Self-reported Body Mass Index Research Articles

Recontacting biobank participants to collect lifestyle, behavioural and cognitive information via online questionnaires: lessons from a pilot study within FinnGen

ObjectivesTo recontact biobank participants and collect cognitive, behavioural and lifestyle information via a secure online platform.DesignBiobank-based recontacting pilot study.SettingThree Finnish biobanks (Helsinki, Auria, Tampere) recruiting participants from February 2021 to...

Exploring non-linear relationships between neighbourhood walkability and health: a cross-sectional study among US primary care patients with chronic conditions

BackgroundA recent study of licensed drivers found a non-linear relationship between density of non-residential destinations (NRDs), a proxy for walkability and body mass index (BMI) across a wide range of...

A heavy burden: Associations between sexual minority status, mental health, and BMI in women.

Sexual minority women (SMW) are at increased risk of elevated body mass index (BMI) compared to heterosexual women, increasing their vulnerability to chronic diseases. Nonmonosexual SMW appear to be at additional risk for elevated BMI, likely due to unique sexual minority stressors. A total of 437 SMW and heterosexual women completed a cross-sectional, online survey including self-report measures of sexual orientation dimensions, weight, psychological distress, and eating behaviors. We investigated relations among these variables to better understand disparities in self-reported BMI based on sexual orientation and sexual orientation discordance (SOD). SMW self-reported more psychological distress, more binge eating, and higher BMIs than their heterosexual peers, with nonmonosexual groups of SMW often reporting the highest values. SOD was positively associated with psychological distress. SMW-particularly nonmonosexual SMW-are at increased risk for psychological distress, binge eating, and elevated BMI relative to heterosexual peers. Future research should further elucidate mechanisms for these disparities.

Relationship Between Weight Status and Self-Image Mediated by Pubertal Timing and Athletic Competence: A Cohort Study With Taiwanese Adolescents.

BackgroundSelf-image reflects overall self-acceptance in developing adolescents. Using a representative cohort of Taiwanese youth, this study aims to explore the relationship between weight status, pubertal timing, athletic competence, and adolescent self-image.MethodsData come from the Taiwan Youth Project that comprised a longitudinal cohort of adolescents (N = 2690, 51% males, Mage = 13.3 ± 0.5 years) surveyed annually from seventh grade. Self-image was measured by perceived satisfaction with appearance and physique. Weight status was proxied by self-reported body mass index (BMI; kg/m2). Pubertal timing was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Athletic competence was assessed by experiences with participation in competitive sports and self-perceived talent for sports. Linear regression analysis was applied to test for an association between BMI and self-image. In order to test for mediating roles of pubertal timing and athletic competence, Hayes' PROCESS macro on SPSS was conducted applying 5,000 bootstrap resamples with 95% confidence intervals of the indirect effect.ResultsBMI was inversely associated with self-image in both males (β = −0.074, [−0.095, −0.053]) and females (β = −0.095, [−0.122, −0.069]). The boot-strapped 95% confidence intervals indicated statistically significant mediating effects of pubertal timing (β = −0.008, [−0.015, −0.001]) and athletic competence (β = −0.006, [−0.011, −0.002]) in the link between BMI and self–image in females, whilst only athletic competence mediated this association (β = −0.006, [−0.009, −0.002]) in males. Moreover, BMI at baseline were also associated with long-term self-image in males (β = −0.037, [−0.057, −0.017]) and females (β = 0.132, [0.073, 0.190]).ConclusionsUnderstanding the mediating factors may help enhance adolescents' self-image by providing guidance on healthy weight and physical activity behaviors according to different stages of pubertal progression.

Associations of Eating Identities With Self-Reported Dietary Behaviors and Body Mass Index.

