Underweight Research Articles

KARAKTERISTIK STATUS GIZI DAN HUBUNGANNYA DENGAN BERBAGAI FAKTOR DETERMINAN PADA ANAK USIA 12-36 BULAN DARI KELUARGA SOSIO-EKONOMI MENENGAH KE ATAS

NUTRITIONAL STATUS CHARACTERISTICS AND ITS RELATED DETERMINANT FACTORS AMONG HEALTHY CHILDREN AGED 12-36 MONTHS FROM MIDDLE UP SOCIO-ECONOMIC STATUS. Background: There are very few studies had been carried out among children from middle up socio-economy status, and therefore, the prevalence of malnutrition as well as characteristics of nutritional status of children from middle­ upper socioeconomic families have not been well reported. Objectives: To describe the nutritional status of children from well being families, and its related determinant factors. Methods: A total of 235 children aged 12-36 months from middle upper socio-economic status in Bogor city, West Java had been studied. The cross-sectional study design was implemented. Data on general characteristics of the families and anthropometric measurements on both the child and the mother were collected by well trained field workers. Results: The study reveals that the average birth weight was 3.2 ± 0.41 kg and birth length was 49.2 ± 1.96 cm. Most mothers (43.2%) breastfed their children until 3 months, 22.0% less than 3 months and the remaining 34,8% above 3 months. Using NCHS standard, underweight was found 6.1%, stunting was 4.2%, and wasting was 2.8%, There were no subjects with Z-score above 2 SD of weight-for-age, length-for-age or weight-for-length, classified as overweight or obese children. There is no association observed between nutritional status and household income, percentage of foods expenditure, and education level of fathers. A positive trend was observed between nutritional status of children and height of mothers A stronger positive trend was also observed for education level of mothers against nutritional status of the children. A significant (P<0.05) association between education of mothers and nutritional status (based on weight for age) of the children was demonstrated in these subjects. Conclusion: Level of education of mothers substantially contributed to nutritional status of children aged 12-36 months. Keywords: wellbeing families, nutritional status, determinant factors

Amniotic membrane as a carrier for cultivated and labeled corneal endothelial cell transplantation

To investigate the feasibility of using amniotic membrane (AM) as a carrier for cultured corneal endothelial cells transplantation. Rabbit corneal endothelial cells were cultivated, passaged, and labeled with the fluorescent tracker CM-DiI, then transplanted onto denuded AM. The cell density, morphology, histology and ultrastructure of the cultured cells on AM were examined by light microscope, fluorescent microscopy and scanning electron microscope. To determine whether these composite endothelial sheets were functional in vivo, the sheets were transplanted onto rabbit corneas whose deep lamellar with Descemet's membrane and endothelial cells had been completely removed. The deep layer excised rabbit corneas without any transplantation or with transplantation of denuded AM were treated as controls. After transplantation, the corneal appearance and corneal thickness were examined. The grafts were examined for cell density, morphology and histology 4 weeks after the surgery. A monolayer of endothelial cells were confluent on the AM 5 - 7 days after seeding. The density of the endothelial cells was (3202.84 +/- 347.77)/mm(2). Morphologically, the sheets consisted of a fairly continuous layer of flat polygonal endothelial cells that appeared uniform in size with tight junctions. The labeled cells were red in color under fluorescent microscopy. After transplantation, the corneas that received cultured endothelial cells had little edema and retained their thinness and transparency, while the corneas of controls showed prominent edema and opacity, indicating that these cells were transplanted cells rather than the cells migrated from peripheral cornea. Four weeks after surgery, the labeled endothelial cells were still found in the cornea with red fluorescence. AM maintains cultured endothelial cells' morphology and function both in vitro and in vivo. AM could serve as a carrier for corneal endothelial cells transplantation. These results provide a promising method for the treatment of diseases caused by corneal endothelial disorders.

