Mean Change In BMI Research Articles

Psychosocial stress is positively associated with body mass index gain over 5 years: evidence from the longitudinal AusDiab study.

Emerging evidence suggests that psychosocial stress may influence weight gain. The relationship between stress and weight change and whether this was influenced by demographic and behavioral factors was explored. A total of 5,118 participants of AusDiab were prospectively followed from 2000 to 2005. The relationship between stress at baseline and BMI change was assessed using linear regression. Among those who maintained/gained weight, individuals with high levels of perceived stress at baseline experienced a 0.20 kg/m(2) (95% CI: 0.07-0.33) greater mean change in BMI compared with those with low stress. Additionally, individuals who experienced 2 or ≥3 stressful life events had a 0.13 kg/m(2) (0.00-0.26) and 0.26 kg/m(2) (0.14-0.38) greater increase in BMI compared with people with none. These relationships differed by age, smoking, and baseline BMI. Further, those with multiple sources of stressors were at the greatest risk of weight gain. Psychosocial stress, including both perceived stress and life events stress, was positively associated with weight gain but not weight loss. These associations varied by age, smoking, obesity, and multiple sources of stressors. Future treatment and interventions for overweight and obese people should consider the psychosocial factors that may influence weight gain.

Effect of Bougie Size and Level of Gastric Resection on Weight Loss Post Laparoscopic Sleeve Gastrectomy

Objectives: To study the effect of bougie size and level of gastric resection on the outcome of laparoscopic sleeve gastrectomy (LSG) in morbid obese patients. Methods: A prospective randomized trial on 90 patients with morbid obesity who underwent LSG between February 2010 and April 2012. The Patients were prospectively randomized into two groups, the first group in which a bougie size of 34 French was used and resection of the stomach was performed 4 cm from pylorus. In the second group, a bougie size of 36 French was used, and resection of the stomach was performed 6 cm from the pylorus. A comparison between the two groups was carried out by assessing percentage of excess weight loss (%EWL), mean body mass index changes (mean BMI) at 6 months and one year post-operative, and complications of surgery . Results: Out of 45 patients in first group, 15 were males (33.3%) and 30 were females (66.7%), mean age was 31.3 years and mean BMI 46.1 kg/m2 (range 40-55.6). out of 45 patients in second group, 14 were males (31.2%) and 31were females (68.8%) with mean age of 32.3 years and mean BMI 45.4 kg/m2 (range 40-56). Six months after LSG, the %EWL in first group was 79% while in second group was 68% (P-value=0.011), and the mean BMI change was 10.1 kg/m2 (range 5-11) and 8.3 kg/m2 (range 4-9) respectively (P-value=0.009). One year after LSG, the %EWL in first group was 84% while in second group was 76 % (P-value=0.015), and the mean BMI change was 14.3 kg/m2 (range 7-15) and 11.2 kg/m2 (range 5-13) respectively (P-value=0.012). In both groups, the duration of operative time, bleeding, gastric leak, Intensive care unit admission, and hospital stay were similar in which statistically insignificant (p-value>0.05). Conclusion: Using bougie size 34fr and gastric resection at 4cm from the pylorus is safe and results in greater weight loss and higher change in BMI.

Impact of nutritional counseling on dietary practices and body mass index among people living with HIV/AIDS at a tertiary care teaching hospital in Mumbai

Background: In India, human immunodeficiency virus (HIV) epidemic occurs in the population in which malnutrition is already endemic. The relationship between HIV and nutrition is multi-faceted and multi-directional. HIV can cause or worsen malnutrition due to decreased food intake, increased energy requirements, and poor nutrient absorption. Malnutrition in turn further weakens the immune system, increasing susceptibility to infections and worsening the disease impact. Materials and Methods: This interventional study was carried out in the antiretroviral therapy (ART) Centre of Topiwala National Medical College and BYL Nair Ch. Hospital, Mumbai during the period of July 2011 to February 2012. A total of 123 patients during the study period were included and a pre-designed and pre-tested questionnaire was used to collect data. Data were analyzed using Statistical Package of Social Sciences (SPSS) 16.0. Results: In the present study, out of 123 study participants taken into consideration, 47.15% were males and 52.85% were females. After nutritional counseling, the percentage of participants practice of using boiled or clean water for drinking purpose increased significantly from 30.90% to 82.12% ( P < 0.0001) and to not eat leftover food increased from 26.83% to 81.30% ( P < 0.0001). The change in mean BMI was observed to be statistically significant from baseline Visit I (20.859) to Visit III (21.916) ( P < 0.0001). Conclusion: Effects of nutritional counselling in our study groups were favourable. There were improvements in dietary practices about nutrition in people living with HIV/AIDS.

