Changes In BMI Research Articles

Usability and engagement of web application on parental behaviors for child obesity intervention

Background: Childhood obesity is a growing global health issue, with increasing prevalence in Asian countries, including Malaysia. Web applications such as JEJAK BMI offer an alternative intervention to address this concern by targeting parental behaviors that could influence their children’s weight. The usability and engagement of the app used are important elements that could influence the intervention outcome. Objective: To assess the engagement and usability of JEJAK BMI apps that could affect parental use of apps in child obesity interventions. Methods: To evaluate the app’s usability, three criteria were evaluated which were ease of use, visual appeal and functionality, post-intervention questionnaires were completed by the parents. Results: The study found that most parents considered the app practical, easy to use, visually engaging and functional. However, the impact on children's BMI over the short term was inconclusive. Conclusion: The JEJAK BMI web application demonstrated strong usability and positive effects on parental behaviors. Nonetheless, significant changes in children's BMI may require longer-term interventions and additional strategies.

Long-term changes in cardiac geometry and mechanics after bariatric surgery- insights from the FatWest study

Abstract Background Patients with severe obesity have a high prevalence of subclinical cardiac organ damage including impaired longitudinal and radial cardiac mechanics. Previous studies on the impact of bariatric surgery on cardiac remodeling, most of them with short patient follow-up, have yielded inconsistent results. Purpose To assess progressive changes in cardiac geometry and mechanics up to five years following bariatric surgery. Methods In the prospective Bariatric Surgery on the West Coast of Norway (FatWest) study, cardiac remodeling was assessed by 2D echocardiography preoperatively and at six months, one year and five years after Roux-en-Y gastric bypass in a cohort of 97 patients (44±10 years, 72% women, body mass index [BMI] 41.8±4.8 kg/m²). Excess weight loss (EWL) was calculated as: absolute weight loss/(initial weight-ideal weight)x100. Left ventricular (LV) size was assessed by the LV mass/ height^2.7, LV longitudinal mechanics by the peak global longitudinal strain (GLS) and radial mechanics by the midwall shortening (MWS). LV myocardial oxygen demand was estimated from the LV mass-wall stress-heart rate product. Right ventricular diameter was measured in the basal one-third of the ventricular cavity. Left atrial (LA) reservoir function was assessed by the LA emptying fraction. Results After a mean follow-up of 63±13 months, the average postoperative EWL was 66%. Overall, both right ventricular diameter, LV mass index, LV GLS, myocardial oxygen demand and LAEF (68% vs. 64%) improved significantly at the 5-year follow-up (all p<0.05), while MWS remained unchanged (Figure). Prevalence of normal LV geometry increased gradually from 56% to 80%, while that of LV hypertrophy fell from 36% to 16% (p<0.001). Analyses of temporal trends showed that improvement in BMI, LV mass and LV GLS occurred during the first postoperative year (Figure). In Cox regression analysis, a low 5-year GLS was associated with preoperative hypertension after adjustment for age, sex, preoperative diabetes mellitus, and postoperative changes in BMI, mean blood pressure and myocardial oxygen demand (p<0.01). In a similar linear model, after adjustment for the same covariates, LV mass index at the 5-year follow-up was independently related to the magnitude of the postoperative BMI reduction (R² = 0.58, p<0.001). Conclusion Ventricular size and longitudinal mechanics are significantly improved 5 years after bariatric surgery, with the reverse remodeling occurring during the first postoperative year. Residual abnormal 5-year LV geometry and mechanics are related to preoperative hypertension and suboptimal BMI reduction.Figure

Effect of body mass index on quadriceps angle and tibial torsion in school-aged children

BackgroundThe prevalence of excessive body mass (BMI) is increasing in pediatric population. Accordingly, the number of musculoskeletal problems in this population is also likely to increase. The quadriceps angle (Q-angle) is a clinical measure used to measure knee alignment in relation to the hip, femur, and tibia, as well as evaluating alignment of the patella. Tibial torsion (T.T) is an important morphological feature of human tibia. The aim of that study was to study the relationship between the Q-angle and TT in children 8 to 12 years old, the effect of BMI on Q-angle and T.T, and the difference in Q-angle and TT between dominant and non-dominant side.Results“Seventy-five children from primary schools” were enrolled in the study and allocated into 3 groups (25 subjects in each group), according to BMI: group I (normal weight = 25), group II (overweight = 25), and group III (obese = 25). The mean value of age of groups I, II, and III was 10.35 ± 1, 10.74 ± 1.2, and 10.17 ± 1.18 years respectively; the mean value of weight was 29.88 ± 3.94, 43.68 ± 6.55, and 50.06 ± 10.44 kg respectively; the mean value of height was 135.28 ± 7.63, 143.2 ± 8.85, and 140.72 ± 9.3 cm respectively; and the mean value of BMI was 16.22 ± 1, 21.18 ± 1.4, and 25.17 ± 2.67 kg/m2. The number (%) of boys in groups I, II, and III was 15 (60%), 18 (72%), and 17 (68%) respectively and of girls was 10 (40%), 7 (28%), and 8 (32%) respectively.The significant values were Q-angle and TT. Data were expressed as mean ± SD. ANOVA was used to compare between subjects’ characteristics of the groups. Kolmogorov-Smirnov test was used for testing normality of data distribution. One-way MANOVA was used to compare parametric variables (Q-angle and TT) between the two groups. Compared with normal weight children, there was statistically significant increase in Q-angle and TT angle in overweight and obese children.ConclusionAny change in BMI would eventually lead to change in both Q-angle and TT angle. The greater the BMI values, the greater the values of Q-angle and TT angle.

