Body Mass Index In Young Adults Research Articles

Global Disease Burden Attributable to High Body Mass Index in Young Adults From 1990 to 2019, With Projections to 2050: A Systematic Analysis for the Global Burden of Disease Study 2019.

The global historical and projected health impacts of the escalating burden of obesity on young adults, who are particularly susceptible to weight gain during transitional life stages, remain insufficiently understood. Using data from the Global Burden of Disease Study 2019, we analysed the disability-adjusted life-years (DALYs) and deaths attributable to high body mass index (BMI) among young adults aged 20-44years globally and by age, sex, year, location and disease between 1990 and 2019. Future projections until 2050 were further assessed. The global burden for young adults attributable to high BMI more than doubled from 1990 to 2019, reaching 24,509.8 (95% uncertainty interval [UI] 20,191.8-28,966.0) thousand for DALYs and 321.9 (258.3-384.2) thousand for deaths. Males had a higher burden and faster increase than females. The burden escalated with advancing age. From 1990 to 2019, regions with middle Socio-demographic Index (SDI) replaced regions with high-middle SDI to have the highest age-standardized rates of DALYs and deaths, while regions with low-middle SDI witnessed the largest rise. Stroke, ischaemic heart disease and diabetes mellitus were consistently the top three causes of high BMI-related burden, together accounting for 74.7% (70.8-78.4) for DALYs and 81.2% (77.6-84.2) for deaths in 2019. By 2050, the age-standardized rates of DALYs due to high BMI tripled that in 1990, with the corresponding rates for deaths expected to double. Among the 10 most populous countries, India was projected to have the highest rates and the fastest increase in both DALYs and deaths by 2050. The escalating disease burden attributable to high BMI in young adults, marked by notable demographic and geographic variations, highlights the urgent need for tailored public health interventions on weight management during young adulthood.

Adiposity throughout Adulthood and Risk of Young-Onset Breast Cancer Tumor Subtypes in the Young Women's Health History Study.

The role of adult adiposity in young-onset breast cancer (YOBC) subtype risk is not well understood. In this population-based case (n = 1812)-control (n = 1,381) study of invasive YOBC (ages <50 years), cases were identified from the Los Angeles County and Metropolitan Detroit Surveillance, Epidemiology, and End Results registries, 2010 to 2015. Area-based, frequency-matched controls were sampled from the 2010 Census. General adiposity [body mass index (BMI)] and central adiposity (waist circumference and waist-to-height ratio) across adulthood and covariates were collected from in-person interviews and measurements. ORs and 95% confidence intervals (CI) for adiposity and YOBC tumor subtypes [i.e., luminal A, luminal B, HER2+, and triple negative (TN)] were calculated, overall and by parity, using multivariable weighted logistic regression. Obese young adult BMI was inversely associated with luminal A YOBC (OR = 0.35, 95% CI, 0.16-0.79); other subtype associations were nonsignificant. Similarly, adult overweight and obese BMIs were inversely associated with luminal A (OR = 0.66, 95% CI, 0.48-0.91 and OR = 0.59, 95% CI, 0.46-0.87, respectively), but not other subtypes. Conversely, larger waist circumference was associated with higher odds of luminal B and TN YOBC (OR = 1.48, 95% CI, 1.01-2.15 and OR = 2.48, 95% CI, 1.52-3.88, respectively), but not other subtypes (with similar results for weight-to-height ratio); highest odds were among parous women. Findings show greater general adult adiposity is associated with reduced odds of luminal A YOBC, whereas greater central adiposity is associated with increased odds of luminal B and TN YOBC, particularly among parous women. Additional studies of central adiposity and YOBC subtype risk, especially incorporating pregnancy history, are warranted.

MiR-21, miR-221, miR-29 and miR-34 are distinguishable molecular features of a metabolically unhealthy phenotype in young adults.

Discrepancies between the measurement of body mass index (BMI) and metabolic health status have been described for the onset of metabolic diseases. Studying novel biomarkers, some of which are associated with metabolic syndrome, can help us to understand the differences between metabolic health (MetH) and BMI. A group of 1469 young adults with pre-specified anthropometric and blood biochemical parameters were selected. Of these, 80 subjects were included in the downstream analysis that considered their BMI and MetH parameters for selection as follows: norm weight metabolically healthy (MHNW) or metabolically unhealthy (MUNW); overweight/obese metabolically healthy (MHOW) or metabolically unhealthy (MUOW). Our results showed for the first time the differences when the MetH status and the BMI are considered as global MetH statures. First, all the evaluated miRNAs presented a higher expression in the metabolically unhealthy group than the metabolically healthy group. The higher levels of leptin, IL-1b, IL-8, IL-17A, miR-221, miR-21, and miR-29 are directly associated with metabolic unhealthy and OW/OB phenotypes (MUOW group). In contrast, high levels of miR34 were detected only in the MUNW group. We found differences in the SIRT1-PGC1α pathway with increased levels of SIRT1+ cells and diminished mRNA levels of PGCa in the metabolically unhealthy compared to metabolically healthy subjects. Our results demonstrate that even when metabolic diseases are not apparent in young adult populations, MetH and BMI have a distinguishable phenotype print that signals the potential to develop major metabolic diseases.

