Longitudinal Changes In Body Mass Index Research Articles

Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study

BackgroundThe association between longitudinal body mass index (BMI) change and clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) has not fully investigated.MethodsThis retrospective cohort study included 116,463 COPD patients aged ≥ 40, with at least two health examinations, one within 2 years before and another within 3 years after COPD diagnosis (January 1, 2014, to December 31, 2019). Associations between BMI percentage change with all-cause mortality, primary endpoint, and initial severe exacerbation were assessed.ResultsBMI decreased > 5% in 14,728 (12.6%), while maintained in 80,689 (69.2%), and increased > 5% in 21,046 (18.1%) after COPD diagnosis. Compared to maintenance group, adjusted hazard ratio (aHR) for all-cause mortality was 1.70 in BMI decrease group (95% CI:1.61, 1.79) and 1.13 in BMI increase group (95% CI:1.07, 1.20). In subgroup analysis, decrease in BMI showed a stronger effect on mortality as baseline BMI was lower, while an increase in BMI was related to an increase in mortality only in obese COPD patients with aHRs of 1.18 (95% CI: 1.03, 1.36). The aHRs for the risk of severe exacerbation (BMI decrease group and increase group vs. maintenance group) were 1.30 (95% CI:1.24, 1.35) and 1.12 (95% CI:1.07, 1.16), respectively.ConclusionsA decrease in BMI was associated with an increased risk of all-cause mortality in a dose-dependent manner in patients with COPD. This was most significant in underweight patients. Regular monitoring for weight loss might be an important component for COPD management.

Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later.

The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology. In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40-70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline. Postmenopausal females showed higher levels of baseline blood lipids (HDL = 0.14, p < 0.001, LDL = 0.20, p < 0.001, triglycerides = 0.12, p < 0.001) and HbA1c ( = 0.24, p < 0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group ( = -0.08, p < 0.001), while WHR increased to a similar extent in both groups ( = -0.03, p = 0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes ( range = 0.03-0.13, p ≤ 0.002). HDL showed a significant inverse relationship with WMH volume ( = -0.27, p < 0.001). Our findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.

Change in BMI in Children Over the First 30 Months After the Start of the SARS-CoV-2 Pandemic.

Our study aim was to assess body mass index (BMI) change in children in the immediate 6 months of the pandemic, to follow longitudinal BMI change up to 30 months after the pandemic start, and to identify sociodemographic factors associated with these changes. Our study included a retrospective chart review of 1298 children 2 to 18 years old with office visits at an Indianapolis primary care clinic. Body mass index and sociodemographic information were collected at visits during 3 time periods: Prepandemic (March 1, 2019-February 28, 2020), Early Pandemic (June 1, 2020-November 30, 2020), and Late Pandemic (December 1, 2020-September 30, 2022). Data analysis indicated statistically significant increases in BMI monthly rate of change from Prepandemic to Early Pandemic periods. Interestingly, BMI rate of change stabilized from Early Pandemic to Late Pandemic periods but remained positive, suggesting children had slower, but persistent, continued BMI increase after the pandemic initiation.

Per- and polyfluoroalkyl substances in umbilical cord serum and body mass index trajectories from birth to age 10 years: Findings from a longitudinal birth cohort (SMBCS)