Heavy tails in last-passage percolation

We consider last-passage percolation models in two dimensions, in which the underlying weight distribution has a heavy tail of index α < 2. We prove scaling laws and asymptotic distributions, both for the passage times and for the shape of optimal paths; these are expressed in terms of a family (indexed by α) of “continuous last-passage percolation” models in the unit square. In the extreme case α = 0 (corresponding to a distribution with slowly varying tail) the asymptotic distribution of the optimal path can be represented by a random self-similar measure on [0,1], whose multifractal spectrum we compute. By extending the continuous last-passage percolation model to \(\mathbb{R}^2\) we obtain a heavy-tailed analogue of the Airy process, representing the limit of appropriately scaled vectors of passage times to different points in the plane. We give corresponding results for a directed percolation problem based on α-stable Lévy processes, and indicate extensions of the results to higher dimensions.

Association of Perceived Weight Status and Change in Physical Activity in Young Adults

PURPOSE: To investigate the longitudinal association between perceived weight status and physical activity (PA) change in a population based sample of young adults. METHODS: The sample consisted of 338 females and 290 males, aged 21–25 years (85% white). At baseline, subjects classified themselves as underweight (UW), normal weight (NW), slightly overweight (OW) and very overweight (VOW). PA (hrs/wk) averaged over the past year was assessed by questionnaire twice (mean time between assessments = 25.3±5.9 months) and change in PA between the two assessments was calculated. Analysis of covariance was used to examine the relation between baseline perceived weight status and change in PA, while adjusting for demographic characteristics. RESULTS: Perception of weight status at baseline for females was 7%-UW, 40%-NW, 40%-OW and 13%-VOW; and for males 15%-UW, 51%-NW, 30%-OW, and 4% -VOW. Overall, PA decreased by −1.2±7.3 hrs/wk with PA in males decreasing significantly more than in females (−0.3±6.6 vs. −2.1±7.9, p < 0.01). Baseline perceived weight status was a significant predictor of change in PA for both males (p <.01) and females (p <0.05). Analysis of covariance indicated that females who perceived their weight status to be OW or VOW significantly increased their PA by 0.2 and 1.7 hrs/wk respectively while females who perceived their weight status to be UW or NW decreased their PA by −1.2 and −1.4 hrs/wk respectively. Among males, those who perceived their weight status to be VO significantly increased their PA by 2.6 hrs/wk while males who perceived their weight status as UW, NW or OW decreased their PA by −4.7, −2.5 and −1.1 hrs/wk respectively. CONCLUSION: These data indicate that perception of weight status may be a predictor of change in physical activity. Over a 2 year period, PA decreased in those who perceived they were under or normal weight while PA increased among those who perceived they were overweight.

Redefining Womanhood (?): Gender, Power, and the “Religion of Thinness”

Ce travail examine la manière dont les femmes utilisent les régimes amincissants comme moyen de surmonter les normes culturelles dominantes concernant les genres, aux Etats-Unis, au cours des dernières décennies. Bien que les femmes qui se consacrent à la perte de poids ne constituent pas un « groupe religieux » dans l’acception traditionnelle du terme, les symboles, rituels et croyances qui accompagnent leur quête de la minceur finissent par fonctionner exactement comme une religion. A partir de discours de femmes aux prises avec leur nourriture et l’image de leur corps, ainsi qu’avec toute une série d’images, rituels et croyances de la culture populaire, je mène l’analyse de cette religion séculière, que je nomme « la Religion de la Minceur » ; je vise à éclairer la manière dont les femmes s’en servent pour tenter d’obtenir le type de pouvoir et de visibilité qui est longtemps demeuré l’apanage des hommes. Enfin, je soutiens que la Religion de la Minceur ressuscite les dynamiques d’une religion patriarcale, dans laquelle le « salut » (libération) de la femme passe par son sacrifice et son obéissance aux normes sociales dominantes.