Association between BMI and Survival in Adolescents and Young Adults (AYA) with Acute Myeloid Leukemia Treated with Intensive Chemotherapy

Introduction: Obesity is linked to a higher incidence of acute myeloid leukemia (AML) in older adults as well as B-cell acute lymphoblastic leukemia in children and adolescents and young adults (AYA). To date, however, the relationship between weight and clinical outcomes in AYA patients (pts) diagnosed with AML has not been clearly established. We hypothesized that obesity reflected by higher body mass index (BMI) would confer worse prognosis in AYA pts treated with intensive chemotherapy and/or allogeneic stem cell transplant (SCT) for AML. Methods: We conducted a single institute retrospective chart review of AYA patients aged 18 to 39 years diagnosed with AML between Jan 2006 and Oct 2022. All patients received intensive chemotherapy with cytarabine- and anthracycline-based induction and consolidation chemotherapy followed in some cases by SCT. BMI was calculated based on height and weight on the date of AML diagnosis. Additional information including European Leukemia Net (ELN) 2022 risk classification, therapy response (complete remission (CR), CR with incomplete count recovery [CRi]), receipt of SCT, relapsed disease, event-free (EFS), overall survival (OS) and percentage of pts alive at 2- and 5-years after diagnosis were collected. All data was de-identified and procured on an IRB-approved protocol. Results: Seventy-six AYA patients were identified. Median age was 25.2 (range 18-39) years. 39 (51%) were female. The majority (65, 86%) were Caucasian. Per ELN 2022 risk classification, 24 (32%) had favorable, 36 (47%) had intermediate, and 16 (21%) had adverse risk disease. The CR rates based on ELN 2022 risk classification were 86%, 72% and 50%, respectively. Median OS for all pts was 791 days and per risk group was 1379, 569, and 595 days, respectively. Pts were then categorized per initial BMI into 4 categories. The majority of pts (44, 58%) had above average BMI (≥ 25), with 21 (28%) considered overweight with BMI 25-29.9 and 23 (30%) obese defined as BMI &amp;gt;30. Only 3 pts (4%) were underweight with BMI &amp;lt;18.5 (Table 1). Of note, 43% of obese pts had ELN favorable risk vs 33% of overweight pts and 24% of normal weight pts. Overall response rates in each BMI category were similar, ranging from 96-100% except in overweight pts where only 6 of 21 pts (29%) obtained CR. Relapse occurred in approximately one third (29-35%) of pts in the three highest BMI categories. Two thirds of all pts with BMI ≥18.5 underwent SCT. Excluding underweight pts due to small numbers (n=3), there was a trend to decreased survival in pts with BMI ≥18.5. Median overall survival among normal, overweight, and obese pts was 1403, 1295, and 777 days, respectively, with a significant difference between healthy and obese pts (p-value 0.0274 by log rank test). The percentage of pts alive after 5 years was 41%, 29%, and 17%, respectively (Table 2). Conclusion: Our real-world single-institute retrospective analysis suggests that AYA pts aged 18-39 yrs old diagnosed with AML and with higher BMI have decreased overall survival following intensive chemotherapy and/or allogeneic transplant. Obese patients with the highest BMI (&amp;gt;30) had a markedly shorter overall survival (median 777 days) and lower percentage of pts (17%) alive after five years following therapy than AYA AML pts with normal BMI (median 1403 days, 41% 5-year survival). This was despite over 40% of obese pts having favorable ELN risk. Potential reasons for this include biological heterogeneity in BMI cohorts, chemotherapy dosing, weight-related medical co-morbidities (i.e. cardiovascular disease) and/or transplant-related complications leading to shorter survival. Additional analyses to rule out the contribution of these and other factors and to confirm these results in a larger cohort are ongoing.

