Greater Increase In Body Mass Index Research Articles

Trend analysis, gender-specific patterns, and age dynamics of childhood and adolescent obesity: insights from the Tehran lipid and glucose study

BackgroundChildhood and adolescent obesity pose significant challenges to global health, with escalating prevalence and associated short- and long-term health consequences. This longitudinal study leveraged data from the Tehran Lipid and Glucose Study (TLGS) to investigate the trends of obesity among Tehranian children and adolescents over a 21-year period.MethodsUtilizing data from TLGS phases I to VII (1999–2021), we included 3845 participants aged 3–18 years at the beginning of phase I. Anthropometric measures, including height and weight, were collected, and body mass index (BMI) was calculated. Childhood obesity (2–19 years) was defined as BMI-for-age > 2SD based on World Health Organization (WHO) standards, and adult obesity was defined as BMI ≥ 30. Descriptive statistics, trend analysis, prevalence calculations, odds ratios, and interaction analyses were employed for data interpretation.ResultsThe mean BMI increased from 18.46 ± 4.37 kg/m² at Phase I to 26.36 ± 5.03 kg/m² at Phase VII. Boys exhibited a greater increase in BMI than girls, and age at study entry influenced BMI trajectories. The prevalence of obesity rose from 6.4% at Phase I to 21.5% at Phase VII, with a more pronounced increase in boys. Odds ratios for obesity steadily increased across phases, indicating a growing risk. Interaction analyses revealed age-specific dynamics, with older participants demonstrating lower odds ratios initially but higher odds ratios in later phases.ConclusionOur study shows a worrisome increase in childhood obesity among Tehranian children and adolescents over 21 years. Sex- and age-specific trends emphasize the necessity for targeted interventions, informing policymakers, healthcare practitioners, and educators regarding public health strategies and interventions against the obesity epidemic.

Trends in Body Mass Index Among Individuals With Neurodevelopmental Disorders

Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are increasingly common. Individuals with NDDs have heightened obesity risks, but long-term data on body mass index (BMI) trends over time in this population are lacking. To assess secular BMI changes from 2004 to 2020 among children with NDDs compared with those without NDDs. This repeated cross-sectional study used data from the Child and Adolescent Twin Study in Sweden. Children born between January 1, 1992, and December 31, 2010, were screened for neurodevelopmental symptoms using the Autism-Tics, ADHD, and Other Comorbidities inventory between July 2004 and April 2020 when they were 9 or 12 years of age. Data analysis was conducted between September 27, 2023, and January 30, 2024. BMI percentiles (15th, 50th, and 85th) were modeled using quantile regression and compared between youths with and without NDDs. Secular changes in BMI percentiles over time spanning 2004 to 2020 were evaluated and stratified by NDD subtype. The cohort included 24 969 Swedish twins (12 681 [51%] boys) born between 1992 and 2010, with mean (SD) age of 9 (0.6) years. Of these, 1103 (4%) screened positive for 1 or more NDDs, including ADHD, ASD, and/or learning disability. Results indicated that at the 85th BMI percentile, there was a greater increase in BMI from 2004 to 2020 among youths with NDDs compared with those without NDDs (β for interaction [βint] between NDD status and time, 1.67; 95% CI, 0.39-2.90). The greatest divergence was seen for ASD (βint, 2.12; 95% CI, 1.26-3.70) and learning disability (βint, 1.92; 95% CI, 0.65-3.82). Within the latest cohort (2016-2020), the 85th BMI percentile was 1.99 (95% CI, 1.08-2.89) points higher among children with NDDs compared with those without NDDs. In this repeated cross-sectional study, at the higher end of the BMI distribution, children with NDDs had significantly greater increases in BMI compared with peers without NDDs over a 16-year period, highlighting an increasing risk of overweight over time in youths with NDDs compared with those without NDDs. Targeted obesity prevention efforts for this high-risk population are needed.

Childhood Maltreatment and Body Mass Index in Older Adults With Chronic Illness

BackgroundChildhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing coronary artery disease (CAD). Emotional dysregulation and increased body mass index (BMI) may be involved. This study evaluated whether (1) childhood maltreatment is associated with a higher BMI at study onset and with greater increases in BMI 5 years later among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status moderate these results; and (3) baseline symptoms of anxiety, depression, and perceived stress (emotional dysregulation) mediate the association between childhood maltreatment and BMI at follow-up. MethodsA total of 1232 men and women (aged 60.86 [6.95] years) completed validated questionnaires on childhood maltreatment and symptoms of psychological distress. The weight and height of the participant were measured, and the BMI was calculated using the weight (kg)/height (m2) ratio. ResultsChildhood maltreatment was not significantly associated with BMI at study onset nor at follow-up. This relation did not differ as a function of sex nor CAD status. Although childhood maltreatment was associated with significantly greater psychological distress at study onset (all P < 0.001), there latter was not found to mediate the relation between maltreatment and change in BMI at follow-up. ConclusionsIn contrast to previous literature, childhood maltreatment was not associated with BMI nor with the change in BMI over 5 years in men and women with chronic disease. However, as psychological distress increases risk for morbidity and mortality, it may represent an important target for prevention and intervention in survivors of childhood maltreatment.

