Waist Circumference Measurements Research Articles

Development of a Model for Modifying Eating Behaviour among Overweight Working People in Health Region Sixth Ministry of Public Health

This research and development study aimed to develop and evaluate the effectiveness of a program designed to modify eating behaviors among overweight working individuals. Phase 1: A draft prototype was synthesized by applying the stages of change model and studying weight loss activities and eating behaviors among 65 overweight factory employees. Phase 2: The prototype was developed in 10 small groups, totaling 36 participants, resulting in three behavioral modification modules: 1. "Well Begun is Half Done" 2. "Win Small, Win Early, Win Often" and 3."I Can Do It". Phase 3: The effectiveness of the prototype was tested among experimental groups, with 39 participants per module, compared to control groups of equal size. Data were analyzed using t-tests. Research Results: 1) The stages of change in the experimental groups improved significantly. 2) The process of behavior change showed statistically significant improvement. 3) Perceptions of the pros of behavior change increased significantly, while perceptions of the cons decreased significantly. 4) Confidence levels increased significantly, while temptation levels decreased significantly. 5) Body mass index, waist circumference, and visceral fat measurements improved significantly.

Ethnic disparities in the prevalence of diabetes and its association with sleep disorder among older adults in rural southwest China.

This study aimed to examine ethnic disparities in the prevalence of diabetes and its association with sleep disorders among the older adults Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China. A cross-sectional survey of 5,642 was conducted among the rural southwest population aged ≥60 years, consisting of a structured interview and measurement of fasting blood glucose, height, weight, and waist circumference. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The overall prevalence of diabetes and sleep disorder was 10.2% and 40.1%, respectively. Bai participants had the highest prevalence of diabetes (15.9%) and obesity (9.9%)(P < 0.01), while Ha Ni participants had the lowest prevalence of diabetes (5.1%) and obesity (3.4%)(P < 0.01). The highest prevalence of sleep disorder (48.4%) was recorded in Bai participants, while Dai participants had the lowest prevalence of sleep disorder (25.6%)(P < 0.01). In all four studied ethnicities, females had a higher prevalence of sleep disorder than males (P < 0.01), and the prevalence of sleep disorder increased with age (P < 0.01). The results of multivariate logistic regression analysis indicated older adults with sleep disorder had a risk of developing diabetes (P < 0.05). Moreover, the higher educational level, family history of diabetes, and obesity were the main risk factors for diabetes in participants (P < 0.01). There are stark ethnic disparities in the prevalence of diabetes and sleep disorders in southwest China. Future diabetes prevention and control strategies should be tailored to address ethnicity, and improving sleep quality may reduce the prevalence of diabetes.

The association between waist circumference and adult asthma attack using nationally representative samples

AimsThis study aims to explore the relationship between waist circumference and asthma attack in adults.MethodsIn this cross-sectional study, we analysed data from 5,530 U.S. adults diagnosed with asthma. Participants were categorized into two groups based on their experience of asthma attacks: with or without asthma attacks. We employed adjusted weighted logistic regression models, weighted restricted cubic splines, subgroup and sensitivity analyses to assess the association between waist circumference and asthma attack.ResultsThe median age of all participants was 43 years, and the median waist circumference was 98.9 cm, with a median BMI was 28.50 kg/m2. Participants in the asthma attack group had significantly higher waist circumferences than those in the non-attack group (P < 0.001). After full adjustment for body mass index-defined obesity, age, gender, race, education levels, poverty income ratio levels, smoking status, and metabolic syndrome, every 5 cm increase in waist circumference exhibited a 1.06 times higher likelihood of asthma attack probability. The weighted restricted cubic spline analysis demonstrated an increased risk of asthma attacks with rising waist circumference. Subgroup analyses confirmed this relationship across various groups differentiated by gender, age, and smoking status. When applying a stricter definition of asthma attack, the weighted logistic regression models showed robust association between waist circumference and asthma attack.ConclusionWaist circumference is an independent predictor of asthma attacks. Our findings underscore the importance of waist circumference measurement in evaluating the risk of asthma attacks.

