Difference In Mean Body Mass Index Research Articles

Changes in weight and waist circumference over 9 years in a Scottish population

To document patterns of measured weight and waist circumference (WC) change and the increase in overweight and obesity over a 9-year period. A total of 1044 subjects from two age-defined cohorts aged 39 and 59 in 1991. Height, weight and WC were measured in 1991, 1995 and 2000 and body mass index (BMI) was calculated. Pattern of weight and WC change was studied over approximately 9 years. The prevalence of overweight and obesity increased markedly and the younger cohort showed greater increases in weight and WC than the older cohort. There was no significant difference in mean BMI and/or mean 9-year weight change between men and women in either age cohort, and mean weight gain was similar for all occupational groups. Only 20% of subjects maintained a stable weight (+/-2 kg), while 42.2 and 17.6% gained greater than 5 and 10 kg over the 9-year period, respectively. The rate of weight gain appeared to be relatively steady over the 9 years among younger subjects but declined in the older subjects in the second half of the observation period. Health promotion strategies to prevent weight gain need to be population-based, targeting all social and age groups, but particularly those in their early middle-age.

Body Mass Index and Chronic Energy Deficiency Among Urban Bengalee Male Slum Dwellers of Kolkata, India: Relationship with Family Income

A cross-sectional study of 191 adult (>18 years) Bengalee male slum dwellers of Kolkata, India, was undertaken to study the relationships of family income with body mass index (BMI) and chronic energy deficiency (CED). Results revealed that the mean height, weight, and BMI of the subjects were 162.2 cm, 54.0 kg, and 20.5 kg/m2, respectively. The overall frequency of CED (BMI < 18.5 kg/m2) was 33.5%. Based on the World Health Organization classification, the prevalence of CED among this population was high (20–39%) and thus the situation is serious. Overall, monthly family income (MFI) was significantly positively correlated (r = 0.18, p < 0.05) with BMI. Linear regression analyses showed that MFI had significant impact (p < 0.05) on BMI. The percent variation in BMI explained by MFI was 2.6%. Subjects belonging to the lowest family income group (FIG) had the lowest mean BMI (19.5 kg/m2) and the highest rate of CED (46.6%) while those in the highest FIG had the largest mean BMI (21.4 kg/m2) and lowest rate of CED (23.1%). There was a significant FIG difference (F = 2.965, p < 0.05) in mean BMI. Moreover, there existed FIG differences (χ 2 = 7.54, p < 0.06) in CED rates. In conclusion, this study provided strong evidence that FIG was significantly associated with BMI and the presence of CED. The rate of CED was high, indicating a serious situation. These findings may have severe public health implications. It is recommended that immediate nutritional intervention programs be initiated among this population along with serious efforts to increase their family income.

The incidence and impact of low body mass index on patients with operable lung cancer

To prospectively assess the nutritional status of patients referred for lung cancer surgery, as well as to assess the prognostic value of nutritional status in determining the surgical outcome. One hundred and forty-six patients with potentially operable lung cancer were recruited. Loss of appetite and weight loss were recorded. All patients had serum albumin levels and body mass index (BMI) measured. Surgical outcome were noted. Mean age was 69 (range 42-85) years; 29/146 were not referred for surgery. Eight patients underwent failed thoracotomy. In the remaining 109 patients, mean BMI was 26. Seven patients had BMI of 19 or less. Forty-four patients had ideal body weight. The majority of patients (n=58) were overweight. Mean serum albumin was 37g/l and lower than 30g/l in 5 cases. There were 4% postoperative deaths and 32% with poor surgical outcome. There was no statistical difference in mean BMI, serum albumin, loss of appetite or weight loss between the two outcome groups. BMI is usually well preserved in patients with operable lung cancer. There was no association between low BMI, low serum albumin, loss of appetite or weight loss, and postoperative death or poor surgical outcome in this study.

