Higher Average Body Mass Index Research Articles

Longitudinal study of body mass index in Asian men who immigrate to the US.

Cross-sectional studies indicate that adaptation to Western norms, especially at a younger age, might explain the higher average body mass index (BMI) among Asians living in the United States (US) compared to Asians living in Asia. However, migrants differ from non-migrants in sociocultural factors that are difficult to measure and, thus, longitudinal studies on the same individuals prior to and after immigration are needed. The objective of this study was to determine differences in changes in BMI across age by residence (US or Asia) and age at immigration using longitudinal data on BMI prior to and after immigration. The California Men's Health Study includes 1,549 foreign-born Asian men who were aged 44-71 at baseline in 2002-03. BMI at ages 30, 40, 50 and 60 was calculated using self-reported weight history and current height. Residence at each age decade and age at immigration were determined. Data were analyzed using generalized estimating equations. Ten-year BMI increases were smaller among Asians who lived in Asia prior to migrating to the US compared to those who already lived in the US. This effect was most evident be-tween ages 30-40 when Asians in Asia had a 0.69 kg/m2 (95% CI: -1.08, -0.30) smaller increase in BMI. Immigrants who moved to the US before age 40 experienced greater increases in BMI than immigrants who moved to the US at an older age. This study is the first to support the hypothesis that living in the US and younger age at immigration results in larger BMI increases in Asian men.

Hepatic arteriolosclerosis: a small-vessel complication of diabetes and hypertension.

Liver involvement in diabetes is well recognized in the form of steatohepatitis and glycogenic hepatopathy. More recently, sinusoidal fibrosis, even in the absence of steatosis, has also been suggested to be associated with diabetes (diabetic hepatosclerosis); however, case-control studies are lacking. In addition, microangiopathy (hyaline arteriolosclerosis), a well-known complication of diabetes, has not been well studied in liver. Therefore, we undertook a cross-sectional blinded study with the specific aim of evaluating the association between hepatic sinusoidal fibrosis and hepatic arteriolosclerosis (HA) with diabetes. Liver biopsy findings from 89 diabetic patients obtained between January 2006 and December 2009 were compared with those of 89 nondiabetic patients matched by age and hepatitis C virus infection status. Patients with cirrhosis, liver mass, right heart failure, significant alcohol use, or insufficient available clinical information were excluded. Medical records were reviewed for the presence of diabetes, body mass index, diabetes treatment, and comorbidities at the time of biopsy (eg, underlying liver disease, hypertension, dyslipidemia). Liver biopsies were evaluated blinded to all clinical data (including presence or absence of diabetes) for a variety of histologic features, especially patterns of fibrosis and HA. Diabetic patients had a higher average body mass index (33 vs. 30 m/kg, P=0.0039), prevalence of hypertension (78% vs. 33%, P<0.0001), and dyslipidemia (52% vs. 20%, P<0.0001). Among diabetic patients, 87% had type 2 diabetes, and 57% used insulin. Whereas sinusoidal fibrosis, with or without steatosis, was not significantly associated with the presence of diabetes, HA was significantly more prevalent among diabetic patients compared with controls: 45% versus 29% (P=0.0298). The presence of both diabetes and hypertension had a significant odds for HA: with an adjusted odds ratio of 2.632 (95% confidence interval, 1.178-5.878; P=0.0183). Biliary changes were associated with HA in some cases (10.6%).In this study, we describe the histopathologic entity of HA for the first time. It is a small-vessel complication (microangiopathy) of the liver observed mainly in patients with diabetes who also have arterial hypertension. The clinical and prognostic implications of this finding, particularly regarding liver injury, remain to be further investigated.

High body mass index did not result in poor outcome in Taiwanese children with acute myeloid leukemia: a single-institution experience.

