Rise In Body Mass Index Research Articles

Classical risk factors of cardiovascular disease among Chinese male steel workers: a prospective cohort study for 20 years

BackgroundCardiovascular disease (CVD) constitutes a major public health problem in China and worldwide. We aimed to examine classical risk factors and their magnitudes for CVD in a Chinese cohort with over 20 years follow-up.MethodsA cohort of 5092 male steelworkers recruited from 1974 to 1980 in Beijing of China was followed up for an average of 20.84 years. Cox proportional-hazards regression model were used to evaluate the risk of developing a first CVD event in the study participants who were free of CVD at the baseline.ResultsThe multivariable-adjusted hazard ratio (HR) associated with every 20 mmHg rise in systolic blood pressure (SBP) was 1.63 in this Chinese male population, which was higher than in Caucasians. Compared to non-smokers, men who smoked not less than one-pack-a-day had a HR of 2.43 (95% confidence interval [CI], 1.75-3.38). The HR (95% CI) for every 20 mg/dl increase in total serum cholesterol (TC) and for every point rise in body mass index (BMI) was 1.13 (1.04-1.23) and 1.06 (1.02-1.09), respectively.ConclusionsOur study documents that hypertension, smoking, overweight and hypercholesterolemia are major conventional risk factors of CVD in Chinese male adults. Continued strengthening programs for prevention and intervention on these risk factors are needed to reduce the incidence of CVD in China.

Fatter and fatter: South Africa’s rise in body mass index

Fatter and fatter: South Africa’s rise in body mass index

Prediction of Perineal Trauma During Childbirth by Assessment of Striae Gravidarum Score

To explore the association between striae gravidarum (SG) and the risk for perineal trauma (PT) in childbirth. A cross-sectional study. Maternity ward in 5 university medical centers. Three hundred and eighty-five women (28.9+/-5.3 years old) who delivered vaginally. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between PT as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) obtained at the abdomen, hips, buttocks, and breast. Significantly higher TSS scores were found in women with PT compared with women without PT (3.60+/-0.39 vs. 2.31+/-0.23, p=.003). Specifically, striae scores at the breast and hips were significantly higher among women who had PT. Logistic regression analysis revealed that TSS (OR=0.079; 95% CI 1.012, 1.151; p=.021), as well as a rise in body mass index (BMI) during pregnancy (OR=1.025; 95% CI 1.001, 1.049; p=.043) are significant predictors of PT. This study demonstrates a significant relation between SG and PT. The findings suggest that SG assessment may be used in the clinical setting by midwives and nurses as a simple and noninvasive tool to better define women at risk for PT.

Genetic influences on adult body mass index followed over 29 years and their effects on late-life mobility: a study of twin sisters

Background:The rise in body mass index (BMI) during adulthood increases the risk for metabolic disorders, functional limitations and disability in old age. This twin study examined prospectively whether genetic and...

Long‐term changes and variability in diabetes risk factors prior to the development of impaired glucose homeostasis

To determine whether rate of change and variability in risk factors provides insight into the development of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or Type 2 diabetes (DM). In a nested case-control study, repeated risk factor measurements (mean number 4.3, duration 11.4 years) culminated in 59 men developing IFG (n = 37), IGT (n = 14) and/or DM (n = 11). For each case, two control subjects were matched for age and equivalence of follow-up. Rates of change and variability in diabetes risk factors prior to diagnosis were quantified by regression analysis. Changes between penultimate and diagnostic visits were also analysed. The age-related rise in body mass index (BMI) was attenuated prior to IFG compared with control subjects (+0.102 vs. +0.772 kg/m2/decade, P = 0.02). There was also some evidence for this prior to IGT and DM (IGT: -1.530 vs. +0.158 kg/m2/decade, P = 0.09; DM: -1.146 vs. +0.332 kg/m2/decade, non-significant). Prior to onset, IGT cases were distinguished by higher inflammatory marker levels, a decline in insulinogenic index and greater variability in oral glucose tolerance test (OGTT) insulin, and DM cases by lower insulin sensitivity and higher liver enzyme activities. Fasting and OGTT glucose levels changed little during the mean 8.9 years prior to onset of IFG, IGT or DM. The transition to IGT or DM was accompanied by a fall in insulin sensitivity. Except for BMI, change or variability in risk factor levels appears relatively unimportant in the development of clinically elevated glucose levels. Deterioration in glucose levels to IGT or DM occurs as a rapid, incremental increase accompanied by a decline in insulin sensitivity.

