Weight For Height Index Research Articles

Assessment of Malnutrition in Punjabi Urban Males According to Body Mass Index (BMI) and Weight for Height Criteria

A total of 1044 Punjabi urban males were investigated during October 2000 for the assessment of malnutrition using BMI and weight for height index. Following WHO criteria for BMI, 60.62% of the males are found to be underweight, 38.02% are within normal ranges and only 1.34% are overweight. Frequency of malnutrition in the present sample is decreasing with increasing age according to weight for height criteria given by Jellife.

Revaccination of healthy nonresponders with hepatitis B vaccine and prediction of seroprotection response

Sixty healthy nonresponders were randomized to receive intramuscular (IM) high dose hepatitis B virus (HBV) vaccine versus IM standard dose HBV vaccine plus granulocyte–macrophage colony-stimulating factor (GM-CSF) at 0–2 months. Antibody to hepatitis B surface antigen was measured 1 month after each dose and 3 months after the last dose. Two regimens were equivalent in eliciting seroprotection in nonresponders. Weight–height index (WHI) <39 and alanine transaminase (ALT) <39 mg/dl predicted which nonresponders would seroconvert. A three-dose regimen of standard dose HBV vaccine plus GM-CSF may be a useful for seroprotection of healthy nonresponders.

Comparison of weight-for-height indices as a measure of adiposity and cardiovascular risk from childhood to young adulthood: The Bogalusa heart study

The development of obesity in childhood is considered a major determinant of cardiovascular risk. Currently the body mass index (BMI = weight/height 2) is widely used as a measure of obesity. However, since BMI is associated with height during childhood, a weight for height index (weight/height p ) that is independent of height is thought to be more appropriate. Therefore, to compare the utility of such weight/height p index with BMI in assessing adiposity and its relation to cardiovascular risk variable data from the Bogalusa Heart Study participants aged 6 months to 21 years were examined. A total of 31,796 observations on 12,827 subjects was used in the data analysis. Study variables include height, weight, subscapular and triceps skinfolds, blood pressure, serum lipids and lipoproteins, and plasma glucose and insulin. The optimal exponential for the weight/height p index started from 2.42 in the 6 month olds, decreased to 1.86 in 2 to 3 year olds, increased to 3.29 among 10 to 11 year olds, and then decreased to 2.15 in the 20 to 21 year olds. The BMI showed slightly higher correlations than weight/height p index with subscapular skinfold in children. Both in children and young adults BMI also showed a slightly higher correlation with other cardiovascular risk factor variables regardless of age–race–sex groups. These results indicate that weight/height p index is not superior to BMI as an indicator of adiposity and related cardiovascular risk factors during childhood.

Short-term satiety in preschool children: a comparison between high protein meal and a high complex carbohydrate meal

The aim of this study was to investigate whether a high protein meal has a different effect on short-term satiety in preschool children than a high carbohydrate meal by measuring their intake of a subsequent meal. Subjects were 35 normal preschool children of both genders aged 5 to 6 years. All children were healthy and randomly chosen from those who were attending to a day-care center where they received feeding at three meal times: breakfast, lunch and teatime. Children were weighed with light clothes following standard recommendations. They were normal according to the weight for height index, using the NCHS standards. Two meals with different levels of protein and carbohydrate and equal energy contents were assayed at lunch. The lunches were cooked dishes made from common ingredients. The high carbohydrate meal was consumed in greater amount than the high protein meal (P < 0.01) and a significantly greater energy intake was observed (P < 0.01). Food and energy intakes at teatime were greater with the high carbohydrate meal, but only the energy intake was significant (P < 0.05). When subjects consumed the high protein meal during lunch, they ate a significantly lower amount of protein in the subsequent meal, but the carbohydrate intake was similar. The long-term effects of a high protein diet remain to be investigated before recommending of a high protein for obese children.