Patterns of weight change and progression to overweight and obesity differ in men and women: implications for research and interventions.

To evaluate long-term patterns of weight change and progression to overweight and obesity during adulthood. Prospective study. Changes in mean BMI, waist circumference (WC) and weight were assessed over a mean 26-year follow-up (1971–1975 to 1998–2001). Mean BMI (95% CI) and mean WC (95% CI) of men and women in BMI and age groups were computed. Mean weight change in BMI and age categories was compared using analysis of covariance. Framingham Heart Study Offspring/Spouse Nutrition Study. Men and women (n 2394) aged 20–63 years. During follow-up, increases in BMI (men: 2?2 kg/m2; women: 3?7 kg/m2) and WC (men: 5?7 cm; women: 15?1 cm) were larger in women than men. BMI gains were greatest in younger adults (20–39 years) and smallest in obese older adults (50–69 years). The prevalence of obesity doubled in men (to 33?2%) and tripled in women (to 26?6 %). Among normal-weight individuals, abdominal obesity developed in women only. The prevalence of abdominal obesity increased 1?8-fold in men (to 53?0%) and 2?4-fold in women (to 71?2 %). Weight gain was greatest in the youngest adults (20–29 years), particularly women. Gains continued into the fifth decade among men and then declined in the sixth decade; in women gains continued into the sixth decade. Patterns of weight change and progression to obesity during adulthood differ in men and women. Preventive intervention strategies for overweight and obesity need to consider age- and sex-specific patterns of changes in anthropometric measures.

Q20 A multidisciplinary intensive rehabilitation programme for persons with Huntington's disease: results after 1 year

BackgroundPersons with Huntington's disease (HD) may benefit from intensive rehabilitation.AimTo assess effects of an intensive, multidisciplinary rehabilitation programme in subjects with early to mid-stage HD.Methods37 subjects completed a 1-year rehabilitation...

Outcomes of an adolescent bariatric service

<h3>Aims</h3> Bariatric surgery has been shown to be the most effective available intervention for weight loss1. The literature is largely confined to adults but outcome data for adolescents undergoing surgery appear consistent with adult data2. Mean weight loss of approximately 20 kg/m² after Roux-en-Y gastric bypass compare favourably to adolescent lifestyle interventions (mean loss = 3.27 kg/m²) and anti-obesity drugs (orlistat mean loss = 0.83 kg/m², metformin mean loss = 1.43 kg/m²)3,4,5. <h3>Results</h3> 38 young people (YP) have been through the adolescent bariatric pathway at a tertiary hospital since 2007, 11 of whom have completed bariatric surgery. 13 YP aged 14.1 to 18.5 years (mean 16.5 years) are currently undergoing assessment and preparation for surgery. 5 YP have completed surgery within the adolescent bariatric surgery programme. All had completed puberty and were aged 15.5 to 18.6 years. Mean pre-operative BMI was 54.5 kg/m² (range 47.9-77.4). 2/5 had Roux-en-Y gastric bypass procedure, 3/5 had sleeve gastrectomy and 0/5 had gastric band. Mean BMI loss was 15.3 kg/m² (17.7 kg/m² with gastric bypass, 13.7 kg/m² sleeve gastrectomy) and a mean follow-up time of 1.0 year. 9 YP have been assessed and discharged: 3 were not eligible, and 6 decided that they did not want surgery at the time. 12 patients transitioned to the adult bariatric service at the same institution and 5 underwent surgery (age range 17.9 to 19.5 years): 2/5 had Roux-en-Y gastric bypass, 3/5 had gastric sleeve and 0/5 had gastric band. Mean BMI change was −6.1 kg/m² (range +0.2 to −9.9) with a mean follow-up of 0.7 years. One further patient had surgery within the private sector and no follow up data is available. <h3>Conclusion</h3> 11 young people (30% of those who entered the pathway) have undergone bariatric surgery with outcomes comparable to adult studies. Bariatric surgery appears effective and relatively safe within an NHS pathway.

