Changes In Body Mass Index Research Articles

Mandibular trabecular bone pattern before and two years after medical or surgical obesity treatment in young Swedish women

ObjectiveTo investigate if changes in body mass index (BMI) result in changes of the mandibular trabecular bone structure.Materials and methodsFemales (18–35 years at baseline, mean BMI 42,3) were followed from before (n = 117) until two years (n = 66) after obesity treatment (medical or surgical). The mandibular bone trabeculation was classified as sparse, dense, or mixed on intraoral radiographs (Lindh’s index). A digitized method (Jaw-X) assessed the size and intensities of intertrabecular spaces. The main predictor variable was BMI reduction over the period.ResultsBefore treatment, the group with a high BMI (≥ 45) had a significantly denser bone than those with a lower BMI (p = 0.035). Two years after treatment, fewer were classified with sparse bone (Lindh’s index p = 0.001, Jaw-X p = 0.009). The physical activity increased with fewer having a sedentary lifestyle (40% before, 17% after treatment). The association between BMI reduction and the difference in Jaw-X was significant in regression models and not influenced by obesity treatment method but by baseline factors as age, trabecular bone pattern and level of ionized calcium.ConclusionsBefore obesity treatment, high BMI was associated with dense bone trabeculation in the jaw. The group with sparse bone had decreased at follow-up. The association between BMI reduction and bone trabeculation was influenced by individual and medical factors.Clinical relevanceBone trabeculation in the mandible was maintained during the first years after obesity treatment but new health habits should be encouraged, and patients need to be monitored and followed up further.

Effects of Plant-Based Diet on Metabolic Parameters, Liver and Kidney Steatosis: A Prospective Interventional Open-label Study.

This interventional single-center prospective open-label study aims to evaluate the effects of a vegan diet, compared to a vegetarian and omnivorous diet, on metabolic parameters, insulin sensitivity, and liver and kidney steatosis in healthy adults. The study included 53 omnivorous participants aged 18-40 years, body-mass index 18-30 kg/m2, without any chronic disease, chronic medication use, active smoking, or significant alcohol consumption. All participants were omnivorous at baseline and selected to continue an omnivorous diet or transition to a vegetarian or vegan diet, with follow-up over six months. Anthropometric measurements, biochemical parameters, and liver and kidney steatosis were assessed at baseline and after six months using magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Primary outcomes included changes in liver and kidney steatosis, while secondary outcomes were alterations in anthropometric and biochemical markers. Among 53 participants, 18 followed an omnivorous diet, 21 adopted a vegetarian diet, and 14 transitioned to a vegan diet. Dietary interventions did not result in statistically significant changes in body mass index, fat mass, fat percentage, or muscle mass over six months. However, statistically significant improvements in systolic and diastolic blood pressure, favoring the vegan diet, were observed. We aimed to control for potentially confounding variables to ensure the reliability of these findings. We have demonstrated a better decline in steatosis at the lower kidney pole, the total hilus and the Liver 6 index in vegans. We demonstrated that a plant-based diet is associated with improvements in several metabolic parameters and may reduce liver and kidney steatosis.

The prevalence of obesity in children with CHD: what has changed over the past decade in Southwestern Ontario?

To assess the prevalence of obesity and investigate any changes in body mass index in children with CHD compared to age-matched healthy controls, in Southwestern Ontario. The body mass index z-scores of 1259 children (aged 2-18) with CHD were compared with 2037 healthy controls. The body mass index z-scores of children who presented to our paediatric cardiology outpatient clinic from 2018 to 2021 were compared with previously collected data from 2008 to 2010. A longitudinal analysis of patients with data in both cohorts was also completed. In total, 21.4% of patients with CHD and 26.6% of healthy controls were found to be overweight or obese (p < 0.001). The 2018-2021 cohort of CHD patients and controls had significantly higher body mass index z-scores compared to the 2008-2010 cohort (p < 0.001). Longitudinal analysis showed that body mass index z-scores significantly increased over time for CHD patients with data in both cohorts (2018-2021: M = 0.59, SD = 1.26; 2008-2010: M = -0.04, SD = 1.05; p < 0.001). The prevalence of obesity in all children, irrespective of CHD, is rising. The coexistence of obesity and CHD may pose additional cardiovascular risks and complications.

Longitudinal response to standard of care in pediatric metabolic dysfunction-associated steatotic liver disease: Rates of improvement and worsening, and factors associated with outcomes.

