Triceps Skinfold Research Articles

Differences in physical activity, sedentary time, and anthropometric variables among children and adolescents: The TUBON project

Background. Although physical inactivity may lead to increasing obesity prevalence, research on anthropometric variables changes based on physical activity (PA) in children and adolescents is limited. PA decreases with age, while sedentary behavior increases. The study aimed to examine differences in objectively measured sedentary time, light-intensity physical activity (LPA), and moderate-to-vigorous intensity physical activity (MVPA) between children and adolescents, and the differences in the percentiles of anthropometric variables between physically active and inactive groups according to World Health Organization PA recommendations. Methods. A total of 759 participants aged 6-17 years (boys, n=358; girls, n=401) were included in the study. The ActiGraph wGT3x-BT accelerometer was used to measure sedentary time, LPA, and MVPA. Height, weight, waist circumference (WC), triceps skinfold thickness (T-SFT), and medial-calf skinfold thickness (M-SFT) were measured. Body fat percentage (BF%) and body mass index (BMI) were calculated, and the percentiles of anthropometric variables were categorized. Results. The findings showed that children had less sedentary time and a higher LPA than adolescents for both genders (p<0.05). Children had a higher MVPA than adolescents in girls (p<0.05), but the difference was insignificant in boys (p>0.05). In boys, physically active children were in lower percentiles for T-SFT and BF% than those who did not (p<0.05). In boys, adolescents who were physically inactive were in higher percentiles for BMI, T-SFT, M-SFT, and BF% (p<0.05). In addition, in girls, adolescents who were physically active were in lower percentiles of BMI, M-SFT, and BF%, whereas children who were physically active were in lower percentiles of M-SFT and BF% (p<0.05). Conclusion. Sedentary time increases while PA decreases with age. Children and adolescents who met the WHO PA recommendation had lower percentiles of anthropometric variables, indicating the importance of PA in preventing obesity in these age groups.

Role of albumin and prealbumin in assessing nutritional status and predicting increased risk of infectious complications during childhood cancer treatment

IntroductionProper nutrition in patients with cancer is important for preventing treatment complications and achieving remission. Malnutrition in these patients leads to reduced production of essential structural proteins.PurposeThe aim of the study was to assess the role of albumin and prealbumin in assessing the nutritional status of cancer patients and in predicting an increased risk of infectious complications during treatment.Patients and MethodsThe study included 40 pediatric patients with newly diagnosed cancer and 30 healthy children serving as controls. Prealbumin, albumin, and C-reactive protein (CRP) levels and the upper arm muscle area (UAMA) were measured before and after treatment in children with cancer and compared with the control group to evaluate nutritional status. Additionally, we assessed associations between these parameters and the incidence of infectious complications during cancer treatment in patients with anthropometric malnutrition, as well as associations with an increased risk of malnutrition related to inflammation before treatment.ResultsAt baseline, patients with cancer had lower prealbumin and albumin levels (p< 0.001), higher CRP levels (p < 0.001), and lower UAMA percentiles (p = 0.0245) compared with controls. Cancer treatment resulted in an increase in prealbumin and albumin levels (p < 0.001) and a reduction in CRP levels (p < 0.001), with no change in UAMA (p = 1.000). Prealbumin deficiency was more common than albumin deficiency before and after cancer treatment. Median prealbumin and albumin levels tended to increase with an increasing UAMA percentile range, but these differences were not significant (p> 0.05). The incidence of infectious complications during treatment in patients with risk factors for inflammation-related malnutrition was similar to that in patients with pre-existing anthropometric malnutrition without inflammation (p = 1.000). In a univariable logistic regression model including prealbumin and albumin deficiency, as well as low UAMA percentile, albumin deficiency before treatment was shown to be a significant predictor of 3 or more infectious episodes during treatment (p = 0.02).ConclusionAlbumin and prealbumin deficiency may predict the risk of malnutrition associated with inflammation in patients with cancer. Hypoalbuminemia may predict an unfavorable course of treatment complicated by frequent infections in these patients.