The dynamic increment of epicardial adipose tissue is associated with reverse remodeling after guideline-directed medical treatment in dilated cardiomyopathy patients

Abstract Background/Introduction Epicardial adipose tissue (EAT) accumulation is associated with adverse prognosis in patients with HFpEF and a better prognosis in HFrEF patients. Whether EAT is playing a protective role in dilated cardiomyopathy (DCM) patients have been described sparingly. Purpose Aim to explore whether the epicardial fat would change along with the dynamic changes in cardiac function and volumes after receiving guideline-directed medical therapy (GDMT) in patients with DCM. Methods We prospectively enrolled 232 DCM patients who underwent complete baseline and follow-up Cardiac magnetic resonance (CMR) examinations. The measurement of the epicardial fat composition includes epicardial fat thickness, paracardial fat thickness, and paracardial fat volume, while the measurement of body fat composition includes subcutaneous and visceral abdominal fat, while We used univariable and multivariable logistic regression to evaluate the association between different body and cardiac fat depots with the changes in bi-ventricular structure (delta indexed EDV) and function (delta EF). Results The study included 232 patients (mean age 46.1±14.1 years, 157 (67.7%) males). After GDMT, we found that the visceral fat thickness and EAT (thickness and volume) tend to significantly increase. The increase in the (left ventricular reverse remodeling) LVRR group was significantly higher compared with the non-LVRR group. Independently with the changes of BMI and body fat depots, the increment of EAT was associated with the improvement in bi-ventricular function and volumes (significantly positively correlated with the improvement of LVEF (r = 0.499, p < 0.001), and RVEF (r = 0.482, p < 0.001), negatively correlated with delta LVEDVi (r = -0.407, p < 0.001), delta RVEDVi (r = -0.305, p < 0.001)). Conclusions After GDMT, the increment of EAT was positively correlated with the improvement of bi-ventricular structure and function, independent of the changes in BMI and body fat depots.Graphic Abstract

A Review of Lifestyle Interventions in Weight Loss Programs for Community-Based Psychiatric Patients

Abstract Background Psychiatric patients face aggravated physical health issues and reduced life expectancy, primarily due to premature cardiovascular diseases. The intricate relationship between lifestyle factors, illness, and psychotropic medications contributes to this phenomenon. The focus of this research is to evaluate weight management interventions for individuals with Severe Mental Disorders through a comprehensive scoping review, focusing on diverse study designs, outcomes, and their clinical implications. Methods 20 studies were analyzed to understand the effectiveness of interventions and characteristics, such as duration, delivery, and professional involvement. Assessment criteria included weight modifications, BMI changes, and metabolic measures like blood pressure and lipid profiles. Results The total number of participants included in the 20 studies evaluated was 3886. All trials included individuals of all genders. The studies included patients with a weighted mean age of 44.37 (SD = 4.72) and a mean BMI of 34.7 kg/m2 (SD = 3.56). Varied interventions, mostly conducted in the US, showed promising weight reduction and cardiovascular risk management results among psychiatric patients. However, disparate methods used in the studies hindered the evaluation of outcomes. The studies which yielded more interesting results included Gaughran F. et al, 2017 who showed improvements in HDL cholesterol and metabolic indicators, (HR 0.085; 95% CI:0.007-0.16), and Bartels S. et al, 2015 who reported that 51% of participants achieved clinically significant reduction in overall cardiovascular risk. Conclusions Although interventions displayed potential benefits for beneficiaries, the lack of standardized protocols and non-uniform endpoints poses challenges in effectively addressing weight-related concerns in psychiatric patients. Clear guidelines and standardized assessments are necessary to implement psychiatric patients’ weight management interventions. Key messages • The health issues and reduced life expectancy of psychiatric patients is a major health burden. The mean BMI of 34.7 kg/m2, indicating a prevalence of Obese individuals needs to be addressed. • Psychotropic medications are associated with increase in weight. More effort in increasing awareness and including mandatory nutritional educational classes when prescribing these drugs is needed.