Objective:To inform dietary interventions, it is important to understand antecedents of recommended (henceforth: healthy) dietary behaviors, beyond dietary beliefs and self-efficacy. We used the validated “Eating Identity Type Inventory” to assess the extent to which participants identified as healthy eaters, meat eaters, emotional eaters or picky eaters. We examined correlations between participants' race/ethnicity and other socio-demographic characteristics and affinity with these eating identities, how affinity with these eating identities correlated with self-reports of dietary beliefs, self-efficacy, dietary behaviors and Body Mass Index (BMI), and how well affinity with these eating identities predicted self-reported dietary behaviors and BMI, as compared to self-reported dietary beliefs and self-efficacy.MethodsIn an online survey, a diverse sample of 340 Los Angeles County adults reported eating identities, dietary beliefs, and self-efficacy, dietary behaviors and BMI.ResultsPearson correlations revealed that identifying more as a healthy eater was positively associated with self-reports of being non-Hispanic White, non-Hispanic mixed race, older, and college-educated, while identifying more as a meat eater was positively associated with self-reports of being non-Hispanic Black, younger, and male (α = 0.05). Pearson correlations also showed that healthy eaters had more accurate dietary beliefs and self-efficacy, and emotional eaters had lower self-efficacy (α = 0.05). In linear regressions, identifying more as a healthy eater was associated with self-reporting healthier dietary behaviors and lower BMI, and identifying more as a meat eater and emotional eater was associated with reporting less healthy dietary behaviors and higher BMI, even after accounting for correlations with socio-demographics, dietary beliefs, and self-efficacy (α = 0.05).ConclusionsOur findings highlight the importance of eating identities in understanding dietary behaviors and outcomes, with implications for dietary interventions.

Excess mortality estimates may be too high

For a modeling study of excess mortality associated with higher body weight in the USA, Ward et al1 used direct standardisation to measured body-mass index (BMI) as adjustment for bias in “self-reported” BMI (calculated from self-reported weight and height). This method does not reduce systematic error in self-reported BMI and changes neither the overall misclassification rate nor the variance of the differences between self-reported and measured BMI.2 It can overestimate the prevalence of the highest BMI category.

The future costs of cancer attributable to excess body weight in Brazil, 2030-2040

BackgroundExcess body weight (EBW), herein defined as body mass index (BMI) ≥25 kg/m2, is a well-known modifiable risk factor for cancer and a pivotal vector for growing healthcare costs. We estimated the future (2030) federal direct healthcare costs of cancer in the Brazilian Unified Health System (SUS) attributable to EBW. We also projected direct healthcare costs of cancer that could be potentially saved in 2040, considering counterfactual (alternative) scenarios of population-wide reductions in the BMI to be achievedin 2030.MethodsWe developed a macrosimulation model by sex using self-reported BMI data in adults ≥ 20 years who relied exclusively on the public health system from the Brazilian National Health Survey (PNS) 2019; relative risks for 12 types of cancer from the World Cancer Research Fund/American Institute Cancer Research (WCRF/AICR) meta-analysis; and nationwide registries of federal direct healthcare costs of inpatient and outpatient procedures in adults ≥30 years with cancer from 2008-2019. We calculated the attributable costs of cancer via comparative risk assessment, assuming a 10-year lag between exposure and outcome. We used the potential impact fraction (PIF) equation and the Monte Carlo simulation method to estimate the attributable costs and 95% uncertainty intervals, considering the theoretical-minimum-risk exposure and other counterfactual (alternative) scenarios of the EBW prevalence. We assessed the cancer costs attributable to EBW, multiplying PIF by the direct healthcare costs of cancer.ResultsIn 2030, 2.4% or US$ 62.8 million in direct healthcare costs of cancer may be attributable to EBW. We projected potential savings of approximately US$ 10.3 to 26.6 million in 2040 by reducing the prevalence of EBW in 2030.ConclusionsWe estimated high future costs of cancer attributable to EBW in Brazil. Our findings may support interventions and policies focused on the primary prevention of EBW and cancer.