Are preoperative obesity and cachexia risk factors for post heart transplant morbidity and mortality: a multi-institutional study of preoperative weight-height indices

Background: The relationship between pre-transplant body weight and post-transplant outcome has only recently been identified using a single, indirect measure of weight (percent ideal body weight [PIBW]). The literature is equivocal regarding which index is the better indicator of body weight. The purpose of this study was to determine (1) if pre-heart transplant body weight, measured by body mass index (BMI) and PIBW, is associated with post-heart transplant morbidity and mortality and (2) if patient gender, age, and etiology of heart disease affect this association. Methods The sample included 4,515 patients who received a heart transplant from January 1, 1990–December 31, 1995 at 38 institutions participating in the Cardiac Transplant Research Database (CTRD). Patients were divided into groups according to their BMI and PIBW. Data were described using frequencies, measures of central tendency, Pearson correlation coefficients, stratified actuarial analyses and log rank tests for comparisons, and a multivariable risk factor analysis in the hazard domain. Results For all patients ( n = 4,515), being <80% or >140% of IBW before heart transplant was a risk factor for increased mortality after heart transplant. The association between pre-heart transplant PIBW and post-heart transplant survival was affected by gender, age, and etiology of heart disease. In males, a higher PIBW was a significant risk factor for death early after transplant ( p = .0003). Although not significant, there was a trend for a higher PIBW being a risk factor for death in females throughout the post transplant period ( p = .07). No differences in cause of death were found for PIBW and BMI. In male and female recipients <55 years, being overweight pre-heart transplant was a risk factor for infection. In patients with pre-transplant ischemic heart disease, the greatest risk for infection was found in patients who were >140% of IBW. Pre-heart transplant BMI and PIBW were not associated with acute rejection or cardiac allograft arteriopathy after transplant. Conclusions In conclusion, being cachectic or obese preoperatively is associated with decreased survival in all patients after heart transplantation. Being obese preoperatively is associated with increased infection after heart transplant in males and females <55 years and in patients with ischemic heart disease. Of the 2 indices of body weight used in this study, percent ideal body weight appears to be the better predictor of future morbidity and mortality following heart transplantation.

Pattern and distribution of ocular morbidity in primary school children of rural Delhi.

A total of 679 primary school children drawn from developed southern parts and underdeveloped eastern parts of Delhi were examined for ocular morbidity. Their age range was 5-15 years and both sexes had almost equal representation. The prevalence of eye diseases was relatively high. Over 40 percent of all the children studied had one or more ocular problems. Trachoma (18%) was the most common ocular morbidity followed by vitamin A deficiency (10.6%), visual acuity < 6/9 (7.4%) and apparent/latent squint (7.4%). In most of these eye disorders, the majority of the children came from the underdeveloped eastern parts of Delhi. Ocular morbidity seems to be unevenly distributed in rural Delhi with a significantly worse picture in the underdeveloped eastern parts, across the river 'Yamuna'. Though blinding trachoma may cease to be a major problem in India, the country continues to have endemic pockets of its non-blinding form. One puzzling observation was that children with protein-energy malnutrition (PEM) did not show any specific vulnerability to ocular diseases. In fact, those with normal weight-height index were having a higher share of eye diseases. Though this issue needs to be explored further in the light of biological plausibility, it appears that children who do not have PEM are also exposed to ocular diseases at least with comparable risk.

Prediction of response to hepatitis B vaccine in health care workers: whose titers of antibody to hepatitis B surface antigen should be determined after a three-dose series, and what are the implications in terms of cost-effectiveness?