Associations of height, body mass index, and weight gain with breast cancer risk in carriers of a pathogenic variant in BRCA1 or BRCA2: the BRCA1 and BRCA2 Cohort Consortium

IntroductionHeight, body mass index (BMI), and weight gain are associated with breast cancer risk in the general population. It is unclear whether these associations also exist for carriers of pathogenic variants in the BRCA1 or BRCA2 genes.Patients and methodsAn international pooled cohort of 8091 BRCA1/2 variant carriers was used for retrospective and prospective analyses separately for premenopausal and postmenopausal women. Cox regression was used to estimate breast cancer risk associations with height, BMI, and weight change.ResultsIn the retrospective analysis, taller height was associated with risk of premenopausal breast cancer for BRCA2 variant carriers (HR 1.20 per 10 cm increase, 95% CI 1.04–1.38). Higher young-adult BMI was associated with lower premenopausal breast cancer risk for both BRCA1 (HR 0.75 per 5 kg/m2, 95% CI 0.66–0.84) and BRCA2 (HR 0.76, 95% CI 0.65–0.89) variant carriers in the retrospective analysis, with consistent, though not statistically significant, findings from the prospective analysis. In the prospective analysis, higher BMI and adult weight gain were associated with higher postmenopausal breast cancer risk for BRCA1 carriers (HR 1.20 per 5 kg/m2, 95% CI 1.02–1.42; and HR 1.10 per 5 kg weight gain, 95% CI 1.01–1.19, respectively).ConclusionAnthropometric measures are associated with breast cancer risk for BRCA1 and BRCA2 variant carriers, with relative risk estimates that are generally consistent with those for women from the general population.

Lean legacy, heavy heritage: family history of diabetes and its association with young adult body mass index.

Substantial intergenerational transmission of diabetes mellitus (DM) risk exists. However, less is known regarding whether parental DM and DM among extended family members relate to adult offspring's body mass index (BMI), and whether any of these associations vary by sex. Using data from the National Longitudinal Study of Youth 1997 cohort (NLSY97), we assess the sex-specific relationship between DM present in first-degree parents and second-degree relatives and BMI among the parents' young adult offspring.Multivariate regressions reveal a positive relationship between parental DM and young adults' BMI for both daughters and sons, and the magnitude of coefficients is somewhat larger for the same-sex parent. Further, we observe that the link between parental DM and young adults' BMI is strongest when both parents have diagnosed diabetes. In contrast, the relationship between second-degree relatives with DM and the respondent's BMI is weaker and appears to be sex-specific, through same-sex parent and respondent. Logistic regressions show the association is especially strong when assessing how parental DM status relates to young adults' obesity risk. These results generally persist when controlling for parental BMI. The findings of this study point to the need to better distinguish the role of shared family environments (e.g., eating and physical activity patterns) from shared genes in order to understand factors that may influence young adults' BMI. Young adult offspring of parents with diabetes should be targeted for obesity prevention efforts in order to reduce their risks of obesity and perhaps diabetes.

Birth outcomes, puberty onset, and obesity as long-term predictors of biological aging in young adulthood.

Biological aging and particularly the deviations between biological and chronological age are better predictors of health than chronological age alone. However, the predictors of accelerated biological aging are not very well understood. The aim was to determine the role of birth outcomes, time of puberty onset, body mass index (BMI), and body fat in accelerated biological aging in the third decade of life. We have conducted a second follow-up of the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ) prenatal birth cohort in young adulthood (52% male; age 28-30; n = 262) to determine the role of birth outcomes, pubertal timing, BMI, and body fat on biological aging. Birth outcomes included birth weight, length, and gestational age at birth. Pubertal timing was determined by the presence of secondary sexual characteristics at the age of 11 and the age of first menarche in women. Biological age was estimated using the Klemera-Doubal Method (KDM), which applies 9-biomarker algorithm including forced expiratory volume in one second (FEV1), systolic blood pressure, glycated hemoglobin, total cholesterol, C-reactive protein, creatinine, urea nitrogen, albumin, and alkaline phosphatase. Accelerated/decelerated aging was determined as the difference between biological and chronological age (BioAGE). The deviations between biological and chronological age in young adulthood ranged from -2.84 to 4.39 years. Accelerated biological aging was predicted by higher BMI [in both early (R2 adj = 0.05) and late 20s (R2 adj = 0.22)], subcutaneous (R2 adj = 0.21) and visceral fat (R2 adj = 0.25), puberty onset (η p 2 = 0.07), birth length (R2 adj = 0.03), and the increase of BMI over the 5-year period between the two follow-ups in young adulthood (R2 adj = 0.09). Single hierarchical model revealed that shorter birth length, early puberty onset, and greater levels of visceral fat were the main predictors, together explaining 21% of variance in accelerated biological aging. Our findings provide comprehensive support of the Life History Theory, suggesting that early life adversity might trigger accelerated aging, which leads to earlier onset of puberty but decreasing fitness in adulthood, reflected by more visceral fat and higher BMI. Our findings also suggest that reduction of BMI in young adulthood slows down biological aging.

