Body Mass Index Measurements Research Articles

Genetic regulation of body size and morphology in children: a twin study of 22 anthropometric traits

BackgroundAnthropometric measures show high heritability, and genetic correlations have been found between obesity-related traits. However, we lack a comprehensive analysis of the genetic background of human body morphology using detailed anthropometric measures.MethodsHeight, weight, 7 skinfold thicknesses, 7 body circumferences and 4 body diameters (skeletal breaths) were measured in 214 pairs of twin children aged 3–18 years (87 monozygotic pairs) in the Autonomous Region of Madeira, Portugal. Factor analysis (Varimax rotation) was used to analyze the underlying structure of body physique. Genetic twin modeling was used to estimate genetic and environmental contributions to the variation and co-variation of the anthropometric traits.ResultsTogether, two factors explained 80% of the variation of all 22 anthropometric traits in boys and 73% in girls. Obesity measures (body mass index, skinfold thickness measures, as well as waist and hip circumferences) and limb circumferences loaded most strongly on the first factor, whereas height and body diameters loaded especially on the second factor. These factors as well as all anthropometric measures showed high heritability (80% or more for most of the traits), whereas the rest of the variation was explained by environmental factors not shared by co-twins. Obesity measures showed high genetic correlations (0.75–0.98). Height showed the highest genetic correlations with body diameter measures (0.58–0.76). Correlations between environmental factors not shared by co-twins were weaker than the genetic correlations but still substantial. The correlation patterns were roughly similar in boys and girls.ConclusionsOur results show high genetic correlations underlying the human body physique, suggesting that there are sets of genes widely affecting anthropometric traits. Better knowledge of these genetic variants can help to understand the development of obesity and other features of the human physique.

Predicting Childhood Obesity Based on Single and Multiple Well-Child Visit Data Using Machine Learning Classifiers.

Childhood obesity is a public health concern in the United States. Consequences of childhood obesity include metabolic disease and heart, lung, kidney, and other health-related comorbidities. Therefore, the early determination of obesity risk is needed and predicting the trend of a child's body mass index (BMI) at an early age is crucial. Early identification of obesity can lead to early prevention. Multiple methods have been tested and evaluated to assess obesity trends in children. Available growth charts help determine a child's current obesity level but do not predict future obesity risk. The present methods of predicting obesity include regression analysis and machine learning-based classifications and risk factor (threshold)-based categorizations based on specific criteria. All the present techniques, especially current machine learning-based methods, require longitudinal data and information on a large number of variables related to a child's growth (e.g., socioeconomic, family-related factors) in order to predict future obesity-risk. In this paper, we propose three different techniques for three different scenarios to predict childhood obesity based on machine learning approaches and apply them to real data. Our proposed methods predict obesity for children at five years of age using the following three data sets: (1) a single well-child visit, (2) multiple well-child visits under the age of two, and (3) multiple random well-child visits under the age of five. Our models are especially important for situations where only the current patient information is available rather than having multiple data points from regular spaced well-child visits. Our models predict obesity using basic information such as birth BMI, gestational age, BMI measures from well-child visits, and gender. Our models can predict a child's obesity category (normal, overweight, or obese) at five years of age with an accuracy of 89%, 77%, and 89%, for the three application scenarios, respectively. Therefore, our proposed models can assist healthcare professionals by acting as a decision support tool to aid in predicting childhood obesity early in order to reduce obesity-related complications, and in turn, improve healthcare.

Assessing temporal differences of baseline body mass index, waist circumference, and waist-height ratio in predicting future diabetes.

