BMI Range Research Articles

Buccal Versus Vaginal Misoprostol Combined with a Foley Catheter Among Individuals with Obesity Undergoing Induction

Combining pharmacologic agents with mechanical ripening achieves the shortest labor, yet there is no clear evidence on route of drug administration in patients with obesity. Our objective was to evaluate the difference in time to delivery of buccal compared to vaginal misoprostol in combination with a Foley catheter (FC) for labor induction (IOL) in the obese population. This was a planned secondary analysis of a randomized controlled trial comparing identical dosages (25μg) of buccal and vaginal misoprostol in combination with a FC. Labor management was standardized among participants. Women undergoing IOL at ≥37 weeks with a singleton gestation and cervical dilation ≤2cm were included. Body mass index (BMI, kg/m2) was stratified. Our primary outcome was time to delivery. Kruskal-Wallis, Pearson chi-square and Cox survival analyses with intent-to-treat principles were performed. 215 participants were included with the following weight stratifications: 55 (25.6%) BMI < 30; 110 (51.2%) BMI 30-39.9; 50 (23.3%) BMI ≥40. Demographic characteristics were similar between the three groups. Vaginal drug administration achieved a faster median time to delivery than the buccal route among patients with a BMI range of 30-39.9, (vaginal miso–FC: 21.3hrs vs. buccal miso–FC: 23.6hrs, p=0.04). There was no difference in the cesarean delivery rate between the various groups. Furthermore, patients with a BMI range of 30-39.9 receiving vaginal misoprostol delivered 1.2 times faster than women who received buccal misoprostol after censoring for Cesarean delivery and adjusting for parity, (Hazard Ratio [HR] 1.2, 95% confidence interval [CI] 1.1-1.7). There were no significant differences in maternal and neonatal outcomes. We found that vaginal misoprostol was superior to buccal misoprostol when combined with a FC among individuals with a BMI range of 30-39.9. Therefore, vaginal misoprostol should be the preferred route of drug administration for term IOL in this population.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Dynamic alteration of plasma levels of betatrophin in younger female onset obesity post acute moderate-intensity exercise training

Obesity is a global metabolic disease anchored by a lack of physical activity lipid disturbances. Hitherto, betatrophin is a potential liver-derived hormone that regulates lipid metabolism. A total of 26 selected onset obese individuals (BMI range ± 28–31) were enrolled in this study and given moderate-intensity exercise. Importantly, our data show that acute moderate-intensity interval exercise (MIIE) and acute moderate-intensity continue to exercise (MICE) for 40 min significantly decrease the plasma level of full-length betatrophin respectively (174.18 ± 48.19 ng/mL; 182.31 ± 52.69 ng/mL), compared to the placebo (283.97 ± 32.23 ng/mL) post 10 min and 6 h exercise treatment (p ≤ 0.05). The plasma level of betatrophin was significantly and negatively correlated with BMI (r = − 0.412, p = 0.037), fasting blood glucose (r = − 0.390, p = 0.049), and positively correlated with VO2max (r = 0.456, p = 0.019). In addition, the linear and ordinal logistic regression analysis shows that betatrophin, is a potential predictor for BMI [estimate value = 0.995, p = 0.037 and OR (95 % CI) = 0.992 (0.0984–1.00), p = 0,048]. In summary, our data demonstrate that the circulating levels of betatrophin were decreased after acute moderate-intensity exercise training.

BS O04 Nip it in the bud - Need for changing perceptions of obesity amongst medical students along with inclusion in the medical school curriculum

Abstract Background Obesity needs to be included in medical school curriculum in the context of the obesity pandemic Methods A multiple-choice survey was sent out to students in a medical school attached to a university teaching hospital. Respondents provided information on demographics and perceptions about obesity and bariatric surgery. Results were presented as frequencies and analysed. Results There were 223 respondents with M:F = 93:130. 61.8% were in years 1–3 and 65.9% were in normal BMI range. 8 had BMI of 35 and above. 16.0% were not aware obesity is classified as a disease, but 87.9% understood the term bariatric surgery. 73.9% defined obesity as BMI more than 30. 23.8% felt that obesity is a self-inflicted disease. 23.6% felt that bariatric surgery should not be funded by the NHS with 6.3% feeling that bariatric surgery is a waste of money. 54.0% students agreed that bariatric surgery is an effective treatment for obesity. Conclusions Though overall perceptions were positive, a quarter of medical students felt that obesity is self-inflicted and just over 50% of students thought bariatric surgery was effective, indicating the need to include obesity and bariatric surgery in the curriculum in order to change firmly entrenched views around obesity.