Mobile-Based Platform With a Low-Calorie Dietary Intervention Involving Prepackaged Food for Weight Loss for People With Overweight and Obesity in China: Half-Year Follow-Up Results of a Randomized Controlled Trial.

Obesity is a rapidly increasing health problem in China, causing massive economic and health losses annually. Many techniques have emerged to help people with obesity better adhere to intervention programs and achieve their weight loss goals, including food replacement and internet-delivered weight loss consultations. Most studies on weight loss interventions mainly focused on the change in body weight or BMI; however, body fat, especially visceral fat mass, is considered the main pathogenic factor in obesity. In China, more reliable evidence is required on this topic. Moreover, it is unclear whether an integrated weight loss program combining food replacement products, mobile app-based platforms, and daily body composition monitoring using a wireless scale is useful and practical in China. In this 2-arm, parallel-designed, randomized study, we explored the effectiveness and safety of the Metawell (Weijian Technologies Inc) weight loss program in China, which combines prepackaged biscuits, a wireless scale, and a mobile app. Participants in the intervention group were guided to use food replacement products and a scale for weight loss and monitoring, whereas participants in the control group received printed material with a sample diet and face-to-face education on weight loss at enrollment. The intervention lasted for 3 months, and follow-up visits were conducted at months 3 and 6 after enrollment. Dual-energy x-ray absorptiometry and quantitative computed tomography were used to assess body fat. A multilevel model for repeated measurements was used to compare differences between the 2 groups. In total, 220 patients were randomly assigned to intervention (n=110) and control (n=110) groups. Participants in the intervention group had significantly greater decreases in BMI, total body fat, visceral adipose area, and subcutaneous adipose area (all P<.001) than those in the control group. However, the rate of change in lean mass was not significantly different between the 2 groups (P=.62). Further, 35 participants in the intervention group reported adverse events. Constipation was the most frequently reported adverse event (11/110), followed by dizziness (6/110), hypoglycemia (4/110), fatigue (3/110), and gastritis (3/35). The Metawell program was effective for weight loss. After the intervention, participants in the intervention group lost more body weight and body fat while retaining muscle mass than those in the control group.

Lifestyle and BMI Changes after the Release of COVID-19 Restrictions: Do Humans Go ‘Back to Normal’?

Humans adapt their life history strategy and lifestyle behavior to the environment. The social restrictions during the COVID-19 pandemic in the years 2020–2021 led to changes in diet and physical activity habits in large parts of populations worldwide. Additionally, many people reported an increase in body weight during the pandemic. We investigated how diet quality, physical activity, and BMI changed since the end of the COVID-19 restrictions in Switzerland (2019–2023). We assessed diet and physical activity using a standardized questionnaire. We measured anthropometry and BMI using a stadiometer and a balance of a medical bioimpedance analyzer. Our results show a stable BMI in men and women during the pandemic. In both sexes, diet quality and physical activity levels did not change significantly during this time. Among women, physical activity and age were associated with BMI, while in men, apart from physical activity, high diet quality and living in the agglomeration were associated with BMI. Overall, we did not find evidence for a transient “unhealthier” lifestyle immediately after the COVID-19 pandemic. However, we found constituent sex differences in BMI determinants. Our results could indicate a higher resilience in highly educated persons and might contribute to more personalized approaches to prevent obesity.

The Efficacy and Safety of Liraglutide in Patients Remaining Obese 6 Months after Metabolic Surgery.

The safety and efficacy of liraglutide as a weight loss intervention in individuals who remain obese within 1year post-metabolic surgery remain unclear. This study aimed to evaluate the effects and safety of liraglutide (1.8mg) in patients with persistent obesity at 6months postoperatively. This retrospective cohort study included 61 patients who remained obese (body mass index [BMI] ≥ 28.0kg/m2) at 6months postoperatively. Among these patients, 27 were treated with 1.8mg of liraglutide for 12weeks, whereas 34 served as controls. The primary endpoint was the change in total weight loss (%TWL) after 24weeks. Changes in weight, BMI, complications, and adverse events were also assessed. The liraglutide group showed a greater reduction in %TWL than the control group (11.6% ± 1.1% vs. 4.9% ± 1.0%), with an estimated treatment difference of 6.6% (95% confidence interval [CI], 3.7-9.6%, P < 0.01). The adjusted mean differences in the reduction of weight and BMI between the liraglutide and control groups were -6.2kg (95% CI -8.9 to -3.4, P < 0.01) and -3.0kg/m2 (95% CI -4.2 to -1.7, P < 0.01), respectively. The liraglutide group exhibited increased rates of remission in non-alcoholic fatty liver disease and hypertension. No serious adverse reactions were observed. For patients who remained obese at 6months postoperatively, 12-week liraglutide treatment resulted in increased weight loss, improved metabolic control, and high rate of remission for obesity-related metabolic diseases after 24weeks. Earlier and more timely adjuvant weight loss medication intervention based on BMI within 1year postoperatively may enhance weight loss after metabolic surgery. Graphical abstract available for this article.