We identified the demographics of 385 health care workers (HCWs) to identify those whose chance of developing a protective response to a standard primary hepatitis B immunization series was so high that the need for testing for antibodies to hepatitis B surface antigen (anti-HBs) would be obviated following immunization. In addition, using sensitivity analysis, we analyzed the economic consequences of not determining anti-HBs titers for any individual after primary immunization and of using the Centers for Disease Control and Prevention (CDC)-recommended post-hepatitis B exposure prophylaxis for high-risk HCWs. Nonsmoking women < 50 years old with a weight-height index of < 42 had a 98.2 +/- 0.9% chance of developing a protective anti-HBs titer. Male nonsmokers < 50 years old with a weight-height index of < 29 had a 94.7 +/- 1.8% chance of a protective response. Economic analysis revealed that use of the CDC guidelines for post-hepatitis B exposure prophylaxis in male HCWs whose anti-HBs status is unknown is always more cost-effective than determining anti-HBs titers following primary immunization for those at high risk. In female HCWs, post-hepatitis B exposure prophylaxis is more cost-effective until hepatitis B exposure rats are approximately 50%. It is possible to predict who will have a high probability of developing a protective response to hepatitis B vaccine; for these people, determining postimmunization anti-HBs titers is unnecessary and not cost-effective.

Trends in growth in England and Scotland, 1972 to 1994

AIMTo monitor the growth of 5 to 11 year old English and Scottish children from 1972 to 1994. No similar data are available from any other study.DESIGNMixed longitudinal.SUBJECTSIn England 7000...

Vitamin A and beta carotene levels in constitutional delay of growth and puberty.

The objective of this study was to investigate the vitamin A (vit A) status and beta carotene levels of children with constitutional delay of growth and puberty (CDGP). Serum vit A and beta-carotene levels of 26 children with CDGP were measured. 20 age-matched healthy children with normal pubertal development served as controls. Except for the height SDS, which was significantly lower in the CDGP group (p < 0.05), no significant differences were found between chronological ages, weight for height indices and beta-carotene levels of the two groups (p > 0.05). Although serum vit A levels of children in both groups were within normal limits according to WHO criteria, serum vit A levels were significantly lower in the CDGP group than in controls (44.13 +/- 12.25 and 59.60 +/- 19.75 micrograms/dl respectively, p < 0.05). It was concluded that vit A deficiency may play a role in CDGP in developing countries.

Height and weight in children with vesicoureteric reflux and renal scarring.

Height standard deviation scores (HSDS) and weight-for-height index (WHI) at diagnosis were evaluated in 156 children aged 2 months to 10.8 years (mean 3.7 years) with vesicoureteric reflux (VUR) and normal creatinine clearance, and in 156 age- and sex-matched healthy controls. Forty-three patients had bilateral VUR with scintigraphic signs of renal scarring (B SCAR+), 25 had bilateral VUR without renal scarring (B SCAR-); 40 had unilateral VUR with (U SCAR+) and 48 unilateral VUR without (U SCAR-) renal scarring. B SCAR+ patients had an average HSDS of -0.5 +/- 1.4 (SD) which was significantly (P = 0.02) below that of controls (0.05 +/- 1 HSDS) and an average WHI of 100.6% +/- 16% which was significantly (P = 0.007) below that of controls (108% +/- 12%); 14% of B SCAR+ patients had a height below -2 HSDS. B SCAR-, U SCAR+, and U SCAR- patients had heights near to O HSDS which was not different from that of controls, as well as WHI between 104% and 107.9%, which was not different from that of controls. HSDS and WHI were significantly (P = 0.00001) correlated in patients but not in controls. B SCAR-, U SCAR+, and U SCAR- patients are similar to healthy controls in weight and in height growth and have, on average, some excess weight as do the latter. In contrast, B SCAR+ subjects have a significant decrease of the relative height and normal WHI.

Review of Turkish patients with growth hormone insensitivity (Laron type).

