Overweight Categories Research Articles

Reducing BMI below the obesity threshold in adolescents treated with once-weekly subcutaneous semaglutide 2.4 mg.

To examine how improvement in body mass index (BMI) with the glucagon-like peptide-1 receptor agonist, semaglutide, translated to changes in BMI category in a post-hoc analysis of the double-blind, phase 3a randomized controlled STEP TEENS trial (NCT04102189). Adolescents with obesity received once-weekly subcutaneous semaglutide 2.4 mg or placebo, plus lifestyle intervention which comprised counseling in healthy nutrition and a goal of 60 minutes of moderate- to high-intensity physical activity per day. Achievement of an improvement in BMI category and attainment of normal weight or overweight BMI category by week 68 were analyzed using logistic regression models. In the overall population, 44.9% of participants receiving semaglutide achieved normal weight or overweight BMI category versus 12.1% receiving placebo at week 68 (odds ratio: 22.7; 95% confidence interval [CI]: 7.6-67.9). The proportion of semaglutide-treated participants in obesity class III decreased from 37.3% to 13.6%, but increased with placebo. The odds ratio for achieving an improvement of ≥1 BMI category was significantly greater with semaglutide versus placebo (23.5; 95% CI: 9.9-55.5); an improvement of ≥1 BMI category was seen in 73.7% of participants receiving semaglutide compared with 19.0% with placebo. Semaglutide was highly effective in reducing BMI category. While on treatment, most trial participants' BMI improved by ≥1 category and > 40% reached a category below the obesity threshold. This article is protected by copyright. All rights reserved.

Added value of waist circumference to body mass index for predicting fracture risk in obesity: a prospective study from the CARTaGENE cohort.

Waist circumference (WC) is a stronger risk factor of metabolic disorders than body mass index (BMI), but whether it holds true for fracture risk prediction remains unclear. We aimed to evaluate relationships between WC and fracture incidence within BMI categories and evaluate whether BMI modifies these relationships. Men and women aged 40-70years from the CARTaGENE cohort were divided by BMI category at baseline: normal weight, overweight, and obesity. Incident fractures were identified over 7years via linkage with healthcare administrative databases. Cox proportional hazard models estimated the relationships between WC and incident fractures at any site and by skeletal site within each BMI category. Results are reported as adjusted hazard ratios (95% confidence intervals) per 10cm increase in WC. Effect modification was evaluated qualitatively by comparing relationships between BMI categories. Of the 18 236 individuals included, 754 sustained a fracture. Significant relationships were found between WC and distal lower limb fractures in the normal (1.25 [1.08, 1.45]) and overweight (1.28 [1.07, 1.52]) BMI categories, but not in the obesity category. In the overweight category, we found an increased risk of distal upper limb fractures with increasing WC (1.49 [1.04, 2.15]). No significant relationship was observed regarding WC and fracture risk at any site or major osteoporotic fractures. An effect modification of BMI on the relationships between WC and distal lower limb fractures was observed. WC provides both independent and additive information to BMI for the identification of individuals at risk of obesity-related fractures.

Body weight, weight change and the risk of cardiovascular disease in patients with hypertension: a primary-care cohort study.

Obesity and cardiovascular disease (CVD) often co-occur. However, the effects of excessive body weight and weight change on CVD in patients with hypertension are not clearly established. We examined the associations of BMI, weight change and the risk of CVD in patients with hypertension. Our Data were drawn from the medical records of primary-care institutions in China. A total of 24,750 patients with valid weight measurements attending primary healthcare centers were included. Body weight were grouped in BMI categories of underweight ( < 18.5 kg/m2), healthy weight (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2) and obesity ( ≥ 25.0 kg/m2). Weight change over 12 months was divided into: gain >4%, gain 1-4%, stable (-1 to 1%), loss 1-4%, and loss ≥4%. Cox regression analyses were used to estimate hazard ratio (HR) and 95% confidence interval (95% CI) between BMI, weight change and the risk of CVD. After multivariable adjustment, patients with obesity were related to higher risks of CVD (HR = 1.48, 95% CI: 1.19-1.85). Higher risks were seen in participants with loss ≥4% and gain >4% of body weight compared to stable weight (loss ≥4%: HR = 1.33, 95% CI: 1.04-1.70; gain >4%: HR = 1.36, 95% CI: 1.04-1.77). Obesity and weight change of loss ≥4% and gain >4% were related to higher risks of CVD. Close monitoring and appropriate interventions aimed at achieving an optimal weight are needed to prevent adverse cardiovascular outcomes for patients with hypertension.