Effects of changes in residential fast-food outlet exposure on Body Mass Index change: longitudinal evidence from 92,211 Lifelines participants

BackgroundEvidence on the association between fast-food outlet exposure and Body Mass Index (BMI) remains inconsistent and is primarily based on cross-sectional studies. We investigated the associations between changes in fast-food outlet exposure and BMI changes, and to what extent these associations are moderated by age and fast-food outlet exposure at baseline.MethodsWe used 4-year longitudinal data of the Lifelines adult cohort (N = 92,211). Participant residential addresses at baseline and follow-up were linked to a register containing fast-food outlet locations using geocoding. Change in fast-food outlet exposure was defined as the number of fast-food outlets within 1 km of the residential address at follow-up minus the number of fast-food outlets within 1 km of the residential address at baseline. BMI was calculated based on objectively measured weight and height. Fixed effects analyses were performed adjusting for changes in covariates and potential confounders. Exposure-moderator interactions were tested and stratified analyses were performed if p < 0.10.ResultsParticipants who had an increase in the number of fast-food outlets within 1 km had a greater BMI increase (B(95% CI): 0.003 (0.001,0.006)). Decreases in fast-food outlet exposure were not associated with BMI change (B(95% CI): 0.001 (-0.001,0.004)). No clear moderation pattern by age or fast-food outlet exposure at baseline was found.ConclusionsIncreases in residential fast-food outlet exposure are associated with BMI gain, whereas decreases in fast-food outlet exposure are not associated with BMI loss. Effect sizes of increases in fast-food outlet exposure on BMI change were small at individual level. However, a longer follow-up period may have been needed to fully capture the impact of increases in fast-food outlet exposure on BMI change. Furthermore, these effect sizes could still be important at population level considering the rapid rise of fast-food outlets across society. Future studies should investigate the mechanisms and changes in consumer behaviours underlying associations between changes in fast-food outlet exposure and BMI change.

Clinical and biochemical predictors of longitudinal changes in left atrial structure and function: A general population study.

There is a need for better understanding the factors that modulate left atrial (LA) dysfunction. Therefore, we determined associations of clinical and biochemical biomarkers with serial changes in echocardiographic indexes of LA function in the general population. We measured LA maximal and minimal volume indexes (LAVImax and LAVImin) by echocardiography and LA reservoir strain (LARS) by two-dimensional speckle-tracking in 627 participants (mean age 50.8 years, 51.2% women) at baseline and after 4.8 years. During follow-up, LARS decreased significantly in men (-.90%, P=.033) but not in women (-.23%, P= .60). In stepwise regression analysis, stronger decrease in LARS over time was associated with male sex, a higher age, body mass index (BMI), mean arterial pressure (MAP) and serum insulin at baseline and with a greater increase in BMI and MAP over time (P≤.018). Similarly, an increased risk of developing or retaining abnormal LARS was observed in older participants, in subjects with a higher baseline BMI, MAP, heart rate (HR), troponin T and ΔMAP, and in those who used β-blockers at baseline. Both LAVImax and LAVImin increased significantly over time (P≤.0007). This increase was associated with a higher baseline age, pulse pressure and a lower HR at baseline and a greater increase in pulse pressure over time (P≤.029). Higher serum insulin and D-dimer were independently associated with a stronger increase in LAVImin (P≤.0034). Subclinical worsening in LA dysfunction was associated with older age, hypertension, obesity, insulin resistance and troponin T levels. Cardiovascular risk management strategies may delay LA deterioration.

Impact of elexacaftor/tezacaftor/ivacaftor on lipid and fat-soluble vitamin levels and association with body mass index.

