative to current mainstays of OSA management. Further investigation is warranted.

Obesity trends over 10 years in primary hip and knee arthroplasty—a study of 12,000 patients

Objectives/AimsObesity and its increasing prevalence are global public health concerns. Following joint replacement, there is evidence to support that obese patients are more likely to suffer complications. We examined 10-year trends in BMI of the primary total hip and total knee replacement cohorts in our institution to discern whether the BMI of these patients has changed over time.MethodsWe examined BMI data of patients who underwent primary hip and knee arthroplasty from our institutional database from January 1, 2010 to December 31, 2019 (n = 12,169). We analysed trends in BMI over this period with respect to (i) surgical procedure, (ii) gender, and (iii) age categories.ResultsThe overall number of surgical procedures increased over the study period which meant more obese patients underwent surgery over time. Average BMI did not change significantly over time; however, there was a statistically significant increase in BMI in females aged < 45 in both arthroplasty groups.ConclusionThe average BMI of patients undergoing primary hip and knee arthroplasty in our high-volume tertiary orthopaedic centre has remained relatively unchanged over the past 10 years; however, our local service is caring for a greater number of overweight/obese patients due to the increase in overall volume. This will have significant implications on health care expenditure and infrastructure going forward which further emphasises the importance of ongoing national obesity prevention strategies. The increase in BMI seen in females aged < 45 may mark an impending era of obese younger patients with end-stage osteoarthritis.

An Assessment of the Relationship Between BMI and Children Undergoing Surgical Procedures: A Retrospective Study.

Background: While multiple studies have documented that obesity increases the risk of operative complications among adults, little data exist on how obesity impacts surgical outcomes among children. We aimed to determine if children with obesity have different postoperative outcomes than their peers. Methods: A retrospective chart review was conducted of 875 patients aged between 2 and 18 years who underwent surgery during 2018. Patients were stratified, based on BMI percentile for age, as having less than healthy weight (<5th percentile), healthy weight (5th-84th percentile), excess weight (85th-94th percentile), or obesity (≥95th percentile). Demographic information and data on medical comorbidities and postoperative complications were collected. All analyses were conducted using chi-square or Kruskal-Wallis testing. Results: Eighty-two patients were excluded due to lack of BMI data and 56 were excluded as they had below healthy weight. Of the remaining 737 patients, 475 (64.4%) had healthy weight, 124 (16.8%) had excess weight, and 138 (18.70%) had obesity. Children with obesity had more tonsillectomy/adenoidectomy (p < 0.01) and vascular access (p = 0.04) procedures compared with peers. Additionally, patients with obesity were more likely to have a pre-existing history of liver disease (p < 0.01) and more frequently developed postoperative wound dehiscence (p < 0.01). No other complications occurred more frequently among children with obesity. Conclusions: Children with obesity required more tonsillectomy/adenoidectomy and vascular access procedures. Wound dehiscence was the only complication that was associated with obesity. This suggests that children with obesity are not inherently more prone to experience surgical complications and therefore elective procedures should likely not be deferred until preoperative weight loss is achieved.

VITAMIN D DEFICIENCY IN PATIENTS WİTH EARLY BREAST CANCER ACCORDING TO PATHOLOGICAL SUBTYPIES; ONE CENTER EXPERIENCE

Giriş ve Amaç: D vitamini, meme kanseri riskiyle ilişkilendirilmiştir. Bu çalışmanın birinci amacı erken evre meme kanserli hastalarda D vitamin eksikliğini ve meme kanseri patolojik subtiplerine göre D vitamini düzeylerindeki farklılıkları göstermektedir. &#x0D; Gereç ve Yöntemler: Çalışmaya erken meme kanseri tanısı almış toplam 208 kadın hasta dahil edildi. Patolojik Subtiplere göre (Lüminal; HER2 pozitif; Üçlü negatif; Üçlü pozitif) dört gruba ayrıldı ve meme kanseri alt tiplerinin ortalama D vitamini düzeyleri, VKİ ve dosya verileri SPPS programına girildi.&#x0D; Bulgular: Ortalama yaş 51.37 +/-10.0 idi. 25(OH)D3 düzeyi ortalama 22.3 +/- 10.6 nmol/L idi. Hastaların % 79.1’inde D vitamini seviyeleri eksikti(

Association between obesity and frequency of high-grade prostate cancer on biopsy in men: A single-center retrospective study.

