Body Mass Index Cut-off Points Research Articles

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys.

BackgroundEconomic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth.MethodsWe used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index.ResultsWomen in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor.ConclusionAs the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

Effects of body mass index on the outcomes of in vitro fertilization in Chinese patients with polycystic ovary syndrome: a retrospective cohort study

To investigate the effects of body mass index (BMI) on the outcomes of in vitro fertilization (IVF) in Chinese patients with polycystic ovary syndrome (PCOS). In the retrospective cohort study, a total of 1074 patients with PCOS undergoing IVF between April 2010 and May 2017 in two reproductive medicine centers, respectively in eastern China (Women’s Hospital, School of Medicine, Zhejiang University, Zhejiang Province) and in southern China (Maternal and Child Health Care Hospital of Liuzhou, Guangxi Province), were included. The patients were divided into four groups according to the recommended Chinese BMI cut-off points: underweight (BMI< 18.5 kg/m2), normal weight (18.5 kg/m2≤BMI<24.0 kg/m2), overweight (24.0 kg/m2≤BMI<28.0 kg/m2), and obese (BMI≥ 28.0 kg/m2). The basic characteristics of the PCOS patients, the details of IVF treatment, and the pregnancy outcomes were collected. There were no significant differences among the normal weight, overweight, and obese PCOS patients undergoing IVF on the biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, or term delivery rate (P>0.05), although the overweight and obese PCOS patients required more gonadotropin (Gn) (P<0.001) as well as longer stimulation period (P<0.001), and got less retrieved oocytes (P<0.05) and fertilized oocytes (P<0.05). The underweight PCOS patients required less Gn (P<0.05) and achieved higher live birth rate and term delivery rate (P<0.05), compared with the normal weight PCOS patients. High BMI had no negative effects on the outcomes of IVF in Chinese patients with PCOS; however, the conclusion may seem a little limited due to the retrospective design and the potential bias.

Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

BackgroundThe generalizability of the gestational weight gain (GWG) ranges recommended by the Institute of Medicine (IOM) to Chinese women is disputed.MethodsIn 2016, 16,780 pregnant women who gave birth to live singletons in Changsha, China, were enrolled. First, subjects with optimal pregnancy outcomes were identified for the GWG percentile distribution description and for comparison to the IOM recommendations. Second, all subjects with optimal GWG according to the IOM body mass index (BMI) cutoffs and those with optimal GWG according to the Asian BMI cutoffs were selected. Pregnancy outcomes were compared between those two groups.ResultsA total of 13,717 births with optimal pregnancy outcomes were selected to describe the GWG distribution. The height and central position of the GWG distributions determined by the Asian BMI cutoffs differed from those determined by the IOM BMI cutoffs among the overweight and obese groups. The recommended IOM GWG ranges were narrower than and shifted to the left of the observed distributions. In both BMI classification schemes, however, the IOM-recommended ranges were within the middle 70% (Pc 15th–85th) and 50% (Pc 25th–75th) of the observed distribution. A total of 6438 (38.37%) and 6110 (36.41%) women gained optimal GWG, according to the IOM and Asian BMI classifications, respectively. Compared with those with optimal GWG according to IOM BMI cutoffs, women with optimal GWG according to the Asian BMI cutoffs had lower risks of both macrosomia (adjusted OR = 0.79, 95%CI: 0.67–0.94) and large-for-gestational age (adjusted OR = 0.86, 95%CI: 0.76, 0.98). However, no significantly different risks of preterm, low birthweight, small-for-gestational age, pregnancy-induced hypertension, or gestational diabetes were found between them.ConclusionsThe IOM-recommended GWG ranges are within the middle 70% of the distributions in Chinese women, and pre-pregnancy weight status should be determined by the Asian BMI cut-off points for monitoring and making GWG recommendations to Chinese women.

Clinical effects of low body mass index on geriatric status in elderly patients.

