Normal Body Mass Index Range Research Articles

The obesity paradox in patients with hypertrophic cardiomyopathy: A Korean nationwide cohort study

Abstract Background In cardiomyopathies, obesity is known to affect the cardiac remodeling and is associated with a poor prognosis. However, in hypertrophic cardiomyopathy, which is included in the category of heart failure with preserved ejection fraction, the risk of underweight has been suggested, and its impact in practice is controversial. Purpose The aim of this study was to investigate the potential relationship between obesity and cardiovascular outcomes in patients diagnosed with hypertrophic cardiomyopathy. Methods We conducted a retrospective national cohort study from 2013 to 2020 utilizing administrative claims data and health check-up database from the Korean National Health Insurance Service. Patients newly diagnosed with hypertrophic cardiomyopathy from January 2015 to December 2019 were included. Body mass index was stratified into five groups based on the World Health Organization's recommended criteria for Asian populations, and patients were followed until the date of each outcome or the end of the study period. Predefined clinical outcomes included heart failure hospitalization events, fatal arrest events, all-cause death, and composite clinical outcomes. Results A total of 6,361 patients were included in the study, with a mean age was 60 ± 13 years and 32.6% female. During a median follow-up of 3.0 years (interquartile range, 1.8 to 4.3), 921 heart failure hospitalization, 185 fatal arrest, and 340 deaths occurred. The underweight group had higher adjusted hazard ratios for heart failure hospitalization, fatal arrest, all-cause death, and the composite outcome compared to the normal range body mass index group (HR 1.69, 95% CI 1.16-2.47; HR 2.29, 95% CI 1.06-4.93; HR 2.74, 95% CI 1.77-4.24; HR 1.77, 95% CI 1.28-2.45). In addition, the adjusted hazard ratios for the composite outcome were lower in the overweight and obese I group compared to the normal range (HR 0.80, 95% CI 0.68-0.95; HR 0.84, 95% CI 0.72-0.98). Conclusions Among patients with hypertrophic cardiomyopathy, those classified as underweight had an increased risk of heart failure hospitalization, fatal arrest, all-cause death, and composite outcomes compared with normal weight patients, while those classified as overweight and obese had a decreased risk of composite outcomes.

The association between caffeine intake and BMI

Caffeine, a widely consumed psychoactive substance, has attracted interest because of its potential effects on body weight. This study examines the relationship between caffeine intake and Body Mass Index (BMI) across genders and obesity subgroups using data of 4,937 adult participants from the NHANES examination. The findings indicate that there is a significant positive correlation between caffeine intake and BMI in both male and female groups respectively. This suggests that higher caffeine consumption is associated with increased BMI. The association remains consistent within the normal BMI range but becomes less pronounced among individuals classified as obese. However, due to the limitations of the cross-sectional design and the exclusion of certain variables, this model still needs to be further refinement. This study highlights needs for further research into the association between caffeine consumption and body weight, with relevant implications for individuals and the health and wellness industry.

Obesity paradox in atrial fibrillation patients on oral anticoagulation therapy: a Korean nationwide cohort study

Abstract Background The obesity paradox is a phenomenon that has been observed in specific pathological conditions, wherein individuals who are overweight or obese exhibit a survival advantage over those with a normal weight. This phenomenon has also been noted in patients diagnosed with atrial fibrillation (AF), although the impact of body mass index (BMI) on clinical outcomes in AF patients undergoing oral anticoagulant (OAC) therapy remains uncertain. Purpose The aim of this study was to investigate the potential relationship between obesity and cardiovascular outcomes in patients diagnosed with AF who were receiving OAC. Methods We utilized administrative claims data from the Korean National Health Insurance Service and the combined health check-up database of the National Health Insurance Corporation to conduct a retrospective national cohort study spanning from 2013 to 2020. The patients newly prescribed OAC for AF were included, between January 2015 and December 2019. We followed up with patients from their index date until each outcome event or the end of the study period. BMI was categorized into 5 groups based on the World Health Organization's recommended criteria for Asian populations. The predefined clinical outcomes included thromboembolism, major bleeding, all-cause death, and the composite outcome. Results A total of 35,333 patients were included in the study. The mean age was 69 ± 10 years, and 37.1% were female. During a median follow-up of 2.0 years (IQR, 0.4–3.3), there were 11,634 thromboembolic events, 1,521 major bleeding events, and 2,586 deaths. The adjusted hazard ratio (HR) for thromboembolism, major bleeding, all-cause death, and a composite outcome were lower in obese II group (HR 0.79, 95% CI 0.73–0.86; HR 0.99, 95% CI 0.79–1.24; HR 0.75, 95% CI 0.62–0.91; HR 0.81, 95% CI 0.75–0.88) compared to the normal range BMI group. Conclusions In AF patients undergoing OAC therapy, individuals classified as obese exhibited a reduced risk of thromboembolism, major bleeding, all-cause mortality, and composite outcome compared to patients with normal weight.Adjusted hazard ratio of outcomes by BMI