BackgroundPrenatal exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to low birth weight but higher childhood weight and obesity. However, little is known regarding the associations between PFAS exposure and dynamic body mass index (BMI) trajectories, particularly from birth through preadolescence. ObjectiveTo evaluate the associations of cord serum PFAS concentrations with BMI trajectories from birth to age 10 years and longitudinal BMI in different periods. MethodsBased on 887 mother–child pairs in the longitudinal prospective birth cohort, we measured 12 PFAS congeners in cord serum and calculated BMI with anthropometric indicators at 9 follow-up time points from birth to age 10 years. The BMI trajectories were identified using group-based trajectory model (GBTM). To estimate the associations of cord serum PFAS levels with BMI trajectories and longitudinal changes in BMI, logistic regression models, linear mixed models, Bayesian kernel machine regression, and quantile-based g-computation models (QGC) were used. ResultsThe median concentrations of 10 PFAS congeners included in statistical analysis ranged from 0.047 to 3.623 μg/L. Two BMI trajectory classes were identified by GBTM, characterized by high group and low group. In logistic regression models, five PFAS congeners (PFBA, PFHpA, PFHxS, PFHpS, and PFDoDA) were associated with the higher probability of being in high BMI trajectory group (odds ratio, OR: 1.21 to 1.74, p < 0.05). Meanwhile, higher PFAS mixture were related to elevated odds for the high group in both BKMR models and QGC models, with PFHpA and PFHpS being the two most important drivers jointly. In the sex-stratified analysis, the positive associations remained significant exclusively among males. In the longitudinal analysis, PFUnDA and PFDoDA were associated with increased BMI from birth to age 10 years. Furthermore, PFBS and PFHpA were negatively related to BMI throughout infancy and toddlerhood (from birth to age 3 years), whereas PFDoDA confirmed a positive association with mid-childhood (from age 6 to 10 years) BMI. ConclusionsPrenatal PFAS exposure was positively associated with BMI trajectories from birth to preadolescence and longitudinal BMI in various periods. Future research could use better trajectory modeling strategies to shape more complete growth trajectories and explore the relationship between BMI trajectories and adulthood health.

Sweet taste preference is associated with greater hypothalamic response to glucose and longitudinal weight gain

The hypothalamus has an abundant expression of sweet taste receptors that play a role in glucose sensing and energy homeostasis. Evidence suggests that liking “sweets” can be associated with weight gain, but the relationship between sweet taste preference and hypothalamic regulation of appetite is unknown. This study tested the hypothesis that sweet taste preference is associated with increased hypothalamic activation in response to glucose (a purported neural marker for weight gain risk) and greater longitudinal increases in body mass index (BMI). Fifty-four adults aged 18–35 years with a mean (± SD) BMI of 27.99 ± 5.32 kg/m2 completed the study. Height and weight were measured at baseline and 6–12 months later in a subset of 36 participants. Sweet taste preference was assessed via the Monell 2-series, forced-choice tracking procedure. Arterial spin labeling magnetic resonance imaging was performed before and after oral glucose ingestion to determine hypothalamic blood flow response to glucose. Linear models were used to examine relationships between sweet taste preference and the hypothalamic response to glucose and longitudinal changes in BMI, adjusting for age, sex, and baseline BMI. Sweet taste preference was positively associated with glucose-linked hypothalamic blood flow (beta = 0.017, p = 0.043), adjusted for age, sex and BMI. We also observed a positive association between sweet taste preference and longitudinal change in BMI (beta = 0.088, p = 0.015), adjusted for age, sex and baseline BMI. These findings suggest that heightened sweet taste preference is associated with glucose-linked hypothalamic activation and may be linked to increased susceptibility for weight gain.

1276-P: Level of Injury Affects Body Mass Changes but Has No Influence on Alteration in Glycaemic Index in Persons with Spinal Cord Injury—A Prospective Cohort Study

