Normal Body Mass Index Range Research Articles

Impact of maternal risk factors on the structure and function of the heart in newborns

Abstract Introduction Maternal factors such as smoking during pregnancy, advanced age, and obesity are associated with increased risk of complex congenital heart defects in the offspring. It is unknown whether maternal risk factors may also cause subtle abnormalities in cardiac structure and function. Purpose To investigate whether the following maternal factors: advanced age, high body mass index (BMI), and smoking during pregnancy are associated with changes in left ventricle (LV) dimensions and systolic function in the newborn child. Methods Data was obtained as part of a population-based cohort study with prenatal inclusion and postnatal transthoracic echocardiography (TTE) of newborns within 60 days of birth. The TTE protocol included measurements of: Interventricular septal thickness at end-diastole (IVSd), LV posterior wall thickness at end-diastole (LVPWd), LV internal diameter at end-diastole (LVIDd) and LV internal diameter at end-systole (LVIDs). Fractional shortening (FS) was calculated by use of Teicholz's formula. Children of mothers with data available on age, BMI, and smoking status, respectively, were divided into the following groups depending on whether their mothers were: of young age <25 years, 25–29 years, 30–34 years (reference group), 35–39 years, and advanced age ≥40 years; underweight BMI <18.5, normal range BMI 18.5–24.9 (reference group), preobese BMI 25–29.9, and obese BMI ≥30; smoking or nonsmoking (reference group). Associations between different groups with each maternal risk factor and newborn LV parameters were analysed using a multiple linear regression model. Results Children of mothers with advanced age at the time of childbirth (n=1,411) had significantly smaller LVIDd and LVIDs (Table 1) compared to children of mothers in their early thirties (n=10,045). Children of preobese (n=4,707) and obese mothers (n=2,138) had significantly smaller LVIDd and LVIDs than children of mothers in the normal BMI range (n=17,654). Children of mothers who smoked during pregnancy (n=808) had significantly larger LVPWd than children of non-smoking mothers (n=24,072). A significant difference in FS was only seen in children of obese mothers. Subanalyses of the quantity of maternal smoking (available data in n=548 [67.8%] of mothers who smoked during pregnancy) showed that children of heavy smoking mothers (≥15 cigarettes/day, n=101), had significantly thicker IVSd and LVPWd compared with children of nonsmoking mothers, whereas no significant effect was identified in newborns of mothers smoking less than 15 cigarettes per day (Table 2). Conclusions Systematic population-based echocardiography of newborns showed that an increased maternal BMI and maternal age above 40 years were associated with smaller LV cavity dimensions in the offspring and that heavy smoking during pregnancy was associated with increased LV myocardial thickness. FS was only affected in children of obese mothers. The long-term effects of these novel findings are unknown. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Herlev-Gentofte Hospital Internal Funding for Cardiological Research andThe Novo Nordisk Foundation