Overweight/obese patients with acute myeloid leukemia (AML) are reported as experiencing inferior outcomes and greater numbers of treatment-related complications. We retrospectively studied 58 children with newly diagnosed AML who received chemotherapy at Chang Gung Memorial Hospital between January 2003 and December 2011. Patients enrolled were considered overweight if body mass index (BMI) was ≥85th percentile. Fifteen of 58 (25.9 %) patients were judged overweight by this criterion. Patients diagnosed in the last third of this period (2009-2011) had a higher average BMI (P = 0.06). The rates of documented infection in overweight patients and non-overweight patients were not significantly different (53.3 vs. 62.8 %). The 5-year event-free survival (EFS) of overweight patients was superior to that of non-overweight patients (78.8 vs. 55.4 %). Patients (n = 11) who received hematopoietic stem cell transplantation (HSCT) in first remission (CR1) had a significantly higher 5-year EFS (87.5 vs. 55.2 %, P = 0.04). Among 47 children who did not receive HSCT in CR1, 10 (21.3 %) were overweight. The 5-year EFS of overweight patients was consistently superior to that for non-overweight patients (70.0 vs. 51.2 %). In conclusion, overweight/obese children with AML did not experience poor outcomes in the present study.

Abstract 13901: Elevated Cardiovascular Risk Factors among Appalachian Women with a History of Pregnancy Complications

Introduction: A growing body of evidence links complications of pregnancy (gestational diabetes, preeclampsia, and pregnancy-induced hypertension) with double the risk of future cardiovascular disease (CVD) related death in affected women. However, little is known about which CVD risk factors are more prominent among women who have experienced pregnancy complications. Purpose: Compare the presence of modifiable CVD risk factors among women with and without a self-reported history of pregnancy complications living in Appalachian Kentucky- an area with the highest rate of CVD mortality in the U.S. Methods: Rural Kentucky Appalachian women (n = 122, 97% Caucasian, 42 ± 12 years) engaged in a comprehensive measurement of CVD risk factors including body mass index (BMI), waist circumference, blood pressure, A1C, lipid profile (total cholesterol, triglycerides, HDL, and LDL), tobacco smoke exposure (objectively measured with urine cotinine), depression (Patient Health Questionnaire-9), and anxiety (Brief Symptom Inventory). We used independent t-tests and chi-square analysis to compare risk factors between women with and without a history of pregnancy complications. Results: One-fourth of the sample had one or more pregnancy complications: gestational diabetes (8.2%), preeclampsia (6.6%) and pregnancy-induced hypertension (15.6%). Women with at least one pregnancy complication had a higher average BMI (33.4 vs. 30.4, p = .014), larger waist circumference (42.8 vs. 39.1 cm, p = .006), and a higher proportion with moderate to severe symptoms of depression (27.6% vs. 15.9%, p = .02) compared to women without a history of pregnancy complications. There were no differences between groups in systolic or diastolic blood pressure, A1C levels, lipid profiles, tobacco smoke exposure, or anxiety. Conclusions: Women with a history of pregnancy complications have several modifiable risk factors- higher BMI, higher waist circumference, and higher levels of depression- that could constitute a link between past pregnancy complications and their risk of future CVD death. Pinpointing which modifiable risk factors are elevated in these women will help us develop self-management interventions to prevent the development of CVD in this high-risk population.

Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer.

The aim of this study was to evaluate dietary habit changes in patients undergoing chemotherapy for epithelial ovarian cancer. Sixty one patients undergoing chemotherapy for epithelial ovarian cancer were enrolled to the study and 44 completed. The dietary intake was evaluated by 7-day food records, and the changes in dietary intake and food-preparing methods were estimated based on a 101-item semiquantitative food frequency questionnaire. Nutritional status was checked with the use of body weight and height, waist and hip circumferences, skinfolds and subjective global assessment tool. Quality of life was measured with the use of EORTC QLQ-C30 and EORTC QLQ-OV28. Despite high average body mass index (BMI) (26.7-28.0 kg/m(2)), malnutrition risk was observed in 43.7 and 10.7 % of patients receiving first-line and subsequent-line chemotherapy, respectively (p < 0.001). Dietary intake and quality of life did not differ between the studied groups. A lot of dietary habits changes were observed. Women undergoing subsequent-line chemotherapy consumed more frequently rye bread, pasta, buttermilk, vegetable, fruit, oils, nuts, and juices. Women undergoing first-line chemotherapy consumed more milk, cottage cheese, cream, eggs, fish and seafood, meat offal, salty snacks, and jam. Additionally, women undergoing subsequent-line chemotherapy more often applied cooking in water (p < 0.0001) and baking (p < 0.05). Women undergoing chemotherapy for ovarian cancer change their dietary habits in a pro healthy direction, and these changes are more expressed in patients undergoing subsequent-line chemotherapy.