BS P01 Obesity – the last bastion of prejudice and stigma in the NHS?

Abstract Background There is anecdotal evidence to suggest that patients with obesity face stigma in the NHS Methods A multiple-choice survey was sent out to consultants in a university teaching hospital with an established bariatric surgery unit. Respondents provided information on demographics and perceptions of obesity and bariatric surgery. Results were presented as frequencies and this was analysed. Results There were 167 consultant respondents with M:F = 114:53. 58% belonged to medical speciality and the rest belonged to the surgical speciality. 90% had over 10 years of NHS experience. 46.7% were in the normal BMI range and 3.5% had BMI 35 and above. 1.8% were not aware that obesity is classified as a disease. 42.5% felt that obesity is a self-inflicted disease. 73.4% agreed that bariatric surgery should be funded by the NHS, but 12% disagreed. 4.2% were of the opinion that bariatric surgery is a waste of money. 97% agreed that bariatric surgery resulted in weight loss and resolution of comorbidities. Conclusions There is a significant negative perception that obesity is a self inflicted life style disease even amongst the consultant work force reinforcing the premise that perhaps obesity is the last bastion of prejudice in the NHS.

Abstract 114

Background: Losing about 7% of body weight is known to reduce insulin resistance, blood pressure and reduce the risk for diabetes. Large waistlines have been a marker for metabolic syndrome. This study explores the effectiveness of the Fitterfly Weight loss digital therapeutics (DTx) program among individuals in overweight and obese categories. Method: De-identified data of 135 participants (Mean age: 39.35 ± 11.83 years, gender: 38.51% (52/135) females) enrolled in the Fitterfly Weight loss program was analyzed. BMI in the range of 25.0- 29.9 kg/m2 and ³ 30 kg/m2 and was used as a criterion for classification in overweight and obese category respectively. All participants completed 90 days on the Fitterfly weight loss program and were provided access to Fitterfly mobile application along with continuous remote health coaching, expert-led care (nutritionists, physiotherapists, and psychologists). Intensive behavioral therapy was used to promote sustained weight-loss. Digital logging of meals and physical activity, access to in-house nutrition database consisting of dietary information for each meal item logged was provided. The outcomes were analyzed at the beginning and end of the program. Wilcoxon signed rank test was used for analysis. The data has been shown as median (IQR). Results: Significant median reduction in weight, body mass index (BMI), and waist circumference was observed by 4.00 (-6.00, -2.70) kg, 1.50 (-2.20, -1.00) kg/m2, 6.00 (-9.00, -3.00) cm from a baseline of 83.00 (75.00, 95.00) kg, 31.70 (29.20, 34.60) kg/m2, and 107.00 (99.00, 115.00) cm respectively (p &lt; 0.0001 for all). Out of all the participants, 94.07% (127/135) participants showed weight loss, with minimum 5% and minimum 10% weight loss observed in 50.39% (64/127) and 7.08% (9/127) participants respectively. At the end of the program, a significant median reduction in intake of calories, carbohydrates, proteins, and fats by 427.00 (-704.00, -221.00) kcal, 56.00 (-105.00, -30.00) gm, 6.40 (-14.80, 4.40) gm, and 18.40 (-29.40, -7.50) gm from a baseline value of 1535.00 (1299.00, 1876.00) kcal, 205.00 (165.00, 236.00) gm, 47.00 (40.10, 56.20) gm, and 61.00 (49.00, 74.00) gm were observed respectively (p &lt; 0.0001 for all). Conclusion: Significant reduction in weight, BMI, waist circumference was observed among participants. Fitterfly weight loss program can help in clinically significant weight loss among individual in obese or overweight category.

Quantification of Breast Volume According to age and BMI: A Three-Dimensional MRI Analysis of 400 Women.