S1568 Spectrum of Body Mass Index in Patients With Celiac Disease

Introduction: Although generally perceived to be mostly underweight, patients with celiac disease (CeD) can be of normal weight or even overweight/obese. We conducted a comparative cross-sectional study to assess the body mass index (BMI) of treatment-naïve patients with CeD in comparison to the population controls. Methods: In a retrospective analysis of a prospectively maintained database of treatment-naive patients with CeD, we included 583 patients (419 adults [43.7% males] and 164 adolescents [43.9% males]). Details extracted from our database included demographic details, height, weight, laboratory and histopathological parameters. The data of 375,460 adults (12.7% males) and 71,315 adolescents (12.1% males) of Indian National Family Health Survey-4 was considered as the population controls. Results: Although majority of adult and adolescent patients with CeD patients had BMI in normal or underweight range, a significant proportion were overweight or obese (adults 10.3%, adolescents 3.7%) (Figure). The mean BMI in patients with CeD was significantly lower than the population controls for adults (men 19.8 vs 21.8 kg/m2, P < 0.001; women 20.5 vs 21.8 kg/m2, P < 0.001) and adolescents (BMI Z-scores: boys -1.4 vs -0.5, P < 0.001; girls -1 vs -0.4, P < 0.001). Higher proportion of adults (men 11.2% vs 1.9%, P < 0.001; women 10.7% vs 3.2%, P < 0.001) and adolescents (boys 10.4% vs 0.2%, P < 0.001; girls 1.6% vs 0.2%, P = 0.01) with CeD were severely underweight compared to population controls. Conclusion: While majority of adult and adolescent patients with CeD have a lower BMI compared to population controls, a significant proportion can be overweight and even obese.Figure 1.: Graphs depicting comparison of adult and adolescent patients with celiac disease (CeD) against population controls from India. (A) Spectrum of body mass index (BMI) in men with CeD as compared to population controls. (B) Spectrum of BMI in women with CeD as compared to population controls. (C) Spectrum of BMI in boys with CeD as compared to population controls. (D) Spectrum of BMI in girls with CeD as compared to population controls

Universıty Employees’ Healthy Lifestyle Behaviors And Fastıng Blood Glucose

Background: Adopting healthy lifestyle behaviors is an important step in preventing diseases.Objective: This study aims to determine healthy lifestyle behaviors, fasting blood glucose (FBG) levels, and waist circumference of employees in a public university in Turkiye.Methods: This descriptive study was conducted. A total of 191 academic and administrative staff were recruited for this study.We used sociodemographic data form and the Health-Promoting Lifestyle Profile II (HPLP II) for data collection. We measured and recorded each participant’s FBG (at least 8 hours), height, weight, and waist circumference in the data sheet.Results: Of the participants, 77% were aged under 40; 74.9% were male; 71.2% were administrative staff; 48.2% had FBG between 100-125 mg/dl.; 49.2% were within the normal BMI (Body Mass Index) range; 29.2% of women had a waist circumference greater than 90 cm, 25.2% of men had a waist circumference greater than 100 cm. The average HPLP II score of the participants was 128.67±18.51.Conclusion: It was determined that healthy lifestyle behaviors did not change according to age, that 48.2% of the participants had FBG between 100-125 mg/dl and were not aware of their blood glucose levels, that half of the participants were overweight and obese, and that waist circumference and FBG increased as BMI increased. The incidence of diabetes might be higher than predicted in guidelines in near future.International Journal of Human and Health Sciences Vol. 06 No. 04 Oct’22 Page: 383-392

SOCIODEMOGRAPHIC PROFILE, PHYSICAL ACTIVITY, DIETARY PATTERNS, AND NUTRITIONAL STATUS OF VEGETARIANS

Vegetarianism is one of the most popular dietary patterns in the world, and Indonesians are as well. This study was conducted to determine the profile of vegetarians in Palembang based on socio-demographic characteristics, physical activity level, dietary type, total energy intake, total macronutrient intake, and nutritional status. This study is a descriptive observational study with a cross-sectional design. Maha Vihara Maitreya Duta (MVMD) was the vegetarian population in this survey. Participants who agreed to take part in the survey were at least 18 years old, have been vegetarian for at least three years, were not pregnant or planning to become pregnant, and did not have any chronic ailments. A total of 148 samples were acquired using a consecutive sampling technique. To establish nutritional status, Primary data were collected by completing food recall interviews during the last 24 hours on two non-consecutive days. and measuring height and weight to determine nutritional status. The highest age range of participants was 30–49 years (54,1%). The majority of the population was female (61,5%) and had a college degree (56,1%). Most participants work (85,8%), engage in light-to-moderate physical activity, and have a normal body mass index range (68,2%). Most ate lacto-ovo-vegetarian (59,5%). Most participants were vegetarian for 6-10 years (31,1%). Most motivations for becoming a vegetarian are health-related (45,3%). Vegans consumed more calories, carbs, and protein than non-vegans, but less fat. Most vegan and non-vegan respondents had good nutritional status and were in the sufficient category for achieving calorie and macronutrient requirements.

