Lowered Body Mass Index Research Articles

Effectiveness of a family-based health promotion intervention for women with prior GDM: The Face-it RCT.

Gestational diabetes mellitus (GDM) increases the risk of future type 2 diabetes (T2DM), but effective and feasible interventions to reduce this risk are lacking. To evaluate the effectiveness of a family-based health promotion intervention on T2DM risk factors and quality of life among women with recent GDM. Multicenter, parallel, open-label randomized controlled trial with 2:1 allocation ratio. Three sites in Denmark. Women diagnosed with GDM. The intervention consisted of (i) home visits with tailored family-based counseling (ii) digital health coaching, (iii) structured cross-sectoral communication. Primary outcomes were body mass index (BMI) and quality of life (SF12 MCS) 1-year after delivery. We randomized 277 women to the intervention (n=184) or usual care group (n=93). The intervention did not result in significantly lower BMI (-0.44 kg/m2; 95%CI -0.98 to 0.11) or higher SF12 MCS (0.06; 95%CI -2.15 to 2.27) compared to the usual care group. A pre-specified post hoc analysis demonstrated a reduced BMI in the intervention group among women with BMI ≥25 kg/m2 (-0.86 kg/m2; (-1.58 to -0.14)).Analyses of secondary and tertiary outcomes indicated significantly lower 2-h insulin (-94.3 pmmol/L; 95%CI -167.9 to -20.6) and triglycerides (-0.18 mmol/L; 95%CI -0.30 to -0.05) levels, and odds of fasting plasma glucose ≥6·1 mmol/L (OR 0.33; 95%CI 0.12 to 0.91) in the intervention group. The intervention did not result in lower BMI or increased quality of life, but seemingly reduced other risk factors, and lowered BMI in the subgroup of overweight women.

Body Mass Index and Hypertension as Mediators of the Association Between Age at Menarche and Subclinical Atherosclerosis: A Sex-Specific Mendelian Randomization Analysis.

Early age at menarche (AAM) has been associated with a higher risk of carotid artery intima-media thickness (cIMT), an indicator of subclinical vascular disease, albeit the mechanisms underlying this association remain elusive. A better understanding of the relationship between AAM, modifiable cardiometabolic risk factors, and subclinical atherosclerosis may contribute to improved primary prevention and cardiovascular disease treatment. We aimed to investigate the putative causal role of AAM on cIMT, and to identify and quantify the potentially mediatory effects of cardiometabolic risk factors underlying this relationship. We conducted linkage disequilibrium score regression analyses between our exposure of interest, AAM, our outcome of interest, cIMT and potential mediators of the AAM-cIMT association to gauge cross-trait genetic overlap. We considered as mediators the modifiable anthropometric risk factors body mass index (BMI), systolic blood pressure (SBP), lipid traits (total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), and glycemic traits (fasting glucose). We then leveraged the paradigm of Mendelian randomization to infer causality between AAM and cIMT, and to identify whether cardiometabolic risk factors served as potential mediators of this effect. Our analyses showed that genetically predicted AAM was inversely associated with cIMT, BMI, SBP, and triglycerides, and positively associated with high-density lipoprotein, low-density lipoprotein, and total cholesterol. We showed that the effect of genetically predicted AAM on cIMT may be partially mediated through BMI (20.1% [95% CI, 1.4% to 38.9%]) and SBP (13.5% [95% CI, 0.5%-26.6%]). Our cluster-specific Mendelian randomization revealed heterogeneous causal effect estimates of age at menarche on BMI and SBP. We highlight supporting evidence for a potential causal association between earlier AAM and cIMT, and almost one third of the effect of AAM on cIMT may be mediated by BMI and SBP. Early intervention aimed at lowering BMI and hypertension may be beneficial in reducing the risk of developing subclinical atherosclerosis due to earlier age at menarche.