Decision Making in Abdominoplasty

Improvements and variations in abdominoplasty techniques have complicated patient and procedure selection. The authors describe their guidelines for selecting the ideal procedure to be used with patients by stratifying them into treatment groups according to the presence and location of excess skin and subcutaneous tissue, lipodystrophy, and abdominal wall laxity. A prospective study analyzed 151 female patients treated for abdominal contour deformities from January 2004 to July 2005. The patients were systematically classified into five treatment groups: mini-abdominoplasty (5%), standard abdominoplasty (42%), abdominoplasty with liposuction and minimal midline undermining (10%), standard abdominoplasty with removal of deep fat (13%), and circumferential abdominoplasty (30%). The patients had a mean age of 42 years and a mean body mass index (BMI) of 26 kg/m(2). The prevalence of overweight (BMI, 25.0-29.9) was 37%, and that of obesity (BMI > 30.0) was 19%. Comparison of pre- and postoperative photographs included improved tension of the entire abdominal wall, enhancement of the waistline, and increased uniformity of the contour of the abdomen. There was a significant difference in mean BMI between preabdominoplasty (26 kg/m(2)) and postabdominoplasty (24 kg/m(2)) (p = 0.01). The prevalence of overweight and obesity decreased by 8% and 9%, respectively (p = 0.01), and a decrease in BMI occurred within each abdominoplasty subgroup (p = 0.01). The prevalence of complications was 11%. Seroma (4%) and delayed wound healing (4%) were the most common. One case of pulmonary embolus was encountered. Although there was a positive trend in complications with higher BMI, no statistically significant difference was found (p = 0.74). Half of the patients had additional procedures performed without a significant increase in complications (p = 0.5). The described algorithm for abdominoplasty selection is safe, effective, and flexible, with long-term improvement in abdominal contour and BMI.

INTER-RELATIONSHIPS OF INCOME, CHRONIC ENERGY DEFICIENCY, MORBIDITY AND HOSPITALIZATION AMONG ADULT MALE SLUM DWELLERS OF MIDNAPORE, WEST BENGAL, INDIA

A cross-sectional study of 212 adult (>18 years) male slum dwellers (mean age=34.6+/-14.4 years) of Midnapore town, West Bengal, India, was undertaken to study the inter-relationships of chronic energy deficiency (CED), monthly family income (MFI), self-reported morbidity and hospitalization due to severe illness. The mean height, weight and body mass index (BMI) of the subjects were 160.0 cm, 50.8 kg and 19.9 kg/m2, respectively. The overall frequencies of CED (BMI<18.5 kg/m2), morbidity and hospitalization were 38.2%, 34.4% and 13.7%, respectively. Based on the WHO classification, the prevalence of CED among this population was high (20-39%), indicating a serious situation. Overall, MFI was significantly (p<0.01) positively correlated with BMI (r=0.21). Linear regression analyses showed that MFI had a significant impact (t=3.08; p<0.002) on BMI. Overall, MFI explained 3.9% variation in BMI. Subjects belonging to the lowest family income group (FIG I) had the lowest mean BMI (19.1 kg/m2) and the highest rate of CED (46.3%) and morbidity (36.6%). Those in the highest family income group (FIG III) had the largest mean BMI (20.8 kg/m2) and lowest rate of CED (30.2%) and morbidity (30.2%). The highest rate (18.9%) of hospitalization was found in this group. There were significant family income group differences in mean BMI (F=3.134, p<0.05). The frequency of morbidity (24.6%) and hospitalization (11.9%) was lowest among normal BMI individuals. Morbidity was significantly higher (chi2=11.92, p=0.0026) among CED (48.2%) subjects compared with normal BMI individuals (OR=2.85; CI=1.49-5.46). Similarly, compared with normal BMI subjects, morbidity was higher (38.5%; OR=1.92; 95% CI=0.50-7.18) among overweight subjects. Hospitalization was more common among CED subjects (16.1%; OR=1.42; CI=0.58-3.45) compared with normal BMI subjects. Similarly, the frequency of hospitalization was more among overweight individuals (15.4%; OR=1.35; 95% CI=0.0-7.59). In conclusion, this study provides evidence that the frequency of CED among this population is high, indicating a serious situation. Moreover there exists strong inter-relationships between BMI, CED, MFI and morbidity.

Metabolic consequences of body size and body composition in hemodialysis patients

Small body mass index is associated with increased mortality in chronic hemodialysis patients. The reasons for this observation are unclear but may be related to body composition. This study aimed to investigate the body composition in chronic hemodialysis patients. The difference between body mass and the sum of muscle, bone, subcutaneous, and visceral adipose tissue masses, measured by whole body magnetic resonance imaging, was defined as the high metabolic rate compartment representing the visceral mass. Protein catabolic rate was calculated from urea kinetics. Forty chronic hemodialysis patients (mean age 54.7 years; 87.5% African Americans; 45% females) were studied. High metabolic rate compartment expressed in percent of body weight was inversely related to body weight (r=-0.475; P=0.002) and body mass index (r=-0.530; P<0.001). In a multiple linear regression model, protein catabolic rate was significantly correlated only with high metabolic rate compartment (r=0.616; P<0.001). Assuming that protein catabolic rate in addition to protein intake reflects urea and uremic toxin generation, it follows that high metabolic rate compartment is the major compartment involved in their generation. Consequently, uremic toxin production rate may be relatively higher in patients with low body weight and low body mass index as compared to their heavier counterparts. The poorer survival observed in smaller dialysis patients may be related to these relative differences.