Body Mass Index assessment of health care professionals in a primary care setting in Portugal: a cross sectional study.

Obesity is an important public health problem because it is a risk factor for numerous diseases and is associated with a higher death risk. Evidence concerning the prevalence of excess weight in health professionals is scarce and this group is often overlooked in weight interventions programs. This paper aims to estimate the prevalence of obesity and overweight among Portuguese primary health care professionals and to describe differences between occupational groups. This was a cross sectional study based on a primary care setting in Portugal in 2011. We collected data on occupation, age, sex and height of professionals from four primary care centers. We did a descriptive analysis of the main variables and an analysis of covariance to compare mean Body Mass Index. Our sample represented 52.8% of the total population of the four primary care centers, and 38.6% were overweight and 16.9% were obese. When adjusted for age and gender, health service personnel had the highest average Body Mass Index, followed by nurses, physicians, and superior technicians, in that order. Although we can't ensure the generalisation of the results and cannot exclude the possibility of sampling bias, these results suggest high prevalence obesity and overweight in workers of primary health care in Portugal. In this primary care setting more than half of the health care professionals were overweight or obese. Tailored interventions might be needed to tackle this issue.

The Patient Experience with DSM-5-Defined Binge Eating Disorder: Characteristics, Barriers to Treatment, and Implications for Primary Care Physicians

Background: Binge eating disorder (BED) is now a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). However, post–DSM-5 patient profiles and viewpoints on BED diagnosis and treatment remain unclear. This study used a focus group methodology to examine demographic and clinical characteristics, as well as perceptions of diagnosis and treatment from patients with BED symptoms who were either formally diagnosed with BED or undiagnosed. Methods: Binge eating disorder-diagnosed individuals (n = 11) or those meeting the DSM-5 BED diagnostic criteria but were undiagnosed (n = 14) participated in 6 semistructured focus groups conducted by trained staff at 3 geographic locations in the United States. Patients completed a series of demographic and clinical measures and then engaged in a moderated discussion focused on identifying factors associated with their experiences with BED. Results: Sixty percent of the patients were female, 48% were white and 40% were black, and 76% were employed. The diagnosed group had a slightly higher socioeconomic status; undiagnosed patients had a higher average body mass index. In the overall sample, comorbid anxiety (40%) and depression (40%) were the most common psychiatric comorbidities. Even in the diagnosed group, only half of the patients (54.5%) became aware of BED through their health care provider (HCP; n = 6). Patients perceived that HCPs were focused more on physical ailments, were judgmental about weight, and were unable to distinguish BED from obesity. They also expressed a desire for safe, nonjudgmental interactions with HCPs. Conclusions: Education and income may be factors affecting access to care and BED diagnosis. Both patient groups reported considerable psychopathology and medical comorbidities. Moreover, the patient groups perceived HCPs as both having inadequate understanding of BED and providing insensitive and ineffective communication regarding eating behaviors. The study findings in diagnosed and undiagnosed patient groups underscore the need for greater BED disease state awareness and patient sensitivity among HCPs.

Explaining educational disparities in adiposity: the role of neighborhood environments.