Malnutrition among Egyptian hemodialysis patients: prevalence and risk factors

Background Malnutrition commonly affects hemodialysis (HD) patients. Malnourished HD patients have increased morbidity and mortality. We aimed to assess the prevalence and risk factors of malnutrition among Egyptian hemodialysis patients. Material and methods This is a cross-sectional study carried out on ESRD patients with regular HD. All participants were subjected to detailed history taking and complete physical examination. Assessment of nutritional status was done using subjective global assessment (SGA). Anthropometric measures included mid-arm circumference (MAC), triceps skin fold (TSF), and body mass index (BMI) assessment. Results One hundred thirty patients with a mean age of 55.2 ± 12.6 years, completed the study. The mean duration of HD was 4.51 ± 3.68 years. The mean SGA was 12.1 ± 3.9. Malnutrition was present in 34 (26.2%) patients [mild to moderate (23.8%), severe (2.4%)]. Patients had a mean BMI of 25.69 ± 4.5 kg/m2, a mean MAC of 25.9 ± 4.9 cm, and a mean TSF of 18.1 ± 8.9 mm. There was a significant negative correlation between malnutrition and mid arm circumference and serum Na with P value of 0.003 and 0.012, respectively. Patients with malnutrition had a significantly longer duration on HD (P=0.004), lower Kt/V (P=0.040), lower serum albumin (P=0.007), lower BMI (P=0.002), less MAC (P=0.002), less TSF (P=0.002). Conclusions Malnutrition is common in HD patients with a significant inverse correlation with mid arm circumference and serum Na. Malnourished patients had a longer duration on HD, lowered serum albumin, BMI, dialysis adequacy and anthropometric measures.

Myo-inositol versus metformin effects on clinical features, endocrine and metabolic profiles in infertile women with polycystic ovary syndrome: A randomized controlled trial

Objective: To compare the effectiveness of inositol and metformin on the clinical characteristics, and endocrine and metabolic profiles of infertile polycystic ovarian syndrome (PCOS) women from Vietnam. Methods: From June 2018 to August 2022, a randomized trial was undertaken at the Hue Center for Endocrinology and Reproduction on infertile women aged 18 to 40 years with polycystic ovarian syndrome. The clinical, endocrine, and metabolic features of these individuals were assessed before and after 3 months of treatment with 2 g of inositol or 1700 mg of metformin per day. Natural pregnancy rates, adverse effects, and tolerance of inositol were recorded. Results: The study included 171 infertile PCOS women who were eligible to participate and took part in the baseline assessment, of whom 132 women participated in data analysis after 3 months. After metformin treatment, 42.1% of women with oligomenorrhea experienced regular menstruation. Metformin significantly lowered body mass index (BMI), waist circumference and testosterone levels, but had no effect on other clinical characteristics, endocrine profiles, or metabolic profiles. 29.2% Of women reported experiencing side effects. 21% Of them attained pregnancy, which resulted in 17.1% of live births. In the inositol group, the rate of regular cycle increased by 18.2% and the total testosterone concentration significantly decreased. In overweight/obese women with PCOS, inositol significantly decreased weight, BMI, waist and hip circumferences (P<0.05). 100% Of women tolerated inositol and continued treatment. 18.9% Of them became pregnant, leading to 17% of live births. Conclusions: Metformin and inositol can improve weight and waist circumference in overweight/obese infertile women with PCOS. Metformin is associated with a higher rate of regular menstruation, whereas inositol is associated with a lower rate of adverse effects. The spontaneous conception, clinical pregnancy, and live birth rates between two groups are comparable.

Body Mass Index Asian populations category and stroke and heart disease in the adult population: a longitudinal study of the Indonesia Family Life Survey (IFLS) 2007 and 2014