There is limited information on the relationship of low body mass index (BMI) to the geriatric conditions in elderly patients. The objective of this study is to investigate whether low BMI associates with geriatric status in elderly patients by calculating suitable cut-off point of BMI for assessment of geriatric conditions. A total of 1223 elderly patients was enrolled (male/female: N = 472/751), and cut-off point of the BMI values to assess the geriatric status such as aspiration pneumonia, cognitive impairment was determined by receiver operating characteristic (ROC) analyses. Logistic regression analyses were performed to examine the association between several geriatric status and low BMI. Of these patients, 262 patients (male/female: 101/161) had received standard rehabilitation treatment. Functional Independence Measure (FIM) scores were measured both at admission and discharge to calculate FIM gain and efficiency, and retrospective cohort study was performed. Cut-off point of BMI value to assess the geriatric status was determined (19.0 kg/m2). Significant associations of low BMI to several geriatric factors such as loss of posterior occlusion, cognitive impairment were observed in both male and female. FIM scores in above cut-off point group were significantly higher than in below cut-off point group in female (FIM gain, P = 0.0005; FIM efficiency, P = 0.0025, Mann-Whitney U test). On the other hand, there were no significant differences between low and above BMI cut-off point in FIM scores of male patients. Low BMI might be a useful parameter to evaluate the geriatric status, and the viewpoint would contribute to decide the care plan for the good end-of-life of elderly.

Maternal preconception weight trajectories are associated with offsprings' childhood obesity.

This study aimed to examine the associations between (1) mothers' preconception body mass index (BMI) trajectories over 6-7 years and offspring childhood BMI, and (2) mothers' BMI changes between first and second pregnancy and the second-born child's BMI. We used data (1606 mothers with 2733 children with mean age 7.7 years, SD 2.9) from the Australian Longitudinal Study on Women's Health and the Mothers and their Children's Health study. Preconception BMI trajectories were identified using latent class growth modeling. Children were categorized as underweight, normal, overweight or obese based on age and sex-specific BMI cut-off points for children. Multinomial and binary logistic regression were used for analyses. We identified three preconception BMI trajectories, named as 'normative' (61.2%), 'chronically overweight' (30.7%), and 'chronically obese' (8.1%). Children born to 'chronically overweight' and 'chronically obese' mothers were more likely to be overweight than normal weight relative to children born to women with a 'normative' BMI trajectory. The corresponding adjusted relative risk ratios (RRRs) (95% confidence interval [CI]) of childhood overweight were 1.75 (1.33, 2.31) for chronically overweight mothers and 2.48 (1.65, 3.73) for chronically obese mothers. Similarly, we found a much stronger association between 'chronically overweight' and 'chronically obese' BMI trajectories and childhood risk of obesity; RRR (95% CI), 2.49 (1.41, 4.40) and 6.65 (3.40, 13.01), respectively. Second-born children of mothers with high interpregnancy weight gain (≥4 BMI units) were also at higher risk of being overweight or obese (OR = 2.20, 95% CI: 1.02, 4.75) compared with children of mothers with stable interpregnancy weight (gain or loss of 1 BMI unit or less). In this population-based prospective cohort study, we found strong dose-response associations between preconception BMI trajectories and offsprings' childhood BMI.

Obesity and physical fitness indices of children aged 5-12 years living on remote and isolated islands.

Obesity has become one of the major health risks in childhood, significantly affecting children's health and physical fitness. Although the marked increase of obesity in urban areas is well established, evidence is limited in remote and isolated areas with adverse socioeconomic features. The aim of this study was to examine the prevalence of obesity and its association with physical performance indices in young school-aged children living in 18 remote and isolated Greek islands. Four hundred and sixty-three children (244 boys, 219 girls), aged 5-12 years underwent a series of physical fitness tests including 20 m sprint, standing long jump, 1 kg medicine ball throw, agility T-test and sit-and-reach test. Age and gender BMI cut-off points were determined according to World Health Organisation (WHO) norms. The prevalence of obesity was 23.8% and 13.2% for boys and girls, respectively. A negative body mass index (BMI) main effect was observed for weight-bearing activities, such as 20 m sprint (F=6.21, p=0.000, &eta;2=0.041) and standing long jump (F=11.369, p=0.000, &eta;2=0.074), while medicine ball throw was positively correlated with BMI in children aged 9-12 years. The results of this study confirmed previous findings on obesity prevalence in Greece. A negative association was also found between BMI and physical fitness indices and, in particular, in weight-bearing activities. It is critical to establish physical education interventions and physical fitness programs at schools, aiming to increase motivation for physical activity participation.

