Overweight Body Mass Index Categories Research Articles

Multimorbidity Accumulation by Race or Ethnicity and Body-Weight Status Among Middle-Aged and Older Americans

Obesity and multimorbidity are more prevalent among U.S. racial/ethnic minority groups. Evaluating racial/ethnic disparities in multimorbidity accumulation according to body-mass index (BMI) may guide interventions to reduce multimorbidity burden in vulnerable racial/ethnic groups. Data from the 1998-2016 Health & Retirement Study (N=8,106, 51-55 years at baseline) and generalized estimating equations models with inverse probability weights estimated the accumulation of seven chronic diseases (arthritis, cancer, diabetes, heart disease, hypertension, lung disease, and stroke) between racial/ethnic groups [Non-Hispanic White (reference; 64.2%), Non-Hispanic Black (21.6%), Hispanic (14.2%)]. Overweight and obesity were more prevalent in Black (82.3%) and Hispanic (78.9%) than White (70.9 %) participants at baseline. Initial burden of morbidity was higher among Black participants [risk ratio (RR) =1.3, p<0.001] but similar among Hispanic compared with White participants; and higher in overweight or greater BMI categories compared with normal BMI (RR=1.07, 1.15, 1.22, p<0.001, for overweight, obese 1, and obese 2/3 BMI, respectively). Disease accumulation did not differ among racial/ethnic groups. Higher BMI was associated with less disease accumulation compared with the normal BMI category (RR=0.99, 0.98, 0.97, all p<0.001, for overweight, obese 1, and obese 2/3 BMI, respectively, per two-year interval). Black participants crossed the threshold of multimorbidity (≥2 diseases) 4-6 years earlier than White and Hispanic participants. There are substantial differences in initial disease burden between Black and White middle-aged/older adults, but not in the accumulation of disease, suggesting the need to intervene prior to entering middle age to reduce disparities in the burden of multimorbidity among vulnerable racial minorities.

How reliable is BMI? Bioimpedance analysis of body composition in underweight, normal weight, overweight, and obese women

BackgroundThe human body consists of water, proteins, lipids, carbohydrates, and minerals that build cells, tissues, and organs. In healthy people, the content of these molecules remains nearly constant. The body mass index (BMI) is commonly used to classify abnormal body composition among adults. According to the WHO, a high BMI is a major risk factor for many diseases. Bioelectrical impedance analysis is a commonly used method for assessing body composition in clinical practice and medical research.AimsThe aim of this study was to identify the advantages and disadvantages of using BMI in diagnosis of underweight, overweight, and obesity, by comparing the value of the index with the values of body composition analysis parameters.MethodsA total of 267 healthy women 18 to 35 years of age participated in this study. Bioelectrical impedance analysis was performed on all participants at the beginning of the experiment with an InBodyS10 device.ResultsIn the BMI categories of overweight and obese, only women with excessive BFM were measured with BIA. The BMI category of normal body weight, apart from women with normal body composition, includes people with both deficient and excess body components, e.g., body fat or lean body mass. The BMI category of underweight includes women with different body compositions as well as people with excessive fat content.ConclusionsThe BMI is useful to provide a warning of excessive fat content in overweight and obese women, whereas among normal weight and underweight women, it may mask various types of body composition defects.

Too Fat for Transplant? The Impact of Recipient BMI on Pancreas Transplant Outcomes.