Knowledge of adequate diet among nursing students at Achievers University, Owo, Nigeria

Abstract Context: A well-rounded and nutritionally balanced diet forms a foundational pillar of a healthy lifestyle, underscoring the pivotal role of sound nutrition. Studies have indicated a prevalence of malnutrition among student nurses, yet the underlying factors contributing to this prevalent issue remain to be fully elucidated. Objective: This study aims to evaluate the depth of knowledge concerning an appropriate diet among nursing students enrolled at Achievers University, situated in Owo, Ondo State, Nigeria. Materials and Methods: From August 2022 to September 2022, a descriptive cross-sectional investigation was conducted, employing a Purposive sampling technique to ascertain a representative sample size of 307 participants. A carefully crafted and validated questionnaire was used for data collection, and tables, percentages, and Chi-square analysis were all used in the analysis to assess the level of statistical significance. A P-value of less than 0.05 was designated as indicative of statistical significance. Results: The study’s findings indicated that a significant proportion of participants (96.4%) agreed regarding the beneficial effects of consuming more than three meals daily for maintaining a healthy lifestyle. Additionally, all participants clearly understood the significance of maintaining a healthy diet. Notably, a considerable majority (89.6%) exhibited a commendable grasp of proper nutritional principles, while 3.6% demonstrated lower levels of understanding. Regarding participants’ weight status, the distribution was as follows: 50.8% were categorized as having an average weight, 36.2% fell into the overweight category, 10.1% were classified as obese, and 2.9% were underweight. The analysis of collected data yielded a noteworthy observation. Such as, it shows that there is no statistically significant correlation was found between the participants’ knowledge of sufficient nutrition and the practical implementation of this knowledge (χ 2 = 11.550, P = 0.072). Conclusion: In this study, nursing students who took part deeply understood a balanced diet, but this did not translate into the practice of an adequate diet. As a result, it is necessary to use other methods to encourage student nurses to practice good nutrition.

Influence of boot stud shapes and pitch surfaces on rugby players’ sprinting performance

Introduction: In rugby, a player’s sprinting prowess emerges as a pivotal determinant for bridging the gap to opponents and eluding their pursuit. Hence, a proper rugby boot assumes paramount importance in enhancing sprinting capabilities. However, the tropical climate conditions in Malaysia, with high temperatures, humidity and heavy rainfall, possess the potential to rapidly degrade rugby pitch conditions, thereby exerting a pronounced impact on sprinting performance. Aims: This study aims to investigate the influence of different boot studs and pitch surfaces on the sprinting performance of junior rugby players. Methods: A cohort of 36 rugby players completed the sprinting tests with different boot stud shapes, i.e. cone, triangular and blade shapes, on normal, puddle and muddy surfaces. Fully automated timing gates were placed at the 0 m and 40 m mark along the track. Data obtained from the experiments were recorded for the statistical analysis using the repeated-measure analysis of variance. Results: The results revealed that the players’ sprinting performance declined by an average of 1.26% on the puddle pitch surface and by 16.51% on the muddy pitch surface using all types of boots. It was also discovered that the sprinting performance of players in the overweight and obese categories dropped by an average of 8.5% and 12.73% on all types of pitch surfaces, respectively. On muddy pitch surfaces, players in all positions and body mass index categories who used boots with cone and triangle studs had better sprinting performance when compared to blade studs. Conclusions: In essence, this study demonstrated the sprinting evaluation framework on various pitch conditions. Furthermore, it imparts invaluable technical insights to rugby players and coaches in selecting appropriate boots, particularly within Malaysia’s distinctive climatic and pitch conditions.