Obesity is the prominent modifiable risk factor known to influence the occurrence and progression of diabetes other than age, and the objective of this study was to evaluate and compare the predictive value of three simple baseline anthropometric indicators of obesity, body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR), for the occurrence of diabetes at different time points in the future. The study subjects were 12,823 individuals with normoglycemic at baseline who underwent health screening and had measurements of BMI, WC, and WHtR. The outcome of interest was new-onset diabetes during follow-up. Time-dependent receiver operator characteristics (ROC) curves of baseline BMI, WC, and WHtR for predicting the risk of diabetes in the next 2 to 12 years were constructed and their area under the ROC curves (AUCs) and corresponding optimal threshold values were calculated for each time point, which were used to compare the accuracy and stability of the above three indicators for predicting the occurrence of diabetes in different future periods. During a median follow-up period of 7.02 years, with a maximum follow-up of 13 years, 320 new-onset diabetes were recorded. After adjusting for confounders and comparing standardized hazard ratios (HRs), WC was shown to be the best simple anthropometric indicator of obesity reflecting diabetes risk in all models, followed by WHtR. Time-dependent ROC analysis showed that WC had the highest AUC in predicting the occurrence of diabetes in the short term (2-5 years), and WHtR had the highest AUC in predicting the occurrence of diabetes in the medium to long term (6-12 years), while in any time point, both WC and WHtR had higher AUC than BMI in predicting future diabetes. In addition, we found relatively larger fluctuations in the thresholds of BMI and WC for predicting diabetes over time, while the thresholds of WHtR consistently remained between 0.47-0.50; comparatively speaking, WHtR may have greater application value in predicting future diabetes. Our analysis sustained that central obesity is a more important predictor of diabetes, and in clinical practice, we proposed measuring WHtR as a useful tool for predicting future diabetes.

Separating the effects of early and later life adiposity on colorectal cancer risk: a Mendelian randomization study

BackgroundObservational studies have linked childhood obesity with elevated risk of colorectal cancer; however, it is unclear if this association is causal or independent from the effects of obesity in adulthood on colorectal cancer risk.MethodsWe conducted Mendelian randomization (MR) analyses to investigate potential causal relationships between self-perceived body size (thinner, plumper, or about average) in early life (age 10) and measured body mass index in adulthood (mean age 56.5) with risk of colorectal cancer. The total and independent effects of body size exposures were estimated using univariable and multivariable MR, respectively. Summary data were obtained from a genome-wide association study of 453,169 participants in UK Biobank for body size and from a genome-wide association study meta-analysis of three colorectal cancer consortia of 125,478 participants.ResultsGenetically predicted early life body size was estimated to increase odds of colorectal cancer (odds ratio [OR] per category change: 1.12, 95% confidence interval [CI]: 0.98–1.27), with stronger results for colon cancer (OR: 1.16, 95% CI: 1.00–1.35), and distal colon cancer (OR: 1.25, 95% CI: 1.04–1.51). After accounting for adult body size using multivariable MR, effect estimates for early life body size were attenuated towards the null for colorectal cancer (OR: 0.97, 95% CI: 0.77–1.22) and colon cancer (OR: 0.97, 95% CI: 0.76–1.25), while the estimate for distal colon cancer was of similar magnitude but more imprecise (OR: 1.27, 95% CI: 0.90–1.77). Genetically predicted adult life body size was estimated to increase odds of colorectal (OR: 1.27, 95% CI: 1.03, 1.57), colon (OR: 1.32, 95% CI: 1.05, 1.67), and proximal colon (OR: 1.57, 95% CI: 1.21, 2.05).ConclusionsOur findings suggest that the positive association between early life body size and colorectal cancer risk is likely due to large body size retainment into adulthood.

Oropharyngeal dysphagia and nutritional status in elderly patients in the chronic post-stroke phases

Cerebrovascular accident is the most common disorder in the older adult population and can impair the swallowing function, resulting in neurogenic dysphagia with greater occurrence in its acute phase. This study aimed to check how the oropharyngeal dysphagia degree impacts the oral intake and nutritional status of older adults affected by cerebrovascular accident in the late stage after stroke. This is a retrospective cross-sectional study. According to the Dysphagia Outcome and Severity Scale (DOSS), three judges classified the oropharyngeal dysphagia after analyzing the instrumental evaluation of swallowing images captured through fiberoptic endoscopic evaluation of swallowing (FEES). The level of oral intake classification (FOIS) was performed by reviewing the usual patterns of food intake reported in the 24-hour food recall, and the nutritional status assessment was performed using data from the Mini Nutritional Assessment (MNA®) and anthropometric measurements: weight, height, body mass index (BMI), circumferences (arm), skin folds (triceps; biceps; subscapular; suprailiac). Researchers included 25 older adult subjects (14 male and 11 female) with an average age of 72 years old. A positive correlation was found between the oropharyngeal dysphagia degree and FOIS (p=0.051), screening score (p=0.011), and total score (p=0.006) of the MNA® protocol, as well as between the classification of FOIS levels with the BMI (p=0.029) and anthropometric measurements referring to muscle mass – AC (p=0.021), AMC (p=0.010) and AMA (p=0.023). That leads to the conclusion that, although most research individuals had functional swallowing or mild dysphagia, their dysphagia influenced their level of oral intake and nutritional status.