The present study aimed to investigate the relationship between BMI and the prostate cancer (PCa) risk at biopsy in Italian men. Retrospective analyses of the clinical data of 2,372 consecutive men undergoing ultrasound-guided multicore (≥10) prostate biopsy transrectally between May 2010 and December 2018 were performed. BMIs were categorized, according to Western countries' classification of obesity, as follows: <18.5 kg/m2 (underweight), 18.5-24.99 kg/m2 (normal weight), 25-30 kg/m2 (overweight) and >30 kg/m2 (obese). The distribution of patients undergoing biopsy was compared with a model population from the official survey data. Patient characteristics and the relationships between characteristics were investigated using correlation analysis, ANOVA, Kruskal-Wallis and Dunn's tests. The present study estimated the influence on cancer incidence not only of BMI but also of other patient characteristics using multi-variable logistic modelling and compared, using the models, the expected outcomes for patients who differed only in BMI. From a sample of 2,372 men, the present study enrolled 1,079 men due to a lack of clinical data [such as prostate specific antigen (PSA) and BMI data] in the other patients undergoing prostate biopsy. Their distribution was significantly different from the model distribution with the probability of undergoing biopsy increasing with increasing BMI. The median age was 69.4 years. The median BMI was 26.4 kg/m2, while the median PSA level was 7.60 ng/ml. In total, the biopsies detected PCa in 320 men (29.7%) and high-grade PCa (HGPCa) in 218 men (20.2%). Upon applying the aforementioned Western countries' criteria for BMI categories, there were 4 (0.4%) underweight, 318 (29.5%) of normal weight, 546 (50.6%) overweight, and 211 (19.6%) obese patients. ANOVA/Kruskal-Wallis tests revealed that overweight and obese men were younger than the normal-weight men, while there was no statistical difference in their PSA values. Furthermore, 29.3% of normal-weight men, 29.5% of overweight men and 29.9% of obese men were diagnosed with PCa, while 19.5% of normal-weight men, 20.1% of overweight men and 21.8% of obese men were affected by severe cancer. BMI was found to be positively correlated with PCa risk and negatively correlated with both age and PSA level. Age and PSA level were both positively correlated with PCa risk, while digital rectal examination (DRE) outcome was strongly indicative of PCa discovery if the test outcome was positive. Logistics models attributed a positive coefficient to BMI when evaluated against both PCa risk and HGPCa risk. In patients having a negative DRE outcome who differed only in BMI, logistic regression showed a 60% increased risk of PCa diagnosis in obese patients compared with in normal-weight patients. This risk difference increased when other characteristics were less indicative of PCa (younger age/lower PSA), while it decreased when patient characteristics were more indicative (older age/higher PSA, positive DRE). In conclusion, the present study demonstrated that, in men with higher BMIs, the risk of PCa is higher. The relative difference in risk between low and high BMI is most pronounced in younger patients having a lower PSA level and a negative DRE outcome.

Association between ultrasonographic parameters, clinical and biochemical indicators and results of surveys in patients with heart failure with moderately reduced left ventricle fraction