In many transplant centers, a recipient body mass index (BMI) >30 kg/m2 would be considered a contraindication for pancreas transplantation. This study aims to investigate the impact of recipient BMI on graft outcomes after pancreas transplantation. Retrospective data on all UK solid organ pancreas transplants from 1994 to 2016 were obtained from the National Health Service Blood and Transplant UK Transplant Registry, n = 2618. Cases missing BMI data were excluded, resulting in a final cohort of n = 1452. Graft and patient survival analysis were conducted using Kaplan-Meier plots and Cox regression models. The mean recipient BMI was 24.8 kg/m2 (±2.4). There were 507 overweight (BMI 25-29.9) and 146 obese (>30) recipients receiving pancreas transplants. Univariate analysis showed no statistically significant difference between overweight BMI categories compared with normal BMI (18.5-24.9 kg/m2). Multivariate analysis revealed increasing recipient BMI had a significant impact on graft survival (P = 0.03, hazard ratio 1.04, 95% confidence interval, 1.00-1.08). Receiver operating characteristic curve analyses revealed no value of BMI that provided both specific and sensitive discrimination between death and survival of both grafts or patients. Recipients on dialysis with a BMI >30 kg/m2 had a statistically significant decrease in both graft (P = 0.002) and patient survival (P = 0.015). Analysis of available UK Pancreas data has shown recipient BMI is an independent risk factor for patient survival after transplantation. However, we have been unable to define a specific cutoff value above which patients have poorer outcomes. Obese patients on hemodialysis had the poorest graft survival, and preemptive transplantation may be beneficial in this cohort.

Utility of Liver Function Tests and Fatty Liver Index to Categorize Metabolic Phenotypes in a Mediterranean Population.

The aim of this study was to analyze the utility of liver function tests (LFT) and fatty liver index (FLI), a surrogate marker of non-alcoholic fatty liver disease, in the categorization of metabolic phenotypes in a Mediterranean population. A cross-sectional study was performed on a random representative sample of 2233 adults assigned to a health center in Málaga, Spain. The metabolic phenotypes were determined based on body mass index (BMI) categorization and the presence or absence of two or more cardiometabolic abnormalities (high blood pressure, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, pre-diabetes) or type 2 diabetes. No difference was observed between metabolically healthy and metabolically abnormal phenotypes on LFT. The mean FLI of the population was 41.1 ± 28.6. FLI was significantly higher (p < 0.001) in the metabolically abnormal phenotypes in all BMI categories. The proportion of individuals with pathological FLI (≥60) was significantly higher in the metabolically abnormal overweight and obese phenotypes (p < 0.001). On a multivariate model adjusted for sex, age, and waist circumference, a significant correlation was found between pathological FLI and metabolically abnormal phenotypes in the overweight and obese BMI categories. Area under the curve (AUC) of FLI as a biomarker was 0.76, 0.74, and 0.72 for the metabolically abnormal normal-weight, overweight, and obese groups, respectively. Liver biochemistry is poorly correlated with metabolic phenotypes. Conversely, a good correlation between FLI, as a marker of non-alcoholic fatty liver disease (NAFLD), and metabolically abnormal phenotypes in all BMI ranges was found. Our study suggests that FLI may be a useful marker for characterizing metabolically abnormal phenotypes in individuals who are overweight or obese.

The influence of maternal obesity on pregnancy intention: A cross-sectional analysis.

This prospective cross-sectional study of 1498 pregnant women in early pregnancy sought to investigate the prevalence of pregnancy intention between women of differing body mass index (BMI) categories. There was no difference in the risk of unintended pregnancy between women who were in the healthy weight, overweight or obesity BMI categories. The study identifies and highlights the potential missed opportunities for all women to engage in healthy reproductive life planning behaviours to support health in pregnancy and beyond.

Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy.

Sleeve gastrectomy is a well-standardized surgical treatment for obesity. However, rates of weight regain after sleeve gastrectomy in long-term follow-up are relatively high. This multicenter study is the first to evaluate the use of an endoscopic sleeve gastroplasty (ESG) technique for the management of this population. This was a multicenter retrospective study, including patients with weight regain following sleeve gastrectomy who underwent ESG for weight loss. Primary outcomes included absolute weight loss, percent total weight loss (%TWL), change in body mass index (BMI), percent excess weight loss (%EWL) at 6 and 12 months, and safety profile. Clinical success was defined as achieving ≥ 25 % EWL at 1 year, ≤ 5 % serious adverse event (SAE) rate following society-recommended thresholds, and %TWL ≥ 10 %. 34 patients underwent ESG after sleeve gastrectomy. Technical success was 100 %. At 1 year, 82.4 % and 100 % of patients achieved ≥ 10 %TWL and ≥ 25 % EWL, respectively. Mean (SD) %TWL was 13.2 % (3.9) and 18.3 % (5.5), and %EWL was 51.9 % (19.1) and 69.9 % (29.9) at 6 months and 1 year, respectively. Mean (SD) %TWL was 14.2 % (12.5), 19.3 % (5.3), 17.5 % (5.2), and 20.4 % (3.3), and %EWL was 88.5 % (52.8), 84.4 % (22.4), 55.4 % (14.8), and 47.8 % (11.2) for BMI categories of overweight and obesity class I, II, and III, respectively, at 1 year. No predictors of success were identified in the multivariable regression analysis. No SAEs were reported. ESG appears to be safe and effective in the management of weight regain following sleeve gastrectomy.