Longitudinal outcomes in children with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear due to the absence of a standardized monitoring approach. This study aimed to 1) define improvement and worsening in children with MASLD, 2) estimate rates of improvement or deterioration with standard of care (SOC) over one and two years, and 3) identify baseline and longitudinal factors associated with improvement or worsening. Using data from two large randomized controlled trials, we derived definitions for composite improvement and worsening of MASLD based on associations between changes in ALT, GGT, and liver histology after one and two years. Improvement was defined as ≥40% decrease in ALT and ≥20% decrease in GGT and worsening as ≥20% increase in both ALT and GGT. We applied definitions to a cohort of 440 children with MASLD. After one year of SOC, 22% of children with MASLD showed improvement, increasing to 31% after two years. However, 20% showed worsening after both one and two years despite receiving SOC. Logistic regression analysis, employing stepwise model selection, identified changes in body mass index (BMI) z-score and cholesterol to be most associated with improvement or deterioration. This study developed criteria for improvement and worsening in children with MASLD over one and two years of follow-up. With SOC, over one-quarter of children are likely to improve while one-fifth of children are likely to worsen. Targeting interventions that affect BMI and lipid parameters may help improve MASLD over time.

The Impact of Contemporary Glucagon-like Peptide-1 Receptor Agonists on the Onset, Severity, and Conversion to Arthroplasty in Hip and Knee Osteoarthritis.

The growing popularity of glucagon-like peptide-1 receptor agonists (GLP-1-RAs) for weight loss could significantly impact joint preservation and arthroplasty. While this will in part be driven by the association between obesity, osteoarthritis (OA), and total joint arthroplasty (TJA), recent evidence also indicates that GLP-1-RAs may have direct joint-protective, anti-inflammatory effects. To evaluate the association between GLP-1-RA use and the onset and progression of hip and knee OA in an obese population. Cohort study; Level of evidence, 3. A national health network was queried for patients with an index visit between June 1, 2021, and January 1, 2023, and a body mass index (BMI) ≥30. Patients were stratified into groups without (n = 1,092,225) and with(n = 237,043) preexisting hip and/or knee OA. One-to-one propensity score matching was used to balance GLP-1-RA use based on age, sex, race, BMI, and comorbid type 2 diabetes mellitus. Primary outcomes were incidence of hip OA, knee OA, major joint injections, total hip arthroplasty (THA), and total knee arthroplasty (TKA) within 1 year. Cox proportional hazards models were used to estimate hazard ratios (HRs) between cohorts prescribed and not prescribed GLP-1-RAs. In patients with preexisting OA, GLP-1-RA use correlated with reduced odds of conversion to THA (1.1% vs 2.2%; HR, 0.6; 95% CI, 0.5 to 0.8) and TKA (1.4% vs 2.1%; HR, 0.8; 95% CI, 0.6 to 0.9) within 1 year. In patients without preexisting OA, GLP-1-RA use was associated with an increased incidence of hip OA (0.9% vs 0.7%; HR, 1.4; 95% CI, 1.2 to 1.6), knee OA (2.1% vs 1.9%; HR, 1.3; 95% CI, 1.2 to 3.1), major joint injections (2.2% vs 1.8%; HR, 1.4; 95% CI, 1.3 to 1.5), and TKA (0.09% vs 0.04%; HR, 2.6; 95% CI, 1.6 to 4.3). Comparing cohorts without prior OA, patients who were prescribed a GLP-1-RA demonstrated slightly greater decreases in BMI (-1.00; 95% CI, -1.06 to -0.96) at 1-year after the index visit compared with patients not prescribed a GLP-1-RA (-0.90; 95% CI, -0.94 to -0.84). However, in patients with a prior diagnosis of hip or knee OA, there was no difference noted in BMI change. GLP-1-RAs may provide direct disease-modifying behaviors in patients with preexisting OA diagnosis, per a reduced risk of conversion to TJA not attributable to weight loss. Further investigation is also needed to elucidate the association between GLP-1-RA use and the increased incidence of OA diagnosis and conversion to TKA in patients with no preexisting OA diagnosis.