In able-bodied individuals, an increase in body mass index (BMI) enhances the risk of glucose tolerance deterioration and diabetes mellitus (DM). This relationship can be altered after spinal cord injury (SCI) due to muscle atrophy and the potential effects of autonomic dysfunction on glucose metabolism, which are more exaggerated in those with tetraplegia (TP) compared to paraplegia (PP). Here, we investigated the relationship between longitudinal changes in BMI and glycated haemoglobin (HbA1c), as well as the effect of level of injury (LOI) on this relationship, among nondiabetic patients with SCI. In a retrospective cohort of veterans with SCI, electronic data of BMI, LOI, glucose concentration and HbA1c were obtained from Jan 2001 to Dec 2021. A total of 728 patients without DM at baseline were identified (LOI: 350 TP/378 PP, age: 52±15 years, sex: 690 male/38 female), and followed up for a mean of 94 months (TP) and 114 months (PP). At baseline, using the SCI-specific BMI classification (normal weight BMI&amp;lt;22 kg/m2, obesity BMI&amp;gt; 25 kg/m2), 48% of TP and 65% of PP were obese at baseline (BMI TP: 25.6±5.9 kg/m2; PP: 28.0±6.6 kg/m2,; p&amp;lt;0.001). HbA1c at baseline was similar between TP and PP (5.21±0.59% vs 5.27±0.70%, p = 0.175). At the end of follow-up, BMI was increased to a larger extent in PP compared with TP (-0.02±4.11 kg/m2 in TP, +0.55±4.31 kg/m2 in PP; p = 0.05). However, HbA1c changes did not differ between TP versus PP (p = 0.323). The final BMI was associated with baseline BMI (p&amp;lt;0.001) and LOI (p = 0.007), but the last HbA1c value was only associated with baseline HbA1c (p&amp;lt;0.001) and not LOI (p = 0.821) or baseline BMI (p = 0.605). Together, these findings indicate that neither LOI nor BMI appear useful predictors of DM development in persons with SCI. Disclosure S. Hoekstra: None. M.J. Mader: None. M. Trbovich: None. M. Salehi: None.

Association between physical activity and longitudinal change in body mass index in middle-aged and older adults

BackgroundIn middle-aged and particularly older adults, body mass index (BMI) is associated with various health outcomes. We examined associations between physical activity (PA) and longitudinal BMI change in persons aged ≥ 50 years.MethodsThe sample included 5159 community-dwelling individuals aged ≥ 50 years (50.5% males, mean (SD) age 73.0 (10.2) years at baseline) who were enrolled in the Mayo Clinic Study of Aging (MCSA). Participants had information on PA within one year of baseline assessment, BMI at baseline, and potential follow-up assessments (mean (SD) follow-up 4.6 (3.7) years). Linear mixed-effect models were used to calculate the association between PA (moderate-vigorous physical activity, MVPA; and all PA composite score) and the longitudinal change in BMI, adjusted for baseline age, sex, education and medical comorbidities. In addition to interactions between years since baseline and PA, we also included 2- and 3-way interactions with baseline age to further assess whether age modifies the trajectory of BMI over time.ResultsWe observed a decrease in BMI among participants engaging at a mean amount of PA (i.e., MVPA: 2.7; all PA: 6.8) and with a mean age (i.e., 73 years) at baseline (MVPA: estimate = -0.047, 95% CI -0.059, -0.034; all PA: estimate = -0.047, 95% CI -0.060, -0.035), and this decline is accelerated with increasing age. Participants with a mean age (i.e., 73 years) that engage at an increased amount of MVPA or all PA at baseline (i.e., one SD above the mean) do not decrease as fast with regard to BMI (MVPA: estimate = -0.006; all PA: estimate = -0.016), and higher levels of MVPA or all PA at baseline (i.e., two SD above the mean) were even associated with an increase in BMI (MVPA: estimate = 0.035; all PA: estimate = 0.015). Finally, MVPA but not all PA is beneficial at slowing BMI decline with increasing age.ConclusionPA, particularly at moderate-vigorous intensity, is associated with slower decline in longitudinal BMI trajectories. This implies that engaging in PA may be beneficial for healthy body weight regulation in middle and late adulthood.

