Underweight Research Articles

Joint association among physical activity, sedentary leisure time, job intensity, adiposity and the risks of diabetes in adult population of Zhejiang province

To investigate the joint association of adiposity, physical activity, sedentary leisure time and job intensity on diabetes and impaired glycoregulation. Data was from the 2010 Zhejiang survey and 17 437 adults ( ≥18 years) were examined. Logistic regression was used in this cross-sectional study. Under the same level of sedentary leisure time, adiposity anticipants showed an OR of 2.52-2.75 times for people with diabetes than those with normal or underweight BMI, and anticipants with highest WC having an OR of 2.09-3.71 times than those with the lowest WC. With the same level of physical activity, those adiposity anticipants had an OR of 2.19-5.98 times for diabetes than those with normal or underweight BMI, and anticipants with the highest WC had an OR of 3.10-6.25 times than those with the lowest WC. Anticipants who had no physical activity but with adiposity. BMI had an OR of 3.21 times than those with normal or underweight BMI, but there was no significant difference between diabetes and BMI in those that practising physical activities. Within the 3 levels of physical activity, participants that practising no physical activity, had an OR of 1.68-4.23 times for diabetes than those who were physically active when WC was used as a measure for adiposity. Controlling weight and waist seemed more important than improving physical activity or reducing sedentary leisure time in the prevention program on diabetes. WC was better measure on the risks for adiposity-related diabetes than BMI, especially when physical activity was under consideration.

A survey on underweight and growth retardation of 51 children before and after liver transplantation

To evaluate the growth of children in weight and height before and after liver transplantation and the relation between malnutrition and postoperative time. Growth was assessed for children who received liver transplantation from July 2007 to December 2012 after operation during follow-up. Weight and height were measured for 51 children in May 30, 2013. Weight and height percentiles of each child were calculated in accordance with data surveying on physical development of children in nine provinces/municipalities. Underweight was defined as weight less than the third percentile of same age and sex groups. Growth retardation was defined as height less than the third percentile of same age and sex groups. Children were set into 2 groups (before liver transplantation group, after liver transplantation group). The incidence of underweight and growth retardation were analyzed by chi-square test. Children were divided into 4 groups according to the length of time from operation time to May 30, 2013: 1 year after liver transplantation (1-365 days); 2 years after liver transplantation (366-730 days); 3 years after liver transplantation (731-1 095 days) ; 4 years or more after liver transplantation (1 096-2 133 days) . The underweight and growth retardation were analyzed by hierarchical log linear model. The mean age of 51 children was 44.78 months (range 13 months to 13 years old), 26 of them were male and 25 female. The number of children with underweight and growth retardation were 20 (39%) and 35 (69%) respectively before transplantation and were 5 (10%) and 14 (27%) respectively after transplantation. There was a significant difference between underweight incidence before and after operation (χ(2) = 10.385, P = 0.001). There was significant difference between growth retardation incidence before and after operation (χ(2) = 15.710, P = 0.000). The subjects included 10 patients at 1 year after operation (underweight n = 3, growth retardation n = 3), 19 patients at 2 years (underweight n = 1, growth retardation n = 9), 10 patients at 3 years (underweight n = 1, growth retardation n = 2), 12 patients at 4 years and above (underweight n = 0, growth retardation n = 0). Parameter analysis of hierarchical log linear estimates: underweight at 1 year = 0.661, underweight at 2 years = -0.214, underweight at 3 years = 0.119, underweight at 4 years and above = -0.566. Growth retardation at 1 year = 0.282, at 2 years = 0.613, at 3 years = 0.051, at 4 years and above = -0.946. Compared with after liver transplantation, obvious malnutrition existed in patients before transplantation. Patients have the ability to catch-up growth after liver transplantation. Reduced effect of underweight occurred in second year after liver transplantation. Reduced effect of growth retardation occurred in third year after liver transplantation.