Prevalence of Hypertension and Prehypertension among Young Adult Students of Midnapore Town, Paschim Medinipur, West Bengal, India

Background: Hypertension is one of the most prevalent public health concerns and also one of the prominent factors in affecting the cardiovascular diseases (CVDs), coronary heart diseases (CHDs). It has been termed as “Silent Killer’. About 46.0% of adults worldwide with hypertension are unaware that they have the condition. Methods: The present study aimed at the investigation on the anthropometric, derived variables and blood pressure variables. It also determined the correlation between anthropometric, derived variables and blood pressure variables. It estimated the prevalence rate of hypertension and prehypertension among the young adult students of Midnapore Town, Paschim Medinipur, West Bengal, India. The cross-sectional study was conducted among 201 young adult male students aged between 18 to 28 years. Height (HT), Weight (WT), Mid upper arm circumference (MUAC), Hip circumference (HC), Waist circumference (WC), Biceps skinfold (BSF), Triceps skinfold (TSF), Subscapular skinfold (SSF) and Suprailliac skinfold (SISF), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and pulse rate measurement were taken using standard procedure. Results: The overall prevalence of hypertension was found to be 10.9% among the studied participants and 44.3% was the prehypertension prevalence rate. A significant correlation (p<0.05) was found between blood pressure variables and different anthropometric and derived variables. Conclusion: This study demonstrated that there is a very strong prevalence of prehypertension and HTN among the young adult students of Midnapore town. Results of such kind of researches can be helpful in the formulation of appropriate awareness programmes in the universities and colleges.

The Relationship Between Gestational Age, Parity, Nutritional Status with the Incidence of LBP in Pregnant Women

Background: Low Back Pain (LBP) is pain that arises in the lower back of the body, including the lower spine, waist, pelvis, and can radiate to the buttocks or legs. low back pain is one of the most common pains in pregnant women with an incidence of about 60%-90%. Objective: The purpose of the study was to determine the relationship between gestational age, parity and nutritional status of pregnant women with the incidence of low back pain based on the Oswestry Disablity Index (ODI). Method: The research design used was non-experimental with a cross sectional research approach. This research was conducted at Wirahusada Medical Center Clinic Makassar 2022 and there were 95 research samples. This research data uses primary data from the results of filling out questionnaires by respondents. Data were processed using SPSS with the Chi-Square test. Result: The results showed that gestational age with low back pain had a p-value of 0.000, parity with low back pain had a p-value of 0.000, nutritional status based on upper arm circumference with low back pain had a p-value of 0.020, and nutritional status based on upper arm circumference with low back pain had a p-value of 0.000. Conclusion: The results showed that there was a relationship between gestational age, parity, and nutritional status of pregnant women with the incidence of low back pain based on the Oswestry Disability Index at the Wirahusada Medical Center Clinic Makassar 2022 with a p-value <0.05.

The association of human milk intake and outcomes in biliary atresia.

Human milk intake has many benefits which could influence outcomes in biliary atresia (BA). However, the role of human milk in BA has not been examined. We hypothesized that human milk intake would be associated with improved outcomes in BA. We assessed the impact of any human milk (AHM) as compared to formula only (FO) intake before Kasai portoenterostomy (KP) on outcomes in 447 infants with BA using the PROBE database (NCT00061828) post hoc. The primary outcome was clearance of jaundice (COJ = total bilirubin (TB) < 2 mg/dL by 3 months post-KP). Secondary outcomes included 2-year native liver survival (SNL), bilirubin levels, cholangitis, ascites, and growth. We assessed the fecal microbiome (n = 8) comparing AHM versus FO. At baseline, 211 infants received AHM and 215 received FO. 53.9% of AHM and 50.5% of FO achieved COJ (p = NS). SNL was insignificantly increased in AHM (odds ratio = 1.47, 95% confidence interval: 1.00-2.12, p = 0.053). TB decreased in AHM from 4 weeks to 3 months post-KP [4.8-4.0 mg/dL (p = 0.01)] unlike the FO group (4.9-4.9 mg/dL, p = 0.4). At 3 months post-KP, AHM infants had greater weight gain (1.88 ± 0.66 vs. 1.57 ± 0.73 kg, p < 0.001) and mid-upper arm circumference (12.9 ± 1.4 vs. 12.2 ± 1.7 cm, p < 0.001). Other secondary outcomes were not different. Microbiome differences were seen between AHM and FO. Human milk intake in infants with BA did not significantly improve COJ or SNL. However, growth parameters were improved, and TB 3 months post-KP was decreased. Thus, human milk intake should not be discouraged. Prospective studies with detailed assessment of human milk intake are needed.