CORRELATION BETWEEN VARIOUS ANTHROPOMETRIC AND MUSCULOSKELETAL MEASUREMENTS AND HEMORRHOIDS IN PREGNANCY

Purpose: The aim of this study was to determine the presence of hemorrhoids in pregnancy and symptoms related to hemorrhoids and to evaluate the relationship between hemorrhoids in pregnancy and various anthropometric and musculoskeletal parameters. Methods: The retrospective cross-sectional study included pregnant women in 3 different trimesters (1st, 11-15 weeks; 2nd, 16-23 weeks; 3rd, 24-40 weeks) without any anorectal problems before pregnancy. The presence of hemorrhoids and other anorectal symptoms during pregnancy was evaluated with yes/no questions on self-reported scales. Results: Evaluation was made of 268 pregnant women (92, 1st Trimester; 107, 2nd Trimester; 69, 3rd trimester). In the whole study sample, waist circumference measurement (p = 0.042; OR = 1.13; 95% CI 1.07–1.92), bi-iliac width (p = 0.036; OR = 1.17; 95% CI 1.09–1.38), rectus abdominis muscle strength (p = 0.006; OR = 0.45; 95% CI 0.04–0.58), Diastasis-recti-abdominis grade measured from umbilicus level (p = 0.023; OR = 1.38; 95% CI 1.14–1.83), hypermobility score (p = 0.006; OR = 3.34; 95% CI 1.98–7.94) and parity (p = 0.032; OR = 2.47; 95% CI 1.85–7.19) were found to be important risk factors for the presence of hemorrhoids in pregnancy. Conclusion: This is the first study to have evaluated hemorrhoids and hemorrhoid-related symptoms and to examine the associated risk factors comprehensively. It was also demonstrated for the first time that waist circumference measurement, bi-iliac width, increased grade of Diastasis-recti-abdominis measured at umbilicus level, hypermobility score, and decreased rectus abdominis muscle strength were risk factors for hemorrhoids in pregnancy.

The association between waist-to-height ratio and cognitive function in older adults

ABSTRACT Objectives The waist-to-height ratio (WHtR) is a simple, practical, and effective tool used to assess central obesity. Despite its usefulness, few studies have investigated the association between WHtR and cognitive function among older adults in the United States. This study aims to investigate the associations between WHtR and cognitive function. Methods The study sample comprised adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014. WHtR was calculated from measured waist circumference and height. Cognitive function was assessed using the digit symbol substitution test. A weighted multiple linear regression analysis was performed to evaluate the association between WHtR and cognitive function, with smooth curve fitting applied to detect non-linearities. Results Our analysis included 1709 participants over the age of 65. After adjusting for potential confounders, WHtR was found to have a negative association with cognitive function (β = −36.91, 95% CI: −54.54 to −19.29, P < 0.001). Subgroup analyzes stratified by sex and race showed that the negative correlation of WHtR with cognitive function remained in both men and women, as well as in non-Hispanic white and other races. Among women, the association between WHtR and cognitive function followed an inverted U-shaped curve, with an inflection point of 0.68. Conclusion This study provides evidence of a negative association between WHtR and cognitive function in older adults. These findings suggest that in advanced age, central obesity may have negative implications for cognitive function.

Seasonal variability in body mass index, waist circumference, and skinfolds in Norwegian children.

Studies have shown that children develop a higher body weight during summer months. This has been demonstrated repeatedly using the body mass index (BMI), but the effect of season on other weight-related anthropometric measurements is still unclear. Measurements of height, weight, waist circumference (WC), triceps, and subscapular skinfolds (TSF and SSF), collected from September till May in a cross-sectional sample of 4-16-year-old children and adolescents (n = 4525) from the Bergen Growth Study 1 (BGS1). Differences in z-score by season were tested with linear models adjusted for age group and separately for sex. Overall differences were tested with a one-way between-group analysis of variance. The girls had higher BMIz (+0.12, p = .03) and WCz (+0.18, p = .002) in fall compared with spring. TSFz (-0.19, p < .001) and SSFz (-0.18, p < .001) were lower in winter in girls, and in boys both in fall (TSFz -0.10, p = .046; SSFz - 0.16, p < .001), and winter (TSFz -0.15, p = .004; SSFz -0.14, p = .003), when compared with spring. Seasonal variation was detected for all anthropometric measures, but differences in the direction of the effect between measures of global (BMI), central (WC) or subcutaneous (SF) adiposity suggest a more complex mechanism that needs further exploration.