Breast size alteration is the most common aesthetic surgical procedure worldwide. This study aimed to assess the correlation between breast volume and BMI or age. The analyses were conducted utilizing 400 patients selected by a retrospective review of the archives at our institution. Epidemiological data and medical history were assessed. Adjusting for the age and BMI of patient from previously described cohorts, we calculated mean breast volumes per side and differences from the upper and lower percentiles to the mean volumes. The patients had a median BMI of 23.5 (range: 14.7-45.6) and a median age of 51 (range: 24-82). The average total breast volume increased strongly with BMI (r=0.834, p<0.01) and moderately with age (r=0.305, p<0.01). Within a BMI range of 18-24, breast volumes in the 8th and 18th percentile differ on average by about 50ml. One BMI unit increase in women with breast sizes in the 10th percentile accounts for a breast volume difference of about 30ml. BMI strongly correlates with breast size. To achieve natural results, preoperative consultation and planning of aesthetic and reconstructive breast surgery must recognize BMI as a major determinant of average breast size. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effect of yoga intervention on skeletal muscle linked glucose homeostasis in pre-diabetic individuals: Study protocol for a randomized controlled trial

BackgroundThe pre-diabetic stage is important in terms of identification and timely management due to its reversible nature. Along with other factors, insulin resistance in skeletal muscle is often considered as primary defect before development of overt hyperglycemia and Diabetes Mellitus (DM). Physical exercises are beneficial in prevention of DM by improving skeletal muscle mediated glucose metabolism. Evidence suggests that Yoga interventions appear to be equal and/or superior to exercise in most outcome measures. As the Yogic postures are relatable to exercises, they are considered to improve skeletal muscle function and reverse the pre-diabetic stage. MethodsThis open-labelled, randomized clinical study is planned to evaluate effect of Yoga interventions on muscle mass, strength, endurance and flexibility which are direct/indirect indicators of fat deposition in skeletal muscles. Association between changes in muscle quality/ functionality and glycemic control will also be explored. With ethics committee permission, 120 pre-diabetic individuals of either sex between age group of 35–49 years with BMI range of 25–35 kg/m2 and family history of Type 2 Diabetes Mellitus (T2DM) will be recruited after obtaining written informed consent. They will be randomly allocated to either Yoga or exercise group by computer generated randomized method in a 1:1 ratio. One group will receive defined Yoga interventions, while other group will receive fixed program of physical exercises. Prior to initiating this 12-week study, both groups will undergo a training session for 4 weeks under supervision of a trained instructor. The outcome measures will be parameters related to muscle quality/functionality and glucose metabolism markers. DiscussionOur study aims to explore practicality of Yoga in pre-diabetic stage on skeletal muscle related glycemic control, which is novel. Additionally, the study will generate awareness about pre-diabetes and provide people with active coping skills for reversing it.

Abstract 10901: Differential Burden of Prediabetes and Diabetes Among Asians Subgroups in a Large US Healthcare System

Introduction: We previously reported that Chinese, Filipino, and South Asian adults have higher prevalence of prediabetes (PreDM) than non-Hispanic White (White) adults, with nearly twice the burden in healthy BMI ranges. This study further examines the differential burden of diabetes (DM) in these Asian subgroups using Asian specific BMI categories. Methods: 283,110 White, 33,263 Chinese, 38,766 Filipino, and 17,959 South Asian adults aged 45-64y in a 2016 Northern California health plan with height and weight were examined. PreDM and DM were classified based on lab data, diagnoses, or DM treatment. Modified log Poisson regression was used to determine Asian group vs. White prevalence ratios (PRs) for DM and preDM, adjusted for age and BMI within healthy weight, overweight, and obesity ranges (BMI 18.5 to &lt;25, 23 to &lt;30, ≥30 kg/m2 for Whites; BMI 18.5 to &lt;23, 23 to &lt;27.5, ≥27.5 kg/m2 for Asians). Results: Across all BMI categories, DM prevalence was higher for the Asian groups than White adults. DM prevalence was also higher for Filipino and South Asian vs White than Chinese vs White, especially at healthy BMI levels. PRs for South Asian men/women at healthy BMI were 1.8/2.8 for preDM and 5.9/8.0 for DM (Figure). PRs for Filipino men/women at healthy BMI were 1.8/2.6 for preDM and 5.0/7.5 for DM, respectively. For Chinese men/women at healthy BMI, the PRs for preDM were similar (2.1/2.9) to the other Asian groups, but the PRs for DM were lower (2.1/3.4). Conclusion: The largest difference in DM prevalence relative to White adults was observed in the healthy BMI range for South Asian and Filipino adults. While PreDM risk in these 2 groups was similar to the preDM risk in Chinese compared with White adults at healthy BMI, their DM risk was 5-8 times greater than White adults at healthy BMI. Our data emphasize the disproportionate metabolic risk among middle-aged adults of different Asian groups and underscore the need for DM screening among high-risk Asian subgroups at healthy BMI levels.