To examine the extent to which characteristics of the neighborhood built environment explain the association between adiposity and educational qualifications in Australian women. A community sample of 1,819 women (aged 18-66) from the Melbourne SESAW study provided information regarding their body mass index (BMI) and level of education. Objective measures of participants' residential neighborhood built environments were obtained using a Geographic Information System. Compared with women with a high school degree or above, women who did not complete high school had higher average BMI, which was partially explained by lower density of sports facilities and living less proximally to the coastline and to supermarkets. In a multiple mediator model, which explained 16.6% of the educational disparity in BMI, the number of sports facilities and presence of the coastline within 2 km of participants' homes were significant mediators of the observed socioeconomic disparity in BMI. The residential neighborhood environment may help to explain socioeconomic patterning of overweight and obesity in Australian women. These results provide further support for considering the built environment in obesity prevention initiatives, suggesting a potential role in decreasing social inequalities in obesity.

Some determinants of nourishment rates of boys and girls enrolling primary schools and in adolescence (7, 14 and 17 years of age), the 1996 generation born in Zajecar

Some determinants of nourishment rates of boys and girls enrolling primary schools and in adolescence (7, 14 and 17 years of age), the 1996 generation born in Zajecar

A comparison of exercise economy between obese and non-obese 8 to 10-year old children

Background: Obesity is socioeconomically patterned in developed countries, with low socioeconomic position (SEP) individuals at greater risk of being overweight and obese; however, the mechanisms by which this occurs are not well understood. One possibility is that persons of low SEP have less opportunity (e.g., financially) to live in neighbourhoods supportive of exercise and healthy eating, and are consequently more likely to be of unhealthy weight. The present study examined whether the neighbourhood physical environment played an explanatory role in the greater adiposity of less educated women, compared to those with higher educational qualifications. Methods: A cohort of 1819 women from the Melbourne SESAW study provided information regarding their body mass index (BMI) and level of education; objective measures of participants’ home neighbourhood environments were obtained using a Geographic Information System (GIS). Results: Compared to women with high levels of education, women with less education had higher average BMI, which was partially explained by lower density of sports facilities, supermarkets and green grocers, and worse proximity to coastlines and supermarkets among less educated women. In a multiple mediator model, which explained 17.7% of the low-high education difference in BMI, the number of sports facilities and presence of a coastline within 2 km of participants’ homes were both significant mediators of the observed sociodemographic disparity in BMI. Conclusions: These findings indicate that the neighbourhood physical environment may help explain the socioeconomic patterning of overweight and obesity. Specifically, women with low levels of education appear to live in more obesogenic environments with poorer access to places in which to exercise or purchase a wide range of healthy foods, which may foster greater obesity risk. Improving the availability of physical activity and sport facilities in particular should be considered as part of public health initiatives aimed at reducing obesity risk among low SEP women.

Multifactorial analysis of changes in body mass index across the adult life course: a study with 65 years of follow-up

BackgroundAlthough the negative consequences on health of being obese are well known, most adults gain weight across the life span. The general increase in body mass index (BMI) is mainly considered to originate from behavioral and environmental changes, but few studies have evaluated the influence of these factors on change in BMI in the presence of genetic risk. We aimed to study the influence of multifactorial causes of change in BMI, over 65 years.Methods and FindingsTotally, 6,130 participants from TwinGene, who had up to 5 assessments, and 536 from the Swedish Adoption/Twin Study of Aging, who had up to 12 assessments, ranging over 65 years were included. The influence of lifestyle factors, birth cohort, cardiometabolic diseases, and an individual obesity genetic risk score based on 32 single nucleotide polymorphisms on change in BMI was evaluated with a growth model. For both sexes, BMI increased from early adulthood to age 65 years, after which the increase leveled off; BMI declined after age 80 years. A higher obesity genetic risk score, birth after 1925, and cardiometabolic diseases were associated with higher average BMI and a steeper increase in BMI prior to age 65 years. Among men, few factors were identified that influence BMI trajectories in late life, while for women, type 2 diabetes mellitus and dementia were associated with a steeper decrease in BMI after the age of 65 years.ConclusionsThere are two turning points in BMI in late adulthood, one at age 65 years and one at age 80 years. Factors associated with an increase in BMI in midlife, were not associated with an increase in BMI after the age of 65 years. These findings indicate that the causes and consequences of change in BMI differ across the life span. Current health recommendations need to be adjusted accordingly.