Association of weight change with all-cause and cause-specific mortality: an age-stratified analysis

BackgroundThe associations of weight change with all-cause and cause-specific mortality stratified by age remains unclear. We evaluated the age-stratified (< 65 vs ≥ 65 years) associations of weight change with all-cause and cause-specific mortality in a large sample of Chinese adults.MethodsOur cohort study included 746,991 adults aged at least 45 years from the Shenzhen Healthcare Big Data Cohort in China. BMI change were categorized as change within 5% (stable), decrease by 5% to 10%, decrease by > 10%, increase by 5% to 10%, and increase by > 10%. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, non-communicable disease, cardiovascular disease (CVD), and cancer mortality according to BMI change, with adjustment for potential confounders.ResultsDuring a median follow-up of 2.2 years (2,330,180 person-years), there were 10,197 deaths. A notable interaction emerged between weight change and age. For participants ≥ 65 years, compared with stable BMI, more than a 10% decrease in BMI was associated with higher risk of all-cause mortality (HR: 1.69, 95% CI: 1.54–1.86), non-communicable disease mortality (HR: 1.67, 95% CI: 1.52–1.84), CVD mortality (HR: 1.55, 95% CI: 1.34–1.80), and cancer mortality (HR: 1.59, 95% CI: 1.33–1.92). Similar patterns of results for 5% to 10% decrease in BMI were observed. More than a 10% increase in BMI was associated with increased risk of all-cause mortality (HR: 1.13, 95% CI: 1.04–1.24), non-communicable disease mortality (HR: 1.14, 95% CI: 1.04–1.25), and CVD mortality (HR: 1.27, 95% CI: 1.12–1.44). For participants < 65 years, only more than a 10% decrease in BMI was associated with higher risk of all-cause mortality (HR: 1.41, 95% CI: 1.12–1.77), non-communicable disease mortality (HR: 1.43, 95% CI: 1.13–1.81), and cancer mortality (HR: 1.79, 95% CI: 1.29–2.47).ConclusionsWeight loss and excessive weight gain were associated with increased risks of mortality among older adults, while only excessive weight loss was associated with increased risks of mortality among middle-aged adults.

Pancreatic Enzyme Replacement Leads to Increased Vitamin D Uptake in Patients Undergoing Sleeve-gastrectomy - A Prospective, Monocentric Trial.

Metabolic and bariatric surgery (MBS) is often considered to be associated with macro- and micronutrient deficiency. A possible treatment option can be the implementation of pancreatic enzyme replacement (PERT) and may lead to better outcomes. We designed a prospective trial investigating the possible impact of PERT in patients undergoing MBS at a high-volume center. A prospective two-arm randomized controlled trial was conducted on patients who underwent either sleeve gastrectomy or gastric bypass procedures at a high-volume center. Patients underwent bariatric surgery and follow-up examinations at 3, 6, and 12 months after surgery. Patients were stratified either to the treatment group with PERT or to the control group. The primary endpoint of the study was a change in BMI. Lab testing was carried out to measure secondary endpoints, including albumin and vitamin D levels. Overall, 204 patients were enrolled. Due to missing follow-ups, surgical complications, and side effects due to Kreon medication, 65 were excluded. Analysis of primary endpoints indicates that PERT does not lead to slower weight loss or BMI reduction. Analysis of secondary endpoints showed significantly better vitamin D levels in patients undergoing MBS and PERT. No statistical difference was seen regarding albumin. In both arms, fatty liver disease improved. Quality of life is positively judged as comparable by patients in both groups. Herein, we show an association between PERT and higher vitamin D levels in patients undergoing MBS. An optimized enzymatic environment due to PERT may therefore result in higher vitamin D levels and may improve clinical outcomes in patients undergoing MBS.

7299 An Eucaloric High-Fat Diet Suppresses Urinary Estrogen and Progesterone Metabolites, Mimicking Reprometabolic Syndrome in Normal Weight Women