Incidence and risk factors for early pregnancy loss in women with first pregnancy undergoing in vitro fertilization-embryo transfer

BackgroundThis study aimed to explore the incidence and influencing factors for early pregnancy loss (EPL) in infertility patients with first pregnancy undergoing in vitro fertilization (IVF) embryo transfer cycles in Jilin province, China.MethodsA retrospective study of 2709 first pregnancy embryo transfer cycles collected from January 2016 to January 2021 was performed. The cycles were divided into the EPL group (n = 411) and the live birth group (n = 2298) according to the cycle outcomes.ResultsThe EPL rate of the first-time pregnancies for infertility patients undergoing fresh/frozen-thaw embryo transfer cycle was 14.1%. Female patients aged 40 and older had increased odds of EPL compared to those under 35 (OR = 3.97, 95%CI: 2.80–7.55). Female patients with a body mass index (BMI) of 25 or greater were more likely to have EPLs than those in the normal BMI range (OR = 1.32, 95%CI: 1.03–1.70). The odds of EPL after frozen-thaw embryo transfer were higher than those after fresh embryo transfer (OR = 1.59, 95%CI: 1.11–2.27). A thin endometrium on the day of embryo transfer increased the odds of EPL (OR = 1.84, 95%CI: 1.01–3.33). Transferring more than two embryos had lower odds of EPL than single-embryo transfer (OR = 0.67, 95%CI: 0.50–0.90). Compared with other infertility diagnoses, tubal factor alone was associated with lower odds of EPL (OR = 0.72, 95%CI: 0.53–0.98).ConclusionsThe risk factors for EPL were age 40 and older, obesity, frozen-thaw cycle, thin endometrium, and non-isolated tubal factor.

Predictors of maternal dietary quality and dietary inflammation during pregnancy: An individual participant data meta-analysis of seven European cohorts from the ALPHABET consortium

Maternal diet during pregnancy is a modifiable behaviour which plays an important role in maternal, neonatal and child health outcomes. Thus, knowledge of predictors of dietary quality and dietary inflammatory potential in European countries may contribute to developing maternal diet-related public health policies that target specific at-risk populations in Europe. We used harmonised data from >26,000 pregnant women enrolled in the ALSPAC, EDEN, Generation R, Lifeways, REPRO_PL, ROLO and SWS cohorts, as part of the ALPHABET consortium. Maternal dietary quality and inflammatory potential were assessed using the Dietary Approaches to Stop Hypertension (DASH) and the energy-adjusted Dietary Inflammatory Index (E-DII). We conducted an individual participant data meta-analysis to investigate the maternal sociodemographic, health and behavioural predictors of maternal diet before and during pregnancy. DASH and E-DII scores were moderately correlated: from-0.63 (95% CI:-0.66,-0.59) to-0.48 (95% CI:-0.49,-0.47) across cohorts. Higher maternal age, education, household income, and physical activity during pregnancy were associated with a better dietary quality and a more anti-inflammatory diet. Conversely, multiparity and smoking during pregnancy were associated with a poorer dietary quality and a more proinflammatory diet. Women with obesity had a poorer pregnancy dietary quality than women with a normal body mass index range. The results will help identify population subgroups who may benefit from targeted public health strategies and interventions aimed at improving women's dietary quality during pregnancy.

Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study.