RF24 | PSUN110 A Cross-Sectional Study Evaluating the Impact of Combined Hormonal Contraceptives on Components of Energy Balance in Pre-Menopausal Women with Overweight or Obesity

Abstract Background Combined estrogen and progestin hormonal contraceptives (CHCs, including combined oral contraceptives, hormonal patches, or vaginal rings) expose women to supraphysiologic levels of reproductive hormones, which in turn suppress endogenous estrogen and progesterone. Sustained elevations of synthetic estrogen/progestin or suppression of endogenous hormones in CHC users may lead to altered dietary intake and/or patterns of physical activity (PA). Previously, we reported that CHC use was associated with higher energy intake (EI) and weight regain over 1 year after weight loss in women with overweight and obesity enrolled in a behavioral weight loss program, suggesting a potential impact of CHCs on energy balance in the weight reduced state. The aim of this secondary data analysis was to compare dietary intake and PA in weight-stable women with overweight or obesity using CHCs to non-CHC users. Methods Pre-menopausal women with overweight or obesity (n=269, age 18-55 years, BMI 27-45kg/m2) enrolled in 3 different interventional weight loss trials were categorized as CHC users (CHC, n=48) or non-CHC controls (CON, n=221). Fat mass (FM) and lean mass (LM) were measured with DXA. Self-reported dietary energy and macronutrient intake was obtained from either 3-day (n=178) or 7-day (n=91) written diet diaries and analyzed using Nutrition Data System for Research (NDSR) software. Healthy eating index (HEI) scores for diet quality were calculated in a subset (CHC=17, CON=84) of participants using variables available in NDSR output files. Additionally, average daily step counts were measured over 1 week in a subset (CHC=27, CON=143) of participants using the activPAL device. Results Age was lower in CHC users (mean±SD; CHC 35.3±9.0 vs. CON 39.4±7.6 years, p&amp;lt;0.01), but race and ethnicity did not differ between the two groups. After controlling for age, there were no significant differences between groups in baseline BMI (mean±SEM; CHC 34.3±0.7 vs. CON 34.8±0.3 kg/m2), weight (93.6±2.4 vs. 94.2±1.1 kg), %FM (43.3±0.6 vs. 42.7±0.3%), or %LM (54.3±0.6 vs. 54.7±0.3%). There were no significant differences between groups in EI (mean±SEM; CHC 1763.7±78.1 vs. CON 1768.8±36.7 kcal); proportions of fat (36.7±0.9 vs. 36.9±0.4%), carbohydrate (43.9±1.1 vs. 44.3±0.5%), and protein intake (17.7±0.6 vs. 17.3±0.3%); or HEI scores (58.3±2.9 vs. 56.8±1.3). There was a trend for lower daily step count in CHC users (mean±SEM; CHC 5978±460 vs. CON 6913±197 steps/day, p=0.07). Conclusion Daily steps tended to be lower in CHC users compared to controls, while differences in self-reported dietary intake were not observed. Future studies that are done in larger samples over a greater range of BMI and with more detailed measures of PA timed to the menstrual cycle are needed to explore the extent to which CHC use may impact energy balance in women. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 1:06 p.m. - 1:11 p.m.

The pattern of TSH and fT4 levels across different BMI ranges in a large cohort of euthyroid patients with obesity.