Clinical and Body Compositional Factors Associated with Metabolic Syndrome in Obese Koreans: A Cross-Sectional Study.

Obesity and metabolic syndrome (MetS) are increasing rapidly worldwide, but metabolically healthy population exists. Thus, this study evaluated the proportion of obesity and MetS and investigated clinical and body compositional factors associated with MetS in obese Koreans. This cross-sectional observational study enrolled subjects from the Korea National Health and Nutrition Examination Survey (n = 15,408). Obesity was defined by body mass index (BMI) cutoff points of 25 and 27.5 kg/m2. Clinical and laboratory parameters were compared by MetS presence and factors associated with insulin resistance or MetS in obese subjects were evaluated by multivariate or logistic regression analyses. The proportion of obesity was 29.7% at a BMI cutoff point of 25 kg/m2 and 10.4% at 27.5 kg/m2. The proportion of MetS was greater in obese population and increased with higher obesity cutoff point, where men were more prevalent than women. The subjects with MetS showed higher age, glycated hemoglobin, insulin resistance, liver enzymes, and ferritin compared with metabolically healthy population in both obese genders. Factors associated with insulin level or presence of MetS were high trunk fat percentage, trunk-to-limb fat ratio, and trunk-to-leg fat ratio, but low limb fat percentage and leg fat percentage. Among body composition indices, trunk-to-limb fat ratio and trunk-to-leg fat ratio showed significantly high odds ratios for MetS in both obese genders regardless of BMI cutoff points. MetS in obese population concurrently increased with higher obesity cutoff point. Higher age, insulin resistance, liver enzymes, ferritin, and higher proportion of truncal fat mass-to-limb or leg fat mass significantly contribute to MetS, where trunk-to-limb fat ratio and trunk-to-leg fat ratio could be helpful in identifying and preventing MetS in the obese Korean population.

Underweight, overweight and obesity in children and adolescents from Minsk, Belarus in the period 2001-2008.

Objective: The aim of the study is to consider the prevalence of all deviations from the body weight standard (underweight, overweight and obesity) among 4-18 years old children, adolescents and youths of Minsk, Belarus examined in the period 2001-2008. Subjects and methods: The measurements of 2969 children, teenagers and young adults carried out in the period 2001-2008 were used. Children were classified as underweight, normal weight, overweight and obese using Body Mass Index (BMI) cutoff points proposed by IOTF. Results: Underweight was recorded more often in girls (10.7%) than in boys (7.5%), differences are significant (p < 0.05). More frequent occurrence of underweight was typical for girls and boys of older age periods (11-18 years) - 11.6-14.2% and 8.9-9.6%, respectively. Overweight was found in boys and girls with the same frequency (10.9 and 10.7%, respectively). Obesity was more often observed in boys than in girls (2.3 and 1.8%). An increase in the proportion of overweight children (especially intensive in boys) was observed before the pubertal growth spurt. Conclusion: Our analysis showed a fairly low percentage of deviations from the standard body weight. The considerable variability of the data on the prevalence of overweight and obesity in children of Belarus obtained by different authors can be related both to differences in levels of living in different regions of the country and fairly rapid changes in this area due to socio-economic changes in society.

RETRACTED ARTICLE: Optimal body mass index cutoff point for cardiovascular disease and high blood pressure