Children with Prader-Willi Syndrome and COVID-19: a longitudinal study of the effect of social re-opening after the lockdown.

This study longitudinally investigated mental health indicators, body mass index (BMI), and access to school and health-care services in children with Prader-Willi syndrome (PWS) and community controls (CC) during the first wave of the COVID-19 pandemic. The parents of 71 children (34 PWS and 37 CC) aged 6-17 years completed an online questionnaire during the initial COVID-19 lockdown (T0) and the subsequent partial (T1) and full re-opening (T2). We examined access to school and health-care services, BMI, and mental health (DSM-5 Parent/Guardian Rated Cross-Cutting Syndrome Measure) across the three time-points. For BMI and DSM-5 measure, we tested within- (Friedman's ANOVA repeated measures) and between- (robustified linear mixed-models, rLMM) group differences over time. Around 30% of PWS children maintained contact with medical personnel through telemedicine. PWS children kept contact with both teachers and classmates at a lower rate than CC. At all time-points, BMI was higher in PWS than CC. During partial reopening, while children with PWS had a decrease in BMI, CC showed an increase, with a significant interaction time*group interaction. Mental symptoms significantly declined in both groups, although in CC the decrease was greater than in PWS. PWS children were at a disadvantage during the COVID-19 outbreak for lower access to school than CC. The improvement of mental health in both groups with the reopening confirms the importance of social activities outside the family. The decrease in BMI in the PWS group indicates the positive role of caregivers' monitoring on eating habits of children.

Assessment of Health-Related Quality of Life in Patients with Idiopathic Hirsutism Compared to Patients with Polycystic Ovary Syndrome.

Hirsutism affects 5-15% of women of reproductive age. Health-related quality of life (HQOL) is a multidimensional assessment of well-being that considers the physical, social, and emotional aspects associated with a specific disease. The aim of this study is to evaluate HQOL in patients diagnosed with idiopathic hirsutism (IH) and compare it with patients diagnosed with polycystic ovary syndrome (PCOS). This cross-sectional observational study was performed on 183 female individuals, consisting of 51 patients diagnosed with idiopathic hirsutism, 76 patients diagnosed with PCOS, and 56 healthy volunteers. Participants with a history of neuropsychiatric disorders, under 18 and over 45 years of age, during pregnancy and lactation, with any chronic disease that could interfere with diagnostic laboratory tests, and who had previously been treated for IH or PCOS were excluded from the study. Demographic, anthropometric, laboratory, and clinical data on the cases were recorded. The Short Form-36 (SF-36) questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were administered in a face-to-face interview by related authors involved in the study. The mean age, level of education, lifestyle, and marital status of all three groups were similar. There were no significant differences in body mass index (BMI) or waist circumference between the groups. Mean modified Ferriman-Gallwey (mFG) scores were similar in the IH and PCOS groups. In the IH patients, the general health and mental health domains of the SF-36 questionnaire scores were significantly lower than in the control group (p<0.001 and p=0.026, respectively). When the SF-36 questionnaire scores were compared between the IH and PCOS groups, the general health and role emotional domains were significantly lower in the PCOS group (p=0.013 and p<0.001, respectively), and the other domains were similar. All SF-36 questionnaire domains were significantly and negatively correlated with BMI and waist circumference measurements in IH patients. Both BDI and BAI scores were significantly and positively correlated with BMI (r=0.348, p<0.001, and r=0.162, p=0.012, respectively) and waist circumference (r=0.326, p<0.001, and r=0.344, p<0.001, respectively). Six out of eight domains of the SF-36 QOL scores were significantly and negatively correlated with the mFG scores. Patients diagnosed with IH have impaired HQOL, similar to patients diagnosed with PCOS. Improving HQOL should be a goal when deciding on a management approach for hirsutism, which is one of the most common reasons for referral to endocrinology and dermatology outpatient clinics.