The relationship between body mass index and health-related quality of life in the adult Chinese population: among the healthy and chronic disease subgroups

Objective To investigate the relationship between body mass index (BMI) and health-related quality of life (HRQOL) in the adult Chinese population. Methods Data of 21 108 adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan province). Rank sum test was used to compare HRQOL with different BMI category. Multiple logistic regression analysis was used to assess the impact of different BMI category on HRQOL after adjusted for sex, age, marital, education, physical activity status, and tobacco and alcohol addiction. Results (1) For healthy subjects, the overweight BMI group had the highest HRQOL score in the physical component summary (PCS)(83.69±14.09) and mental component summary(MCS)(80.29±15.41), while the underweight group had the worst HRQOL(81.20±14.05, 74.82±16.41). For subjects with chronic condition, overweight had the highest HRQOL score in the PCS(74.63±18.51), and obese group had the best HRQOL in the MCS(76.75±18.83). The variation among healthy and chronic disease subjects was much greater than the differences among BMI category groups. (2) Compared with normal weight, data on odds ratio(ORs) of impaired HRQOL in PCS(healthy subjects OR=1.23(1.10-1.35), chronic disease subjects OR=1.48(1.20-1.82)) MCS(healthy subjects OR=1.14(1.03-1.26), chronic disease subjects OR=1.37(1.11-1.68)) and multiple dimensions increased among underweight.ORs of impaired HRQOL in PCS and general health dimension, MCS(healthy subjects OR=0.81(0.72-0.91), chronic disease subjects OR=0.80(0.71-0.91)) and multiple dimensions decreased among overweight. ORs of impaired HRQOL in physical functioning dimension (healthy subjects OR=1.91(1.25-2.92), chronic disease subjects OR=1.65(1.21-2.26)) while in MCS and role emotional and mental health dimension decreased among obese. Conclusion Whatever health or chronic disease, the influence of BMI on HRQOL is similar: the HRQOL score for the underweight group is significantly lower than that for other BMI groups in PCS and MCS.Overweight and the obese people has better HRQOL in MCS, and the obese people has poor physical function.The relation above between BMI and HRQOL is more obvious in people with chronic disease. Key words: Body mass index; Health-related quality of life; Chronic disease

Prevalence of stunting, wasting and underweight in Grade 1-learners: The NW-CHILD Study

Background: Child undernutrition remains a major public health concern in developing countries, with many negative consequences to child development.Objectives: To determine the prevalence of stunting, wasting and underweight amongst Grade 1-learners in the North West Province (NWP) of South Africa (SA), taking into account gender, race and school type.Method: Eight hundred and sixteen (419 boys, 397 girls) learners participated in the study (567 black, 218 white, 31 other races). Underweight, stunting and wasting (Weight-for-age, height-for-age, BMI-for-age) were determined using the z-scores of the 2007 WHO reference sample (-2 SD).Results: A higher prevalence of wasting and underweight were found amongst the boys (8.35%; 5.97%) compared with the girls (6.30%; 2.52%), although this was only significant for underweight (p = 0.02), whilst stunting percentages were very similar amongst girls (4.53%) and boys (4.06%). Underweight was the highest in the black group (5.47%; p < 0.01), compared with the white group (0.46%) and the prevalence of the conditions is associated with school types which represent low socio-economic circumstances (Quintile 1–3 schools). Only black learners showed stunting (p < 0.01) and more black learners were wasted (n = 39) compared with white (n = 15; p = 0.08) learners. Quintile 1–3 schools had a significantly higher prevalence of underweight (5.14% – 8.18%) and stunting (3.88% – 10.7%) (p < 0.01) compared with Quintile 4 and 5 schools.Conclusion: The prevalence of stunting, wasting and underweight need improvement amongst school beginners, especially in Quintile 1–3 type schools but also amongst black learners living in the NWP of SA as it can have significant hampering effects on the future development and well-being of children.Agtergrond: Ondervoeding is steeds ‘n publieke gesondheidsgevaar by kinders in ontwikklende lande, met heelwat negatiewe gevolge vir kinderontwikkeling. Doel: Om te bepaal wat die voorkoms van groei-inperking, ondervoeding en ondergewig by Graad 1-leerders in die Noordwes-Provinsie (NWP) van Suid-Afrika (SA) is, met in ag neming van geslag, ras en skooltipe.Metode: Agt honderd en sestien leerders (419 seuns; 397 meisies) is ewekansig geselekteer vir deelname aan die studie (567 swart, 218 wit, 31 ander rasgroepe). Ondergewig, groei-inperking en ondervoeding is bepaal deur z-tellings vir massa-vir-ouderdom, lengte-vir-ouderdom en LMI-vir-ouderdom volgens die 2007 WHO verwysings (-2 SA).Resultate: ‘n Hoër voorkoms vir ondervoeding en ondergewig is by seuns (8.35%; 5.97%) teenoor meisies (6.30%; 2.52%) gevind, alhoewel slegs betekenisvol vir ondergewig (p = 0.02), terrwyl persentasies van groei-inperking redelik dieselfde was by meisies (4.53%) en seuns (4.06%). Ondergewig het die hoogste voorkoms in die swart groep (5.47%; p < 0.01) getoon, en die voorkoms word geassosieer met skooltipes wat lae sosio-ekonomiese omstandighede verteenwoordig. Slegs swart leerders het groei-inperking getoon (p < 0.01) en meer swart leerders was ondervoed (n = 39) teenoor blanke (n = 15) leerders. Kwintiel 1–3 skole het ‘n betekenisvolle hoër voorkoms vir ondergewig (5.14% – 8.18%) en groei-inperking (3.88% – 10.7%) getoon (p < 0.01) as die Kwintiel 4 en 5 skole.Gevolgtrekking: Groei-inperking, ondervoeding en ondergewig moet by skoolbeginners verbeter word, veral in Kwintiel 1–3 skooltipes en by Swart leerlinge in die NWP van SA, veral weens die negatiewe uitwerking wat dit op die toekomstige ontwikkeling en welstand van leerders wat daaronder gebuk gaan, kan uitoefen.

Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation

AbstractThe rising incidence of pediatric obesity may significantly affect bone marrow transplantation (BMT) outcomes. We analyzed outcomes in 3687 children worldwide who received cyclophosphamide-based BMT regimens for leukemias between 1990 and 2007. Recipients were classified according to age-adjusted body mass index (BMI) percentiles as underweight (UW), at risk of UW (RUW), normal, overweight (OW), or obese (OB). Median age and race were similar in all groups. Sixty-one percent of OB children were from the United States/Canada. Three-year relapse-free and overall survival ranged from 48% to 52% (P = .54) and 55% to 58% (P = .81) across BMI groups. Three-year leukemia relapses were 33%, 33%, 29%, 25%, and 21% in the UW, RUW, normal, OW, and OB groups, respectively (P < .001). Corresponding cumulative incidences for transplant-related mortality (TRM) were 18%, 19%, 21%, 22%, and 28% (P < .01). Multivariate analysis demonstrated a decreased risk of relapse compared with normal BMI (relative risk [RR] = 0.73; P < .01) and a trend toward higher TRM (RR = 1.28; P = .014). BMI in children is not significantly associated with different survival after BMT for hematologic malignancies. Obese children experience less relapse posttransplant compared with children with normal BMI; however, this benefit is offset by excess in TRM.

Cardiovascular disease risk factors are elevated in urban minority children enrolled in head start.

The prevalence of obesity and overweight persists in the preschool population, despite some prevention and treatment advances, particularly in minorities. Investigating the prevalence of dyslipidemia and the effect of family health may also guide the focus of intervention efforts. Anthropometric data were collected from urban minority preschool children (n=161; 42% female) enrolled in USDA Head Start. Blood was collected by finger prick and analyzed with the Cholestech LDX Analyzer (Cholestech Corporation, Hayward, CA). Caregivers provided a self-reported family health history for cardiovascular diseases (CVDs). By BMI percentile, 8% of the children were underweight (UW), 54% healthy weight (HW), 10% overweight (OW), and 28% obese (OB). One of every 5 children had borderline or high-risk levels for total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides based on the National Cholesterol Education Program categories. In OW/OB children only, BMI was positively correlated with TC (r(61)=0.428; p=0.001) and LDL (r(58)=0.395; p=0.005). Child BMI was also associated with family comorbid diseases (r(159)=0.177; p=0.025). UW/HW children with a family history of CVD had significantly higher LDL than UW/HW children without a family history of CVD (p=0.001). Step-wise regression analysis revealed that BMI (p=0.005) plus family history of heart attack (p=0.018) were significant predictors of blood TC levels. Continued efforts to treat and prevent elevated weight are urgently needed for minority preschoolers. Attention to CVD screening may be an important target in school, community, and healthcare arenas for minority populations regardless of weight status.