BackgroundA substantially elevated Body Mass Index (BMI) is one of the largest global modifiable risk factors for stroke and heart diseases. Most studies classify BMI according to the WHO BMI cut-off point in stroke and heart disease studies. However, there is a limited understanding of the association between the BMI cut-off point in the Asian population category and stroke and heart disease. This study aimed to investigate the incidence rate ratio of stroke and heart disease by BMI categories for the Asian population.MethodsA 7-year prospective longitudinal study (2007–2014) was conducted on 6,688 adult Indonesian individuals (≥ 35 years) residing across 13 different provinces in Indonesia during the survey periods. Data on BMI were collected in 2007. Information on stroke and heart disease was obtained in both 2007 and in 2014. A multivariate-adjusted Poisson regression model was used to estimate the incidence rate ratio (IRR) and 95% confidence intervals (CIs) of either stroke or heart disease or both stroke and heart disease by BMI.Results Among the 6,688 eligible participants, 334 (5%) were judged as stroke and heart disease in 2014. The IRR (95% CI) of stroke and heart disease for participants with obesity was 2.57 (1.64–4.04) compared with those within normal weight. This incidence rate ratio was more pronounced among middle-aged adults (< 55 years) rather than the older adults (≥55 years).The IRR of stroke and heart disease among obese middle-aged adults was 4.18 (95% CI 2.10–8.31).ConclusionsAn association was observed between obesity and the risk of stroke and heart disease, especially in middle-aged adults. These findings suggest that lowering BMI through the adoption of healthy dietary habits and increasing physical activity, particularly among middle-aged adults with high education, occupational employment, and residence in either urban or rural areas, may be beneficial for preventing stroke and heart disease.

Prevention of cardiovascular diseases

Cardiovascular diseases (CVD) are socially significant diseases due to high morbidity and loss of people of working age. In Bulgaria, they are the leading cause of mortality among the population and are a consequence of the effect of cardiovascular risk factors. The draft of the National Health Strategy (NHS) 2021–2030 reports on their wide distribution, as well as on the insufficient knowledge, skills and motivation for their prevention and control. The purpose of this review is to address the prevention of cardiovascular disease, which is a significant problem worldwide. Prevention goals for patients with established cardiovascular disease and those at high risk include smoking cessation, healthy eating, physical activity, and lowering body mass index. There are various methods that are part of health promotion to reduce CVD risks. These methods include motivational interviewing, non-pharmacological means, the use of certain medications for CVD prevention, as well as physical activity. Strategies for effective primary prevention refer to engaging the patient to change their lifestyle and identifying risk factors, while secondary prevention is aimed at activities to detect the disease early and to slow down its progression. It is necessary to create a strategy for timely preventive actions with a view to preventing the negative influence of risk factors and improving people‘s heart health.

Foregut bypass vs. restrictive bariatric procedures for nonalcoholic fatty liver disease: a meta-analysis of 3,355 individuals.

Bariatric surgery represents an important treatment option for severely obese patients with nonalcoholic fatty liver disease (NAFLD). However, there remains inadequate data regarding the effects of different bariatric procedures on various NAFLD parameters, especially for histological outcomes. Thus, this meta-analysis aimed to compare the effects of restrictive bariatric procedures and foregut bypass on the metabolic, biochemical, and histological parameters for patients with NAFLD. Medline and Embase were searched for articles relating to bariatric procedures and NAFLD. Pairwise meta-analysis was conducted to compare efficacy of bariatric procedures pre- vs. post-procedure with subgroup analysis to further compare restrictive against foregut bypass procedures. Thirty-one articles involving 3,355 patients who underwent restrictive bariatric procedures (n=1,460) and foregut bypass (n=1,895) were included. Both foregut bypass (P<0.01) and restrictive procedures (P=0.03) significantly increased odds of fibrosis resolution. Compared to restrictive procedures, foregut bypass resulted in a borderline non-significant decrease in fibrosis score (P=0.06) and significantly lower steatosis score (P<0.001). For metabolic parameters, foregut bypass significantly lowered body mass index (P=0.003) and low-density lipoprotein (P=0.008) compared to restrictive procedures. No significant differences were observed between both procedures for aspartate aminotransferase (P=0.17) and alkaline phosphatase (P=0.61). However, foregut bypass resulted in significantly lower gamma-glutamyl transferase than restrictive procedures (P=0.01) while restrictive procedures resulted in significantly lower alanine transaminase than foregut bypass (P=0.02). The significant histological and metabolic advantages and comparable improvements in biochemical outcomes support the choice of foregut bypass over restrictive bariatric procedures in NAFLD management.

Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study.