Body Mass Index and Weight Change as Predictors of Hypertension Development: A Sex-Specific Analysis

Background/Objectives: Obesity is associated with food intake, drinking, and nutrition. It is necessary to examine the association between body mass index (BMI), body weight changes, and the incidence of hypertension, focusing on potential sex differences. Methods: A retrospective two-point cohort study was conducted using data from the Japanese Specific Health Checkup program from 2011 to 2013. Multivariable logistic regression analyses were employed to assess associations between BMI, weight change, and hypertension onset, adjusting for age, sex, and lifestyle factors, including smoking, drinking, and exercise. Results: In total, 397,181 participants were analyzed. A higher BMI was linked to a higher risk of hypertension, with an odds ratio (OR) of 1.11 (95% confidence interval [CI]: 1.11–1.12) for both sexes. Women aged 40–65 showed higher ORs than men. Weight gain was associated with developing hypertension, with an OR (95% CI) of 1.09 (1.09–1.10) in men and 1.08 (1.07–1.08) in women. This association held across all BMI levels, even among individuals without obesity, with the effect being generally stronger in men. Conclusions: Both BMI and weight change contribute to the development of hypertension among the Japanese healthy population, with differences based on sex. Weight reduction may reduce the risk of hypertension for individuals with and without obesity, emphasizing the importance of weight stability through food and nutrition control, particularly for women.

Topiramate treatment of pediatric metabolic dysfunction–associated steatotic liver disease: A descriptive cohort study

AbstractBackgroundMetabolic dysfunction–associated steatotic liver disease (MASLD) is a common disease in children. Lifestyle modification is the primary treatment but difficult to achieve and maintain. Topiramate is a component of an approved weight loss medication (topiramate‐phentermine) in children aged 12 years and older but is more commonly used as a single agent, off‐label, for pediatric obesity. Our aim is to describe change in anthropometrics and laboratory values while providing topiramate treatment of pediatric MASLD.MethodsDescriptive cohort study including patients aged &lt;18 years with MASLD and body mass index (BMI) &gt;95th percentile treated with topiramate for weight loss for ≥3 months from January 1, 2010, to December 30, 2023. The primary outcome was change in serum alanine aminotransferase (ALT) levels from baseline to 3–6 months. Secondary outcomes were changes in BMI z score, glycated hemoglobin, and lipid profile.ResultsOf 43 patients prescribed topiramate, 11 were excluded for nonadherence, leaving 32 (56% boys, 72% non‐Hispanic) for further analyses. With topiramate, ALT levels improved (76 vs 50 U/L, p = 0.001). Further, 43% of patients had either ALT normalization or reduction by &gt;50% from baseline. BMI z score decreased by 0.1 from baseline to 3–6 months. There were no improvements in glycated hemoglobin or lipids. Eight patients (25%) reported mild side effects.ConclusionTopiramate, as an adjunct to lifestyle intervention, may be considered in the treatment of pediatric MASLD, specifically in the context of failed lifestyle modification and inability to tolerate or qualify for other obesity pharmacotherapy.

Evaluation of Body Mass Index as a Marker for Monitoring of Intensive Phase Therapy and Vitamin D Supplementation in Pulmonary TB

Background: In 2022, the success rate of tuberculosis (TB) treatment in Indonesia was 86.50%, which was below the 90.00% target. The decline in nutritional status among TB patients can result from anorexia, leading to inadequate nutrition. In TB patients, the intensive phase of treatment carries a risk of 3,021 times greater for developing malnutrition. It is associated with delayed healing, increasing the risk of death and TB recurrence. This study aimed to observe changes in body mass index (BMI) in TB patients as a marker for measuring the success of the treatment. Methods: This analytical experimental study used a one-group pre-test and post-test design, applying a purposive sampling method. The study sample included all patients diagnosed with TB who met the inclusion and exclusion criteria, with a minimum sample size of 15. Results: As many as 15 new patients were diagnosed with pulmonary TB. Height and weight measurements were taken to determine their BMI. Most respondents had a BMI below normal before therapy, with 6 people (40.00%) classified as thin. After receiving anti-TB drugs and vitamin D therapy for 2 months of intensive treatment, this number decreased to 2 people (13.30%). Results from the paired t-test showed a p-value of &lt; 0.001, indicating a statistically significant difference in nutritional status before and after two months of anti-TB drug and vitamin D therapy. Conclusion: Changes in BMI were observed in pulmonary TB patients after receiving the anti-TB drug therapy and vitamin D for two months during the intensive phase.

The relationship between body mass index changes and mortality in geriatric peritoneal dialysis patients: a case-control study.