Association between body mass index and quality of life in Chinese adults

To assess the relationship between body mass index and quality of life (QOL) in Chinese adults. 83 347 subjects from database of 2010 Chronic Non-communicable Disease and Risk Factor Surveillance in China were included in this study. Questionnaire was used to collect general information and health status. WHO QOL-BREF was adopted as an instrument to measure the quality of life among all the subjects. Weight and height of each subject were measured, and then body mass index (BMI) was calculated. Kruskal-Wallis test was used to compare QOL from different BMI classifications. Multiple logistic regression analysis was used to assess the association of QOL with BMI in different sex. Among 83 347 subjects, when compared with normal weight adults, their QOL scores were relatively low for those underweight, overweight and obese adults. Scores of psychological and environment domains in the overweight adult groups were higher than other groups. The highest score of social relationship domain was for obese group and the lowest score was seen in the underweight group. Differences on the above said groups were significant (P < 0.000 1). When compared to normal weight adults, after adjusting for other factors, OR impaired QOLs in physical (OR = 1.38, 95% CI:1.12-1.70), mental (OR = 1.29, 95% CI:1.08-1.54), social relationship and (OR = 1.26, 95% CI:1.08-1.47) and environment domains (OR = 1.37, 95% CI:1.12-1.67) all increased among men in the underweight group. However, ORs of impaired QOL in physical (OR = 0.88, 95%CI:0.82-0.94; OR = 0.90, 95%CI: 0.82-0.98), psychological (OR = 0.88, 95% CI:0.83-0.94; OR = 0.83, 95% CI:0.77-0.90), social relationship (OR = 0.89, 95%CI:0.84-0.94; OR = 0.78, 95%CI:0.71-0.85) and environment domains (OR = 0.85, 95%CI:0.80-0.92; OR = 0.79, 95%CI:0.73-0.86) decreased among both overweight and obese men, respectively. For women,ORs of impaired QOL in social relationship (OR = 0.92, 95%CI: 0.85-0.98) and environment domains (OR = 0.91, 95%CI:0.80-0.92) both decreased in the overweight group. And the ORs decreased also in impaired QOL in social relationship domain (OR = 0.86, 95%CI: 0.78-0.95) for obese women. QOLs of the four domains were different for adults with different BMl classification. Underweight men showed poor QOL on these four domains while overweight and obese men had better QOLs. For women, overweight group had better QOLs in both relationship and environment domains but obese women had better relationship QOL.

Increased Body Mass Index Negatively Affects Patient Satisfaction After a Posterior Fusion and Instrumentation for Adolescent Idiopathic Scoliosis

Study DesignRetrospective. Summary of Background DataPrevious studies have reported the correlation of body mass index (BMI) with non-spine surgical outcomes; however, only a few reviewed the correlation of BMI to outcomes after spine surgery. ObjectivesTo review the influence of preoperative BMI on the follow-up clinical and functional outcomes after posterior-only fusion (PSF) and instrumentation for adolescent idiopathic scoliosis in a larger patient cohort. MethodsRetrospective review of a consecutive series of patients treated with PSF for adolescent idiopathic scoliosis from 2002 to 2009 at a single institution. There were 3 categories: underweight (UW), normal weight (NML), and overweight (OW). Percent correction of the major curve was collected at 2 years postoperatively and patient outcome scores were analyzed preoperatively and at 2 years postoperatively. Differences between groups were analyzed using analysis of variance, with p < .05. ResultsA total of 459 patients at an average age of 15.0 years (range, 10.0–21.3 years) treated with PSF instrumentation were included. At 2 years, all groups achieved and maintained equal percent correction with no differences between groups. Regarding preoperative Scoliosis Research Society (SRS) outcome scores, OW patients reported more pain than NML (p = .002) and UW patients (p < .001) despite less reported activity than for the NML (p = .033) and UW groups (p = .005). The total SRS score was also lower in the OW patients compared with NML (p = .009) and UW patients (p = .002). At 2 years, the OW group reported more pain than the UW (p = .031) and NML groups (p = .018), lower mental scores (p = .011) and lower SRS total scores (p = .005) than the NML group. ConclusionsAt follow-up, preoperative overweight adolescents reported more pain and lower mental, activity, and appearance domain scores after surgery than UW and NML patients despite equal percent curve correction. This information may help the surgeon with preoperative counseling of OW patients by stressing that their own assessment of outcome is influenced by BMI, which may help promote a healthy weight management program in this patient group.

Factores de riesgo de los trastornos hipertensivos inducidos por el embarazo en mujeres atendidas en una entidad de salud de Santa Marta

The Hypertensive disorders of pregnancy are a public health problem, is the first cause of maternal death in the developed countries and the third in developing countries. Objective: To identify the riskfactors those determine the occurrence of the hypertensive disorders in pregnant women attending in a health institution of Santa Marta, Colombia, in the months of January 2011 to January 2012. Materials and Methods: descriptive study, quantitative retrospective, executed in a group of 51 pregnant patients who had hypertensive disorders. The collection techniques of information used were based on the documentary review (medical history) and the application of an inquest previously validated by experts. Through these methods found variables which allowed identifying the risk factors in the hypertensive disorders of pregnant women. Results: The age distribution was ubicated in the range 26-34 years old / 54.8%), risk factors present were: underweight (45.0%), not attending antenatal care (11.8%), multiparous (56.9%), socioeconomic status medium high (45.1), family history related hypertensive disorder of the mother (39.2%), medical history of urinary tract infections (83.3%) and alcohol consumption (58.8%). Conclusions: The risk factors of medical history of urinary tract infections occurred in a high percentage (83.3%), alcohol consumption, and family history multiparity, occupied an important place, while the significant level of assistance to prenatal care not prevent the appearance of hypertensive disorder.

