Self-reported Body Mass Index Research Articles

Sociodemographic predictors of the association between self-reported sleep duration and depression

Abstract Background This cross-sectional study is apart from one of the first and largest population-based prospective cohort studies in the UAE called the United Arab Emirates Healthy Future Study (UAEHFS). The aim of this study is to investigate the association between self-perceived sleep duration and self-perceived depression after adjustment for sociodemographic factors. Baseline line data from UAEHFS cohort participants were included in this cross-sectional study. Univariable and multivariable logistic regression models were fitted, with the binarized self-reported sleep hours as an outcome. The predictors were the self-reported PHQ-8, sociodemographic factors, and body mass index (BMI). Odds ratios with 95% confidence intervals (CI) were reported. Results Of 11,455 participants, 4,295 (37.5%) were included in the complete case analysis after omitting missing values. We applied a complete case analysis following omitting missing values. Participants’ median age was 32.0 years (Interquartile-Range: 24.0, 39.0). In total, 63.6% of the participants reported sleep duration of more than 7 hours. Statistically significant negative association was observed between the total PHQ-8 score and binarized self-reported sleep, OR = 0.961 (95% CI: 0.948, 0.974). For one unit increase in age and BMI, the odds ratio of reporting shorter sleep with OR of 0.979 (95% CI: 0.969, 0.990) and 0.987 (95% CI: 0.977, 0.998) respectively. Conclusions The study findings indicate a correlation between higher total PHQ-8 scores and an increased probability of individuals reporting shorter self-perceived sleep durations when considering some sociodemographic factors such as age, marital status and employment status. However, there was no difference between females and males in reporting self-perceived sleep duration among depressed individuals. Key messages • There is a correlation between higher total PHQ-8 scores and an increased probability of individuals reporting shorter self-perceived sleep durations. • Our results can help contribute to the knowledge based on current and potential population mental health in the UAE and Gulf Region.

Investigating the mediating role of physical activity within the association between food insecurity and BMI

Food insecurity is linked with obesity and while the mechanisms behind this association are complex, lower levels of leisure-time physical activity in those with food insecurity may contribute to this. Individual-level factors (such as concerns of performing physical activity) may partly determine levels of physical activity within individuals with food insecurity, as such individuals may seek to minimise their levels of physical activity in order to preserve energy. Using the Food Insecurity Physical Activity Concerns Scale (FIPACS) (used to measure concerns of performing leisure-time physical activity, focusing on factors specific to food insecurity), the current study investigated whether the association between household food insecurity and body mass index (BMI) is explained by a mediation pathway of FIPACS scores and leisure-time physical activity. We also investigated whether the association between food insecurity and FIPACS scores is moderated by nutrition knowledge. Participants (N = 329, food insecure = 55) completed an online survey consisting of the FIPACS, the International Physical Activity Questionnaire long-form (IPAQ), the Diet, Disease, and Weight management sub-section of the General Nutrition Knowledge Questionnaire, a measure of diet quality, and self-reported BMI. Findings revealed that FIPACS scores and leisure-time physical activity did not mediate the association between food insecurity and BMI (b < .01, SE = 0.01). Additionally, nutrition knowledge did not moderate the association between food insecurity and FIPACS scores (b = -0.09, SE = 0.08). Findings suggest that concerns of performing physical activity in the context of food insecurity are unrelated to leisure-time physical activity, and that these two factors do not explain the association between food insecurity and BMI. Future research should investigate other factors in the link between food insecurity, physical activity, and BMI.

The intergenerational metabolic-cardiovascular life course: maternal body mass index (BMI), offspring BMI, and blood pressure of adolescents born extremely preterm.