PurposeA multifold association relates the hypothalamo-pituitary-thyroid axis to body weight. The potential underlying mechanisms are incompletely understood. Further, the mild severity of obesity and the small proportion of individuals with obesity in so far published cohort studies provide little insights on metabolic correlates of thyroid function in obesity.MethodsWe retrospectively enrolled 5009 adults with obesity (F/M, 3448/1561; age range, 18-87 years; BMI range, 30.0-82.7 kg/m2), without known thyroid disease in a study on TSH and fT4 levels, lipid profile, glucose homeostasis and insulin resistance, anthropometric parameters including BIA-derived fat mass (%FM) and fat-free mass (FFM).ResultsThe overall reference interval for TSH in our obese cohort was 0.58-5.07 mIU/L. As subgroups, females and non-smokers showed higher TSH levels as compared to their counterparts (p<0.0001 for both), while fT4 values were comparable between groups. There was a significant upward trend for TSH levels across incremental BMI classes in females, while the opposite trend was seen for fT4 levels in males (p<0.0001 for both). Expectedly, TSH was associated with %FM and FFM (p<0,0001 for both). TSH and fT4 showed correlations with several metabolic variables, and both declined with aging (TSH, p<0.0001; fT4, p<0.01). In a subgroup undergoing leptin measurement, leptin levels were positively associated with TSH levels (p<0.01). At the multivariable regression analysis, in the group as a whole, smoking habit emerged as the main independent predictor of TSH (β=-0.24, p<0.0001) and fT4 (β=-0.25, p<0.0001) levels. In non-smokers, %FM (β=0.08, p<0.0001) and age (β=-0.05, p<0.001) were the main significant predictors of TSH levels. In the subset of nonsmokers having leptin measured, leptin emerged as the strongest predictor of TSH levels (β=0.17, p<0.01).ConclusionsOur study provides evidence of a gender- and smoking-dependent regulation of TSH levels in obesity.

Gestational Outcomes and Birth Weight in Japanese Women at the Upper and Lower limits of the Normal BMI range.

To examine the outcome of gestational blood pressure and birth weight in women with normal pre-pregnancy BMI (18.5-25 kg/m2) who are at the lower and upper limits of this range, i.e., slightly underweight or slightly overweight. Overall, 2,038 Japanese women with low -risk who had delivered during January 2014-December 2016 were classified according to their pre-pregnancy BMI: underweight (< 18.5 kg/m2), slightly underweight (18.5≤BMI<21 kg/m2), normal (21≤BMI<23 kg/m2), slightly overweight (23≤BMI<25 kg/m2) and overweight (≤ 25 kg/m2). Their blood pressure during each trimester and birth weight was evaluated. The slightly overweight group showed a significantly higher blood pressure than the underweight and slightly underweight groups. Birth weight was lower in the slightly underweight than in the slightly overweight group (p<0.01). The incidence rate of "heavy for dates" (HFD) infants was significantly higher in the slightly overweight and overweight groups than in the other groups (p<0.05 and p<0.01, respectively). Weight gain of < 7 kg significantly increased the rate of "light for dates" (LFD) infants, while a weight gain of ≥13 kg significantly increased the rate of HFD infants (p<0.05 and p<0.01, respectively). Blood pressure during pregnancy was ssociated with pre-pregnancy BMI. The birth weight of infants of low-risk pregnant women is affected by both pre-pregnancy BMI and gestational weight gain.

Tension-Free Vaginal Tape and Polyacrylamide Hydrogel Injection for Primary Stress Urinary Incontinence: 3-Year Followup from a Randomized Clinical Trial.

We sought to determine whether polyacrylamide hydrogel (PAHG) is noninferior to tension-free vaginal tape (TVT) in the treatment of women with primary stress urinary incontinence (SUI). In this noninferiority trial, 223 women eligible for operative SUI treatment were randomized for TVT (110) or PAHG (113). Primary outcome was patient satisfaction and the noninferiority margin for the difference was 20%. Secondary outcomes were effectiveness and complications. At 3 years, 188 (84.3%) women attended the followup. The satisfaction score (visual analogue scale 0-100) median was 98.5 (IQR 90-100) in the TVT group and 90.0 (IQR 70-100) in the PAHG group, whereas a score ≥80 was reached in 87 (94.6%) and 65 (67.7%), respectively (difference 26.9%, 95% CI 16.7% to 36.8%). Thus, PAHG did not meet the noninferiority criteria set in our study. The cough stress test was negative in 88 (95.7%) of TVT patients vs 75 (78.1%) of PAHG patients (difference 17.5%, 95% CI 8.6% to 26.9%). Any peri- or postoperative complication before crossover between the groups was detected in 40 (43.5%) women in the TVT group and 23 (24.0%) women in the PAHG group (difference 19.5%, 95% CI 6.8% to 31.4%). In midterm followup, PAHG did not reach in patient satisfaction the noninferiority set in our study. Furthermore, mid urethral TVT slings show better subjective and objective cure rates than PAHG. However, complications were more often associated with TVT. Since the majority of PAHG treated women were also cured or improved, primary SUI women can be offered PAHG as a safe and durable alternative treatment.