Assessment of 24 years of infant growth monitoring in a rural area of Senegal (1969-1992)

Undernutrition in young children in developing countries is associated with an increased risk of death. But in several studies, a decrease in mortality was not associated with any decrease in the prevalence of undernutrition. A rural population of Casamance (Senegal) has been under yearly demographic surveillance by The French National Institute of Demographic Studies (INED) since 1985. Between 1960-1964 and 1990-1994, under-5 and child (1-4 years) mortality rates dropped from 312 to 127 and from 201 to 68 per 1,000, respectively. Since 1961, French Catholic nuns who are also professional nurses have been in charge of a private village dispensary located in a rural area of Casamance. This dispensary delivers permanent, high quality service and is widely attended. GROWTH MONITORING PROGRAMME: A growth-monitoring programme, supported by Cathwell, was initiated in 1969 for 0-5-year-old children (0-3 from 1985). Children were weighed wearing light clothes to the nearest 10g. Weights were recorded in a register that also contained information concerning identity (name, sex, date of birth) and address. All weights were plotted on growth charts kept by the mothers. During the sessions, the nurses provided nutrition education messages (i.e., preparation of high-energy and nutrient-dense infant gruels using local foods), advice on illness management (oral rehydration during diarrhoea) and hygiene (well and water-jar disinfection, construction of pit-latrines), importance of vaccination. From 1975, they also distributed free chloroquine during the malaria transmission season (May-November) for prevention and early presumptive treatment. Most likely thanks to this programme, infant and child mortality reached a low level at the end of the 1980s. In 1990, plasmodium resistance to chloroquine appeared, increasing malaria mortality. All weight measurements taken in 1969-1994 were entered into a database. This paper presents an analysis of weight measurements taken at 3-23 months of age from 1969-1992. A total of 4,636 infants were weighed at least once, but only 3,912 infants (1,983 boys and 1,929 girls) were available for the analysis, 724 being excluded due to missing data. The average coverage of the programme during the month of February was 88% for infants aged 3-23 months. Mean weight was examined at three target ages: 5, 11 and 15 months. Not only did the nutritional status not improve between 1969 and 1989, it even deteriorated in some years for all three age-cohorts. The nutritional status of infants in this community did not differ significantly from that of 12-23 month-old Senegalese children in the 1992-1993 Demographic and Health Survey (DHS). Seasonal differences in mean weight and the prevalence of underweight became significant in the rainy season since 1975. Underweight for the 15-month-old children increased over time during the rainy season. These findings were unexpected, since malaria morbidity is thought to be at least partially responsible for seasonal variations in the nutritional status of young children, and despite the fact that the nurses began a malaria control programme in 1975. The rapid transition towards lower childhood mortality observed in this rural area of Casamance (Senegal), was not concomitant with any improvement in infants' nutritional status from 1969 through 1992. Focused public health interventions such as vaccinations and malaria prevention probably did not improve the nutritional status. Paradoxically, growth monitoring may have been more helpful in improving health than growth. Targeted specific nutritional interventions are needed to significantly improve growth of children in this community.

Rajeunissement facial et lifting malaire concentrique : le concept du FACE RECURVE ®