The prevalence of chronic kidney disease (CKD) is increasing, reflecting the rising incidence of chronic diseases. With the continuous growth of the global geriatric population, a significant portion of individuals with CKD consists of those aged over 65. Regardless of the chosen treatment method, protein-energy loss in patients undergoing renal replacement therapy (RRT) has been associated with elevated morbidity and mortality rates. This is a retrospective, single-center study of incident adult PD patients on peritoneal dialysis (PD) from 1998 to 2022. We aimed to compare the survival outcomes of geriatric patients on PD with changing BMI measurements. In the geriatric patient group exhibiting a reduced BMI after dialysis initiation, BMI significantly and negatively influenced survival (p = 0.01). The negative effect of BMI on survival was independent of known risk factors such as diabetes mellitus, a history of cardiovascular disease, gender, residual renal function, and history of hemodialysis before peritoneal dialysis (HD before PD) (p = 0.04). Although BMI is easy and extensively measured, it is not considered the perfect monitoring parameter for dialysis patients. However, regular follow-up of BMI, especially in geriatric cases, can be a guiding tool for estimating patients' prognoses.

Reallocating Time Between 24-h Movement Behaviors for Obesity Management Across the Lifespan: A Pooled Data Meta-Analysis of More Than 9800 Participants from Seven Countries.

The distribution of time across physical activity, sedentary behaviors, and sleep appears to be essential for the management of obesity. However, the impact of reallocating time among these behaviors, collectively known as 24-h movement behaviors, remains underexplored. This study examines the theoretical effects of reallocating time between 24-h movement behaviors on obesity indicators across different age groups. We performed a pooled data meta-analysis of 9818 participants from 11 observational and experimental studies. To estimate the time spent in movement behaviors, we reprocessed and harmonized individual-level raw accelerometer-derived data. Isotemporal substitution models estimated theoretical changes in body mass index (BMI) and waist circumference (WC) associated with time reallocation between movement behaviors. We performed the analysis separately for children, adolescents, adults, and older adults. Even minor reallocations of 10min led to significant changes in obesity indicators, with pronounced effects observed when 30min were reallocated. The most substantial adverse effects on BMI and WC occurred when moderate-to-vigorous physical activity (MVPA) was reallocated to other movement behaviors. For 30-min reallocations, the largest increase in BMI (or BMI z-score for children) occurred when MVPA was reallocated to light-intensity physical activity (LPA) in children (0.26 units, 95% confidence interval [CI] 0.15, 0.37) and to sedentary behavior (SB) in adults (0.72kg/m2, 95% CI 0.47, 0.96) and older adults (0.73kg/m2, 95% CI 0.59, 0.87). The largest increase in WC was observed when MVPA was substituted with LPA in adults (2.66cm, 95% CI 1.42, 3.90) and with SB in older adults (2.43cm, 95% CI 2.07, 2.79). Conversely, the highest magnitude of the decrease in obesity indicators was observed when SB was substituted with MVPA. Specifically, substituting 30min of SB with MVPA was associated with a decrease in BMI z-score by - 0.15 units (95% CI - 0.21, - 0.10) in children and lower BMI by - 0.56kg/m2 (95% CI - 0.74, - 0.39) in adults and by - 0.52kg/m2 (95% CI - 0.61, - 0.43) in older adults. Reallocating time away from sleep and LPA showed several significant changes but lacked a consistent pattern. While the predicted changes in obesity indicators were generally consistent across age groups, inconsistent findings were observed in adolescents, particularly for reallocations between MVPA and other behaviors. This investigation emphasizes the crucial role of MVPA in mitigating obesity risk across the lifespan, and the benefit of substituting SB with low-intensity movement behaviors. The distinct patterns observed in adolescents suggest a need for age-specific lifestyle interventions to effectively address obesity. Emphasizing manageable shifts, such as 10-min reallocations, could have significant public health implications, promoting sustainable lifestyle changes that accommodate individuals with diverse needs, including those with severe obesity.

Relationship between gestational body mass index, blood pressure variability, and postpartum depression in pregnant women with pre-eclampsia.