To use the parametric g-formula to estimate the long-term risk of atrial fibrillation (AF) by sex and education under hypothetical interventions on six modifiable risk factors. We estimated the risk reduction under hypothetical risk reduction strategies for smoking, physical activity, alcohol intake, body mass index, systolic, and diastolic blood pressure in 14 923 women and men (baseline mean age 45.8 years in women and 47.8 years in men) from the population-based Tromsø Study with a maximum of 22 years of follow-up (1994-2016). The estimated risk of AF under no intervention was 6.15% in women and 13.0% in men. This cumulative risk was reduced by 41% (95% confidence interval 17%, 61%) in women and 14% (-7%, 30%) in men under joint interventions on all risk factors. The most effective intervention was lowering body mass index to ≤ 25 kg/m2, leading to a 16% (4%, 25%) lower risk in women and a 14% (6%, 23%) lower risk in men. We found significant sex-differences in the relative risk reduction by sufficient physical activity, leading to a 7% (-4%, 18%) lower risk in women and an 8% (-2%, -13%) increased risk in men. We found no association between the level of education and differences in risk reduction by any of the interventions. The population burden of AF could be reduced by modifying lifestyle risk factors. Namely, these modifications could have prevented 41% of AF cases in women and 14% of AF cases in men in the municipality of Tromsø, Norway during a maximum 22-year follow-up period.

Interaction between uric acid and obesity with myocardial dysfunction in diabetes

Abstract Funding Acknowledgements Type of funding sources: None. Background Both obesity and hyperuricemia are major risk factors for cardiovascular diseases. Few studies have investigated their impact on cardiac structural and functional changes in patients with diabetes. Purpose This study aims to evaluate the impact of obesity, hyperuricemia and their interaction on myocardial dysfunction in patients with diabetes. Methods A total of 1567 patients with diabetes were recruited from two Hospitals. Uric acid (UA), body mass index (BMI) and myocardial structure and function indicators, including left ventricular hypertrophy (LVH), left ventricular ejection function (LVEF), left ventricular global longitudinal strain (GLS), circumferential strain (CS) and radial strain (RS). Multivariate linear regression was conducted to evaluate the association between myocardial structure and function with UA in obesity and non-obesity. The generalised linear models were used to test for the interaction effects of obesity on the associations between UA level and myocardial structure and function. Results Compared to non-hyperuricemia patients, those who were hyperuricemia had a greater left ventricular mass index (LVMi), a higher proportion of LVH and worse GLS and CS (all P &amp;lt;0.05). Similar patterns were found for those with obesity compared to non-obesity (all P&amp;lt;0.05). In patients with obesity and non-obesity, increasing UA was independently related with decreased GLS and CS. There is a significant interaction between hyperuricemia and obesity on LVMi and GLS in patients with diabetes (P for interaction &amp;lt;0.05) but not on LVEF, CS and RS. Conclusions Obesity and hyperuricemia were associated with worse left ventricular remodeling and left ventricular myocardial function. Those who were obesity and with hyperuricemia had more pronounced LVMi and GLS. Our finding emphasizes lowering UA and BMI in patients with diabetes may effectively prevent myocardial remodeling and dysfunction.

School-Day Physical Activity and Academic Achievement: Mediators Among US Elementary Students

ABSTRACT Introduction/Purpose It is recommended that children get 60 min of moderate-to-vigorous physical activity (MVPA) daily. Previous research on MVPA’s effect on academic achievement (AA) is inconclusive, and few studies have investigated the relationship’s mediators. This study assessed whether cardiorespiratory fitness (CRF) and body mass index (BMI) mediate the school-based MVPA–AA relationship. Methods Grade 4 students (n = 4936) were recruited in 40 elementary schools from a large, diverse US public school district. Students wore accelerometers measuring school-day MVPA for 15 d across three semesters. Academic performance data were collected from grades 3 to 5, and CRF and BMI were measured in grades 4 and 5. Multilevel modeling assessed whether BMI and CRF were mediators in the cross-sectional and longitudinal MVPA–AA relationship. Stratified analyses assessed differences in mediation by sex. Results Cross-sectional analyses found that school-day MVPA had a significant positive indirect effect through higher CRF for various teacher-assigned course grades and English language arts standardized test scores (all P &lt; 0.001). Cross-sectional analyses found no significant mediation through BMI. Longitudinal analyses found that a 10-min increase in daily grade 4 school-day MVPA was associated with higher CRF with 0.16-, 0.09-, and 0.14-point increases in grade 5 math, reading, and writing grades, respectively (all P &lt; 0.001). Decreased grade 4 BMI mediated a 0.06-point increase and 0.05-point increase for grade 5 math and writing grades, respectively (both P &lt; 0.001). The total effect of school-day MVPA on AA was negative but negligible in practical terms. Stratified analyses found more evidence for positive indirect effects through CRF among females. Conclusions School-day MVPA can positively impact AA through increased CRF and (to a lesser extent) lowered BMI, but the effect is negligible. The negative total effects and positive indirect effects suggest that there are other unmeasured mediators. It remains important for schools to protect school-based physical activity given its health benefits.