The synergistic effect of obesity and dyslipidemia on hypertension: results from the STEPS survey

BackgroundObesity and dyslipidemia are important risk factors for hypertension (HTN). When these two conditions coexist, they may interact in a synergistic manner and increase the risk of developing HTN and its associated complications. The aim of this study was to investigate the synergistic effect of general and central obesity with dyslipidemia on the risk of HTN.MethodData from 40,387 individuals aged 25 to 64 years were obtained from a repeated cross-sectional study examining risk factors for non-communicable diseases (STEPS) in 2007, 2011 and 2016. Body mass index (BMI) was calculated as a measure of general obesity and waist circumference (WC) as a measure of central obesity. Dyslipidemia was defined as the presence of at least one of the lipid abnormalities. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or current use of antihypertensive medication. To analyze the synergistic effect between obesity and dyslipidemia and HTN, the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated. A weighted logistic regression model was performed to estimate the odds ratios (ORs) for the risk of HTN.ResultsThe results showed an association between obesity, dyslipidemia and hypertension. The interaction between obesity and dyslipidemia significantly influences the risk of hypertension. In hypertensive patients, the presence of general obesity increased from 14.55% without dyslipidemia to 64.36% with dyslipidemia, while central obesity increased from 13.27 to 58.88%. This interaction is quantified by RERI and AP values of 0.15 and 0.06 for general obesity and 0.24 and 0.09 for central obesity, respectively. The corresponding SI of 1.11 and 1.16 indicate a synergistic effect. The OR also show that the risk of hypertension is increased in the presence of obesity and dyslipidemia.ConclusionObesity and dyslipidemia are risk factors for HTN. In addition, dyslipidemia with central obesity increases the risk of HTN and has a synergistic interaction effect on HTN. Therefore, the coexistence of obesity and lipid abnormalities has many clinical implications and should be appropriately monitored and evaluated in the management of HTN.

IJCM_172A: Risk Scoring of Type 2 Diabetes Mellitus and Coverage of Screening Services through Primary Health Care System among Adults in a Block of Murshidabad District, West Bengal

Background: Type 2 diabetes is a major public health challenge. Indian Diabetes Risk Score (IDRS), a simple and cost-effective tool consisting of two modifiable (waist circumference, physical activity) and two non-modifiable risk factors (age, parental history) for diabetes, can be easily applied in mass screening programmes. Opportunistic screening for diabetes among individuals aged = 30 years is being done under the programme for Prevention and Control of Non-communicable Diseases. Objective: To assess the risk of type 2 diabetes mellitus using IDRS, coverage of screening services for diabetes through the primary health care delivery system and to identify their correlates. Methodology: : A descriptive, cross-sectional study was conducted in a block of Murshidabad district, West Bengal during September to November 2023 among permanent residents aged = 30 years on a calculated sample of 300 selected through multi-stage sampling. Required data were collected by interviewing the study subjects using pre-designed, pre-tested schedule including IDRS, reviewing medical records and measuring waist circumference. Analysis was done using SPSS-20. Results: Among 300 participants, 40.7% had high risk; 54% and 5.3% had moderate and low risk of diabetes respectively according to IDRS. In multivariable analysis, age =35 years (AOR 18.10, 95% CI 5.07-64.66), female gender (AOR 2.36, 95% CI 1.40-4.00) and being in joint family (AOR 3.53, 95% CI 1.77-7.04) were significant correlates for high-risk category according to IDRS. Only 67% were screened for diabetes within last six months, of which 89% were through primary health care delivery system. Screening status varied significantly by age group (OR 3.81, 95% CI 1.98-7.35) and IDRS risk categories (OR 1.72, 95% CI 1.06-2.80). Conclusion: Alarmingly substantial proportion of people in the area are at high/moderate risk of diabetes coupled with low opportunistic screening coverage, which highlights the need for intensive behaviour change communication and stronger service delivery.