205. Malnutrition increases risk of complications following posterior lumbar fusion independent of body mass index

205. Malnutrition increases risk of complications following posterior lumbar fusion independent of body mass index

SP8.2.7 Is “Hot” Laparoscopic Cholecystectomy in patients with high BMI a safe option? - Outcomes of Emergency Laparoscopic Cholecystectomy in obese vs non-obese patients

Abstract Aim NICE guidelines currently recommend offering patients presenting with acute cholecystitis a laparoscopic cholecystectomy within 1 week of diagnosis. We compared peri-operative outcomes for patients undergoing emergency laparoscopic cholecystectomy with a BMI of &amp;lt;30 kg/m2 (Group 1) and ≥30 kg/m2 (Group 2). Methods A retrospective review of patients undergoing an emergency laparoscopic cholecystectomy at a District General Hospital between January 2018 and November 2020. Results 159 patients were included. Group 1 had 97 patients (BMI range 18.8–29.9 kg/m2, age range 27–82 years, 56 females: 41 males). Group 2 had 62 patients (BMI range 30–56.3 kg/m2, age range 19–88 years, 38 females: 24 males). ASA breakdown was 1(25.8%), 2(64.9%) and 3(9.3%) for Group 1 and 2(71%) and 3(29%) for Group 2. Indications for surgery included biliary colic, acute cholecystitis and gallstone pancreatitis. Operating surgeons had training in both Upper GI and Bariatric surgery. There were no significant differences between Group 1 and Group 2 for anaesthetic time (minutes, 32.74 vs 32.50 p=0.91), operative time (minutes, 95.82 vs 93.67 p=0.75), total length of stay (days, 6.15 vs 5.17 p=0.30) or readmission rate within 30 days (22.68% vs 19.35% p=0.62). 4 patients in each group had acute complications during the index admission. Conclusion Emergency laparoscopic cholecystectomy for patients with a BMI ≥30 kg/m2 has similar peri-operative outcomes when compared to patients with a BMI &amp;lt;30 kg/ m2 and is safe to be performed in a District General Hospital by operating surgeons with an interest in Upper GI and Bariatric surgery.

CMDB: the comprehensive population genome variation database of China.

A high-quality genome variation database derived from a large-scale population is one of the most important infrastructures for genomics, clinical and translational medicine research. Here, we developed the Chinese Millionome Database (CMDB), a database that contains 9.04 million single nucleotide variants (SNV) with allele frequency information derived from low-coverage (0.06×-0.1×) whole-genome sequencing (WGS) data of 141 431 unrelated healthy Chinese individuals. These individuals were recruited from 31 out of the 34 administrative divisions in China, covering Han and 36 other ethnic minorities. CMDB, housing the WGS data of a multi-ethnic Chinese population featuring wide geographical distribution, has become the most representative and comprehensive Chinese population genome database to date. Researchers can quickly search for variant, gene or genomic regions to obtain the variant information, including mutation basic information, allele frequency, genic annotation and overview of frequencies in global populations. Furthermore, the CMDB also provides information on the association of the variants with a range of phenotypes, including height, BMI, maternal age and twin pregnancy. Based on these data, researchers can conduct meta-analysis of related phenotypes. CMDB is freely available at https://db.cngb.org/cmdb/.

Household food security determinants and nutritional status of inhabitants of a peri-urban community: A case study in the Volta region of Ghana