Pre-eclampsia has long been proven to be an independent risk factor for postpartum depression (PPD). Excessive increase in body mass index (BMI) during pregnancy is an important factor inducing pre-eclampsia. Increased blood pressure is the main symptom of patients with pre-eclampsia. However, whether there is a correlation between BMI and blood pressure variability during pregnancy and PPD occurrence in pregnant women with pre-eclampsia remains unclear. To investigate the relationship between BMI, blood pressure variability, and PPD in pregnant women with pre-eclampsia. Using a cross-sectional survey research, 201 pregnant women with pre-eclampsia who were treated and delivered in Suzhou Ninth People's Hospital from May 2016 to June 2024 were selected as this study's subjects. At 42 days after delivery, the subjects were re-examined in the hospital's outpatient department. The Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate whether PPD symptoms, divided the subjects into two groups: The PPD and non-PPD groups. We analyzed clinical data, changes in BMI during pregnancy, and blood pressure variability in the two groups. The Pearson method was used to test the correlation between BMI increase, blood pressure variability during pregnancy, and EPDS score in patients with pre-eclampsia. Logistic regression analysis was performed to explore whether increased BMI and blood pressure variability during pregnancy are influencing factors for PPD occurrence in patients with pre-eclampsia. Of the 201 pre-eclamptic women who underwent an outpatient review 42 days after delivery, 37 had PPD symptoms based on the EPDS scale evaluation, resulting in an incidence rate of 18.41% (37/201). The differences between the PPD and non-PPD groups in terms of age, educational level, place of residence, reproductive history, gestational age, mode of delivery, newborn gender, and newborn birth weight were not statistically significant (P > 0.05). The gestational BMI increase, 24-hour systolic blood pressure (SBP) variability, and 24-hour diastolic blood pressure (DBP) variability in the PPD group were significantly higher than those in the non-PPD group; the differences were statistically significant (P < 0.001). Pearson correlation analysis showed that BMI increase, SBP variability, and DBP variability during pregnancy correlated positively with the EPDS score of pregnant women with pre-eclampsia (r = 0.349, 0.336, and 0.241; P < 0.001). Logistic regression analysis showed that a high increase in BMI during pregnancy [odds ratio (OR) = 4.614, 95% confidence interval (CI): 1.749-12.170, P = 0.002], large variability in 24-hour SBP (OR = 2.910, 95%CI: 1.322-6.404, P = 0.008), and large variability in 24-hour DBP (OR = 2.347, 95%CI: 1.138-4.831, P = 0.021) were factors affecting PPD occurrence in patients with pre-eclampsia. Increased BMI and blood pressure variability during pregnancy can increase the risk of PPD in patients with pre-eclampsia. Strengthening pregnancy guidance and controlling fluctuations in BMI and blood pressure variability during pregnancy within a reasonable range can help reduce the risk of PPD in patients with pre-eclampsia.

Weight and metabolic changes with long-acting cabotegravir and rilpivirine or bictegravir/emtricitabine/tenofovir alafenamide.

Modest weight and lipid changes have been observed in cabotegravir plus rilpivirine long-acting (CAB+RPV LA) Phase 3/3b studies. The SOLAR study included standardized evaluations of weight and metabolic changes in people living with HIV switching to CAB+RPV LA dosed every 2 months (Q2M) vs. continuing bictegravir/emtricitabine/tenofovir (BIC/FTC/TAF). Phase 3b, randomized, open-label study conducted in 118 centres across 14 countries. Participants (n=687) were randomized 2:1; 454 switched to CAB+RPV LA Q2M and 227 continued BIC/FTC/TAF. Participants who started lipid-modifying agents or underwent cosmetic procedures were excluded. We analysed changes in body weight, body mass index (BMI), waist and hip circumferences (WC, HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), muscle mass, body fat, and proportion with insulin resistance or metabolic syndrome at 1 year. Median (interquartile range) change in body weight from baseline was -0.40 kg (-2.95, +2.10) and +0.05 kg (-2.30, +1.95) in the LA and BIC/FTC/TAF arm, respectively. Median (interquartile range) changes in WC and HC were +0.06 cm (-4.50, 4.00) and +0.00 cm (-4.00, 3.97) in the LA arm, and +1.14 cm (-3.00, 5.09) and +0.13 cm (-3.10, 4.00) in the BIC/FTC/TAF arm. There were no clinically relevant changes in WHtR, WHR, or the proportion with metabolic syndrome or insulin resistance in either arm. Standardized changes in weight, BMI, and body composition were minor and similar between participant switching to CAB+RPV LA Q2M or continuing BIC/FTC/TAF, with no clinically relevant changes in metabolic syndrome or insulin resistance.