Body mass index and cancer incidence:a prospective cohort study in northern China

To evaluate the association and its strength between body mass index (BMI, kg/m(2)) and cancer incidence in a large-scale population-based cohort study. A dynamic cohort was established on May 1, 2006. Baseline information on demography, lifestyle, anthropometry such as body height and weight, were collected during the first interview, and cancer incidence, mortality and other related outcome information were obtained through active follow-up every two years and passive follow-up every year. Cancer cases diagnosed within 1 year follow-up period were excluded. Multivariable Cox proportional-hazards regression model was used to calculate the hazard ratios (HRs)and 95% confidence interval (CI) between BMI and cancer incidence after adjusted for age group, education level, tobacco smoking (smokers and non-smokers), alcohol consumption (drinkers or non-drinkers) and HBsAg status (positive or negative, for liver cancer only) when appropriate. Repeated analysis was carried out on male lung cancer, male liver cancer and female breast cancer, stratified by tobacco smoking, HBsAg status and menopausal status respectively. By December 31, 2011, a total of 133 273 subjects, including 106 630 (80.01%)males and 26 643(19.99%)females were enrolled in the cohort. There were 570 531.02 person-years of follow-up and 4.28-year of average follow-up period. According to the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, study subjects were divided into groups as: underweight (BMI<18.5 kg/m(2)), normal weight (BMI 18.5 kg/m(2)-23.9 kg/m(2)), overweight (BMI 24.0 kg/m(2)-27.9 kg/m(2)) and obese(BMI≥28.0 kg/m(2)). In males, 2 387 (2.24%) were underweight, 45 090(42.29%)were normal weight, 43 774 (41.05%) were overweight and 15 379 (14.42%) were obese. Meanwhile, in females, 858 (3.22%)were underweight, 14 037 (52.69%) were normal weight, 8 507 (31.93%) were overweight and 3 241 (12.16%) were obese. A total of 1 647 incident cancer cases among different cancers were collected during the follow-up, including 1 348 in men and 299 in women. Results from Multivariate Cox proportional-hazards regression model showed that 'underweight' increased the risk on both gastric cancer incidence (adjusted HR = 3.82, 95% CI: 1.97-7.38) and liver cancer incidence (adjusted HR = 3.00, 95% CI:1.36-6.65) in males, while both 'overweight' (adjusted HR = 1.98, 95% CI:1.03-3.82) and 'obesity' (adjusted HR = 2.75, 95% CI: 1.25-6.06) increased the risk of colon cancer incidence in males. But for bladder cancer incidence in males, overweight seemed being protective (adjusted HR = 0.44, 95%CI:0.23-0.84). And for lung cancer incidence in males, both overweight and obesity were protective as well (adjusted overweight vs. normal weight, HR = 0.59, 95%CI: 0.46-0.76;adjusted obese vs. normal weight, HR = 0.64, 95%CI: 0.44-0.92). In females, obesity increased the risk of breast cancer incidence(adjusted HR = 1.86, 95%CI:1.05-3.31). Further analysis for lung cancer cases stratified by tobacco smoking, data showed that overweight decreased the risk of lung cancer in both male non-smokers (adjusted HR = 0.50, 95%CI:0.35-0.72) and male smokers (adjusted HR = 0.70, 95%CI:0.50-0.98) while obesity decreased the risk of lung cancer in male non-smokers(adjusted HR = 0.57, 95% CI:0.33-0.97), but not in smokers (adjusted HR = 0.72, 95%CI:0.43-1.21). Stratified analysis in females by menopausal status, data showed that obesity increased the incidence of breast cancer in postmenopausal subjects (adjusted HR = 1.97, 95% CI:1.01-3.82), but not in premenopausal subjects. The association between BMI and cancer incidence varied by cancer site. Underweight increased the risk of gastric cancer and liver cancer in males, and obesity increased the risk of colon cancer in males, breast cancer and ovarian cancer in females. However, overweight might played a protective role in lung cancer incidence and bladder cancer incidence in males and obesity might play a protective role in lung cancer incidence in male non-smokers.