Mid-term Body Mass Index increase among obese and non-obese individuals in middle life and deprivation status: A cohort study

BackgroundIn the UK, obesity is associated with a clear socioeconomic gradient, with individuals of lower socioeconomic status being more likely to be obese. Several previous studies, using individual measures of soecioeconomic status, have shown a more rapid increase in Body Mass Index (BMI) over time among adults of lower socioeconomic status. We conducted a study to further examine whether ecologically defined deprivation status influences within-individual BMI change during middle life, as the answer to this question can help determine optimal preventive strategies both for obesity per se, and its' associated socioeconomic disparities.MethodsAnonymised records of participants to the Stockport population-based cardiovascular disease risk factor screening programme were analysed. Individuals aged 35–55 who had a first screening episode between 1989 and 1993, and a subsequent screening episode were included in the study. Deprivation status was defined using quintiles of the Townsend score. Mean annual BMI change by deprivation group was calculated using linear regression. Subsequently, deprivation group was included in the model as an ordinal variable, to test for trend. The modelling was repeated separately for individuals who were obese (BMI < 30) and non-obese at the time of first screening. In supplementary analysis, regression models were also adjusted for baseline BMI.ResultsOf 21,976 women and 19,158 men initially screened, final analysis included just over half of all individuals [11,158 (50.8%) women and 9,831 (51.3%) men], due to the combined effect of loss to follow-up and incomplete BMI ascertainment. In both sexes BMI increased by 0.19 kg/m2 annually (95% Confidence Intervals 0.15–0.24 for women and 0.16–0.23 for men). All deprivation groups had similar mean annual change, and there was no evidence of a significant deprivation trend (p = 0.801, women and 0.892, men). Restricting the analysis to individuals who were non-obese at baseline did not alter the results in relation to the lack of a deprivation effect. When restricting the analysis to individuals who were obese at baseline however, the findings were suggestive of an association of BMI increase with higher deprivation group, which was further supported by a significant association when adjusting for baseline BMI.ConclusionIn the study setting, the BMI of non-obese individuals aged 35–55 was increasing over time independently of deprivation status; among obese individuals a positive association with higher deprivation was found. The findings support that socioeconomic differences in mean BMI and obesity status are principally attained prior to 35 years of age. Efforts to tackle inequalities in mean BMI and obesity status should principally concentrate in earlier life periods, although there may still be scope for focusing inequality reduction efforts on obese individuals even in middle life.

Ethnic differences in body mass index and associated factors of adolescents from minorities in Oslo, Norway: a cross-sectional study

To examine ethnic differences in body mass index (BMI), food habits and physical activity, and determine the factors contributing to differences in BMI. In 2000-2001, 7343 (response rate 88%) 15- and 16-year-old students, enrolled in lower secondary schools in Oslo, participated in the cross-sectional Oslo Health Study. Of these participants, 1719 were defined as ethnic minorities. Significant gender and ethnic differences in mean BMI were observed. Of the ethnic minority adolescents, 5.8% were underweight (<5th percentile of the US Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) reference distribution) and 9.1% were overweight (>85th percentile of the US CDC/NCHS reference distribution). BMI was not significantly associated with either socio-economic factors or physical activity. Food habits and physical activity differed with ethnicity but not with socio-economic factors. An ordinal regression showed that girls from East Asia (odds ratio (OR) 0.4) and boys from sub-Saharan Africa (OR 0.4) had lower BMI than the Western group. Among girls, higher BMI was associated with less frequent consumption of chocolates and sweets, full-fat milk and breakfast (OR 2.4, 1.7 and 1.7, respectively). Higher BMI, for both boys and girls, was associated with current and past dieting (OR 3.7 and 4.2, respectively). Adolescent food habits and physical activity varied by gender and ethnicity but not with socio-economic factors. BMI was associated with ethnicity, gender and food habits, but no significant relationship was observed with socio-economic factors or physical activity. Ethnicity, in addition to gender, should be taken into consideration when studying BMI and associated factors among adolescents.