Increase in body mass index value is a serious health problem across the world. Humans with high body mass index value have the higher probability of getting the cardiovascular disease and high blood pressure. The proposed work is concerned in predicting the probability of CVD and high blood pressure in India. The disease has been predicted with body mass index value; from the health reports of India, the pervasiveness of CVD and HBP is identified. The demographic health survey 2016 of India is used in this work. Bayesian model is used to find the pervasiveness of CVD and HBP based on the gender and the place of living. Out of 432 articles studied, 34 articles suggested the pervasiveness of CVD and HBP. Pervasiveness of CVD increased (95% of interval) rapidly between 1992 and 2016 from 3.0% (0.3–5.7) to 16.4% (9.4–16.2) for men, and from 5.2% (2.3–8.6) to 15.4% (3.3–18.6) for women. Pervasiveness of high blood pressure increased rapidly between 1992 and 2016 from 11.0% (8.6–17.4) to 21.4% (19.4–23.6) for men and from 14.0% (4.3–16.7) to 20.4% (5.6–25.6) for women. The pervasiveness of CVD in 2030 is predicted as 24.6% (13.6–37.8), and pervasiveness of high blood pressure is predicted to be 21.7% (19.6–27.8). The annual average of pervasiveness of CVD is high for women in village areas, and pervasiveness of high blood pressure is found high for men in city regions. The cutoff point for pervasiveness of CVD for overall population is 23.02 kg/m2.

PREVALENCE OF CHILDHOOD OBESITY AND UNDERNUTRITION AMONG URBAN SCHOOL CHILDREN IN BANGLADESH.

Despite the ongoing problems of undernutrition and infectious disease, obesity and overweight have become a major problem in developing countries, including Bangladesh. This cross-sectional study was undertaken to determine the prevalence of obesity, overweight and underweight among school children aged 6-12 years in Bangladesh. The study was conducted from June 2012 to May 2013 and the study sample comprised 1768 children (980 boys; 788 girls) from eight purposively selected schools in different areas of Dhaka city. Students were interviewed about their diet and physical activity, and anthropometric measurements were made, including height, weight, mid-upper-arm circumference (MUAC), waist circumference, hip circumference and body mass index (BMI). Undernutrition, overweight and obesity were defined using internationally accepted BMI cut-off points. Mean height, weight, BMI, MUAC, waist circumference and hip circumference values were found to be higher in boys than in girls, except at age 12 when these were found to be significantly higher in girls than in boys (p&lt;0.05). The mean prevalence of overweight was 10.0% (boys 10.2%; girls 9.8%), and that of obesity 5.0% (boys 4.3%; girls 5.8%). The prevalence of underweight was 16.3% in boys and 12.7% in girls. The prevalence of underweight was significantly higher in poor than in rich children (22.1% vs 11.2%) and that of obesity was higher in rich than in poor children (9.9% vs 1.3%; p&lt;0.001). A family history of obesity and hypertension emerged as a significant predictor of developing overweight and obesity (p&lt;0.001). The data suggest that underweight and obesity co-exist in urban areas of Bangladesh, posing a challenge for the nutritional health of Bangladeshi children.

Relationship between Eating Quickly and Overweight : A Cohort Study of Schoolchildren in Japan.

Several cross-sectional studies have shown that eating quickly is associated with overweight in children and adolescents. However, few cohort studies have examined this relationship. Here we investigated the relationship between eating quickly and overweight in a cohort study of fourth-grade schoolchildren (aged 9 or 10 years) who attended elementary schools in Ina-town, Japan. The children were followed for 3 years from 2001-2004 (at baseline) to 2004-2007. A questionnaire survey including information about eating speed (fast, medium, or slow) was administered, and height and weight measurements were obtained at baseline and follow-up. Overweight was defined according to the body mass index cutoff points proposed by the International Obesity Task Force. We used a Poisson regression model to examine the association between eating quickly at baseline and being overweight 3 years later. Data from 934 non-overweight children (465 boys, 469 girls) were analyzed. Eating quickly was not significantly associated with being overweight in the boys, whereas it was significantly associated with being overweight in the girls. Our analysis indicates that among girls, eating quickly leads to overweight, and that the modification of eating quickly could help prevent overweight in adolescents.

Current data in Greek children indicate decreasing trends of obesity in the transition from childhood to adolescence; results from the National Action for Children's Health (EYZHN) program.