PA01.77. Clinical study on effect of Tila Taila Pana on Karshya wsr to Vata Dominating Prakriti)

The diseases related to nutrition constitute the most important health problem of the world. It may be due to over nutrition in the form of obesity (Sthula) as in developed countries and due to under nutrition in the form of underweight (Karshya) as in the developing countries. It has been estimated that as many as two third of the world population suffer by under nutrition. According to Ayurvedic classics Vataja Prakriti person has lean body constitution and there is continuous degradation and aggradations in the body (Chakrapani Tika). So in person of Vataja Prakriti this phenomenon of degradation will lead to undernourishment thus resulting in difficulty for the person to cope with requirements of his life and falling prey to many disease even death. Aims and objectives: To study the effect of oral administration of "Tila Taila" in Karshya person. To include "Tila Taila" in the food for well-being of the person. Materials and methods: The study was carried out in 80 individuals of Karshya, which were divided into 2 Groups. Group A having 35 persons were treated with Tila taila and Group B having 37 persons were treated with Mahish ghrita. Result & Observations: It was found that Group A i.e. treatment with Tila taila showed highly significant results in BMI followed by Group B showing significant results in serum cholesterol. Percentage of relief in symptoms was better in Group A but statistically both group shows significant result separately. Conclusion: Maximum individuals i.e. 25% are with weight gain between 0.6 1kg. Mean change in serum cholesterol in Group A was 8.45 and in Group B was 18.27 and p value was 0.0001. Mean change in BMI in Group A was 0.43 and in Group B was 0.29 and p value was <0.05.

Relationship between the absorption of 5-hydroxytryptophan from an integrated diet, by means of Griffonia simplicifolia extract, and the effect on satiety in overweight females after oral spray administration.

The management of overweight may include the use of dietary supplements targeted to counter the feeling of hunger. A randomized, double-blind, placebo-controlled trial has been performed in 20 overweight females. These subjects were randomly assigned to supplement their diet with either an extract from Griffonia Simplicifolia (10 subjects) or a placebo (10 matched subjects) for 4-weeks, in conjunction with a personalised reduced calorie diet. The main aim of this study was to evaluate the efficacy, by the assessment of 24-h urinary 5-hydroxyindoleacetic acid levels (5-HIAA), of 1-month administration of a dietary supplement containing 5-hydroxytryptophan (5-HTP) from botanical extracts in healthy, overweight females. Secondary endpoints were the assessment of sensation of appetite (by Haber score), body composition, and severity of binge eating. The supplemented group had a significant increase of 24-h urinary 5-HIAA levels (p<0.001), and a decrease in Haber score (p<0.001) while the placebo group did not show significant changes. With regard to changes in body composition, statistically significant differences between the treatment groups were found for the mean change in BMI, suprailiac skinfold thicknesses, arm circumference and hip circumference. Other parameters were found to be similar in the treated and in the placebo groups. In conclusion, this study shows that the 5-hydroxytryptophan present in the Griffonia extract, administered via spray to the oral cavity, is adequately absorbed, as confirmed by the increase in 24-h urinary 5-HIAA, and that the supplementation of the diet of overweight women with 5-hydroxytryptophan increases the feeling of satiety associated with a decrease in BMI.