Variaciones del índice de masa corporal (IMC) de acuerdo al grado de desarrollo puberal alcanzado

Body mass index (BMI) is the recommended parameter to assess the nutritional status of subjects aged less than 20 years. However, during puberty the correlation between BMI and fat mass decreases notably. Therefore, the use of BMI for the diagnosis of obesity during puberty may be misleading. To evaluate the variations of the BMI during puberty according to chronological and biological ages. Descriptive cross sectional study in school age children of elementary and high schools (4,531 males and 5,326 females) representing all socioeconomic strata of 4 regions of Chile. BMI was calculated from weight and height measurements (W/H2) and pubertal development was evaluated according to Tanner stages. The sample selected to evaluate the variations of BMI according to chronological age and pubertal stages consisted in 3,913 females aged 8-14 years and 2,494 males aged 10-16 years. Analyses of variance (F test) and Tukey HSD test were used to compare mean BMI according to chronological and biological ages. The age of onset of puberty (Tanner Stages IB2 and G2) varied greatly, from 8 to 14 years in females and 10 to 16 years in males. Mean BMI in a specific stage of pubertal development did not show significant differences according to age in both sexes. However, there were significant differences (p < 0.05) in mean BMI when comparing children of the same chronological age but in different Tanner stages. Per each stage of Tanner development, BMI increased 1.0 or more points among females and 0.6 points among males. During puberty, BMI is associated to biological and not chronological age.

LAPAROSCOPIC RIGHT DONOR NEPHRECTOMY

P159 Aims: Laparoscopic donor nephrectomy preferentially involves the left kidney in order to optimize vessel length and safety of the operation. Occasionally right donor nephrectomy is preferred for a variety of reasons. Although right donor nephrectomy has been reported in the literature, no single study reports more than 20 operations. This retrospective study evaluates donor and organ outcome for right and left donor nephrectomy. Methods: All laparoscopic donor nephrectomies performed at a single transplant program from 2000 to 2004 were reviewed for pre-operative and post-operative outcome of the donor patient, the recipient patient and the renal allograft. Donor age, gender, race, body mass index (BMI), operative time, warm ischemia, cold ischemia, intra-operative urine output (UOP), estimated blood loss (EBL), vessel length and post-operative recipient creatinine were evaluated. Results: Of 253 laparoscopic donor nephrectomies performed between 2000-2004, 40 harvested the right kidney (16%). There was no difference in mean age (41 ± 11 years), gender (45% male), or BMI (27.5 ± 5.8) of donor patients. There was a difference in the number of Caucasian donors (80% of each group, p = 0.009). There was no difference in the number of vessels of the right donor kidney (30 of 40 single vessel) compared to the left kidney (164 of 213 single vessel). The right kidney selection was based on more numerous vessels in the left kidney (90%), early bifurcation of the left renal vessels (5%) or presence of a left renal cyst (5%). There was no difference in operative time or cold ischemia, although warm ischemia was longer for the right-sided operation (3:55 ± 1:22 min) than the left-sided operation (3:18 ± 1:06 min) (p = 0.004). There was no difference in the intra-operative UOP or EBL. The right renal artery length (2.7 ± 0.6 cm) differed significantly from the left renal artery length (3.2 ± 0.5 cm) (p = 0.003), as the right renal vein length (1.9 ± 0.3 cm) differed from the left renal vein length (3.8 ± 0.9 cm) (p = 0.001). There was no difference in the complication rate of 18%, the most common being hemorrhage (15%), resulting in only rare conversions to an open procedure (1%). Post-operative hospital length of stay was similar for both donor groups (45 ± 12 hours). Post-operative allograft function was similar for both groups at post-operative day one (creatinine 4.89 ± 3.41 for right kidney donor, 4.5 ± 2.7 for left kidney donor), post-operative day seven (creatinine 1.77 ± 1.21 for right kidney donor, 1.7 ± 1.5 for left kidney donor) and one year (creatinine 1.5 ± 0.4 for right kidney donor, 1.23 ± 0.28 for left kidney donor), with only one graft loss of the right kidney group due to chronic rejection (2.5%). Conclusions: Although right kidney donor nephrectomy is performed only rarely due to concerns about shortened vessel length, this operation can be performed safely. We report no significant differences in donor demographics or allograft function at one year. With experience, laparoscopic right donor nephrectomy can be performed safely for the donor and recipient producing equal long term results.