Clinical spectrum and endocrine details of thirteen Turkish children (age 0.3-14.2 years; eight females and five males; ten prepubertal, three pubertal) with growth hormone insensitivity are presented. All patients display phenotypical features of severe growth hormone deficiency. The diagnosis based on height standard deviation score (SDS), basal growth hormone (GH), basal insulin-like growth factor I (IGF-I, IGF-I response in an IGF generation test and growth hormone binding protein (GHBP) measurements. The median height SDS was -7.4 (range -3.2 to -10), weight for height index was 100 (range 81-152) and bone age/height age ratio was 2 (range 1.6-3.3). Endocrine investigations showed a median basal GH concentration of 61.4 mU/l (range 23.5-120 mU/l). Basal IGF-I level was below 10 ng/ml in all patients except one. None of the patients showed a significant IGF-I response to injections of GH (0.1 U/kg body weight for 4 days). The median IGFBP-3 level was 0.23 mg/l (range 0.1-0.56 mg/l). The GHBP level was undetectable in all of 10 patients. The high number of patients in our center may be due to the high rate of consanguinity among the Turkish population and the referral facility of our center in the area. These patients may benefit from the new therapy with recombinant human IGF-I.

A unified pattern standard score method for construction of age-related weight-for-height.

Analysis of data from the Shiraz (Iran) growth study requires to take age into account when assessing weight-for-height of school children aged 6-12. A unified structure standard score method for construction of weight-for-height is designed to overcome the age dependence problem. This method first applies Healy-Rasbash-Yang (HRY) distribution-free estimation method of age-related centiles to calculate log (weight) and height-for-age centiles, and convert them to their standard scores. These scores are age and sex independent, and are called weight index (WI) and height index (HI), respectively. Then WI is regressed on HI and age-adjusted centiles of weight-for-height are derived at each age of weight and height to their respective zeta-scores. Finally, weight-for-height centiles are drawn for each age-sex category of children. This zeta-score method is shown to be efficient, simple, and stable, and may generally be applied to other data.

A PREDICTION MODEL FOR THE FIRST YEAR GROWTH RESPONSE TO GROWTH HORMONE IN TURNER SYNDROME (TS) BASED ON KIGS (Kabi Pharmacia International Growth Study) DATA

In order to optimize treatment with GH, a large-scale, complex analysis on the response to GH in terms of auxological data, as well as treatment modalities is essential.1 We analyzed 175 TS patients <11 yrs. The median values were: CA=7.9 yrs; HT SDS = -2.5 SD; target HT=0.0 SD; Weight for Height index (WHI %)=97; GH dose (IU/kg/wk)=0.8; No. of GH inj/wk = 6). Out of 10 potential predictors, only the following were validated: No. of inj/wk, GH dose, CA and WHI. The corresponding regression equation is: HV (cm/yr)=9.02 + [0.36 × No. inj/wk] + [2.01 × GH dose (IU/kg/wk) ] - [0.25 × CA (yrs)] - (0.036 × WHI (%)]; r2=0.37; error SD=1.26 cm/yr). We concluded firstly that the mode of treatment rather than the auxology determines growth in TS, early treatment being possibly advantageous. Secondly, in contrast to GHD, WHI is negatively correlated to the growth response, thus pointing to a different body composition in TS. Thirdly, we found the growth response to GH in TS was less predictable with the variables used. Lastly, other predictors eg. degree of dysmorphology, may improve the prediction model.

Glucose tolerance, plasma insulin, HDL cholesterol and obesity: 12-year follow-up and development of coronary heart disease in Edinburgh men

The insulin response to a standard oral glucose tolerance test (OGTT) and other anthropometric and biochemical risk factors for coronary heart disease (CHD) were measured in a random sample of 107 Edinburgh men, who were initially studied in 1976 when they were 40 and who were reexamined in 1988–1989. Fasting glucose and glucose response to OGTT were higher in 1988–1989 than in 1976. In contrast, insulin levels did not differ between the initial and follow-up study either before or after the glucose load. Body mass indices increased, except triceps skinfold. Changing patterns in both fasting and OGTT insulin or glucose levels in individuals were related to changes in bodyweight or in subscapular skinfolds. Modifications in serum total and HDL cholesterol were related to changes in fasting insulin and insulin area, respectively, but not to glucose data. Eleven men developed clinical CHD. Neither glucose nor insulin measures obtained in 1976 differed between those with and without CHD. Weight-height index and abdominal skin-folds were higher in those with CHD. HDL cholesterol was significantly lower ( P < 0.05). Abdominal skin-fold but not body mass index remained significant when adjusted for HDL cholesterol. This small study confirms the importance of central obesity and low HDL cholesterol but failed to identify insulin as a risk factor for CHD in this Scottish population.