Association Between Physician Recommendation for Adolescents to Join a Weight Loss Program and BMI Change

To explore whether reasons for enrollment in a pediatric multidisciplinary weight management program (PMWMP) are associated with subsequent weight loss. A retrospective analysis of obese adolescents (12-18 years old, body mass index [BMI] > 95th percentile) who enrolled in a PMWMP from April 2007 to March 2009, and had BMI measurements at weeks 1 and 12. Reasons for enrollment were obtained from parents' responses to an enrollment questionnaire (which allowed selection of more than one reason). The most common reasons for enrollment were computed. Linear regression was used to explore associations between mean change in BMI and reasons for enrollment, controlling for demographic and anthropometric factors. Most of the 90 adolescents who met the inclusion criteria were female (70%) and white (57%). Mean age was 14.5 years and mean initial BMI was 42 kg/m(2). The most common reasons for enrolling in the PMWMP were due to concerns about adolescents' physical health (96%), concerns about adolescents' mental health (76%), and because of a physician recommendation (73%). The mean 12-week change in BMI showed a greater decrease for those who enrolled due to a physicians' recommendation versus those who did not (-1.5 vs -0.5 kg/m(2): P < .05). This finding remained significant even when controlling for the covariates of interest. A physician's recommendation to join a PMWMP appears to be associated with greater weight loss among obese adolescents than other reasons for enrollment. Further research should explore how physician involvement affects long-term weight loss.

Plateau in obesity and overweight in a cross sectional study of low, middle and high socioeconomic status schoolchildren between 2004 and 2009

To examine cross-sectional trends in obesity and overweight by gender, age and school socioeconomic status (SES) in 1,239 children aged 9-12 years from the same 10 primary schools in 2004 and 2009. Self report questionnaire with measured height and weight. BMI and international (IOTF) standards were used to classify overweight and obesity. School SES was determined using a combined government measure of family income and parental education. There was no significant change in obesity, overweight or mean BMI between 2004 and 2009. Obesity decreased slightly but not significantly at 7.0% in 2004 and 4.8% in 2009 (P = 0.42). The significant predictors of obesity were a low school SES (OR = 2.42, P = 0.007) and age ≤10 years (OR = 2.33, P = 0.002). Male gender was a marginally significant predictor (OR = 1.60, P = 0.08). School SES, age and gender were not predictors of overweight. Obesity and overweight remain high, but the increase of earlier years has abated. Children from low SES schools and in younger age groups remained most at risk of obesity. Preventive measures, physical activity and nutrition interventions are needed.

Weight change in middle age poor Mexican women in a 10y period

To explore the weight change over time and its associated factors in women from semi‐rural area in Mexico.MethodsWomen participating in a randomized controlled micronutrient supplementation trial during pregnancy in 1998 were followed in 2005 and 2008. Information on weight, physical activity (PA) and socio‐demographic information was collected on each contact (n= 632). Furthermore, in a subsample (n=100) we collected blood samples in order to explore the distribution of SNP LEPTINA 3UTR, and SNP PPARG Pro12Ala. General estimating equations (GEE) were estimated to explore the association of weight change over time, and socio‐demographic, characteristics and changes in PA level.ResultsWomen were on average 23.6±5.5y and had a parity of 2.4±1.4 when were first recruited. The combined prevalence of overweight and obesity increased from38.1% in 1997 to 74.2% and 83.6 % for 2005, and 2008 respectively. The mean BMI change was 5.1±3.3 from 1998–2008. After adjusting for potential confounders, BMI change was associated to parity, (beta coefficient 1.5± 0.05, p&lt; 0.01), and socioeconomic level, showing that women at the highest tertile had a greater increase in BMI (p&lt;0.01).DiscussionThe overweight and obesity in this sample increased almost 46 percentage points in a 9 years period. In women from poor semi‐rural community, having a wealthier economic status and high parity might be potential risk factors for obesity

P02-301 - Risperidone and weight change in children with learning disability. A retrospective study