Variation in the heritability of body mass index based on diverse twin studies: a systematic review

Over the past three decades, twin studies have shown variation in the heritability of obesity. This study examined the difference of body mass index (BMI) heritability (BMI-H) by population characteristics, such as sex, age, time period of observation and average BMI, as well as by broad social-environmental factors as indicated by country-level gross domestic product (GDP) per capita and GDP growth rate. Twin studies that reported BMI-H and were published in English from January 1990 to February 2011 after excluding those with disease, special occupations or combined heritability estimates for country/ethnic groups were searched in PubMed. 32 studies were identified from Finland (7), the United Kingdom (6), the United States (3), Denmark (3), China (3), Netherlands (2), South Korea (2), Sweden (2) and four from other countries. Meta-regression models with random effects were used to assess variation in BMI-H. Heterogeneity of BMI-H is significantly attributable to variations in age (<20, 20-55 and ≥56 years), time period of observation (i.e. year of data collection), average BMI and GDP (≤$20,000, $20,001-26,000 and >$26,000). BMI-H was higher in adolescents (<20 years), in studies done in past years, and in populations with higher average BMIs or higher GDP per capita (≥$26,000) than their counterparts. Consistent lowering effects of high GDP growth rate (>median) on BMI-H were shown through stratified analyses by GDP. BMI-H was lower in countries of mid-level GDP, particularly those experiencing rapid economic growth. BMI-H is sensitive to age, time period of observation, average BMI, GDP and rapid economic growth.

The impact of obesity on sepsis mortality: a retrospective review

BackgroundRecent sepsis guidelines have focused on the early identification and risk stratification of patients on presentation. Obesity is associated with alterations in multiple inflammatory regulators similar to changes seen in sepsis, suggesting a potential interaction between the presence of obesity and the severity of illness in sepsis.MethodsWe performed a retrospective chart review of patients admitted with a primary billing diagnosis of sepsis at a single United States university hospital from 2007 to 2010. Seven hundred and ninety-two charts were identified meeting inclusion criteria. Obesity was defined as a body mass index (BMI) ≥ 30 kg/m2. The data recorded included age, race, sex, vital signs, laboratory values, length of stay, comorbidities, weight, height, and survival to discharge. A modified APACHE II score was calculated to estimate disease severity. The primary outcome variable was inpatient mortality.ResultsSurvivors had higher average BMI than nonsurvivors (27.6 vs. 26.3 kg/m2, p = 0.03) in unadjusted analysis. Severity of illness and comorbid conditions including cancer were similar across BMI categories. Increased incidence of diabetes mellitus type 2 was associated with increasing BMI (p < 0.01) and was associated with decreased mortality, with an odds ratio of 0.53 compared with nondiabetic patients. After adjusting for age, gender, race, severity of illness, length of stay, and comorbid conditions, the trend of decreased mortality for increased BMI was no longer statistically significant, however diabetes continued to be strongly protective (odds ratio 0.52, p = 0.03).ConclusionsThis retrospective analysis suggests obesity may be protective against mortality in septic inpatients. The protective effect of obesity may be dependent on diabetes, possibly through an unidentified hormonal intermediary. Further prospective studies are necessary to elaborate the specific mechanism of this protective effect.