Cystic fibrosis transmembrane conductance regulator (CFTR) modulators improve gastrointestinal absorption of nutrients and may result in changes in body mass index (BMI), serum lipids, and fat-soluble vitamin levels. We hypothesized that serum lipids and vitamin levels would increase with CFTR modulator therapy and that greater increase in lipids and vitamin levels would be related to greater increase in BMI. A retrospective study was performed to evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) on nutritional parameters, serum lipids, and fat-soluble vitamin levels. Pre-ETI values (<2 years prior) and post-ETI values (>1 month after) were compared. Linear regression was used to evaluate whether change in BMI is associated with the change in lipid and/or vitamin levels and whether modulator duration is associated with the degree of rise in lipid and/or vitamin levels. Adults and adolescents with CF (n = 137) were evaluated before and 31-300 days after starting ETI. Median BMI (adults 21.9 vs. 23.5 kg/m2 ; adolescents 48 vs. 63 percentile) increased after initiation of ETI. Total cholesterol (126 vs. 154 mg/dL), low-density lipoprotein cholesterol (63 vs. 78 mg/dL), non-high-density lipoprotein cholesterol (84 vs. 102 mg/dL), and high density lipoprotein cholesterol (43 vs. 49 mg/dL) increased after ETI, while triglycerides and very low density lipoprotein did not change. Median values for vitamin D (34.5 vs. 38.0 ng/mL) and vitamin A (40.1 vs. 47.9 µg/dL) increased, while vitamin E did not change significantly. There was no significant correlation between BMI change or duration of modulator therapy with vitamin levels or lipid changes. After initiation of ETI therapy, serum lipids increased in our population, but most values remained within the normal range. Vitamins A and D levels increased post-ETI and no changes were noted in vitamin E. No significant correlation between the degree of BMI change and the magnitude of increase in lipids or vitamin levels was found.

METHYLATION RISK SCORES ARE ASSOCIATED WITH CARDIOVASCULAR RISK FACTORS IN OLDER US ADULTS

Abstract DNA methylation risk scores (MRS) are biomarkers that may prove clinically useful by enabling earlier prevention and individualized treatment of cardiovascular diseases (CVD). However, it is unclear whether relationships between methylation and CVD risk factors differ by demographics or health behaviors. Using existing epigenome-wide association studies, we created MRSs for eight CVD risk factors: systolic and diastolic blood pressure, body mass index (BMI), C-reactive protein (CRP), low- and high-density lipoprotein cholesterols (LDL-C, HDL-C), triglycerides (TG), and fasting glucose. Methylation was measured in whole blood samples from Health and Retirement Study participants (N=3,996, mean age=69.5 years). In linear regression, each MRS was positively associated with its corresponding CVD risk factor after controlling for demographics and health behaviors (all p&amp;lt; 0.001). Adding interaction terms between each MRS and age, gender, or alcohol use revealed differences in MRS associations with their corresponding CVD risk factors across groups: higher MRSs were associated with greater increases in BMI, HDL-C, and TG in younger participants than older participants, greater increases in BMI and HDL-C in females than males, and a greater increase in CRP in non-drinkers than heavy drinkers (≤65 years old: &amp;gt;2 per day for males and &amp;gt;1 per day for females; &amp;gt;65 years old: &amp;gt;1 per day for both genders). In conclusion, some MRSs for CVD risk factors have stronger associations in younger adults, women, and non-drinkers. Additional research is needed to better understand the potential clinical utility of MRSs for early CVD prevention and intervention.

Abstract 16730: Neighborhood Deprivation and Left Ventricular Mass in Women, NGHS Longitudinal Cohort Analysis

Left ventricular hypertrophy is an independent predictor of cardiovascular disease. Neighborhood level deprivation is a risk factor for increased morbidity and mortality for a variety of diseases and conditions. However, to date, no study has assessed the relationship between neighborhood level deprivation and left ventricular hypertrophy. Methods: The NHLBI National Growth and Health Study (NGHS) is a 36-year longitudinal study of 871 women (50% white/50% Black). All participants were enrolled between 9-10 years of age in 1987. Annual assessments of anthropometric, echocardiographic and neighborhood level deprivation data, between the ages of 20-28 years (visits 11-17), were analyzed. We assessed the relationship between quartiles of deprivation index (DI) (high/worst, moderately high, moderately low, low/best) at ~age 20 years with levels of systolic blood pressure (SBP), body mass index (BMI) and indexed left ventricular mass (LVMI, g/m 2.7 ), between ages 20-28, adjusting for race. Results: Data from 531 (55% Black) women were examined. Compared to the lowest DI quartile, the highest DI quartile exposure at ~20 years was associated with a 3.37 [1.34, 8.44] greater odds of BMI &gt; 30 (obesity) at age 28, p=0.01 . An interaction between visit and DI quartile was significant, such that women in the highest DI quartile at age 20 had greater increases in BMI by age 28 than those in lower DI quartiles ( p=0.001 , Figure 1). There was no significant relationship between SBP and DI quartile in this cohort (data not shown). Compared with women who resided in the lower 2 DI quartiles at age 20, the LVMI of women exposed to higher (worse) DI was significantly greater after age 23 (visit 14 , p&lt;0.05 , Figure 2). Conclusion(s): In summary, increased deprivation is associated with increased BMI in young adult women, adjusting for race. In addition, increased deprivation is also associated with greater indexed left ventricular mass, an independent predictor of cardiovascular disease.