AimRisperidone has been recommended for the management of disruptive behaviour disorders in children with learning disabilities. This study explored the effects of Risperidone on absolute body weight in children with learning disabilities who received Risperidone for disruptive behaviour disorders.MethodologyData was collected for children (n = 70) with learning disabilities who were prescribed Risperidone for disruptive behaviour disorders in out patient clinic. Weight, height and BMI were recorded at the first appointment and at the follow up for up to one year. Data was analysed to find any changes in weight and BMI during the course of treatment with Risperidone.ResultsMean weight gain for the sample was 6.1 kg (sd = 2.7), 1.7 kg more than expected in one year which was statistically significant (t = 6.2, df = 69, p &lt; 0.001). Mean BMI change was 1.51 kg; significantly larger than the mean expected BMI change of 0.62 of this sample (t = 4.98, df = 1.6, P = 0.001). Change in BMI was more for girls, 2.17 (sd = 1.00) compared with boys 1.36 (sd = 1.18), but this was not significant (t = 1.90, df = 49, p = 0.06). There is no significant relationship between Risperidone dose and weight gain (Pearson's r = 0.21, p = 0.42) and BMI (Pearson's r = 0.03, p = 1.00).ConclusionRisperidone should be used with caution in children where weight gain could have long lasting impact. Prescribing clinicians should obtain baseline measures of weight, height, BMI and monitor them at regular intervals. Emphasis should be placed on life style interventions such as diet, physical activities etc. Further comparable studies with larger sample sizes using more homogenous diagnostic samples are needed.

Long-term stable obesity increases risk of hypertension

Although some prospective cohort studies have shown that baseline BMI is positively associated with a future incident risk for hypertension, these studies do not account for weight changes during the observation period. Therefore, it is not evident whether future incident risk for hypertension in obese, non-hypertensive people increases when their weight remains stable. We examined the association between long-term weight stability and risk for developing hypertension. A total of 5201 Japanese male workers aged 30-59 years underwent health checkups in 2002 and were followed through 2006. To consider transitions in covariates during the follow-up period, we used a time-dependent covariate Cox proportional hazard model to compute the relative risks (RRs) of incident hypertension. Furthermore, as a complementary analysis, we restricted the data to individuals whose BMI remained unchanged (± 5% of baseline BMI) during the follow-up and compared the RRs between BMI categories. During the follow-up, there were 899 newly diagnosed cases of hypertension among the 5201 men (14,888 person-years). Mean change in BMI during the follow-up period of all subjects was 0.2 ± 1.1 kg/m(2) (range: -6.6 to 6.3 kg/m(2)). The multivariate RRs for hypertension increased as BMI increased when we applied the time-dependent covariate Cox proportional hazard model. The complementary analysis showed that the multivariate RR (confidence interval) within the ≥ 27.0 kg/m(2) BMI category was 1.43 (1.16-1.77) times higher than the reference of 23.0-24.9 kg/m(2), whereas the RR for the <21.0 kg/m(2) BMI category was 0.63 (0.51-0.79) times lower than the reference. A higher baseline BMI increases future incident risk for hypertension even when there has been no major weight increase. Weight management should be encouraged for obese, non-hypertensive people to prevent future hypertension.

Levelling off of prevalence of obesity in the adult population of Sweden between 2000/01 and 2004/05

BackgroundThe escalating global epidemic of obesity is of worldwide concern because of its association with several chronic diseases and premature mortality. Some subgroups seem to be more affected than others. The aim of this study was to examine whether the mean BMI (adjusted for age) and the prevalence of obesity (adjusted for all the explanatory variables) changed between 2000/01 and 2004/05 in different subgroups of the Swedish population.MethodsThis study compared two cross-sectional, nationwide random samples of persons aged 16 to 84 years: the first from 2000/01 (5515 men, 5838 women) and the second from 2004/05 (4681 men, 4821 women). After stratification by gender, a logistic regression model was applied to analyse possible changes in mean BMI and the prevalence of obesity between 2000/01 and 2004/05.ResultsTotal mean BMI remained almost unchanged between 2000/01 and 2004/05 for both men and women. The prevalence of obesity increased slightly in both men and women, but not significantly (from 9.7 to 10.8% and from 9.6 to 10.2%, respectively). The prevalence of obesity in 2004/05 was especially high in some subgroups: men aged 45-54 (14.3%) or 55-64 (16.5%), women aged 65-74 (15.9%) or 75-84 (16.8%), men and women of middle educational level (15.6% and 14.4%, respectively), male former smokers (13.4%), and men from small towns or rural areas (13.1%).ConclusionsAlthough the mean BMI and obesity were almost unchanged in the Swedish adult population between 2000/01 and 2004/05, obesity levels in Sweden remained unacceptably high, especially in certain subgroups. Primary and secondary intervention actions should strive to decrease the prevalence of obesity in Sweden.