Pilot Using World Wide Web to Prevent Diabetes in Adolescents

This pilot study tested the effects of an interactive nutrition education Web site on fruit, vegetable, and fat consumption in minority adolescents genetically at risk for Type 2 diabetes. A one-group nonexperimental pretest, posttest focus group design was used. Twenty-one sixth-grade to eighth-grade junior high adolescents who were minorities volunteered to participate. Participants received 5 hours of Web-based nutrition education over 3 weeks. A significant difference in fat consumption was supported from the computerized dietary assessment. No difference was found in fruit or vegetable consumption. Comparative data indicated a rise in body mass index (BMI) percentile from 88.03 (1999) to 88.40 (2002; boys) and 88.25 (1999) to 91.2 (2002; girls). Focus group responses supported the satisfaction of adolescents in the study with the use of the Web-based intervention for nutrition education. Healthy eating interventions using Web-based nutrition education should be further investigated with adolescents.

Adolescent Drug Addiction Treatment and Weight Gain

SUMMARY Neurotransmitter release in the nucleus accumbens use has been linked to self-administration and learning following drug use. This endogenous reward system is also activated following food intake or sex. Therefore, rebound hyperphagia following abstinence may be a mechanism to replenish the release of neurotransmitters in this reward system, leading to increased weight gain and a rise in Body Mass Index during recovery from substance abuse. In this report, we examined the relationship between supervised drug abstinence and increased weight gain among adolescents at a residential substance abuse treatment center. Mean weight change over time was followed by repeated analysis of weight and body mass index. Significant weight gain and body mass index increase was observed during supervised and confirmed abstinence from drug use. Furthermore, significant interactions between tobacco use and primary substance use disorder with weight gain was demonstrated by multivariate analysis of variance.

Children grow and horses race: is the adiposity rebound a critical period for later obesity?

BackgroundThe adiposity rebound is the second rise in body mass index that occurs between 3 and 7 years. An early age at adiposity rebound is known to be a risk factor for later obesity. The aim here is to clarify the connection between the age at rebound and the corresponding pattern of body mass index change, in centile terms, so as to better understand its ability to predict later fatness.DiscussionLongitudinal changes in body mass index during adiposity rebound, measured both in original (kg/m2) and standard deviation (SD) score units, are studied in five hypothetical subjects. Two aspects of the body mass index curve, the body mass index centile and the rate of body mass index centile crossing, determine a child's age at rebound. A high centile and upward centile crossing are both associated separately with an early rebound, while a low centile and/or downward centile crossing correspond to a late rebound. Early adiposity rebound is a risk factor for later fatness because it identifies children whose body mass index centile is high and/or crossing upwards. Such children are likely to have a raised body mass index later in childhood and adulthood. This is an example of Peto's "horse racing effect". The association of centile crossing with later obesity is statistical not physiological, and it applies at all ages not just at rebound, so adiposity rebound cannot be considered a critical period for future obesity. Body mass index centile crossing is a more direct indicator of the underlying drive to fatness.SummaryAn early age at adiposity rebound predicts later fatness because it identifies children whose body mass index centile is high and/or crossing upwards. Such children are likely to have a raised body mass index later. Body mass index centile crossing is more direct than the timing of adiposity rebound for predicting later fatness.

Metformin in patients with type 2 diabetes mellitus: reconsideration of traditional contraindications

Background: The strict limiting criteria for the use of metformin in diabetes mellitus stem largely from reports, in the 1970s, of mortality and lactic acidosis associated with phenformin. Data about metformin are less clear and are based mainly on case reports. The aim of this study was to evaluate the safety of continued use of metformin in patients with contraindications to this agent. Patients: Some 393 patients with type 2 diabetes mellitus (serum creatinine 130–220 μmol/l) were studied. Among them were 266 patients with coronary heart disease (CHD), 94 with congestive heart failure (CHF), and 91 with chronic obstructive pulmonary disease (COPD), all of whom had been treated with metformin. The patients were randomized to either continue or to stop metformin and were then followed for 4 years. Results: Analysis was by intention-to-treat. The patients who stopped taking metformin showed a rise in body mass index and in hemoglobin A1c significantly greater than those who continued the drug. There were no cases of lactic acidosis. Lactic acid values did not differ in the two groups and correlated only with serum creatinine and body mass index. Microvascular diabetic complications, cardiovascular events, and cardiovascular and total mortality were identical in the two groups. Conclusions: Diabetic patients who are treated with metformin and who tolerate the drug well may continue taking it, even when mild renal impairment develops, possibly up to serum creatinine levels of 220 μmol/l. There is also no apparent reason why patients with CHD, CHF, and COPD should discontinue metformin.