Changes and predictors of sleep quality with a 2-year follow-up in older adults according to living arrangements

ObjectivesThis study aimed to explore changes and predictors of sleep quality with a 2-year follow-up in Chinese elderly individuals and to further present them according to living arrangements. MethodsA total of 3005 individuals were effectively surveyed at baseline and at the 2-year follow-up. Generalized estimating equation (GEE) was performed to explore associations between sleep quality and predictor variables. ResultsThe rate of poor sleep quality was 32.6% at baseline and 27.4% at follow-up. According to living arrangements, sleep quality improved among empty nesters living as a couple (P < 0.001). After adjusting for sex, age, and other influencing factors, empty nesters living alone had poorer sleep quality (OR = 1.399, 95% CI = 1.022-1.917) than nonempty nesters. Sex, age, education, self-reported health, depression, and social support were predictors of poor sleep quality for all participants. In the subgroup analyses, self-reported physical health and body mass index (BMI) were predictors of sleep quality in the nonempty-nester group, but depression was not a predictor. Depression was a predictor of sleep quality in the empty-nester group. ConclusionsSleep quality was improved in this 2-year follow-up survey. However, sleep quality problems in the elderly cannot be ignored, especially empty nesters living alone. Therefore, according to living arrangements, different intervention methods should be selected to prevent and control poor sleep quality.

Vitamin D insufficiency as a peripheral neuropathy risk factor in white and black patients in SWOG 0221.

12023 Background: Peripheral neuropathy (PN) is a treatment-limiting toxicity of paclitaxel. Black patients have higher rates of PN and vitamin D insufficiency, and our prior work suggests vitamin D insufficiency increases risk of paclitaxel-induced PN. The objective of this study was to validate that patients with vitamin D insufficiency have higher risk of paclitaxel-induced PN and investigate whether this explains racial disparities in PN risk. Methods: This retrospective validation study was conducted in the phase III SWOG 0221 (NCT00070564) trial comparing paclitaxel-containing chemotherapy regimens for early-stage breast cancer. Pre-treatment 25-hydroxy-vitamin D was quantified in cryopreserved serum. Males and patients who received less than a third of the paclitaxel treatment were excluded. The association between vitamin D insufficiency (≤20 ng/mL) and grade 3+ sensory PN was tested via logistic regression and then adjusted for self-reported race, age, paclitaxel schedule (QW vs Q2W), and body mass index. Results: Of the 1,116 female patients in the analysis, 169 (15.1%) experienced PN and 376 (33.7%) had vitamin D insufficiency. Vitamin D insufficiency was associated with higher PN risk (19.4% vs 13.0%, OR = 1.62, p = 0.005, Data Table). The association was borderline significant (OR = 1.44, p = 0.056) after adjustment for black race (OR = 2.41, p = 0.001), paclitaxel schedule (OR = 2.22, p &lt; 0.001), and age (OR = 1.03, p = 0.005). Compared with white patients (n = 943), black patients (n = 99) had more prevalent vitamin D insufficiency (77.8% vs 28.6%, OR = 8.72, p &lt; 0.001) and increased PN risk (29.3% vs 13.5%, OR = 2.66, p &lt; 0.001); adjusting for vitamin D insufficiency decreased but did not eliminate the higher PN risk in black patients (OR = 2.23, p = 0.002). Conclusions: Vitamin D insufficiency increases risk of paclitaxel-induced PN and partially explains the higher risk of PN in black patients. Prospective trials are needed to test whether vitamin D supplementation lessens PN and reduces disparities in treatment outcomes. [Table: see text]

Assessment of Weight Status, Food Security Level, and Fiber Intake Among Hispanic/Latino Adults Residing in New Hampshire