Identifikasi Profil Antropometri Atlet Karate Berdasarkan Kelompok Usia di Pontianak

This study aims to identify the anthropometric profiles of karate athletes based on age groups in Pontianak. This study aims to identify the anthropometric profiles of karate athletes based on age groups in Pontianak. This research is a quantitative descriptive study. The sample used in this study was karate athletes in the city of Pontianak, consisting of 45 athletes. Data collection techniques using tests and measurements. Data analysis was assisted by the SPSS version 25 application. The results showed an anthropometric profile of the physical condition of karate athletes in Pontianak city with a normal category average with the following distribution of results and percentages, the less category was 9 people with a percentage of 39%, the normal category with a percentage of 59 % with a total of 35 athletes in the overweight category the percentage is 2% with a total of 1 athlete while for athletes in the obese category the percentage is 0% with the number of athletes being 0. From the results of the measurement tests it can be concluded that the anthropometric profile of karate athletes based on the age group in Pontianak normal category.&#x0D; Keywords: Anthropometry, Athlete, Karate

Obesity and breast cancer prognosis: pre-diagnostic anthropometric measures in relation to patient, tumor, and treatment characteristics

PurposeExamine the association between obesity and clinical outcomes in early breast cancer and assess if patient, tumor, and treatment characteristics modify such associations in Malmö Diet and Cancer Study patients (MDCS).MethodsThe MDCS enrolled 17,035 Swedish women from 1991 to 1996. At enrollment, participants' body mass index (BMI), waist circumference and body fat percentage measures were collected. We identified all female MDCS participants with invasive breast cancer from 1991 to 2014. Follow-up began at breast cancer diagnosis and ended at breast cancer recurrence (BCR), death, emigration, or June 8, 2020. The World Health Organization guidelines were used to classify BMI, waist circumference, and body fat percentage into three categories of healthy weight, overweight, and obesity. We fit Cox regression models to compute adjusted hazard ratios (HRs) with 95% confidence intervals (CI) of BCR according to body composition. To evaluate effect measure modification, we stratified Cox models by patient, tumor, and treatment characteristics.ResultsIn total, 263 BCRs were diagnosed over 12,816 person-years among 1099 breast cancer patients with a median follow-up of 11.1 years. Obesity according to BMI (HR = 1.44 [95%CI 1.00–2.07]), waist circumference (HR = 1.31 [95%CI 0.98–1.77]), and body fat percentage (HR = 1.41 [95%CI 1.02–1.98]) was associated with increased risk of BCR compared with healthy weight. Obesity was stronger associated with BCR in patients with low socioeconomic position (HR = 2.55 [95%CI 1.08–6.02]), larger tumors > 20 mm (HR = 2.68 [95%CI 1.42–5.06]), estrogen-receptor-negative breast cancer (HR = 3.13 [95%CI 1.09–8.97]), and with adjuvant chemotherapy treatment (HR = 2.06 [95%CI 1.08–4.31]).ConclusionHigher pre-diagnostic BMI, waist circumference, and body fat percentage was associated with increased risk of BCR. The association between obesity and BCR appears dependent on patient, tumor, and treatment characteristics.

Nutritional Status of People with Schizophrenia in Sidoarjo District and its review according to Islamic View

Schizophrenia is a psychiatric illness that affects the brain and causes strange thoughts, perceptions, emotions, movements and behaviors. Schizophrenia is associated with many health problems that will increase morbidity and mortality due to changes in body weight. Lack of nutrition will make the body more susceptible to infection, while excess nutrition can trigger degenerative diseases. Decreased ability to care for oneself in schizophrenic patients can cause the patient's nutritional status to become malnourished or even malnourished. The purpose of this study was to determine the demographics and nutritional status of people with schizophrenia in Sidoarjo Regency. The method used in this research is descriptive quantitative method. The type of analysis used in this research is univariate data analysis. The results showed that people with schizophrenia in Sidoarjo district, especially in Wonoayu, Krian, and Tarik sub-districts, as many as 30 people (17.6%) were included in the Underweight category, 62 people (36.5%) were included in the Normal Weight category. 29 people (17.1%) were included in the overweight category with Risk, 38 people (22.4%) were included in the Obesity I category, 11 people (6.5%) were included in the obesity category II.