The aim of this study was to evaluate associations between pre-pregnancy maternal obesity and adolescent blood pressures (BPs) among children born extremely preterm. This longitudinal observational cohort study included participants in the multicenter Extremely Low Gestational Age Newborn (ELGAN) study, born before 28weeks of gestation, recruited at birth between 2002 and 2004, and followed prospectively through late adolescence. Between 2015 and 2022, three oscillometric BPs were obtained from participants (mean age 17.8years). We used linear regression modeling to evaluate the association between maternal self-reported pre-pregnancy body mass index (BMI) and offspring adolescent systolic BP (SBP). In secondary analyses, we evaluated the association between maternal pre-pregnancy and offspring preadolescent (10-year-old) BMI and between offspring preadolescent BMI and adolescent SBP. The 100 (24%) participants born to a mother with a history of pre-pregnancy obesity (BMI ≥ 30) had a greater mean SBP of 120.5 (± 14.3) mmHg compared to the 324 (76%) of adolescents born to mothers without pre-pregnancy obesity (SBP 115.6 (± 12.0) mmHg). Pre-pregnancy obesity was associated with higher offspring BMI (aβ 10.8, 95% CI 2.3, 19.2), and higher offspring BMI was associated with higher adolescent SBP (aβ 0.12, 95% CI 0.09,0.16). For ELGANs, higher maternal pre-pregnancy BMI was associated with higher adolescent SBP. Findings from secondary analyses suggest potential mediation through preadolescent BMI. Future research directions include multi-level interventions to reduce maternal pre-pregnancy obesity, followed by offspring obesity prevention interventions as a way of reducing intergenerational cardiovascular disease in high-risk infants born extremely preterm.

'My words would have more weight': exploring weight stigma in UK dietetic practice and dietitian's lived experiences of weight stigma.

Weight stigma is pervasive within healthcare and negatively impacts both access to care and the patient-practitioner relationship. There is limited evidence on weight stigma among registered dietitians, particularly in the United Kingdom, though data show weight-related prejudice towards people living with obesity. The aim of this study was to examine both explicit and implicit weight stigma in practicing dietitians in the United Kingdom, as well as the lived experience of weight stigma among dietitians, both towards themselves and towards others. An online cross-sectional survey was disseminated between February and May 2022 using snowball sampling. Inclusion criteria were that participants were UK registered dietitians aged 20-70 years. Four hundred and two dietitians responded to the survey (female [94.1%], mean age 40.2 years [standard deviation (SD) 10.7]; White ethnicity [90%]; median 12 years [interquartile range (IQR) 6, 22] within dietetic practice). Mean self-reported body mass index was 25.1 kg/m² (SD 8.7). Most dietitians reported experiencing weight stigma prior to (51%) and postregistration (59.7%), whereas nearly a quarter (21.1%) felt that weight influenced their ability as a dietitian. Weight stigma was experienced across the weight spectrum. Overall participants reported explicit weight bias attitudes, moderate beliefs that obesity is controllable and implicit antifat bias. Within open-ended responses, dietitians reported three key themes related to their personal experiences of weight stigma: (1) experiences of stigma in dietetic practice, (2) impact of weight stigma and (3) perception of weight, appearance and job. This study shows that UK dietitians exhibit both explicit and implicit weight bias towards people living with obesity. Dietitians reported experiencing weight stigma, which impacted their career-related decisions and their perception of their own ability to perform as dietitians. The study highlights the need to address weight stigma and its implications within the dietetic profession.

A cross-sectional analysis between physical activity levels, weight status and empathy-related behaviors in a sample of Tuscany primary school children.

The present study aimed to investigate the relationship between physical activity (PA) and the development of relational empathy skills in children, taking into account weight status. Parents/guardians of primary school children were involved in filling out a questionnaire: the Empathy Questionnaire (EmQue-I13) and children were asked to complete the Physical Activity Questionnaire for Children (PAQ-C) to investigate the self-reported PA levels. The weight status was assessed using a self-reported Body Mass Index (BMI). Three hundred seventy parents or guardians of students who attended primary school (8.53±1.61 yrs) were recruited. The total score was 2.41±0.89 for PAQ-C and 41.17±6.32 for EmQue-I13. The three domains of EmQue-I13 were: contagion (8.16±2.67), attention to others' feelings (19.40±2.99) and prosocial actions (13.62±3.01). Linear regression models showed that a higher PAQ-C score was positively associated with empathy-related total score P<0.000. Weight status, age and gender were not associated with EmQue-I13. Our results underline the positive association between physical activity and the development of relational empathic skills.

Maternal Body Mass Index Associates with Prenatal Characteristics and Fecal Microbial Communities.