Correlation of Sagittal Abdominal Diameter and Other Anthropometric Parameters with Serum Leptin Levels in Young AdultsA Cross-sectional Study

Introduction: Leptin is secreted in concentrations proportional to body fat mass. The anthropometric parameter among Sagittal Abdominal Diameter (SAD), Body Mass Index (BMI), Hip Circumference (HC), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) that correlates maximally with serum leptin levels could be used preferably to assess adiposity. Aim: The present study aims to correlate serum leptin levels with SAD, BMI, HC, WC, WHR and WHtR in young and healthy North Indian adults. Materials and Methods: The present cross-sectional study was conducted jointly in the Department of Physiology and Biochemistry at the King George’s Medical University, Lucknow, Uttar Pradesh, India from September 2015 to August 2016 and it included apparently healthy individuals, aged 18-25 years, native to North India, after obtaining an informed consent. A convenient sample size of 100 was taken. One investigator took all anthropometric measurements. (SAD, BMI, HC, WC, WHR and WHtR) RayBio human leptin ELISA kit was used for the estimation of leptin level. For statistical analysis, Pearson’s correlation coefficient was used. P&lt;0.05 was considered significant. Results: The study involved 55 males and 45 aged 21.4±1.5 years with BMI 22.7±2.7 kg/m2 , HC 91.5±6.9 cm, WC 81.9±7.9 cm, WHR 0.9±0.1, WHtR 0.50±0.04, SAD 20.8±3.1 cm and serum leptin level 389.6±102.7 pg. Serum leptin level correlated significantly with HC (r=0.23, p=0.02), WC (r=0.29, p=0.003), WHtR (r=0.36, p&lt;0.001), and SAD (r=0.56, p&lt;0.001). A non significant correlation was obtained with BMI (r=0.15, p=0.12) and WHR (r=0.11, p=0.26). Conclusion: SAD is a better predictor of body fat and hence, cardiometabolic health than other anthropometric parameters in the present study, as it correlated most strongly with serum leptin levels.

Racial differences in the association of body mass index and ovarian cancer risk in the OCWAA Consortium.

Obesity disproportionately affects African American (AA) women and has been shown to increase ovarian cancer risk, with some suggestions that the association may differ by race. We evaluated body mass index (BMI) and invasive epithelial ovarian cancer (EOC) risk in a pooled study of case-control and nested case-control studies including AA and White women. We evaluated both young adult and recent BMI (within the last 5 years). Associations were estimated using multi-level and multinomial logistic regression models. The sample included 1078 AA cases, 2582 AA controls, 3240 White cases and 9851 White controls. We observed a higher risk for the non-high-grade serous (NHGS) histotypes for AA women with obesity (ORBMI 30+= 1.62, 95% CI: 1.16, 2.26) and White women with obesity (ORBMI 30+= 1.20, 95% CI: 1.02, 2.42) compared to non-obese. Obesity was associated with higher NHGS risk in White women who never used HT (ORBMI 30+= 1.40, 95% CI: 1.08, 1.82). Higher NHGS ovarian cancer risk was observed for AA women who ever used HT (ORBMI 30+= 2.66, 95% CI: 1.15, 6.13), while in White women, there was an inverse association between recent BMI and risk of EOC and HGS in ever-HT users (EOC ORBMI 30+= 0.81, 95% CI: 0.69, 0.95, HGS ORBMI 30+= 0.73, 95% CI: 0.61, 0.88). Obesity contributes to NHGS EOC risk in AA and White women, but risk across racial groups studied differs by HT use and histotype.

Association Between Time Spent on Electronic Devices and Body Mass Index in Young Adults.

ObjectiveTo evaluate the association between time spent on electronic devices (TSED) and body mass index in young adults.MethodsThis cross-sectional study was conducted from June to December 2021 on 1877 students (aged 18–22 yrs) from multiple health Colleges of Imam Abdulrahman Bin Faisal University. The main tools of the study were 1) Body mass index (BMI) and an online questionnaire. The subjects were categorized into 3 main groups based on their TSED: 1) Low TSED < 2 hours/day, 2) Medium TSED= 3 to 5 hours/day, 3) Excessive TSED ≥ 6 hours /day. Based on BMI, subjects were categorized into three main groups: Normal and underweight (BMI ≤ 24.9), overweight (BMI > 25–29.9), and obese (BMI > 30).ResultsParticipants’ average age was 20 ± 2 years. The average BMI was 23.5 k/m2. The % of students falling into the categories of normal weight, overweight, and obesity was 69.2%, 19.05%, and 11.7% respectively. The average TSED of study participants was 8.2 ± 3.45 hrs /24 hours. 71.15% of participants indicated a TSED of ≥6 hrs/24 hours and 23.71% reported a TSED of 3–5 hrs/24 hours. Only 3.15% of participants reported TSED of ≤2 hrs/24 hours. Although a rise in the mean BMI was observed with an increase in the TSED, but this difference was not statistically significant. The pairwise wise comparison also failed to demonstrate any difference in BMI between different categories of TSED. Furthermore, no significant positive correlation was found between increased BMI and excessive TSED (P = 0.37).ConclusionA high percentage of young adults (31.2%) were overweight or obese, but excessive TSED was not significantly associated with increased BMI in this study population. Further studies are recommended to identify the effects of other factors in causing increased BMI in young adults.