LAPAROSCOPIC MULTIPLE VESSEL DONOR NEPHRECTOMY

P160 Aims: Laparoscopic donor nephrectomy usually involves the kidney that has one artery to achieve ease of operation, improve outcomes and minimize complications. Occasionally, multiple vessel nephrectomy is preferred for a variety of reasons. Although multiple vessel donor nephrectomy has been reported in the literature, no single study reports more than 20 operations. This retrospective study evaluates donor and allograft outcomes for single and multiple vessel laparoscopic donor nephrectomy. Methods: All laparoscopic donor nephrectomies performed at a single transplant program from 2000 to 2004 were reviewed for pre-operative and post-operative outcomes of the donor patient, the recipient patient and the renal allograft. Donor age, gender, race, body mass index (BMI), operative time, warm ischemia, cold ischemia, urine output (UOP), estimated blood loss (EBL), vessel length, complication rate and post-operative recipient creatinine were evaluated. Results: Of 240 laparoscopic donor nephrectomies performed, 37 had multiple vessels (15%). There were no significant differences in mean age (41 ± 11 years), gender (45% male), race (75% Caucasian) or BMI (27.5 ± 5.8) of donors. Of the 37 organs with multiple vessels, nine were right kidneys (25%) and 28 were left kidneys (75%). The multiple vessel kidney was selected for donation based on anatomic and donor considerations. There was no difference in total operative time. Cold ischemia time (CIT) was longer for the multiple vessel organs (46 ± 24 mins) than for single vessel organs (35 ± 13 mins)(p = 0.001). Warm ischemia time (WIT) was also longer for the multiple vessel organs (4:20 ± 2:05 min) than the single vessel organs (3:13 ± 0:47 min)(p = 0.001). There was no difference in the intra-operative UOP or EBL. The renal artery length (3.0 ± 0.6 cm) showed no difference, but the renal vein length showed a difference in the multiple vessel group (3.0 ± 0.9 cm) compare to the single vessel group (4.0 ± 0.9 cm)(p<0.05). There was no difference in the complication rate of 18%, the most common being hemorrhage (15%), resulting in only rare conversions to an open procedure (1%). Post-operative hospital length of stay was similar for both donor groups (46 ± 17 hours). Post-operative allograft function was similar for both groups at post-operative day one (creatinine 4.65 ± 2.57 for multiple vessel kidney donor, 4.63 ± 2.95 for single vessel kidney donor), post-operative day seven (creatinine 1.76 ± 1.38 for multiple vessel kidney donor, 1.7 ± 1.47 for single vessel kidney donor) and one year post-operatively (creatinine 1.06 ± 0.3 for multiple vessel kidney donor, 1.34 ± 0.44 for single kidney donor). Conclusions: Although multiple vessel laparoscopic kidney donor nephrectomy is performed only rarely due to concerns about patient safety and vessel length, this operation can be performed safely. CIT and WIT are slightly increased due to the need to reconstruct multiple arteries or to perform multiple anastomoses. We report no significant differences in donor demographics or allograft function through one year post-transplant. With experience laparoscopic donor nephrectomy of organs with multiple vessels can be performed safely for the donor and recipient

Prevalence and predictors of asymptomatic liver disease in patients undergoing gastric bypass surgery.

Nonalcoholic steatohepatitis (NASH) is a form of fatty liver disease that is increasingly recognized. There are limited data on the prevalence of NASH and the role of risk factors for NASH among the morbidly obese. The prevalence of asymptomatic NASH among morbidly obese patients undergoing gastric bypass surgery is high, and there are identifiable risk factors for NASH. Prospective case study. University hospital. Forty-eight consecutive patients undergoing gastric bypass surgery who had a concurrent open liver biopsy. Exclusion criteria included current consumption of more than 2 alcohol beverages monthly and known cirrhosis. A hepatopathologist blinded to clinical data reviewed biopsy specimens. The presence of NASH or severe fibrosis, preoperative body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters), fasting triglyceride level, and presence of type 2 diabetes mellitus (DM). Patients (mean +/- SD age, 42 +/- 10 years; 33 women) had an initial mean BMI of 59.9 +/- 12. Thirty-one patients (65%) had moderate to severe steatosis. Only 6 (12%) had advanced fibrosis. Sixteen (33%) had evidence of NASH. There was no difference in mean age, sex, BMI, or fasting triglyceride level between patients with and without NASH or advanced fibrosis. The odds of NASH were 128 times greater (95% confidence interval [CI], 5.2-3137.0) and the odds of severe fibrosis 75 times greater (95% CI, 4.5-1247.0) in patients with DM than in those without DM. Preoperative BMI was not independently associated with NASH (odds ratio, 1.01; 95% CI, 0.9-1.1) or severe fibrosis (odds ratio, 0.9; 95% CI, 0.86-1.02) after adjustment for DM. Moderate to severe hepatic steatosis and NASH are common among individuals undergoing gastric bypass procedures. Diabetes mellitus but not BMI is associated with NASH and advanced hepatic fibrosis in these patients.