The aim of the study is to present the most recent estimates of obesity (total and central) prevalence in Greek children and associated risk factors. Population data are derived from a yearly, school-based health survey polled in 2015 on 336,014 (51% boys) children aged 4 to 17 years old from almost 40% of all schools of primary and secondary education in Greece. Anthropometric and physical fitness measurements were obtained by trained investigators. Dietary habits, physical activity status, sedentary activities and sleeping hours were assessed through self-completed questionnaires. The gender and age-specific Body Mass Index (BMI) cut-off points were used in order to define BMI groups. The prevalence of overweight and obesity in the whole population was 22.2% and 9.0% in boys and 21.6% and 7.5% in girls, respectively. Obesity presented decreasing trends in the transition from childhood to adolescence. Central obesity was diagnosed in 95.3% and 93.5% of the simple obese boys and girls, respectively, in almost two to three of overweight children (68.6% of boys and 64.3% of girls), and in 12% of normal weight children. Age, physical fitness, low adherence to Mediterranean diet, insufficient sleeping hours, inadequate physical activity levels and increased screen time were all associated with higher odds of total and central obesity. Serious and urgent actions need to be taken from public health policy makers in order not only to prevent a further increase in obesity rates but, more important, to treat obesity and/or the obesity associated co-morbidities.

Impact of the Social and Natural Environment on Preschool-Age Children Weight.

Background: The complex impact of environmental and social factors on preschool children being overweight/obese is unclear. We examined the associations between the levels of green space exposure and the risk of being overweight/obese for 4–6 year-old children and assessed the impact of maternal education on these associations. Methods: This cross-sectional study included 1489 mother-child pairs living in Kaunas, Lithuania, in 2012–2013. We assessed children overweight/obesity by standardized questionnaires using international body mass index cut-off points, and the level of greenness exposures by satellite-derived normalized difference vegetation index (NDVI) of each child’s home and by the distance to a nearest city park. The maternal education was used as the SES indicator. We used logistic regression models to investigate the strength of the associations. Results: Children from families with poorer maternal education, pathological mother-child relations and smoking mothers, and living in areas with less greenness exposure (NDVI-100 m), had significantly higher odds ratios of being overweight/obese. Lower maternal education and distance to a city park modified the effect of greenness cover level exposure on the risk of children being overweight/obese. Conclusions: Higher greenness exposure in the residential settings has beneficial effects on children’s physical development. The green spaces exposures for psychosocial stress management is recommended as a measure to prevent overweight/obesity among children.

Effects of eating dinner alone on overweight in Japanese adolescents: a cross-sectional survey

BackgroundThe decrease in the frequency of family meals among Asian youth is often lamented. In Japan, adolescents who eat breakfast alone might have an unhealthy diet, which increases the risk of overweight or obese. However, there are few studies on the relationship between eating dinner alone and overweight in Japanese adolescents. Here, we investigated if eating dinner alone is associated with being overweight in Japanese adolescents of each sex.MethodsThe participants consisted of 890 seventh graders (12–13 years of age) from the junior high schools of Ina, Japan who were recruited from 2011 to 2012. Information about eating dinner alone was obtained using a self-reported questionnaire, which was given to each participant. The participants were classified into the following three groups: does not eat alone, eats alone 1–2 times/week, or eats alone ≥3 times/week. A logistic regression model was used to examine the relationship between eating dinner alone and being overweight. The height and weight of each participant were measured. Childhood overweight status was defined using the body mass index cutoff points proposed by the International Obesity Task Force.ResultsWhen compared with girls who did not eat dinner alone, a significantly increased odds ratio (OR) was observed among girls who ate dinner alone ≥1 time/week (adjusted OR = 2.78; 95% confidence interval = 1.21–6.38). In contrast, there was no statistically significant difference between eating dinner alone and being overweight among boys.ConclusionThe present study found that eating dinner alone is associated with being overweight among adolescent girls in this community in Japan. Therefore, reducing the frequency of eating dinner alone might contribute to decreasing the risk for becoming overweight or obese among adolescent girls.

Effectiveness of the CANRISK tool in the identification of dysglycemia in First Nations and Métis in Canada.