69 Influence of Cardiovascular Risk Factors on Neuropsychological Trajectories in Black/African American Adults Living with HIV

Objective:Human immunodeficiency virus (HIV) type 1 (HIV-1), cardiovascular disease, and HIV-associated neurocognitive disorders (HAND) disproportionately affect Black/African American individuals compared to other racial and ethnic groups. Understanding the mechanisms of cognitive health disparities is essential for developing policy and health interventions to combat such disparities. Cardiovascular risk factors/diseases are common comorbidities that likely contribute to cognitive health disparities among Black/African American people living with HIV (PWH), but their impacts on cognition longitudinally in this population are unclear. The current study examines the relationship between cardiovascular risk and cognitive functioning over time in Black/African American adults living with HIV.Participants and Methods:A sample of 122 Black/African American adults with HIV (ages 25-68, M=51.8, SD=7.7; 98% on antiretroviral therapy; 91% with undetectable viral load) were selected from the Drexel/Temple Comprehensive NeuroHIV Center, Clinical and Translational Research Support Core (CTRSC; based at Drexel University College of Medicine) Cohort. They completed longitudinal visits (300 total visits, average follow-up time=4.9 years) that included clinical interviews, medical record review, biometric measurements, and comprehensive neuropsychological assessments. Cardiovascular risk factors of interest were body mass index (BMI), waist-to-height ratio (WHtR), and a total vascular risk burden score (VBS) representing five risk factors: obesity, central obesity, diabetes, hyperlipidemia, and hypertension. Based on a prior principal component analysis, three cognitive domains were examined: (1) verbal fluency, (2) visual memory/visuoconstruction, and (3) motor speed/executive functions. Mixed models were used to examine domain-specific cognitive trajectories in relation to baseline cardiovascular risk factors and changes in cardiovascular risk factors.Results:Overall, cognitive test performance improved over time (p&lt;.003). Baseline VBS was marginally associated with longitudinal change in verbal fluency (p=.06). Participants with low baseline VBS (0-1 risk factors) demonstrated improvement in verbal fluency (p=.002), while those with higher VBS (2-5 risk factors) demonstrated stability in verbal fluency. In contrast, greater increases in BMI and in WHtR predicted more favorable trajectories in motor speed/executive function (both p&lt;.001). Patients with increasing BMI over time improved in this domain (p=.02), while patients with stable or decreasing BMI did not. A similar pattern was observed for WHtR change. No vascular risk factors were associated with trajectories of visual memory/visuoconstruction.Conclusions:Higher total vascular risk burden was associated with less favorable verbal fluency trajectories, reflecting the negative cognitive consequences of disorders such as diabetes, hyperlipidemia, and hypertension. Unexpectedly, greater increases in BMI and WHtR were associated with more favorable trajectories in motor speed and executive functioning. In this population, weight gain may be a proxy for other positive health factors, such as immune reconstitution, which will be examined in future analyses. Taken together, cardiovascular risk factors have heterogeneous associations with cognitive trajectories, emphasizing the importance of examining the mechanisms of these varying relationships. Future research will examine how social determinants of health, such as racial/ethnic discrimination, contribute to disparities in cardiovascular risk factors and cognitive outcomes.

Long-Term Health Outcomes of Limb Salvage Compared with Amputation for Combat-Related Trauma.

There are little long-term health data, particularly in terms of body composition and development of metabolic syndromes, to help surgeons to guide the decision between limb salvage and amputation in patients with limb-threatening trauma. The purpose of this study was to compare long-term health outcomes after high-energy lower-extremity trauma between patients who underwent attempted flap-based limb salvage or amputation. We performed a retrospective review of servicemembers with a minimum 10-year follow-up who underwent flap-based limb salvage followed by unilateral amputation or continued limb salvage after combat-related, lower-extremity trauma between 2005 and 2011. Patient demographic characteristics, injury characteristics, and health outcomes including body mass index (BMI) and development of metabolic disease (e.g., hyperlipidemia, hypertension, heart disease, and diabetes) were compared between treatment cohorts. Adjusted BMIs were calculated for the amputation cohort to account for lost surface area. We performed multivariable and propensity score analysis to determine the likelihood of developing obesity or metabolic disease. In this study, 110 patients had available long-term follow-up (mean, 12.2 years) from the time of the injury. Fifty-six patients underwent limb salvage and 54 patients underwent unilateral amputation. There was no difference in preinjury BMI (p = 0.30). After adjusting for limb loss, the amputation cohort had a trend toward higher BMIs at ≥1 years after the injury, a higher rate of obesity, and a greater increase in BMI from baseline after the injury. The development of metabolic comorbidities was common after both amputation (23 [43%] of 54) and limb salvage (27 [48%] of 56). With the numbers available, we were unable to demonstrate a difference in risk for the development of hypertension, hyperlipidemia, diabetes, heart disease, or any comorbidity other than obesity (p > 0.05). Amputations may be medically necessary and may decrease pain, improve mobility, and/or expedite return to activity compared with limb salvage after similar injuries. However, limb loss may negatively impact metabolic regulation and may contribute to a higher risk of obesity despite beneficial effects on mobility. Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