The effect of obesity on the outcome of infertility management in women with polycystic ovary syndrome.

Obesity has become a worldwide epidemic with ever increasing incidence and public health problems in both developing and developed countries. The objective of the study is to investigate the incidence of obesity among patients with polycystic ovarian syndrome attending infertility clinic and the effect on treatment outcome. Two hundred and seventy women with polycystic ovarian syndrome attending the infertility clinic were evaluated clinically, biochemically, and laparoscopically. They were stratified according to their body mass index (BMI) as follows: normal weight: 18-24; overweight: 25-29, obese:30-34, and grossly obese: > or = 35. Therapy included induction of ovulation with clomiphene citrate and gonadotrophins. The patients were followed up through during induction of ovulation and pregnancy. There were ethnic differences in mean BMI. Significantly more obese women had oligomenorrhoea (p<0.01) and anovulation (p<0.01) than women with normal weight. Obesity adversely affected the outcome of ovulation induction with clomiphene citrate and gonadotrophins; 79% of women with BMI 18-24 ovulated at 6 months compared to 15.3% in those with BMI 30-34 (p<0.001) and 11.8% in women with BMI > or = 35 (p<0.001). The pregnancy rate and outcome were also adversely affected by obesity. Obesity has a negative impact on the outcome of treatment of infertility. Weight reduction programme should be an essential component of infertility management.

Diet and body mass index in 38000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans.

To compare body mass index (BMI) in four diet groups (meat-eaters, fish-eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) and to investigate lifestyle and dietary factors associated with any observed differences. Cross-sectional analysis of self-reported dietary, anthropometric and lifestyle data. A total of 37875 healthy men and women aged 20-97 y participating in EPIC-Oxford. Age-adjusted mean BMI was significantly different between the four diet groups, being highest in the meat-eaters (24.41 kg/m(2) in men, 23.52 kg/m(2) in women) and lowest in the vegans (22.49 kg/m(2) in men, 21.98 kg/m(2) in women). Fish-eaters and vegetarians had similar, intermediate mean BMI. Differences in lifestyle factors including smoking, physical activity and education level accounted for less than 5% of the difference in mean age-adjusted BMI between meat-eaters and vegans, whereas differences in macronutrient intake accounted for about half of the difference. High protein (as percent energy) and low fibre intakes were the dietary factors most strongly and consistently associated with increasing BMI both between and within the diet groups. Fish-eaters, vegetarians and especially vegans had lower BMI than meat-eaters. Differences in macronutrient intakes accounted for about half the difference in mean BMI between vegans and meat-eaters. High protein and low fibre intakes were the factors most strongly associated with increasing BMI.

Association of BMI with the beta3-adrenergic receptor gene polymorphism in Japanese: meta-analysis.

To assess the effect of the Trp64Arg polymorphism in the beta3-adrenergic receptor gene (ADRB3) on body mass index (BMI) in the Japanese population. We selected studies that evaluated the association between BMI and ADRB3 polymorphism among Japanese, using MEDLINE and PubMed. After data collection, an extension of ANOVA was performed to assess the differences according to the genotype. In a total of 35 subgroups including 2316 subjects with the Trp64Arg variant and 4266 subjects without this variant, the weighted mean difference in BMI was 0.26 kg/m(2) (95% confidence interval: 0.18 to 0.42; p < 0.01), indicating that variant carriers exhibited higher BMI than did normal homozygous subjects. Although it is known that the allele frequency of the ADRB3 polymorphism differs among races, this study focuses on the Japanese population, which has a high allele frequency of ADRB3 polymorphism. We assumed that statistical errors would be prevented due to the sufficient number of subjects. In conclusion, the results support the hypothesis that ADRB3 gene polymorphism is associated with BMI.