Obesity Paradox in the Burn Patient.

Despite the fact that obesity is a known risk factor for comorbidities and complications, there is evidence suggesting a survival advantage for patients classified by body mass index (BMI) as overweight or obese. Investigated in various clinical areas, this "Obesity Paradox" has yet to be explored in the burn patient population. We sought to clarify whether this paradigm exists in burn patients. Data collected on 519 adult patients admitted to an American Burn Association Verified Burn Center between 2009 and 2017 was utilized. Univariable and multivariable logistic regression were used to determine the association between in-hospital mortality and BMI classifications (underweight <18.5 kg/m2, normal 18.5 to 24.9 kg/m2, overweight 25-29.9 kg/m2, obesity class I 30 to 34.9 kg/m2, obesity class II 35 to 39.9 kg/m2, and extreme obesity >40 kg/m2). For every kg/m2 increase in BMI, the odds of death decreased, with an adjusted odds ratio of 0.856 (95% confidence interval [CI] 0.767 to 0.956). When adjusted for total BSA (TBSA), being obesity class I was associated with an adjusted odds ratio of mortality of 0.0166 (95% CI 0.000332 to 0.833). The adjusted odds ratio for mortality for underweight patients was 4.13 (95% CI 0.416 to 41.055). There was no statistically significant difference in odds of mortality between the normal and overweight BMI categories. In conclusion, the obesity paradox exists in burn care: further investigation is needed to elucidate what specific phenotypic aspects confer this benefit and how these can enhance the care of burn patients.

Fat Mass Index Better Identifies Metabolic Syndrome: Insights from Patients in Early Outpatient Cardiac Rehabilitation.

Body mass index (BMI) does not differentiate fat and lean mass or the distribution of adipose tissue. The purpose of this study was to examine the prevalence of metabolic syndrome (MetS) among patients entering outpatient cardiac rehabilitation (CR) across fat mass index (FMI) categories compared with BMI. This retrospective cross-sectional study evaluated dual-energy x-ray absorptiometry in 483 CR patients from 1 January 2014, through 31 December 2017. Clinical data were extracted from the electronic health record. Patients were grouped by FMI and BMI categories. Mean (SD) age of patients was 64.3 (14) years. The normal FMI category had 15 patients; excess fat, 74; and obese, 384. In contrast, 93, 174, and 216 were in the normal, overweight, and obese BMI categories, respectively. Prevalence of MetS was 0 (0%) in normal, 5 (1%) in excess fat, and 167 (54%) in obese FMI, with 97% in the obese category. MetS prevalence was 4 patients (0.8%) in normal, 39 (8%) in overweight, and 129 (27%) in obese BMI categories, with 75% of MetS in the obese category. FMI more accurately classified CR patients with metabolically abnormal fat (p < 0.001). FMI is a more sensitive index than BMI for metabolically abnormal fat of outpatient CR patients.

Cardiorespiratory Fitness, Different Measures of Adiposity, and Cardiovascular Disease Mortality Risk in Women.