Postoperative hypothyroidism and body weight dynamics in patients operated on for diffuse toxic goiter

Postoperative hypothyroidism is a consequence of thyroidectomy. However, observation of patients with diffuse toxic goiter (DTG) after thyroidectomy shows that achieving euthyroidism while taking L-thyroxine, as well as maintaining weight in some cases, is difficult or not possible at all. Thus, the study of thyroid function and body weight dynamics in the first year after thyroidectomy remains an urgent task of clinical thyroidology.Aim. To study thyroid function and body weight dynamics in patients with DTG after various types of surgical treatment.Material and methods. The study included 310 patients with DTG (234 women — 75,5% and 76 men — 24,5%), the average age was 46,46±0,99 years. In all patients with DTG before surgery, after 1 month and 1 year after the operation, the results of hormonal examination (levels of thyroid-stimulating hormone (TSH), free T4), body weight dynamics were evaluated. Levels of TSH and free T4 was determined by enzyme immunoassay. To assess the dynamics of body weight one year after the operation, depending on the change in weight, the patients were divided into 3 groups: group 1 — body weight decreased by more than 5%; group 2 — body weight did not change; group 3 — body weight increased by more than 5%. Statistical analysis of the study results was performed using the SPSS 16.0 program (SPSS Inc., USA).Results. Before surgical treatment, blood TSH levels were normal in all patients, and there were no differences between the groups (p=0,94). In patients after subtotal resection, the average level of TSH in the blood after 1 month. after surgery was significantly higher (p=0,02) than in patients who underwent extirpation of the thyroid gland (TG). Blood TSH was monitored in all patients 1 year after surgery. In patients with thyroid extirpation, the level of TSH in the blood was significantly higher compared to patients who underwent organ-preserving surgery (p=0,01).Next, the body mass index (BMI) was analyzed in the examined groups of patients. When analyzing the BMI of patients before and after surgery, there were no significant differences in both groups: group 1 — before surgery BMI 25,67±0,57 kg/m2, after surgery 25,87±0,60 kg/m2; group 2 — before surgery BMI 25,13±0,40 kg/m2, after surgery 25,67±0,46 kg/m2. In group 1, there was a decrease in weight after surgery during the first year in 14,9% of patients, while in group 2 only in 7,2% of patients (p=0,01). Weight gain was high in both groups: in group 1 — 20,7%, in group 2 — 29,0%, but in the group after thyroidectomy was significantly higher (p=0,04). In patients with weight gain, a positive correlation was found between weight gain during the year and blood TSH 1 year after surgery (p=0,02, r=0,247).Conclusion. The obtained results suggest that after thyroidectomy performed for DTG, patients have a significantly greater increase in BMI and uncompensated hypothyroidism is more common than in patients after subtotal resection of the thyroid gland.

ODP619 Trends in Obesity in Gender Diverse Adolescents in Northern Nevada

Abstract Obesity in the pediatric population is increasing with 19.3% of adolescents having a body mass index (BMI) at or above 95th percentile. Childhood obesity impacts physical and psychological health, increasing the risk of developing various diseases. Studies show that prevalence of gender diverse (GD) adolescents is increasing and is estimated to be 7 per 1000 in the US. GD adolescents are at increased risk for cardiovascular disease and mental health disorders. GD adolescents who are diagnosed with obesity are at an increased risk for poor health outcomes. There is a lack of research regarding the prevalence of obesity and the impact of hormone therapy in GD adolescents. A retrospective chart review was conducted at Renown Regional Medical Center in Reno, NV. A total of 119 adolescents, aged 8-21, diagnosed with gender dysphoria prior to June 2021, were enrolled using ICD-10 codes. Patient demographics including age, sex assigned at birth, gender identity, BMI, and use of puberty blockers or hormone therapy were retrieved. Patients were categorized into two groups - no treatment and treatment with puberty blockers and/or testosterone. Average change in BMI was calculated. Fisher exact tests were conducted using SAS version 9.4. Nineteen of the 119 GD patients enrolled were classified as obese using age and sex appropriate BMI charts (15.9%). Thirteen participants were assigned female at birth (AFAB) and six were assigned male at birth (AMAB). Of these participants, 12 had no medical interventions and 7 were treated with puberty blockers and/or without testosterone. No participants received estrogen therapy. The average change in BMI was +1.84 (no treatment group) and + 3.70 (treatment group). The average change in BMI for AFAB participants was +2.24 and +3.16 for AMAB participants. Association of obesity with treatment compared to no treatment was not found to be statistically significant (p=0.4125). The prevalence of obesity in this population was similar to the prevalence of obesity in non-GD adolescents regionally. In Nevada, obesity in adolescents age 10-17 increased from 12.9% to 16% from 2018-2021. We expected to observe a higher prevalence of obesity in the adolescent GD population compared to the non-GD pediatric population. Additionally, we expected to see a greater increase in BMI in the group of GD patients receiving treatment. Although the results were not statistically significant, patients undergoing treatments did experience a greater average increase in BMI compared to those who had no medical intervention. The lack of statistical significance is likely due to having a small sample size. Further research is needed to observe obesity trends in adolescent GD populations, as well as the effects of hormone therapy on BMI. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Integrase Strand Transfer Inhibitors &amp; Weight Gain in Children with Perinatal HIV