Cell ageing is responsible for the increasingly creased appearance of our skin. The ageing of the structures of the face is attributed primarily to the effect of gravity on the tissues. The theory expounded below sets out to prove that the main and initial cause of this ageing is the repeated contractions of the mimic muscles. This concept attributes only a secondary role to gravity in the ageing process, which is initially brought about by muscular contractions. An MRI study recently made it possible to demonstrate the anterior convexity curve of the mimic muscles in the young subject. This curve is due to the existence at the back of these muscles of a deep fat pad. In the young subject, the extent of its convexity and its location give a specific, youthful character to the movements, in terms of direction and amplitude, of the facial muscles. With age, the muscle gradually straightens and shortens due to the repeated contractions that expel the underlying fat and increase the tonus at rest. The application of these new findings to the ageing of the face gives rise to new technical possibilities both in the field of medicine and aesthetic surgery. These new techniques have the same targets: segments of the mimic muscles (maintain over time a good muscular curve and a low tonus at rest) and the underlying fatty convexities. As far as medicine is concerned, the combination of botulinum toxin and filling has proved its worth. But two technical elements are new: the filling products must, at several points, be injected primarily behind the muscle to treat the depressions naturally and restore the initial curve of the overlying muscle. A very low number of units (a quarter to one unit) of botulinum toxin must be injected into certain muscles to diminish the tonus at rest of these muscles without diminishing their strength in maximum contraction. In surgery, new possibilities to treat premature ageing include procedures that combine segmentary muscular weakening, micro liposuctions and retromuscular reinjections. The advantage with regard to the medical procedures is greater stability over time and the greater precision of these muscular actions (one third of a muscle can be weakened for example) and the fat reinjections can be more stable. These procedures can be performed under local anesthesia. In cases of more advanced ageing, surgery offers new treatment possibilities that include, for the midface region, the concentric malar lift. It replaces, on the orbital rim, the sub-orbicularis oculi fat that has descended eccentrically as a result of the contractions of the orbicularis oculi muscle. The procedure, using the subperiosteal detachment plane, is therefore stable over time. At the same time, specific muscles are weakened. The aims of restoring fatty volumes and muscular tonuses are thus achieved. Similarly, in the neck, the platysma muscle is specifically weakened. Each area is studied in line with its specificities. For the first time, the skin tension of the facelift has no more to be maximum to treat the relief of the jawl line, of the palpebro malar groove and so on. The skin tension becomes moderate, just to remove the excess of skin. The relief is faded with the specific muscular and fatty action. The name of this new concept is Face Recurve ®.

STATUS GIZI BALITA DI DAERAH TERTINGGAL TAHUN 2004 (KAJIAN DATA SKRT 2004)

Nutritional Status of Under-Five In Less Developed Areas (Analysis of Household Health Survey of 2004). Background: Less Developed Areas (LOA) as defined areas that have in part area with low socio-economic status or low access to public services including health. These conditions are unfavourable for growth of children. Aware about these problems may create programs to lift up the quality of human resources in the areas. Therefore, it is important to have information of the nutritional status of under fives in LOA. Objectives: To have information on the nutritional status of under five children in LOA districts. Methods: This exercise used data of household health survey 2004. The samples were classified into wasting, stunting and underweight. Descriptive analysis was conducted to compare the prevalence of wasting, stunting and underweight between LOA and non LOA. Results: The prevalence of wasting, stunting and underweight are higher in LOA as compared to non LOA. Except in urban LOA the prevalence of underweight is 9.1% as compared urban non LOA 11.3%. Keywords: nutritional status, less developed area.

WHO class‐specific equations using height2 for predicting body weight: Crude indicator for dry weight in haemodialysis patients

Body weight (BW) might be related to total body water, and the difference between a patient's actual BW and ideal BW (IBW) might be the volume marker. However, there has been no information about the association between IBW and dry weight (DW) in haemodialysis (HD) patients. First, we analysed the relationship between DW and IBW in 51 HD patients. The IBW was calculated by 21 x Height (Ht)(2). Weight status was analysed by the WHO classification. Second, in 12 436 controls, linear equations using Ht(2) were sought to predict the BW in each sex and WHO class. Third, using these equations, predicted BW (PW) was compared with DW in each WHO class at the initiation and after 1 year in 619 new HD patients, retrospectively. Among 51 HD patients, 38 were normal weight in whom there was no difference between DW and IBW. In each sex and WHO class of the 12 436 controls, linear equations using Ht(2) were developed to predict BW. These equations were applied to 619 new HD patients. In males, there were no differences between PW and DW in underweight (UW), overweight (OW), obese (OB) and extremely obese (EOB) patients at the initiation of the HD. In females, there were no differences between PW and DW in OW patients. Despite no statistical differences, there were wide ranges of distribution from -6 to 6 kg between PW and DW. BW had a linear relationship with Ht(2) and might be predictable by the WHO class-specific equation using Ht(2). These equations might be useful as a crude indicator of DW in HD patients.