Chocolate intake is associated with a lower body mass index in adult men and women in transitional Albania

Aim: In light of the controversial evidence regarding health effects of chocolate intake, we aimed to assess its association with body mass index (BMI) among adult individuals in Albania, a transitional post-communist country in South Eastern Europe which has traditionally employed a Mediterranean dietary pattern. Methods: A cross-sectional study was conducted in 2003-2006 involving a population-based sample of 737 Tirana residents aged 35-74 years (469 men, 268 women; overall response: 70%). Of these, 565 individuals (373 men and 192 women) provided data on chocolate intake and anthropometrics (77% of the sample). A 105-item food frequency questionnaire, including chocolate consumption, was administered to all individuals. Nine categories were used to assess the average frequency of intake of each food item in the past 12 months. In the analysis, chocolate intake was dichotomized into: consumption of &lt;1/month vs. ≥1/month. A physical examination included measurement of weight and height. Furthermore, information on socio-demographic characteristics and classical risk factors was collected. Multivariable-adjusted general linear model was used to calculate the mean BMI values by chocolate intake groupings. Results: Upon simultaneous adjustment for socio-demographic characteristics, classical risk factors and nutritional factors, there was an inverse association between BMI and chocolate intake in both sexes (sex-pooled mean BMI: 26.1 among participants who consumed chocolate &lt;1/month vs. 27.0 in those with an intake of ≥1/month; P&lt;0.001). Conclusions: This study points to a beneficial effect of moderate chocolate intake on lowering BMI, which deserves further vigorous investigation and replication in prospective studies in Albania and other populations.

ANALYSIS OF THE BURDEN OF CARDIOVASCULAR DISEASES IN UKRAINE IN 1990-2019.

The aim: To analyze the burden of cardiovascular diseases (CVD) and their modified risk factors in Ukraine to substantiate ways of prevention. Materials and methods: The burden of CVD was estimated by DALYs (Disability-Adjusted Life Years). The statistical method was used to analyze the data obtained from the statistical database of the international epidemiological study «Global Burden of Disease», updated for 2019. The analysis was carried out in the dynamics for 1990-2019 in Ukraine in comparison with European and EU countries. Results: Age-standardized DALYs per 100,000 population in Ukraine are 2.6 times higher than the average in European countries and 4 times higher than in the EU. Over the 1991-2019 the gap in DALYs increased due to a significant decrease in the burden of CVD in Europe, against the consistently high level in Ukraine. The burden of CVD in Ukraine can be reduced on 54.2% by normalizing blood pressure, on 42.1% by improving diet, on 37.3% by lowering low-density lipoprotein cholesterol, on 28.1% by lowering body mass index, and on 22.9% by quitting smoking. Conclusions: The Ukrainian strategy of reducing the burden of CVD should be intersectoral, comprehensive, combine population and individual (for high-risk groups) approaches to the control of modified CVD risk factors with modern methods of secondary and tertiary prevention of CVD, which have proven their efficiency in European countries.

Evaluation of coronary microvascular dysfunction and risk factors in children and youth with Turner syndrome by magnetic resonance myocardial perfusion imaging.