Important features of bench press performance in non-disabled and Para athletes: A scoping review.

Understanding important features for performance in non-disabled bench press and Paralympic powerlifting may inform talent identification and transfer models. The aim of this scoping review was to describe features associated with bench press performance. We conducted a systematic search of three electronic databases (PubMed, SportDiscus and EMBASE) to identify studies involving non-disabled and Para athlete populations that investigated features related to bench press one-repetition maximum (1RM), across six domains (anthropometric, body composition, demographic, technical, disability and neuromuscular). Search terms included "resistance training", "para powerlifting' and "one repetition max". No date restrictions were include in searches. Studies using adult participants, with at least six-months of bench press experience, who were able to bench press their body mass were included. Thirty-two studies met our inclusion criteria. Twenty-four studies involved non-disabled athletes (total n = 2,686; 21.9% female) and eight involved Para athletes (total n = 2,364; 39.4% female). Anthropometric (17 studies) and body composition (12 studies) features were most studied; half of the 32 studies investigated features from a single domain. Of anthropometric variables, upper arm circumference shared the strongest association with bench press 1RM in non-disabled (r = 0.87) and para-athletes (r = 0.65). Upper limb fat free mass (r = 0.91) and body mass index (r = 0.46) were the body composition variables sharing the strongest association with bench press 1RM in non-disabled and para-athletes. Few studies considering the uncertainty of their results. Practices of open and transparent science, such as pre-registration and data sharing, were absent. The development of bench press talent identification and sport transfer models will require future studies to investigate both non-training and training modifiable features, across multiple domains. Large longitudinal studies using information from athlete monitoring databases and multivariable model approaches are needed to understand the interacting features associated with bench press performance, and for the development of talent identification models.

Cost- effectiveness of a simplified acute malnutrition program: a secondary analysis of the OptiMA randomized clinical trial in the Democratic Republic of the Congo.

Acute malnutrition (AM) causes large loss of life and disability in children in Africa. Researchers are testing innovative approaches to increase efficiency of treatment programs. This paper presents results of a cost-effectiveness analysis of one such program in the Democratic Republic of the Congo (DRC) based on a secondary analysis of a randomized controlled trial Optimizing Treatment for Acute Malnutrition (OptiMA), conducted in DRC in 2018-20. 896 children aged 6-59 months with a mid-upper arm circumference (MUAC) <125 mm or with oedema were treated and followed for six months. Cost-effectiveness of OptiMA using ready-to-use therapeutic food (RUTF) at a tapered dose was compared with the standard national program in which severe cases (SAM) received RUTF proportional to weight, and moderate cases (MAM) were referred to another clinic for a fixed dose regimen of ready-to-use supplementary food. Cost analysis from provider perspective used data collected during the trial and from administrative records. Statistical differences were derived using t-tests. The mean cost per enrolled child under OptiMA was $123 [95%CI: 114-132], not statistically different from the standard group ($127 [95%CI: 118-136], p=0.549), while treatment success (i.e. recovery to MUAC > 125mm and no relapse for 6 months) under OptiMA was 9 percentage points higher (72% vs 63%, p=0.004). Among children with SAM at enrollment, there was no significant difference in treatment success between OptiMA and standard (70% vs 62%, p=0.12) but OptiMA's mean cost per enrolled child was 23% lower ($128 vs $166, p<0.0001). OptiMA was more effective at preventing progression to SAM among those enrolled with MAM (5% vs 16%, p<0.0001) with an incremental cost-effectiveness ratio (ICER) of $234 per progression to SAM prevented. Overall, OptiMA had significantly better outcomes and was no more expensive than standard care. Its adoption could enable more children to be successfully treated in contexts where therapeutic food products are scarce.