Effect of the Several Herbal Medicines Mixture on BMI and Lipid Profile -The Animal Study

Objective: Obesity involves complex pathological mechanisms. Multi-herbal formulations targeting diversepathways may provide synergistic therapeutic benefits. This study aimed to evaluate the anti-obesity effects ofa standardized multi-herbal formulation (GUTAC), consisting of Glycyrrhiza glabra, Urtica dioica, Trigonellafoenum-graecum, Artemisia persica and Camellia sinensis Materials and Methods: Obesity was induced in male Wistar rats (n= 30) via a high-fat diet (HFD) forthree months. Subsequently, the rats were divided into three groups (n= 10 per group): (1) HFD alone, (2)HFD with GUTAC, and (3) standard diet (SD) with GUTAC, for an additional three months. Key parameterssuch as body mass index (BMI), blood biomarkers, and histopathological changes in the liver and kidney wereevaluated. Results: BMI was significantly lower in both the HFD+GUTAC and SD+GUTAC groups compared to theHFD group (P&lt; 0.05). Notably, the SD+GUTAC group exhibited a more pronounced BMI reduction,indicating that combining GUTAC with a standard diet yields greater benefits than its combination with ahigh-fat diet. GUTAC treatment significantly reduced blood glucose levels (P= 0.0013), liver enzyme activity(AST and ALT), and improved lipid profiles, including total cholesterol, HDL, LDL, and triglycerides,compared to the HFD group (all P&lt; 0.05). Furthermore, GUTAC enhanced renal function markers (BUN andcreatinine) and mitigated hepatic steatosis, as evidenced by histological analysis. Conclusion: The standardized multi-herbal GUTAC formulation demonstrated significant anti-obesity,hypolipidemic, hepatoprotective, and renoprotective effects in a rat model. These benefits are likely mediatedby the bioactive compounds’ modulation of lipid metabolism, oxidative stress, and inflammatory pathways.These findings highlight GUTAC's potential as a multi-target therapeutic strategy for obesity, warrantingfurther exploration in human clinical trials.

Early response in people with anorexia nervosa receiving cognitive–behavioural therapy for eating disorders (CBT-ED): a latent change study

Objective Early improvement predicts good outcome in psychotherapy for eating disorders. Prior studies have examined change in body mass index (BMI) or Eating Disorder Examination Questionnaire scores (EDE-Q) as indicators of early response, but not both simultaneously. Little research has examined early change among Anorexia Nervosa (AN) samples treated with eating disorder-focussed cognitive behavioural therapy (CBT-ED). We studied the process of early change in a fine-grained way to better understand whether early response predicts later response and post-treatment outcomes in CBT-ED for AN, and how the changes in EDE-Q and BMI are related. Method Adults (N = 193) diagnosed with AN were treated with outpatient CBT-ED. We used bivariate Latent Change Score models to examine change in BMI and EDE-Q and relations between them. Results Early change in BMI was independent of early change in EDE-Q. Larger changes in EDE-Q over the first five weeks of therapy followed smaller ones over the next five weeks, meanwhile smaller changes followed larger ones. Early change was predictive of post-treatment scores. Conclusion Early change in BMI and EDE-Q during CBT-ED appear to be unrelated and follow different trajectories. Therefore, individuals declared as early responders may differ depending on which variable is used for the decision.

Impact of Medically Tailored Meals on Clinical Outcomes Among Low-Income Adults with Type 2 Diabetes: A Pilot Randomized Trial.

Adults with type 2 diabetes (T2DM) and adverse social determinants of health experience barriers to healthful eating, and achieve poorer glycemic control and clinical outcomes. To examine the impact of medically tailored meals (MTM) with medical nutrition therapy (MNT) on clinical outcomes among adults with DM. Pilot randomized controlled trial. English-speaking adults with DM and hemoglobin A1c (A1c) levels > 8% insured by Maryland Medicaid plans. The treatment group received home delivery of 12 medically tailored, frozen meals and a fresh produce bag weekly for 3months, and individual calls with a registered dietitian monthly for 6months in addition to usual care. The control group received usual care. Outcomes were change from baseline to 6months in A1c (primary), body mass index (BMI), blood pressure, food insecurity, and diabetes-related quality of life, knowledge, and self-efficacy (secondary). We randomized 74 adults; 77% completed data collection. The mean age was 48years, 40% were male, 77% were Black, and the mean A1c was 10.3%. Eighty-six percent of meals were delivered, and on average 4.8 nutrition visits were completed. At 6months, both groups had similar improvements in A1c (- 0.7 vs. - 0.6%); the control group reported more favorable changes in diabetes medications. Changes in systolic blood pressure and BMI at 6months did not differ between groups. Diabetes-related quality of life, knowledge, and self-efficacy improved modestly, but not differently by group. Food insecurity decreased significantly from baseline to 3months in the intervention (53 to 17%) compared to control (48 to 44%; p < 0.05), which lessened but remained significant at 6months. Recruitment and retention of an at-risk group of adults with DM was feasible. Intervention uptake was good but did not improve clinical outcomes. More comprehensive and clinically integrated interventions are likely needed to achieve significant clinical benefits. NCT04034511.