Abstract Disclosure: K. Kuhn: None. A.P. Bradford: Consulting Fee; Self; Amazon. N.F. Santoro: Advisory Board Member; Self; Menogenix, Astellas, Que Oncology, Amazon. Consulting Fee; Self; Ansh. Introduction: Reprometabolic syndrome is associated with relative hypogonadotropic hypogonadism, reduced fecundability, and increased pregnancy loss in women with obesity. We employed a eucaloric, high-fat diet (HFD) to attempt to reproduce the decreased urinary estrogen and progesterone metabolites, characteristic of this phenotype, in healthy women of normal BMI. Materials and Methods: 18 women with normal BMI (18-24.9kg/m²), mean age 29.1±6.3, were recruited for a four-month study including a prescribed 30-day, eucaloric, high-fat, dietary intervention (48% calories from fat). Women collected daily morning urine for 4 menstrual cycles. Daily urinary estrone conjugate (E1c) and pregnanediol-3-glucuronide (Pdg) levels were measured by immunoassay before, during and after the HFD. Paired t tests were used to compare average urinary E1c and Pdg levels and area under the curve (AUC) to determine the impact of the HFD. Cycles were aligned by LH peak (day 0). Results: Participants were weight stable throughout the 4 month study period with no change in BMI (pre-diet BMI 21.46±1.95 kg/m2 and post-diet BMI 21.35±1.81 kg/m2). Average mid cycle E1c peak was significantly lower during (32.4 ng/mg creatinine) and after the HFD (26.5 ng/mg creatinine), compared to pre-diet levels (43.2 ng/mg creatinine; p&amp;lt; 0.001). Post-diet urinary Pdg (AUC) was also significantly lower than pre-diet (p&amp;lt; 0.01). Follicular (days -14 to 0) and luteal phase (days 2-14) E1c AUC was significantly decreased post HFD (p&amp;lt; 0.05). Follicular and luteal phase Pdg levels were also significantly decreased post HFD (p&amp;lt;0.001, both). No significant changes in menstrual cycle length were observed throughout the study. Conclusion: Consumption of a high-fat diet for one month was sufficient to induce a significant reduction in E1c and Pdg, characteristic of Reprometabolic Syndrome of obesity, in normal weight, eumenorrheic women. This finding provides important insights regarding the mechanisms underlying reproductive dysfunction in obesity and indicates that a dietary intervention may be an effective strategy to mitigate sub-optimal reproductive hormone levels in women with obesity-related subfertility. Presentation: 6/1/2024

8553 GDF-15 Levels In Patients With Prostate Cancer On Androgen Deprivation Therapy

Abstract Disclosure: S.D. Jaramillo-Quiroz: Other; Self; VAPSHCS: Director Fund Research Fellowship/UW Abrass Family Fellowship Fund. CDMRP (PC170059).. L. Caeiro: None. L.J. Anderson: None. J.M. Garcia: None. Growth Differentiation Factor 15 (GDF-15) is a stress-induced cytokine known to induce anorexia and cachexia and a biomarker of biological aging, mitochondrial dysfunction, and worse hand grip strength and poor survival in different settings. Also, GDF-15 has pleiotropic functions at all stages of tumorigenicity and is suggested as a marker to differentiate BPH from PCa. Androgen Deprivation Therapy (ADT) is the standard treatment for advanced prostate cancer (PCa), but it also decreases muscle mass and function and Quality of life (QOL). The role and effects of GDF-15 in prostate cancer patients undergoing ADT are not well characterized and was explored in this longitudinal, 6-month, observational study that recruited men with (PCa) starting ADT (n=60, mean age 69). Body composition [dual energy X-ray absorptiometry (DEXA), body weight history], physical performance [handgrip strength (HGS), 6-minute walk test (6MWT), energy expenditure (indirect calorimetry and actigraphy)], were assessed before, at 3 and 6 months after starting ADT. QoL was assessed by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). GDF-15 was measured by ELISA. Mean differences performed with standard error of the mean, repeated measures ANOVA and Tukey’s Post Hoc test. Correlations were assessed by Spearman’s. After 6 months of ADT, fat mass was increased (mean difference: 1.14 ±0.38, p=0.0029), and lean muscle mass (mean difference: -1.214 ± 0.38, p=0.005), appendicular lean mass (ALM, mean difference: -0.879 ± 0.19, p=&amp;lt;0.0001). HGS (mean difference: -2.927 ± 0.59, p=&amp;lt;0.0001), and VO2 max decreased (mean difference -3.31 ± 0.83, p=0.0007). Baseline GDF-15 (mean 1456.59 ± 1022.80) was correlated with the changes in weight (r: -0.38, p=0.01), BMI (r: -0.33, p=0.01), ALM (r: -0.29, p=0.04), and fatigue (r: -0.38, p=0.004). As shown, baseline GDF-15 was inversely correlated with changes in weight, appendicular lean mass, and fatigue in subjects undergoing ADT, highlighting the possibility of its role as a biomarker and therapeutic target of body composition and patient-reported outcomes in this setting. Presentation: 6/1/2024

Assessment of Musculoskeletal Loads among Office Workers Due to Predicted BMI Increase

The increasing prevalence of adult obesity is a major global health problem. Causes include sedentary lifestyles and physical inactivity, as well as the place and style of work. This work aimed to assess the impact of an increase in BMI, resulting from a sedentary lifestyle, on the functioning of the human musculoskeletal system during daily activities. Standing and sitting down were analyzed using numerical simulations in the AnyBody Modeling System. The results showed that by 2050, an increase in body weight will lead to an 11% increase in lumbar spine loads and up to 14% increase in knee and hip joint loads compared to 2015. Increased body weight will also increase muscle fatigue, requiring the body to exert more force to perform the same activities. The BMI change prediction model shows that the average man will be overweight or obese in the coming years, which will likely increase musculoskeletal loads.