A Cross-Sectional Study to Assess the Physical Activity, Eating Behaviour and Correlation of Overweight and Obesity among College Students of Various Colleges in Indore District

Background: Overweight and obesity are the fifth greatest risk of global deaths. Over 1.9 billion persons aged 18 and older were overweight in 2016. Over 650 million of these men and women were obese. Instead of changes in dietary intake or other causes, it has been suggested that the increase in body weight in industrialized nations is mostly the result of decreased levels of physical activity.Aim and Objectives: To assess the eating behaviour/pattern and type of physical activity/duration of physicalactivity among college students in Indore city, and to determine correlation of eating behaviour & physical activity with overweight /obesity.Materials and Methods: A cross–sectional study conducted between January to June 2023 among 200 randomly selected students of age 17 to 25 years of various colleges of Central India in Indore district who gave consent, using a pre-designed, semi-structured, pre-tested questionnaire. Data entered in Microsoft excel was analysed using SPSS software25.0 (trial version).Results: 46% had Body Mass Index (BMI) in normal range and 42.5% were overweight. 60% male participantshad their BMI in normal range and 30.4% were overweight whereas 58.8% female participants were overweight.Majority (75.3%) of female participants had low Metabolic Equivalent of Task(MET) score whereas only 48.7% of male participants had low MET score. Both the Three Factor Eating Questionnaire (TFEQ) Scores and International Physical Activity Questionnaire(IPAQ) Scores were found to be statistically significant (p-value <0.05) among BMI categories.100% of obese participants, 91.8% of overweight participants and 32.6% of participants with BMI in normal range had low MET score, found to be statistically significant (p-value<0.001).
 Conclusion: TFEQ and MET scores were found to be statistically significant (p-value<0.001) among BMI categories suggesting that, both eating behaviour and physical activity were associated with overweight and obesity.

Association Between Body Mass Index and Infertility Among Women: An Age-Matched Case-Control Study

Ample literature exists which time and over has established the association between overweight/ underweight and fertility problems. Further in this context, it should be noted that there are very few studies in the Indian context regarding the effect of body mass index (BMI) on infertility in women. To evaluate the association of BMI with infertility among women in Tamil Nadu, India. An age-matched hospital-based case-control study was conducted including 204 women attending a tertiary care hospital in the Chengalpattu district of Tamil Nadu. Of these, 102 women who had a clinical diagnosis of infertility were selected as cases. Hospital controls were defined as women who did not have a clinical diagnosis of infertility and were selected after matching for age and years of marriage (± 2 years). BMI was calculated from the height and weight measurements taken during the time of recruitment to the study. Basic socio-demographic data were also collected from all the study participants. Among cases, 17.6% were underweight, 25.5% were overweight and 5.9% were obese. Whereas, among controls, 7.8% were underweight, 47.1% were overweight and 11.8% were obese. Among the cases, 68% had primary infertility and 32% had secondary infertility. Overweight and obese women had 2.82 odds (95% CI, 1.48 – 5.38) and 3.06 odds (95% CI, 1.05 – 8.93) respectively of having infertility when compared to women who fell within the normal BMI range. Both overweight and obesity were observed to be significantly associated with infertility. The focus should be given to the prevention and control of both as an effective means of reducing the risk of infertility and other associated disorders.

Impact of online learning on physical activity during COVID-19 lockdown period among female undergraduate students in Saudi Arabia: a cross-sectional study.

During early 2020, because of the COVID-19 pandemic and related lockdown, most education systems-including universities-shifted from face-to-face classes to online learning. In Saudi Arabia, this might have contributed to a decreased level of physical activity (PA) and a concurrent increase in sedentary behaviour among young adults. This study aimed to investigate the impact of online learning on PA during the COVID-19 lockdown period among female undergraduate students in Saudi Arabia. Data were collected through an online survey administered to participants. It consisted of three sections including demographic information, participants' perception towards online learning and PA, and PA level using the self-reported active-questionnaire survey tool. The association between online learning and PA was measured using linear regression. The statistical significance was set at P<0.05. A total of 197 female undergraduate students were included; 95.4% of them were aged 18-24 years old, and 59.9% were in the normal body mass index range (18.5-24.9 kg/m2). In terms of PA level, 55.3% were highly active, 33.5% were moderately active and 10.1% were low-active. In terms of students' perception of engaging in PA, 53.3% of students reported that engaging in PA definitely affected their psychological status. Moreover, compared with those attending <25 hours/week of online learning, those who attended >30 hours/week had lower PA (r=-363.24; 95% confidence interval (CI) -593.97, -132.50), followed by those attending 25-30 hours/week (r=-277.66; 95% CI -484.65, -70.66). Online learning has negatively affected the PA level of female undergraduate students in Saudi Arabia during the COVID-19 lockdown period, in a dose-dependent manner. Moreover, this might affect their phycological status. Nevertheless, future studies are warranted to further investigate the relationship between PA level and psychological status.