Background: Associations among cardiorespiratory fitness (CRF), different adiposity exposures, and cardiovascular disease (CVD) mortality in women are not well defined. Materials and Methods: A total of 19,838 women completed a baseline examination between 1971 and 2013. Measures included body mass index (BMI), waist circumference (WC), waist-to-height (W:HT) ratio, skinfold-derived percent body fat (% Fat), and CRF estimated from a maximal treadmill test. CRF categories were low (quintile 1), moderate (quintiles 2-3), and high (quintiles 4-5); standard cut points were used for adiposity exposures. Hazard ratios (HRs) were estimated using Cox regression. Results: During a mean follow-up period of 19.2 ± 10.3 years, 391 cardiovascular deaths occurred. HRs (95% confidence interval) for CVD in moderate and low CRF groups, using high CRF as the referent, were 1.87 (1.46-2.38) and 2.54 (1.93-3.35), respectively (p trend <0.001). HRs of obese women within each adiposity exposure were higher when compared with normal-weight women (p ≤ 0.03). Joint associations of CRF × adiposity showed a positive trend in CVD mortality across decreasing categories of CRF within each category of W:HT and % Fat, as well as within the normal and overweight BMI categories and the normal WC category (p ≤ 0.03 for each). Conclusion: Higher levels of CRF are associated with lower CVD mortality risk in women, and predict lower risk of CVD mortality in normal-weight women and in obese women. Using different measures of adiposity to predict CVD mortality risk in women may be misleading unless CRF is taken into account. These results support the American Heart Association (AHA) recommendation for including CRF as a clinical vital sign.

Socioeconomic and nutritional factors associated with age of eruption of third molar tooth among Ugandan adolescents.

This study aimed to establish the influence of socioeconomic and nutritional factors on the age of eruption of the mandibular third molar among Ugandans aged 10–20 years.Materials and Methods:This was a cross-sectional study carried out in a dental clinic of Mulago Hospital between January and December 2017. The background information was obtained from the participants using a questionnaire in the form of an oral interview. The anthropometric measurements were obtained using a tape measure and a weighing scale, while dental radiographs were used to determine the eruption stages of the mandibular third molar.Statistical Analysis:The data were analyzed using STATA 13 and summarized using descriptive statistics and multivariate analyses. Statistical significance was inferred at P < 0.05.Results:Participants in the overweight body mass index category were statistically significantly associated with the age of the mandibular third molar eruption (P < 0.05) compared to their normal counterparts. There was no statistically significant association between socioeconomic status and age of eruption of third molar teeth (P > 0.05). Age of eruption was statistically significantly higher among males than females (P > 0.05).Conclusion:The findings of the present study reveal that overweight influences early eruption of the mandibular third molar tooth, although there is no trend between socioeconomic status and the age of eruption of the mandibular third molar.

Facial soft tissue thicknesses in Bulgarian adults: relation to sex, body mass index and bilateral asymmetry.

The aim of the study is to measure the facial soft tissue thicknesses (STTs) in Bulgarians, to evaluate the relation of the STTs to the nutritional status, sex and bilateral asymmetry, and to examine the correlations between the separate STTs as well as between the STTs and body weight, height, and body mass index (BMI). In the present study, the facial STTs were measured on computed tomography scans of the head of Bulgarian adults. The STTs were measured at 7 midline and 9 bilateral landmarks. The measurements were performed in the free software InVesalius in the axial and sagittal planes. The mean, standard deviation, minimum and maximum values, median and coefficient of variation were reported for the STT at each landmark according to the sex and BMI category. The BMI, sex and bilateral differences were assessed for statistical significance. Pearson correlation analysis was applied to assess the strength and direction of the relationships between the STTs and body height, weight and BMI, as well as between separate STTs. The facial soft tissues in Bulgarian adults changed in accordance with the nutritional status of the individual and in both sexes all STTs augmented with the increasing BMI. For both normal and overweight BMI categories, males had more soft tissue at the majority of facial points than females, as the only exceptions were observed in the cheek zone, where STTs were thicker in females. Significant bilateral differences were observed in either sex and BMI category. Stronger correlations were established for the STTs in the jaw region and between the cheek and jaw soft tissues. Besides, the correlations between the homologous bilateral landmarks were among the strongest ones.