First Nations/Métis populations develop diabetes earlier and at higher rates than other Canadians. The Canadian diabetes risk questionnaire (CANRISK) was developed as a diabetes screening tool for Canadians aged 40 years or over. The primary aim of this paper is to assess the effectiveness of the existing CANRISK tool and risk scores in detecting dysglycemia in First Nations/Métis participants, including among those under the age of 40. A secondary aim was to determine whether alternative waist circumference (WC) and body mass index (BMI) cut-off points improved the predictive ability of logistic regression models using CANRISK variables to predict dysglycemia. Information from a self-administered CANRISK questionnaire, anthropometric measurements, and results of a standard oral glucose tolerance test (OGTT) were collected from First Nations and Métis participants (n = 1479). Sensitivity and specificity of CANRISK scores using published risk score cut-off points were calculated. Logistic regression was conducted with alternative ethnicity-specific BMI and WC cut-off points to predict dysglycemia using CANRISK variables. Compared with OGTT results, using a CANRISK score cut-off point of 33, the sensitivity and specificity of CANRISK was 68% and 63% among individuals aged 40 or over; it was 27% and 87%, respectively among those under 40. Using a lower cut-off point of 21, the sensitivity for individuals under 40 improved to 77% with a specificity of 44%. Though specificity at this threshold was low, the higher level of sensitivity reflects the importance of the identification of high risk individuals in this population. Despite altered cut-off points of BMI and WC, logistic regression models demonstrated similar predictive ability. CANRISK functioned well as a preliminary step for diabetes screening in a broad age range of First Nations and Métis in Canada, with an adjusted CANRISK cutoff point for individuals under 40, and with no incremental improvement from using alternative BMI/WC cut-off points.

Comparison of anthropometric indices in predicting the risk of hypertension, Iran - 2014

Purpose: The best anthropometric index has not been established to investigate the relationship between hypertension and obesity. Since a similar study was not conducted in Bojnurd, we began to investigate the comparison of anthropometric indices (body mass index, waist circumference, and waist-to-hip and waist-to-height ratios) in predicting the risk of hypertension. Materials and Methods: The present cross-sectional study was conducted on women referring to Bojnurd health centers. For analyzing the data, we used t-test, Chi-square, logistic regression, and the receiver operating characteristic curve in SPSS 19 software. Results: The prevalence of blood pressure was 53.4% (confidence interval = 46.8–60). All four anthropometric indicators were used as a screening tool for hypertension diagnosis; however, body mass index (BMI) had a higher sub-curved surface than other anthropometric indices (area under curve = 0.717). The cutoff point of BMI for predicting the risk of hypertension was 25.6. Conclusions: This study suggested that BMI as an anthropometric indicator to evaluate the risk of hypertension. Since a significant percentage of people are unaware of the existence of hypertension, continuing education is needed to encourage people to pay more attention to this problem.

Lifestyle factors associated with underweight among Japanese adolescents: a cross-sectional study

BackgroundBecause underweight in adolescents poses several health problems, it is important to prevent it in adolescence. For the prevention of underweight, it is necessary to investigate risk factors, especially lifestyles, because these can be modified. However, a limited number of studies exist regarding lifestyle factors associated with underweight among adolescents. The present study aimed to investigate the relationship between lifestyle factors and underweight among Japanese adolescents.MethodsStudy subjects comprised 2641 seventh-grade school children (age 12 or 13 years) from the town of Ina, Saitama Prefecture, Japan. Measurements of height and weight were made for each subject, while information regarding lifestyles of each subject was obtained using a self-administered questionnaire. Underweight was determined by the age- and sex-specific body mass index cut-off points. A logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for underweight.ResultsAdolescents who ate slowly were more likely to be underweight than those who did not eat slowly; the OR (95% CI) was 2.78 (1.77–4.39) in boys and 2.69 (1.81–3.98) in girls. Girls who did not exercise were more likely than those who exercised to be underweight (OR: 1.64, 95% CI: 1.07–2.51).ConclusionsThe present study showed that eating slowly and exercise were associated with underweight among Japanese adolescents. These results suggest that eating speed and exercise need to be considered in school health programs for healthy body weight.