Turner syndrome (TS) has an increased predisposition to ischaemic heart disease and the status of coronary microcirculation in TS is largely unknown. This study aims to evaluate myocardial microvascular function in TS using first-pass magnetic resonance perfusion imaging and determine significant risk factors contributing to microvascular dysfunction in the early stage. Perspective cohort study. The study cohort consisted of 67 children and youth with TS and 32 age- and gender-matched controls. Measurements Clinical characteristics, left ventricle (LV) volume and functionand cardiovascular magnetic resonance-derived myocardial perfusion parameters were assessed. Univariable and multivariable linear regression analyses were performed to assess the potential risk factors for microvascular dysfunction. Microvascular perfusion decreased in TS in global and segmented myocardium as reflected in the lower upslopecor and maximum signal intensity (MaxSI) of LV myocardium compared to controls. Multivariable linear regression analysis indicated that age (β = -0.107, 95% confidence interval [CI] = -0.201 to -0.013, p = .026) and being overweight/obese (β = -1.155, CI = -2.134 to -0.176, p = .021) were independent impact factors of microvascular dysfunction. Subgroup analysis showed the upslopecor of older patients with TS decreased more significantly compared with that of normal controls. Upslopecor and MaxSI were lower in overweight/obese patients with TS than in patients with normal body mass index (BMI) and controls. Myocardial microvascular dysfunction can occur in children and youth patients with TS. Age and overweight/obesity were the independent risk factors of microvascular dysfunction, which imply the importance of lowering BMI for the prevention of coronary heart disease in young TS population.

Effects of access to food retailers and convenience of public transportation on residents’ fresh food intake and body mass index

IntroductionThis study analyzes the effects of food accessibility on fresh food intake and body mass index (BMI) in the lowest level of local government areas (LLGAs) of South Korea. MethodsWe used four sub-variables of physical food accessibility: access to food retailers, availability of public transportation, car ownership, and apartment residence. We used data from the Korea National Health and Nutrition Survey, which were matched with the number of food retail stores and the number of bus stops and subway exits in each respondent's LLGA. We divided the respondents into urban dwellers and rural dwellers in the path analysis. ResultsThe access to food retailers and convenience in public transport were inferior in rural areas relative to urban areas. In urban areas, access to food retailers and public transportation did not affect fresh food intake and BMI, and there was no indirect effect of fresh food intake on BMI. In rural areas, fresh food intake decreased as access to food retailers decreased, which indirectly deteriorated BMI. ConclusionsThe issue of physical accessibility to food supplies in rural areas must be prioritized, and relevant policy interventions from local governments are necessary. Owning private automobiles increased the opportunity to eat fresh foods, and the effect was higher in rural areas, where car ownership lowered BMI indirectly. This suggests that the relative disadvantage of access to food retailers and inconvenient public transport in rural areas can be overcome through transport policies. By doing so, residents can be provided with better access to competitively priced, good-quality food.

Effect of a six-week times restricted eating intervention on the body composition in early elderly men with overweight

The main aim of the study was to determine the effectiveness of time-restricted eating (TRE) in reducing body fat and lowering body mass index in early elderly men with overweight (65–74 years). An additional goal was to determine the feasibility of applying TRE for extensive use in elderly men. This study included a group of 46 healthy men (EXP = 23 persons, CON = 23 persons). The six-week intervention in the experimental group involved complete abstinence from food intake for 16 h per day, from 08:00 to 12:00 p.m. After the intervention, the body weight decreased in the EXP group (− 1.92 kg) with a 95% CI (1.14–2.70) compared to the CON group. There was also a decrease in the Visceral fat mass (− 0.64 l) with 95% CI (0.46–0.82) and in the waist circumference (− 3.11 cm) with 95% CI (1.89–4.33) in the EXP group compared to the CON group. The skeletal muscle mass did not change significantly. There was no significant change in the control group, either. The application of TRE in early elderly overweight men resulted in positive changes in body composition and visceral fat. All participants succeed in the prescribed diet plan, which shows that TRE is easy to maintain for early elderly overweight men and may become an essential obesity treatment tool in these age groups.