Food shortages and malnutrition widely persist and continue to be rural peculiarities across the sub-region. A cross-sectional study was conducted in a peri-urban community of Dzodze in the Volta region to ascertain the level of food security as well as the nutritional status of the inhabitants using a random sampling technique. This community-based comparative cross-sectional study conducted from May to July 2018 adopted a multistage random sampling and selected 105 households. Socio-demographic data were collected using a structured questionnaire. Chi-square, Cramer’s-V, and Pearson’s correlations models were used to assess the association of socio-demographic, anthropometric and food frequency data while the Logit model, FSI, HCR were used to measure food security. Over half of the sample (59.6%) were in the normal range of BMI which implied good nutritional status. Remarkably, a majority of those in this normal BMI range 81 (77%) were female. Women aged 41years and above constituted a large portion of study participants (54.3%) of which many 43 (41%) were married. Just 4.8% of this group said they were both separated and cohabited with their partners non-customarily. Data on the frequency of food intake by the community revealed that, a majority of 63.4% of the respondents ate three times a day. Most of the people (77.2%, 68.7%, and 86.9%) ate breakfast, lunch, and supper, respectively, daily over a week. The fallouts from the work showed majority (71.5%) of the respondents were food secure and the remaining (about 28.5%) were food insecure. Factors such as age, gender, educational level, household size, and age were found to be significant predictors that influenced food security of the peri-urban community according to the logit model used. The smallholder households according to the computed food security index of 1.13 and normal range of BMI were identified to be indices of food security. Key words: Household food security, peri-urban community, Ghana, Volta Region, Nutritional status

Can the WHO ‘s recommendations of physical activity volume decrease the risk of heart disease in middle and older aged Chinese People: the evidence from a seven year longitudinal survey

BackgroundAt present, there is a lack of direct evidence to confirm whether the recommendations of the World Health Organization can play a role in fitness and disease prevention in the Chinese population. Therefore, we aimed to analyse 7-year longitudinal survey data to explore whether the physical activity volume recommended by the World Health Organization can help Chinese middle-aged and elderly people reduce the risk of heart disease.MethodsData for the 8327 participants who were finally included in this study were derived from the 7-year data of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. The physical activity volume is expressed by the product of physical frequency and duration, and heart disease is screened according to self-reported diagnosis and related treatment. The relationship between different physical activity volume groups and the incidence rate of heart disease was determined by a multivariate Cox proportional hazards regression model.ResultsAfter adjusting for all covariates, participants meeting the WHO’s recommendations had a 20% lower risk of heart disease than those who did not meet the WHO’s recommendations (HR = 0.80, 95% = 0.68–0.96). Subgroup analysis showed that among the participants meeting the WHO’s recommendations, men (HR = 0.71) had a lower risk of heart disease than women (HR = 0.74); in addition, the risk of heart disease was significantly reduced in participants who were middle-aged (26%), had a normal BMI range (49%), did not have hypertension (24%), did not have hyperlipidaemia (21%) and did not have lung disease (21%). It should be noted that the risk of heart disease was reduced by 72 and 67% in participants with untreated hyperlipidaemia and untreated lung disease, respectively.ConclusionsThis study revealed that meeting the WHO’s recommendations for physical activity volume can reduce the risk of heart disease in middle-aged and older people in China and can also effectively prevent heart disease for people with some common chronic diseases, such as hyperlipidaemia and lung disease. The results showed that physical activity for leisure and exercise had a lower preventive effect on heart disease than physical activity for a job, which may be related to the inappropriate leisure and exercise methods of the participants.Trial registrationIRB00001052–11015.

Impact of Aerobic Exercise and Yoga Asanas along with Diet Supplements on Haemoglobin Level among Female Collegiate

Haemoglobin is a conjugate iron containing protein molecule in red blood cells that carries oxygen from the lungs to the body tissues and returns carbon dioxide from the tissues back to the lungs during all body functions. In India, anaemia is a widespread condition, due to lack of haemoglobin in children, non-pregnant women, and pregnant women. Anaemia increases the risk of death during pregnancy and leads to fatigue, poor motor and mental performance in adolescent girls. Recent literature also suggests an independent association of chronic anaemia with increased mortality in a variety of conditions including chronic kidney disease, heart failure, acute coronary syndromes and acute stroke. Hence, it is necessary to prevent the occurrence and progression of anaemia from mild to a severe form in young girls. Although the current medical management is effective in improving the Hb level, researches have found few adverse effects due to the high dose usage of such medications. Thus, this study intended to investigate the effects of aerobic exercise versus yoga along with diet supplement on the haemoglobin level. 20 female collegiate between 17 to 22 years with a BMI range of 20-25 kg/m2 and haemoglobin level from 8 to 11.5g/dl participated in this study. 10 subjects in Group A performed moderate intensity aerobic exercise and 10 subjects in Group B performed yoga asanas for 1 hour in the morning for 2 months after taking 5 grams jaggery and raisins. The result of this study suggested that both aerobic activity and yoga asanas along with raisins and jaggery helped to speed up the Hb synthesis and reduce mental and physical fatigue.