The Influence of Breastfeeding and Complementary Foods on Growth Until Three Years of Age in the Euro-Growth Study

WHO1,2 recommends exclusive breastfeeding during the first 4–6 months of life but limited information is available regarding the growth of infants fed according to the recommendation. The present study used data from the Euro-Growth Study to determine the growth of breastfed European infants who did or did not receive complementary foods from an early age, in comparison to growth of infants receiving formula before the age of 4 months.The Euro-Growth Study was a longitudinal, multicenter study using standardized methodology. Healthy term infants between 37 and 44 weeks' gestational age weighing >2500 g at birth3 were enrolled before 30 days of age. The cohort consisted of 2145 children from 21 study sites, who visited the study centers regularly up to 36 months of age for anthropometric measurements and for collection of nutritional data.Infants were categorized according to WHO criteria4 in a “WHO” group and an “Early solids” group. The other infants served as the “Control” group. The z-scores (according to the Euro-Growth) of the 3 feeding groups were compared using analysis of covariance, including mid-parent height and educational level of the mother as covariates.The infants in the “WHO” feeding group (n = 319) were, by definition, exclusively breastfed through 4 to 5 months of age. At 9 to 12 months of age 54% were still breastfed, and 28% were breastfed beyond 12 months of age. In the “Early solids” feeding group (n = 185), infants were breastfed through 4 to 5 months age while also receiving solids before 4 to 5 months of age. By 9 to 12 months of age, 31% were breastfed, and 18% continued to be breastfed in the second year of life. In the “Control” feeding group (n = 1509) the percentage of breastfed infants was substantially lower, 65% received formula already between 1 and 2 months of age.Mean z-scores for length, weight, and body mass index (BMI) of the 3 feeding groups are presented in Table 1, all corresponding standard deviations (SDs) are close to 1. Drop-offs in numbers after 12 months and 24 months are attributable to the fact that some centers that did not perform measurements past these ages. Overall, the significant differences between the feeding groups are in the magnitude of 0.3z-scores.The growth pattern of the “WHO” group consisted in higher weight during the first 2 to 3 months of life (and higher BMI) and lower weight and length during the second half of the first year of life compared with the “Control” group. During the second year of life differences were small and not statistically significant. However, at 30 and 36 months of age, length of the “WHO” group was significantly less than that of the “Control” group.With the large sample size of the Euro-Growth Study it was possible to examine the impact on growth of 2 key recommendations—the duration of exclusive breastfeeding and the time of introduction of solids.1,2 Interesting is the “Early solids” group that tended to have greater length but lower body weight, which resulted in lower BMI between 3 and 36 months of age (Table 1). Differences in mean BMI from 4 to 6 months of age indicated that early introduction of solids was associated with greater leanness. An explanation can be that leanness may prompt parents to introduce solids earlier.Our study confirmed that infants who are fed according to WHO recommendations have higher weight and length during the first 2 to 3 months of age than infants fed by other modes. Thereafter, they tend to be shorter and lighter, but the differences between feeding groups were small and probably not of clinical relevance. At an age of 2 years, differences up to 0.3 z-scores correspond to differences of approximately 9 mm in length and 400 g in weight. These differences are not much more than the usual measurement errors in length and weight.5How to assess the relevance of these anthropometric measurements for the immediate and long-term quality of life and health of infants?

Preliminary study of body mass index and its relationship to percent body fat in Harare, Zimbabwe.

The aims of this paper were to document the body mass index (BMI) and anthropometric characteristics of the city of Harare urban dwellers of Zimbabwe. To investigate the relationship between BMI, sum of skin folds (SSF) and percent body fat (PBF). Cross sectional study. Designated fitness awareness locations in the city of Harare during the 1998 physiotherapy awareness week. The participants were 140 apparently healthy adults, males (n = 71) and females (n = 69). Body Mass Index. The minimum and maximum values of BMI were 17.7 and 33.3 for men, 17.6 and 47.8 for women. BMI was not found to increase with aging but PBF on the contrary did. The mean BMI value for the males and females was 24.89 +/- 3.18 and 27.8 +/- 5.89 respectively. There was no significant difference in mean BMI between sexes (p = 0.331). Weight was also similar by gender (p = 0.4691). In both sexes, the BMI showed a significant positive correlation with PBF, SSF, body weight and age (for males r = 0.721, 0.731, 0.900, 0.369, p < 0.01 respectively; and in females r = 0.786, 0.804, 0.940, 0.404 and p < 0.01 respectively). Women were found to have higher BMI, PBF, SSF than their male counterparts. On the average, men were found to be taller, with no significant difference in weight. There was a linear relationship between BMI and PBF, and all the variables investigated except age and stature in both sexes. Because of the differences of environment and industrialisation, estimation of BMI should involve such factors as ethnicity, race, gender and age.