IMPACTO DA PANDEMIA DE COVID-19 EM CRIANÇAS E ADOLESCENTES COM EXCESSO DE PESO: INFLUÊNCIA DO CONFINAMENTO E DO FECHAMENTO DAS ESCOLAS NA OBESIDADE INFANTIL

The COVID-19 pandemic lockdown caused schools closures, increased sedentary time and greater consumption of ultra-processed foods, an environment that might have aggravated the childhood obesity epidemic. AIMS: To verify the impact of school closure on the body mass index (BMI), on lifestyle habits as well as the prevalence of obesity in children and adolescents. METHODS: Cross-sectional observational study of overweight/obesity patients followed at an Endocrinology referral service. A review of the last pre-pandemic visit and the first visit during the pandemic were carried out, and a questionnaire was applied. RESULTS: 50 patients (31 girls) aged 11.5±2.4 years, interval between visits of 379.5±79.5 days. Twenty-nine (58%) reported an increase in the daily number of snacks, 76% reported greater consumption of ultra-processed foods, while 54% reported eating the same amount of food. Greater sedentary time was also reported. Forty-five patients gained weight and there was an increase of 19.6% compared to pre-pandemic weight, a gain of 9.0 kg (-3.6 to 25.5). The median BMI and its z-score variations between visits were +1.9kg/m2 (-2.9 to +7.7) and +0.11 (-0.93 to +1.47), respectively. The change in adjusted BMI to the median for sex and age was +1.65kg/m2 (-3.60 to +6.90). There was an increase in the prevalence of obesity of 6% in the group. CONCLUSION: Defining the longitudinal change in BMI in the pediatric age group is a challenge. This study showed unhealthy weight gain, increased BMI, increased sedentary time and some difficulties faced by children during quarantine.

Differences in body mass index trajectories of adolescent psychiatric inpatients by sex, age, diagnosis and medication: an exploratory longitudinal, mixed effects analysis.

Adolescents in secure psychiatric care typically report high obesity rates. However, longitudinal research exploring the rate and extent of change is sparse. This study aimed to analyse sex differences in longitudinal body mass index (BMI) change for adolescents receiving treatment in a secure psychiatric hospital. The sample comprised 670 adolescents in secure psychiatric care. BMI trajectories from admission to 50 months of hospitalisation were produced using sex-stratified multilevel models. Systematic difference in mean BMI trajectories according to age at admission (14, 15, 16, or 17 years), medication (Olanzapine or Sodium Valproate), and primary diagnosis (Psychotic, non-Psychotic or Functional/behavioural disorders) were investigated. Together, males and females experienced a mean BMI increase of 2.22 m/kg2 over the 50-month period. For females, BMI increased from 25.69 m/kg2 to 30.31 m/kg2 , and for males, reduced from 25.01 m/kg2 to 23.95 m/kg2 . From 30 to 50 months, a plateau was observed for females and a reduction in BMI observed for males. Psychotic disorders in males (β 3.87; CI 1.1-6.7) were associated with the greatest rate of BMI change. For medication, Olanzapine in females was associated with the greatest rate of change (β1.78; CI -.89-4.47). This is the first longitudinal study exploring longitudinal BMI change for adolescent inpatients. Results highlight that individual differences in adolescent inpatients result in differing levels of risk to weight gain in secure care. Specifically, males with psychotic disorders and females taking Olanzapine present the greatest risk of weight gain. This has implications for the prioritisation of interventions for those most at risk of weight gain.

Body mass index across adulthood and the development of airflow obstruction and emphysema.

Low body mass index (BMI) is associated with COPD, but temporal relationships between airflow obstruction (AO) development and emphysematous change are unclear. We investigated longitudinal changes in BMI, AO, and lung density throughout adulthood using data from the Framingham Offspring Cohort (FOC). BMI trajectories were modelled throughout adulthood in 4587 FOC participants from Exam 2 (mean age = 44), through Exam 9 (mean age = 71), in AO participants and non-AO participants (AO n = 1036), determined by spirometry, using fractional polynomial growth curves. This process was repeated for low lung density (LLD) and non LLD participants (LLD n = 225) determined by Computed Tomography. Spirometry decline was compared separately between tertiles of BMI in those aged <40years and associations between fat and lean mass (measured using Dual Energy X-ray Absorptiometry, DEXA) and development of AO and LLD were also assessed. Additional analyses were performed with adjustment for smoking volume. The BMI trajectory from 30years of age was visually lower in the AO group than both non-AO smokers (non-<AO-S) and non-AO non-smokers (non-AO-N). Similarly, BMI trajectories were visually lower in participants with LLD throughout adulthood compared to normal lung density smokers and non-smokers. Differences remained after adjustment for smoking volume. The lowest BMI tertile in ages <40years was associated with the steepest subsequent decline in FEV1/FVC ratio in both sexes. Mean BMI is lower throughout adulthood in AO and LLD participants. Lower BMI is associated with a steeper decline in the ratio of FEV1/FVC. These findings suggest body mass may precede and potentially have a role in the development of COPD lung pathophysiology.