Background: In the past, HIV infection was associated with weight loss due to metabolic wasting. Now with early initiation of antiretroviral therapy (ART) an increasing number of patients are being classified as overweight/ obese both prior to initiation and during the course of ART. Certain integrase strand transfer inhibitors (INSTIs) have been associated with weight gain in the adult population, but data in the pediatric population is lacking. This study explores the association of ART with an INSTI backbone and changes in weight and body mass index (BMI) in children with perinatal HIV who are followed in the HIV clinic at Riley Hospital.&#x0D; Methods: We performed a retrospective review of 59 patients with perinatally acquired HIV from 2016 to 2021. Weight, BMI, z-score, blood pressure (BP) percentiles, and lipid panels were recorded from the patients’ most recent visit. BMI and BP percentiles were compared between patients on Bictegravir, Dolutegravir, and Elvitegravir. For patients currently on an INSTI-backbone ART regimen, BMI was compared before and up to 5 years after INSTI initiation.&#x0D; Results: In our cross-sectional analysis between patients on Bictegravir, Dolutegravir, and Elvitegravir there was no significant difference in BMI (p=0.859), systolic BP percentile (p=0.188), or diastolic BP percentile (p=0.541). In our longitudinal analysis, we observed a significant increase in BMI over 3 years compared to pre-INSTI initiation (p=0.049). In addition, we observed an upwards trend with patients on Bictegravir (p=0.094) and Elvitegravir (p=0.121).&#x0D; Conclusion/Impact: Our study suggests that ART regimens with an INSTI backbone are associated with greater increases in BMIs. Our study is limited by a small n, but provides pilot data to direct future studies. It also illustrates that emphasis on healthy body weight maintenance may be necessary when patients are placed on ART regimens with INSTI backbones.

Development of Children's Actual and Perceived Motor Competence, Cardiorespiratory Fitness, Physical Activity, and BMI.

To examine synergistic associations between developmental trajectories of motor competence, perceived motor competence, cardiorespiratory fitness, moderate-to-vigorous physical activity (MVPA), and body mass index (BMI) from late childhood to adolescence. In this 3-yr follow-up study, motor competence, perceived motor competence, cardiorespiratory fitness, MVPA, and BMI were assessed in 1167 Finnish school-age children (girls = 583, boys = 565; Mage = 11.27 ± 0.33). Moderate-to-vigorous physical activity was measured using hip-mounted accelerometers. Developmental trajectories were analyzed using latent growth curve modeling. The development of motor competence, cardiorespiratory fitness, and BMI was positive over time, whereas the development of perceived motor competence and physical activity was negative. The development of BMI was inversely associated with the development of cardiorespiratory fitness and physical activity. In the transition from late childhood to adolescence, motor competence, cardiorespiratory fitness, and BMI increased, and perceived motor competence and physical activity decreased. However, individual variance in the developmental trajectories was significant. Moreover, children with a greater increase in BMI showed a greater decrease in cardiorespiratory fitness and physical activity from late childhood to adolescence.

Weight Goals, Disordered Eating Behaviors, and BMI Trajectories in US Young Adults

BackgroundCommunity sample data indicate that weight control efforts in young adulthood may have associations with greater increases in body mass index (BMI) over time.ObjectiveTo determine the prospective associations between weight goals and behaviors in young adults and BMI trajectories over 15-year follow-up using a nationally representative sample.DesignLongitudinal cohort data collected from 2001 to 2018 of the National Longitudinal Study of Adolescent to Adult Health.ParticipantsYoung adults aged 18–26 years old at baseline stratified by gender and BMI category.Main MeasuresPredictors: weight goals, any weight loss/maintenance behaviors, dieting, exercise, disordered eating behaviors. Outcomes: BMI at 7- and 15-year follow-up.Key ResultsOf the 12,155 young adults in the sample (54% female, 32% non-White), 33.2% reported a goal to lose weight, 15.7% to gain weight, and 14.6% to maintain weight. In unadjusted models, all groups have higher mean BMI at 7- and 15-year follow-up. In mixed effect models, goals to lose weight in men with BMI < 18.5 (5.94 kg/m2; 95% CI 2.58, 9.30) and goals to maintain weight in men with BMI ≥ 25 (0.44; 95% CI 0.15, 0.72) were associated with greater BMI increase compared to no weight goal. Engaging in disordered eating behaviors was associated with greater BMI increase in men with BMI < 18.5 (5.91; 2.96, 8.86) and women with 18.5 ≤ BMI < 25 (0.40; 0.16, 0.63). Dieting (− 0.24; − 0.41, − 0.06) and exercise (− 0.31; − 0.45, − 0.17) were associated with lower BMI increase in women with 18.5 ≤ BMI < 25. In women with BMI < 18.5, dieting was associated with greater BMI increase (1.35; 0.33, 2.37).ConclusionsWeight control efforts may have variable effects on BMI over time by gender and BMI category. These findings underscore the need to counsel patients on the effectiveness of weight control efforts and long-term weight management.