Effect of body mass index trajectory on lifetime risk of cardiovascular disease in a Chinese population: A cohort study

Background and aimsThe longitudinal trajectories of body mass index (BMI) can reflect the pattern of BMI changes. Lifetime risk quantifies the cumulative risk of developing a disease over the remaining life of a person. We aimed to identify the trajectory of BMI and explore its association with cardiovascular disease (CVD) in the Chinese population. Methods and resultsA total of 68,603 participants with a mean age of 55.46 years were included from the Kailuan cohort in Tangshan, China, who were free of CVD and cancer and with repeated measurements of BMI from 2006 to 2010. A latent mixture model was used to identify BMI trajectories. An improved Kaplan-Meier estimator was used to predict the lifetime risk of CVD according to BMI trajectories. During a median follow-up of 7.0 years, 3325 participants developed CVD. Five BMI trajectories were identified at three index ages (35, 45, and 55) respectively. For index age 35 years, compared with the stable low-normal weight group (22.7% [95% CI, 20.0%–25.4%]), the stable high-normal weight (27.6% [25.6%–29.5%]), stable overweight (29.4% [27.4%–31.4%]), stable-low obesity (32.8% [30.0%–35.5%]), and stable-high obesity (38.9% [33.3%–44.5%]) groups had a higher lifetime risk of CVD (P < 0.05). We observed similar patterns for stroke and myocardial infarction. Similarly, the lifetime risk of CVD was higher in the long-term overweight and obese groups at 45 and 55 index ages. ConclusionsLong-term overweight and obesity were associated with an increased lifetime risk of CVD. Our findings could assist in predicting the population burden of CVD.

The association between lower socioeconomic position and functional limitations is partially mediated by obesity in older adults with symptomatic knee osteoarthritis: Findings from the English Longitudinal Study of Ageing.

To assess the longitudinal associations of socioeconomic position (SEP) with functional limitations and knee joint replacement surgery (JRS) in people with symptomatic knee osteoarthritis (OA), and whether body mass index (BMI) mediated these relationships. Data came from the English Longitudinal Study of Ageing, a national longitudinal panel study of adults aged ≥50 years. A total of 1,499 participants (62.3% female; mean age 66.5 (standard deviation (SD) 9.4) years; 47.4% obese) self-reporting an OA diagnosis and knee pain, with at least one BMI measurement were included. Mixed effect models estimated longitudinal associations of each SEP variable (education, occupation, income, wealth and deprivation index) and obesity (BMI ≥30.0 kg/m2) with repeated measures of functional limitations. Cox regression analyses estimated associations between SEP indicators and obesity at baseline and risk of knee JRS at follow-up. Structural equation modeling estimated any mediating effects of BMI on these relationships. Lower SEP and obesity at baseline were associated with increased odds of functional limitations in people with knee OA [e.g., difficulty walking 100 yards: no qualification vs. degree adjOR 4.33 (95% CI 2.20, 8.55) and obesity vs. no obesity adjOR 3.06 (95% CI 2.14, 4.37); similar associations were found for the other SEP indicators]. A small proportion of the association between lower SEP and functional limitations could be explained by BMI (6.2-12.5%). Those with lower income, lower wealth and higher deprivation were less likely to have knee JRS [e.g., adjHR most vs. least deprived 0.37 (95% CI 0.19, 0.73)]; however, no clear association was found for education and occupation. Obesity was associated with increased hazards of having knee JRS [adjHR 1.87 (95% CI 1.32, 2.66)]. As the direction of the associations for SEP and obesity with knee JRS were in opposite directions, no mediation analyses were performed. Lower SEP was associated with increased odds of functional limitations but lower hazards of knee JRS among people with knee OA, potentially indicating underutilization of JRS in those with lower SEP. Obesity partially mediated the relationship between lower SEP and increased odds of functional limitations, suggesting adiposity as a potential interventional target.

Cardiovascular Disease Risks Among Medical Students in A Public University

Introduction: Cardiovascular disease (CVD) is a major global health problem, with hazards evident even in children and adolescents. The purpose of this study is to measure the knowledge, attitude and practice of young medical students at the International Islamic University of Malaysia (IIUM) with regards to CVD, their CVD risk score and its associated factors. Method: A cross-sectional study was conducted among 247 preclinical students from March to July 2019. Validated self-reported questionnaires were used which includes sociodemographic, socioeconomic, lifestyle, International Physical Activity Questionnaire (IPAQ) and Knowledge, Attitude and Practice of CVD. A standardized scales were used to measure body mass index (BMI), digital sphygmomanometer for measuring blood pressure and blood glucose test kit for random blood sugar. CVD risk score was calculated based on a 30-years risk Framingham simple model of calculation using BMI. Univariate analysis and linear regression were used to identify the significant predictors. Results: The mean age was 21 (SD = 1.016) years old. 13.4 % of the students had elevated CVD risk scores. Prevalence central obesity, abnormal random blood glucose and abnormal BMI were 35.2%, 70.4% and 40.5% respectively. The participants scored good marks in KAP (97.6%). The relationship between CVD risk score with increasing age, male gender, smoking, increasing weight, low height, increased BMI and high systolic blood pressure were significant. Conclusion:The major risks of cardiovascular disease are widely distributed among students. Despite being in medical school and having a decent KAP score, there are smokers and students who live a sedentary lifestyle.