Sarcopenia prevalence between obese and morbid obese patients in an obesity center

Background/Aim: Sarcopenia and obesity are independent diseases that result in decreased muscle strength and function. Few studies have been conducted on the association of sarcopenia and obesity, especially in women. This study aims to measure the possibility of sarcopenic obesity in women with obesity. Methods: Our study was organized using a prospective cross-sectional study in Turkey. A total of 135 volunteer were included in the study. Inclusion criteria required the patients to have a BMI &gt;35 kg/m2 or BMI &gt;40 kg/m2 and no current comorbid disease. The exclusion criteria included: age (&lt;18 and &gt;70 years were excluded), history of muscle disease, malignancy, psychiatric disorders such as bipolar disease and psychosis, malnutrition, and recent corticosteroid (CS) use (within the last three months). Probable sarcopenia is determined by low skeletal muscle strength, and confirmed sarcopenia is defined if there is both low skeletal muscle mass and low skeletal muscle quality. Muscle strength was measured with isometric dynamometry using the handgrip method. A six-minute walk test (6MWT), in which we measured walking speed, was performed to determine the physical performance of the patients. We adjusted appendicular skeletal muscle (ASM) using height squared (ASM/height2) bioelectrical impedance analysis (BIA) to measure the muscle mass. Results: Patients’ mean age was 43 (11.4) (20-69) years. Of the total participants, 64.6% were in the age range of 40-59; 19.2% of patients were defined as possible sarcopenia; and 2.2% had confirmed sarcopenia. A total of 78.5% of patients did not meet any of the sarcopenia criteria. We determined that there was no difference in anthropometric measurements between sarcopenic and non-sarcopenic patients (P&gt;0.05), except for waist and hip circumferences. However, we did observe a noteworthy distinction in waist and hip circumference measurements between the two groups, with sarcopenic patients exhibiting larger circumferences (P=0.05 and P=0.032, respectively). Our study revealed a significant disparity in the results of the six-minute walk test and handgrip strength values between sarcopenic and non-sarcopenic patients (P&lt;0.001). Specifically, non-sarcopenic patients demonstrated higher values in both tests.. Conclusion: Obesity and sarcopenic obesity will continue to be a public health problem in the future among middle-aged women. It should be considered that the prevalence of decreased muscle strength was high in our study group, and physical performance decreased due to muscle strength. We concluded that as success in the six-minute walk test and handgrip values increased, the diagnosis of sarcopenia decreased, and each increase in platelet count increased the risk of sarcopenia in obese female patients.

Revisiting Waist Circumference: A Hypertension Risk Factor that Requires a More In-depth Understanding.

As a major cause of various cardiovascular diseases, the prevalence of hypertension has been increasing in the past 30 years, leading to significant socioeconomic and health burdens. Obesity is one of the major risk factors for hypertension. Body mass index (BMI) is the most used anthropometric index to measure obesity in clinical practice and to assess the risk of obesity-related diseases. However, obesity is a heterogeneous disease, and the accumulation of fat in different body regions leads to differences in cardiovascular and metabolic risks. BMI only reflects the overall obesity but does not consider the distribution of fat and muscle mass. The limitation of BMI makes it insufficient to assess the risk of hypertension attributed to obesity. In addition, waist circumference is an easily obtainable anthropometric index to evaluate abdominal fat distribution. High waist circumference is an independent risk factor for various cardiovascular diseases and all-cause mortality regardless of BMI. Preliminary data indicate that waist circumference is significantly associated with the risk of hypertension at different BMI levels. However, routine measurement of waist circumference is currently not required in current clinical guidelines or is only recommended for obese populations, indicating an insufficient understanding of waist circumference. In this review, we summarize the measurement methods and diagnostic thresholds of waist circumference for abdominal obesity, the trend of central obesity prevalence, the superiority of waist circumference over other anthropometric indices, and recent cross-sectional and longitudinal studies on the association between obesity and hypertension.