B-140 Use of the metabolic health index for correlation with comorbidity reduction for patients undergoing bariatric surgery

Abstract Background Bariatric surgery is a commonly performed procedure aimed at addressing obesity and its associated health issues. However, while weight loss is often a primary focus, the broader improvements in metabolic health, including reductions in conditions such as type 2 diabetes mellitus (T2DM) and dyslipidemia, are not consistently quantified. The recent development of the Metabolic Health Index (MHI) by van Loon et al. provides a potential laboratory index that encompasses various metabolic parameters to predict improvements in comorbidities post-surgery. Our study aimed to assess the utility of MHI in correlating with changes in metabolic health status among patients undergoing bariatric surgery at a U.S. medical center. Methods In our current study, we conducted a retrospective analysis of 300 patients who had undergone bariatric surgery between 2012 and 2019 at the University of Minnesota. We selected patients who had both baseline and one-year post-surgery laboratory values available, including age, hemoglobin A1C (HbA1c), triglycerides, potassium, and creatinine for estimated glomerular filtration rate (eGFR), which were necessary for calculating MHI using the equation of van Loon et al. Thirty patients met the inclusion criteria and their eGFRs were calculated using the 2021 CKD-EPI equation. Using the published formulae, we calculated the MHI for each patient before and after surgery. Patients were stratified based on improvements in diabetic (T2DM) and dyslipidemic status, with lower stratification numbers indicating better outcomes. We then conducted correlation analyses to examine the relationship between changes in MHI, individual components of MHI, BMI, and the reduction in the two comorbidities. We also examined if any of the initial values of MHI, its components and BMI correlated with the magnitude of reduction in the two comorbidities. Results In the patient cohort examined, initially 46.7% of the population were non-diabetic and this changed to 53.3% one year after surgery. The number of patients with diabetes decreased from 33.3% to 13.3%, indicating a benefit of bariatric surgery in alleviating type 2 diabetes mellitus (T2DM). Dyslipidemia decreased from 36.7% to 13.3% post-surgery. Most of the patients had reductions in both the BMI and MHI scales and a linear relationship between the two values was observed. A Spearman correlation analysis revealed that the values of HbA1c (rho= 0.56, p = 0.0014)) and MHI (rho = 0.5, p = 0.005) had a correlation with the reduction in T2DM and the reduction in triglycerides (rho= 0.73, p= 0.0) correlated with reduction in dyslipidemia. On the other hand, the reduction in BMI did not correlate with the improvement in the comorbidities examined. It was determined that the initial values of MHI, its components, and BMI had no correlation to the degree of reduction in comorbidities. Conclusions Our findings suggest that MHI and HbA1C may serve as valuable indicators of metabolic health improvements following bariatric surgery, while BMI changes alone may not fully capture these improvements. Laboratory-based measurements such as MHI offer a promising approach for assessing and monitoring metabolic health outcomes in bariatric surgery patients, providing insights beyond traditional weight-based metrics.

Interpregnancy maternal weight change is not associated with offspring weight and obesity at age 2 years.

Weight retention between pregnancies is associated with increased risk of perinatal complications, but it is unclear whether there is an association with offspring weight status. This study aimed to determine whether maternal interpregnancy weight change is associated with offspring overweight/obesity, controlling for confounding variables. Routinely collected linked data from perinatal and child datasets, in Flanders, Belgium were used. Women having their first and second live births between 2009-2018 were included. The association between maternal interpregnancy weight change and overweight/obesity in the second child at 2 years was examined by logistical regression models. A total of 33,172 women were included. 52.7% (n = 17478) had a stable interpregnancy BMI, 24.1% (n = 8024) and 8.5% (n = 2821) had moderate and substantial BMI increases respectively. At 2 years, 91.6% (n = 30383) of the second offspring had a healthy weight, 0.6% (n = 210), 7.0% (n = 2312) and 0.8% (n = 267) were in the underweight, overweight and obesity BMI categories respectively. Multivariate analysis showed no statistical evidence that maternal interpregnancy BMI change is independently associated with overweight/obesity in the second child. The strongest independent factors were the first child (sibling) being in the obesity category at 2 years (odds ratio [OR] 7.2, [95% CI, 5.49-9.45] and being born Large for Gestational Age (LGA) (2.13 [1.92-2.37]). The following variables were also independently associated with the outcome measure: maternal African origin (1.90 [1.59-2.26]), maternal obesity at start of first pregnancy (1.33 [1.16-1.53]), excessive gestational weight gain in the second pregnancy (1.15 [1.04-1.28]), being born after a < 1-year interpregnancy time interval (1.17 [1.05-1.30]) and not being exclusively breastfed at 12 weeks old (1.29 [1.10-1.52]). Sibling obesity and being born LGA were most strongly independently associated with overweight/obesity at 2 years. This supports the need for family interventions and to address risk factors for development of LGA infants. There was no independent association with interpregnancy weight gain, contrary to what was hypothesised.