This study aimed to estimate the risk of cancer incidence and mortality according to adherence to lifestyle-related cancer prevention guidelines. Men and women who participated in the general health screening program in 2002 and 2003 provided by the National Health Insurance Service were included (n=8,325,492). Self-reported smoking, alcohol consumption, and physical activity habits and directly measured body mass index were collected. The participants were followed up until the date of cancer onset or death or 31 December 2018. The Cox proportional hazard model was used to evaluate the hazard ratio (HR) for cancer incidence and mortality according to different combinations of lifestyle behaviors. Only 6% of men and 15% of women engaged in healthy behavior at baseline, such as not smoking, not drinking alcohol, being moderately or highly physically active, and within a normal body mass index range. Compared to the best combination of healthy lifestyle behaviors, the weak and moderate associations with increased all cancer incidence (HR < 1.7) and mortality (HR < 2.5) were observed in those with heavy alcohol consumption and in former or current smokers. HRs of cancer mortality were significantly increased among current smokers in most combinations. Compared to full adherence to cancer prevention recommendations, unhealthy behaviors increase cancer risk. As few people meet these recommendations, there is a great opportunity for cancer prevention.

Is Secretory Activation Delayed in Women with Type Two Diabetes? A Pilot Study.

(1) Background: Breastfeeding duration may be reduced in women with type 2 diabetes. Delayed secretory activation (SA) is associated with poorer breastfeeding outcomes; however, no prior studies have examined SA in women with type 2 diabetes. This pilot study aimed to assess SA in women with type 2 diabetes by assessing breastmilk constituents. Secondary aims were to assess breastfeeding rates postpartum, and contributory factors. (2) Methods: A prospective cohort of pregnant women with type 2 diabetes (n = 18) and two control groups with age- and parity-matched nondiabetic pregnant women (body mass index (BMI)) matched (n = 18) or normal-range BMI (n = 18)) were recruited. Breastmilk constituents (citrate, lactose, protein, and fat) were measured twice daily for 5 days postpartum and compared between groups. Associations between peripartum variables, breastmilk constituents, and breastfeeding at 4 months postpartum were explored. (3) Results: Women with type 2 diabetes had a slower increase in breastmilk citrate concentration postpartum, indicative of delayed SA, compared to both control groups. Higher predelivery insulin doses in women with type 2 diabetes were associated with increasing time to SA. Both women with type 2 diabetes and BMI-matched controls were less likely to fully breastfeed at 4 months, compared with normal-BMI controls. (4) Conclusion: SA is delayed in women with type 2 diabetes when compared to BMI-matched and normal-BMI women. Women with type 2 diabetes are less likely to fully breastfeed, at hospital discharge and by 4 months postpartum, compared to women with normal-BMI.

Comparison of University Students' Perceived Stress Levels in terms of Body-Mass Index Categories and Gender

The main purpose of this study is to compare the perceived stress level of university students in terms of body-mass index categories and gender. 235 university students (183 female, 53 male) between the ages of 18-40 participated in the study. Participants were selected from six different departments of six universities by convenient sampling. In the study, a personal information form asking about university, department, age, disease status, drug use, weight, height and gender, and a perceived stress scale were used as data collection tools. While body mass index (BMI) categories and gender were determined as independent variables in the study, perceived stress level was determined as dependent variable and the data were analysed with a one-way ANOVA test. The findings revealed that there was no statistically significant difference in the perceived stress levels of the participants in terms of gender and body mass index categories. However, for one factor of the stress scale (readiness to cope with stress), participants in the normal body mass index range reported significantly less stress than participants in the obese body mass index range. The findings will be discussed in the light of the literature.

EPIDEMIOLOGY OF PROXIMAL FEMUR FRACTURE IN OLDER ADULTS IN A PHILANTHROPICAL HOSPITAL IN SÃO PAULO.