The Impact of Soy Isoflavone Supplementation on the Menopausal Symptoms in Perimenopausal and Postmenopausal Women.

Introduction:Approximately one-third of a woman's life is spent in the menopausal phase. The unpleasant menopausal symptoms are unacceptable as a part of routine life. Indications of menopausal hormone therapy (MHT) are for alleviation of vasomotor symptoms, prevention of osteoporosis, and genitourinary symptoms associated with menopause. MHT is associated with an increased risk of breast cancer, cerebrovascular accidents, and coronary heart disease. Soy isoflavones have been extensively used as an alternative treatment in patients who cannot take MHT. The evidence of the efficacy of isoflavones in the literature is equivocal.Aim:The aim of the study was to evaluate the efficacy of soy isoflavone supplementation on menopausal symptoms in perimenopausal and postmenopausal women and to evaluate the effect on blood pressure (BP) and body mass index (BMI).Materials and Methods:A questionnaire-based prospective observational study was undertaken involving 39 perimenopausal and 61 postmenopausal women, who were prescribed 40 mg soy isoflavone supplements twice daily for 12 weeks. Menopause Rating Scale questionnaire was given to the patients before starting soy isoflavone therapy and at the end of the treatment; BP and BMI were also noted.Results:The total score of both the groups was comparable at baseline. Among perimenopausal and postmenopausal women, the highest score was noted in symptoms of somatic domain. At the completion of our study, the total scores improved significantly by 38.6% and 33.3% in perimenopausal and postmenopausal women, respectively. The greatest improvement was seen in somatic subscale (42.5%) and psychological subscale (42.5%) and the least in urogenital subscale (16.1%) for perimenopausal women. For postmenopausal women, the greatest improvement was seen in psychological subscale (40.0%) and the least in urogenital subscale (14.2%).Conclusion:Soy isoflavone supplementation is beneficial in both perimenopausal and postmenopausal women, more so in perimenopausal women. There is no beneficial effect of soy isoflavone supplementation on lowering systolic BP and BMI.

Impact of Body Mass Index on Postoperative Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy Undergoing Septal Myectomy.

BackgroundObesity is an established cardiovascular risk factor in patients with hypertrophic cardiomyopathy. Postoperative atrial fibrillation (POAF) is one of the most common complications after surgery in patients with obstructive hypertrophic cardiomyopathy (OHCM). We aimed to determine the impact of body mass index (BMI) on the occurrence of POAF in patients with OHCM who underwent septal myectomy.Methods and ResultsIn all, 712 OHCM patients without previous atrial fibrillation who underwent septal myectomy were identified. Patients were stratified into 3 groups based on BMI. Of these, 224 (31.5%) had normal weight (BMI<24 kg/m2), 339 (47.6%) were overweight (BMI, 24 to <28 kg/m2), and 149 (20.9%) were obese (BMI≥28 kg/m2). Overweight and obese patients had increased levels of left atrial diameter (P<0.001) and left ventricular end‐diastolic diameter (P<0.001), compared with patients with normal weight. Among 184 patients (25.8%) developing POAF, 32 cases (14.3%) occurred in the normal weight group, 100 cases (29.5%) occurred in the overweight group, and 52 cases (34.9%) occurred in the obese group (P<0.001). Logistic regression analysis indicated that overweight (odds ratio [OR]: 2.161, 95% CI, 1.333–3.503; P=0.002) or obesity (OR, 2.803; 95% CI, 1.589–4.944; P<0.001), age (OR, 1.037; 95% CI, 1.018–1.057; P<0.001), and left atrial diameter (OR, 1.060; 95% CI, 1.027–1.095; P<0.001) were independently associated with the occurrence of POAF in patients with OHCM.ConclusionsOverweight and obesity are strong predictors of POAF in patients with OHCM. Strategies aimed at lowering BMI may be a potential way to prevent POAF.

The IMAGINE Intervention: Impacting Physical Activity, Body Fat, Body Mass Index, and Dietary Inflammatory Index.