Body Mass Index Is Associated With Myocutaneous Free Flap Reliability: Overcoming the Obesity Obstacle With a Proposed Clinical Algorithm to Identify and Manage High-Risk Patients Undergoing Gracilis Free Flap With Skin Paddle Harvest.

The purpose of this study was to evaluate the role of body mass index (BMI) in predicting postoperative complications following myocutaneous free flap transfer. In addition, we sought to identify certain body composition variables that may be used to stratify patients into low- versus high-risk for gracilis myocutaneous free flap with skin paddle failure. Using the National Surgical Quality Improvement Program database, we collected data for all patients who underwent myocutaneous free flap transfer from 2015 to 2021. Demographic data, medical history, surgical characteristics, and postoperative outcomes, including complications, reoperations, and readmissions, were collected. Body mass index was correlated with outcome measures to determine its role in predicting myocutaneous free flap reliability. Subsequently, we retrospectively obtained measurements of perigracilis anatomy in patients who underwent computed tomography angiography bilateral lower extremity scans with intravenous contrast at our institution. We compared body composition data with mathematical equations calculating the potential area along the skin of the thigh within which the gracilis perforator may be found. Across the United States, 1549 patients underwent myocutaneous free flap transfer over the 7-year study period. Being in obesity class III (BMI ≥40 kg/m2) was associated with a 4-times greater risk of flap complications necessitating a return to the operating room compared with being within the normal BMI range. In our computed tomography angiography analysis, average perigracilis adipose thickness was 18.3 ± 8.0 mm. Adipose thickness had a strong, positive exponential relationship with the area of skin within which the perforator may be found. In our study, higher BMI was associated with decreased myocutaneous free flap reliability. Specifically, inner thigh adipose thickness can be used to estimate the area along the skin within which the gracilis perforator may be found. This variable, along with BMI, can be used to identify patients who are considered high-risk for flap failure and who may benefit from additional postoperative monitoring, such as the use of a color flow Doppler probe and more frequent and prolonged skin paddle monitoring.

Do current pregnancy weight gain guidelines balance risks of adverse maternal and child health in a United States cohort?

BackgroundThe Institute of Medicine pregnancy weight gain guidelines were developed without evidence linking high weight gain to maternal cardiometabolic disease and child obesity. The upper limit of current recommendations may be too high for the health of the pregnant individual and child. ObjectivesThe aim of this study was to identify the range of pregnancy weight gain for pregnancies within a normal body mass index (BMI) range that balances the risks of high and low weight gain by simultaneously considering 10 different health conditions. MethodsWe used data from an United States prospective cohort study of nulliparae followed until 2 to 7 y postpartum (N = 2344 participants with a normal BMI). Pregnancy weight gain z-score was the main exposure. The outcome was a composite consisting of the occurrence of ≥1 of 10 adverse health conditions that were weighted for their seriousness. We used multivariable Poisson regression to relate weight gain z-scores with the weighted composite outcome. ResultsThe lowest risk of the composite outcome was at a pregnancy weight gain z-score of −0.6 SD (standard deviation) (equivalent to 13.1 kg at 40 wk). The weight gain ranges associated with no more than 5%, 10%, and 20% increase in risks were −1.0 to −0.2 SD (11.2–15.3 kg), −1.4 to 0 SD (9.4–16.4 kg), and −2.0 to 0.4 SD (7.0–18.9 kg). When we used a lower threshold to define postpartum weight increase in the composite outcome (>5 kg compared with >10 kg), the ranges were 1.6 to −0.7 SD (8.9–12.6 kg), −2.2 to −0.3 SD (6.3–14.7 kg), and ≤0.2 SD (≤17.6 kg). Compared with the ranges of the current weight gain guidelines (−0.9 to −0.1 SD, 11.5–16 kg), the lower limits from our data tended to be lower while upper limits were similar or lower. ConclusionsIf replicated, our results suggest that policy makers should revisit the recommended pregnancy weight gain range for individuals within a normal BMI range.