Worksite environment intervention to prevent obesity among metropolitan transit workers

Objective The results of an 18-month worksite intervention to prevent obesity among metropolitan transit workers are reported. Methods Four garages in a major metropolitan area were randomized to intervention or control groups. Data were collected during the fall of 2005 prior to the start of the intervention and during the fall of 2007, after the intervention ended. Intervention program components at the garage included enhancement of the physical activity facilities, increased availability of and lower prices on healthy vending machine choices, and group behavioral programs. Mixed model estimates from cross-sectional and cohort samples were pooled with weights inverse to the variance of their respective estimates of the intervention effects. Results Measurement participation rates were 78% at baseline and 74% at follow-up. The intervention effect on garage mean BMI change was not significant (-0.14 kg/m 2). Energy intake decreased significantly, and fruit and vegetable intake increased significantly in intervention garages compared to control garages. Physical activity change was not significant. Conclusion Worksite environmental interventions for nutrition and physical activity behavior change may have limited impact on BMI among transit workers who spend most of their workday outside the worksite.

The Legume Inflammation Feeding Experiment (LIFE): Weight Loss Effects

The LIFE study was a randomized controlled crossover feeding experiment intended to assess the effects of a low‐glycemic legume‐rich diet on biomarkers of inflammation and insulin resistance (IR). Sixty‐four male participants (35‐75 yrs) were recruited from Central Pennsylvania and divided into 4 possible groups: IR (Y or N) and history of adenomatous polyps (Y or N). All participants consumed a legume diet (LG; 1 1/2 cup cooked dry beans) and an average American diet (AA), each for four weeks split by a 3‐week washout interlude. A total of 44 of the subjects completed the required two dietary periods and then completed an optional 4‐week weight‐loss period. During the weight loss period we tested whether the legume rich diet would facilitate weight loss. Subjects were asked to consume the bean‐containing foods but were able to eliminate other foods. For the weight loss period, incipient mean BMI (±S.D.) was 29.04 (3.39). Initial results indicate a mean change in BMI of 1.36 (1.01) accounting for a 5.09% decrease in BMI with a significant difference over the dietary period (P=0.0001). Mean change in BMI was calculated for each of the classifications and proved to be significantly different from across strata (P= 0.0033). Those participants experiencing the most weight loss (&gt; 5.2kg) also experienced a significant decrease in serum total cholesterol (TC) and LDL cholesterol (LDL‐C) (P=0.0345 and 0.001, respectively). Results indicate that the legume‐rich diet may have favorable effects on weight‐loss among individuals at high risk for colon cancer. Supported by the National Cancer Institute; partial support provided by the GCRC, PSU.

Energy density and weight change in a long-term weight-loss trial.

BackgroundHealth risks linked to obesity and the difficulty most have in achieving weight loss underscore the importance of identifying dietary factors that contribute to successful weight loss.MethodsThis study examined the association between change in dietary energy density and weight loss over time. Subjects were 213 men and women with BMI of 30–39 kg/m2 and without chronic illness enrolled in 2004 in a randomized trial evaluating behavioral treatments for long-term weight loss. Subjects completed a 62-item food frequency questionnaire at baseline and at 6, 12, and 18 months.ResultsPearson correlations between BMI and energy density (kcals/g of solid food) at baseline were not significantly different from zero (r = -0.02, p = 0.84). In a longitudinal analysis, change in energy density was strongly related to change in BMI. The estimated β for change in BMI (kg/m2) of those in the quartile representing greatest decrease in energy density at 18 months compared to those in the quartile with the least was -1.95 (p = 0.006). The association was especially strong in the first six months (estimated β = -1.43), the period with greatest weight loss (mean change in BMI = -2.50 kg/m2 from 0–6 months vs. 0.23 kg/m2 from 12–18 months) and the greatest contrast with respect to change in energy density.ConclusionDecreased energy density predicted weight loss in this 18 month weight loss study. These findings may have important implications for individual dietary advice and public health policies targeting weight control in the general population

Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational studies and interventions