Weight overgrowth of coeliac children on gluten-free diet

Linear and weight growth were assessed in 17 coeliac children on gluten-free diet and followed up for 2 to 7 years (mean 3.8). Mean height was −0.85 height standard deviation scores at first visit, −0.19 after one year and 0.03 at last visit. Weight for Height Index (WHI) was 88.8% at first visit, 111.9 after one year and 111.6 at last visit. WHI values of patients at one year and at last visit were significantly higher than the 100% expected, even after excluding the subjects having at least one parent with body mass index >30 and/or at least one sibling with WHI >120%. A dietary recall at the end of the follow-up revealed an excess in caloric, animal protein and lipid intake and an absolute or relative deficit in complex sugars and vegetal proteins. The exclusion of gluten containing foods from the diet of coeliac children carries the risk of intake of hypercaloric foods, which may lead to some degree of obesity.

Portal-vein obstruction in children leads to growth retardation

The portal vein is the main source of blood and hepatotrophic factors to the liver. Partial portal-vein ligation in rats results in reduced growth compared with that in control rats. To investigate whether extrahepatic portal vein obstruction occurring in early childhood influences growth in humans, anthropometric and nutritional assessments were prospectively carried out in 61 patients with extrahepatic portal vein obstruction. Comparisons were made with 183 matched healthy controls using National Center of Health Statistics reference. Fifty-one percent of children with extrahepatic portal vein obstruction had stunted growth (height for age less than 90% of normal), compared with 16% of controls (p less than 0.01). Growth retardation was severe in patients with longer (greater than 5 yr) than with shorter (less than 2.5 yr) duration of clinical portal hypertension (height for age, 88.0 +/- 3.2 vs. 95.1 +/- 3.0; p less than 0.01). Little difference was seen in the energy intake (1,302 +/- 463 kcal/day vs. 1,335 +/- 449 kcal/day; p = not significant) and weight for height index (83.6 +/- 9.3 vs. 88.0 +/- 7.9; p = not significant) between extrahepatic portal vein obstruction patients and controls. This suggested that despite comparable nutrition, marked growth retardation occurred in extrahepatic portal vein obstruction patients. Incremental growth velocity was studied in 31 patients; in 24 (73%) the baseline Z score (-2.1 +/- 0.2) had decreased further (-2.4 +/- 0.2) at the end of follow-up (15.5 +/- 1.6 mo). Although the incremental height velocity was only 56% of the expected height, incremental weight gain was 98% of the expected weight for the attained height.(ABSTRACT TRUNCATED AT 250 WORDS)

Persistence of anti-HBs among health care personnel immunized with hepatitis B vaccine.

Health care personnel who received the hepatitis B vaccine (Heptavax-BR, MSD) were followed for persistence of hepatitis B surface antibody (anti-HBs). Response occurred in 135/146 (92.5 percent) vaccinees. Loss of anti-HBs (less than 72 RIA units; 10 S/N) occurred in 35.9 percent during the 36-month surveillance. Stepwise discriminant analysis found age and magnitude of initial antibody level, but not weight-height index, to be predictive of antibody loss over the 36 months. Twenty-four of 27 employees (88.9 percent) who lost anti-HBs responded to a fourth vaccine dose. In contrast, three of eight initial non-responders (37.5 percent) developed antibody after a fourth vaccine dose.