Child health, nutrition and gut microbiota development during the first two years of life; study protocol of a prospective cohort study from the Khyber Pakhtunkhwa, Pakistan

Recent evidence suggests that the development of gut microbiota during infancy affects several metabolic, immune, and endocrine pathways in humans. An imbalance in gut microbiota diversity or function, also known as dysbiosis, not only affects early child growth and development, but is also linked with the development of chronic, non-communicable diseases in later life. The Child Health And Microbiome Development Study – Pakistan (CHAMP) study aimed to longitudinally assess gut microbiota development and associated factors (maternal, child, and demographic) during early childhood in populations residing in malnutrition-endemic communities in Pakistan. A prospective cohort of mother-infant pairs (n=70) will be recruited from District Swat, Pakistan, and followed for two years. Complete information about demographic characteristics, anti-natal and post-natal care, dietary intake, feeding practices, and child health will be collected at baseline and 3, 6, 12, 18, and 24 months. Anthropometric measurements (height, weight, mid-upper arm circumference, and head circumference), dry blood spots, and fecal samples were also collected. Ethical approval for the study was obtained from Khyber Medical University, Pakistan. The study is also registered on clincaltrial.gov (Ref no: NCT05793294). The study findings will help researchers understand gut microbiota development, associated factors, and their impact on longitudinal growth in infants during the first two years of life.

Quantitative analysis of pressure levels in manual lymphatic drainage across stages of breast cancer-related lymphedema: implications for optimized treatment protocols.

To quantify the pressure levels necessary for effective Manual Lymphatic Drainage (MLD) in managing Breast Cancer-Related Lymphedema (BCRL) across various stages, and to contribute to the development of standardized protocols for MLD therapy. The study included 42 patients with BCRL (Stages I-III) and 14 certified lymphedema therapists. Forearms and upper arm circumferences were measured pre and post a 21-day MLD intervention. A tactile sensor system recorded the applied pressure during treatment. The data were preprocessed and statistically analyzed to assess pressure patterns and their stage-specific impacts on lymphedema. The mean age of the patients was 52.4years, and that of the therapists was 39.1years. A statistically significant reduction in arm circumference was observed post-MLD treatment (P < 0.05). The pressure applied varied across stages: I forearm 16.5-20.1mmHg, I upper arm 16.1-20.7mmHg; II forearm 16.6-19.8mmHg, II upper arm 19.7-23.8mmHg; III forearm 29.3-34.3mmHg, III upper arm 29.7-34.3mmHg. No statistically significant difference was found between forearm and upper arm treatment pressures within Stages I (P = 0.283) and III (P = 0.08), while Stage II exhibited a significant difference (P < 0.001). Across the same treatment area, pressures for Stages I and II in the forearm were significantly lower than those in Stage III (P < 0.001). The treatment pressure differences between forearm stages I and II were not statistically significant (P > 0.05). Differences in upper arm treatment pressures across Stages I, II, and III were also statistically significant (P < 0.001). The study provides quantitative evidence on the pressure ranges needed for MLD across different stages of BCRL. It highlights the importance for stage-specific pressure adjustments to optimize treatment outcomes. These findings contribute to the existing body of knowledge on MLD and offer valuable data that could inform the development of rehabilitation technologies, including intelligent robots and visualization systems, as well as enhance therapist training programs.

The impact of a pediatric malnutrition telehealth clinic on anthropometric measurements in children aged 6-59 months in rural Guatemala.

Guatemala, a country with high rates of pediatric malnutrition, has significant challenges including food and potable water insecurity and a lack of health care providers. This study examined the impact of telehealth clinic attendance on pediatric malnutrition scores. A sample of 42 Guatemalan children aged 6-59 months with malnutrition were recruited to participate in eight clinic events, including two in-person and six telehealth clinics. Six telehealth clinics were held at 4- to 6-week intervals, bookended by an initial and concluding in-person event. Nonparametric tests were used to analyze changes between baseline and last visit z-scores for height, weight for length, mid-upper arm circumference (MUAC), and body mass index (BMI) and to examine the relationship between the number of telehealth visits and z-score measurements at baseline and last visit. The number of children with severe malnutrition at baseline by weight for length, BMI, and MUAC decreased by the last visit. A decrease occurred in the number of children with stunted height. Changes in z-scores for height, weight for length, BMI, and MUAC between study onset and last visit did not reach statistical significance. Statistically significant relationships existed between clinic attendance and baseline and last visit weight for height/length z-scores and baseline MUAC z-scores. Positive improvements in nutritional status occurred, especially among children with severe malnutrition. Children with severe malnutrition had significantly better telehealth attendance. Studies with larger sample sizes are needed. Study results indicate that telehealth may be a tool to battle global pediatric malnutrition.