Maladaptive Eating Behaviours, Generalised Anxiety Disorder and Depression Severity: A Comparative Study between Adult Women with Overweight, Obesity, and Normal Body Mass Index Range.

(1) Background: Causes of obesity are multifactorial and include genetic predisposition as well as behavioural, psychological, social, and hormonal influences. We aimed to compare adult women with normal weight, overweight, and obesity, with a focus on maladaptive eating behaviours, the presence of generalised anxiety disorder, and the severity of depression. Additionally, we explored the context of anti-obesity pharmacotherapy and the status of bariatric surgery. (2) Methods: The sample was composed of 1105 adult women. The following measures, through the Computer-Assisted Web Interview (CAWI), were used in the present study: the Three Factor Eating Questionnaire (TFEQ-R18), the 7-item Generalised Anxiety Disorders Scale (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9). (3) Results: All domains of the TFEQ-R18 had correlations with Body Mass Index (BMI). There was a weak negative association between BMI and Cognitive Restraint (r = -0.172, p < 0.001) and a weak positive relationship between BMI and Uncontrolled as well as Emotional Eating (r = 0.165, p < 0.001; r = 0.191, p < 0.001, respectively). Women who screened positive for anxiety scored lower in the Cognitive Restraint domain (10.11 ± 3.58, p = 0.042) and higher in the Uncontrolled Eating (12.69 ± 6.04, p < 0.001) and Emotional Eating (5.29 ± 2.75, p < 0.001) domains. Similarly, women screening positive for depression had lower scores in Cognitive Restraint (9.88 ± 3.61, p < 0.001) and higher scores in Uncontrolled Eating (12.64 ± 6.09, p < 0.001) and Emotional Eating (5.31 ± 2.71, p < 0.001). A significant association between liraglutide and semaglutide administration and Cognitive Restraint was observed. (4) Conclusions: Individualised treatment for obesity should consider the existing and confirmed association between maladaptive eating behaviours and generalised anxiety disorder, as well as the severity of depression influencing the BMI altogether. The use of anti-obesity pharmacotherapy needs further exploration because the evidence for the use of liraglutide and semaglutide in terms of positive associations with eating behaviours is encouraging.

High Body Mass Index Is Associated with Favorable Outcome in Younger Patients Receiving CD19 CAR T-Cell Therapy for B-Cell Lymphoma: A Retrospective Study from the EBMT Transplant Complications Working Party

Introduction: Obesity is a major health care burden and has been linked to numerous adverse outcomes including alterations of antitumor immunologic responses. Patients with high body mass index (BMI) undergoing autologous or allogeneic hematopoietic stem cell transplantation (HSCT) for hematological malignancies were repeatedly shown to have higher rates of non-relapse mortality (NRM) and relapse, translating into a reduced overall survival (OS). However, the impact of obesity on outcomes after CAR T-cell therapy has not been studied at large scale. The present study aims to investigate whether high BMI is associated with outcomes in patients receiving anti-CD19 CAR T-cell therapy. Methods: This is a retrospective analysis using EBMT registry data of adult patients after first therapy with commercial CD19 CAR T-cell products for relapsed/refractory B-Non-Hodgkin lymphoma (B-NHL) between 1/1/2016 and 30/6/2022. Only patients with available information on height and weight at CAR T-cell therapy were included. Patients with a history of allogeneic stem cell transplantation were excluded. As we exclusively focused on the impact of increased BMI we excluded all patients with a BMI below 18.5 from the analysis. The primary outcome was the impact of BMI on OS. Multivariate analyses were performed with cause-specific Cox models, employing as risk factors patient age, sex, ECOG status and year of CAR T-cell therapy besides BMI categories (18.5-25, 25-30, &amp;gt;30). Results: A total of 4576 CAR T-cell therapy patients were registered during the study period, with 3125 patients meeting inclusion criteria. Selection of patients with available height and weight including BMI of 18.5 and above resulted in a final study cohort of 1653 patients. Median follow-up was 21.2 months [95% CI: 19.6-22.6]. Patients' characteristics are summarized in Table 1. Half of the cohort had a normal range BMI, while one third was overweight (BMI 25-30) and about 18% met criteria for obesity. A significant interaction was found between age and BMI. Therefore, we divided the cohort in two groups by the median age of 62.5 years. OS was significantly reduced in younger patients with normal range BMI compared to higher BMI patients. However, this effect was not significant in the older patients (Figure 1). Upon multivariate analysis, younger patients with BMI 25-30 had a survival advantage with a hazard ratio (HR) of 0.74 (0.57-0.95, P=0.02) and patients with BMI &amp;gt;30 a HR of 0.68 (0.51-0.91, P=0.01) compared to normal range BMI. Progression free survival was significantly improved for younger BMI 25-30 (HR 0.79, 0.64-0.99, P=0.04) but not BMI &amp;gt;30 (HR 0.82, 0.64-1.05, P=0.11), and NRM was reduced only in the younger BMI 25-30 subgroup (HR 0.52, 0.31-0.9, P=0.02) but not in the obese patients (HR 0.7, 0.42-1.18, P=0.19). Multivariate analysis of BMI subgroups in patients above the age of 62.5 years did not show significant differences with regard to OS (BMI 25-30 HR 0.94, 0.74-1.18; BMI &amp;gt;30 HR 1.04, 0.77-1.41), PFS (BMI 25-30 HR 1.06, 0.86-1.31; BMI &amp;gt;30 HR 1.1, 0.83-1.47), or NRM (BMI 25-30 HR 1.35, 0.89-2.06; BMI &amp;gt;30 HR 1.11, 0.6-2.06). Conclusion: Our European real world data on the impact of increased BMI on anti-CD19 CAR T-cell therapy for relapsed/refractory B-NHL shows that half of these patients are overweight or obese and that this seems to confer a survival benefit to younger (&amp;lt;62.5 years) patients. As this finding is rather surprising, future studies are required to fine tune the risk analysis, including in-depth analysis of patients' characteristics to identify protective factors linked to an elevated BMI as well as a possible selection bias. Our findings could in part be explained by the body weight-dependent dose of infused CAR T-cells for B-cell lymphoma. Therefore, for the same tumor burden, obese patients might receive more CAR T-cells than normal weight ones. A future study should test this hypothesis also in B-ALL or multiple myeloma patients, as they typically receive a fixed dose of CAR T-cells regardless of their body weight. Ultimately, our study might contribute to identify underlying mechanisms for improved outcome of CAR T-cell patients.