Longitudinal Associations of Fitness and Obesity in Young Adulthood With Right Ventricular Function and Pulmonary Artery Systolic Pressure in Middle Age: The CARDIA Study.

BackgroundLow cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood.Methods and ResultsParticipants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow‐up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow‐up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable‐adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow‐up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age.ConclusionsHigher CRF in young adulthood and less decline in CRF over time are each significantly associated with better RV systolic function. Higher baseline BMI and greater age‐related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.

Maternal Stress Moderates the Relationship of Food Insufficiency with Body Mass Index Trajectories from Childhood to Early Adulthood among U.S. Rural Youth.

Background: Findings on the relationships between household food insufficiency (HFI), maternal stress, and youth body mass index (BMI) are mixed, possibly due to cross-sectional study designs and measurement issues. Furthermore, little is known about how childhood exposure to HFI and maternal stress influences BMI into young adulthood among rural youth. We aimed to determine the independent and moderating relationships of HFI and maternal perceived stress on youth BMI trajectories from age 9 to 24 years. Methods: We used longitudinal data from rural New York youth (n = 341). At youth age 9 years, parents reported HFI using a reliable one-item measure, and mothers responded to the 10-item Perceived Stress Scale (PSS; range: 0-40). BMI was calculated (kg/m2) from objective measures of height and weight at 9, 13, 17, and 24 years. Multivariate random-intercept trajectory models estimated the relationships of HFI and PSS on BMI trajectories (p < 0.05 for main effects, p < 0.10 for interactions). Results: At age 9 years, 16.4% experienced HFI and mean (standard deviation) BMI and PSS were 18.4 (3.6) kg/m2 and 7.7 (2.9), respectively. HFI and PSS were not associated with BMI trajectories (p = 0.18, p = 0.64, respectively), but their interaction was significant (p < 0.01). Each one-unit increase in PSS was associated with 0.6 (0.2) kg/m2 higher mean change in BMI trajectories for youth in food-insufficient, compared with food-sufficient, households. Conclusions: Higher levels of maternal stress in food-insufficient households may lead to greater increases in BMI from childhood to young adulthood. Public health interventions should simultaneously address parental stress and quality food access among low-income rural households.

Genetic associations with temporal shifts in obesity and severe obesity during the obesity epidemic in Norway: A longitudinal population-based cohort (the HUNT Study).