Long-term trajectories of BMI and cumulative incident metabolic syndrome: A cohort study.

Body mass index (BMI) has been widely recognized as a risk factor for metabolic syndrome (MetS). However, the relationship between the trajectory of BMI and cumulative incident MetS is still unclear. We investigate the associations of long-term measurements of BMI with MetS among young adults in the China Health and Nutrition Survey. We enrolled individuals aged 10 to 20 at baseline with recorded BMI at each follow-up interview, and 554 participants were finally included in our study. The assessment and incidence of MetS were evaluated by blood tests and physical examinations in their adulthood. A latent class growth mixed model was used to identify three BMI trajectory patterns: a low baseline BMI with slow development (low-slow, n=438), a low baseline BMI with fast development (low-fast, n=66), and a high baseline BMI with fast development (high-fast, n=50). Logistic regression was used to explore the relationship between different BMI trajectories and the incidence of MetS. During a follow-up of 16 years, 61 (11.01%) participants developed MetS. The combination of elevated triglycerides and reduced high-density lipoprotein cholesterol was most frequent in diagnosed MetS. In multivariate adjusted models, the low-fast and high-fast BMI trajectories showed a significantly higher risk of MetS than those with the low-slow BMI trajectory (low-high: OR = 3.40, 95% CI: 1.14-10.13, P < 0.05; high-fast: OR = 5.81, 95% CI: 1.63-20.69, P < 0.05). Our study identified three BMI trajectories in young adults and found that long-term measurements of BMI were also associated with cumulative incident MetS.

Body mass index versus surrogate measures of central adiposity as independent predictors of mortality in type 2 diabetes

BackgroundAn “obesity paradox” for mortality has been shown in chronic disorders such as diabetes, and attributed to methodological bias, including the use of body mass index (BMI) for obesity definition. This analysis investigated the independent association of BMI versus surrogate measures of central adiposity with all-cause mortality in individuals with type 2 diabetes.MethodsThe Renal Insufficiency And Cardiovascular Events Italian Multicentre Study is a prospective cohort study that enrolled 15,773 patients in 19 Italian centres in 2006–2008. Exposures were BMI and the surrogate measures of central adiposity waist circumference (WC), waist-to-height ratio (WHtR), and A Body Shape Index (ABSI). Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%),ResultsAge- and sex-adjusted hazard ratios and 95% confidence intervals were significantly higher in BMI-based underweight (1.729 [1.193–2.505), P = 0.004), moderately obese (1.214 [1.058–1.392), P = 0.006) and severely obese (1.703 [1.402–2.068), P < 0.0001), lower in overweight (0.842 [0.775–0.915), P < 0.0001) and similar in mildly obese (0.950 [0.864–1.045), P = 0.292), compared to normal-weight individuals. When further adjusting for smoking, physical activity (PA), and comorbidities, risk was lower also in mildly obese versus normal-weight patients. The BMI-mortality relationship did not change after sequentially excluding ever smokers, individuals with comorbidities, and those died within two years from enrollment and when analyzing separately participants below and above the median age. Conversely, a paradox relationship was observed among inactive/moderately inactive, but not moderately/highly active patients. Mortality risk adjusted for age, gender, smoking, PA and comorbidities was significantly higher in the highest tertile of WC (1.279 [1.089–1.501], P = 0.003), WHtR (1.372 [1.165–1.615], P < 0.0001), and ABSI (1.263 [1.067–1.495], P = 0.007) versus the lowest tertile. However, risk was lower in the intermediate versus lowest tertile for WC (0.823 [0.693–0.979], P = 0.028), similar for WHtR, and higher, though not significantly, for ABSI.ConclusionsAn “overweight paradox” remained after controlling for age, smoking, and comorbidities, arguing against a collider bias or reverse causation. However, it could be partly explained by confounding from PA level, possibly through its impact on lean mass and cardiorespiratory fitness. No obesity paradox was observed with WHtR and especially ABSI, which predicted mortality risk associated with central adiposity better than WC.Trial registration ClinicalTrials.gov, NCT00715481, 15 July, 2008