Sugar-sweetened soft drinks (SSD) are a special target of many obesity-prevention strategies, yet critical reviews tend to be more cautious regarding the aetiological role of SSD in promoting excess body weight. Since ongoing evaluation of this issue is important, the present systematic review re-examined the evidence from epidemiological studies and interventions, up to July 2008. Database searches of Medline, Cochrane reviews, Google scholar and a hand search of cross-references identified forty-four original studies (twenty-three cross-sectional, seventeen prospective and four intervention) in adults and children, as well as six reviews. These were critically examined for methodology, results and interpretation. Approximately half the cross-sectional and prospective studies found a statistically significant association between SSD consumption and BMI, weight, adiposity or weight gain in at least one subgroup. The totality of evidence is dominated by American studies where SSD consumption tends to be higher and formulations different. Most studies suggest that the effect of SSD is small except in susceptible individuals or at high levels of intake. Methodological weaknesses mean that many studies cannot detect whether soft drinks or other aspects of diet and lifestyle have contributed to excess body weight. Progress in reaching a definitive conclusion on the role of SSD in obesity is hampered by the paucity of good-quality interventions which reliably monitor diet and lifestyle and adequately report effect sizes. Of the three long-term (>6 months) interventions, one reported a decrease in obesity prevalence but no change in mean BMI and two found a significant impact only among children already overweight at baseline. Of the six reviews, two concluded that the evidence was strong, one that an association was probable, while three described it as inconclusive, equivocal or near zero. Reasons for some discrepancies are presented.

Overweight and Obesity Doubled Over a 6-year Period in Young Women Living in Poverty in Mexico

To document the changes in BMI and the prevalence of overweight and obesity in young women living in poverty in a semi-urban community in Mexico. Women who had previously participated in a longitudinal research study (1997-2000) were re-assessed in 2005. Anthropometric measurements were obtained using standard procedures, and socio-demographic questionnaires were administered. Total and annual rate of change in BMI and change in the prevalence of overweight and obesity (BMI > or = 25.0 and > or =30.0) were estimated. Mean age in 2005 was 30.0 +/- 5.7 years (n = 683) and time between recruitment and follow-up was 6.4 +/- 1.0 years. Mean change in BMI was +3.6 +/- 2.7 (range -8.2 to +14.6). In 2005, 500 (73.2%) women were overweight, up from 263 (38.5%) in the original assessment. The prevalence of obesity tripled over the follow-up period (from 9.8% to 30.3%). The mean annual rate of change in BMI was +0.6 (+/-0.4). After adjustment for age and parity at baseline, an annual rate of change of BMI above the sample median (>0.5) was associated with lower levels of formal education. The annual increase in the prevalence of overweight and obesity in this sample is double that which was reported at a national level in Mexico. An understanding of the determinants of this rapid increase among the women living in poverty in Mexico is urgently needed.

A well-being programme in severe mental illness. Reducing risk for physical ill-health: A post-programme service evaluation at 2 years

Introduction Cardiovascular disease is more prevalent in patients with severe mental illness (SMI) than in the general population. Method Seven geographically diverse centres were assigned a nurse to monitor the physical health of SMI patients in secondary care over a 2-year period in the “Well-being Support Programme” (WSP). A physical health screen was performed and patients were given individual weight and lifestyle advice including smoking cessation to reduce cardiovascular risk. Results Nine hundred and sixty-six outpatients with SMI >2 years were enrolled. The completion rate at 2 years was 80%. Significant improvements were observed in levels of physical activity ( p < 0.0001), smoking ( p < 0.05) and diet ( p < 0.0001). There were no changes in mean BMI although 42% lost weight over 2 years. Self-esteem improved significantly. Low self-esteem decreased from 43% at baseline to 15% at 2 years ( p < 0.0001). At the end of the programme significant cardiovascular risk factors remained, 46% of subjects smoked, 26% had hypertension and 81% had BMI >25. Conclusion Physical health problems are common in SMI subjects. Many patients completed 2 years follow up suggesting that this format of programme is an acceptable option for SMI patients. Cardiovascular risk factors were significantly improved. Interventions such as the Well-being Support Programme should be made widely available to people with SMI.