Obese Trauma Patients Have Worse Outcomes

To determine complication and mortality rates for obese trauma patients, researchers reviewed records for nearly 150,000 patients older than 16 years who were admitted to 28 level I and II trauma centers in Pennsylvania between 2000 and 2009. Patients were categorized as underweight …

Effects of pre-pregnancy body mass index on pregnancy outcomes

To explore the effects of pre-pregnancy body mass index (BMI) upon adverse pregnancy outcomes. We selected a population-based cohort of 48 867 nulliparous women in mainland China with singleton and full-term deliveries in 2011. The cohort was categorized in accordance with pre-pregnancy BMI as follows: underweight <18.5; normal weight = 18.5-23.9; overweight = 24-27.9; obesity ≥ 28. Logistic regression was used to estimate the association between BMI and adverse maternal, peripartum and perinatal outcomes with normal weight as a reference range. (1) Overweight and obese women were more likely to have hypertensive disorders with odds ratios of 2.29 and 6.02, gestational diabetes mellitus 2.27, 4.99; (2)the odds ratios for fetal macrosomia increased among women with higher BMI as follows: 0.59, 1.99 and 3.15, whereas only lean women had significantly increased risk of delivering babies with low birth weight (LBW) 1.62; (3)increased BMI was associated with reduced rates of assisted vaginal delivery and increased rates of caesarean section. As an independent risk factor for adverse maternal and fetal outcomes, pre-pregnancy obesity should be managed properly.

Trends, Patterns and Issues of Child Malnutrition in Bangladesh

Good nutrition is a prerequisite for the national development of countries and wellbeing of individuals. Although problems related to poor nutrition affect the entire population, but children and women are especially vulnerable because of their unique physiology and socioeconomic characteristics. Bangladesh is among the top listed countries where the prevalence of malnutrition is highest in the world. According to UNICEF, malnutrition rates have seen a marked decline in Bangladesh throughout the 1990s, but remained high at the turn of the decade. A number of studies have been done by national and international organizations to evaluate the nutritional situation of Bangladesh. According to the latest national study, 41 percent of children under age 5 are stunted, 16 percent are wasted and 36 percent are underweight. The prevalence of anemia among infants, adolescent girls and pregnant women is still at unacceptable levels. The present study is an attempt to determine the trends and patterns of malnutrition among children in Bangladesh. The study also focused on potential issues of child malnutrition in Bangladesh. This study involved an analysis of secondary data and information which have been collected from different sources. The analysis shows a clear picture of the current trend and pattern of malnutrition in Bangladesh. Malnutrition and ill health are traceable partly to economic causes, food availability and educational factors. Ignorance is perhaps the biggest hurdle facing the silent majority in Bangladesh. Women’s education, knowledge about sound feeding practices and eating habits, growth monitoring and women supportive socio-cultural norms need to be given more emphasis to overcome the present situation. Key words : Child malnutrition, Health, Bangladesh, Child care, Food availability, Poverty, Education, Natural disaster.

A cross sectional study to measure the prevalence of malnutrition and factors associated with malnutrition among under five children of an urban slum of Vadodara city

Background: Malnutrition is one of the most common causes of morbidity and mortality among children throughout the world, more so in developing nations. Malnutrition among urban poor children is worse than in rural areas. Children living in the urban slums are exposed to risks of infectious diseases, malnutrition and possibly impaired cognitive development. Aim: To know the prevalence of malnutrition and its factors among under five children of an urban slum Material & Methods: Community based cross-sectional study was carried out in an urban slum area of Vadodara city, Gujarat (population = 7000). Total 395 children of 0-5 years of age were enrolled in the study. Equal numbers of children were selected from each of the five Anganwadi area of that urban slum. All mothers or primary care takers of the children were interviewed and weight and height of the children was recorded. Results: Prevalence of underweight, stunting and wasting was 32.4%, 46.1% and 17.2% respectively. Mother’s literacy, low birth weight and morbidities like diarrhoea, fever and cough in previous fifteen days were significantly associated with malnutrition. Conclusion: chronic malnutrition was more prevalent in this area. No child was found to be overweight or obese. Mother’s literacy had a much higher impact on better nutritional status of children. Low birth weight was found to have adverse effect on nutritional status of children. Morbidities like diarrhoea, fever and cough had made the children nutritionally vulnerable as malnutrition was higher in those children. Key words: under five children, urban slum, prevalence, malnutrition