To evaluate the age and anthropometry profile of patients with a diagnosis of fracture of the proximal femur in older adults admitted to a philanthropic hospital in São Paulo. Retrospective observational cross-sectional study. All patients older than 59 years with femoral fractures diagnosed and hospitalized between January, 2019 and April, 2020 were included. The analysis of the 85 medical records resulted in the data collected in the present study. Anthropometry, age, sex, ethnicity, presence of comorbidities and mechanism of trauma of these patients were considered in this study. Most traumas, as expect, presented low energy mechanisms. Prevalence of 3:1 in females, aged between 60-104 and mean of 78.5 years, with an increased risk in patients over 80 years. The body mass index (BMI) between 16.53 and 39.80 with an average of 24.16 kg/m2. Being 89.4% cases of fall from own height. Proximal femur fractures in older adults occur more often in women, with a mean age of 78.5 years, normal BMI range, whose main trauma mechanism is fall to ground level. The most prevalent injury is transtrochanteric fracture, with a mean of 70.5% and the most performed treatment is internal fixation with cephalomedullary nail, with a mean of 66.1%. Level of Evidence VI, Descriptive Epidemiological Study.

Bone Mineral Density, Bone Microarchitecture and Vertebral Fractures in Male Patients with Alcohol Use Disorders.

To investigate abnormalities in bone mineral density, trabecular bone score and vertebral fractures in male patients with alcohol use disorder to understand the impact on bone health. The study subjects included 134 male patients. Controls were 134 age matched healthy males. Assessments were made of the bone mineral density (BMD), trabecular bone score (TBS) and vertebral morphometry (VFA) for vertebral fractures. Biochemical measurements included serum total T4, thyroid stimulating hormone (TSH), parathyroid hormone (PTH) and 25- Hydroxyvitamin D 25(OH) D. The mean BMD at total forearm, proximal forearm (or distal 1/3) and mid forearm was significantly higher in the alcohol use disorders (AUD) group than the controls (P < 0.01). Around 15% of patients with AUD had VFs compared with 9.0% of the healthy controls (P = 0.19). For each kg/m2 gain in body mass index (BMI), lumbar spine and total hip BMD increased by 0.009 and 0.014g/cm2, respectively. Lumbar and hip BMD decreased by 0.002 and 0.003g/cm2 per year increase in duration of alcohol used. For every 5years increase in age of the patients the odds of having VFs increased by 39% (odds ratio 1.393 [95% confidence interval = 1.031-1.881, P = 0.03]). The findings of the current study suggest that persons with AUD in third and fourth decades of life, with BMI in normal range and with alcohol use disorder duration of around one decade might have no major alteration in BMD and TBS. Impact of alcohol use in this population was manifest by marginal increase in the prevalence of mild grade of vertebral fractures, mostly in the thoracic region.

High incidence of type 2 diabetes in a population with normal range body mass index and individual prediction nomogram in Vietnam.

The study aimed at determining 5-year incidence and prediction nomogram for new-onset type 2 diabetes (T2D) in a middle-aged population in Vietnam. A population-based prospective study was designed to collect socio-economic, anthropometric, lifestyle and clinical data. Five-year T2D incidence was estimated and adjusted for age and sex. Hazard ratio (HR) for T2D was investigated using discrete-time proportional hazards model. T2D prediction model entering the most significant risk factors was developed using the multivariable logistic-regression algorithm. The corresponding prediction nomogram was constructed and checked for discrimination, calibration and clinical usefulness. The age- and sex-adjusted incidence was 21.0 cases (95% CI: 12.2-40.0) per 1000 person-years in people with mean BMI of 22.2 (95% CI: 21.9-22.7kg/m2 ). The HRs (95% CI) for T2D were 1.14 (1.05-1.23) per 10mmHg systolic blood pressure, 1.05 (1.03-1.08) per 1cm waist circumference, 1.40 (1.13-1.73) per 1mmol/L fasting blood glucose, 1.77 (1.15-2.71) per sleeping time (<6h/day vs 6-7h/day) and 2.12 (1.25-3.61) per residence (urban vs rural). The prediction nomogram for new-onset T2D had a good discrimination (area under curve: 0.711, 95% CI: 0.666-0.755) and fit calibration (mean absolute error: 0.009). For the predicted probability thresholds between 0.03 and 0.36, the nomogram showed a positive net benefit, without increasing the number of false positives. This study highlighted an alarmingly high incidenceof T2D in a middle-aged population with a normal range BMI in Vietnam. The individual prediction nomogram with decision curve analysis for new-onset T2D would be valuable for early detection, intervention and treatment of the condition.