Waist Circumference and Mortality in Korea: Evidence from the National Health Insurance Health Checkup 2009-2015

Background: Higher waist circumference (WC) is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality. Methods: A total of 23,263,878 subjects who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85-90 cm in men and 80-85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC. Findings: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65–85 years than subjects aged 40–65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1·156, 1·412, and 1·614 in normal BMI and 1·145, 1·401, and 1·909 in overweight, respectively). Interpretation: This study provides evidence of the need to lose WC in the subjects with normal or overweight BMI categories. The importance of assessing WC routinely should be raised and the guidelines to keep proper WC are stressed. Funding Statement: We would like to thank the Korean National Health Insurance Corporation and all the participants of the study and health check-up. This study was supported by grant HC16C2285 from the Korean Health Technology and Research and Development project, Ministry of Health and Welfare, Republic of Korea. This research was also supported by a grant of the Development of an Interactive Medical History Taking Software (2017-0-00588), funded by the Ministry of Science and ICT, Republic of Korea Declaration of Interests: The authors have nothing to disclose. Ethics Approval Statement: The study protocol was approved by the Institutional Review Board of the Korea University Anam Hospital (ED17115) and permission for the use of health checkup data was granted by the NHIS (NHIS-2018-1-035).

Weight History and Subclinical Myocardial Damage.

Excess weight is associated with subclinical myocardial damage, as reflected by high-sensitivity cardiac troponin T (hs-cTnT) concentrations, which portends high heart failure risk. However, the association between weight history and myocardial damage is unknown. We evaluated 9062 Atherosclerosis Risk in Communities (ARIC) visit 4 (1996-1999) participants with a body mass index (BMI) ≥ 18.5 kg/m2 and no previous cardiovascular disease. We cross-tabulated visit 4 ("current") BMI categories of normal weight, overweight, and obese with those at visit 1 (1987-1989) and with BMI categories calculated from self-reported weight at age 25 years. Duration of obesity was calculated in years. A cumulative weight measure of "excess BMI-years" was also calculated [product of mean BMI (centered at 25 kg/m2) over all ARIC time points × follow-up duration]. We used logistic regression to estimate associations of weight history metrics with increased hs-cTnT (≥14 ng/L) at visit 4. Overall, 623 individuals (7%) had increased hs-cTnT at visit 4. Within each current BMI category, previous excess weight was associated with increased hs-cTnT, with the strongest associations for those with past and current obesity [odds ratio (OR), 3.85; 95% CI, 2.51-5.90 for obesity at age 25 years and visit 4]. Each 10-year longer obesity duration was associated with increased hs-cTnT (OR, 1.26; 95% CI, 1.17-1.35). Each 100 higher excess BMI-years was also progressively associated with increased hs-cTnT (OR, 1.21; 95% CI, 1.14-1.27). Previous obesity and greater cumulative weight from young adulthood increase the likelihood of myocardial damage, indicating long-term toxic effects of adiposity on the myocardium and the need for weight maintenance strategies targeting the entire life span.

Gut microbiome diversity influenced more by the Westernized dietary regime than the body mass index as assessed using effect size statistic.