Obesity has tripled worldwide since 1975 as environments are becoming more obesogenic. Our study investigates how changes in population weight and obesity over time are associated with genetic predisposition in the context of an obesogenic environment over 6 decades and examines the robustness of the findings using sibling design. A total of 67,110 individuals aged 13-80 years in the Nord-Trøndelag region of Norway participated with repeated standardized body mass index (BMI) measurements from 1966 to 2019 and were genotyped in a longitudinal population-based health study, the Trøndelag Health Study (the HUNT Study). Genotyping required survival to and participation in the HUNT Study in the 1990s or 2000s. Linear mixed models with observations nested within individuals were used to model the association between a genome-wide polygenic score (GPS) for BMI and BMI, while generalized estimating equations were used for obesity (BMI ≥ 30 kg/m2) and severe obesity (BMI ≥ 35 kg/m2). The increase in the average BMI and prevalence of obesity was steeper among the genetically predisposed. Among 35-year-old men, the prevalence of obesity for the least predisposed tenth increased from 0.9% (95% confidence interval [CI] 0.6% to 1.2%) to 6.5% (95% CI 5.0% to 8.0%), while the most predisposed tenth increased from 14.2% (95% CI 12.6% to 15.7%) to 39.6% (95% CI 36.1% to 43.0%). Equivalently for women of the same age, the prevalence of obesity for the least predisposed tenth increased from 1.1% (95% CI 0.7% to1.5%) to 7.6% (95% CI 6.0% to 9.2%), while the most predisposed tenth increased from 15.4% (95% CI 13.7% to 17.2%) to 42.0% (95% CI 38.7% to 45.4%). Thus, for 35-year-old men and women, respectively, the absolute change in the prevalence of obesity from 1966 to 2019 was 19.8 percentage points (95% CI 16.2 to 23.5, p < 0.0001) and 20.0 percentage points (95% CI 16.4 to 23.7, p < 0.0001) greater for the most predisposed tenth compared with the least predisposed tenth, defined using the GPS for BMI. The corresponding absolute changes in the prevalence of severe obesity for men and women, respectively, were 8.5 percentage points (95% CI 6.3 to 10.7, p < 0.0001) and 12.6 percentage points (95% CI 9.6 to 15.6, p < 0.0001) greater for the most predisposed tenth. The greater increase in BMI in genetically predisposed individuals over time was apparent after adjustment for family-level confounding using a sibling design. Key limitations include a slightly lower survival to date of genetic testing for the older cohorts and that we apply a contemporary genetic score to past time periods. Future research should validate our findings using a polygenic risk score constructed from historical data. In the context of increasingly obesogenic changes in our environment over 6 decades, our findings reveal a growing inequality in the risk for obesity and severe obesity across GPS tenths. Our results suggest that while obesity is a partially heritable trait, it is still modifiable by environmental factors. While it may be possible to identify those most susceptible to environmental change, who thus have the most to gain from preventive measures, efforts to reverse the obesogenic environment will benefit the whole population and help resolve the obesity epidemic.

The association between weight-promoting medication use and weight gain in postmenopausal women: findings from the Women's Health Initiative

With the rise in obesity, there has been a concomitant increase in prescription medications associated with weight gain. The objective of this study is to quantify the magnitude of association between putative weight-promoting medications and 3-year weight change in a diverse cohort of postmenopausal women in the Women's Health Initiative (WHI). This is a prospective observational cohort study, considering 40 sites in the WHI and a cohort of seventy six thousand two hundred fifty-two postmenopausal women aged 50-79 years, with weight measured at both baseline and 3 years, in the WHI-Observational Study. Body mass index (BMI) and waist circumference (WC) were measured at baseline and 3 years. An in-clinic medication inventory identified prescribed medications, including antidepressants, beta-blockers, insulin, and/or glucocorticosteroids. Generalized linear models evaluated if intermittent or persistent use of weight-promoting drugs was associated with increased BMI and WC during a 3-year follow up. Women with overweight or obesity at baseline were more likely to be taking antidepressants, beta-blockers, and/or insulin. Taking at least one putative weight-promoting medication was associated with a greater increase in BMI (0.37 vs 0.27 kg/m, P = 0.0045) and WC (1.10 cm vs 0.89 cm, P = 0.0077) over the course of 3 years compared to women not on these medications. Both BMI and WC increased with the number of weight-promoting drugs prescribed (P for trend per medication used < 0.00001 for both variables). Those who took either antidepressants or insulin, or a combination of antidepressants and beta-blockers, were most likely to have a significant increase in BMI compared to nonusers. Antidepressants, beta-blockers, and insulin were associated with weight gain in postmenopausal women. This information may help to inform clinical decision-making and efforts to mitigate medication-related weight gain. : Video Summary:http://links.lww.com/MENO/A617.

Longitudinal association between food frequency and changes in body mass index: a prospective cohort study.

ObjectivesAnalysing data of the Young Lives Study in Peru, we aimed at assessing the association between daily food frequency and body mass index (BMI) changes between 2006 and 2016.DesignSecondary analysis of a prospective ongoing cohort study.Setting20 sentinel sites in Peru.ParticipantsChildren enrolled in the younger cohort of the Young Lives Study. We used information from the second (2006–2007), third (2009–2010), fourth (2013–2014) and fifth (2016–2017) rounds of the younger cohort in Peru.Primary and secondary outcomesBMI as well as BMI-for-age z-score, both as numerical variables.ResultsData from 1948 children, mean age 4.3 (SD: 0.3) years and 966 (49.6%) women were included at baseline. In multivariable model, lower food consumption frequency was associated with increased BMI and BMI-for-age z-scores: children reporting <4 times of food consumption per day had a greater increase in BMI (β=0.39; 95% CI 0.17 to 0.62) and BMI-for-age z-score (β=0.07; 95% CI 0.01 to 0.13) compared with those reporting 5 per day. Results were consistent for those reporting exactly eating 4 times per day (β for BMI=0.16; 95% CI 0.02 to 0.30 and β for BMI-for-age z-score=0.05; 95% CI 0.01 to 0.09).ConclusionsChildren who eat <5 times per day, gain more BMI compared with those who eat ≥5 times. Parents should receive information to secure adequate nutrition for their children, both in terms of quality and quantity.