Central obesity, obesity, and physical activity among university staffs

Waist circumference (WC) is considered as a superior indicator to predict central obesity and its related comorbidities. Limited studies were conducted to infer central obesity using WC among university staffs. A cross-sectional study through the convenience sampling method was employed using the short form international physical activity questionnaire, anthropometric measurements, and WC measurement to infer a level of physical activity, body mass index (BMI), and central obesity. Seventy staff from three private universities in Malaysia participated in this study. There is a high prevalence (78.6%) of central obesity among the participants irrespective of their age. Majority of the participants fall under the overweight (37.1%) and obese (21.4%) category of BMI 48.6% reported to be involved in low level of physical activity. No difference in prevalence of central obesity based on age, gender, and level of physical activity. There is a moderately strong correlation between BMI and WC. In this study notably a high prevalence of central obesity in participants with underweight and desirable weight category of BMI was reported, which synergizes the concept of including WC measurement in health promotion activities. Appropriate multi- component and multi-level interventions can be considered to this population to prevent/combat obesity.

Effect of Body Mass Index on Chiari Malformation 1 Tonsil Ectopia Length in Adults

Diagnosis of Chiari I malformation (CM-1) is based on measurements of the inferior extension of the cerebellar tonsils into the foramen magnum on cranial or cervical spine magnetic resonance imaging. Imaging may be obtained before the patient is referred to the neurosurgical specialist. The length of time raises questions about the possibility that body mass index (BMI) fluctuations could affect the measurement of ectopia length. However, previous literature on BMI and CM-1 has reported conflicting findings on BMI. We conducted a retrospective chart review of 161 patients who were referred to a single neurosurgeon for CM-1 consultation. Patients with multiple recorded BMI values (n= 71) were compared to see if BMI changes correlated with changes in ectopia length. In addition, we compared and tested 154 recorded ectopia lengths from the patients (1 per patient) and patient BMI values with Pearson correlation and Welch t tests to determine if BMI changes either influenced or were associated with ectopia changes. For the 71 patients with multiple BMI values, change in ectopia length ranged from-4.6-9.8mm but was not statistically significant (r=0.019; P=0.88). For the 154 measured ectopia lengths, changes in BMI did not correlate with ectopia length (P>0.05). Likewise, differences in ectopia length between patients in normal, overweight, and obese categories were not statistically significant (|tstat|<|tcrit|, P>0.05). In individual patients, we found that BMI and changes in BMI were not accompanied by changes in tonsil ectopia length.

Association between body mass index and posterior spine fusion among patients with adolescent idiopathic scoliosis.

Previous studies have found mixed associations between body mass index (BMI) and adolescent idiopathic scoliosis (AIS) incidence and progression. The aim of this study was to examine the association between BMI and the incidence of posterior spine fusion (PSF) among pediatric patients with AIS. This was a retrospective cohort study of patients diagnosed with AIS at a single large tertiary care center between January 1, 2014 and December 31, 2020. BMI-for-age percentiles were used to categorize BMI into four categories: underweight (<5th percentile), healthy weight (≥5th to <85th percentile), overweight (≥85th to <95th percentile), and obese (≥95th percentile). Chi-square and t-tests were used to compare distributions of baseline characteristics by incident PSF outcome status. Multivariable logistic regression assessed the association between BMI category at baseline and incident PSF adjusting for sex, age at diagnosis, race/ethnicity, health insurance type, vitamin D supplementation, and low vitamin D levels. A total of 2,258 patients met the inclusion criteria with 2,113 patients (93.6%) who did not undergo PSF during the study period and 145 patients (6.4%) who did undergo PSF. At baseline, 7.3% of patients were categorized as underweight, 73.2% were healthy weight, 10.2% were overweight, and 9.3% were obese. Compared to those in the healthy weight group, there was no significant association between PSF and being underweight (adjusted odds ratio [AOR] 1.64, 95% CI 0.90-2.99, p = 0.107), being overweight (AOR 1.25, 95% CI 0.71-2.20, p = 0.436), or being obese (AOR 1.19, 95% CI 0.63-2.27, p = 0.594). This study did not find a statistically significant association between underweight, overweight, or obese BMI category and incident PSF among patients with AIS. These findings add to the current mixed evidence on the relationship between BMI and surgical risk and may support the recommendation of conservative treatment to patients regardless of BMI.

Effect of body habitus on surgical outcomes following bilateral axillo-breast approach robotic thyroidectomy: a retrospective cohort study.