The aim: to evaluate the probable impact of type 2 diabetes on quality of life, clinical, biochemical and ultrasonographic parameters in patients with HFwmrLVEF and associations between them. Materials and methods: the study included 68 patients with HFwmrLVEF, including 36 patients with concomitant DM type 2 and 32 patients without type 2 DM, and 18 healthy individuals. All study participants underwent anthropometric (height, weight, BMI), laboratory (clinical blood test, biochemical blood test to determine ACT, ALT, creatinine, glucose, lipid spectrum, potassium, sodium and magnesium, ELISA to determine glycated hemoglobin and NT-proBN ), instrumental (EchoC, ECG) surveys and surveys to assess quality of life (EQ-5D-5L). Statistical processing of the obtained results was performed using the statistical software package SPSS v.19.0. Results: between the group of patients with HFwmrLVEF with concomitant type 2 DM and the group with HFwmrLVEF without type 2 DM according to the results of the study there is a significant difference in quality of life in carbohydrate metabolism, NT-proBNP, BMI and echocardiographic data. Conclusions: patients with HFwmrLVEF with concomitant type 2 DM compared with patients with HFwmrLVEF without type 2 DM had significantly worse carbohydrate metabolism, significantly higher mean serum NT-proBNP concentration, higher LVMM and iLVMM in transthoracic E quality of life according to the results of the EQ-5D-5L questionnaire in the absence of a significant difference in age and LVEF between groups. In addition, there was a stronger correlation between NT-proBNP and iLVMM in patients without type 2 DM and no correlation between NT-proBNP and LVMM in patients with concomitant type 2 DM, which may be due to certain influence of type 2 DM on the process of pro-BNP conversion

Weight Bias: Examining Achalasia Therapy in the Obese Patient.

We hypothesize that obesity is a common diagnosis in those with achalasia at our institution but time to diagnosis and treatment is longer compared to normal weight counterparts due to implicit bias. We retrospectively reviewed all adult patients between 1/1/2013 and 6/31/2020 with a diagnosis of achalasia. Demographics, comorbidities, Eckardt scores, interventions, complications, time to consult, duration of symptoms, and follow-up were evaluated. More than half of the patients were seen in the most recent 2 years following POEM introduction and 138 had available BMI data. 46 were obese (33%) and 92 were non-obese (67%). Obese patients reported a shorter duration of symptoms prior to seeking treatment 12 versus 24 months. There was no difference in time to intervention or procedure offered. There was a non-significant trend toward higher leak (11 vs 5%) and overall complication rate (19 vs 17%) in obese patients. In follow-up 98 patients had BMI data. There was a a significant difference in mean BMI change -1.2 +/- 4.2 kg/m2 in obese patients and +0.1 +/- 2.1 kg/m2 in normal weight patients. One year follow-up was available in 16 (47%) obese and 25 (33%) non-obese patients and showed a non-significant trend toward greater weight gain in the normal/overweight group (+3.2 +/- 1.1 kg/m2) compared to obese (+2.0 +/- 3.5 kg/m2). Obese patients with achalasia have unique considerations. Duration of symptoms may be shorter in the obese patient with esophageal dysphagia. We noted trends toward greater weight gain following interventions in non-obese patients with equivalent complication rates.

Cancer sleep symptom-related phenotypic clustering differs across three cancer specific patient cohorts.

Specific sleep disorders have been linked to disease progression in different cancers. We hypothesised sleep symptom clusters would differ between cancer types. The aim of this study was to compare sleep symptom clusters in post-treatment melanoma, breast and endometrial cancer patients. Data were collected from 124 breast cancer patients (1 male, 60 ± 15 years, 28.1 ± 6.6kg/m2 ), 82 endometrial cancer patients (64.0 ± 12.5 years, 33.5 ± 10.4kg/m2 ) and 112 melanoma patients (59 male, 65.0 ± 18.0 years, 29.1 ± 6.6kg/m2 ). All patients completed validated questionnaires to assess sleep symptoms, including the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10). Snoring, tiredness, observed apneas, age, BMI, and gender data were also collected. Binary values (PSQI, ISI, FOSQ), or continuous variables for sleepiness (ESS) and perceived sleep quality (PSQI), were created and sleep symptom clusters were identified and compared across cancer cohorts. Four distinct sleep symptom clusters were identified: minimally symptomatic (n=152, 47.7%); insomnia-predominant (n=87, 24.9%); very sleepy with upper airway symptoms (n=51, 16.3%), and severely symptomatic with severe dysfunction (n= 34, 11.1%). Breast cancer patients were significantly more likely to be in the insomnia predominant or severely symptomatic with severe dysfunction clusters, whereas melanoma patients were more likely to be minimally symptomatic or sleepy with upper airway symptoms (p <0.0001). Endometrial cancer patients were equally distributed across symptom clusters. Sleep symptom clusters vary across cancer patients. A more personalised approach to the management of sleep-related symptoms in these patients may improve the long term quality of life and survival.