Effect of body mass index trajectory on hypertension among children and adolescents aged 5–18 years: a retrospective cohort study

Background Hypertension has become increasingly prevalent in Chinese children and adolescents in recent decades, which affects growth and development of children, leads to cognitive decline and multiple target organ damage. Here, we assessed the impact of different body mass index (BMI) trajectories on the occurrence of hypertension in children and adolescents using a cohort study in Northeast China. Materials and methods Children and adolescents aged 5–18 years was extracted for physical examination in Fuxin City, Liaoning Province, China during the 2009–2015 period. A latent category growth mixed model (LCGMM) was used to classify BMI changes and analyze the effect of different BMI trajectories on the risk of occurrence of hypertension in these participants within 5 years. Results All participates were divided into five BMI trajectories by LCGMM method: slow increasing group (n = 2616, 30.8%), overweight and obesity (OW/OB) group (n = 1141, 13.4%), normal decreasing group (n = 232, 2.7%), stable normal group (n = 4383, 51.6%), and fast-increasing group (n = 120, 1.4%). Compared with the stable normal group, the slow increasing group [adjusted odds ratio (AOR): 1.610, 95% confidence interval (CI): 1.304–1.989], the OW/OB group (AOR: 3.172, 95% CI: 2.500–4.023) and the fast-increasing group (AOR: 2.708, 95% CI: 1.445–5.074) all increased the risk of developing hypertension in children and adolescents. Conclusion The potential of developing hypertension varies among groups of children aged 5–18 with different BMI trajectories. Children and adolescents in the normal BMI range (the slow growth group) still need to be aware of the change in BMI trajectory to stop or slow down the progression of BP abnormalities.

Nutritional Status of Women of Reproductive Age in a Rural Area of Southwestern Bihar during COVID-19 Pandemic: A Cross-sectional Study

Abstract Introduction: Health and well-being of any population are reflected by its nutritional status, which is mainly determined by two important factors, namely dietary intake and the food habits. About 22.9% of women in reproductive age (15–49 years) in India and about 30.4% of women in Bihar are undernourished, with a body mass index (BMI) of &lt;18.5 kg/m2. Aims and Objectives: The aims and objectives of the study were to assess the nutritional status and to find out the association between sociodemographic variables and nutritional status of women in the reproductive age group in a rural area of southwestern Bihar. Methodology: A cross-sectional study was conducted among 311 women of the reproductive age group residing in rural field practice area of NMCH, Sasaram, who gave informed consent to participate in the study. Results: After analysis, it was found that 74% of the women consumed a mixed Indian diet, 24% of women took their first meal in the afternoon and in 64% of women, diet diversity was not maintained, about 74% of the women are within the normal range of BMI. Diet diversity was maintained in the literate group with educational status above the primary level and the association between diet diversity and educational status was statistically significant (P &lt; 0.05). Conclusion: It was concluded from the study that women of reproductive age in this part of Bihar also suffer from a dual burden of malnutrition, with the majority being undernourished, whereas a few also being suffering from a higher waist–hip ratio.