우리나라 중학생의 체질량지수 및 주관적 체형인식과 우울감 경험의 관련성

이 연구에서는 우리나라 중학생의 체질량지수 및 주관적 체형인식과 우울감 경험의 관련성을 파악하였다. 2012년도 청소년 건강행태 온라인 조사에 참여한 중학교 1학년부터 3학년 재학생 37,297명을 분석대상으로 하였다. 비만 및 주관적 체형인식과 우울증의 관련성은 위계적 로지스틱 회귀분석을 이용하여 분석하였다. 연구결과, 자신의 체형이 저체중이라고 인지하는 중학생은 우울감 경험의 관련성이 약 111%(OR=1.11, 95% CI: 1.03-1.20) 더 높았고(p 【The aim of this study was to determine the association between the Body Mass Index (BMI), weight perception and depression-like symptoms in Korean middle school students. The data was obtained from the 2012 Korea Youth Risk Behavior Web-based Survey. The subjects were 37,297 students living in the community. Adjusting for covariates (sex, school year, home economics, city-type, school record, self-reported happiness, self-reported health status, suicidal thinking, smoking, alcohol consumption), the self-reported obesity (OR=1.14, 95% CI: 1.06-1.22) and self-reported underweight (OR=1.11, 95% CI: 1.03-1.20), compared to the self-reported healthy weight, were more likely to have depression-like symptoms. On the other hand, the BMI-based weight was not associated independently with depression-like symptoms. These findings suggest that weight perception is significantly associated with depression-like symptoms.】

Měranao Adolescent Students with Weight Problems: Their Eating Habits and Nutritional Intake

Normal body weight is important for longevity among adolescents. This is usually the function of eating habits, nutrition and genetics. This study aimedto 1) determine the existence of weight problems among high school student adolescents in the province of Lanao del Sur; 2) describe the eating habits and nutritional intake of this age group in the context of Měranao culture; and, 3) find out possible correlates of the weight problems. A survey of a representative sample of 148 Měranao high school students with weight problems aged 12-19 years old in the different high schools in Lanao del Sur was conducted, which inquired about their eating habits and nutritional intake and basic demographics. Calculation of Body Mass Index (BMI) was based on students’ health record of height and weight from the School Clinic.Based on Body Mass Index (BMI), almost 80% of respondents with weight problems were overweight while the 20% were underweight. Eating habits and nutritional intake were poor to moderate. Age and estimated monthly family income were significantly correlated with weight problems. Měranao adolescent students’ weight problems were more on being overweight than underweight; their poor eating habits and deficient nutritional intake contributed to their weight problems. Hence, mothers’ role in their children’s nutrition should be given emphasis. Keywords: Health Education, Měranao adolescents, overweight, eating habits, nutritional intake, Philippines

Risk factors associated with malnutrition of infants exposed to HIV in Henan province, 2010-2012

To examine the malnutrition status of infants exposed to HIV in rural areas of Henan province and related risk factors. Z scores of weight for age, height for age and weight for height of infants exposed to HIV in rural areas of Henan province born in 2010-2012 were calculated at 1, 3, 6, 9, 12 and 18 months of age. Z scores were used to evaluate the nutrition status of infants under study. Data regarding the pregnant women and infants were collected and analyzed by non-conditional logistic regression model. One hundred fifty-seven infants were surveyed in which 125 were HIV negative and 32 were HIV positive. The incidence rates of underweight, athrepsia and growth retardation of HIV-negative infants were 8.8%, 16.8% and 30.4%, respectively. The incidence rates of underweight, athrepsia and growth retardation among the HIV-positive infants were 15.0%, 30.0% and 41.7%, respectively. Anemia in pregnancy (RR = 2.05, 95% CI:1.15-3.66), low count of CD(4)(+)T leuko-monocyte (RR = 1.43, 95% CI:1.18-1.74), status of complementary feeding before 4 months old (RR = 1.96, 95% CI:1.40-2.74) might serve as the risk factors related to the situation. Infants received antiviral treatment (RR = 0.14, 95% CI:0.02-1.04), normal birth weight (RR = 0.08, 95%CI:0.04-0.15) might serve as the protective factors. The malnutrition incidence was high among those infants younger than 18 months exposed to HIV in rural area of Henan province. Essential health services such as antenatal care, artificial feeding and growth monitoring for infants and pregnant infants should be provided to prevent malnutrition among these sub-populations.

Relationship of low lean body mass with body weight increase until one year of age and current lifestyles in Japanese young women.