Relationship between obesity, self esteem and emotional maturity among young men and women in Bengaluru

The study finds the relationship between obesity, self-esteem and Emotional maturity among young men and women between the age group 23-35 years in Bengaluru City and with the help of Rosenberg Self-Esteem Scale, Emotional Maturity Scale and demographic information sheet, the level of self-esteem, level of emotional maturity and BMI data have been captured for 50 Men and 50 women. The primary goal was examining the level of self-esteem and emotional maturity between obese young men and women. And it is observed that the level of self-esteem between obese men and women are not differing very significantly. However, Males have less self-esteem than females. The secondary goal was to identify relationship between Emotional Maturity and self-esteem, and it is found that they are negatively correlated.

Evaluation of Quadriceps Angle and Waist Hip Ratio in Relation to Body Man Index Among Multiparous Women

It is difficult to determine the appropriate way to assess body habitus as a risk factor for chronic illness. This study examined the age, BMI, and WHR data of 200 multiparous women who were diagnosed with knee osteoarthritis (OA) in our registry. The study also conducted stratified analysis by multiparous women and computed risk ratios (RRs) by WHR for those who were already considered obese according to the BMI criterion. According to the study's findings, 38% of multiparous women and 42% of single women were obese according to the BMI criterion. WHR categorised obese women as being multiparous (92% vs. 82%). For multiparous women, the RR of being obese, as measured by WHR, if considered obese according to the BMI criterion was 1.04 (95% confidence range (95% CI 1.03-1.46). The overlap between BMI and WHR is larger in multiparous women than it is in other individuals with knee OA.

Ultrasonographic measurements of the testicular volume in Turkish boys aged 0-8years and comparison with international references.

Proper diagnosis and follow-up of children with testicular disorders depend on the presence of adequate references for testicular volume. The objective of this study was to determine the testicular volume by ultrasound in Turkish boys aged between 0 and 8 years. A total of 320 boys with bilaterally descended testes underwent scrotal ultrasound examinations. The testicular volume (mL) was calculated by the empirical formula of Lambert (V=L×T×AP×0.71) and the formula for an ellipsoid (V=L×T×AP×π/6). The testicular volume was compared with children's age, and Z-score data for weight, height, and BMI. The age-specific 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles of the testicular volume were produced and compared with the international references. The median (IQR) volume of the right and left testis were 0.75 (0.57-0.99) and 0.72 (0.56-0.98) mL (formula of Lambert), respectively; and 0.56 (0.42-0.73) and 0.53 (0.41-0.72) mL, (formula for an ellipsoid), respectively. The age-specific median of the average volume of the right and left testis estimated by the Lambert equation in the first five years was measured between 0.63 and 0.71mL, followed by an increase to about 1.31mL at the age of 8. This increase was highly statistically significant (p<0.0001). No significant association was found between the Z-scores for weight, height, and BMI of boys and the testicular volumes. This study provides the first national ultrasound-based estimates for testicular volume in Turkish boys aged 0-8 years.

Incidence of Obesity at 1 and 3 Years Among Community Dwelling Adults: A Population-Based Study.