Abstract 684: Body mass index throughout adulthood and incidence of colorectal cancer subclassified by T cell, macrophage, and myeloid cell infiltrates in cancer tissue

Abstract Abstract Background: Biological evidence indicates that obesity influences immune responses, interacting with various immune cell populations via obesity-related systemic inflammation. We hypothesized that the association of obesity with colorectal cancer (CRC) incidence differed by T-cell, macrophage, and other myeloid cell infiltrates in tumor tissue. Methods: We developed multiplexed immunofluorescence assays to identify immune cells, including T-cell (CD3, CD4, CD8, CD45RO, and FOXP3), macrophage [CD68, CD86, IRF5, MAF, and MRC1 (CD206)], and myeloid cell (CD14, CD15, HLA-DR, ARG) subsets in tumor. Utilizing the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS), we examined the association of body mass index (BMI) with incidence of CRC subtypes classified by each immune cell subset. We applied inverse probability-weighted Cox proportional hazards models to control for selection bias and potential confounders. We used the stringent α level of 0.005 due to multiple comparisons. Results: During follow-up of 131,144 participants (3,648,371 person-years), we documented 3,203 incident CRC cases including 886 CRC cases with available data on immune cell densities in tumor tissue. The association of cumulative average BMI (from baseline to the most recent questionnaire cycle) with CRC incidence differed by CD15+CD33- cell (mature granulocyte) densities in tumor intraepithelial regions (Phet=0.004). Cumulative average BMI was associated with incidence of tumors with low CD15+CD33- cell densities [18.5-22.5 kg/m2: reference; 22.5-24.9 kg/m2: HR (95% CI), 1.67 (1.12-2.48); 25.0-27.5 kg/m2: 1.73 (1.14-2.61); 27.5-29.9 kg/m2: 2.06 (1.32-3.21); ≥30 kg/m2: HR, 2.26 (1.45-3.52), Ptrend&amp;lt;0.001], but not with incidence of tumors with intermediate or high CD15+CD33- cell densities (Ptrend&amp;gt;0.049, with the α level of 0.005). The association of young adult BMI (at age 18 for NHS and at age 21 for HPFS) with CRC incidence differed by CD15+CD33+ cell [granulocytic myeloid-derived suppressor cell (MDSC)-like phenotype] densities in tumor intraepithelial regions (Phet&amp;lt;0.001). Young adult BMI was associated with incidence of tumors with low CD15+CD33+ cell densities [18.5-22.5 kg/m2: reference; 22.5-24.9 kg/m2: HR (95% CI), 1.18 (0.96-1.44); 25.0-27.5 kg/m2: 1.44 (1.11-1.87); ≥27.5 kg/m2: 1.88 (1.35-2.62), Ptrend&amp;lt;0.001], but the association was attenuated for tumors with intermediate and high CD15+CD33+ cell densities (Ptrend&amp;gt;0.087). Similar differential associations were not observed in analyses of CRC subclassified by T cell or macrophage densities. Conclusions: The association of BMI with CRC incidence differed by intraepithelial myeloid cell densities. Our findings suggest an interplay of obesity from early life and granulocytic MDSCs/other granulocytes in colorectal carcinogenesis. Citation Format: Tomotaka Ugai, Juha P. Väyrynen, Yasutoshi Takashima, Seyed Mostafa Mousavi Kahaki, Benjamin Langworthy, Koichiro Haruki, Naohiko Akimoto, Mai Chan Lau, Rong Zhong, Sara A. Väyrynen, Melissa Zhao, Andressa Dias Costa, Jennifer Borowsky, Jennifer L. Guerriero, Xuehong Zhang, Andrew T. Chan, Molin Wang, Marios Giannakis, Jeffrey A. Meyerhardt, Edward L. Giovannucci, Jonathan A. Nowak, Shuji Ogino. Body mass index throughout adulthood and incidence of colorectal cancer subclassified by T cell, macrophage, and myeloid cell infiltrates in cancer tissue [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 684.

Body size and risk of non-Hodgkin lymphoma by subtype: A pooled analysis from six prospective cohorts in the United States.