Anterior Encephalocele and Its Association with MTHFR Polymorphisms: A Case-Control Study

Background Neural tube defects (NTDs) are thought to be associated with genetic defects and environmental factors. This study aims to determine the association of MTHFR gene polymorphisms and maternal body mass index (BMI) with anterior encephalocele (AE). Methods Blood samples of 20 patients (out of 41 children) were available for genetic analysis. Genomic DNA was extracted from whole blood samples using Wizard genomic DNA purification kit. The MTHFR C677T and A1298C polymorphisms genotyping protocols were adapted from Cicek et al. Eighty-two age- (1–14 years) and sex-matched apparently healthy children were taken as controls. We assessed the nutritional status of all the volunteers by measuring their BMI and then classified according to WHO BMI cutoff points. Results Nasofrontal AE was seen mostly among the female cases while among males, nasoethmoidal AE was predominant. We observed a weak association between MTHFR 677CT genotype and AE. In the case of MTHFR A1298C, both the 1298AC and 1298CC genotypes increased the risk of acquiring AE by several folds. Multivariate analysis revealed that both 1298AC and 1298CC genotypes increased the risk of acquiring AE. However, only 1298AC was significantly associated with the risk of AE. The study also showed significantly low BMI among the children and their mothers. Conclusion There is a strong association between MTHFR A1298C polymorphism and the risk of anterior encephalocele in this community. The C677T polymorphism, however, did not constitute a genetic risk factor in this study. Children with AE also had significantly low BMI.

Accuracy of the WHO's body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil.

Introduction.Obesity is defined by the World Health Organization (WHO) as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. However, the appropriate cut-off point of body mass index (BMI) based on body fat percentage (BF%) for classifying an individual as obese in middle-aged adults living in Rio de Janeiro remains unclear.Materials and methods.This was a prospective cross-sectional study comprising of 856 adults (413 men and 443 women) living in Rio de Janeiro, Brazil ranging from 30-59 years of age. The data were collected over a two year period (2010-2011), and all participants were underwent anthropometric evaluation. The gold standard was the percentage of body fat estimated by bioelectrical impedance analysis. The optimal sensitivity and specificity were attained by adjusting BMI cut-off values to predict obesity based on the WHO criteria: BF% >25% in men and >35% in women, according to the receiver operating characteristic curve (ROC) analysis adjusted for age and for the whole group.Results.The BMI cut-offs for predicting BF% were 29.9 kg/m2 in men and 24.9 kg/m2 in women.ConclusionsThe BMI that corresponded to a BF% previously defining obesity was similar to that of other Western populations for men but not for women. Furthermore, gender and age specific cut-off values are recommended in this population.Significance for public healthWorld Health Organization (WHO) defines obesity as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. The WHO suggested cut-off point for obesity is a body mass index (BMI) of 30 kg/m2, which is associated with morbidity and mortality. An important issue in the debate over measuring obesity concerns the use of BMI to define obesity across different populations. However, it is not clear, what is an appropriate cut-off point of BMI based on body fat percentage (BF%) to classify an individual as obese within gender-age groups and to distinguish categories of BF% in middle-aged adults living in the city of Rio de Janeiro.

Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated blood pressure among children and adolescents

Background: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, little is known the difference in BP levels among children and adolescents with different patterns of fat distribution. The present study examined the association of subcutaneous fat distributional pattern with obesity and elevated BP among children and adolescents.Methods: A total of 38,687 students (19,386 boys and 19,301 girls) aged 7–17 years participated in the study. Body mass index (BMI) cutoff points recommended by the International Obesity Task Force (IOTF) were used to define overweight and general obesity. Abdominal obesity was defined as waist-to-height ratio (WHtR) ≥ 0.5. Relatively high BP (RHBP) status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. All individuals were classified into four groups (Q1–Q4) according to the age and sex-specific quartiles of subscapular to triceps skinfold thickness ratio (STR), the prevalence rates of overweight, general obesity, abdominal obesity and RHBP among the four groups were compared.Results: In both boys and girls, significant differences in the prevalence rates of overweight, general obesity, abdominal obesity and RHBP were observed among the four groups, an increasing trend was observed from the Q1 (STR <25 th) group to the Q4 (STR ≥ 75th) group (p < 0.01). Children and adolescents with high STR had higher prevalence of overweight, obesity and RHBP than their counterparts with low STR (p < 0.01).Conclusion: Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated BP among children and adolescents. Public health attention should not only focus on the amount of body fat, but also on the distributional pattern of body fat.