Objective:This study determined the incidence rates for obesity among adult patients ages 20 and older empaneled in primary care practice in Midwest United States to potentially identify an optimum timeframe for initiating intervention.Background:Primary care practice patients are likely to reflect underlying community trends in overweight and obesity; however, data on overweight and obesity in primary care patients is limited. While childhood incidence rates of obesity have been well reported, there is still a paucity of data on the incidence of obesity among adult population; literature has mainly focused on its prevalence.Methods:Medical record review of identified cohort with BMI data was conducted. Population was stratified by age and sex and overweight category was subdivided into tertiles.Results:Majority of 40 390 individuals who comprised the final population and had follow-up data, consisted of adults ages 40 to 69 years (47.5%), female (59.8%) of non-Hispanic ethnicity (95.9%) with 21 379 (52.8%) falling in weight category of overweight. Incidence of obesity was 7% at 1 year and 16% at 3 years follow-up. Highest percentages of individuals who became obese at 1 and 3 years were in age category of 40 to 69 years among men and 20 to 39 years among women. In Cox regression analysis, there was statistically significant association to developing obesity among all tertile groups in the overweight category. Age and particularly gender appeared to be modifying factors to likelihood of developing obesity.Conclusion:Study results suggest that while obesity incidence is higher among certain age groups in both genders, middle-aged women, and men in all tertiles of overweight category are at highest risk and may be the optimum population to target for weight loss interventions. Findings support the initiation of population-based interventions before onset of obesity.

Diagnostic capacity of neck circumference to evaluate obesity in a young adult population. Data analysis from the second national health survey in Chile, 2009-2010

Introduction: Chile is among the countries with the highest rate of excess malnutrition, for that reason it is important to have effective tools to evaluate the nutritional status; interest in neck circumference (NC) measurement as a potential prognostic tool that is easy to access and low-cost has increased. Objective: to evaluate the diagnostic capacity of neck circumference to predict obesity in the population aged 15-16 years, using data from the third National Health Survey 2009-2010. Materials and methods: Concurrent Criteria of Diagnostic Validation were used for the study. The sample consisted of 536 people of ages from 15 to 26 years, where BMI data where taken in order to classify obesity versus normality (gold standard), as was NC (measured in centimeters). People with hyperthyroidism were excluded. Indicators of diagnostic accuracy were obtained; the SPSS, version 25 was used for calculations. Results: according to age and gender ranks, the NC cut-off points to classify general obesity showed sensitivities and specificities above 0.85, with an area under the curve over 0.90, all with p < 0.001. Conclusion: there is evidence that supports that NC cutoff points are a suitable tool for diagnosing obesity in this age group.

Fad Diet vs. Balanced Diet in Adults Living in Islamabad

Adults have a variety of experiences with social pressure to have low weight. Thus, there is a desire to lose weight with a variety of efforts, such as fad diets. This type of diet can lead to insufficient intake of nutrients in the body and increase the risk of health problems in the long run. The research aimed to analyze fad diets, BMI, and activity levels of adults in Islamabad. The research design was cross-sectional in 50 adults aged 19–58 years who were selected by simple random sampling. The data of fad diets used in the questionnaire, BMI data using the calculation of the last body weight and height, and activity level were measured using food frequency questionnaire. Data analysis used the chi-square test. The results of this research showed that most respondents implement fad diets (56%), had normal BMI (60%), had fairly activity levels (32%), while overweight BMI (34%), and obese (4%) of BMI, and had moderate and inactive activity level (26%). There was an insignificant (p =.085) correlation between fad diets and age (r = -.232), and in addition, there was an insignificant correlation (p =.171) between fad diets and BMI (r =.013). It is concluded that the adults who implemented fad diets and below normal tended to not have activity levels of BMI because of improper food selection and psychological factors. Adults are expected to be able to conduct weight loss with the assistance of a nutritionist or in accordance with balanced nutrition guidelines.