The maternal microbiome plays a vital role in shaping pregnancy outcomes, but there remains a substantial gap in understanding its precise relationships to maternal health, particularly in relation to potential effects of body mass index (BMI) on gut microbial diversity. The aim of this observational study was to assess maternal characteristics in association with pre-pregnancy BMI and to further assess microbial diversity in association with specific maternal characteristics. Eighty-four pregnant women were recruited during their third trimester of pregnancy from various prenatal clinics across the state of Michigan. The participants completed an enrollment questionnaire including self-reported pre-pregnancy BMI; stool samples were collected to assess the fecal microbial community composition. Pre-pregnancy obesity (BMI 30+) was associated (univariably) with antibiotic use before pregnancy, ever smoked, lower education level, and being unmarried. The gut microbiota alpha diversity was significantly different for pregnant women by pre-pregnancy BMI category (normal, overweight, obese). The beta diversity was unique for the gut microbiotas of pregnant women within each BMI category, by education level, and by marital status. Multivariable models revealed that pre-pregnancy BMI, maternal education, marital status, and maternal age were associated with the microbial diversity of the gut microbiota during pregnancy. These results give new insight into the relationship between a woman's microbiome during pregnancy and their prenatal health, along with an understanding of the relationships between socioeconomic factors and microbial diversity.

Impact of Previous Dietary and Exercise Education on Knowledge of Obesity and its Comorbidities: Case Study on a College Campus

Greater than 40% of the adult U.S. population is estimated to be clinically obese based on body mass index (BMI) ≥ 30 kg/m2. Obesity is associated with several debilitating comorbidities that impact both physical and mental health including cardiovascular disease, type 2 diabetes, cancer, and depression. A college community is not immune to obesity, but with a typically younger and more active population the prevalence of obesity is generally lower on campus than the neighboring area. We hypothesized that a formal education of diet and exercise would be strongly associated with reduced obesity, and moreover an increased knowledge of obesity-linked comorbidities. College students were surveyed on their educational background, obesity and associated comorbidity knowledge, as well as anthropometric information including height and weight. Correlations were analyzed to determine links between education, obesity knowledge, and BMI. We received completed surveys from 158 students with an average age of 20.5 ± 3.0 years and BMI of 24.5 ± 5.1 kg/m2. Students with formalized education in diet and exercise were more informed about current nutritional and physical activity guidelines than those students who had not received similar education. Despite this disparity, both groups of students were similarly knowledgeable about obesity and its comorbidities. Additionally, there was no difference in the self-reported BMIs between these two groups of students. Based on our survey, the prevalence of obesity was 10.8%, much lower than the national average. We conclude that a formal education in diet and exercise did not lead to differences in weight status or obesity knowledge amongst students on this college campus. This suggests that on-campus health promotion initiatives regarding obesity would be equally beneficial to all students regardless of educational background. Honors Program; Herbert H. &amp; Grace A. College of Health Professions; Offce of Graduate Studies Central Michigan University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Kids SIPsmartER reduces sugar-sweetened beverages among Appalachian middle-school students and their caregivers: a cluster randomized controlled trial