Determinants of Self-Rated Health for Adults in Türkiye

Objective: Self-rated health as an important health outcome is affected by several factors. It is of great importance to investigate the determinants of self-rated health of individuals in order to obtain better results regarding public health. The purpose of this study was to determine the factors that affect the self-rated health of adults in Türkiye. &#x0D; Methods: Logistic regression analysis was performed to analyze data from the TurkStat’s 2014 Health Survey, with 19,129 people. The independent variables were related to socio-economic characteristics, health problems, lifestyle, and utilisation of healthcare services, while the dependent variable was self-rated health. &#x0D; Results: It was found that younger people, men, and people with higher educational and income levels rated their health status better. The health status of individuals with chronic diseases, mental disorders, sleeping problems and those who did not have a normal range body mass index also rated their health status as poor. However, the self-rated health of people who had no inpatient treatment in the last 12 months and those who took no prescription medicine in the last two weeks was good. &#x0D; Conclusion: This study provided the identification of the most advantaged and disadvantaged groups through determining the factors affecting the health status of adults in Türkiye. To improve the unfavourable condition of disadvantaged individuals, more specific interventions need to be designed and implemented.

Impact of obesity on the risk of immune-related adverse events (irAEs) among patients receiving immune-checkpoint inhibitors (ICI) treatment: A retrospective cohort study.

2660 Background: Recent studies suggest that obesity is linked to improved progression-free and overall survivals in patients treated with Immune-Checkpoint Inhibitors (ICI). Studies have also shown that irAEs occurrence following ICI infusion is associated with improved survival. Current evidence on the relationship between obesity and the risk of irAEs has been inconclusive. We aimed to assess the impact of obesity on the risk of irAEs after ICI infusion using data from a large retrospective cohort. Methods: The study included newly diagnosed stage I-VI cancer patients treated with ICIs between 2012 and 2021 at the Ohio State University Comprehensive Cancer Center. Patients’ body mass index (BMI) data at or before ICI infusion were classified into normal &lt;25.0 Kg/M2, 25 to &lt; 30 Kg/M2 overweight and obese ≥ 30 Kg/M2. An incident irAE was defined as any gastrointestinal, pulmonary, dermatological, endocrine or hepatobiliary irAEs following ICI infusion. Cox proportional hazard models were fitted to test the associations between obesity and 1) any irAEs and 2) organ-specific irAEs. We evaluated the dose-response association between BMI and irAEs using a three-knot restricted cubic spline in the adjusted Cox proportional models. Results: A total of 4,761 patients were included in the study with a median age of 62 years, 59.2% males and 89% White non-Hispanics. An estimated 34.7%, 31.5% and 33.8% of patients had normal, overweight, and obese BMIs. The median time to incident irAEs was 4.3 months. An estimated 2,791 (58.6%) experienced an irAE, with 28.8% having gastrointestinal, 17.7% pulmonary, 23.7% dermatological, 21.8% endocrine, and 4.4% hepatobiliary irAEs. BMI was a significant predictor of increased risk of irAEs, adjusted hazard ratio (aHR) 1.08 (95%CI: 0.98 to 1.19) overweight vs. normal BMI and aHR 1.17 (95% CI: 1.06 to 1.28) obese vs. normal BMI. In the organ-specific irAEs models, obese vs. normal BMI patients had higher risks of gastrointestinal aHR 1.23 (95% CI: 1.07 to 1.41), dermatological aHR 1.25 (95% CI: 1.07 to 1.28), and hepatobiliary aHR 1.61 (95% CI: 1.11 to 2.36) irAEs. A dose-response was observed in the relationship between BMI and the risk of irAEs whereby patients with BMIs lower than 22 Kg/M2 (median normal BMI range 18.5-24.9 Kg/M2) had lower risks of irAEs [BMI 18.5 Kg/M2 vs. 22 Kg/M2, aHR 0.93 (95% CI, 0.88 to 0.97)] and those with BMIs higher than 22 Kg/M2 had higher risks of irAEs [BMI 30 Kg/M2 vs. 22 Kg/M2, aHR 1.19 (95%CI, 1.09 to 1.29)] and [BMI 40 Kg/M2 vs. 22 Kg/M2, aHR 1.22 (95% CI, 1.11 to 1.34)]. Conclusions: Among patients treated with ICIs, higher BMI was significantly associated with an increased risk of irAEs. Patients with obesity should be monitored for symptom management following ICIs infusion. Our findings help to explain the previously reported benefits of increased BMI and higher irAEs rates on improved survival.

