Lower Body Mass Index Values Research Articles

An audit of nutritional status in renal replacement therapy patients — Is there a place for hand dynamometry?

• ■ Objective: To audit the nutritional status (including hand dynamometry) of patients receiving renal replacement therapy. • ■ Design: To audit the physical nutritional measurements performed regularly on dialysis patients. Body mass index (BMI), midarm circumference (MAC), triceps skinfold thickness (TSF), midarm muscle circumference (MAMC), and grip strength (GS) were examined. • ■ Setting: Hospital. • ■ Patients: 140 patients (69 on hemodialysis [HD] and 71 on continuous ambulatory peritoneal dialysis [CAPD]). Hand dynamometry quantifying GS was measured in 90 patients. • ■ Results: TSF in male patients on CAPD was significantly higher than in those on HD. For patients younger than 65 years, BMI and MAC values were compared with British norms. In female patients, a distribution similar to that of the normal population was found. In men, a higher proportion (mainly on HD) than expected had low BMI values. For patients older than 65 years, TSF values were distributed in a pattern similar to that of published norms. MAMC values were highly skewed toward the upper range; more than 30% had values above the 90th percentile. Only 12% were classified as mildly/moderately undernourished. None were severely undernourished. Mean GS values achieved were poor (53.8% of expected normative standards) despite favorable nutritional profiles. Multiple regression modeling suggests that the bulk of variability in GS is due to age and gender (51%). Of nutritional parameters examined, only MAMC and albumin contribute together to account for only 6% of the variability. A total of 40% of the variability could not be explained on the basis of the examined variables. • ■ Conclusion: Undernutrition is not as prevalent as cited in other studies. Poor Gs justifies further research, but it does not appear to enhance nutritional assessment.

Anorexia nervosa: correlation between MR appearance of bone marrow and severity of disease.

To identify bone marrow abnormalities on magnetic resonance (MR) images of patients with anorexia nervosa (AN) and to correlate the findings with body mass index (BMI) and blood cell count. The signal intensity patterns in the lumbar, pelvic, and femoral marrow spaces were evaluated on MR images obtained in 14 patients with AN and 14 control subjects. Six patients with AN had a waterlike signal intensity pattern either throughout the three marrow spaces (five patients) or only in the marrow cavity of the proximal femur (one patient). Results of biopsy performed in one of the six patients showed that the marrow had findings typical of serous atrophy. The BMI values and blood cell counts in the six patients were lower than those of the eight other patients with AN and the 14 control subjects. Bone marrow has an unusual signal intensity and distribution at MR imaging in patients with AN who have a low BMI value and biologic signs of bone marrow dysfunction.

Sarcopenia: A critical review of its measurements and health-related significance in the middle-aged and elderly.

A summary of the work performed by Stanley Garn relating to muscle mass while he worked at the Fels Research Institute is followed by a critical review of the measurement of sarcopenia, which is a deficiency of muscle mass, and its implications for health. The only satisfactory data for total muscle mass come from one cadaver study of a small selected sample. Analyses in relation to health (mortality rates) are limited to indices of muscle mass of which the body mass index (BMI) and arm muscle area or circumference are the most important because large amounts of serial data are available for analysis. The association between low BMI values and increased mortality rates is well established. Multiple studies, some of large samples, indicate that the increased mortality in those with low BMI values at entry is not fully explained by smoking behavior or disease at entry. There are, however, contrary findings from one major study. Associations between arm muscle circumference or area with mortality rates have also been reported. Independent effects of low BMI and low arm muscle values on mortality rates could be due to effects of low fat-free mass, particularly low muscle mass, on host defense mechanisms and risk factors for disease but few relevant data have been reported. © 1994 Wiley-Liss, Inc.