Estudio prospectivo a 10 años sobre la incidencia y factores de riesgo de diabetes mellitus tipo 2

The aims of this study were to determine the incidence of diabetes mellitus type 2 and to define the associated risk factors. A 10-year prospective study was done over 584 people identified by screening of the Lejona (Vizcaya, Spain) adult population in 1985. Data on age, sex, body mass index, family history of diabetes mellitus and blood pressure were collected. Also an oral glucose tolerance test was done following the criteria recommended by the WHO. Age-adjusted cumulative incidence per year was 8 per 1,000 persons. In a multivariate logistic regression analysis, impaired glucose tolerance was the major predictor of worsening to diabetes (relative risk 4.17; 95% confidence interval 1.80-9.63). Age and sex were also statistically significant predictors (p < 0.05), and family history of diabetes was almost significant (p = 0.057). Body mass index was not an independent and significant risk factor in this study. However, the rise in body mass index was larger in those who progressed to diabetes mellitus type 2 than in those who did not. The incidence of diabetes mellitus type 2 found in Lejona was similar to that reported in other european countries. Subjects having impaired glucose tolerance as well as those with elevated blood glucose levels are at higher risk of worsening to diabetes mellitus type 2. Body mass index seems to play a precipitating role in the progression to diabetes mellitus type 2.

Increase in body fatness as a major determinant of changes in serum total cholesterol and high density lipoprotein cholesterol in young men over a 10-year period.

Serum cholesterol rises with age in most Western (and Westernized) populations. To identify causes of this rise, the authors studied 315 young Dutch men in 1976 in the district of Utrecht, The Netherlands, when they were aged 18 or 19 years, and again in various towns in the same region 10 years later, in 1986. These men formed the lower and upper quartiles of the distribution of changes in body mass index (weight (kg)/height (m)2) from 1976 to 1986 in a larger cohort of men representative of all Dutch men aged 18 or 19 years in 1976. In 10 years, mean serum total cholesterol (+/- standard deviation) had increased by 1.20 +/- 0.88 mmol/liter (46 +/- 34 mg/100 ml), and high density lipoprotein (HDL) cholesterol had decreased by 0.12 +/- 0.21 mmol/liter (4.6 +/- 8.1 mg/100 ml). The mean increase in body mass index was 2.7 +/- 2.5 kg/m2, and the mean increase in body fat percentage (assessed from skinfolds) was 3.3 +/- 4.6 g/100 g. The mean subscapular:tricipital skinfold thickness ratio--an indicator of body fat distribution--had not changed. In multiple regression analysis, the change in body mass index was the only significant (p less than 0.001) determinant of changes in serum total cholesterol; an increase of 1 kg/m2 in body mass index was associated with an increase of 0.20 mmol/liter (standard error, 0.02) in serum total cholesterol. Changes in body mass index and in smoking habits both contributed significantly toward explanation of changes in HDL cholesterol and in the HDL cholesterol:total cholesterol ratio. If smoking habits were adjusted for, HDL cholesterol decreased by 0.02 mmol/liter and the HDL cholesterol:total cholesterol ratio decreased by 0.012 (standard error, 0.001) for every 1 kg/m2 increase in body mass index. Changes in body fat distribution, as assessed by skinfold ratio, were not associated with changes in lipids. By interpolation, the authors estimated that for the full cohort of men, including the second and third quartile of body mass index changes, the mean rise in cholesterol had been 1.15 mmol/liter (44 mg/100 ml), of which 0.47 mmol/liter could be explained by the estimated rise in body mass index of 2.4 kg/m2. An increase in body fatness between ages 19 and 29 years is a powerful determinant of the rise in total cholesterol and the fall in HDL cholesterol occurring over that period of time.

Effect of anthropometrical parameters on portal vein diameter and liver size in a subset of Karachi based population

The purpose was to study the impact of anthropometrical parameters on portal vein diameter and liver size by ultrasound in a subset of Karachi population. Four hundred and fifty nine apparently healthy subjects were included in this cross sectional study. After recording weight and height of each subject, Portal vein diameter and both liver lobes were measured by gray scale ultrasonography. Students T test and ANOVA were applied for statistical analyses. With increasing age, portal vein diameter and right lobe of liver increased significantly (p value < 0.001). Increase in portal vein diameter was also observed with rise in body mass index (0.8 cm in underweight - 1.1 cm in obese subjects). Sizes of right and left liver lobes also increased with a rise in body mass index (p value < 0.001 and 0.001). Gender, however, did not have any effect on portal vein diameter and liver size. Age and body mass index are reliable parameters to consider for avoiding false positive diagnosis of hepatomegaly and portal hypertension. Knowing the right and left liver size with respect to anthropometrical measurements also assist a clinician in selecting a subject for liver transplantation.