Factors associated with body mass index changes among older adults: a ten-year follow-up.

To examine changes in body mass index (BMI) among older Brazilian adults and associated factors. Longitudinal, population-based study, conducted in São Paulo, Brazil. Adults aged 60 years or over (n = 1,796) from the first wave of data collection from the Health, Well-Being, and Aging Study (SABE Project) conducted from 2000 to 2010. Repeated mixed-effects linear regression was used to analyze longitudinal changes in BMI and to examine whether sociodemographic characteristics, health conditions, and social behaviors were associated with these changes. Mean BMI decreased after 70 years. Men had lower BMI than women (β = -1.86, 95%CI: -2.35; -1.37). Older adults who consumed alcohol (β = 0.30, 95%CI: 0.06; 0.54), had more than one chronic disease (β = 0.19, 95%CI: 0.26; 0.72) and who did not perform physical activity (β = 0.56, 95%CI: 0.38; 0.74) had higher BMI. Subjects who smoked (β = -0.40, 95%CI: -0.76; -0.04) and who reported having eaten less food in recent months (β = -0.48, 95%CI: -0.71; -0.24) had lower BMI. In older Brazilians, several sociodemographic characteristics, health conditions, and behaviors predict BMI. Increasing prevalence of chronic diseases and growing sedentary behaviors in Brazil may have detrimental effects on BMI at older ages.

Changes in Nutritional Status in Pulmonary Tuberculosis: Longitudinal Changes in BMI According to Acid-Fast Bacilli Smear Positivity

Malnutrition is closely associated with pulmonary tuberculosis (PTB). However, changes before and after treatment remain unclear. We aimed to investigate the longitudinal changes in nutritional status from treatment to follow-up of TB in 215 PTB cases in South Korea. First, we evaluated the trend in body mass index (BMI) from the time of diagnosis to a 2-year follow-up. Second, we compared the BMIs of our cases with 5694 controls who participated in a Korean national survey after treatment. During the treatment period, the BMI of the smear-positive group (n = 72) significantly increased compared with that of the smear-negative group (n = 143) (+1.9 kg/m2 vs. +0.4 kg/m2, p = 0.001). Almost all the changes occurred in the early phase, with unremarkable differences in the rest of the treatment period and up to the 2-year follow-up period. When compared with controls, the smear-positive PTB group also had a lower BMI than the smear-negative PTB group, which, however, was lower than that of the general population, though all the participants regained their BMIs during treatment. These results clarify the nutritional aspects of PTB and enable better strategies to support patients with PTB.

Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease

Background: Low body mass index (BMI) is an important prognostic factor in chronic obstructive pulmonary disease (COPD). However, the prognostic value of longitudinal BMI change in COPD has not been well studied. Objective: We aimed to evaluate the association between longitudinal change of BMI and prognosis of COPD in Korean COPD cohort. Methods: This study was conducted in a prospective Korean Obstructive Lung Disease (KOLD) cohort where COPD patients were recruited on an outpatient basis at 17 hospitals in South Korea. Annual BMI was measured over a period of 3 years or more. All patients were categorized into underweight (UW), normal weight (NW), and overweight (OW) groups by BMI. Clinical characteristics and outcomes including exacerbation and mortality were compared based on initial BMI grade and longitudinal change of BMI. Results: This analysis included 537 COPD patients (mean age = 67.4 ± 7.9 years, male = 97.0%, mean BMI = 23.0 ± 3.1) of KOLD cohort. The proportions of UW, NW, and OW groups were 6.9% (n = 37), 68.9% (n = 370), and 24.2% (n = 130) respectively. The UW group showed lower forced expiratory volume in 1 s (FEV₁) (p < 0.001), shorter 6-minute walk distance (p < 0.001), higher modified Medical Research Council score (p = 0.002), higher St. George Respiratory Questionnaire score (p < 0.001), higher emphysema index (p < 0.001) and air-trapping index (p < 0.001), and more frequent (p < 0.001) and severe exacerbations (p = 0.003). Multivariable analyses demonstrated that decrease of BMI (hazard ratio [HR] = 0.786, p = 0.038) and the descent of BMI group (HR = 3.167, p = 0.016) at 3-year follow-up along with age, initial BMI, post-bronchodilator FEV₁, and severe exacerbations were significantly associated with mortality. Conclusions: This study demonstrated that BMI decrease during follow-up was independently associated with exacerbation and higher mortality of COPD, suggesting BMI reduction in COPD should be carefully managed.

Effects of gender affirming hormone therapy on body mass index in transgender individuals: A longitudinal cohort study

IntroductionMany transgender people take hormone therapy to affirm their gender identity. One potential long-term consequence of gender affirming hormone therapy is increased body mass index (BMI), which may be associated with metabolic syndrome, cardiovascular disease and higher mortality. Only a few published studies explored changes in BMI in transgender people taking gender affirming hormone therapy (GAHT). ObjectiveTo examine the changes in BMI longitudinally in response to GAHT in transgender women and men. MethodsWe conducted a retrospective cohort study of transgender individuals who received GAHT from the endocrinology clinic between January 1, 2000 and September 6, 2018. Subjects who sought GAHT were included if they had two separate measurements of BMI and were excluded if they had a BMI greater than 35 kg/m2 or were missing demographic data at entry. We used a linear mixed model to analyze the longitudinal change in BMI. ResultsThere were a total of 227 subjects included in this cohort. Among subjects already on GAHT, transgender women were receiving GAHT longer than transgender men (6.59 ± 9.35 vs 3.67 ± 3.43 years, p-value = 0.04). Over the period of 7 years, there was a significant increase in BMI in transwomen who newly initiated GAHT (p-value 0.004). There were no changes in BMI in transgender men and women already on GAHT or in transgender men who newly initiated GAHT in the study. ConclusionWe conclude that BMI significantly increases in transwomen but not in transmen after initiation of GAHT in a single center based in the United States. In transwomen and transmen, BMI appears to be stable following 3 to 6 years of GAHT. Future investigations should examine the causes for increased BMI in transgender women including type of GAHT, diet and lifestyle, and association with risk of metabolic syndrome and cardiovascular disease.

Late bedtime and body mass index gain in indigenous Australian children in the longitudinal study of indigenous children.

To explore sleep patterns in indigenous Australian children and assess the role of sleep timing in longitudinal changes in body mass index (BMI). Latent profile analysis was conducted with the Australian Longitudinal Study of Indigenous Children (LSIC) cohort data (wave 5), to determine distinct patterns of bed and wake timing, taking account of weekday sleep duration, weekday and weekend bedtimes, and weekday wake times. Multilevel models with a random intercept were used to investigate the role of baseline sleep pattern in predicting longitudinal changes in BMI. Baseline data for 1258 children (50.7% males), mean age 6.32±1.52years, indicated the presence of five classes of sleep patterns: early/long sleepers (4.5%), normative sleepers (25.5%), late sleepers (49.9%), consistent late sleepers (11.1%) and early risers (9%). Late sleeping was significantly associated with longitudinal gains in BMI. Compared with early sleepers, consistent late sleepers experienced 1.03 unit gain in BMI at follow-up (95% CI: 0.001-2.05, P=.05). This study underscores the importance of looking beyond sleep duration and highlights the positive outcomes of early bedtimes in children. As sleep timing is modifiable, this offers the opportunity for improvement in sleep and protecting against future weight gain in indigenous children.