Body mass index and 2‐year change of in vivo Alzheimer's disease pathologies in cognitively normal older adults

AbstractBackgroundMultiple studies supported that low body mass index (BMI) or underweight status in late‐life was associated with increased risk of dementia. We tried to test the hypothesis that lower late‐life BMI is related with greater increase of in vivo AD pathology including Aβ and tau deposition for two years in cognitively healthy individuals. Additionally, we explored the same relationship in each sex separately, considering previous reports that showed prominent sex differences for the relationship between BMI and AD dementia risk.MethodTotal 194 cognitive normal older adults from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE) were included. All participants underwent comprehensive clinical assessment including BMI measurement, [11C] Pittsburg compound B and [18F] AV‐1451 PET at baseline. The same brain imaging scans were repeated at a year follow‐up assessment. The association of baseline BMI with longitudinal changes of AD biomarkers were analyzed using linear mixed effect models.ResultLower BMI at baseline was significantly associated with greater increase of tau deposition in AD‐signature region for 2 years. In contrast, BMI was not related with 2‐year change of global Aβ deposition. In additional exploratory analysis for each sex, lower baseline BMI was associated with greater increase of both Aβ and tau deposition in male, whereas neither Aβ nor tau change was not related with baseline BMI in female.ConclusionThe present study suggest that lower late‐life BMI may accelerate the accumulation of AD pathology in the brain, especially in male. To prevent AD, more attention is needed to be paid to avoiding underweight in old age and maintaining an appropriate BMI status.

Food intake and prevalence of malnutrition in nursing homes. A multicenter observational study

Objective. The aim of this study was to investigate malnutrition prevalence and its associated factors in NHs including resident food and liquid intake. Methods. We conducted a multicenter observational study in Italian NHs. NHs were recruited using a convenience sample from regional register. To detect malnourished residents, we used Body Mass Index (BMI) &lt; 18.5 kg/m2 and another criterion based on unintentional weight loss combined with reduced BMI. We performed logistic regression to identify associated factors with malnutrition. Results. We recruited 1795 residents that lived in 29 NHs. 76% were female, with mean age 85.4 ± 8.5 years. 275 out of 1787 residents (15.4, 95% CI 13.8-17.2%) were malnourished . Moreover, when we combined BMI measures (&lt; 20 kg/m2 if residents &lt; 70 years or &lt; 22 kg/m2 if residents ≥ 70 years) with unintentional weight loss data in the previous 6 months (5-10% or greater than 10%) we found that 18.1% residents were malnourished. Malnourished residents drank less (median 702 ml per day) than well nourished ones (median 800 ml per day) and ate less, especially at dinner. Malnutrition was significantly associated to age, psychiatric disorders, disability in activity of daily life, feeding assistance, swallowing and chewing problems and poor fluid intake. Moreover, we found a higher number of malnourished residents amongst those who needed more feeding care during dinner, when there was a lower number of staff. This result confirms the strong relationship between the care feeding and malnutrition. Conclusions. In this study we found that malnourished residents were older with poor functional ability, chewing problems, dependence in feeding and poor fluid intake. Interventions to prevent malnutrition in nursing homes are a priority for the practice and for further studies.

Sodium Intake and Nutritional Status Hypertension Patients In Hative Passo Hospital

Hypertension is the result of measuring systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg carried out twice with an interval of five minutes in a calm state with provisions for someone aged ≥ 18 years. Nutritional status is one of the factors that can increase a person's risk of hypertension. Someone who is overweight tends to experience hypertension because being overweight will affect a person's physiology, namely insulin resistance and hyperinsulinemia. The purpose of this study was to determine sodium intake and nutritional status in hypertensive patients at Hative Hospital, Passo. This research method is quantitative using a descriptive approach with a sample of 8 people. The number of outpatient visits of hypertensive patients without complications during May at the hospital was only 8 people. Data collection used a research instrument in the form of a semi-quantitative food frequency questionnaire (FFQ-SQ), as well as determining nutritional status by measuring body mass index (BMI). Data analysis technique using univariate analysis. Sodium intake of patients is categorized as grade I hypertension which is recommended for 3 (100%), grade II hypertension is recommended for 3 people (75%), 1 person (25%) is not recommended and grade III hypertension is not recommended 1 person (100%). Patients often consumed junk food with high sodium, resulting in an increase in blood volume and nutritional status caused by calorie intake, lack of physical activity, and other disease disorders

Is adiposity related to repeat measures of blood leukocyte DNA methylation across childhood and adolescence?