In 2022, more than 100 000 non-Hodgkin lymphoma (NHL) diagnoses are expected, yet few risk factors are confirmed. In this study, data from six US-based cohorts (568 717 individuals) were used to examine body size and risk of NHL. Over more than 20years of follow-up, 11 263 NHLs were identified. Hazard ratios (HRs) and 95% confidence intervals (CI) estimated associations with NHLs for adult body mass index (BMI), height, weight change, waist circumference and predicted fat mass. Adult height was broadly associated with NHL, but most strongly with B-cell NHLs among non-White participants (e.g. HRBLACK =2.06, 95% CI: 1.62-2.62). However, the strongest association among the anthropometric traits examined was for young adult BMI and risk of diffuse large B-cell lymphoma (DLBCL), particularly those who maintained a higher BMI into later adulthood. Individuals with BMI over 30kg/m2 throughout adulthood had more than double the DLBCL risk (HR=2.67, 95% CI: 1.71-4.17) compared to BMI 18.5-22.9kg/m2 . Other anthropometric traits were not associated with NHL after controlling for BMI. These results suggest that sustained high BMI is a major driver of DLBCL risk. If confirmed, we estimate that up to 23.5% of all DLBCLs (and 11.1% of all NHLs) may be prevented with avoidance of young adult obesity.

Experiencing Household Food Insecurity During Adolescence Predicts Disordered Eating and Elevated Body Mass Index 8 Years Later

PurposeGrowing evidence indicates that experiencing household food insecurity during adolescence is associated with disordered eating and elevated body mass index (BMI). However, little is known about the temporal nature of these relationships. The current longitudinal study examined how adolescent experiences of household food insecurity are related to disordered eating and weight status 8 years later. MethodsA population-based sample of ethnically/racially and socioeconomically diverse participants (n = 1,340) were surveyed as adolescents (mean age = 14.5 years) and as young adults (mean age = 22.0 years). Parents/caregivers completed the six-item U.S. Household Food Security Survey Module at baseline. ResultsHousehold food insecurity was common at baseline (37.8% of sample). In analyses adjusted for ethnicity/race and parental education, adolescent food insecurity longitudinally predicted a higher new onset of binge eating (food insecure: 21.3% vs. food secure: 16.2%, p = .038) and BMI ≥30 kg/m2 (food insecure: 15.9% vs. food secure: 11.0%, p = .024), but not unhealthy weight control behaviors in young adulthood. The majority of adolescents with unhealthy weight control behaviors and elevated BMI still had these problems in young adulthood, but persistence was not associated with adolescent household food insecurity for any outcome. DiscussionResults of this longitudinal study suggest that household food insecurity during adolescence is a risk factor for disordered eating and elevated BMI in young adulthood, highlighting a need to comprehensively address these intersecting problems.

Sleep Duration Determines Excess Body Mass Index among Young Adults in Surabaya

Introduction: Lack of sleep duration is one of the risk factors that cause excess body mass index (BMI). One of the mechanisms are by regulating an increase in appetite and reducing the energy used. This study aimed to identify the relationship between sleep duration and excess BMI in young adults.Methods: This descriptive-analytic observational study with cross-sectional design was conducted on 70 respondents aged 18-25 years old. The primary outcomes measured were sleep duration and BMI. Sleep duration was grouped as &lt;7 hours (short sleepers), and ≥7 hours. BMI was classified as 18.5-22.9 as normal, and ≥23 as excess BMI (including overweight and obesity) according to Asia-Pacific classification. Data were analyzed using SPSS 21 software.Results: The study showed that the prevalence of excess BMI was higher in respondents with sleep deprivation (&lt;7 hours) of 67% compared to respondents with enough sleep of 33%. The average sleep duration was 42 minutes shorter on respondents with excess BMI with an average of 6.1 hours and 6.8 hours on normal-weight respondents. According to the results of the study, there was a significant relationship between sleep duration and excess BMI (p &lt; 0.05).Conclusion: The study revealed that sleep duration was related with excess BMI in young adults.

Emotional eating and cognitive restraint mediate the association between sleep quality and BMI in young adults