Nutritional Risk, Nutritional Status and Some Biochemical Parameters In Adult Burn Patients in Burn Intensive Care Unit: A Prospective Study

Nutritional therapy is very important in burn patients and plays a role in the prevention and treatment of malnutrition. Therefore, it is necessary to assess nutritional status, prevent or minimize nutritional problems, and monitor nutritional therapy. This study was conducted to determine the nutritional risk, nutritional status and biochemical parameters of adult burn patients in the burn intensive care unit. The 59 patients (women: 16, men: 43) between the ages of 19-64 were included in the study. Parameters such as NRS-2002 (admission and discharge), dietary intake, nutritional support status, serum albumin, and total protein (admission and discharge) were evaluated to determine the nutritional risk and nutritional status of the patients. In addition, body weight, mid-upper arm circumference, and triceps skinfold thickness were measured and body mass index was calculated (admission and discharge). The duration of hospitalization and burn percentage of men patients were higher than women (P &lt; 0.05). A significant decreases were determined in the mean body weight, body mass index, and triceps skinfold thickness of men patients at discharge compared to admission (P &lt; 0.05). In men patients, a statistically significant difference was found in serum albumin, hemoglobin, and hematocrit values between admission and discharge (P &lt; 0.05). A statistically significant difference was found in NRS-2002 scores at admission and discharge in both genders, and the scores increased (P &lt; 0.05). While a significant relationship was found between immunonutrition support and gender (P &lt; 0.05), no relationship was found between genders in terms of the diet given and the consumption status of the diet intake (P &gt; 0.05). No statistically significant difference was found between genders in terms of feeding duration with nutritional support products, energy intake with nutritional support products and diet, macronutrients, and total energy expenditure values (P &gt; 0.05). Since burn injuries can cause serious metabolic disorders, impaired nutritional status was encountered during hospitalization. While the treatment process was positively affected by the increase in the NRS-2002 score during hospitalization, a decrease in parameters such as albumin, total protein, and anthropometric measurement values brought about by the catabolic process was encountered. Therefore, to prevent or treat malnutrition, the nutritional status of patients should be evaluated at the time of hospitalization and they should be able to receive the necessary nutritional support.

Associations of Maternal Nutritional Status and Supplementation with Fetal, Newborn, and Infant Outcomes in Low-Income and Middle-Income Settings: An Overview of Reviews.

Despite advances in maternal nutritional knowledge, the effect of maternal diet, micronutrient status and undernutrition, and the effect of maternal supplementation on fetal, neonatal and infant outcomes still have gaps in the literature. This overview of reviews is intended to assess the available information on these issues and identify the main maternal nutritional factors associated with offspring outcomes in low- and middle-income countries as possible targets for public health interventions. The literature search was performed in Medline (PubMed) and Cochrane Library datasets in June 2024. Pre-specified outcomes in offspring were pooled using standard meta-analytical methods. We found consistent evidence on the impact of maternal undernutrition indicated by low body mass index (BMI), mid-upper arm circumference (MUAC), and stature, but not of individual micronutrient status, on intrauterine-growth retardation, preterm birth, low birth weight, and small for gestational age, with research showing a possible effect of maternal undernutrition in later child nutritional status. Studies on micronutrient supplementation showed possible beneficial effects of iron, vitamin D, and multiple micronutrients on birthweight and/or decreasing small for gestational age, as well as a possible effect of calcium on preterm birth reduction. Interventions showing more consistent beneficial outcomes were balanced protein-energy and lipid base supplements, which demonstrated improved weight in newborns from supplemented mothers and a decreased risk of adverse neonatal outcomes. Further research is needed to identify the benefits and risks of maternal individual micronutrient supplementation on neonatal and further child outcomes.