BMI has been shown to predict perioperative outcomes in patients undergoing surgery. Most studies assessing the role of body habitus in thyroid surgery have focused on open surgery, with few studies assessing patients undergoing robotic surgery. The present study evaluated the effects of BMI on surgical outcomes in patients undergoing bilateral axillo-breast approach (BABA) robotic thyroidectomy. This study included patients who underwent BABA robotic thyroidectomy between January 2013 and September 2021 at Seoul National University Bundang Hospital. Patients were categorized into six groups based on the WHO classification of overweight and obesity. Clinicopathological characteristics, postoperative complications, and surgical outcomes were evaluated. A total of 1921 patients were included. Comparisons of the six BMI groups showed no statistically significant differences in postoperative stay, resection margin involvement, postoperative complications, and recurrence. Subgroup analysis showed that hypocalcemia rates differed among BMI groups in patients who underwent lobectomy, with underweight and class II obese patients being at the highest risk ( P =0.006). However, the actual number of complications was relatively small and similar among the groups. In patients who underwent total thyroidectomy and isthmectomy, BMI was not correlated with postoperative complications, including hypocalcemia, recurrent laryngeal nerve palsy, postoperative bleeding, and chyle leakage. Body habitus was not significantly associated with operative time and postoperative complications in patients undergoing BABA robotic thyroidectomy, indicating that this approach is safe and feasible in obese patients.

PO-02-167 IMPACT OF OBESITY ON QUALITY OF LIFE AND CLINICAL OUTCOME IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING PRIMO PULMONARY VEIN ISOLATION

Obesity is a major risk factor for the incidence and progression of atrial fibrillation (AF), negatively impacting AF ablation outcomes. Weight loss in obese patients prior to AF ablation may improve quality of life (QoL) and AF ablation success rates. To assess the impact of overweight and obesity on patient-reported outcomes (QoL scores) and clinical outcomes (AF recurrence) in patients undergoing index AF ablation procedure. This single-center cohort study retrospectively included 238 patients undergoing primo radiofrequency (RF) pulmonary vein isolation (PVI) who completed 1 year follow-up, including the Toronto AF Severity Scale (AFSS) questionnaire at baseline, 4-, and 12 months post-PVI for assessment of QoL (AF severity, AF burden, and global well-being). At baseline, patients were categorized by body mass index (BMI): normal (<25 kg/m2); overweight (≥25 - <30 kg/m2); and obese (≥30 kg/m2). AF recurrence was evaluated by either 24-h Holter monitoring, AliveCor KardiaMobile devices, or conventional electrocardiograms (ECG). Patients were divided based on BMI: 37.8% normal; 44.1% overweight; and 18.1% obese. Obese patients were more likely to be women (men 46.5%,p<0.01), and have diabetes mellitus (25.6%,p<0.01). AF recurrence rates detected during 12 months follow-up were similar among the three BMI groups: normal 27.8%, overweight 33.3%, and obese 30.2% (p=0.70). After AF ablation, all QoL scores in each BMI group improved, with no between-group differences (Table 1). Subgroup analysis showed significantly improved QoL scores in patients without AF recurrence independent of BMI category, however in patients with AF recurrence no significant improvement of AF severity and global well-being was found (Fig 1). Despite AF recurrence, self-reported AF burden significantly improved in the normal and overweight categories, but not in obese patients. A high BMI was not a major determinant of AF recurrence rates after a primo PVI. QoL after PVI was found to be determined by AF recurrence rather than BMI. This study suggests that obese patients might benefit from PVI to a similar extent compared to non-obese patients, though self-reported AF burden might differ between groups.

Is Obesity Driving the Increase in Young Stroke? (P6-5.002)