Ratio of actual to predicted weight as an alternative to a power-type weight-height index (Benn index)

In 1971 Benn described a form of relative weight that can be calculated as the ratio of actual to predicted weight from the linear regression of weight on height in a population. He also showed how to compute the exponent for a power-type weight-height index that would be approximately equivalent to this relative weight. Benn did not, however, recommended that this "Benn index" be used instead of relative weight. The properties of these two weight-height functions were investigated in data on 10,606 white men and women aged 18-74 y examined in the 1976-1980 Second National Health and Nutrition Examination Survey (NHANES II). Compared with the power-type index, relative weight was preferable in that it was easier to compute with current software packages, was invariant at standard weight-for-height, and offered more flexibility. The limitations shared by both functions are discussed. Neither function should be used uncritically.

Absence of relation between nutritional parameters and renal function in non-seminomatous testicular cancer patients.

Earlier studies revealed that renal function is reduced in non-cancer patients with a malnutritional status. We have studied the effect of nutritional status on renal function in 46 patients with disseminated non-seminomatous testicular cancer treated with combination chemotherapy including cis-diammine dichloroplatinum (cDDP) according to the Einhorn regimen. The renal function was expressed as glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and filtration fraction (FF) measured by radioisotope infusion methods. Nutritional assessment of the patients was performed by means of three nutritional parameters: weight-for-height index (WHI), creatinine height index (CHI), and serum albumin concentration (Salb). The patients were also divided into two groups: group 1, patients with a sufficient nutritional status, defined as patients with only one abnormal nutritional parameter or none at all (n = 30); group 2, patients with an insufficient nutritional status, defined as patients with two or three abnormal nutritional parameters (n = 16). Median values of WHI, CHI and Salb in group 2 patients were significantly lower than the median values in group 1. Before treatment no correlation was found between the individual nutritional parameters and GFR, ERPF and FF respectively. The median GFR, ERPF and FF of both group 1 and group 2 did not differ significantly. Although the renal function of the total group of patients was reduced as a result of cDDP, this reduction was not influenced by the individual parameters and not higher in the group with an initially insufficient nutritional status. In this study no relation was found between nutritional status and renal function of patients with disseminated non-seminomatous testicular cancer.

Techniques of measurement of body composition. Part II.

The measurement of lean body and fat mass has developed with the increase in sports participation and the prescription of exercise. Quantification of body fat is also related to the treatment of obesity and to assess nutritional status. Different levels of evaluation have been proposed depending on expertise and need. Body density estimation from skinfold measurements has the advantage of simplicity, low cost and reasonable validity with predictions to within 3 to 4% for 70% of the population. The choice of prediction equation will depend on whether a generalised equation or a population-specific equation is appropriate. In all cases tester reliability and standard error of estimation should be established. There is strong evidence that a quadratic equation should be applied and that measures of the lower limb should be included with circumference and diameter measures to strengthen the prediction. Methodological errors need to be reduced by careful training of experimenters. Crossvalidation of regression equation will strengthen their validity, particularly when fat loss is to be quantified. The popularity of skinfold assessment of body fat is enhanced by the use of nomograms to predict body fat, although some accuracy will be lost. Skinfold estimation of body fat will continue to be a useful guide to adiposity for epidemiological studies and for popular usage. The hydrostatic weighing procedure to estimate body density is considered by many to be the criterion method. Under carefully controlled conditions with maximum subject compliance, it is highly reliable, particularly if residual volume can be determined accurately. The conversion of body density to percentage body fat is based on a number of assumptions which need to be considered with respect to the population being studied. Simple methods for adiposity include various weight for height indices, for example, the body mass index of weight (kg) divided by height2 (m) which is often used to define obesity, frame size for the prediction of ideal weight and visual estimation for predicting body fat. Differences in the literature concerning fat cell size and number have their origins in variations of methodology. The choice of site for removal of tissue will influence the size of adipocytes, those obtained from deep sites are generally smaller than subcutaneous fat cells. If total cell number is determined from cell size, there will also be variability of cell number. The correlation between different methods of sizing cells is high for most techniques, but as the validity of the criterion method is not based on statistical evidence, the validity of the other methods cannot be readily accepted.(ABSTRACT TRUNCATED AT 400 WORDS)