Impact of Healthy Food Consumption Practice on Normal BMI among College Girls

Background: Food is considered a natural body defender against different diseases, and it keeps the body healthy. The lifestyles always have a great influence on both health and food consumption. College students represent a major segment of the young adult population. Young adults, in consideration of important lifestyle changes, are arranged to negatively modify their way of eating. Hence, this study aimed to predict of healthy eating Practice of college students with their Body Mass Index. Methods: A descriptive study conducted among students from nursing college, King Khalid university to evaluate the impact of healthy food consumption on normal BMI. Healthy eating practice questionnaire distributed via online self-reported by 135 study subjects, and their anthropometric measurement height, weight, hip, and waist circumferences were measured in the nursing laboratory. 7 items questionnaire consists of 5-point frequency ranges from ‘‘Less than 1time, 2-3 times, 4-5 times and 6 or more times per day’’. The total score was 35 of the healthy eating practice, which is categorized as good (26-35), fair 16- 25 and need improvement (7-15). The responses were analyzed using SPSS IBM version 21. A binary logistic regression was performed to predict the relationship between healthy food consumption practices and normal BMI. Results: Half of the study participants 50.37% were in normal BMI, BMI (body mass index) and WHR (waist hip ratio) was negatively correlated with healthy food practice score which infers that as Healthy food practice score increases BMI and WHR decreases. The consumption of sweetened beverages was 18.2%, Desserts was 23.3%, and Fried food/or packaged snacks was 17.6%. Meat/Fish/Beans consumption Frequency: &lt; 1 time/ day category (P= 0.029); Sugar beverages: sodas, coffee, tea &amp; energy sports drinks (P= 0.013) 6 or more times per day was significant predictors of keeping the body weight in normal BMI range. Conclusion: Healthy food consumption practice has a significant impact on keeping the body weight in Normal BMI range. Keywords: [BMI, Healthy eating practice, food practice, healthy food consumption]

Gastric Cancer Risk in Association with Underweight, Overweight, and Obesity: A Systematic Review and Meta-Analysis.

This study aimed to investigate the risk of gastric cancer (GC) in abnormal body mass index (BMI) groups. A systematic search was carried out on Embase, PubMed/Medline, and Scopus from January 2000 to January 2023. The pooled risk ratio (RR) with a 95% confidence interval (CI) was assessed using a random-effect model. Thirteen studies with total of 14,020,031 participants were included in this systematic review. The pooled RR of GC was 1.124 (95% CI, 0.968-1.304, I2: 89.08%) in underweight class, 1.155 (95% CI, 1.051-1.270, I2: 95.18%) in overweight class, and in 1.218 (95% CI, 1.070-1.386, I2: 97.65%) obesity class. There is no difference between cardia and non-cardia gastric cancer, while non-Asian race and female gender have higher risk of cancer, as Meta-regression of obesity and overweight classes showed. These findings suggest that there is a positive association between excess body weight and the risk of GC, with a higher impact in women than men and in non-Asian than Asian populations. Since abnormal weight is tied to various diseases, including GC, healthcare experts, and policymakers should continue interventions aiming to achieve a normal BMI range.

Detection of The Lower Limb Asymmetries and Discomfort Considering Foot Pressure as an Attribute

A greater number of diseases and chronic conditions are making their presence since more than a decade. It has really taken its toll during the COVID-19 period. Our concern is totally the lower part of our body which includes the hip portion along with upper thigh, knees, lower limbs and ankles. Some diseases which we have surveyed has been taking place as such are Achilles’s tendonitis, arthritis in the ankle or ankles, bunions, hammertoes, plantar pressure diseases, et cetera. There are also a lot of conditions associated with lower limb muscles such as irregular muscle toning, muscle stressing, fatigue, et cetera which takes place in individuals of almost all kinds of ages. In order to nullify these conditions, we have decided to concentrate on various foot pressure points in our body. We will be analyzing the positions and intensity of these pressure points and conclude our experiment by chalking out a graphical representation of all the data accumulated with the help of certain equipment. We will be asking the subject by giving instructions to place his or her feet on the multiple sensors insole normally (with no extra pressure from the subject’s side). Each sole sensor will send analog input data as the values of the applied foot pressure. Voltage outputs are collected from each input sensor. We will then compare the different output from different sensors with predetermined standard data (collecting from those who have normal Body Mass Index range). The comparative graph of the current subject and the standard data will then be able to help us to analyze where the disease condition is taking place. Key Words: Foot pathology, foot pressure points, lower-limb asymmetry, sole sensor, body mass index range.

Cardiopulmonary Fitness of Preschoolers with Congenital Heart Disease: An Observational Study.