Contraindications to magnetically controlled growing rods: consensus among experts in treating early onset scoliosis.

The purpose of this study was to describe contraindications to the magnetically controlled growing rod (MCGR) in patients with early onset scoliosis (EOS) by establishing consensus amongst expert surgeons who treat these patients frequently. Nine pediatric spine surgeons from an international EOS study group participated in semi-structured interviews via email to identify factors that influence decision making in the use of MCGR. A 39-question survey was then developed to specify these factors as contraindications for MCGR-these included patient age and size, etiology, medical comorbidities, coronal and sagittal curve profiles, and skin and soft tissue characteristics. Pediatric spine surgeons from the EOS international study group were invited to complete the survey. A second 29-item survey was created to determine details and clarify results from the first survey. Responses were analyzed for consensus (> 70%), near consensus (60-69%), and no consensus/variability (< 60%) for MCGR contraindication. 56 surgeons of 173 invited (32%) completed the first survey, and 64 (37%) completed the second survey. Responders had a mean of over 15years in practice (range 1-45) with over 6years of experience with using MCGR (range 2-12). 71.4% of respondents agreed that patient size characteristics should be considered as contraindications, including BMI (81.3%) and spinal height (84.4%), although a specific BMI range or a specific minimum spinal height were not agreed upon. Among surgeons who agreed that skin and soft tissue problems were contraindications (78.6%), insufficient soft tissue (98%) and skin (89%) to cover MCGR were specified.Among surgeons who reported curve stiffness as a contraindication (85.9%), there was agreement that this curve stiffness should be defined by clinical evaluation (78.2%) and by traction films (72.3%). Among surgeons who reported sagittal curve characteristics as contraindications, hyperkyphosis (95.3%) and sagittal curve apex above T3 (70%) were specified. Surgeons who indicated the need for repetitive MRI as a contraindication (79.7%) agreed that image quality (72.9%) and not patient safety (13.6%) was the concern. In the entire cohort, consensus was not achieved on the following factors: patient age (57.4%),medical comorbidities (46.4%), etiology (53.6%),andcoronal curve characteristics (58.9%). Surgeon consensus suggests that MCGR should be avoided in patients who have insufficient spinal height to accommodate the MCGR, have potential skin and soft tissue inadequacy, have too stiff a spinal curve, have too much kyphosis, and require repetitive MRI, particularly of the spine. Future data-driven studies using this framework are warranted to generate more specific criteria (e.g. specific degrees of kyphosis) to facilitate clinical decision making for EOS patients. Level V-expert opinion.

Poster 169: Prior Rotator Cuff Repair Is Not Associated with Worse Outcomes After Subsequent Superior Capsular Reconstruction: A Comparative Analysis

Objectives:To compare the outcomes of two patient cohorts: (1) primary SCR and (2) SCR after failed rotator cuff repair.Methods:A retrospective review was performed of all patients who had a SCR at our institution from 2015 to 2020. Data was collected for patient demographics, prior rotator cuff surgery, comorbidities, and preoperative and postoperative range of motion, strength testing, visual analog scale (VAS) pain scores, Patient-Reported Outcomes Measurement Information System (PROMIS) 10 scores, American Shoulder and Elbow Surgeons (ASES) score, Brophy-Marx shoulder activity scale, and revision surgeries. Missing data points were excluded from analysis at that time point. Comparative analysis was used to assess for differences between patients that underwent an SCR only versus SCR after rotator cuff repair.Results:Fifty-four patients met inclusion criteria, consisting of 33 SCR only patients (61 ± 10 years, BMI 30 ± 6, 79% male) and 21 SCR after rotator cuff repair patients (59 ± 8 years, BMI 32 ± 5, 95% male). In the SCR only and SCR after rotator cuff repair groups, no significant difference was observed in age, BMI, gender, comorbidities, preoperative and postoperative range of motion, strength testing, VAS pain scores, PROMIS 10 scores, ASES score, Brophy-Marx shoulder activity scale, and revision surgeries (p>0.05).Conclusions:Similar outcomes were observed in patients who underwent primary SCR versus SCR after a failed rotator cuff repair, suggesting that surgeons should attempt to repair the rotator cuff at the index surgery if possible.