This cross-sectional study was designed to investigate whether diet quality and eating behaviors could mediate the association between sleep quality and body mass index (BMI) in young adults. For all participants (n = 925; aged 21.4 ± 2.5 years; 77.8% women) we evaluated: BMI, sleep quality, diet quality, and eating behavior dimensions (emotional eating, cognitive restraint, and uncontrolled eating). Linear regression models were used to test associations between exposure and outcome variables. Path analysis was conducted with all potential mediators and covariates entered at the same time. Results showed that emotional eating (β = 0.04 [95% CI: 0.03; 0.06]), cognitive restraint (β = 0.03 [95% CI: 0.01; 0.04]), uncontrolled eating (β = 0.02 [95% CI: 0.01; 0.04]) and diet quality (β = −0.14 [95% CI: 0.19;-0.08]) were significantly associated with sleep quality. Additionally, BMI was significantly associated with PSQI score (β = 0.09 [95% CI: 0.01; 0.17]), emotional eating (β = 0.89 [95% CI: 0.60; 1.18]), and cognitive restraint (β = 1.37 [95% CI: 1.02; 1.71]). After testing for mediation, results revealed that emotional eating and cognitive restraint evidenced a significant mediating effect on the association between sleep quality and BMI. Additionally, diet quality was significantly associated with emotional eating (β = −0.35 [95% CI: 0.56;-0.13]), cognitive restraint (β = 0.53 [95% CI: 0.27; 0.79]), and uncontrolled eating (β = −0.49 [95% CI: 0.74;-0.25]). In conclusion, young adults with poor sleep quality are more likely to deal with negative emotions with food, which, in turn, could be associated with higher cognitive restraint, becoming a vicious cycle that has a negative impact on body weight. Our results also emphasize the role of eating behaviors as determinants of diet quality, highlighting the importance of considering sleep quality and eating behaviors when designing obesity prevention strategies in this population.

Birth weight and young adult body mass index for predicting the risk of developing adult heart failure in men.

Hospitalizations for heart failure among young adults and middle-aged individuals have increased. The aims of the present study were to evaluate the association between birth weight and risk of adult heart failure and the importance of change from low birth weight to overweight/obesity at young adulthood. We used the population-based body mass index (BMI) Epidemiology Study cohort Gothenburg (n = 35 659) with birth weight and young adult BMI (20 years) available from child healthcare records, school health records, and military conscription register for men born 1945-1961. The cohort includes all children who finished school, which was mandatory, in Gothenburg, Sweden. Information on heart failure diagnosis was retrieved from the National Patient Register and the Cause of Death Register (n = 415). In cox regression analyses, there was an inverse association between birth weight and risk of heart failure [hazard ratio (HR) 0.83 per standard deviation (SD), 95% confidence interval (CI) 0.76-0.90], and a direct association for young adult BMI (HR 1.48 per SD, 95% CI 1.36-1.61). Of note, individuals with birth weight in the lowest tertile, who were overweight/obese in young adulthood had a five-fold risk of heart failure (HR 4.95, 95% CI 3.36-7.31) compared with individuals in the middle birth weight tertile who were normal weight at 20 years. Birth weight was inversely associated with the risk of hospitalization due to heart failure. The combination of low birth weight and overweight/obesity in young adulthood results in excess risk of heart failure beyond that of low birth weight or young adult overweight/obesity separately. These findings indicate the need of a life course perspective in heart failure prevention and risk assessment.

Nocturnal Fat Oxidation and Metabolic Flexibility of Young Male Indian Adults Using Indirect Calorimetry

Indian adults tend to inappropriately accumulate body fat even at low Body Mass Index (BMI). Usually, fat that is stored in the fed state is mobilized for energy during nocturnal fasting, thus achieving daily fat balance. This is called metabolic flexibility, which may be lost in some individuals leading to body fat accumulation. Measuring fat balance requires 24h measurement of fat oxidation, but nocturnal fat oxidation could be a reasonable surrogate. The variability of nocturnal fat oxidation is also unknown. A retrospective analysis on 24h fat oxidation in adult men (n=18) was carried out to test the former hypothesis, while the variability of nocturnal fat oxidation was measured prospectively in 5 adult men, who were fed the same diet for 2 days prior to the measurement. Whole-body indirect calorimetry was used for measuring Respiratory Quotient (RQ), energy expenditure and fat oxidation. In 24h analyses, nocturnal (0.44 ± 0.21 g/kg) was significantly higher than diurnal fat oxidation (0.24 ± 0.21 g/kg) and was 64.5% of the total 24h value. Nocturnal fat oxidation was positively correlated with 24h fat oxidation (r = 0.937; p&lt;0.01) and inversely correlated with 24h fat balance (r = -0.850; p&lt;0.01). Metabolic flexibility, measured as the Fed: Fasted RQ ratio, was negatively correlated with BMI (r = -0.226; p=0.366). The intra- and inter-individual variability of 12h nocturnal fat oxidation was low, at 4.7% and 7.2%, respectively. Nocturnal fat oxidation has a low variability when prior diets over 2 days are constant and the Fed: Fasted RQ ratio is an index of metabolic flexibility, which relates to BMI in young adults.

Associations of Body Mass Index and Waist Circumference in Young Adulthood with Later Life Incident Diabetes.