With advancements in cardiopulmonary rehabilitation over the past few decades, the survival rate of patients with congenital heart disease (CHD) has increased. However, the Cardiopulmonary fitness (CPF) of these patients is poor. Here, we aimed to investigate CPF in preschoolers with CHD (aged 4 to 6 years) using cardiopulmonary exercise testing. We retrospectively compared 102 healthy preschoolers with 80 preschoolers with CHD. The latter had lower peak oxygen consumption, oxygen consumption at anaerobic threshold and metabolic equivalent at anaerobic threshold. The same result was observed in boys with CHD, but not in girls, when sex was sub-analyzed. Considering the body composition, children with CHD had a lower fat-free mass index (FFMI) than their healthy peers. Healthy preschoolers with a normal body mass index (BMI) had higher anaerobic threshold and peak metabolic equivalent values than overweight or underweight children. This was categorized under the BMI reference of the Ministry of Health and Welfare in Taiwan. In conclusion, the CPF difference between the CHD and healthy groups was identified as early as in preschool age, and better CPF in healthy preschoolers within the normal BMI range suggests the importance of weight control in young children.

Variability of oral/taste sensitivity to fat: An investigation of attribution from detection threshold methods with repeated measurements

Accumulating psychophysical evidence suggests substantial individual variability in oral/taste sensitivity to non-esterified, long-chain fatty acids (NEFA), which is commonly referred to as fat taste or oleogustus. Recent studies have sought to determine its associations with human factors such as body mass index (BMI) and food preferences, as it has been claimed that excessive fat consumption is related to several health conditions, including obesity. Yet, the findings are controversial. On the other hand, it has been noted that considerable variability also occurs based on the methodology used to measure the fatty acid taste. Specifically, learning effects have been observed over repeated measurements of the detection threshold of NEFA, yet there has been no methodology available to take into account these learning effects. Accordingly, in the present study, a novel methodology using a descending-block dual reminder A-Not A (DR A-Not A) method with a warm-up has been proposed to measure the NEFA detection threshold based on the signal detection theory and considering NEFA taste learning effects over repeated sessions. Homogeneous subjects (young adult Korean females within the normal BMI range, non-vegetarians) were randomized to either the novel descending-block DR A-Not A method or ascending triangle method that is commonly used for fat perception studies. Pure oleic acid emulsions were used as fat taste stimuli to be discriminated from pure mineral water. Each subject completed 14 repeated visits. For the ascending triangle method, 14 thresholds were determined using a stopping rule, while for the novel method, 7 thresholds were determined each per two consecutive days, using a criterion of a lower limit of 50% confidence interval of d' = 0.5, considering the practical aspects of taste studies in food sensory science. Based on the group median results of the last two visits, the variability of the detection thresholds was reduced using the novel descending-block DR A-Not A method due to better learning effects over repeated sessions. This shows the potential of the descending-block DR A-Not A threshold method for further studies on oral/taste sensitivity to fat.

Left atrial epicardial adipose tissue exacerbates electrical conduction disturbance in normal-weight patients undergoing pulmonary vein isolation for atrial fibrillation.

Epicardial adipose tissue (EAT) exacerbates both electrical and structural remodeling in obese atrial fibrillation (AF) patients, but the impacts of EAT on atrial arrhythmogenicity remain unclear in normal-weight AF patients. Therefore, we sought to investigate this issue using electroanatomic mapping. We enrolled drug-refractory 105 paroxysmal AF patients in the normal body mass index range (18.5-24.9 kg/m2 ), who had undergone electroanatomic mapping after pulmonary vein isolation (PVI). One day before PVI, we assessed P-wave duration in a 12-lead electrocardiogram and left atrial (LA)-EAT volumes using contrast-enhanced computed tomography. The patients were divided into two groups based on the median LA-EAT volume (16.0 ml); the high LA-EAT group (≥16.0 ml, n = 53) and low LA-EAT group (<16.0 ml, n = 52). We compared P-wave duration, LA conduction velocity and bipolar voltage, the presence of low-voltage zone (<0.5 mV), and LA volume index on echocardiography between the two groups. The LA bipolar voltage, low-voltage zone, and LA volume index were not different between the high and low LA-EAT groups. However, P-wave duration was significantly longer in the high group than in the low group (p < .001). Additionally, the LA conduction velocity was significantly more depressed in the high group than in the low group (p < .001). Multivariate linear regression analysis revealed that LA-EAT volume was correlated with P-wave duration (β = .367, p < .001) and conduction velocity (β = -.566, p < .001), respectively. Increased LA-EAT volumes were associated with electrical conduction disturbance after PVI in normal-weight patients with AF. P-wave duration may be a clinically useful predictor of LA-EAT.