To investigate factors affecting the low lean body mass (LBM) of young women, we focused on the increase in body weight until one year of age and current lifestyles. In 442 young women, the increase in body weight from birth until one year of age, breast-feeding method in infancy, current physique index and body composition, and physique and lifestyles were investigated using a questionnaire. Subjects with an LBM percentile of less than 33.3 (less than 36.8 kg) were classified as having a low LBM (n = 150), and those with a 33.3 or higher LBM percentile as the control (n = 293). Based on body weight changes from birth to days 3 and 7, the subjects were divided into a rapid weight gain group and two non-rapid weight gain groups (groups 1-3). To analyze factors involved in a low LBM, multivariate analysis using a logistic model was employed. The prevalence of a low LBM in the rapid weight gain group was 0.41 times higher than in the others. The prevalence of a low LBM with a low birth weight was 0.58 times higher, indicating that a low birth weight is likely to result in a low LBM. Regarding the lifestyles, the prevalence of a low LBM in subjects with a current breakfasting habit was 0.60 times higher than in those without one. These findings suggest that the thinness of young women characterized by a low LBM is associated with the increase in body weight until one year of age and current lifestyles.

Trend in gender disparities of BMI and height between 2004 and 2011 among adolescents aged 17-18 years in Changzhou China.

to describe the trend in gender disparities of overweight/obesity and underweight, as well as height, among Chinese adolescents. the study is based on population-based data from annual health checks of approximately 7,000 students finishing high school each year between 2004-2011. Height and weight were measured. Overweight/obesity and underweight were defined using International Obesity Task Force (IOTF) criteria. School level socioeconomic status (SES) was constructed based on real-estate prices near each school. there was a slight increase in the prevalence of obesity between 2004 and 2011; 3.7% to 4.7% in boys and 1.1% to 1.5% in girls. The prevalence of overweight was quite stable in both genders (boys: 12%-15%; girls: 7%-10%). In most years, the prevalence of underweight was above 10%. The prevalence of underweight in girls born after 1991 increased dramatically. However, the opposite trend was seen in boys. School SES was positively associated with overweight and inversely associated with underweight among boys. There was a significant increase in height in both genders. Height and BMI was positively associated in boys but this relation was inversely associated in girls. between 2004 and 2011, the prevalence of overweight/obesity was plateauing among adolescents finishing high school. A substantial increase in the prevalence of underweight was observed among girls born after 1991 but this seemed to be positively associated with high SES.

Choices of pedicle skin flaps in repairing cutaneous defects of foot and ankle

Objective To explore and summarize the choices of pedicle skin flaps in repairing cutaneous defect of foot and ankle.Methods Defects of forefoot,pedal dorsum,pedal plantar and ankle were repaired with pedicle skin flaps such as dorsal pedal flap,medial plantar flap,plantar metatarsal flap,fibular hallux flap,tibial flap of 2nd toe,anterior tibial artery flap,posterior tibial artery flap,sural nerve flap,lateral tarsal artery flap,anterior ankle artery flap peroneal artery flap etc.Results Except for necrosis of 2 cases of flap,the other 249 flaps all survived.Blood vessel crisis was induced in 5 patients on 1st postoperative day,and in 2 cases on 2nd postoperative day,by tight package of transplanted skin,which was treated by emergent explorative operation.Finally 135 cases got 3 to 96 months' followed up(average of 16 months).There were 4 cases of medial pedal flap and 3 cases of plantar metatarsal flap received secondary reshaping for treating skin wear out.Nine cases of posterior tibial artery flap,and 6 cases of sural nerve flap were reshaped secondarily to improve bulk shape.Other flaps did not need secondary reshaping.Among them,in medial pedal flap,fibular-side flap of hallux,and tibialside flap of 2nd toe,sensory nerve were all transferred together with the flap,and normal sensory was got,with 4-10 mm two point discrimination.Condusion In covering tissue defects on heel or plantar side of forefoot,medial plantar artery flap is ideal.For defects on plantar side of forefoot,plantar metatarsal flap,fibular hallux flap,tibial flap of 2nd toe have the advantages of wear resistance and nerve innervation.While dorsal pedal flap,anterior tibial artery flap,posterior tibial artery flap,sural nerve flap,lateral tarsal flap,anterior ankle artery flap,and peroneal artery perforator flap have the advantages of large size,thinness,similar color with recipient site,and constant anatomical position,they are feasible for repairing defects on dorsum of foot or near ankle. Key words: Foot ; Ankle ; Surgical flap; Transplantation; Microsurgery