Obesity, tidal volume, and pulmonary deposition of fine particulate matter in children with asthma.

Obese children with asthma are more vulnerable to air pollution, especially fine particulate matter (PM2.5), but reasons are poorly understood. We hypothesised that differences in breathing patterns (tidal volume, respiratory rate and minute ventilation) due to elevated body mass index (BMI) may contribute to this finding. To investigate the association of BMI with breathing patterns and deposition of inhaled PM2.5. Baseline data from a prospective study of children with asthma were analysed (n=174). Tidal breathing was measured by a pitot-tube flowmeter, from which tidal volume, respiratory rate and minute ventilation were obtained. The association of BMI z-score with breathing patterns was estimated in a multivariable model adjusted for age, height, race, sex and asthma severity. A particle dosimetry model simulated PM2.5 lung deposition based on BMI-associated changes in breathing patterns. Higher BMI was associated with higher tidal volume (adjusted mean difference (aMD) between obese and normal-range BMI of 25 mL, 95% CI 5-45 mL) and minute ventilation (aMD 453 mL·min-1, 95% CI 123-784 mL·min-1). Higher tidal volumes caused higher fractional deposition of PM2.5 in the lung, driven by greater alveolar deposition. This translated into obese participants having greater per-breath retention of inhaled PM2.5 (aMD in alveolar deposition fraction of 3.4%, 95% CI 1.3-5.5%), leading to worse PM2.5 deposition rates. Obese children with asthma breathe at higher tidal volumes that may increase the efficiency of PM2.5 deposition in the lung. This finding may partially explain why obese children with asthma exhibit greater sensitivity to air pollution.

Comparison of Perceived Stress of University Students in terms of Body-Mass Index Categories and Gender

In this study main purpose is to compare perceived stress of university students in terms of body-mass index categories and gender. The participants of this study involved 235 university students (183 females, 53 male) at the ages from 18 to 40. The participants were selected by convenient sampling and they were from six different departments of six universities. In the study, a personal information form asking about university, department, age, illnesses, medicine use, weight, length and gender, and perceived stress scale were used as data collection tools. Data of the study was analyzed by one-way ANOVA by setting perceived stress as dependent variable while setting body-mass index categories and gender as independent variables. The findings revealed that there were no statistically significant differences in perceived stress of the participants in terms of gender and body-mass index categories. However, for one factor of the stress scale (Being powerful to overcome stress), the participants in normal range of body-mass index reported significantly less stress than the participants in obese range of body-mass index. The findings will be discussed in light of the literature.

Changes in Body Mass Index Associated with Antiretroviral Regimen Switch Among Treatment-Experienced, Virologically Suppressed People Living with HIV in the United States

With obesity on the rise among people living with HIV (PLWH), there is growing concern that weight gain may result as an undesired effect of antiretroviral therapy (ART). This analysis sought to assess the association between ART regimens and changes in body mass index (BMI) among ART-experienced, virologically suppressed PLWH. ART-experienced, virologically suppressed PLWH ≥18 years of age in the Observational Pharmacoepidemiology Research and Analysis (OPERA) cohort were included for analysis if prescribed a new regimen containing one of the following core agents: dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), raltegravir (RAL), rilpivirine (RPV), or boosted darunavir (bDRV), for the first time between August 1, 2013 and December 31, 2017. Multivariable linear regression was used to assess the association between regimen and mean changes in BMI at 6, 12, and 24 months after switch. In unadjusted analyses, BMI increases ranged from 0.30 kg/m2 (bDRV) to 0.83 kg/m2 (RPV) at 24 months following switch, but gains were observed with every regimen. In adjusted analyses, compared to DTG, only bDRV was associated with a smaller increase in BMI at all time points, while EVG/c and RAL were associated with smaller increases in BMI at 6 months only. Overall, results were consistent in analyses stratified by baseline BMI category. BMI increases were relatively small but followed an upward trend over time in this cohort of treatment-experienced, suppressed PLWH. Gains were attenuated with a longer period of follow-up. BMI gains did not differ by regimens, except for bDRV regimens, which were consistently associated with smaller BMI increases than DTG.