<h3>Objective:</h3> Our aim was to identify the association of obesity with young acute ischemic stroke (AIS), and the burden of lifestyle-related risk factors based on different body-mass-index (BMI) categories in patients with young AIS. <h3>Background:</h3> Obesity is a known risk factor for AIS in both the adult and young (&lt;50 years) population. Prior studies suggest that this association is mediated through risk factors such as diabetes and hypertension; however, the extent of this association has not been reported. <h3>Design/Methods:</h3> All patients with AIS, younger than 50 years, admitted to the University of Maryland hospital system hospitals Jan 2017 and December 2020, were included. Patients were categorized into 3 BMI categories: 1) Normal (18.5–24.9), 2) Overweight (25–29), and 3) Obese (≥30). Lifestyle-related risk factor (HTN, DM, DLD, and sleep apnea) burden and distribution was analyzed across the three groups using Chi-squared tests of association. One-way Welch’s ANOVA was utilized to test mean differences in number of risk factors across BMI categories. <h3>Results:</h3> We identified 1272 patients with young stroke. A total of 797/1272 (63%) of our young stroke patients were obese and 23.1% (n=294) were in the overweight category. In the obese category: mean age was 41.4 years (SD +/−6.75), 49.4% were women and 53.4% were Black. Risk factor burden was significantly higher in the obese vs. the overweight and normal weight categories (p = &lt;0.001). The proportion of patients with HTN, DM, DLD and sleep apnea was significantly higher in the obese category. <h3>Conclusions:</h3> A majority of young stroke patients were obese, and the obese and overweight patients were predominantly African American. Obese patients had the highest proportion of all medical risk factors, as well as a risk factor burden nearly twice as high as those with normal BMI. Efforts to reduce obesity hold promise in mitigating the burden of stroke in young adults. <b>Disclosure:</b> Dr. Solomonow has nothing to disclose. Karen Yarbrough has nothing to disclose. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra Zeneca. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Calgary. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Ramar &amp; Paradiso. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Cole, Scott, Kissane. The institution of Dr. Chaturvedi has received research support from NINDS. Dr. Mehndiratta has nothing to disclose.

The Prevalence of Elevated Blood Pressure and Its Association With Obesity in Children Aged 6-13 Years in Rural India: A Cross-Sectional Study.

Introduction Globally, hypertension is one of the major risk factors for cardiovascular disease. Childhood hypertension is one of the emerging conditions due to the increase in the prevalence of obesity in children in developing countries. An increase in blood pressure (BP) can be classified as secondary hypertension if it is caused by an underlying disease process or as primary hypertension if there is no identifiable cause. Primary hypertension during childhood often tracks into adulthood. The prevalence of primary hypertension, mostly in older school-aged children and adolescents, has increased in parallel with an obesity epidemic. Materials and methods This cross-sectional descriptive study was taken in different schools in the rural areas of Trichy District, Tamil Nadu, for a period of six months from July 2022 to December 2022; the study was done in children between six and 13 years. Anthropometry was taken, and blood pressure was measured using an appropriate-size BP cuff and standardized sphygmomanometer. Three values were taken at an interval for a minimum of five minutes, and the mean of the three values was calculated. Blood pressure percentiles were adopted from the American Academy of Pediatrics (AAP) 2017 guidelines for childhood hypertension. Results Out of 878 students, 49 (5.58%) students had abnormal BP, of which 28 (3.19%) students were categorized into elevated BP and 21 (2.39%)students had hypertension both in stages 1 and 2. Abnormal blood pressure was equally distributed in both males and females. More students were from the age group between 12 and 13 years (chi-square value: 58.469, P=0.001), which shows that as age increases, the prevalence of hypertension increases. The mean weight was around 31.97 kg, and the mean height was 135.34cm. In this study, we found that 223 (25%) students were overweight and 53 (6.03%) students were obese. The prevalence of hypertension was 15.09% in the obese category and 1.35% in the overweight category (chi-square value: 83.712, P=0.000). Conclusion Due to limited data available on childhood hypertension based on the American Academy of Pediatrics (AAP) 2017guidelines, this study highlights the AAP 2017 guidelines for early diagnosis of elevated BP and various stages of hypertension in children, and also, the need for early detection of obesity is essential for the implementation of a healthy lifestyle. This study helps create awareness among parents regarding the rise of obesity and hypertension in children in rural populations of India.

Physical Activity and Body Mass Index Among Hypertensive Patients Attending Outpatient Clinic at a Tertiary Hospital in Kelantan, Malaysia