Human gut microbiome dysbiosis has been associated with the onset of metabolic diseases and disorders. However, the critical factors leading to dysbiosis are poorly understood. In this study, we provide increasing evidence of the association of diet type and body mass index (BMI) and how they relatively influence the taxonomic structure of the gut microbiota with respect to the causation of gut microbiome dysbiosis. The study included randomly selected Alabama residents (n = 81), including females (n = 45) and males (n = 36). The demographics data included age (33 ± 13.3 years), height (1.7 ± 0.11 meters), and weight (82.3 ± 20.6 kg). The mean BMI was 28.3 ± 7.01, equating to an overweight BMI category. A cross‐sectional case–control design encompassing the newly recognized effect size approach to bioinformatics analysis was used to analyze data from donated stool samples and accompanying nutrition surveys. We investigated the microbiome variations in the Bacteroidetes‐Firmicutes ratio relative to BMI, food categories, and dietary groups at stratified abundance percentages of <20%, 20%, 30%, 40%, 50%, 60%, and ≥70%. We further investigated variation in the Firmicutes and Bacteroidetes phyla composition (at the genus and species level) in relation to BMI, food categories, and dietary groups (Westernized or healthy). The Pearson Correlation coefficient as an indication of effect size across Alpha diversity indices was used to test the hypothesis (H0): increased BMI has greater effect on taxonomic diversity than Westernized diet type, (Ha): increased BMI does not have a greater effect on taxonomic diversity than Westernized diet type. In conclusion, we rejected the (H0) as our results demonstrated that Westernized diet type had an effect size of 0.22 posing a greater impact upon the gut microbiota diversity than an increased BMI with an effect size of 0.16. This implied Westernized diet as a critical factor in causing dysbiosis as compared to an overweight or obese body mass index.

Profile of Obesity and Diabetes Mellitus in Adult Female Population in North Sumatera, Indonesia

Non-communicable diseases (NCDs) have become the leading causes of death globally, including Indonesia. This study is conducted to find out the distribution of obesity and diabetes mellitus (DM) in adult female population in North Sumatera Utara, Indonesia. A cross-sectional study was conducted from August to September 2016 on a total of 200 adult female respondents aged 20-65 years who agreed to participate in Langkat district and Medan city, North Sumatra. Criteria of obesity based on Body Mass Index (BMI), might be inappropriate for Asian population. DM was diagnosed if plasma glucose level is >200 mg/dl. The prevalence of obesity in female among aged ≥20 years were 68.5%. Subsequently, obesity and overweight categories of BMI are highest in the 41-50 year age group (35.5% and 20.5% respectively) as well as pre-DM and DM (24.5 and 11.5%, respectively). The age group of 41-50 years old have also the highest rates of obesity and overweight BMI categories as well as highest rate of DM in this research. In addition, more investigation is needed to establish a relationship between obesity and DM. Therefore, comprehensive strategies for the prevention and control of the problem of obesity and DM in adult female are urgently required.

Impact of parental obesity on neonatal markers of inflammation and immune response.

Background/ObjectivesMaternal obesity may influence neonatal and childhood morbidities through increased inflammation and/or altered immune response. Less is known about paternal obesity. We hypothesized that excessive parental weight contributes to elevated inflammation and altered immunoglobulin (Ig) profiles in neonates.Subjects/MethodsIn the Upstate KIDS Study maternal pre-pregnancy body mass index (BMI) was obtained from vital records and paternal BMI from maternal report. Biomarkers were measured from newborn dried blood spots (DBS) among neonates whose parents provided consent. Inflammatory scores were calculated by assigning one point for each of 5 pro-inflammatory biomarkers above the median and one point for an anti-inflammatory cytokine below the median. Linear regression models and generalized estimating equations were used to estimate mean differences (β) and 95% confidence intervals (CI) in the inflammatory score and Ig levels by parental overweight/obesity status compared to normal weight.ResultsAmong 2974 pregnancies, 51% were complicated by excessive maternal weight (BMI>25), 73% by excessive paternal weight, and 28% by excessive gestational weight gain. Maternal BMI categories of overweight (BMI 25.0-29.9) and obese class II/III (BMI≥35) were associated with increased neonatal inflammation scores (β=0.12, 95% CI: 0.02, 0.21; p=0.02, and β=0.13, CI: −0.002, 0.26; p=0.05, respectively) but no increase was observed in the obese class I group (BMI 30-34.9). Mothers with class I and class II/III obesity had newborns with increased IgM levels (β=0.11, CI: 0.04, 0.17; p=0.001 and β=0.12, CI: 0.05, 0.19); p<0.001, respectively). Paternal groups of overweight, obese class I and obese class II/III had decreased neonatal IgM levels (β=−0.08, CI: −0.13,-0.03, p=0.001; β=−0.07, CI: −0.13, −0.01, p=0.029 and β=−0.11, CI:−0.19,-0.04, p=0.003, respectively).ConclusionsExcessive maternal weight was generally associated with increased inflammation and IgM supporting previous observations of maternal obesity and immune dysregulation in offspring. The role of paternal obesity requires further study.