Estado nutricional e anemia ferropriva em gestantes: relação com o peso da criança ao nascer

OBJETIVO: Avaliar o estado nutricional e a prevalência de anemia durante a gestação e correlacioná-los com o peso do recém-nascido. MÉTODOS: Foi realizado estudo transversal com gestantes que realizaram o pré-natal no único serviço público de saúde do município de Viçosa, MG, no período de dezembro de 2002 a maio de 2003. Foi aplicado questionário com informações maternas e realizada dosagem de hemoglobina através do Hemocue, além da obtenção de dados de peso e estatura da gestante. As informações referentes aos recém-nascidos foram obtidas no programa Sistema de Informação de Nascidos Vivos/MS. RESULTADOS: Foram avaliadas 168 gestantes de baixo nível socioeconômico e baixa escolaridade. Encontraram-se 41,3% de gestantes com estado nutricional pré-gestacional inadequado, sendo 25,7% com baixo peso e 17,4% com sobrepeso ou obesidade. A maioria das gestantes apresentou ganho de peso inadequado durante a gestação. A prevalência total de anemia ferropriva foi de 21,4%, sendo que essa aumentou com a idade gestacional. A freqüência de baixo peso e peso insuficiente ao nascer foi de 8,9% e 28,6%, respectivamente. As variáveis antropométricas (peso pré-gestacional, estatura, índice de massa corporal pré-gestacional e ganho de peso total) apresentaram associação estatisticamente significante com o peso ao nascer. CONCLUSÃO: As variáveis antropométricas maternas apresentaram correlação com o peso ao nascer. Neste estudo não houve relação entre o estado nutricional de ferro das gestantes e o peso de nascimento.

Social Physique Anxiety, Physical Self-perceptions And Eating Disorder Risk

Purpose To ascertain if a previous unpublished study–(Bratrud, 1998) in which physical self-perceptions and social physique anxiety substantially and independently predicted eating disorder risk in a convenience sample of female college athletes–could be cross validated. METHOD Fifty eight female college athletes from five sports completed the Physical Self-Perception Profile (PSPP), the Social Physique Anxiety Scale (SPAS), and the Drive For Thinness (THIN), Bulimia (BUL), and Body Dissatisfaction (BDIS) subscales of the Eating Disorder Inventory. They also completed two scales designed to measure socially desirable (SD) response tendencies (Paulhus, 1991). As in the initial study, and in line with extant literature (e.g., Williamson et al., 1994), it was assumed that BDIS mediates the risk and development of eating disorders. Thus, the data were analyzed to assess the unique contribution of BDIS to risk prediction (THIN and BUL) after SD, SPAS and PSPP had been statistically controlled for. RESULTS Analysis of the data from the cross validation study gave results that were conceptually and substantively similar to the earlier study in terms of the pattern of associations between variables, and in the levels of predictive contributions of PSPP, SPAS, and BDIS to eating disorder risk as measured by THIN. However, the results of the two studies were dissimilar with regard to prediction of risk as measured by BUL. Specifically, after controlling for SD, PSPP explained 25% of the variance in THIN, followed by substantial unique contributions from SPAS (15%) and BDIS (18%) respectively. In the overall hierarchical analyses, 62% of the variance in THIN was explained (compared to 66% previously), but only 20% of the variance in BUL was explained (compared to 31% previously). The degree of R2 shrinkage between studies suggests that the samples could be combined for an overall data analysis with respect to predicting THIN, but such a combination might be problematic for further study of the contribution of PSPP, and SPAS to the prediction of BUL (Pehazur, 1982). CONCLUSION These data add support to the hypothesis that PSPP and SPAS may make important and unique contributions to predicting eating disorder risk as measured by THIN, but the previous findings with respect to predictions of BUL were not substantively replicated. Overall, this attempt to cross validate the results of an earlier study was partially successful, and further study of the contributions of PSPP and SPAS to eating disorder risk seems to be warranted.