Introduction: Hypertension is one of the predisposing factors for increased morbidity and mortality rate in Malaysia as it significantly contributes to the risk of non-communicable diseases such as heart disease, stroke, and kidney injuries. Non-pharmacological intervention such as physical activity (PA) helps to reduce the progression of hypertension severity and body mass index (BMI) among hypertensive patients. Limited studies were conducted among hypertensive patients at outpatient clinics in the east-coast region of Malaysia. Objective: To determine the level of PA and BMI of hypertensive patients attending outpatient clinics.Methods: This is a cross-sectional study using purposive sampling. The study was conducted among 73 hypertensive patients who attended the outpatient clinic at a tertiary hospital in Kelantan state, the Northern East of Malaysia. Data was collected using a self -reported questionnaires for BMI and hypertension and the short form of the International Physical Activity Questionnaire (IPAQ) was used to measure the level of PA. Results: The findings show that most of the respondents above 50 years old are moderately active (54.8%, n=40) and nearly half (45.2%, n=33) were overweight. There is no significant association between the level of PA and BMI (p=0.854). A significant association was only found between the respondents’ marital status and their BMI (p=0.034). Conclusion: The majority of the respondents in the study were moderately active in performing physical activity and within the category of overweight. PA and BMI are not significantly associated in the study. The non-significance findings could be due to the small sample size in this study and other contributing factors such as co-morbidities, lifestyle variables including dietary habits, and sedentary behaviour that were not investigated in the study. Overall, the study underlined the importance of physical activity and body mass index in achieving public health recommendations. Conclusion: Overall, the study underlined the importance of physical activity and body mass index in achieving public health recommendations.

A Cross-Sectional Study to Assess the Prevalence of Obesity among Second Professional MBBS Students of One of the Medical Colleges of Indore, Madhya Pradesh

Introduction: Obesity is a complex multifactorial preventable disease. The problem of obesity is important to discuss because it is closely associated with an increasing risk to many diseases. Objective: To assess the prevalence of obesity among Second MBBS students and find the anthropometric parameters of obesity. Method: This was a cross-sectional, observational study conducted among 100 second MBBS students. Demographic data and anthropometric measures, such as Height, Weight, Body mass index, Waist circumference, and Waist/Hip ratio of the students were collected. Results: BMI was &lt; 18.5 in 17.34% of male and 28% of female students. Around 18.67% of male and 24% of female students had BMI of more than 25 and where as student shaving BMI of more than 30 were 6.66% and 4% in male and female students, respectively. According to the Waist/Hip ratio,16% male (&gt;0.95) and16% female (&gt;0.86) students were categorized as at risk for obesity (p-value 0.86). Conclusion: Almost half of the male and female students were having normal BMI. More number of female students had BMI lower than normal. Students falling in the category of overweight were higher as compared to obese students. Such students were advised for nonpharmacological measures of weight reduction through proper exercise, consuming a healthy balanced diet, and role of physical activity, so as to maintain proper bodyweight and to prevent future complications of obesity were advised to the students.

Association between obesity and short- and medium-term mortality in critically ill patients with atrial fibrillation: a retrospective cohort study

BackgroundThere has been controversy about how obesity affects the clinical prognosis for patients with atrial fibrillation (AF), and the relationship between obesity and outcomes in critically ill patients with AF remains unclear. The purpose of this study was to explore the association between obesity and short- and medium-term mortality in critically ill patients with AF.MethodsThe Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was used to conduct a retrospective cohort analysis on 9282 critically ill patients with AF. Patients were categorized into four groups based on their body mass index (BMI) values: underweight, normal-weight, overweight, and obese. The outcomes of this study were 30-day, 90-day, and 1-year all-cause mortality. Cox proportional-hazards models and restricted cubic spline analyses were performed to investigate the association between BMI and mortality.ResultsFor 30-day mortality, after adjustment for all confounding factors, the hazard ratio (HR) with 95% confidence interval (CI) for the underweight, overweight, and obese categories were 1.58 (1.21, 2.07), 0.82 (0.72, 0.93), and 0.79 (0.68, 0.91), respectively, compared to the normal-weight category. Using multivariable-adjusted restricted cubic spline analysis, an “L-shaped” correlation was observed between BMI and 30-day mortality. For each 1 kg/m2 increase in BMI when BMI was less than 30 kg/m2, the risk of 30-day mortality decreased by 6.4% (HR, 95% CI: 0.936 [0.918, 0.954]; P < 0.001); however, this relationship was not present when BMI was greater than or equal to 30 kg/m2. Similar results were observed for 90-day and 1-year mortality.ConclusionsThere was a nonlinear relationship between BMI and all-cause mortality among critically ill patients with AF. All-cause mortality and the BMI were negatively correlated when the BMI was less than 30 kg/m2.