BackgroundHigh consumption of sugar-sweetened beverages (SSB) is a global health concern. Additionally, sugar-sweetened beverage (SSB) consumption is disproportionately high among adolescents and adults in rural Appalachia. The primary study objective is to determine the intervention effects of Kids SIPsmartER on students’ SSB consumption. Secondary objectives focus on caregivers’ SSB consumption and secondary student and caregiver outcomes [e.g, body mass index (BMI), quality of life (QOL)].MethodsThis Type 1 hybrid, cluster randomized controlled trial includes 12 Appalachian middle schools (6 randomized to Kids SIPsmartER and 6 to control). Kids SIPsmartER is a 6-month, 12 lesson, multi-level, school-based, behavior and health literacy program aimed at reducing SSB among 7th grade middle school students. The program also incorporates a two-way text message strategy for caregivers. In this primary prevention intervention, all 7th grade students and their caregivers from participating schools were eligible to participate, regardless of baseline SSB consumption. Validated instruments were used to assess SSB behaviors and QOL. Height and weight were objectively measured in students and self-reported by caregivers. Analyses included modified two-part models with time fixed effects that controlled for relevant demographics and included school cluster robust standard errors.ResultsOf the 526 students and 220 caregivers, mean (SD) ages were 12.7 (0.5) and 40.6 (6.7) years, respectively. Students were 55% female. Caregivers were mostly female (95%) and White (93%); 25% had a high school education or less and 33% had an annual household income less than $50,000. Regardless of SSB intake at baseline and relative to control participants, SSB significantly decreased among students [-7.2 ounces/day (95% CI = -10.7, -3.7); p < 0.001, effect size (ES) = 0.35] and caregivers [-6.3 ounces/day (95% CI = -11.3, -1.3); p = 0.014, ES = 0.33]. Among students (42%) and caregivers (28%) who consumed > 24 SSB ounces/day at baseline (i.e., high consumers), the ES increased to 0.45 and 0.95, respectively. There were no significant effects for student or caregiver QOL indicators or objectively measured student BMI; however, caregiver self-reported BMI significantly decreased in the intervention versus control schools (p = 0.001).ConclusionsKids SIPsmartER was effective at reducing SSB consumption among students and their caregivers in the rural, medically underserved Appalachian region. Importantly, SSB effects were even stronger among students and caregivers who were high consumers at baseline.Trial registrationClincialtrials.gov: NCT03740113. Registered 14 November 2018– Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03740113.

Validation of Long-term Recall of Pregnancy-related Weight in the Life-course Experiences And Pregnancy Study.

Prepregnancy body mass index (BMI) and gestational weight gain (GWG) are determinants of maternal and child health. However, many studies of these factors rely on error-prone self-reported measures. Using data from Life-course Experiences And Pregnancy (LEAP), a US-based cohort, we assessed the validity of prepregnancy BMI and GWG recalled on average 8 years postpartum against medical record data treated as alloyed gold standard ("true") values. We calculated probabilities of being classified into a self-reported prepregnancy BMI or GWG category conditional on one's true category (analogous to sensitivities and specificities) and probabilities of truly being in each prepregnancy BMI or GWG category conditional on one's self-reported category (analogous to positive and negative predictive values). There was a tendency toward under-reporting prepregnancy BMI. Self-report misclassified 32% (95% confidence interval [CI] = 19%, 48%) of those in LEAP with truly overweight and 13% (5%, 27%) with obesity into a lower BMI category. Self-report correctly predicted the truth for 72% (55%, 84%) with self-reported overweight to 100% (90%, 100%) with self-reported obesity. For GWG, both under- and over-reporting were common; self-report misclassified 32% (15%, 55%) with truly low GWG as having moderate GWG and 50% (28%, 72%) with truly high GWG as moderate or low GWG. Self-report correctly predicted the truth for 45% (25%, 67%) with self-reported high GWG to 85% (76%, 91%) with self-reported moderate GWG. Misclassification of BMI and GWG varied across maternal characteristics. Findings can be used in quantitative bias analyses to estimate bias-adjusted associations with prepregnancy BMI and GWG.

ACTION APAC: Understanding perceptions, attitudes and behaviours in obesity and its management across south and Southeast Asia.

To identify perceptions and attitudes among people with obesity (PwO) and healthcare professionals (HCPs) toward obesity and its management in nine Asia-Pacific (APAC) countries, a cross-sectional online survey was conducted among adult PwO with self-reported body mass index of ≥25 kg/m2 (≥27 kg/m2, Singapore), and HCPs involved in direct patient care. In total, 10 429 PwO and 1901 HCPs completed the survey. Most PwO (68%) and HCPs (84%) agreed that obesity is a disease; however, a significant proportion of PwO (63%) and HCPs (41%) believed weight loss was the complete responsibility of PwO and only 43% of PwO discussed weight with an HCP in the prior 5 years. Most respondents acknowledged that weight loss would be extremely beneficial to PwO's overall health (PwO 76%, HCPs 85%), although nearly half (45%) of PwO misperceived themselves as overweight or of normal weight. Obesity was perceived by PwO (58%) and HCPs (53%) to negatively impact PwO forming romantic relationships. HCPs cited PwOs' lack of interest (41%) and poor motivation (37%) to lose weight as top reasons for not discussing weight. Most PwO (65%) preferred lifestyle changes over medications to lose weight. PwO and HCPs agreed that lack of exercise and unhealthy eating habits were the major barriers to weight loss. Our data highlights a discordance between the understanding of obesity as a disease and the actual behaviour and preferred approaches to manage it among PwO and HCPs. The study addresses a need to align these gaps to deliver optimal care for PwO.