Prevalencia de sobrepeso y obesidad en niños que se controlan en pediatría ambulatoria en Clínica Las Condes

Obesity has increased among Chilean children, with the long-term health risks associated. Aim : to study the prevalence of overweight and obesity in children followed up at the paedriatric unit of a private health center, Clinica Las Condes (CLC), in Chile. Patients and methods : a one- year prospective study of 1310 children, mean age 7,19 ± 4,02 years, 51,6% males. Age, sex, weight and height were recorded, BMI (kg/m2, absolute and corresponding percentile) and %weight/height (%W/H) was calculated. Results : Age distribution in the sample was 45,7% between 2-5 years, 29,5% 6-10 years and 24,8% older than 10 years. 66,8% had normal weight, OW 13,9%, O 12% and underweight (UW) 7,3%, without differences for gender or age. Conclusiones : The prevalence of UW, OW and O children are similar to those provided from low to medium low income populations in Chile. The largest prevalence of OW and O children was found in the 6-10 year range, and reinforces the necessity of education in healthy habits of nutrition and activity to prevent the development of abnormal weight during the school years.

Urbanisation, malnutrition des enfants et sexe au Burkina Faso : une analyse économétrique spatiale

Au Burkina Faso, l'analyse de l'impact de l'urbanisation regionale en termes de malnutrition des enfants de moins de 5 ans, fondee sur une approche econometrique spatiale selon la division administrative des 30 provinces, a l'aide des enquetes demographiques et de sante de 1992-93 et 1998-99, aboutit a trois conclusions. En premier lieu, l'urbanisation s'accompagne, d'une part, d'une reduction des niveaux d'insuffisance ponderale et de retard de croissance - un doublement du taux d'urbanisation regionale engendre une reduction de 5,2 a 5,4 % du taux de malnutrition des enfants de moins de 5 ans -, et, d'autre part, d'une elevation des disparites de malnutrition des enfants, exprimee par les relations poids pour âge et taille pour âge - un doublement du taux d'urbanisation regionale implique une elevation de l'ordre de 30 % des indicateurs d'inegalite de malnutrition des enfants. Par ailleurs, si le niveau du retard de croissance a augmente entre 1992-93 et 1998-99, les estimations econometriques ne confirment pas l'aggravation des inegalites de malnutrition des enfants au cours de la meme periode, contrairement a ce que semblent suggerer les statistiques descriptives. En deuxieme lieu, l'analyse econometrique spatiale en termes de regimes montre qu'il n'existe pas de difference significative selon le sexe quant a la relation entre, d'une part, le niveau ou l'inegalite du retard de croissance, et, d'autre part, le taux d'urbanisation provinciale. En outre, seul le niveau du retard de croissance des filles a significativement augmente entre 1992-93 et 1998-99, contrairement a l'inegalite. En troisieme lieu, ces resultats, inherents aux changements structurels et aux mouvements de population, reduisent les chances d'un developpement plus egalitaire, meme si en 2030, un tiers seulement de la population burkinabe est susceptible de resider en ville.

The unrealistic quest to thinness

The unrealistic quest to thinness

Gender, marital status, and body weight in older U.S. adults

Marital terminations are life transitions that may lead to changes in diet, activity, and body weight. This investigation examined how marital status was associated with relative body weight, underweight, overweight, and obesity among men and women in the United States using cross-sectional nationally representative data from the 1992 HRS cohort age 51–61 and the 1993 AHEAD cohort age 70 and older. Results in the HRS cohort revealed that even when adjusting for demographic and behavioral variables, widowed women were significantly more likely to be obese than married women, while men who were never married, divorced, or separated were more likely to be underweight. Results in the AHEAD cohort showed few significant associations between marital status and weight for either men or women when demographics were controlled. Clear gender variations appeared to exist in how marriage is related to body weight among unmarried older adults, with widows in their 50s being obese and divorced/separated/never married men being underweight. However, marital status differences in weight were not present among much older adults of either gender.