Effectiveness of moringa biscuit (Moringa oleifera) and snakehead fish (Channa striata) in improving the nutritional status of pregnant women with chronic energy deficiency

The objective of this study was to analyse the effectiveness of moringa biscuits and snakehead fish in improving the nutritional status of pregnant women with chronic energy deficiency (CED). The study was a randomized control trial carried out in two stages. The first stage was carried out in 2020, while the second stage was implemented in 2021 in Sigi Regency, Central Sulawesi Province, Indonesia. Thirty pregnant women with CED were divided into two groups. Five pieces of biscuits (60g) were given every day for three months to women in the intervention group while the control group were given biscuits without moringa and snakehead fish. The analysis consisted of paired t-test statistics. The results showed that giving biscuits significantly improved the nutritional status of pregnant women with CED, with the mean body mass index Centre (BMI) having a value of (P 0.000). In contrast, the upper arm circumference did not differ between the intervention and control groups. (P 0.247). We conclude that the consumption of moringa and snakehead fish biscuits provides a higher average contribution of energy and nutrients in pregnant women with CED.

Adding Metastasis-Directed Therapy to Standard-of-Care Systemic Therapy for Oligometastatic Breast Cancer (EXTEND): a Multicenter, Randomized Phase II Trial

PurposePrior evidence suggests a progression-free survival (PFS) benefit from adding metastasis-directed therapy (MDT) to standard-of-care (SOC) systemic therapy for patients with some oligometastatic solid tumors. Randomized trials testing this hypothesis in breast cancer have yet to be published. We sought to determine whether adding MDT to SOC systemic therapy improves PFS in oligometastatic breast cancer. MethodsEXTEND is a multicenter phase II randomized basket trial testing the addition of MDT to SOC systemic therapy in patients with ≤5 metastases (NCT03599765). Patients were randomized 1:1 to MDT (definitive local treatment to all sites of disease, plus SOC systemic therapy) or to SOC systemic therapy only. Primary endpoint was PFS, and secondary endpoints included overall survival (OS), time to subsequent line of systemic therapy, and time to the appearance of new metastases. Exploratory analyses included quality of life (QOL) and systemic immune response measures. ResultsFrom September 2018 through July 2022, 22 and 21 patients were randomized to the MDT and no-MDT arms, respectively. At a median follow-up of 24.8 months, PFS was not improved with the addition of MDT to SOC systemic therapy (median PFS 15.6 months MDT vs 24.9 months no-MDT [hazard ratio {HR} 0.91; 95% CI 0.34–2.48, p=0.86]). Similarly, MDT did not improve OS, time to subsequent line of systemic therapy, or time to the appearance of new metastases (all p>0.05). No significant differences were found in QOL measures, systemic T-cell activation, or T-cell stimulatory cytokine concentration. ConclusionAmong patients with oligometastatic breast cancer, the addition of MDT to SOC systemic therapy did not improve PFS. These findings suggest that MDT may have no systemic benefit in otherwise unselected oligometastatic breast cancer patients, although this trial was limited by a heterogenous and small sample size and overperformance of both treatment arms.

Mid-upper arm circumference as a screening tool for identifying physical frailty in community-dwelling older adults: The Korean Frailty and Aging Cohort Study.

Frailty in older adults is influenced by various factors, such as poor nutritional status. Mid-upper arm circumference (MUAC) is a validated, simple, and non-invasive tool for assessing nutritional status. Despite its potential, no study has explored the association between MUAC and physical frailty in older adults. This study aims to investigate this association and assess whether MUAC can be used as a screening tool in community and primary clinical practice. A cross-sectional study was conducted with 1178 participants aged 71.8 to 86.7 years from the 2019 Korean Frailty and Aging Cohort Study (KFACS). Physical frailty was defined using the Fried frailty phenotype criteria. MUAC was measured as the average circumference of both upper arms without compressing the subcutaneous tissue. Odds ratios (ORs) and 95% confidence intervals (CIs) for physical frailty, stratified by sex, were estimated using multiple logistic regression analysis after adjustments. MUAC was lower in physically frail men compared with non-frail men (28.0 ± 2.9 vs. 29.4 ± 2.6 cm, P < 0.001). MUAC was negatively correlated with the Frailty Index (r = -0.155, P < 0.001). Multiple logistic regression analysis revealed that MUAC was an independent factor for physical frailty in men (OR 0.986, 95% CI 0.973-1.000, P = 0.049). The optimal MUAC cutoff for identifying physical frailty in men was 28.2 cm (sensitivity 60.7%, specificity 71.4%, AUC 0.672, 95% CI 0.595-0.749, P < 0.001). No significant results were found for women. Low MUAC is significantly associated with physical frailty in older men, suggesting the potential for MUAC to be utilized as a screening tool for physical frailty in community and primary clinical settings. Geriatr Gerontol Int 2024; ••: ••-••.