Improved Air Quality and Attenuated Lung Function Decline: Modification by Obesity in the SAPALDIA Cohort

Background: Air pollution and obesity are hypothesized to contribute to accelerated decline in lung function with age through their inflammatory properties.Objective: We investigated whether the previously reported association between improved air quality and lung health in the population-based SAPALDIA cohort is modified by obesity.Methods: We used adjusted mixed-model analyses to estimate the association of average body mass index (BMI) and changes in particulate matter with aerodynamic diameter ≤ 10 µm (PM10; ΔPM10) with lung function decline over a 10-year follow-up period.Results: Lung function data and complete information were available for 4,664 participants. Age-related declines in lung function among participants with high average BMI were more rapid for FVC (forced vital capacity), but slower for FEV1/FVC (forced expiratory volume in 1 sec/FVC) and FEF25–75 (forced expiratory flow at 25–75%) than declines among those with low or normal average BMI. Improved air quality was associated with attenuated reductions in FEV1/FVC, FEF25–75, and FEF25–75/FVC over time among low- and normal-BMI participants, but not overweight or obese participants. The attenuation was most pronounced for ΔFEF25–75/FVC (30% and 22% attenuation in association with a 10-μg/m3 decrease in PM10 among low- and normal-weight participants, respectively.)Conclusion: Our results point to the importance of considering health effects of air pollution exposure and obesity in parallel. Further research must address the mechanisms underlying the observed interaction.Citation: Schikowski T, Schaffner E, Meier F, Phuleria HC, Vierkötter A, Schindler C, Kriemler S, Zemp E, Krämer U, Bridevaux P-O, Rochat T, Schwartz J, Künzli N, Probst-Hensch N. 2013. Improved air quality and attenuated lung function decline: modification by obesity in the SAPALDIA cohort. Environ Health Perspect 121:1034–1039; http://dx.doi.org/10.1289/ehp.1206145

Pro12Ala variant of the PPARG2 gene increases body mass index: An updated meta‐analysis encompassing 49,092 subjects

The peroxisome proliferator-activated receptor gamma 2 (PPARG2) gene has been intensively studied with relation to obesity and metabolic disorders. Indeed, a large number of studies assessing the association between the PPARG2 polymorphism Pro12Ala (rs1801282) and body mass index (BMI) have been published with some controversial results. In this meta-analysis, the effects of Pro12Ala polymorphism of the PPARG2 gene on BMI were investigated. Externally published data were collected and we included our own novel data from a study in the elderly participants (>55 years) of a Mediterranean cohort, the SUN ("Seguimiento Universidad de Navarra") Project (n = 972). A total of 75 independent studies with 49,092 subjects (39,806 with the genotype Pro12Pro and 9,286 carrier subjects of the Ala allele) were included. The meta-analysis revealed a higher BMI with an overall estimation of +0.065 kg/m(2) (95%CI = 0.026-0.103, P = 0.001) for homo-/heterozygous carriers of the Ala allele of the PPARG2 gene in comparison to non-carriers. The analysis also showed that there was heterogeneity (P for heterogeneity <0.001), but funnel plots did not suggest apparent publication bias. Furthermore, the association between the Pro12Ala polymorphism of the PPARG2 gene and increased BMI was stronger in Caucasian. Thus, carriers of the Ala allele had significantly higher BMI than non-carriers in a subsample of 6,528 Caucasian male subjects (standardized mean difference = 0.090, 95%CI=0.032-0.148, P = 0.002, P for heterogeneity = 0.121). This updated meta-analysis showed that carriers of the Ala12 allele of the PPARG2 gene had a higher average BMI.

Variation in body mass index heritability based on diverse twin studies

ObjectivesOver three decades, twin studies showed various heritability of obesity, although genetic variation crucially affected obesity. This study examined the difference of body mass index (BMI) heritability (BMI‐H) by population characteristics.MethodsTwin studies with a combination of field tags for keywords, having quantitative information about BMI‐H without disease, special occupations or mixed population and written in English from Jan 1990 to Feb 2011 were searched in PubMed. Total 32 eligible studies identified. Meta regression models with random effect were used to test BMI heritability varied by population characteristics.ResultsHeterogeneity of BMI‐H is attributable to variations in age, year of observation, average BMI, and GDP (&lt; $20,000, $20,000–25,999 &amp; &gt;;= $26,000) significantly. BMI‐H estimates were higher in adolescents, in the past, and study populations with high average BMI, or high GDP than those among their counterparts. Consistent lowering effects of high GDP growth rate were shown on the stratified analysis by GDP. Adults, in recent year and countries with low obesogenic condition (low average BMI) would likely to have lower BMI heritability, especially in middle GDP and experiencing rapid economic growth.ConclusionsBMI heritability is sensitive to age, time of observation, average BMI, GDP and rapid economic growth.