Neck circumference as an alternative marker of metabolic syndrome in Peruvian adults: A retrospective, cross-sectional study

Neck circumference is a low-cost and simple anthropometric measure that has been proven to accurately assess central obesity. However, evidence of its use and feasibility in low-resource settings is limited. We aimed to compare the utility of neck circumference with standard physical measures of obesity in northern Peru. This was a retrospective, cross-sectional study conducted among adults screened for metabolic syndrome. Body mass index, waist circumference, neck circumference, and additional measurements for metabolic syndrome were obtained. Assessments were performed following the WHO STEPS Surveillance Manual. Pearson correlation coefficients and multiple linear regression models were used to estimate the relationship of neck circumference to waist circumference and body mass index. Data from 250 participants showed a normal, homogeneous distribution in both men and women with respect to age and physical/biochemical measurements. The mean age was 53.6 years. A positive correlation of neck circumference with body mass index (r = 0.51 for women and 0.65 for men) and waist circumference (r = 0.6 for women and 0.74 for men) was observed. Multiple linear regression showed that a 1-cm increase in neck circumference increased body mass index by 0.72 kg/m2 (p < 0.001) in men and 0.94 kg/m2 (p < 0.001) in women, and waist circumference by 2.20 cm (p < 0.001) in men and 2.27 cm (p < 0.001) in women. Our findings suggest that neck circumference is a valid and reliable measure that will replace body mass index and waist circumference in Peruvian adults with central obesity; due to the strong correlation that exists between the NC and these anthropometric measurements, mainly because it is an easy, quick measurement and is less vulnerable to errors such as in the measurement of abdominal circumference or variabilities in weight.

Effect of the ‘Pilates stance’ and Pilates-based matwork training on measurements of height, waist circumference, and interscapular distance

BackgroundStandardised guidelines for stance are used to improve interobserver reliability in anthropometric measurements in clinical practice. A key feature of the stance in Pilates is the ‘drawing in and up’ of the abdomen. The aim of this study was to study the impact of the Pilates stance on height, waist circumference and interscapular distance, compared to that recommended in clinical practice. Methods48 healthy females (median age 60 years) were assessed before and after 10-week Pilates-based matwork training. One Pilates expert and one novice took independent measurements of weight, height, waist circumference and interscapular distance (ISD). ResultsPilates stance, compared to Normal, increased height by up to 2.7 cm and decreased waist up to 5.2 cm (each P < 0.001, repeated measures ANOVA). ISD decreased up to 14 mm (P < 0.001) and this decrease was greater after training (P < 0.001). After controlling for age and length of time learning Pilates, greater baseline ISD predicted a greater change in ISD after the intervention. Effect of Pilates stance was greater when the expert took the measurements (each P ≤ 0.001). ConclusionsActivation of trunk muscles in the Pilates stance increases height and decreases waist circumference, compared to the stance recommended in UK healthcare settings. A decrease in ISD was observed, which was greater after a Pilates-based matwork programme. There are significant inter-observer differences, therefore current clinical guidelines for stance are recommended for repeated anthropometry. The value of the Pilates stance in improving posture and the role of ISD as a marker, should be further studied in various contexts, including clinical settings.

Abstract 2197: Weight history and colorectal cancer risk in the Cancer Prevention Study-3 cohort

Abstract While the link between obesity and colorectal carcinogenesis is established, limited evidence suggests that early-life overweight/obesity may be an important consideration, particularly in the development of early-onset colorectal cancer (CRC). Using data from the American Cancer Society’s Cancer Prevention Study-3 (CPS-3), we investigated the association of body weight across the life course and risk of CRC. From 2006-13, over 300,000 participants (ages 30-65) enrolled in the CPS-3 cohort and provided a baseline waist circumference (WC) measure, self-reported baseline weight and height, weight at age 18, and weight at each decade of adulthood (20s to current age). Body shape phenotype (apple, pear, other) was self-reported in 2015. Excess body mass index (BMI)-years was calculated by subtracting a reference BMI of 25 from the reported BMI for each decade of life and aggregating excess BMI for the reported years of life. Through 2018, 424 incident cases of colorectal cancer were reported, of which 94 were younger than 50 years. Associations of BMI measures and WC with incident CRC were estimated using multivariable-adjusted Cox proportional hazards regression and stratified by sex and body shape. After exclusions (n=248,804), 78% of participants were women, 85% were non-Hispanic white, 69% were never smokers, and 8% had a family history of CRC. The mean baseline age was 47.8 (women) and 48.5 (men) years. The mean baseline BMI, WC, and age 18 BMI were 27.6 kg/m2, 91.9 cm, and 21.7 kg/m2, respectively, among women and 28.3 kg/m2, 103.8 cm, and 23.1 kg/m2, respectively, among men. Baseline BMI was associated with 8% higher CRC risk (95% confidence interval (CI) 0.99-1.18) per 5 kg/m2 increase. However, apple body shape was associated with higher CRC risk (hazard ratio (HR) per 5 kg/m2 BMI = 1.18, 95% CI 1.02-1.38). WC was associated with higher CRC risk (HR 1.08, 95% CI 1.01-1.15) per 10 cm increase, and the association was higher for apple body shape (HR 1.14, 95% CI 1.01-1.28). BMI at age 18 was associated with 17% higher CRC risk (95% CI 1.03-1.32) per 5 kg/m2 increase, and the association was higher for apple body shape (HR 1.36, 95% CI 1.12-1.65). Associations for non-apple body shapes were not statistically significant across all exposures. For early-onset CRC, associations with baseline BMI, WC, and age 18 BMI were suggestive of higher risk but not statistically significant. Participants in the highest category of excess BMI-years (women ≥35, men ≥81) relative to those in the lowest had 56% higher risk of overall CRC (95% CI 1.19-2.05), but the association with early-onset CRC was not statistically significant (HR 1.92, 95% CI 0.90-4.07). These findings suggest that while obesity is associated with higher CRC risk, excess weight gain around the waist and at younger ages may be of importance. Studies are needed to confirm these findings and further investigate the potential role of early-life obesity in the development of early-onset CRC. Citation Format: Caroline Y. Um, Christina C. Newton, Aparna Parikh, Marjorie L. McCullough, Alpa V. Patel. Weight history and colorectal cancer risk in the Cancer Prevention Study-3 cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2197.