Application of a Web-based Tool for Quantitative Bias Analysis: The Example of Misclassification Due to Self-reported Body Mass Index.

We describe the use of Apisensr, a web-based application that can be used to implement quantitative bias analysis for misclassification, selection bias, and unmeasured confounding. We apply Apisensr using an example of exposure misclassification bias due to use of self-reported body mass index (BMI) to define obesity status in an analysis of the relationship between obesity and diabetes. We used publicly available data from the National Health and Nutrition Examination Survey. The analysis consisted of: (1) estimating bias parameter values (sensitivity, specificity, negative predictive value, and positive predictive value) for self-reported obesity by sex, age, and race-ethnicity compared to obesity defined by measured BMI, and (2) using Apisensr to adjust for exposure misclassification. The discrepancy between self-reported and measured obesity varied by demographic group (sensitivity range: 75%-89%; specificity range: 91%-99%). Using Apisensr for quantitative bias analysis, there was a clear pattern in the results: the relationship between obesity and diabetes was underestimated using self-report in all age, sex, and race-ethnicity categories compared to measured obesity. For example, in non-Hispanic White men aged 40-59 years, prevalence odds ratios for diabetes were 3.06 (95% confidence inerval = 1.78, 5.30) using self-reported BMI and 4.11 (95% confidence interval = 2.56, 6.75) after bias analysis adjusting for misclassification. Apisensr is an easy-to-use, web-based Shiny app designed to facilitate quantitative bias analysis. Our results also provide estimates of bias parameter values that can be used by other researchers interested in examining obesity defined by self-reported BMI.

Associations between body mass index and episodic memory for recent eating, mindful eating, and cognitive distraction: Across-sectional study.

Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre-registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self-reported BMI. The timing of data collection (April-May 2020) during the SARS-CoV-2 pandemic enabled an investigation of the impact of stay-at-home restrictions imposed on the UK population on the measures of eating behavior. An online survey was completed, including: (i) demographic data (e.g., self-reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12months and the last 7days (during the first UK COVID-19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ). A large adult sample participated (N=846; mean (SD) age=33.0 (14.3) years; mean (SD) BMI=24.6 (5.6)kg/m2). Mindful eating (MEQ-total score) was associated with a lower self-reported BMI (β=-0.12; 95% CI=-0.20, -0.04; p=0.004), whereas disinhibited eating was associated with a higher self-reported BMI (β=0.30; 95% CI=0.21, 0.38; p<0.001). In UK participants (n=520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating. These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.

Validity of self-reported weight and height among female young adults in the United Arab Emirates.

Self-reported weight and height serve as important metrics in estimating overweight and obesity prevalence within epidemiological studies, primarily due to their cost and time efficiency. However, the accuracy and reliability of these self-reported measures remain controversial, with conflicting reports emerging from different regions. This study aims to compare self-reported weight and height with measured values among young female adults in the United Arab Emirates. A cross-sectional study of 131 female university students aged 17-27 reported their weight and height on a self-administered questionnaire and on the same day had their height and weight measured. Body Mass Index (BMI) values of both self-reported and measured weight and height were calculated and categorized according to the World Health Organization's cut-off points. Overall, 87% of students had a resultant self-reported BMI value within their actual BMI category. The mean differences between self-reported and measured weight and height in the present study were -0.92 kg and 0.38 cm, respectively. Results indicated strong agreement between self-reported and direct measurements, as demonstrated by weighted Kappa statistics (kappa = 0.87). Bland & Altman plots illustrated that the majority of values fell within the limits of agreement (2 SD), with no systemic bias detected. BMI calculated from self-reported data demonstrates high sensitivity and specificity. Linear regression analyses revealed that self-reported weight (r2 = 0.973; p<0.001), height (r2 = 0.902; p<0.001), and BMI (r2 = 0.964; p<0.001) accurately predicted measured weight, height, and BMI. The study's results highlight the ability of female university students in the UAE to accurately provide self-reports of their weight and height. This finding provides further support for the utilization of self-reported data on height and weight as a valid method for collecting anthropometric information.