Post-hospitalization Daycare Treatment for Adolescents With Eating Disorders.

Background: There are several possible facilities for the treatment of eating disorders (EDs). Specifically, there is the issue of the use of specialized daycare and ambulatory services over inpatient settings and the place of daycare programs following inpatient treatment.Aim: We sought to examine the contribution of post-hospitalization daycare program to the treatment of adolescents hospitalized with an ED.Methods: We assessed 61 female adolescents hospitalized with an ED. All but three were diagnosed with clinical or subthreshold anorexia nervosa (AN). Three were diagnosed with bulimia nervosa. Thirty-seven patients continued with a post-hospitalization daycare program for at least 5 months, whereas 24 did not enter or were enrolled in the program for <5 months. Patients completed on admission to, and discharge from, inpatient treatment self-rating questionnaires assessing ED-related symptoms, body-related attitudes and behaviors, and depression and anxiety. Social functioning was assessed 1 year from discharge using open-ended questions. One-year ED outcome was evaluated according to the patients' body mass index (BMI) and according to composite remission criteria, assessed with a standardized semistructured interview. To be remitted from an ED, patients were required to maintain a stable weight, to have regular menstrual cycles, and not to engage in binging, purging, and restricting behaviors for at least eight consecutive weeks before their assessment.Results: BMI was within normal range at follow-up, whether completing or not completing daycare treatment, and around 75% of the patients had menstrual cycles. By contrast, when using comprehensive composite remission criteria, less than a quarter of former inpatients not entering/not completing daycare program achieved remission vs. almost a half of the completers. In addition, a greater percentage of completers continued with psychotherapy following discharge. Fifty percent of both groups showed good post-discharge social functioning. No between-group differences were found in the BMI and the scores of the self-rating questionnaires at admission to, and discharge from, inpatient treatment.Conclusion: Adolescent females with EDs can maintain a normal-range BMI from discharge to 1-year follow-up, even if not completing daycare treatment. By contrast, completion of a post-hospitalization daycare program may improve the 1-year follow-up ED-related outcome of former ED inpatients.

Does severity of intellectual disability affect the nutritional status of intellectually disabled children and adolescents?

Background: Balanced and adequate nutrition is important to improve the quality of life of children with intellectual disability but most of these children are negatively affected by nutritional problems. Objective: This study was conducted to determine the nutritional status and effect of the severity of intellectual disability on nutritional status of children and adolescents with intellectual disabilities. Methods: One hundred twenty-two intellectually disabled children aged 4–18 years from five different special education and rehabilitation centers were included in the study. Their socio-demographic characteristics, body weight, height, body mass index (BMI), mid-upper arm circumference (MUAC), and skinfold thickness were examined, and their three-day food consumption record was taken. Results: Anthropometric scores did not differ significantly according to the severity of intellectual disability. According to evaluations made based on the World Health Organization’s 2007 percentile curves, 61.4% of the subjects with mild intellectual disability (MID), 57.1% of those with moderate intellectual disability (MOID), and 53.3% of those with severe intellectual disability (SID) were within the normal BMI range for their age. Conclusion: Rates of malnutrition and shortness in children and adolescents with SID were found to be higher than among children with MID and MOID, though the differences were not statistically significant.