Abstract P497: Saliva, Plasma, and Multi-Fluid Metabolomic Profiles of Excess Adiposity and Their Associations With Diabetes Progression Among Puerto Ricans

Introduction: Plasma metabolomic profiles of BMI are associated with type 2 diabetes (T2D) risk but none have examined saliva or combined information from multiple biofluids. Our aim was to identify plasma, saliva, and plasma-saliva multi-fluid metabolomic profiles of BMI and waist circumference (WC) and examine their associations with diabetes progression. Methods: We included 911 participants from the San Juan Overweight Adult Longitudinal Study, a 3-year prospective cohort of overweight Puerto Ricans. At baseline, using LC-MS, we quantified metabolites from saliva (n=635) and plasma (n=1,051). We used elastic net regression with 10-fold cross-validation to identify metabolomic profiles from plasma, saliva, and plasma and saliva (multi-fluid) that were predictive of BMI and WC. We used Cox-proportional hazard models to evaluate associations between metabolomic profiles and diabetes progression adjusting for age, sex, socioeconomic factors, lifestyle, and medication use. Results: For BMI metabolomic profiles, we identified 207 metabolites in plasma, 118 metabolites in saliva, and 225 in the multi-fluid profile. For WC, we identified 157, 89, and 210 metabolites for plasma, saliva, and multi-fluid profiles, respectively. Highly positively weighted metabolites across all BMI and WC metabolomic profiles included those in pathways of alanine and aspartate metabolism, purine metabolism, and sphingomyelins. BMI and WC metabolomic profiles were highly correlated (r=0.80-0.88). Each SD increase in saliva, but not plasma or multi-fluid, metabolic profile of BMI was significantly associated with diabetes progression (Table). Saliva, but not plasma or multi-fluid, metabolomic profile of WC was significantly associated with progression from pre-diabetes to T2D. All associations became stronger after further adjustment for anthropometric measures of BMI and WC. Conclusion: Saliva is an underexplored and easily accessible biofluid to measure metabolites that associate with diabetes progression.

Abstract P438: Combined Association of Body Mass Index and Central Obesity on Mortality Risk in Diabetes Population: The China Health And Retirement Longitudinal Study (CHARLS)