Impact of Maternal BMI on Urinary Pathology Severity in Pregnancy

The objective of this study is to compare the severity of urinary pathology among women of normal weight, class 1,2 and class 3 obesity. We conducted a retrospective cohort study of women with UTI (acute cystitis or asymptomatic bacteriuria) at a single healthcare system from 7/2013-5/2019. Demographic, infectious, antepartum, and intrapartum data were abstracted. Women with missing BMI or infection data were excluded. Subjects were categorized into < 25 BMI, 30-40 and > 40 based on BMI at their new prenatal visit. The primary outcome was progression to pyelonephritis, and secondary outcomes were recurrent UTI and pyelonephritis-related morbidities. Simple statistics were used to analyze the data and regression analyses were performed to control for confounders. Of 419 patients who met inclusion criteria, 171 had normal weight, 184 had BMI 30-40, and 64 had BMI > 40. As BMI increased, subjects were more likely to be Black, multiparous, and have chronic hypertension and diabetes mellitus type II (p < 0.001). Progression to pyelonephritis did not differ as BMI increased, nor did pyelonephritis-related morbidity, though these were rare (Table). Mothers with BMI 30-40 and > 40 had a slightly increased risk of recurrent UTIs compared to normal weight women (Table). When controlling for confounders, no increase in relative risk of developing pyelonephritis was seen (BMI 30-40:RR=1.06,95%CI 0.58-1.93; BMI > 40:RR=0.59,95%CI:0.24-1.41). Though women with BMI 30-40 did have increased risk of developing recurrent infection (RR=1.68,95%CI:1.10-2.59), this did not extend to women with BMI > 40 (RR=1.04,95%CI:0.62-2.07). Women with recurrent infection were not more likely to develop pyelonephritis or pyelonephritis-related morbidity (data not shown). In this cohort, BMI did not impact risk of developing pyelonephritis. Even among patients with recurrent UTI, BMI did not impact the risk of progressing to pyelonephritis. Larger studies are needed to further investigate these findings to better understand the relationship between increasing BMI and severity of urinary pathology.

Pre-Birth and Early-Life Factors Associated With the Timing of Adiposity Peak and Rebound: A Large Population-Based Longitudinal Study.

Background: The late occurrence of adiposity peak (AP) and the early occurrence of adiposity rebound (AR) are considered the earliest indicators for obesity and its related health conditions later in life. However, there is still limited information for their upstream factors. Therefore, in this study, we aimed to identify the parental and child factors associated with the timing of AP and AR in the early stage of life.Methods: This is a population-based longitudinal study conducted in Shanghai, China. The BMI data of children born between September 2010 and October 2013 were followed from birth to 80 months. Subject-specific body mass index trajectories were fitted by non-linear mixed-effect models with natural cubic spline functions, and the individual's age at AP and AR was estimated. The generalized linear regression models were applied to identify the upstream factors of late occurrence of AP and early occurrence AR.Results: For 7,292 children with estimated AP, boys were less likely to have a late AP [adjusted risk ratio (RR) = 0.83, 95% confidence interval (CI): 0.77–0.90, p < 0.001], but preterm born children had a higher risk of a late AP (adjusted RR = 1.25, 95% CI: 1.07–1.47, p < 0.01). For 10,985 children with estimated AR, children with breastfeeding longer than 4 months were less likely to have an early AR (adjusted RR = 0.80, 95% CI: 0.73–0.87, p < 0.001), but children who were born to advanced-age mothers and who were born small for gestational age had a higher risk of having an early AR (adjusted RR = 1.21, 95% CI: 1.07–1.36, p < 0.01; adjusted RR = 1.20, 95% CI: 1.04–1.39, p = 0.01).Conclusions: Modifiable pre-birth or early-life factors associated with the timing of AP or AR were found. Our findings may help develop prevention and intervention strategies at the earliest stage of life to control later obesity and the health conditions and diseases linked to it.

BMI Data Collection and Communication Practices in a Multistate Sample of Head Start Programs.