ObjectivesTo assess weight status, food security level, and dietary intake, emphasizing consumption of fiber-rich foods, among adults of Hispanic/Latino background. MethodsThis cross-sectional phone-based survey was administered in English or Spanish, and included questionnaires on weight history, dietary intake (NHANES Dietary Screener Questionnaire), and food security (USDA Household Food Security Survey Module) as experienced before and during the COVID-19 pandemic. Eligible participants were New Hampshire adult residents who identified as Hispanic/Latino. Responses were scored using protocols by questionnaire developers. Analysis of covariance was applied to determine the relationship between weight status, food security level, and dietary intake. Age and gender were included as covariates. ResultsParticipants (N = 73; mean (SD) age = 44 (15) years; 84% female) were predominantly immigrants (85%) who had lived in the US for 12.1 (9.4) years or were US citizens of Puerto Rican origin (11%). Self-perception of health status noted as ‘good,’ ‘very good,’ or ‘excellent’ was reported by 81% of participants. There was a high prevalence of overweight (35%) and obesity (33%), with an average self-reported body mass index (BMI) of 28.7 (5.5) kg/m2. Weight gain during the pandemic was reported by 44% of participants, particularly those with obesity (67%), while weight status was perceived to be in the healthy range by 49% of participants. Perceived weight status and BMI category matched for 48% of subjects with overweight and 88% for subjects with obesity. Estimated daily consumption of dietary fiber was lower (15 (2.4) g/d) than recommended levels (22–34 g/d) but was not correlated with food security level or BMI. On average, men consumed more fiber (18.7 vs. 14.7 g/d, p < .0001) and vegetables (1.8 vs. 1.5 cup equivalents/d, p < .0001) than women. Low and very low food security increased from 25% pre-pandemic to 27% during the pandemic, while marginal food security increased from 10% to 16%. ConclusionsThe exacerbation of food insecurity during the pandemic, along with a high burden of overweight/obesity, low awareness of overweight status, and low fiber intake among NH Hispanics warrant the development of interventions to enhance nutrition security and weight management in this population. Funding SourcesUniversity of New Hampshire.

Gender Differences in the Attitudes and Management of People with Obesity in Saudi Arabia: Data from the ACTION-IO Study.

PurposeSeveral studies have investigated gender differences in various obesity-related outcomes. Females were found to have more accurate weight perception and reported more frequency of attempted weight loss. The objective of this study was to assess gender differences in the attitudes and management of people with obesity (PwO) in Saudi Arabia using data from the ACTION-IO study.Patients and MethodsA survey was conducted in Saudi Arabia in June and July 2018 on adults with obesity (based on self-reported body mass index of ≥30 kg/m2).ResultsA total of 1000 people with obesity completed the survey; 565 (56.5%) were male (mean age of 36.9 years and mean BMI of 33.5 kg/m2) and 435 (43.5%) were female (mean age of 36.3 years and mean BMI of 34.5 kg/m2). The two most reported motivations for wanting to lose weight for both groups were to improve appearance (38%) and to have more energy (35%). Females were more likely to trust their health-care provider (HCP) advice about weight management when compared to males (87% females, 82% males, p = 0.059) and were more likely to have concerns regarding long-term safety associated with prescription weight loss medications (65% female versus 59% males, p = 0.043). On the other hand, males were more likely to seek their physician to prescribe weight loss medication if they hear of a new medication (55% males versus 46% females, p = 0.014), and more to believe that there are good options available for weight loss medications (74% males versus 67% females, p = 0.040). Also, more males prefer to take weight loss medications than to have a weight loss surgery (65% males, 59% females, p = 0.054).ConclusionOverall, this study increases our understanding on the attitudes of both females and males towards the management of weight loss and opens the discussion for gender-specific weight loss interventions.

Potential Triggers for Risking the Development of Eating Disorders in Non-Clinical Higher-Education Students in Emerging Adulthood.

Nowadays, eating disorders (ED) among individuals during emerging adulthood have become a crucial challenge to public health, taking into account the fact that the global prevalence of the ED risk in student-aged populations already stands at 10.4% and has been sharply increasing during the COVID-19 pandemic. In all, from 50% to 80% of all the ED cases go undetected or are not correctly diagnosed; moreover, these individuals do not receive specialized treatment. Therefore, early diagnosis detected via screening questionnaires for ED is highly recommended. This study aimed to identify the triggers for ED risk development in emerging-adulthood individuals and to reveal the factors significant not only for ED prevention but also for assessing individuals with subthreshold symptoms. This cross-sectional study provides the results for the ED symptom screening in 1716 Lithuanian higher-education students aged 21.2 ± 3.9, during emerging adulthood. According to the results of this study, 19.2% of students were at risk for ED. Potential risk factors such as sex (odds ratio (OR): 3.1, 95% CI: 1.9–4.9), body weight (self-reported body mass index) (adjusted (A) OR: 1.4; 95% CI: 1.2–1.7) and comorbidities such as smoking (AOR: 2.1; 95% CI: 1.6–2.8), and perceived stress during the pandemic (AOR: 1.4; 95% CI: 1.1–1.8) are involved in anticipating the symptomatology of ED during emerging adulthood. Regular initial screenings with universally adopted questionnaires and further referral to a psychiatrist must be applied to promote both the diagnosis of early-onset symptomatology and the treatment of these ED in student-aged populations. Preventive programs for reducing the prevalence of overweight or obesity among students during emerging adulthood should focus on integration directions for the development of a positive body image.