Introduction: Abdominal fat is associated with an elevated mortality risk and higher healthcare costs. Body mass index (BMI), commonly used to measure body fatness, underestimates excess abdominal fat due to its limited accuracy in reflecting fat and muscle distribution. Waist circumference (WC) is a more precise indicator of central obesity, which is defined as excess abdominal fat accumulation. The joint associations of combined BMI and WC with mortality risk in the diabetes population are not fully understood. Methods: We included individuals with diabetes and at least one measure of BMI and WC, from 2011, 2013, and 2015 waves with follow-up to 2018 in CHARLS. All individuals were classified into four groups: normal weight without central obesity, normal weight with central obesity (WC, male ≥ 90 cm, female ≥ 85 cm), overweight (BMI ≥ 24 kg/m 2 ) without central obesity, and overweight with central obesity. Multivariable logistic regression was used to model the associations between four groups and the mortality risk among people with diabetes adjusted for demographic characteristics, smoking, drinking, multimorbidities, and diabetes treatment. Results: Among 940 participants (mean age 60.4 years, 58.3% women), there were 124 incident cases of death recorded. Compared to normal weight without central obesity group, the mortality risk was increased among normal weight with central obesity group (Adjusted odds ratio = 2.11, 95% CI: [1.07, 4.18]). Other groups exhibited no statistically significant association with mortality risk (Figure 1). In sensitivity analysis excluding individuals with BMI ≤ 18.5 kg/m 2 , results were largely consistent with the previous findings. Conclusions: A significant association between central obesity and increased mortality risk in diabetes population was revealed. While, overweight with central obesity showed no significant association to mortality risk. Our findings stress the importance of customized strategies for central obesity in the diabetes population to reduce medical expenses.

The relationship between dental caries, dietary intake and body composition in school-age children

ObjectiveThe aim of this study is to evaluate the relationship between dental caries, food intake, and body composition in school-age children.MethodsThe study was conducted on 210 children, 105 boys and 105 girls, aged 6–12 years, without mental and/or physical disorders. Oral examinations of the children were performed by paediatric dentists and DMFT–DMFS and dmft–dmfs values were recorded. A detailed food frequency questionnaire was applied to determine the consumption frequency of dairy products and sugar‐added foods. Children’s height, waist and hip circumference measurements were taken by the researcher; body weight and body composition were evaluated with a Tanita body analyzer.ResultsThe DMFS value of children who consumed white cheese daily is lower than children who did not (p < 0.05). The DMFT and DMFS values were found to be higher in children who consumed sweets, biscuits, and spreadable chocolate daily compared to children who did not (p < 0.05). Body weight and waist circumference are positively correlated with DMFT and negatively correlated with dmft. BMI is positively correlated with DMFT and negatively correlated with dmft (p < 0.05). In binary logistic regression, it was found that maternal education level, frequency of added sugar intake and body fat ratio were predictors of the presence of caries.ConclusionIn this study, dental caries was associated with food consumption and body mass index. In children, consumption of sugary foods should be reduced and consumption of dairy products should be increased.

Waist Circumference and Body Mass Index as Predictors of Disability Progression in Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Background: While obesity has been shown to elevate the risk of developing multiple sclerosis (MS), there is a lack of strong evidence regarding its role in the disability progression and status of MS patients. Methods: This systematic review and meta-analysis aimed to provide comparative estimates of WC and BMI in patients with MS (PwMS) and to investigate potential associations between the waist circumference (WC) and body mass index (BMI) and demographic and specific MS characteristics. Adhering to PRISMA guidelines, a detailed search of the MEDLINE PubMed, Cochrane Library, and Scopus databases was conducted. Results: A total of 16 studies were included. The pooled mean WC and BMI among PwMS was estimated to be 87.27 cm (95%CI [84.07; 90.47]) and 25.73 (95%CI [25.15; 26.31]), respectively. Meta-regression models established a significant bidirectional relationship between WC and the Expanded Disability Scale (EDSS) (p < 0.001) but not between BMI and EDSS (p = 0.45). Sensitivity analyses showed no association between WC and age (p = 0.48) and a tendency between WC and disease duration (p = 0.08). Conclusions: Although WC measurements classify PwMS as normal weight, BMI measurements classify them as overweight. Therefore, WC should complement BMI evaluations in clinical practice. Additionally, our findings highlight the significant association between abdominal fat, as indicated by WC, and disease progression. Considering the heightened risk of cardiovascular comorbidity and mortality among PwMS, we recommend integrating both WC and BMI as standard anthropometric measurements in routine clinical examinations and targeted prevention strategies for PwMS.

Low-grade inflammation in persons with recently diagnosed type 2 diabetes: The role of abdominal adiposity and putative mediators.