Many behavior-change interventions focused on nutrition and physical activity (PA) have been implemented to prevent disease and promote optimal health. This study examined changes in PA with Energy-adjusted Dietary Inflammatory Index (E-DII™) and chronic disease risk factors in participants of a multicomponent intervention. Data from the Inflammation Management Intervention (IMAGINE) were used. Participants self-selected into the intervention or control group. At baseline and 12 weeks (post-intervention), participants completed three unannounced 24-hour dietary recalls (24HR), anthropometric measures (height, weight), and a dual x-ray absorptiometry scan. PA was measured using Sensewear® armbands. E-DII scores were calculated from the 24HR. Descriptive statistics and t-tests summarized variables and multiple regression assessed relationships between PA and body mass index (BMI), total body fat percent, and E-DII scores. Intervention participants increased moderate-to-vigorous PA (MVPA) and lowered BMI, total body fat, and E-DII scores compared to controls. Every 10-minute increase in post-intervention MVPA was associated with 1.6 kg/m2 lower BMI (p<0.01) and 2.4% lower body fat percent (p<0.01) among control participants, after adjusting for covariates. Every 10-minute increase in post-intervention MVPA was associated with 0.3 lower (i.e., less inflammatory) post-intervention E-DII (p=0.01) scores among intervention participants, after adjusting for covariates. Participants who changed dietary intake changed PA. While changes were in expected directions, this intervention's emphasis on dietary behaviors compared to PA may have attenuated the relationship between PA and study outcomes.

Functional High-Intensity Interval Training Lowers Body Mass and Improves Coordination, Strength, Muscular Endurance, and Aerobic Endurance of Inmates in a German Prison.

This study examined the effects of circuit-like functional high-intensity interval training (HIIT) on body composition and motor performance of inmates in an open German prison. The group of inmates (n=11) consisted of predominantly overweight males [average body-mass-index (BMI)=31.2]. They performed 6weeks of training including 3 sessions per week. The 6-week training program was framed by a pre-test and a post-test that assessed anthropometry and motor performance. On average, the inmates participated in 91.9% of all training sessions. The intervention significantly lowered body mass (p=0.007) and BMI (p=0.006). Fat mass and fat-free mass did not change significantly from pre-test to post-test. The times in 20m sprint did not change. The performance in lateral jumping from side-to-side (p=0.024), standing long jump (p=0.001), and 30–15 Intermittent Fitness Test (p<0.001) improved significantly. The greatest improvements were observed in the number of sit-ups (p<0.001) and push-ups (p<0.001). These findings suggest that (functional) HIIT is a practical and effective training method in the context of a prison.

Is residential greenness associated with dyslipidemia and lipid levels in Chinese rural-dwelling adults? The Henan rural cohort study.

Scarce epidemiologic research examined the associations between residential greenness and dyslipidemia or lipid levels in low/middle-income countries. Baseline statistics (2015-2017) of 39,259 rural-dwelling adults were obtained from a Chinese longitudinal study. The blood lipid level was measured utilizing an enzymatic assay method. According to the 2016 Chinese guidelines on dyslipidemia (revision), patients with dyslipidemia were defined. Participants' exposure to residential greenness was characterized by the satellite-based normalized difference vegetation index (NDVI). Mixed effects logistic regression and mixed effects linear regression were performed to assess the associations of residential greenness with dyslipidemia and lipid levels. The median (interquartile range, IQR) of 3-year average NDVI1000-m was 0.521 (0.089) units. Each IQR increase in NDVI1000-m was significantly linked with increased odds of hyperbetalipoproteinemia (OR = 1.33, 95%CI 1.21-1.46). The same increment in NDVI1000-m was associated with lower total cholesterol (TC) levels and increased low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels. For instance, the %changes in HDL-C levels was 0.71% (95%CI 0.17%-1.26%). The above relationships were partially mediated by reducing air pollution and lowering body mass index (BMI). Interaction effect analysis observed the greenness-lipid association was stronger in males than females (i.e., NDVI1000-m-TC association). Long-term exposure to residential greenness was associated with odds of dyslipidemia and lipid levels in Chinese rural-dwelling adults, particularly among males. Considering the cross-sectional study design, more longitudinal studies are needed to identify the causal associations.