The economic burden of overweight and obesity in Brazil: perspectives for the Brazilian Unified Health System

ObjectivesParallel to rising obesity prevalence in Brazil, there is expected to be increased direct health care costs related to non-communicable diseases (NCDs). In this study, we estimated the economic burden of NCDs attributable to overweight and obesity in the Brazilian Unified Health System (SUS). MethodsWe used self-reported body mass index of 85,715 adults from the 2019 Brazilian National Health Survey. Annual costs (1 US$ = 2.281 Reais) with inpatient and outpatient procedures were obtained from the Hospital and Ambulatory Information Systems of the Brazilian SUS. Relative risks for cardiovascular disease, chronic respiratory disease, neoplasm, digestive disease, musculoskeletal disorders, diabetes and kidney diseases, sense organ diseases, and neurological disorders were retrieved from the Global Burden of Disease study. ResultsAnnually, US$ 654 million (95% uncertainty interval: US$ 418.4 to US$ 893.2) direct health care costs related to NCDs were attributable to overweight and obesity. Attributable costs were higher in women than men. Cardiovascular diseases had the highest attributable costs (US$ 289 million), followed by chronic respiratory diseases (US$ 110 million), neoplasms (US$ 96 million), digestive diseases (US$ 60 million), musculoskeletal disorders (US$ 44 million), diabetes and kidney disease (US$ 31 million), sense organ diseases (US$ 22 million) and neurological disorders (US$ 11 million). ConclusionsOverweight and obesity account for US$ 654 million direct costs of NCDs annually. Effective policies to promote healthy body weight may have economic benefits.

Steady increase of obesity prevalence in Austria: Analysis of three representative cross-sectional national health interview surveys from 2006 to 2019.

BackgroundObesity is associated with adverse health consequences throughout life. Monitoring obesity trends is important to plan and implement public heath interventions adapted to specific target groups. We aimed to analyze the development of obesity prevalence in the Austrian population using data from the most recent representative Austrian Health Interview Surveys.MethodsThe three cross-sectional Austrian health interview surveys from 2006/2007, 2014 and 2019 were used (n = 45,707). Data correction for self-reported body mass index (BMI) was applied. Sex, age, education level, employment status, country of birth, urbanization, and family status were used as sociodemographic factors. Logistic regression models were applied.ResultsPrevalence of obesity increased in both sexes in the study period (men 13.7% to 20.0%, women 15.2% to 17.8%, p < 0.001). Adjusted odds ratios (95% confidence interval [CI]) for the increase in obesity prevalence was 1.47 (95% CI: 1.38–1.56). In men, obesity prevalence almost doubled from 2006/2007 to 2019 in subgroups of 15–29-year-olds (4.8% to 9.0%), unemployed (13.5% to 27.6%), men born in non-EU/non-EFTA countries (13.9% to 26.2%), and not being in a relationship (8.1% to 15.4%). In women, the largest increase was found in subgroups of 30–64-year-olds (15.8% to 18.7%), women born in non-EU/non-EFTA countries (19.9% to 22.8%) and in women living in the federal capital Vienna (16.5% to 19.9%).ConclusionObesity prevalence in the Austrian population continues to rise significantly. We identified distinct subgroups with a fast-growing obesity prevalence in recent years, emphasizing the importance of regular long-term data collection as a basis for sustainable and target group-specific action planning.

Agreement between self-reported and researcher-measured height, weight and blood pressure measurements for online prescription of the combined oral contraceptive pill: an observational study

Objective(s)To compare agreement between self-reported height, weight and blood pressure measurements submitted to an online contraceptive service with researcher-measured values and document strategies used for self-reporting.DesignAn observational study.SettingAn online sexual...