Background: Although there is a federal mandate to collect anthropometric data in Head Start (HS), little is currently known about the processes used to collect the height and weight measurements across programs and how the results are communicated to parents/guardians. The goal of this study was to understand anthropometric data collection and dissemination procedures in a sample of HS programs serving children 3-5 years. Methods: A convenience sample of HS Health or Nutrition managers were recruited via personal contacts and HS state directors to complete an electronic survey. Quantitative data were analyzed using descriptive statistics (means, standard deviations and frequencies). Open-ended questions were coded using thematic analysis. All protocols and procedures were approved by the Institutional Review Board at Miami University. Results: Approximately half of the programs reported that they have a protocol in place to guide measurements (57.1%) and those measurements are primarily taken by HS staff (64.5%). Most programs explain measurements to parents (82.3%) and report that collecting height/weight data is helpful in supporting children's health (76.0%). Most programs (80.3%) provide resources to parents of children with overweight or obesity. Four themes emerged from open-ended responses: (1) Role of Community Partners (e.g., providing information that conflicts with others); (2) Communicating Children's Weight Status with Families (e.g., using sensitive communication methods); (3) Challenges Measuring Children's Weight Status (e.g., accuracy of data, children's awareness); and (4) Family Reaction to Weight Status Communication (e.g., positive or negative experiences). Conclusion: Opportunities for quality improvement include wider use of standardized, written protocols and policies on data collection and enhanced communication practices to share information with parents.

Association between body mass index and newly diagnosed drug-resistant pulmonary tuberculosis in Shandong, China from 2004 to 2019

BackgroundDrug-resistant tuberculosis (DR-TB), obesity, and malnutrition are growing public health problems in the world. However, little has discussed the impact of different BMI status on the emergence of TB drug resistance. We aimed to explore the drug-resistant profiles of DR-TB and its clinical predictors among underweight, overweight or obesity population.Methods8957 newly diagnosed TB cases with drug susceptibility results and BMI data in Shandong China, from 2004 to 2019 were enrolled. Multivariable and univariable logistic regression models were applied to investigate the impact of BMI on different drug-resistance. Clinical predicators and drug-resistant profiles of DR-TB among obesity, underweight, normal TB group were also described.ResultsAmong 8957 TB cases, 6417 (71.64%) were normal weight, 2121 (23.68%) were underweight, 373 (4.16%) were overweight, and 46 (0.51%) were obese. The proportion of drug resistance and co-morbidity among normal weight, underweight, overweight, obese TB groups were 18.86%/18.25%/20.38%/23.91% (DR-TB), 11.19%/11.74%/9.65%/17.39% (mono-resistant tuberculosis, MR-TB), 3.41%/3.06%/5.36%/0.00% (multidrug resistant tuberculosis, MDR-TB), 4.21%/3.39%/5.36%/6.52% (polydrug resistant tuberculosis, PDR-TB), 10.57%/8.44%/19.57%/23.91% (co-morbidity), respectively. Compared with normal weight group, underweight were associated with lower risk of streptomycin-related resistance (OR 0.844, 95% CI 0.726–0.982), but contributed to a higher risk of MR-TB (isoniazid) (odds ratio (OR) 1.347, 95% CI 1.049–1.730; adjusted OR (aOR) 1.31, 95% CI 1.017–1.686), P < 0.05. In addition, overweight were positively associated with MDR-TB (OR 1.603, 95% CI 1.002–2.566; aOR 1.639, 95% CI 1.02–2.633), isoniazid + rifampicin + streptomycin resistance (OR 1.948, 95% confidence interval (CI): 1.061–3.577; aOR 2.113, 95% CI 1.141–3.912), Any isoniazid + streptomycin resistance (OR 1.472, 95% CI 1.013–2.14; aOR 1.483, 95% CI 1.017–2.164), P < 0.05.ConclusionsThe higher risk of MDR-TB, isoniazid + rifampicin + streptomycin resistance, Any isoniazid + streptomycin resistance, and co-morbidity among overweight population implies that routine screening for drug sensitivity and more attention on co-morbidity among overweight TB cases may be necessary. In addition, underweight TB cases have a higher risk of isoniazid resistance. Our study suggests that an in-depth study of the interaction between host metabolic activity and infection of DR-TB may contribute more to novel treatment options or preventive measures, and accelerate the implementation of the STOP TB strategy.