The Incidence of Antidepressant Use in Obese Veteran Outpatients at VA Mines Hospital

The overall prevalence of depression in the obese population is not well agreed upon in the literature. The incidence is reportedly between 10-16%. Antidepressants are commonly used to treat depression and the types of antidepressants used have been associated with weight loss or gain. A retrospective chart review was conducted on 378 patients with a diagnoses of obesity (ICD-9-CM 278.00–278.01). Obesity was classified as a Body Mass Index (BMI) ≥ 30 or Ideal Body Weight (IBW) > 120%. Dosage, type and duration of antidepressants was recorded as well as weight changes. 272 veterans met the criteria for obesity. Mean age was 61 years ± 2.2 with a mean BMI of 37.5 ± 6.6. Antidepressant use was observed in 68 (25%) of the obese veterans. Average duration for antidepressant use was 8.8 months ± 5.7. There was no significant difference in mean age, BMI, weight change or time between weight measurements between those taking antidepressants and those not taking antidepressants. Use of tricyclic antidepressants was slightly higher than use of selective serotonin reuptake inhibitors (SSRI). There was a significant association between weight loss with use of SSRIs but not with Tricyclics (χ2–4.32, p<0.04). Analysis of variance showed a significant difference in mean weight loss between those taking Tricyclics vs. SSRIs vs. no antidepressants (p<0.007). It appears that the incidence of depression may be higher in our population of obese veterans than what is reported in the literature. The specific type of antidepressant being taken was related to either weight gain or weight loss, with tricyclics associated with weight gain and SSRIs with weight loss.

Meta-analysis of the association of Trp64Arg polymorphism of beta 3-adrenergic receptor gene with body mass index.

A possible pathogenic polymorphism in the beta 3-adrenergic receptor gene (Trp64Arg) has been reported to be associated with increased body weight, clinical features of insulin resistance, and early development of type 2 diabetes mellitus in several populations. However, such findings have not been consistent among studies, making the hypothesis that this genetic marker is associated with clinical features controversial. To assess the effect of the genotypes on body mass index (BMI), we performed a meta-analysis of the data from the literature using an extension of ANOVA for continuous measures. In a total of 48 subgroups containing subjects with (n = 2447) and without (n = 6789) the Trp64Arg variant, the summary weighted mean difference in BMI was 0.30 (95% confidence interval, 0.13-0.47) kg/m2, indicating that variant carriers exhibited higher BMI (on the average, 0.30 kg/m2 higher) than normal homozygous subjects. In this case, there was no significant evidence against homogeneity of the effect (P = 0.36). This is the first meta-analysis assessing quantitative phenotypes in relation to a genetic polymorphism, and the results support the hypothesis that the Trp64Arg polymorphism is associated with BMI across diverse population groups, suggesting that the beta 3-adrenergic receptor gene locus plays a role in genetic predisposition to increased body weight in a universal manner.

Low body mass index in non-meat eaters: the possible roles of animal fat, dietary fibre and alcohol.

To examine the associations of diet and other lifestyle factors with body mass index (BMI) using data from the Oxford Vegetarian Study. 1914 male and 3378 female non-smokers aged 20-89 y at recruitment to the study. All subjects completed a diet/lifestyle questionnaire at recruitment giving details of their usual diet and other characteristics including height and weight, smoking and drinking habits, amount of exercise, occupation and reproductive history. Answers to the food frequency questionnaire were used to classify subjects as either meat eaters or non-meat eaters, and to estimate intakes of animal fat and dietary fibre. Subjects were further classified according to their alcohol consumption, exercise level, social class, past smoking habits and parity. Mean BMI was lower in non-meat eaters than in meat eaters in all age groups for both men and women. Overall age-adjusted mean BMIs in kg/m2 were 23.18 and 22.05 for male meat eaters and non-meat eaters respectively (P < 0.0001) and 22.32 and 21.32 for female meat eaters and non-meat eaters respectively (P < 0.0001). In addition to meat consumption, dietary fibre intake, animal fat intake, social class and past smoking were all independently associated with BMI in both men and women; alcohol consumption was independently associated with BMI in men, and parity was independently associated with BMI in women. After adjusting for these factors, the differences in mean BMI between meat eaters and non-meat eaters were reduced by 36% in men and 31% in women. Non-meat eaters are thinner than meat eaters. This may be partly due to a higher intake of dietary fibre, a lower intake of animal fat, and only in men a lower intake of alcohol.