Consumption of in natura and ultra-processed foods in adults: an analysis of social, metabolic, and lifestyle determinants.

To assess the social, metabolic, and lifestyle determinants of consumption of fruits, vegetables, and greens (FVG) and ultra-processed food (ULT) in adults from Pernambuco. Cross-sectional and analytical study, conducted in 2015/2016. In addition to sociodemographic variables, the determinants of lifestyle were level of physical activity, alcohol consumption, tobacco use, and metabolic variables were self-reported hypertension, blood glucose, and Body Mass Index (BMI). Consumption was measured by the Food Frequency Questionnaire, then created the Frequency of Consumption Index (SFI) of the mean intake of ULT and FVG foods. The indices of FVG and ULT consumption were transformed into quartiles and these variables were included in the multinomial logistic regression, considering their determinants when p<0.05. The sample was representative of the state, with 1,067 people being interviewed, whose intake of ULT was higher than that of FVG in the lowest and highest quartile of the consumption index. Consumption of fruit and vegetables was higher in higher consumption of alcoholic beverages (p=0.031) and BMI>25 kg/m2 (p=0.047); and lower in the lowest income (p=0.001). ULT intake was higher in young adults (p=0.005), lower income (p=0.044), and controlled blood glucose (p=0.021). Rural areas were 52% less exposed to medium-high ULT consumption (p<0.006). Higher rate of ULT consumption in relation to fresh foods, with income as a common determinant, inversely associated with ULT intake and directly related to FVG, which demands structuring policies.

Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation

Maternal pre-pregnancy obesity and excessive gestational weight gain (EGWG) may predispose children to behavioral problems through increased prenatal inflammation. We investigated the association between maternal body mass index (BMI) and gestational weight gain (GWG), and child behavioral problems (primary aim), and the mediating role of prenatal inflammation (secondary aim). We used self-reported pre-pregnancy BMI and estimated-GWG data (N=1137) from a longitudinal cohort study. Maternal serum C-reactive protein (CRP) was measured in the 3rd-trimester. Parent-reported Child Behavior Checklist (CBCL) was used to assess child internalizing and externalizing behaviors at 3-years-of-age. We used analysis of covariance (ANCOVA), multiple linear regression, and mediation analyses for data analysis. Maternal obesity (F=21.98, df 3836), EGWG (F=6.53, df 2764), and their combination (F=18.51, df 3764) were associated with the 3rd trimester CRP, but not child behavior in the whole sample. Maternal underweight was associated with withdrawal problems in all children (β=0.56, 95%CI, 0.11,1.00) and aggressive behaviors in female children (β=2.59, 95%CI, 0.28,4.91). Obesity had a significant association with externalizing behaviors in female children after controlling for maternal CRP (β=3.72, 95%CI, 0.12,7.32). Both inadequate and EGWG were associated with somatic complaints in male children (β=0.50, 95%CI, 0.05,0.95; β=0.36, 95%CI, 0.01,0.71, respectively). Combined obesity/EGWG was associated with externalizing (β=6.12, 95%CI, 0.53,11.70) and aggressive (β=4.23, 95%CI, 0.90,7.56) behaviors in female children. We found no significant effects through CRP. Maternal pre-pregnancy BMI and GWG showed sex-specific associations with child behavioral problems. Prenatal CRP, although increased in obesity and EGWG, did not mediate these associations.

Results of longitudinal Nutri-D study: factors influencing winter and summer vitamin D status in a Caucasian population.