Concordance between self-reported pre-pregnancy body mass index (BMI) and BMI measured at the first prenatal study contact.

BackgroundThe 2009 Institute of Medicine (IOM) gestational weight recommendations are tailored to women’s pre-pregnancy body mass index (BMI). Limited evidence exists on methods for estimating women’s pre-pregnancy BMI, particularly for women living in low and middle income countries. Using data from collected among Peruvian pregnant women, we compared the concordance between self-reported pre-pregnancy BMI with BMI measured at the earliest prenatal study visit.MethodsData were from the Pregnancy Outcomes Maternal and Infant Study (PrOMIS), a cohort of pregnant women at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru. 2605 women aged 18 to 49 years (mean ± SD gestational age = 10.9 ± 3.3 weeks) were included in the study. Self-reported pre-pregnancy weight and height and measured weight and height were collected at the first prenatal study contact. We assessed the concordance between measured and self-reported BMI; and, the agreement among indicators of nutritional status obtained using measured and self-reported BMI.ResultsOn average, weight measured at the first prenatal study visit was 0.27 kg higher than self-reported pre-pregnancy weight (p < 0.05); and, measured height was 0.02 m lower than self-reported pre-pregnancy height (p < 0.001). Correspondingly, measured BMI was 0.71 kg/m2 higher than self-reported BMI (p < 0.001). Scatter and Bland-Altman plots indicated strong concordance between measured and self-reported BMI. The proportion of women in the normal BMI category tended to be higher when using self-reported BMI (59.6 %) than when using measured BMI (50.4 %). Conversely, the proportion of women in the overweight or obese BMI categories tended to be lower when using self-reported BMI (38.2 %) than when using measured BMI (47.7 %).ConclusionSelf-reported pre-pregnancy BMI was strongly correlated with BMI measured at the first prenatal study contact. The findings potentially suggest that, in this context, there is minimal change between pre-pregnancy BMI and BMI measured at the first prenatal study contact; or, that women in this study just recalled their most recent measured anthropometrics (including values obtained during the index pregnancy but before enrollment in the PrOMIS study).Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0983-z) contains supplementary material, which is available to authorized users.

The Relationship between Body Mass Index and Post-Cessation Weight Gain in the Year after Quitting Smoking: A Cross-Sectional Study.

IntroductionThere is wide variability in the amount of weight gained when quitting smoking, but little is known about key predictors of weight gain. We examined the impact of body mass index (BMI) category and sociodemographic variables on post-cessation weight gain.Materials and MethodsWe utilized National Health and Nutrition Examination Survey data from five consecutive cycles of data collection from 2003–2004 to 2011–2012 to estimate post-cessation weight gain by BMI category among recent quitters (n = 654). We analyzed data on their “current weight” and their “past year weight”. We also compared the recent quitters with current smokers, in order to estimate the amount of weight that could be attributed to quitting smoking.ResultsRecent quitters gained 1.4 kg (95% CI: 0.8 to 2.0), while current smokers had a non-significant weight change (-0.01 kg (95% CI: -0.3 to 0.2). Weight gain was significant for those in the normal weight (3.1 kg, 95% CI: 2.3 to 3.9) and overweight BMI categories (2.2 kg, 95% CI: 1.1 to 3.2).ConclusionsBMI category is a key factor in the extent of post-cessation weight gain, with normal and overweight recent quitters gaining significant amounts of weight.

Multivariable analysis of total cholesterol levels in male Swiss Armed Forces conscripts 2006-2012 (N = 174,872).