Adolescents' chronotype and its association with obesity-related outcomes: The EHDLA study.

This study aimed to assess associations between chronotype and obesity-related indicators in a sample of Spanish adolescents. This cross-sectional study used data from The Eating Healthy and Daily Life Activities (EHDLA) Study, which included a representative sample of adolescents from Spain. A total of 820 adolescents (54.7% girls) aged 12-17 years were included in the analyses. The adolescents' chronotype was determined using the Morningness/Eveningness Scale in Children. Obesity-related indicators included body mass index, waist circumference, waist-to-height ratio, triceps and medial calf skinfolds, sum of skinfolds, and body fat percentage. Generalized linear models were used to examine the relationship between the Morningness-Eveningness score and chronotype status and the above-mentioned obesity-related indicators in adolescents. All analyses were adjusted for sex, age, socioeconomic status, sleep duration, physical activity, sedentary behaviour, adherence to the Mediterranean diet, and energy intake. The morningness chronotype was associated with higher abdominal obesity (odds ratio [OR] = 1.67, 95% confidence interval (CI) 1.12 to 2.50; p = 0.001), waist-to-height ratio (unstandardized beta coefficient [B] = 0.01, 95% CI 0.01 to 0.05; p = 0.029) and skinfold calves (B = 1.04 95% CI 0.24 to 1.94; p = 0.011), compared with the intermediate chronotype. Adolescents with a morningness chronotype may be more prone to abdominal obesity than their counterparts with an intermediate chronotype. Effective intervention-related approaches can be applied to those with a morningness chronotype.

Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial.

Children with acute malnutrition are at high risk of morality. Mass azithromycin distribution reduces all-cause mortality among children aged 1-59 months, and effects may be greater in underweight infants. Here, we evaluate the efficacy of azithromycin for reducing all-cause mortality in children aged 6-59 months with acute malnutrition (mid-upper arm circumference, MUAC, < 12.5 cm). Communities in Nouna District, Burkina Faso were 1:1 randomized to biannual mass distribution of single dose azithromycin or placebo to all children aged 1-59 months. Mortality was assessed during each census and treatment round. MUAC measurements were collected for all children. We evaluated the effect of azithromycin on mortality in subgroups of children aged 6-59 months defined by acute malnutrition (MUAC < 12.5 cm versus MUAC ≥ 12.5 cm). In children with MUAC < 12.5 cm, mortality rates were 51% lower among those living in azithromycin communities compared to placebo (incidence rate ratio 0.49, 95% confidence interval, CI, 0.25 to 0.99; incidence rate difference -18.1 deaths per 1,000 person-years, 95% CI -37.0 to -0.01), which was greater than the reduction in mortality among children with MUAC ≥ 12.5 cm (P-value for interaction on the relative scale = 0.09; P-value for interaction of the additive scale = 0.03). Children with acute malnutrition may benefit from single dose azithromycin above and beyond those without acute malnutrition. Trial registration: ClinicalTrials.gov NCT03676764; https://clinicaltrials.gov/study/NCT03676764.

Measurements and medication data are indispensable for population blood pressure monitoring