Plasma Orexin-A Levels and Body Composition in COPD

To study the role of orexins in regulating body composition in patients with COPD. Prospective study. We measured the plasma concentration of orexin-A in 20 patients with COPD and compared the results to those obtained from 10 age-matched control subjects. Patients with COPD were classified into two groups based on their body mass index (BMI): a normal weight (NW) group (BMI > 20) and an underweight (UW) group (BMI < 20). The plasma orexin-A level was significantly lower in patients with COPD than in control subjects. In patients with COPD, the level was significantly lower in the UW group than in the NW group. Plasma orexin-A levels significantly correlated with BMI and fat mass values, but there was no significant relationship between plasma orexin-A levels and the fat-free mass of patients with COPD. These results suggest that orexin-A levels are altered with weight loss and changes in body composition in patients with COPD.

Malnutrition among pre-school children in Alexandria, Egypt.

The study was conducted in Alexandria, Egypt, to assess the current status of malnutrition among 1,217 pre-school children aged 6-71 months. A two-stage cluster-sampling technique was used for selecting the sample. Data on sociodemographic and environmental characteristics of the family, morbidity profiles, and breast-feeding patterns were collected from mothers of the children. Anthropometric measurements were performed, and the prevalence of malnutrition was assessed using three indicators, such as stunting, under-weight, and wasting, following the WHO guidelines and cut-off points. Simple and multiple regression analyses were done for examining the factors associated with the occurrence of malnutrition using principal component factor analysis with varimax rotation. Stunting, under-weight, and wasting were observed in 15%, 7.3%, and 3.6% of the children respectively. High-socioeconomic condition was associated with low prevalence of stunting and underweight (OR = 0.67, confidence interval (CI) = 0.55-0.8 and OR = 0.75, CI = 0.58-0.96 respectively). Good environmental condition was associated with a lower stunting rate (OR = 0.83, CI = 0.72-0.96). Increased age of child and living in a non-squatter area were associated with wasting (OR = 1.02, CI = 1.001-1.03 and OR = 0.38, CI = 0.15-0.97 respectively). Interventions to improve socioeconomic and environmental situations are recommended to reduce the already low level of protein-energy malnutrition further.

More models clinically underweight

More models clinically underweight

“Healthy” vs. “Underweight”

“Healthy” vs. “Underweight”

Influence of body weight on the severity of dyspnea in chronic obstructive pulmonary disease.

A substantial number of patients with COPD are underweight (UW); they comprise the clinical subtype of "dyspneic" or emphysematous. To determine whether these patients are more dyspneic than normal weight (NW) patients with COPD, we quantitated the severity of dyspnea, using a modified Medical Research Council (MRC) dyspnea scale, in 33 UW and 57 NW patients and compared their pulmonary function tests (PFTs), arterial blood gases (ABGs), and respiratory muscle strength as estimated by maximum static inspiratory (PI(max)) and expiratory (PE(max)) mouth pressures (all as means +/- SEM). Body mass index was 18.7 +/- 1.2 and 24.5 +/- 1.8 kg/m(2) in UW and NW patients, respectively (p < 0.0001). The MRC dyspnea scale was 3. 1 +/- 0.9 in UW and 2.5 +/- 1.2 in NW groups (p = 0.035). All PFT and ABG parameters were similar in the two groups except for DCO (36 +/- 11% in UW and 57 +/- 17% in NW, p < 0.001) and PI(max) (55 +/- 18 mm Hg in UW and 66 +/- 19 mm Hg in NW, p = 0.020). In a stepwise multiple regression model, %DCO and %MVV combined were the best predictors of dyspnea severity (R(2) = 0.30, p = 0.001). We conclude that UW patients with COPD are more dyspneic than NW patients. Although the origin of dyspnea in COPD is multifactorial, changes in DCO and respiratory muscle strength may contribute to its intensity.