BackgroundCholesterol is an important contributor to morbidity and mortality risks due to its association with obesity, cardiovascular disease, and cancer. A system of mandatory military conscription is a useful tool for disease-risk monitoring in a given male population. Swiss military conscription data are representative for more than 90 % of a given male birth cohort (with Swiss citizenship). The medical examination also includes voluntary laboratory testing, for which approximately 65 % of the young men present at conscription give consent.MethodsHere we present the temporal and subgroup analyses of total serum cholesterol levels (TCL) among Swiss conscripts from 2006 to 2012 (N = 174,872; mean age = 19.75 years). The voluntary blood samples were tested by a central laboratory (Viollier AG) with identical measurement standards and strict quality control. To test differences in TCL by socioeconomic occupational status, sports test performance, Body Mass Index (BMI), age, and place of residence of the conscripts we used a multivariable regression model with TCL as dependent variable.ResultsMean TCL decreased significantly, by 0.125 mmol/l (95 % CI 0.108–0.142, p < 0.001) from 4.225 mmol/l (95 % CI 4.210–4.240) in 2006 to 4.100 mmol/l (95 % CI 4.091–4.109) in 2012. Similarly, the prevalence of conscripts with an elevated TCL ≥ 5.17 mmol/l decreased from ≥10.2 % prior to 2011 to 6.9 % in 2011 and 8.2 % in 2012. Multivariate regression showed an association between elevated TCL and lower socioeconomic occupational status, lower sports test performance, higher BMI, higher age, and area of residence. There was no longer a significant increase in mean TCL among the three grades of obesity (BMI ≥ 30.0 kg/m2) as defined by the WHO. Within the BMI categories of normal weight and overweight, TCL was stratified by sports performance (better sports performance = lower TCL).ConclusionDecreasing TCL in 2011 and 2012 fits the known pattern of conscripted persons’ stabilizing BMI and sports test performance of the conscripts in recent years. However, small temporal drifts within the laboratory analyses cannot be ruled out as confounding factors. In conclusion, identifying subgroups with unfavorable lipid profiles will contribute to the continuing success of intensified public health programs.

Feasibility of Using Ultrasonography to Establish Relationships Among Sacral Base Position, Sacral Sulcus Depth, Body Mass Index, and Sex.

Identifying relationships among anatomical structures is key in diagnosing somatic dysfunction. Ultrasonography can be used to visualize anatomical structures, identify sacroiliac landmarks, and validate anatomical findings and measurements in relation to somatic dysfunction. As part of the osteopathic manipulative medicine course at A.T. Still University-Kirksville College of Osteopathic Medicine, first-year students are trained to use ultrasonography to establish relationships among musculoskeletal structures. To determine the ability of first-year osteopathic medical students to establish sacral base position (SBP) and sacral sulcus depth (SSD) using ultrasonography and to identify the relationship of SBP and SSD to body mass index (BMI) and sex. Students used ultrasonography to obtain the distance between the skin and the sacral base (the SBP) and the distance between the skin and the tip of the posterior superior iliac spine bilaterally. Next, students calculated the SSD (the distance between the tip of the posterior superior iliac spine and the SBP). Data were analyzed with respect to side of the body, BMI, sex, and age. The BMI data were subdivided into normal (18-25 mg/kg) and overweight (25-30 mg/kg) groups. Ultrasound images of 211 students were included in the study. The SBP was not significantly different between the left and right sides (36.5 mm vs 36.5 mm; P=.95) but was significantly different between normal and overweight BMI categories (33.0 mm vs 40.0 mm; P<.001) and between men and women (34.1 mm vs 39.0 mm; P<.001). The SSD was not significantly different between left and right sides (18.9 mm vs 19.8 mm; P=.08), normal and overweight BMI categories (18.9 mm vs 19.7 mm, P=.21), or men and women (19.7 mm vs 19.0 mm; P=.24). No significant relationship was identified between age and SBP (P=.46) or SSD (P=.39); however, the age range was narrow (21-33 years). The study yielded repeatable and reproducible results when establishing SBP and SSD using ultrasonography. The statistically significant relationship between SBP and higher BMI and between SBP and female sex may point to more soft tissue overlaying the sacrum in these groups. Further research is needed on the use of ultrasonography to establish criteria for somatic dysfunction.