Relationship between Body Mass Index and Gender with Asthma

Background: Asthma is ranked 16th among the leading causes of years lived with disability (YLD) and ranks 28th among the causes of global burden of disease (GBD). Various potential factors can cause asthma, which include body mass index (BMI) and gender. Purpose: This research aimed to determine the relationship between BMI and gender in people living with asthma in Indonesia. Methods: This research employed secondary data obtained from the Indonesian family life support (IFLS) 5th edition. This research used an observational analysis technique with a cross-sectional approach. The number of respondents in this research were 30,713. In this study, the BMI category was based on WHO’s classification for Asians. Data was analyzed using logistic regression tests and chi square. Statistical significance was set at a value of p&lt;0.05. Results: As many as 17,175 respondents had a normal BMI range (56.92%), out of which the majority were women—16,001 respondents (52.10%). After controlling the other variables, statistical test results with logistic regression indicated that male respondents had 1.23 times the odds of experiencing asthma compared to females (adjusted odds ratio (AOR)=1.23; 95% confidence interval (CI), 1.04–1.44; p=0.02). Again, after controlling the other variables, underweight respondents had 1.31 times the odds of experiencing asthma compared to respondents who had a normal BMI (AOR=1.31; 95%CI=1.07–1.59; p=0.01). Conclusion: A relationship between gender and the category of people who were underweight after determining their BMI could be established. Health counseling can be provided to help improve the respiratory conditions of these individuals.

Estimating the causal effect of BMI on mortality risk in people with heart disease, diabetes and cancer using Mendelian randomization

BackgroundObservational data have reported that being overweight or obese, compared to being normal weight, is associated with a lower risk for death - the “obesity paradox”. We used Mendelian randomization (MR) to estimate causal effects of body mass index (BMI) on mortality risks in people with coronary heart disease (CHD), type 2 diabetes mellitus (T2DM) or malignancy in whom this paradox has been often reported. MethodsWe studied 457,746 White British UK Biobank participants including three subgroups with T2DM (n = 19,737), CHD (n = 21,925) or cancer (n = 42,612) at baseline and used multivariable-adjusted Cox models and MR approaches to describe relationships between BMI and mortality risk. ResultsObservational Cox models showed J-shaped relationships between BMI and mortality risk including within disease subgroups in which the BMI values associated with minimum mortality risk were within overweight/obese ranges (26.5–32.5 kg/m2). In all participants, MR analyses showed a positive linear causal effect of BMI on mortality risk (HR for mortality per unit higher BMI: 1.05; 95% CI: 1.03–1.08), also evident in people with CHD (HR: 1.08; 95% CI: 1.01–1.14). Point estimates for hazard ratios across all BMI values in participants with T2DM and cancer were consistent with overall positive linear effects but confidence intervals included the null. ConclusionThese data support the idea that population efforts to promote intentional weight loss towards the normal BMI range would reduce, not enhance, mortality risk in the general population including, importantly, individuals with CHD.

Cancer Risk in Normal Weight Individuals with Metabolic Obesity: A Narrative Review.

Obesity represents one of the most significant public health challenges worldwide. Current clinical practice relies on body mass index (BMI) to define the obesity status of an individual, even though the index has long been recognized for its limitations as a measure of body fat. In normal BMI individuals, increased central adiposity has been associated with worse health outcomes, including increased risks of cardiovascular disease and metabolic disorders. The condition leading to these outcomes has been described as metabolic obesity in the normal weight (MONW). More recent evidence suggests that MONW is associated with increased risk of several obesity-related malignancies, including postmenopausal breast, endometrial, colorectal, and liver cancers. In MONW patients, the false reassurance of a normal range BMI can lead to lost opportunities for implementing preventive interventions that may benefit a substantial number of people. A growing body of literature has documented the increased risk profile of MONW individuals and demonstrated practical uses for body composition and biochemical analyses to identify this at-risk population. In this review, we survey the current literature on MONW and cancer, summarize pathophysiology and oncogenic mechanisms, highlight potential strategies for diagnosis and treatment, and suggest directions for future research.