Abstract Background The National Study on Health of Older People in Germany “Gesundheit 65+” included blood pressure (BP) measurements at home by a study nurse and classification of all current medication. Methods Nationally representative examination survey of the population aged 65 years and older residing in Germany using two-stage population registry sampling from 128 sample points, with a standardized examination at home from June 2022 to April 2023. Three standardized blood pressure measurements at two-minute intervals were taken after 5 minutes rest with an oscillometric device (Mobil-O-Graph) using one of five cuffs according to upper arm circumference. The mean of the second and third measurement was used for analysis. Hypertension was defined as mean systolic BP (SBP) at or above 140 mmHg, or mean diastolic BP (DBP) at or above 90 mmHg, or the use of antihypertensives (antihypertensives, diuretics, beta-blockers, calcium-channel blockers, ACEI and ARB) in participants with self-reported hypertension diagnosis. Provisional weights account for unequal sampling and participation probabilities. Results The “Gesundheit 65+” examination part included 1,493 participants of whom 1,475 (98.8%) had successful BP measurements (763 men and 712 women, aged 66 to 101 years). Based on self-reported diagnoses alone, the prevalence of hypertension would be 58.3% [95% CI 53.2-63.3] in men and 59.5% [53.8-64.9] in women. However, overall hypertension prevalence was estimated at 70.4% [65.8-74.7] in men and 72.3% [66.9-77.1] in women based on the study definition which combines self-reported diagnoses, standardized BP measurements and medication. Conclusions The prevalence of hypertension is greatly underestimated in the absence of examination survey data with standardized measurements and recording of medication use. In addition, measurement and medication data are needed for monitoring the hypertension cascade, i.e. awareness, treatment and control of hypertension. Key messages • Hypertension prevalence is underestimated in the absence of health examination surveys with measurements and medication data. • The hypertension cascade, i.e. assessment of awareness, treatment and control of hypertension needs population surveys with measurements and medication assessment.

Relationship Between The Compliance of Antiretroviral Therapy and The Occurrence of Underweight Conditions, Calf Circumference, Handgrip Strength, and Triceps Skinfold in HIV/AIDS Patients at RSSA Malang

Background: Human Immunodeficiency Virus or commonly known as HIV is a virus that infects CD4 cells thereby impaired the human immune system. The number of new HIV cases in Indonesia in 2019 was reported to have reached 50,282 cases and tends to increase from year to year. What often happens in people with HIV/AIDS (PLWHA) tends to experience weight loss accompanied by opportunistic infections that do not occur in normal people. Adherence to therapy is the main factor that must be emphasized by PLWHA in order to achieve treatment success. However, ARV therapy adherence rates are reported to be &lt;80%. This number can be a predictor of therapy failure. One indicator of the success of therapy is when there is clinical improvement in the patient's condition, such as no opportunistic infections or weight gain. Aim: The aim of this study was to determine whether there is a relationship between adherence to antiretroviral therapy and underweight conditions in HIV/AIDS patients. Methods: This study used a cross sectional design with an analytical observational nature and the research subjects were patients at RSSA Malang who visited from June to August 2023. Results: The results of the study showed that there was a significant relationship between adherence to taking ARVs and being underweight (p=0.018) and there was no significant relationship between adherence to taking ARVs with calf circumference, handgrip strength, and triceps skinfold. Conclusion: The conclusion of this study is that the more compliant the patient is with ARV therapy, the higher the increase in body mass index and the smaller the possibility of becoming underweight.

Examining the burden and relationship between stunting and wasting among Timor-Leste under five rural children.

Globally and in Timor-Leste, wasting and stunting remain major public health problems among 'under five years children, but the interrelationship between the two has been poorly investigated. A better understanding of this interrelationship is a prerequisite to improving wasting and stunting programming. In our study, we assessed the influence of age on the prevalence of wasting and stunting, the overlap between the two conditions, and the effect of wasting parameters on linear growth catch-up using the data of 401 children recruited at 0 to 54 months of age [median (IQR) of 17 (7-32) months] with repeated anthropometric assessments [median (IQR) follow-up time was 25 (16-39) months]. At recruitment, prevalences of stunting, wasting and concurrence of the two conditions were 54.6%, 9.5% and 4.6%, respectively. These prevalences were already high and above the thresholds for public health importance among children below months of age and remained high throughouttheir childhood. Over the follow-up period, the change (95%CI) in Height-for-Age Z-score (HAZ) was -0.01 (-0.13; 0.11) (p = 0.850), and that of the Height-for-Age Difference (HAD) was -3.74 (-4.28; -3.21) cm (p<0.001). Stunting reversal was observed in 25.6% of those stunted at recruitment, while a positive change in HAD was observed in only 19.6% of assessed children. Path analysis by structural equation modelling showed no significant direct effect of WHZ at recruitment on the likelihood of positive change in HAD, with its influence being fully mediated by its change over the follow-up period. This change had an inverse relationship with the occurrence of a positive change in HAD. On the contrary, Mid-Upper Arm Circumference at recruitment had a significant positive direct effect on the likelihood of a positive HAD change. These results show that interventions to combat wasting and stunting need to be integrated.