Overweight and obesity as risk factors for chronic low back pain: a new follow-up in the HUNT Study

BackgroundNumerous studies have examined associations between overweight and obesity and risk of low back pain (LBP), but the exact magnitude of these associations is not yet clear. The purpose of this work was to assess such sex-specific associations in a community-based setting in Norway, taking into account potential relationships with other risk factors.MethodsA cohort study was conducted combining data from two waves of the Trøndelag Health Study, HUNT3 (2006–2008) and HUNT4 (2017–2019). Separate analyses were performed of risk of chronic LBP in HUNT4 among 14,775 individuals without chronic LBP in HUNT3, and of recurrence or persistence in HUNT4 among 5034 individuals with chronic LBP in HUNT3. Relative risks were estimated in generalised linear models for overweight and obesity compared to normal weight. Body size classification was based on values of BMI computed from measurements of height and weight. Chronic LBP was defined as LBP persisting at least 3 months during last year.ResultsAfter adjustment for age, smoking, physical activity in leisure time and work activity, analysis of risk among women produced relative risks 1.11 (95% CI 1.00–1.23) for overweight, 1.36 (95% CI 1.20–1.54) for obesity class I and 1.68 (95% CI 1.42–2.00) for obesity classes II-III. Relative risks among men were 1.10 (95% CI 0.94–1.28) for overweight, 1.36 (95% CI 1.13–1.63) for obesity class I and 1.02 (95% CI 0.70–1.50) for obesity classes II-III, the last estimate being based on relatively few individuals. Analyses of recurrence or persistence indicated similar relationships but with smaller magnitude of relative risks and no drop in risk among obesity classes II-III in men. The change in BMI from HUNT3 to HUNT4 hardly differed between individuals with and without chronic LBP in HUNT3.ConclusionsRisk of chronic LBP increases with higher values of BMI in both sexes, although it is uncertain whether this applies to very obese men. Very obese women carry a particularly large risk. Probabilities of recurrence or persistence of chronic LBP among those already afflicted also increase with higher values of BMI. Adjustment for other factors does not influence relationships with overweight and obesity to any major extent.

Trajectories in mammographic breast screening participation in middle-age overweight and obese women: A retrospective cohort study using linked data

ObjectivesDespite the established benefits and availability of mammographic breast screening, participation rates remain suboptimal. Women with higher BMIs may not screen regularly, despite being at increased risk of postmenopausal breast cancer and worse outcomes. This study investigated the association between prospective changes in BMI and longitudinal adherence to mammographic screening among women with overweight or obesity. MethodsRetrospective cohort study of women (N = 2822) participating in the Australian Longitudinal Study on Women's Health with an average follow-up of 20 years, with screening participation enumerated via BreastScreen NSW, Australia clinical records over the period 1996–2016. Association between BMI and subsequent adherence to screening was investigated in a series of marginal structural models, incorporating a time variant/invariant socio-demographic, clinical, and health behaviour confounders. Models were also stratified by a proxy measure of socio-economic status (education). ResultsParticipants with overweight/obesity were less adherent to mammography screening, compared to healthy/underweight participants (OR=1.29, 95 % CI=1.07, 1.55). The association between overweight/obesity and non-adherence was higher among those who ever had private health insurance (OR=1.30, 95 % CI=1.05, 1.61) compared to those who never had private health insurance and among those with lower educational background (OR=1.38, 95 % CI=1.08, 1.75) compared to those with higher educational background. ConclusionsLong-term impacts on screening participation exist among women with higher BMI, who are less likely to participate in routinely organised breast screening. Women with a higher BMI should be a focus of efforts to improve breast screening participation, particularly given their increased risk of breast cancer and association of higher BMI with worse breast cancer outcomes among older women.

Race, Ethnicity, and Geography as Determinants of Excessive Weight and Low Physical Activity in Pediatric Population: Protocol for Systematic Review and Meta-Analysis.