Body dissatisfaction among undergraduate medical students in the city of Juiz de Fora, Minas Gerais, Brazil.

ABSTRACTObjective To assess the level of body dissatisfaction among undergraduate medical students in the city of Juiz de Fora, Minas Gerais, Brazil.Methods A cross-sectional study with 232 volunteers of both sexes at a private college. The Body Shape Questionnaire was used, which is a tool based on the sum of values that allow classifying body dissatisfaction according to the following scores: less than 111, if absence of body dissatisfaction; between 111 and 138, if mild body dissatisfaction; between 139 and 167, if moderate body dissatisfaction, and from 168, if severe body dissatisfaction. In addition, the self-reported body mass index and an assertion were used to assess the degree and perception (insight) of body dissatisfaction. For the statistical analysis, descriptive comparison, and binary logistic regression tests were performed.Results The mean result of the Body Shape Questionnaire among women was 96.0±34.1 and among men, 76.7±24.7, with 26.3% of students with some level of dissatisfaction with self-image. Most participants (76.3%) wished to have a body mass index lower than the real one. Women (odds ratio of 5.7), overweight individuals (odds ratio of 6.1), and individuals with insight into their condition (odds ratio of 89.7) were more likely to be dissatisfied with the body image measured by the Body Shape Questionnaire.Conclusion The search for a thin body among undergraduate medical students is a reality. In addition to overweight individuals, the female population has a significant level of body distortion, being recognized as the highest rate of body dissatisfaction in the sample surveyed.

Self-Weighing Behaviors of Diverse Community-Dwelling Adults Motivated for a Lifestyle Change.

: BackgroundWe aimed to understand adults’ self-weighing behaviors and explore significant predictors of body mass index (BMI) accuracy based on self-reported height and weight in a diverse sample of community-dwelling adults. Methods: In this cross-sectional study, 531 adults participating in a physical activity program or a weight loss program were analyzed. Participants’ self-reported and objectively measured weight, height, weight scale ownership, self-weighing behaviors, and medical history were collected. Results: The mean age (standard deviation) was 50.0 (12.0) years with a range of 24 to 78 years. Out of 531 participants, 455 (85.7%) were women. The study population was diverse (58.9% non-White). In total, 409 (77.0%) participants had a weight scale at home, but only 222 (41.8%) weighed themselves at least once a week. The weight and BMI underestimation became much more significant as the participant’s weight increased (p ≤ 0.001). Employment status, high cholesterol, and low objectively measured weight were significant predictors of self-reported BMI accuracy after controlling for potential confounding factors (p < 0.05). Interestingly, ownership of a home weight scale and the frequency of self-weighing behavior were not significantly associated with the accuracy of self-reported BMI (p > 0.05). Conclusion: The accuracy of the participants’ BMI, based on self-reported height and weight, was significantly associated with employment status, high cholesterol, and low objectively measured weight, suggesting that BMI accuracy depends on multi factors.

Examining the Conceptual and Measurement Overlap of Body Dissatisfaction and Internalized Weight Stigma in Predominantly Female Samples: A Meta-Analysis and Measurement Refinement Study.

Both body dissatisfaction and internalized weight stigma have been identified as risk factors for many negative health outcomes for women, including depression and eating disorders. In addition to these contributions, these concepts have been found to overlap to various degrees in existing literature. We conducted a systematic review and meta-analysis on articles published prior to February 2022 to demonstrate the conceptual and measurement overlap between body dissatisfaction and internalized weight stigma as currently quantified. We identified 48 studies examining the interrelation between body dissatisfaction and internalized weight stigma in predominantly female samples. Stronger correlations between these two constructs, some bordering on multicollinearity, were prevalent in community samples compared to clinical samples and with some but not all the commonly used measures in the body image and weight stigma fields. Body mass index (BMI) moderated these relations such that individuals with higher self-reported BMI were more likely to report lower correlations between the constructs. This concept proliferation, stronger for individuals with lower BMIs and community samples, necessitates the need change how we conceptualize and measure body dissatisfaction and internalized weight stigma. To this end, we conducted study two to refine existing measures and lessen the degree of measurement overlap between internalized weight stigma and body dissatisfaction, particularly in community samples of women. We aimed to clarify the boundaries between these two concepts, ensuring measurement error is better accounted for. Female university students completed existing measures of body satisfaction and internalized weight stigma, which were analyzed using an exploratory followed by a confirmatory factor analysis. In our attempts to modify two existing measures of internalized weight stigma and body dissatisfaction, the majority of the internalized weight stigma items were retained. In contrast, most of the body dissatisfaction items either cross-loaded onto both factors or loaded on to the internalized weight stigma factor despite being intended for the body dissatisfaction factor, suggesting that the measurement issues identified in recent prior research may be due not only to the way we conceptualize and quantify weight stigma, but also the ways in which we quantify body dissatisfaction, across the existing corpus of body dissatisfaction scales.