Rates of maternal weight gain over the course of pregnancy and offspring risk of neurodevelopmental disorders

BackgroundPrevious studies have suggested that gestational weight gain (GWG) outside an optimal range increases the risks of neurodevelopmental disorders (NDDs) in offspring including autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit/hyperactivity disorder (ADHD). The sequential development of the fetal brain suggests that its vulnerability may vary depending on the timing of exposure. Therefore, we aimed to investigate the associations of not only gestational age-standardized total GWG (GWG z-scores) but also the rate of GWG (RGWG) in the second and third trimesters with risks of NDDs in offspring.MethodsIn this population-based cohort study, we used maternal weight data from antenatal care records collected for 57,822 children born to 53,516 mothers between 2007 and 2010 in the Stockholm Youth Cohort. Children were followed from 2 years of age to December 31, 2016. GWG z-scores and RGWG (kg/week) in the second and third trimesters were considered as continuous variables in cox regression models, clustered on maternal identification numbers. Nonlinear relationships were accommodated using restricted cubic splines with 3 knots. RGWG were also categorized according to the 2009 US Institute of Medicine (IOM) guidelines for optimal GWG. According to the IOM guidelines, the optimal rate of GWG for the second and third trimesters for underweight, normal weight, overweight, and obese categories were 0.44–0.58, 0.35–0.50, 0.23–0.33, and 0.17–0.27 kg/week, respectively.ResultsDuring a mean follow-up of 5.4 years (until children were on average 7.4 years old), 2205 (3.8%) children were diagnosed with NDDs, of which 1119 (1.9%) received a diagnosis of ASD, 1353 (2.3%) ADHD, and 270 (0.5%) ID. We observed a J-shaped association between total GWG z-score and offspring risk of NDDs, with higher total GWG (GWG z-score = 2) associated with 19% increased risk of any NDD (95% CI = 3–37%) and lower total GWG (GWG z-score = − 2) associated with 12% increased risk of any NDDs (95% CI = 2–23%), compared to the reference (GWG z-score = 0). In the second trimester, lower RGWG (0.25 kg/week) was associated with a 9% increased risk of any NDD diagnosis (95% CI = 4–15%) compared to the median of 0.57 kg/week, with no apparent relationship between higher RGWG and risk of NDDs. In the third trimester, there was no apparent association between lower RGWG and risk of NDDs, though higher RGWG (1 kg/week) was associated with a 28% increased risk of NDD diagnosis (95% CI = 16–40%), compared to the median (0.51 kg/week). When considering categorized RGWG, we found that slow weight gain in the second trimester followed by rapid weight gain in the third trimester most significantly increased the risk of ADHD (HRadjusted = 1.55, 1.13–2.13) and ID (HRadjusted = 2.53, 1.15–5.55) in offspring. The main limitations of our study are the relatively few years for which detailed GWG data were available and the relatively short follow-up for the outcomes, limiting power to detect associations and misclassifying children who receive an NDD diagnosis later in childhood.ConclusionsThe relationship between maternal weight gain and children’s risk of NDDs varied according to timing in pregnancy, with the greatest risks associated with slow weight gain in the second trimester and rapid weight gain in the third trimester.

Time trends (2010-2020) in skinfolds thickness in children and adolescents, with different BMI status, from Kraków (Poland).

Objectives: To analyse secular changes (2010-2020) in skinfold thickness in children and adolescents in different BMI categories. Methods: The study group consisted of 3-16-year olds included in two cross-sectional studies. Measurements included height, weight and 5 skinfolds. The Body Mass Index was used to categorize participants into low (underweight), normal or excess (overweight and obesity) weight groups based on IOTF cut-off points. Differences of skinfold thicknesses between both cohorts, within each of the weight status categories, were assessed using two-way ANOVA and Tukey's tests. Results: In both sexes, there was a negative secular trend in limb adiposity among the normal weight and underweight cohorts. However, in both of those subpopulations individuals examined in 2020 had greater trunk adiposity, in comparison to their counterparts examined in 2010. Declining limb adiposity was also present in the overweight category. Although, trunk adiposity among individuals with overweight was generally comparable in both cohorts. Conclusions: There was a tendency towards normal weight obesity, particularly excess abdominal adiposity, among the 2020 cohort. These findings further suggest that using only the BMI, without taking into consideration tissue composition of the body, may result in misclassification of children and adolescents with high adiposity as normal-weight.