Association Between Obesity and Cardiovascular Outcomes: Updated Evidence from Meta-analysis Studies.

The prevalence of obesity and cardiovascular disease (CVD) has been increasing worldwide. Studies examining the association between adiposity and CVD outcomes have produced conflicting findings. The interplay between obesity and CVD outcomes in the general population and in specific subpopulations is complex and requires further elucidation. We report updated evidence on the association between obesity and CVD events through a review of meta-analysis studies. This review identified that obesity or high body mass index (BMI) was associated with an increased risk of CVD events, including mortality, in the general population and that cardiac respiratory fitness (CRF) and metabolic health status appear to stratify the risk of CVD outcomes. In patients with diabetes, hypertension, or coronary artery disease, mortality displayed a U-shaped association with BMI. This U-shaped association may result from the effect of unintentional weight loss or medication use. By contrast, patients with other severe heart diseases or undergoing cardiac surgery displayed a reverse J-shaped association suggesting the highest mortality associated with low BMI. In these conditions, a prolonged intensive medication use might have attenuated the risk of mortality associated with high BMI. For the general population, a large body of evidence points to the importance of obesity prevention and maintenance of a healthy weight. However, for those with diagnosed cardiovascular diseases or diabetes, the relationship between BMI and cardiovascular outcomes is more complex and varies with the type of disease. More studies are needed to define how heterogeneity in the longitudinal changes in BMI affects mortality, especially in patients with severe heart diseases or going under cardiac surgery, in order to target subgroups for tailored interventions. Interventions for managing body weight, in conjunction with improving CRF and metabolic health status and avoiding unintentional weight loss, should be used to improve CVD outcomes.

Sleep pattern and body mass index gain in Indigenous Australian children

Purpose: This study aims to explore different sleep patterns in Indigenous Australian children and assess the role of sleep patterns in longitudinal changes in body mass index (BMI). Methods: This work is based on wave 5 to wave 8 (2012–2015) data of the Australian Longitudinal Study of Indigenous Children (LSIC) cohort. Latent class analysis was used to determine distinct sleep patterns, taking into account weekday sleep duration, weekdays and weekends bedtimes, and weekday wake times. Multilevel models with a random intercept for child and geographic clusters were used to investigate the role of baseline sleep pattern in predicting longitudinal changes in BMI. Results: Baseline data for 1,258 children (50.7% males), mean age 6.32 years (SD ± 1.52), indicated the presence of five classes of sleep patterns: early/long sleepers (4.5%), normative sleepers (25.5%), late sleepers (49.9%), consistent late sleepers (11.1%), and early risers (9%). Family income, child health, food choices, sleep problems, geographic remoteness and area‐level disadvantage, were found to be significantly associated with sleep patterns in children. Regression results indicate that late sleep pattern is significantly associated with longitudinal gains in BMI. Compared with early sleepers, consistent late sleepers were found to have a significant increase in BMI (β = 1.03, 95% CI: 0.001–2.05, p = 0.05). Conclusions: This study underscores the importance of looking beyond sleep duration and highlighting the positive outcomes of early bedtimes in children. As sleep pattern is modifiable, this offers the opportunity for improvement in sleep and protecting against future weight gain in Indigenous children.

Ten-year changes of intraocular pressure in adults: the Liwan Eye Study.