Epigenetic modifications such as DNA methylation may influence gene expression and phenotypes, including obesity in childhood. The directionality of this relationship is nevertheless unclear, and some evidence suggests that adiposity modifies the epigenome, rather than the other way around. In this pilot study, we utilize data from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) study to examine whether measures of adiposity in childhood and early adolescence are associated with repeated measures of blood leukocyte DNA methylation at LINE-1 repetitive elements and two genes implicated in growth and adiposity: H19 and HSD11B2. Longitudinal epigenetic data were generated from cord blood and blood from follow-up visits in early and late adolescence. We assessed interactions between age and measures of body mass index (BMI) at 5 years of age and weight, BMI and waist circumference in early adolescence to infer whether adiposity deflects age-related DNA methylation changes throughout childhood. Applying linear mixed-effects models, we found an inverse association between measures of childhood BMI (kg/m2 ) and early-teen weight (kg) with repeat measures of H19 DNA methylation. We did not observe any statistically significant associations (p-value <.05) between any anthropometric measures and DNA methylation at LINE-1 or HSD11B2. We did not demonstrate statistically significant evidence in support of deflection of age-related DNA methylation trajectories by adiposity-related measures (age by adiposity interaction term). Given the pilot nature of this study, the relationships between repeat measures of DNA methylation and adiposity-measures across childhood merit further exploration in larger study populations.

Obesity and Race As Determinates of Plasma Von Willebrand and Factor VIII Levels

Introduction: Obesity has emerged as a significant public health problem in all ages in the United States. The age-adjusted prevalence of obesity and severe obesity were 42.2% and 9.2% respectively among adults aged 20 or older from 2017-2018. Overall, non-Hispanic black and Hispanic adults and youth had a higher prevalence of obesity compared with other race and Hispanic-origin groups. Obesity prevalence was lower among non-Hispanic Asian men and women compared with other race and Hispanic-origin groups based on National Center for Health Sciences- Center for Disease Control. Factor VIII (FVIII) and von Willebrand factor (vWF) are both coagulation factors that are acute phase reactants. Obesity has been associated with metabolic syndrome and resultant chronic inflammation. Obesity has previously been linked to increasing FVIII levels, however, studies have not been able to confirm a linkage between VWF and body mass index (BMI). Methods: This is a secondary analysis of a single-site retrospective review of the electronic health record of patients that had von Willebrand profiles [VWF:Antigen (Ag), VWF:Activity (Act), and/or FVIII activity] obtained within 24 hours of a hemoglobin level who had no bleeding disorder diagnosis. BMI was recorded when available in the electronic medical record at the time of laboratory testing and correlation between BMI and FVIII/vWF levels was assessed. Data was retrieved from January 1, 2012, through June 1, 2021. Results: We identified 4552 individuals who had VWF profile testing that had an associated hemoglobin level in a 24-hour period and did not carry a diagnosis of VWD. Among all subjects, a total of 2152 subjects were found to have BMI measurements, 1294 subjects <85th percentile, 379 subjects ≥85th - 95th percentile and 479 subjects ≥ 95th percentile. Demographics for the cohort with BMI measurements were White (N=1,673; mean BMI percentile 67.4±29.4), Black (N=377; mean BMI percentile 72±27.3), Asian (N=46, mean BMI percentile 48.0±33.9). There was a statistically significant difference in BMI by race (P<0.001). VWF antigen (P<0.005) and FVIII level (P<0.005) were significantly and positively correlated with increased BMI levels. Similarly, VWF activity/antigen ratio was negatively correlated (P<0.005) with increasing BMI. Further statistical modelling was performed, controlling for hemoglobin, BMI percentile, race, and age. BMI percentile remained a determinant for VWF antigen and FVIII levels. VWF antigen levels were statistically different in those with BMI <85th and ≥ 95th percentile (P<0.0001) and ≤85th-95th and ≥ 95th percentile (P<0.01). FVIII levels were significant between BMI ≤85th and ≥ 95th percentile (P<0.0001). We also examined the cohort for potential differences in VWF and FVIII levels based on race. Black race was found to be associated with higher VWF antigen levels among all races and found to be statistically significant when compared to White race (P<0.0001). Black race was also associated with a higher FVIII level versus White race (P<0.0001). Further statistical modeling was also done for race, controlling for BMI, hemoglobin, and age. VWF antigen levels were statistically significant among races (P<0.0001) with Black race having the highest mean level. Similarly, Race was a significant factor for VWF activity/antigen ratio (P<0.0001) with White race having the highest and Black race the lowest mean ratio. Race was also statistically significant (P<0.0001) for FVIII levels, with Black race having the highest levels and lowest levels in the all-other race category. Conclusions: BMI and race were independently found to be determinants of VWF:Ag and FVIII levels. As patients presenting for a bleeding disorder evaluation may be overweight or obese, the confounding effect of increased BMI should be considered during the diagnostic evaluation. We also observed racial differences in VWF antigen and FVIII levels. As this was antigen testing, it should not be affected by the known racial differences in sensitivity to ristocetin cofactor testing. Further studies to confirm these findings and the potential confounding effect of BMI are needed.