The independent contribution of young adult exposure to overweight and obesity to later-life incident diabetes is not well studied. To assess the associations of exposures to elevated body mass index (BMI) and waist circumference (WC) in young adulthood (ages 18-39 years) with incident diabetes later in life (≥40 years). Pooled data from 6 US prospective cohorts (Atherosclerosis Risk in Communities Study, Cardiovascular Risk Development in Young Adults Study, Cardiovascular Health Study, (4) Framingham Heart Study Offspring Cohort, (5) Health, Aging and Body Composition Study, and (6) Multi-Ethnic Study of Atherosclerosis. Population-based cohort studies. 30 780 participants (56.1% female, 69.8% non-Hispanic white) without a diagnosis of diabetes by age 40. We imputed BMI and WC trajectories from age 18 for every participant and estimated time-weighted average exposures to BMI or WC during young adulthood and later life. Incident diabetes defined as fasting glucose ≥126 mg/dL, nonfasting glucose ≥200 mg/dL, or use of diabetes medications. During a 9-year median follow-up, 4323 participants developed incident diabetes. Young adult BMI and WC were associated with later-life incident diabetes after controlling for later-life exposures [hazard ratios (HR) 1.99 for BMI ≥ 30 kg/m2 and 2.13 for WC > 88cm (women)/>102cm (men) compared to normal ranges]. Young adult homeostatic model of insulin resistance mediated 49% and 44% of the association between BMI and WC with later-life incident diabetes. High-density lipoproteins and triglycerides mediated a smaller proportion of these associations. Elevated BMI and WC during young adulthood were independently associated with later-life incident diabetes. Insulin resistance may be a key mediator.

Adiposity, Adulthood Weight Change, and Risk of Incident Hepatocellular Carcinoma.

Prospective data are limited regarding dynamic adulthood weight changes and hepatocellular carcinoma (HCC) risk. We included 77,238 women (1980-2012) and 48,026 men (1986-2012), who recalled young-adult weight [age 18 years (women); 21 years (men)], and provided biennially updated information regarding weight, body mass index (BMI), and comorbidities. Overall adulthood weight change was defined as the difference in weight (kilograms) between young-adulthood and present. Using Cox proportional hazards models, we calculated multivariable adjusted HRs (aHR) and 95% confidence intervals (CI). Over 3,676,549 person-years, we documented 158 incident HCC cases. Elevated HCC risk was observed with higher BMI in both young-adulthood and later-adulthood [continuous aHRs per each 1 unit = 1.05; 95% CI = 1.02-1.09 (P trend = 0.019), and 1.08; 95% CI = 1.06-1.10 (P trend = 0.004), respectively]. Moreover, overall adulthood weight gain was also significantly associated with increased HCC risk (aHR per each 1-kg increase = 1.03; 95% CI = 1.01-1.08; P trend = 0.010), including after further adjusting for young-adult BMI (P trend = 0.010) and later-adult BMI (P trend = 0.008). Compared with adults with stable weight (±5 kg), the multivariable-aHRs with weight gain of 5-<10 kg, 10-<20 kg, and ≥20 kg were, 1.40 (95% CI = 0.67-2.16), 2.09 (95% CI = 1.11-3.95), and 2.61 (95% CI = 1.42-5.22), respectively. In two prospective, nationwide cohorts, adulthood weight gain was significantly associated with increased HCC risk. PREVENTION RELEVANCE: Our data suggest that maintaining a stable weight during adulthood, specifically by preventing weight gain, could represent an important public health strategy for the prevention of hepatocellular carcinoma.

Low Birth Weight as an Early-Life Risk Factor for Adult Stroke Among Men

To evaluate the association between birth weight and the risk of adult stroke in men, independent of body mass index (BMI) at young adult age. We included 35 659 men born between 1945 and 1961 from the BMI Epidemiology Study with data on birth weight together with BMI in childhood (8years) and young adulthood (20years). Information on stroke events (1184 first stroke events; 905 ischemic stroke [IS] events and 234 intracerebral hemorrhage [ICH] events) was retrieved from national registers in Sweden. Birth weight was inversely associated with the risk of stroke (IS, ICH and uncategorized together; hazard ratio [HR], 0.88 per SD increase, 95% CI, 0.84-0.93), IS, and ICH in a linear manner, independent of young adult BMI. This association was maintained when the analysis was restricted to individuals within the normal birth weight range only. Moreover, individuals with a birth weight in the lowest tertile followed by overweight at 20years had an 81% greater risk of stroke (HR, 1.81; 95% CI, 1.29; 2.54), compared with a reference group of individuals with birth weight in the middle tertile who were of normal weight at age 20years. We demonstrate an inverse association between birth weight and the risk of adult stroke, IS, and ICH independent of young adult BMI. These findings suggest that low birth weight should be included in assessments of stroke risk in adults.