Changes in Body Mass Index (BMI) during the COVID-19 Pandemic among Indonesian Adolescents: The Role of Sex, Urban Area, Baseline BMI and Appetitive Traits.

Little is known about how the COVID-19 situation affected weight development among Indonesian adolescents. This longitudinal study examined whether, and for whom the COVID-19 situation affected weight outcomes over time among adolescents from private schools and higher socioeconomic positions (SEP) in Indonesia, where being overweight is a rather prevalent characteristic. This study specifically examined whether appetitive traits (i.e., emotional overeating, food responsiveness), as well as baseline zBMI, sex, and urban area could explain changes in zBMI. At baseline, 411 adolescents from five private schools in Indonesia (53.3 % males, Mage = 12.02 years, SD = 0.45) filled out questionnaires on appetitive traits and background characteristics. In addition, their height and weight were measured. Of these, 336 adolescents (81.8%) also participated at follow-up. At follow-up, height and weight were measured or reported. We used linear regression to analyse the association between predictors and interactions with zBMI. The results showed a significant decrease in zBMI over time, with a lower average zBMI during COVID-19 compared to before COVID-19. Female adolescents and adolescents with higher baseline zBMI values particularly tended to show this zBMI decreasing pattern. We did not find statistically significant main effects of baseline emotional overeating, food responsiveness, and urban area or any interactions. Indonesian adolescents appeared to decrease in terms of zBMI during COVID-19, particularly females and adolescents with higher pre-COVID-19 zBMI. Our findings suggest that (culturally-specific) contextual changes (i.e., less exposure to the Indonesian food environment at schools and more exposure to the home environment) might have a beneficial impact in terms of preventing overweight among Indonesian adolescents, particularly among those being more vulnerable (i.e., having higher baseline zBMI).

Association Between Maximum Lifetime Body Mass Index and Nailfold Capillary Changes in Patients With Type 2 Diabetes Mellitus.

Microvascular changes, such as crossing nailfold capillaries, could be crucial for linking maximum lifetime body mass index (BMI) and microvascular complications in patients with type 2 diabetes mellitus (T2DM). However, the relationship between maximum lifetime BMI and microvascular changes remains elusive. This study aimed to elucidate the relationship between maximum lifetime BMI and the percentage of crossing nailfold capillaries among patients with T2DM. As an extension of a cross-sectional study at Osaka University Hospital, this study was conducted among 63 patients with T2DM aged 40-75 years. Maximum lifetime BMI data were extracted from medical records, and nailfold capillaroscopy was applied to assess capillary morphology, following the simple capillaroscopic definitions established by the European Alliance of Associations for Rheumatology Study Group. The association between maximum lifetime BMI and percentage of crossing fingernailfold capillaries was evaluated using multiple linear regression, adjusting for potential confounders such as age, sex, obesity status at the time of the survey, and other diabetes-related factors. After adjusting for confounding factors, maximum lifetime BMI was significantly correlated with higher crossing capillary percentage (standardized regression coefficients: 0.47; P= 0.026). BMI at the time of the survey showed no significant association with the percentage of crossing capillaries (standardized regression coefficients: -0.21; P = 0.381). Maximum lifetime BMI was associated with a higher percentage of crossing capillaries in patients with T2DM, rather than obesity status at the time of the survey. These results emphasize the importance of lifelong weight management in the prevention of T2DM and its complications and highlight the necessity of considering maximum lifetime BMI alongside current BMI in the management of patients with T2DM.

Genetic Risk, BMI Status, BMI Change Patterns, and the Risk of Steatotic Liver Disease and Liver Enzyme Elevation in Chinese Adults.