Perfil antropométrico e fisiológico dos jogadores de rugby portugueses - Parte II: comparação entre atletas de diferentes níveis competitivos

INTRODUÇÃO: Desde a introdução, em 1995, do profissionalismo, que os estudos publicados têm vindo a apontar para uma maior diferenciação dos atletas, em todos os níveis, para cada uma das posições. Todavia, apesar de serem comuns em países onde o rugby é mais popular, nenhum estudo procurando caracterizar do ponto de vista antropométrico e fisiológico o atleta de rugby português foi, até agora, publicado. Procuramos avaliar e caracterizar antropométrica e fisiologicamente os atletas de rugby portugueses de diferentes níveis competitivos, estudando as seguintes variáveis: idade, massa corporal, estatura, composição corporal, capacidade aeróbia máxima, aceleração, velocidade e agilidade. OBJETIVOS: Caracterizar antropométrica e fisiologicamente os atletas de rugby portugueses, procurando identificar eventuais diferenças entre atletas de patamares competitivos distintos. Comparar os resultados obtidos com os demais trabalhos já publicados. MÉTODOS: Avaliamos 46 jogadores de rugby de duas equipes a disputarem competições nacionais seniores masculinas em escalões distintos. Dos 46 atletas avaliados, 24 pertenciam a uma equipe semiprofissional e 22 a uma equipe amadora. Os atletas foram submetidos a uma avaliação antropométrica através da determinação das suas estaturas, massas corporais e pregas cutâneas. Do total de atletas avaliados, 40 submeteram-se, também, a uma avaliação das suas capacidades físicas que consistiu na determinação da velocidade e capacidade de aceleração, através dos testes de corrida de 30 e dez metros, respectivamente. Determinou-se, igualmente, as suas capacidades aeróbias máximas, através da realização do teste de Luc Léger. A análise estatística foi realizada com recurso ao software IBM® SPSS® Statistics v.19, tendo sido considerado um valor de significância de 5%. RESULTADOS: Verificamos que os semiprofissionais eram, em média, 3cm mais altos que os recuados e apresentavam uma percentagem de massa gorda média de apenas 15,09% (± 6,03) contra os 22,39% (± 6,54) dos recuados. Os amadores eram igualmente quatro anos mais velhos e apresentavam um índice de massa corporal superior aos semiprofissionais. Nos testes físicos os resultados obtidos foram semelhantes para ambos os grupos de atletas. DISCUSSÃO E CONCLUSÕES: Não se verificaram, no presente estudo, as esperadas diferenças entre atletas de diferentes patamares competitivos. Efetivamente, no que diz respeito à composição corporal e à estatura dos atletas, verificamos uma vantagem dos atletas semiprofissionais, quando comparados com os amadores. No entanto, a homogeneidade verificada parece indicar que o rugby português ainda não terá dado o salto qualitativo que o profissionalismo trouxe aos países com maior tradição na modalidade.

Obesity Increases the Odds of Acquiring and Incarcerating Noninguinal Abdominal Wall Hernias