To determine the magnitude of the association between abdominal adiposity and low-grade inflammation in persons with recently diagnosed type 2 diabetes (T2D) and to determine to what extent this association is mediated by low physical activity level, hyperinsulinaemia, hyperglycaemia, dyslipidaemia, hypertension,and comorbidities. We measured waist circumference, clinical characteristics, and inflammatory markers i.e. tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6),and high-sensitivity C-reactive protein (hsCRP), in >9000 persons with recently diagnosed T2D. We applied multiple mediation analysis using structural equation modelling, with adjustment for age and sex. Waist circumference as a proxy for abdominal adiposity was positively associated with all inflammatory markers. Hence, a one-standard deviation (SD) increase in waist circumference (SD = 15 cm) was associated with a 22%, 35%,and 46% SD increase in TNF-α (SD = 1.5 pg/mL), IL-6 (SD = 4.4 pg/mL),and hsCRP (SD = 6.9 mg/L), respectively. The level of hyperinsulinaemia assessed by fasting C-peptide was quantitatively the most important mediator, accounting for 9%-25% of the association between abdominal adiposity and low-grade inflammation, followed by low physical activity (5%-7%) and high triglyceride levels (2%-6%). Although mediation of adiposity-induced inflammation by greater comorbidity and higher glycated haemoglobin levels reached statistical significance, their impact was minor (1%-2%). In persons with recently diagnosed T2D, there was a clear association between abdominal adiposity and low-grade inflammation. A considerable part (20%-40%) of this association was mediated by other factors, with hyperinsulinaemia as a potentially important driver of adiposity-induced inflammation in T2D.

Food insecurity, poor diet, and metabolic measures: The roles of stress and cortisol

Food insecurity is highly prevalent and linked to poorer diet and worse metabolic outcomes. Food insecurity can be stressful, and could elicit chronic psychological and physiological stress. In this study, we tested whether stress could be used to identify those at highest risk for worse diet and metabolic measures from food insecurity. Specifically, we hypothesized that cortisol (a physiological marker of stress) and perceived psychological stress would amplify the link between food insecurity and hyperpalatable food intake as well as metabolic measures. In a sample of 624 Black and White women aged 36–43 who participated in the NHLBI Growth and Health Study's midlife assessment, we assessed associations between food insecurity with hyperpalatable food intake (high fat + high sodium foods; high fat + high sugar foods; and high carbohydrate + high sodium foods), and metabolic measures (fasting glucose, insulin resistance, and waist circumference). We found that food insecurity was associated with higher levels of perceived stress (R2 = 0.09), and greater intake of high fat + high sugar (hyperpalatable) foods (R2 = 0.03). In those with higher cumulative cortisol (as indexed by hair cortisol), food insecurity was associated with higher levels of fasting glucose. Neither cortisol nor perceived stress moderated any other relationships, and neither variable functioned as a mediator in sensitivity analyses. Given these largely null findings, further research is needed to understand the role stress plays in the chronic health burdens of food insecurity.

Relation between Body Composition Trajectories from Childhood to Adolescence and Nonalcoholic Fatty Liver Disease Risk.

NAFLD has become the leading cause of chronic liver disease in children, as a direct consequence of the high prevalence of childhood obesity. This study aimed to characterize body composition trajectories from childhood to adolescence and their association with the risk of developing nonalcoholic fatty liver disease (NAFLD) during adolescence. The participants were part of the 'Chilean Growth and Obesity Cohort Study', comprising 784 children who were followed prospectively from age 3 years. Annual assessments of nutritional status and body composition were conducted, with ultrasound screening for NAFLD during adolescence revealing a 9.8% prevalence. Higher waist circumference measures were associated with NAFLD from age 3 years (p = 0.03), all skin folds from age 4 years (p < 0.01), and DXA body fat measurements from age 12 years (p = 0.01). The fat-free mass index was higher in females (p = 0.006) but not in males (p = 0.211). The second and third tertiles of the fat mass index (FMI) had odds ratios for NAFLD during adolescence of 2.19 (1.48-3.25, 95% CI) and 6.94 (4.79-10.04, 95% CI), respectively. Elevated waist circumference, skin folds, and total body fat were identified as risk factors for future NAFLD development. A higher FMI during childhood was associated with an increased risk of NAFLD during adolescence.