Over 80 Years and No Evidence of Coronary Heart Disease: Characteristics of a Survivor Group

To determine factors that characterize those 80 years and over free of clinical coronary heart disease (CHD). Cross-sectional intergroup comparison. Rural New Zealand town. All those 70 years and over registered with the sole health center. Seven hundred eighty-two subjects were seen, a 91.4% response rate. Subjects were divided by World Health Organization cardiovascular questionnaire criteria, history, examination, and coded 12-lead electrocardiogram into four groups: 1) those 70-79 years of age with evidence of CHD; 2) those 80 years and older with evidence of CHD; 3) those 70-79 years of age free of CHD; and 4) those 80 years and older free of clinical CHD. Mean values and distributions of cholesterol, high-density lipoprotein (HDL) cholesterol, apolipoproteins (apos), triglycerides, insulin, glucose, anthropometric measurements, and psychosocial variables. In the initial analysis of variance there was a significant difference in the mean values among the four groups for body mass index (BMI), HDL cholesterol, apo A1, and triglycerides. Using the Duncan procedure, the mean value of HDL cholesterol in the group 80 years and older with no evidence of clinical CHD was significantly higher than in each of the other groups. The group 80 years and older without clinical CHD had a significantly higher mean value for apo A1 and significantly lower mean values for triglycerides and BMI than the group 70-79 years old with CHD (p < 0.05). Three-factor analysis of variance showed those free of clinical CHD had significantly higher values of HDL cholesterol (P = 0.024) and apo A1 (P = 0.022), and lower values of BMI (P = 0.017) and triglycerides (P = 0.018) compared with those who had CHD after controlling for age and sex. Those 80 years and older had lower values of BMI (P = 0.001) and triglycerides (P = 0.018) than those 70-79 years old after controlling for CHD and sex. The group who were 80 years and older and free of clinical CHD had a significantly narrower distribution of values for insulin (P < 0.001), glucose (P = 0.001), diastolic blood pressure (P = 0.001), BMI (P = 0.001), and waist-hip ratio (P = 0.002) when compared with those 80 years and older with CHD; a significantly narrower distribution of values for insulin (P = 0.024), glucose (P = 0.003), and BMI (P = 0.002) when compared with those 79-79 years old with CHD and a significantly narrower distribution of glucose (P = 0.002) and BMI (P = 0.014) when compared with those 70-79 years old and free of clinical CHD. Those 80 years and older who were free of clinical CHD were characterized by differences in lipid and anthropometric values, particularly higher HDL cholesterol and apo A1 levels. Results were also consistent with this survivor group maintaining tighter homeostatic control over a number of variables.

Adiposity in Czech children followed from 1 month of age to adulthood: analysis of individual BMI patterns.

In Czechoslovakia, overweight and nutrition-associated pathologies are frequent. The body mass index (BMI) is often used in the clinical assessment of adiposity in children and adults. Its variations during growth are well documented. A cohort of 300 newborns were selected at random in Prague between 1956 and 1960. Weight and height were collected in these subjects at the ages of 3, 6, 9, and 12 months and twice a year from 1 to 20 years. Charts of longitudinal variations of the BMI were drawn for males and females. The three expected phases of BMI development were observed: initial rise until 12 months, subsequent decrease, and second augmentation (the 'adiposity rebound', 'AR') between 4 and 8 years of age. The inverse relationship between age at AR and the BMI in adulthood was confirmed: in the leanest adults, AR had happened by age 7.6 years, in the heaviest adults, age at AR was around 5 years. Many lean (44%) and fat (58%) infants developed into average-size adults. The risk of becoming a heavy adult was increased in fat infants (31%) as opposed to non-fat (22%) ones. The relative risk of fat infants to become obese adults as compared to non-fat infants is 31/22 = 1.8. Individual growth curves of children with very high or very low adult BMI values illustrate the relationships between BMI at 12 months, age at AR and adult BMI. The Czech BMI distribution was higher than a comparable French one at all percentiles after age 7 years.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of selected health-related data from surveys of a general population and a sporting population

This paper presents a comparison of health-related data from two surveys of British adults. Respondents from one survey formed a representative sample of the British population, whilst respondents from the other were characterised by their participation in sport. Statistical analysis revealed that sports participants had significantly lower body mass index values, lower blood pressures and lower resting pulse rates ( P < 0.05). In addition, sports participants possessed better self-perceived health and perceived themselves overall to be more active than members of the general population. When controls were introduced for gender and age, many of these differences remained, particularly among females. It is concluded that despite the cross-sectional nature of these data, evidence is provided that supports the health-promoting case for sport.