The current data available describing the relationship of obesity and abdominal wall hernias is sparse. The objective of this study was to investigate the current prevalence of noninguinal abdominal wall hernias and their correlation with body mass index (BMI) and other demographic risk factors. Patients with umbilical, incisional, ventral, epigastric, or Spigelian hernias with or without incarceration were identified using the regional database for 14 hospitals over a 3-year period. Patients were stratified based on their BMI. Univariate and multivariate analyses were performed to distinguish other significant risk factors associated with the hernias. Of 2,807,414 patients, 26,268 (0.9%) had one of the specified diagnoses. Average age of the patients was 52 years and 61 per cent were male. The majority of patients had nonincarcerated umbilical hernias (74%). Average BMI was 32 kg/m2. Compared with patients with a normal BMI, the odds of having a hernia increased with BMI: BMI of 25 to 29.9 kg/m2 odds ratio (OR) 1.63, BMI of 30 to 39.9 kg/m2 OR 2.62, BMI 40 to 49.9 kg/m2 OR 3.91, BMI 50 to 59.9 kg/m2 OR 4.85, and BMI greater than 60 kg/m2 OR 5.17 (P<0.0001). Age older than 50 years was associated with a higher risk for having a hernia (OR, 2.12; 95% [CI], 2.07 to 2.17), whereas female gender was associated with a lower risk (OR, 0.53; 95% CI, 0.52 to 0.55). Those with incarcerated hernias had a higher average BMI (32 kg/m2 vs 35 kg/m2; P<0.0001). Overall, BMI greater than 40 kg/m2 showed an increased chance of incarceration, and a BMI greater than 60 kg/m2 had the highest chance of incarceration, OR 12.7 (P<0.0001). Age older than 50 years and female gender were also associated with a higher risk of incarceration (OR, 1.28; 95% CI, 1.02 to 1.59 and OR, 1.80; CI, 1.45 to 2.24). Increasing BMI and increasing age are associated with a higher prevalence and an increased risk of incarceration of noninguinal abdominal wall hernias.

Prevalence of Laryngopharyngeal Reflux Symptoms

To investigate the prevalence of laryngopharyngeal reflux (LPR) symptoms in health checkup examinees and in patients with otitis media with effusion (OME) of undetermined etiology and the significance of age, body mass index (BMI), and pepsinogen (PG) concentration in middle ear effusions (MEEs). Cross-sectional study. Health checkup and private clinics. A total of 410 subjects who had undergone a health checkup were asked to respond to the reflux symptom index (RSI) to identify the distribution of the RSI score, and the results were compared with 62 patients with OME by BMI and PG concentration in the MEEs. The RSI-positive (score >13) rate was 7.1% in the health checkup examinees. The highest rate was observed in men in their 40s, who had the highest average BMI. None of the men in their 80s were RSI positive. The RSI-positive rate in patients with OME was 21.0%. None of the male patients ≥ 70 years of age were RSI positive, whereas the average PG concentration was significantly higher in this group. The prevalence of LPR symptoms evaluated by the RSI was significantly higher in OME patients than in the health checkup examinees; however, a similar pattern in which LPR symptoms were prominent in middle-aged men with a high BMI and much less in elderly men was observed. Middle-aged men with a high BMI might be diagnosed as having LPR disease based on the relevant symptoms. LPR findings would be more sensitive than symptoms in elderly men.

Heterogeneity moderates treatment response among patients with binge eating disorder.

The purpose of the study was to explore heterogeneity and differential treatment outcome among a sample of patients with binge eating disorder (BED). A latent class analysis was conducted with 205 treatment-seeking, overweight or obese individuals with BED randomized to interpersonal psychotherapy (IPT), behavioral weight loss (BWL), or guided self-help based on cognitive behavioral therapy (CBTgsh). A latent transition analysis tested the predictive validity of the latent class analysis model. A 4-class model yielded the best overall fit to the data. Class 1 was characterized by a lower mean body mass index (BMI) and increased physical activity. Individuals in Class 2 reported the most binge eating, shape and weight concerns, compensatory behaviors, and negative affect. Class 3 patients reported similar binge eating frequencies to Class 2, with lower levels of exercise or compensation. Class 4 was characterized by the highest average BMI, the most overeating episodes, fewer binge episodes, and an absence of compensatory behaviors. Classes 1 and 3 had the highest and lowest percentage of individuals with a past eating disorder diagnosis, respectively. The latent transition analysis found a higher probability of remission from binge eating among those receiving IPT in Class 2 and CBTgsh in Class 3. The latent class analysis identified 4 distinct classes using baseline measures of eating disorder and depressive symptoms, body weight, and physical activity. Implications of the observed differential treatment response are discussed.