Background/Objectives: Whether an increased genetic risk of steatotic liver disease (SLD) can be offset by maintaining a healthy weight remains unknown. We aimed to clarify the associations among the body mass index (BMI) and its change patterns with SLD and assess whether genetic susceptibility can modify these associations in Chinese people. Methods: A total of 10,091 and 6124 participants from the Health Omics Preventive Examination (HOPE) Program were enrolled in cross-sectional and follow-up analyses, respectively. BMI change patterns were defined according to the BMI at baseline and the last follow-up visit. Genetic risk was estimated using the polygenic risk score (PRS) derived from variants in PNPLA3, TM6SF2, MBOAT7, and GCKR. Data were analyzed using logistic regression models and Cox proportional-hazards models. Results: The analyses of the BMI and genetic risk simultaneously showed a dose-response association with the risk of SLD (p-trend < 0.001). Significant interactions between BMI and PRS were found for alanine aminotransferase (ALT) elevation (p = 0.007) and aspartate aminotransferase (AST) elevation (p < 0.001). Weight loss led to a 71%, 60%, and 67% lower risk of SLD, ALT elevation, and AST elevation, compared with stable overweight/obesity. A significant interaction between the genetic risk and BMI change patterns in ALT elevation was observed (p = 0.008). The absolute risk reductions associated with weight loss were greater for participants at a high genetic risk (26.60, 12.29, and 9.31 per 100 person years for SLD, ALT elevation, and AST elevation, respectively). Conclusions: Maintaining a healthy weight reduces the liver injury risk among all individuals, and the risk reduction is greater among the subset with a high genetic risk of SLD.

The Association Between Longitudinal Changes in Body Mass Index and Longitudinal Changes in Hours of Screen Time, and Hours of Physical Activity in German Children

ABSTRACTIntroductionThe association of screen time and physical activity with body weight in children has been investigated in cross‐sectional and prospective studies, as well as randomized controlled trials. The present study extends previous research by examining how longitudinal within‐person changes in screen time and physical activity relate to changes in Body Mass Index (BMI) in children, and how changes in screen time and physical activity relate to each other.MethodsThe data for the present study came from the PIER Youth Study. Data were collected from 971 children and their parents at two time points approximately 1 year apart. A multilevel modeling approach with measurement occasions nested within children was used to model changes in BMI across age.ResultsWithin a child, a change in daily hours of TV viewing was associated with a corresponding change in BMI, whereas a change in daily hours of physical activity was associated with an opposite change in BMI. Within‐person correlations between changes in screen time and physical activity were small but positive.ConclusionThe present findings have important implications for interventions to reduce and prevent childhood overweight and obesity. Specifically, interventions should focus on both reducing daily TV viewing and promoting physical activity.

Association of early life cardiovascular risk factors with grey matter structure in young adults in the United Kingdom: the ALSPAC study

Cumulative exposures to obesity, hypertension, and physical inactivity from midlife (40-65 years) onwards are three known cardiovascular risk factors for dementia and associated cerebral structural damage. Exactly how early in the lifespan sensitive periods for exposure to these risk factors begin is yet to be established, specifically with respect to onset of cerebral structural changes. We aimed to investigate whether cardiovascular risk across childhood and adolescence is already associated with cerebral structure in regions previously linked with dementia, during young adulthood. Participants were selected from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort of young people, if they had participated in a neuroimaging sub-study (N=862). We entered data from repeated clinical assessments into mixed-effects models to estimate baseline and rate of change in body mass index (BMI) and mean arterial pressure (MAP) between ages 7-17 years, and physical activity (PA) between 11-15 years. Linear models assessed whether cardiovascular risk factors were associated with grey matter macrostructural indices (cortical thickness, surface area, volume) in young adulthood (∼20 years). BMI was found to be associated with grey matter macrostructure in nodes of Default Mode Network previously found to show atrophy in dementia. Baseline BMI was associated with thickness of precuneus cortex and entorhinal surface area, whilst rate of change in BMI across childhood and adolescence was associated with thickness of parahippocampal and middle temporal gyri and inferior parietal cortex in addition to entorhinal and parahippocampal surface area. Further, we identified associations between baseline MAP and PA and entorhinal surface area. Exploratory whole-brain analyses revealed associations between baseline and rate of change in these cardiovascular risk factors and the cortical thickness, surface area, and volume of broader groups of cortical and subcortical regions. Findings provide preliminary evidence that cerebral structural differences in regions linked to dementia in old age may be legacy of developmental differences associated with cardiovascular risk exposure during early life. This has relevance for lifespan models of dementia risk and timing of preventative interventions. Further work is required to generalise findings beyond this predominantly white, male, and middle-class sample to more diverse cohorts. NIHR Oxford Health BRC (NIHR203316), Wellcome Trust (203139/Z/16/Z).