Association between self-reported body mass index and active life expectancy in a large community-dwelling sample of older U.S. adults

BackgroundObesity may have a protective effect (greater survival) in older adults, a finding known as the “obesity paradox.” This study examined the association between self-reported body mass index (BMI) and active life expectancy (ALE) among older U.S. adults.MethodsUsing the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up), we estimated life expectancy and ALE by participants’ baseline BMI and age using multi-state models. A participant was classified as in an active state if this person reported having no difficulty for any of these six activities of daily living (ADLs).ResultsSmall differences in life expectancy were noted among persons in normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), and obesity ranges (BMI 30 kg/m2 and higher). However, persons with obesity had a significantly lower ALE. ALE at age 65 was 11.1 (11.0–11.2) years for persons with obesity, 1.2 (1.1–1.3) years less than that for the normal weight and overweight persons (12.3 years for both, 12.2–12.4). Persons with class III obesity had a significantly lower life expectancy and ALE than normal weight persons. Although persons with class I or II obesity had a similar life expectancy as normal weight persons, they have a shorter ALE.ConclusionsAlthough older adults with obesity have a similar life expectancy as normal weight persons, they have a significantly shorter ALE. Given the complex relationship of BMI and ALE, a “one size fits all” approach to weight management is not advisable.

Effects of adding a diet intervention to exercise on hip osteoarthritis pain: protocol for the ECHO randomized controlled trial

BackgroundHip osteoarthritis (OA) is a leading cause of musculoskeletal pain. Exercise is a core recommended treatment. Despite some clinical guidelines also recommending weight loss for hip OA, there is no evidence from randomised controlled trials (RCT) to substantiate these recommendations. This superiority, 2-group, parallel RCT will compare a combined diet and exercise program to an exercise only program, over 6 months.MethodsOne hundred people with symptomatic and radiographic hip OA will be recruited from the community. Following baseline assessment, participants will be randomly allocated to either, i) diet and exercise or; ii) exercise only. Participants in the diet and exercise group will have six consultations with a dietitian and five consultations with a physiotherapist via videoconferencing over 6 months. The exercise only group will have five consultations with a physiotherapist via videoconferencing over 6 months. The exercise program for both groups will include prescription of strengthening exercise and a physical activity plan, advice about OA management and additional educational resources. The diet intervention includes prescription of a ketogenic very low-calorie diet with meal replacements and educational resources to support weight loss and healthy eating. Primary outcome is self-reported hip pain via an 11-point numeric rating scale (0 = ‘no pain’ and 10 = ‘worst pain possible’) at 6 months. Secondary outcomes include self-reported body weight (at 0, 6 and 12 months) and body mass index (at 0, 6 and 12 months), visceral fat (measured using dual energy x-ray absorptiometry at 0 and 6 months), pain, physical function, quality of life (all measured using subscales of the Hip Osteoarthritis Outcome Scale at 0, 6 and 12 months), and change in pain and physical activity (measured using 7-point global rating of change Likert scale at 6 and 12 months). Additional measures include adherence, adverse events and cost-effectiveness.DiscussionThis study will determine whether a diet intervention in addition to exercise provides greater hip pain-relief, compared to exercise alone. Findings will assist clinicians in providing evidence-based advice regarding the effect of a dietary intervention on hip OA pain.Trial registrationClinicalTrials.gov . Identifier: NCT04825483. Registered 31st March 2021.