Understanding the longitudinal intraocular pressure (IOP) changes and potential risk factors in adults is important for future glaucoma control in the aging society. Limited longitudinal studies exist in Asia investigating the longitudinal IOP changes and with varying results. Population-based cohort study. 1405 baseline participants from the Liwan Eye Study. All baseline participants were invited for the 10-year follow-up examination in 2013. IOP (by Tonopen), central corneal thickness (CCT; by ultrasound), refractive error (by autorefractor), blood pressure, height and weight were measured per standardized protocol and the presence of hypertension or diabetes was collected by questionnaire. Follow-up examinations were conducted using the same equipment with proper calibration. Linear regression analysis was used to assess the association between IOP change and potential risk factors. 10-year IOP change. Of the 791 participants at the 10-year follow-up, IOP data were available for 602 participants with a mean age of 60.9 years (55.5% female). The average IOP change over 10 years was an increase of 1.44 mmHg (95% confidence interval, 1.12-1.75). Linear regression showed that 10-year IOP change was not associated with baseline age, gender, body mass index (BMI), CCT, spherical equivalence (SE), hypertension or diabetes. However, it was positively associated with longitudinal increase of BMI when longitudinal changes of BMI and SE were included in the model (P < 0.001). We observed a small increase in IOP over 10 years in this adult Chinese population, which was positively related to the longitudinal change in BMI.

DNA methylation variant, B-vitamins intake and longitudinal change in body mass index.

Growing evidence has implicated DNA methylation (DNAm) in the regulation of body adiposity; a recent epigenome-wide association study (EWAS) identified a genetic variant determining DNAm at the SREBF1 gene that affected body mass index (BMI). In the present study, we tested interactions between DNAm variant rs752579 and methylation metabolism-related B-vitamins (folate, vitamin B2, vitamin B6, and vitamin B12) on longitudinal change in BMI in the Women's Health Initiative Memory Study (WHIMS). A total of 5687 white women aged 65-79 from WHIMS with genotyping data on SNP rs752579 were included in the analysis. B-vitamins intakes were estimated by a self-report semi-quantitative food frequency questionnaire. BMI was measured at baseline and 6-year follow-up. We found significant interactions between the SREBF1 rs752579 genotype and intake of food source B-vitamins on 6-year change in BMI (p interaction <0.01 for all). BMI changes (kg/m2) per DNAm-increasing (C) allele were -0.29, 0.06, and 0.11 within subgroups of increasing tertiles of food source folate intake; and the corresponding BMI changes (kg/m2) were -0.25, -0.01, and 0.15 for vitamin B2 intake; -0.17, -0.16, and 0.21 for vitamin B6 intake; and -0.12, -0.23, and 0.26 for vitamin B12 intake, respectively. Similar gene-diet interaction patterns were observed on the change in body weight. Our data suggest that habitual intake of food source B-vitamins may modify the effect of DNAm-related variant on long-term adiposity change.

Relation of longitudinal changes in body mass index with atherosclerotic cardiovascular disease risk scores in middle-aged black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

PurposeWe assessed whether longitudinal changes in body mass index (BMI) are positively associated with changes in 10-year American College of Cardiology/American Heart Association atherosclerotic cardiovascular disease (ASCVD) risk scores in middle-aged blacks compared to whites. MethodsData were from 1691 participants enrolled in the Coronary Artery Risk Development in Young Adults Study aged 40 years or more in 2000–2001, who had follow-up examinations 5 and 10 years later. ResultsThe prevalence of obesity increased from 32.3% in 2000–2001 (mean age: 42.8 years) to 41.7% in 2010–2011, higher in blacks than whites. The corresponding change in 10-year ASCVD risk was significantly higher for blacks (men: 4.5%–9.6%, women: 1.7%–5.0%) than whites (men: 2.4%–5.2%, women: 0.7%–1.6%). In 2010–2011, 57.5% of black men had ASCVD risk scores of 7.5% or more compared to white men (14.7%), black women (17.4%), and white women (1.6%). Although BMI trends were positively associated with 10-year change in ASCVD risk scores (0.07% per 1 kg/m2 increase), it explained very little variance in risk score trends in all race–sex groups. ConclusionsIn middle-aged adults, longitudinal changes in BMI had little independent influence on changes in 10-year ASCVD risk scores as its effect may be largely mediated through ASCVD risk factors already accounted for in the risk score.