Inadequate vitamin D status is a worldwide public health issue. In humans, vitamin D status is affected by diet, and even more by exposure to ultraviolet B (UVB) light and consequential endogenous synthesis. Various personal and environmental factors influence endogenous synthesis. Factors affecting vitamin D status were investigated in a prospective longitudinal cohort study with a summer and winter observation period. The final sample included 292 adults, of those 111 (38%) males and 181 (62%) females, with a mean age of 38.2 (±11.8) years from Slovenia who were not supplementing vitamin D. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured in both periods; vitamin D intake, self-reported body mass index (BMI), and protective behaviors against sun were also recorded. Other measured parameters included measurements of constitutive skin color using the objective individual typology angle (ITA), and difference in the melanin index (ΔMI) for assessment of objective sun exposure. In winter a high prevalence (63.4%) of insufficient vitamin D status (< 50 nmoL/L) was observed with higher odds ratios (OR) for insufficiency in those with a higher BMI and light ITA. During summer, insufficiency prevalence was low (5.5%), but half of the participants (50.0%) had suboptimal 25(OH)D concentration (< 75 nmol/L). In summer OR for suboptimal status were higher in those with obesity, lower ΔMI, light ITA, low vitamin D intake, and protective clothing behaviors. Using a series of measures, we showed that vitamin D status is hugely affected by several personal factors such as BMI, ITA, vitamin D intake, ΔMI, and protective behavior against the sun. This conclusion questions the usefulness of generalized population-level recommendations since personal factors are a major predictor of vitamin D status.

Physical Activity and Life Stress Are Associated With Illness Intrusiveness in Persons With Multiple Sclerosis

ObjectivesTo explore which modifiable lifestyle behaviors contribute to illness intrusiveness in persons with multiple sclerosis (MS). DesignCohort study. SettingCommunity-based comprehensive MS center. ParticipantsAdults with MS (N=154) who completed an online battery of self-report questionnaires. InterventionsNot applicable. Main Outcome MeasuresIllness intrusiveness was measured with the 13-item Illness Intrusiveness Ratings Scale. Lifestyle behaviors were measured using the respective components of the Simple Lifestyle Indicator Questionnaire (ie, Diet, Physical Activity, Alcohol, Smoking, and Life Stress) and self-reported body mass index (BMI). ResultsAfter controlling for age, race, sex, disease duration, and level of physical disability (“disability”), life stress was associated with greater illness intrusiveness (b=4.65, P<.001), and physical activity was associated with less illness intrusiveness (b=-0.67, P=.009). Exploratory mediation analyses revealed physical activity had an indirect effect on illness intrusiveness through disability (b=-0.39, 95% CI: -0.68, -0.16). Conversely, disability also displayed an indirect effect on illness intrusiveness through physical activity (b=0.57, 95% CI: 0.12, 1.16). ConclusionsLife stress and physical activity are 2 modifiable lifestyle behaviors that contribute to illness intrusiveness, with the latter also having an indirect effect through disability. These findings may help inform future behavioral interventions for improving health-related quality of life in persons with MS.

Burden and predictors of diabetic kidney disease in an adult Ugandan population with new-onset diabetes

BackgroundDespite the growing evidence of diabetic kidney disease (DKD) in adult patients with long-standing diabetes in sub-Saharan Africa, data on its burden and correlates in adult African patients with new-onset diabetes are limited. We, therefore, undertook this study to determine the burden and predictors of DKD in an adult population with new-onset diabetes in Uganda.MethodsWe collected data on the relevant sociodemographic, clinical, anthropometric, and metabolic characteristics in 519 participants with newly diagnosed diabetes recruited from seven tertiary hospitals. A spot mid-stream urine sample was collected for determination of the urine albumin creatinine ratio (UACR) using Clinitek® microalbumin strips and a point-of-care Clinitek® status analyser. The estimated glomerular filtration rate (e-GFR) was determined using the Chronic Kidney Disease Epidemiology formula. The presence of DKD was defined as a spot UACR ≥ 3 mg/mmol with or without an e-GFR < 60 ml/min/1.73m2.ResultsThe median (IQR) age, UACR, and e-GFR of the participants were 48 years (39–57), 2.27 mg/mmol (1.14–3.41), and 121.8 ml/min/1.73m2 (105.4-133.9). UACR ≥ 3 mg/mmol and e-GFR < 60 ml/min/1.73m2 was noted in 175 (33.7%) and 7 (1.4%) participants, respectively. DKD was documented in 175 participants (33.7%). Compared with those without DKD, participants with DKD were more likely to be ≥ 50 years of age (53.7% vs. 43%, p = 0.02) and to have co-existing hypertension at the time of diagnosis (40.6% vs. 30.1%, p = 0.02). On multivariate analysis, self-reported hypertension comorbidity (OR 1.76 95% CI 1.24–2.48, p = 0.002) and body mass index (BMI) ≥ 30 kg/m2 (OR 0.61 95% CI 0.41–0.91, p = 0.02) were noted to independently predict DKD.ConclusionIn this study population, DKD was relatively common and was independently associated with self-reported hypertension comorbidity and BMI ≥ 30 kg/m2.