Getting them through the door: Social and behavioral determinants of uptake and engagement in an obesity intervention

Using data from a large-scale screening program (N = 19634), we aimed to prospectively identify factors predicting uptake (i.e. acceptance of the invitation) and engagement (i.e. participation in at least two sessions) in a multi-component-intensive-behavioral-intervention for obesity-management (MBIOM) intervention targeting adolescents (n = 2862; 12–14 years; BMI ≥90th percentile). Approximately one third of adolescents most in need of weight management declined the initial invitation to enter the MBIOM. Poor diet, sedentary behavior, and parental education predicted willingness to enter and stay in the intervention, however measured body mass index did not matter. Perceived family support, instead of initial motivation, facilitated engagement. Our results provide new insights on the importance of regional socio-geographical factors including trust in local authorities.

Prevalence And Associated Sociodemographic Factors of Obesity And Overweight among Public School Teachers in Kurdistan Region

Background: Obesity and overweight are two of the main serious health risk factors worldwide. Teachers have been found to be more likely than other groups of the population to be obese or overweight. The study aimed to explore the overweight and obesity prevalence and determine their sociodemographic factors among public school teachers in a sample population in Iraqi Kurdistan. Methods: The cross-sectional study design was applied from September 15th, 2021, to April 1st, 2022. Stratified-simple random sampling technique was used to select 500 school teachers aged from 18 to 64. The current study used a questionnaire and composed of two parts: the first part; included sociodemographic characteristics, and the second part, consisted of measuring body mass index. Results: The majority (40.6%) of teachers were aged 30–39 and 64.8% of them were female, and 54.6% were primary school teachers. The combined overweight and obesity prevalence was 71.4%. The higher obesity and being overweight prevalence was found in those over the age of 30, female, married, low to moderate-income teachers, and teachers with a diploma and lower education levels. The BMI of teachers was statistically associated with age (p=0.024), gender (p≤ 0.001), marital status (p≤0.001), income (p≤ 0.001), and education level (p=0.007). Conclusions: The prevalence of overweight and obesity is high among primary school teachers in this region. They are associated with socio-demographic characteristics

Associations Between Rurality, pre-pregnancy Health Status, and Macrosomia in American Indian/Alaska Native Populations.

To examine the relationships between pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI) and county-level social determinants of health, with infant macrosomia within a sample of American Indian/Alaska Native (AI/AN) women receiving Indian Health Service (IHS) care. The sample included women-infant dyads representing 1,136 singleton births from fiscal year 2011 (10/1/2019-9/30/2011). Data stemmed from the IHS Improving Health Care Delivery Data Project. Multivariate generalized linear mixed models were fitted to assess the association of macrosomia with pre-pregnancy health status and social determinants of health. Nearly half of the women in the sample were under age 25 years (48.6%), and most had Medicaid health insurance coverage (76.7%). Of those with a pre-pregnancy BMI measure, 66.2% were overweight or obese. Although few women had pre-pregnancy DM (4.0%), GDM was present in 12.8% of women. Most women had a normal term delivery (85.4%). Overweight, obesity, pre-pregnancy DM, and county-level rurality were all significantly associated with higher odds of infant macrosomia.