The rationale for the current study is the sparsity of data on the combined effect of the environmental and individual risks of obesity and sedentary lifestyle in children of different races/ethnicities from different regions. An effective weight management strategy is hard to design due to insufficient evidence. This work was initiated to study race, ethnicity, and geography as determinants of excessive weight and low physical activity in the pediatric population. To achieve this aim, we systematically review publications on daily length of physical activity of light, moderate, and vigorous intensity, as well as sedentary time and BMI and its dynamics in children of different races/ethnicities and geographies. The extracted data are stratified into six major geographic regions and six races/ethnicities. Then, a random-effects meta-analysis is used to calculate the pooled mean of each outcome measure. A ridge regression is constructed to explore age-related change in BMI. A Kruskal-Wallis H test is applied to compare the pooled duration of physical activity and sedentary time in the subgroups. Finally, we calculate paired correlation coefficients between BMI and physical activity/inactivity for each group. The findings can be further used in public health surveillance to clarify the epidemiology of obesity, to guide priority setting and planning, and to develop and evaluate public health policy and strategy.

Effectiveness of an mHealth App That Uses Financial Incentives and Gamification to Promote Health Behavior Change in Adolescents and Caregivers: Protocol for a Clinic-Based Randomized Controlled Trial.

Adolescent and adult obesity continues to be a public health epidemic in the United States. Despite the popularity of mHealth apps with gamification among adolescents, there are insufficient studies to evaluate the efficacy of gamified mHealth apps and financial incentives to motivate sustained health behavior change in adolescents or their adult caregivers. This study aims to evaluate the effectiveness of gamification techniques and financial incentives used in the novel "CommitFit" mHealth app to motivate health behavior change and improve various mental and physical health metrics in adolescents and their caregivers. This study is a 3-month randomized controlled trial (RCT) with 30 adolescents (aged 13-15 years) and their adult caregivers (N=60). It evaluates "CommitFit," which uses gamification including points and leaderboards to motivate logging and achievement of self-selected health behavior goals (eg, more water, sleep, physical activity, fruits, or vegetables or fewer sugary beverages). The RCT had three arms, each with 10 dyads: (1) CommitFit-only users; (2) CommitFit$, where adolescents were paid US $0.05 for each point they earned; and (3) waitlist control. Intervention dyads used the app for 3 months and had the option to use it for the fourth month without prompts or extra financial incentives. User analytic software was used to evaluate the frequency of user logs and goal achievement. Monthly surveys evaluated self-reported change in the 5 CommitFit health behaviors. Changes in BMI and blood pressure were evaluated for all participants at 3 clinical visits. Mental health, gamification, and behavior economics surveys were completed during the clinical visits. Recruitment began in August 2023 and was completed in 10 weeks. The research team successfully recruited and enrolled 30 dyads. Researchers emailed and called 89 caregivers on a physician-approved adolescent patient list, a 33% recruitment rate. Data collection and analysis will be conducted in the spring and summer of 2024. The results of this study are anticipated to be published between late 2024 and early 2025. This RCT will expand knowledge of the effectiveness of gamification techniques, financial incentives, and mHealth apps to motivate sustained health behavior change among adolescents and caregivers. These results may offer new opportunities to caregivers, health insurers, health care systems, and clinicians to motivate health behavior change in adolescents and caregivers, with the ultimate goal of preventing or reducing obesity and obesity-related diseases. Additional gamification, mental health surveys, and app user analytics included in the study may provide further insight into the characteristics of adolescents or caregivers who would benefit the most from using a gamified mHealth app like CommitFit. DERR1-10.2196/63505.

Secular Changes in Growth in the Maya Village of Yalcoba: 1986-2023.

ABSTRACTObjectiveTo analyze the changes in children's height, weight, BMI and rates of stunting and overweight and obesity over three periods: 1986–1987, 1996–1998, and 2023 for the community of Yalcoba in the Yucatan Peninsula.Material and MethodsFour hundred forty (6‐to‐15 years) children measured in 2023 were compared with data obtained in 1986–1987 (n = 675) and 1996–1998 (n = 628). Z‐scores of height and BMI were calculated to estimate percentages of stunting and high BMI‐for‐age (overweight and obesity). Comparisons of anthropometric parameters by sex and age groups between years of measurement were performed through one way ANOVAs.ResultsDifferences in anthropometric parameters were significant in all age groups of both sexes. Boys measured in 2023 were, on average, 6.4 and 3.3 cm taller than boys measured in the 1980s and 1990s, respectively. Increases in girls were 12 and 7.3 cm, respectively. Average increases in weight of boys measured in 2023 were 7.9 kg compared to the 1980s and 5.8 kg compared to 1990s. Average increases in girls measured in 2023 were 11.3 kg compared to the 1980s, and 7.6 kg compared to the 1990s. Stunting between the 1980s and 1990s decreased by 15 percentage points and between the 1990s and 2023 decreased by 47 percentage points. The percent of children deemed overweight/obese during these periods increased from 8 to 12–50 by 2023.ConclusionResults reflect the overall trends seen in the Yucatan where stunting has decreased substantially but the numbers of overweight/obese youths have increased dramatically in the past 30 years.