Self-reported and measured anthropometric variables in association with cardiometabolic markers: A Danish cohort study.

General obesity is a recognized risk factor for various metabolically related diseases, including hypertension, dyslipidemia, and pre-diabetes. In epidemiological studies, anthropometric variables such as height and weight are often self-reported. However, misreporting of self-reported data may bias estimates of associations between anthropometry and health outcomes. Further, few validation studies have compared self-reported and measured waist circumference (WC). This study aimed to quantify the agreement between self-reported and measured height, weight, body mass index (BMI), WC, and waist-to-height ratio (WHtR), and to investigate associations of these anthropometric measures with cardiometabolic biomarkers. A total of 39,514 participants aged above 18 years were included into the Diet, Cancer, and Health-Next Generation Cohort in 2015-19. Self-reported and measured anthropometric variables, blood pressure, and cardiometabolic biomarkers (HbA1c, lipid profiles, C-reactive protein and creatinine) were collected by standard procedures. Pearson correlations (r) and Lin's concordance correlations were applied to evaluate misreporting. Misreporting by age, sex and smoking status was investigated in linear regression models. Multivariable regression models and Receiver Operating Characteristic analyses assessed associations of self-reported and measured anthropometry with cardiometabolic biomarkers. Self-reported height was overreported by 1.07 cm, and weight was underreported by 0.32 kg on average. Self-reported BMI and WC were 0.42 kg/m2 and 0.2 cm lower than measured, respectively. Self-reported and measured height, weight, BMI, WC and WtHR were strongly correlated (r = 0.98, 0.99, 0.98, 0.88, 0.86, respectively). Age, sex, smoking, and BMI contributed to misreporting of all anthropometric measures. Associations between self-reported or measured anthropometric measures and cardiometabolic biomarkers were similar in direction and strength. Concordance between self-reported and measured anthropometric measures, including WC, was very high. Self-reported anthropometric measures were reliable when estimating associations with cardiometabolic biomarkers.

Comparison of the body mass index (BMI) in physical education students, established by anthropometric, self-report and figure test techniques

The purpose of the study was to compare the BMI according to different measurement techniques and to analyze differences between age and sex of Physical Education students. Type of descriptive research with a non-experimental cross-sectional research design. 107 students from Catamarca (Argentina) participated, 67 men (62.6%) and 40 women (37.4%) between 21 and 40 years old. Body weight (self-reported and real) will be reduced, to estimate the BMI the formula will be improved: models weight (kg) / height (m2) and to determine the perception by figures, the 7 anatomical sheet of Montero will be taken. The real BMI of 24.59 kg/m2 was established, self-reported BMI of 24.25 kg/m2 and a perceived BMI by figure of 24.06 kg/m2, 88.8% of the students are of normal weight. . The results determined significant differences of p&lt;.001 in all the study variables between men and women. In the sample in general, significant differences were found between the real and self-informed height (p&lt;.001) and between the real BMI with self-reported and with that perceived by figures (p&lt;.05). The men turned out to be more effective in the perception of the figure and the women in the self-report with respect to the real BMI. Positive and significant correlations are presented between the real and self-perceived measurements in each of the variables, highlighting the real BMI with the self-reported BMI (r =915) and with the BMI perceived by figures (r =629) with significance. (p&lt; .001). It is concluded that the BMI established by the techniques of self-report and perception by figures, underestimate the BMI measured by anthropometry, being the self-report technique the most effective of them, obtaining a high connection with the real BMI and with a high predictive value of estimation of the same.