Body mass index (BMI)

We examined gender differences in the association between body mass index (BMI) and psychological well-being. Regression analysis involving 3,251 adults indicated that gender moderated the BMI-psychological well-being link. In follow-up analyses, higher BMI predicted lower psychological well-being only among women. When participants were categorized into 5 BMI groups, women reported lower psychological well-being than men in the overweight and obese I groups, but no gender differences were observed in the more seriously obese or normal-weight groups. Also, among women, all 4 groups with higher-than-normal BMI had lower psychological well-being than normal-weight women; for men, no significant differences were found across the 5 groups. These findings are discussed in relation to research on stigma theory and gender-differentiated cultural norms regarding weight.

Low body mass index (BMI) is a well-documented risk factor for future fracture. The aim of this study was to quantify this effect and to explore the association of BMI with fracture risk in relation to age, gender and bone mineral density (BMD) from an international perspective using worldwide data. We studied individual participant data from almost 60,000 men and women from 12 prospective population-based cohorts comprising Rotterdam, EVOS/EPOS, CaMos, Rochester, Sheffield, Dubbo, EPIDOS, OFELY, Kuopio, Hiroshima, and two cohorts from Gothenburg, with a total follow-up of over 250,000 person years. The effects of BMI, BMD, age and gender on the risk of any fracture, any osteoporotic fracture, and hip fracture alone was examined using a Poisson regression model in each cohort separately. The results of the different studies were then merged. Without information on BMD, the age-adjusted risk for any type of fracture increased significantly with lower BMI. Overall, the risk ratio (RR) per unit higher BMI was 0.98 (95% confidence interval [CI], 0.97-0.99) for any fracture, 0.97 (95% CI, 0.96-0.98) for osteoporotic fracture and 0.93 (95% CI, 0.91-0.94) for hip fracture (all p <0.001). The RR per unit change in BMI was very similar in men and women (p >0.30). After adjusting for BMD, these RR became 1 for any fracture or osteoporotic fracture and 0.98 for hip fracture (significant in women). not linearly distributed across values for BMI. Instead, the contribution to fracture risk was much more marked at low values of BMI than at values above the median. This nonlinear relation of risk with BMI was most evident for hip fracture risk. When compared with a BMI of 25 kg/m 2 , a BMI of 20 kg/m 2 was associated with a nearly twofold increase in risk ratio (RR=1.95; 95% CI, 1.71-2.22) for hip fracture. In contrast, a BMI of 30 kg/ m 2 , when compared with a BMI of 25 kg/m 2 , was associated with only a 17% reduction in hip fracture risk (RR=0.83; 95% CI, 0.69-0.99). We conclude that low BMI confers a risk of substantial importance for all fractures that is largely independent of age and sex, but dependent on BMD. The significance of BMI as a risk factor varies according to the level of BMI. Its validation on an international basis permits the use of this risk factor in case-finding strategies.

Purpose: The purpose of this study was to determine if increased body mass index (BMI) is associated with an increased risk for dental caries. Methods: Caries severity averages were calculated for a convenience sample of 178 children, ages 8 to 11 years, who participated in the University of Louisville Dental School-based dental treatment program "Smile Kentucky." Caries severity averages were then analyzed against the children's BMI, with gender and age used as covariates. Results: The mean caries average for permanent molars significantly increased with increased BMI, even after adjusting for age and gender. The mean overall caries average did not vary significantly with patient age, BMI, or gender and may be due to confounding mixed dentition events such as eruption, extraction, variable teeth exfoliation, etc. Conclusions: Elevated body mass index is associated with an increased incidence of permanent molar interproximal caries. (Pediatr Dent 2006;28:23-28)

Background The enzyme 11-β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyzes intracellular glucocorticoid reactivation by conversion of cortisone to cortisol in different tissues and have been implicated in several metabolic disorders associated with obesity. The aim of this study was to evaluate the 11β-HSD1 expression in liver, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) in morbidly obese patients undergoing bariatric surgery and its correlations with clinical, anthropometric, and biochemical variables. Methods A prospective study was conducted over a 27-month period. Hepatic, VAT, and SAT samples were obtained at the time of surgery. 11β-HSD1 and 18S gene expression was measured using real-time quantitative reverse transcriptase-polymerase chain reaction. Results Forty nine patients met the inclusion criteria [mean age: 42.2 ± 10 years, body mass index (BMI): 42 ± 6 kg/m2, 71% women and 63% with metabolic syndrome (MS)]. 11β-HSD1 mRNA levels were higher in liver than fat tissue (p < 0.001), being higher in SAT than in VAT (p < 0.001) without gender-specific differences. Hepatic expression of 11β-HSD1 correlated positively with SAT and VAT, alanine aminotransferase (ALT), and serum glucose and was inversely associated with BMI. 11β-HSD1 mRNA in VAT correlated positively with insulinemia, ALT, and LDL cholesterol. There were no associations between 11β-HSD1 mRNA in SAT and the variables analyzed. Conclusions 11β-HSD1 expression is higher in liver in comparison to adipose tissue in obese patients. The observed correlations between hepatic and VAT 11β-HSD1 expression with dyslipidemia and insulin resistance suggest that this enzyme might have a pathogenic role in obesity and related metabolic disorders.

Objective The aim was to examine risk factors for ovarian borderline tumors overall, and according to histological subtype (serous vs. mucinous), in a large Danish population-based case-control study. Methods Ovarian borderline cases and controls were recruited from 1995 to 1999, and personal interviews were conducted. In all, 202 cases and 1,564 randomly selected controls were included. The analysis was performed using multiple logistic regression models. Results The risk of ovarian borderline disease decreased with increasing parity (OR=0.79 per birth, 95% CI: 0.63-0.98) and older age at first birth (OR=0.67 per 5 years, 95% CI: 0.53-0.84). Both a history of breastfeeding and use of oral contraceptives reduced the risk of borderline tumor, the effect being most pronounced for serous tumors. Increasing body mass index (BMI) was associated with elevated risk of serous borderline tumor (OR=1.05 per BMI unit; 95% CI: 1.00-1.10), whereas current smoking was a strong risk factor only for mucinous tumors (OR=2.10; 95% CI: 1.22-3.60). Finally, increasing consumption of milk (all types) was found to increase the risk of borderline disease (OR=1.04 per glass milk per week; 95% CI: 1.02-1.06), and increasing intake of total lactose also increased the risk significantly (OR=1.16 per 50 gram lactose per week; 95% CI: 1.06-1.26). Conclusion The risk profile of ovarian borderline tumors is similar to that of ovarian carcinomas, and we observed significant etiological differences between serous and mucinous borderline tumors.

Due to increasing prevalence of the COVID-19 virus, athletes were unable to train optimally. This study aimed to determine the differences in aerobic capacity, body mass, and body mass index in soccer players as the effect of lockdown due to the COVID-19 pandemic. Methodology: Fourteen male participants were recruited from the university soccer team. Anthropometric characteristics were as follows: age = 20.75 ± 1.48 years, height = 174.35 ± 5.59 cm, body mass = 68.95 ± 6.17 kg, and body mass index = 21.92 ± 0.94 kg/m 2. Single-group pretest and posttest designs were selected to conduct this study. A multistage fitness test determined aerobic capacity. ANOVA test was used to identify aerobic capacity, body mass, and body mass index differences between pretest and posttest on university soccer players. Results: The pretest and posttest were similar in anthropometric characteristics, and there were no significant differences in age (P = 0.382), height (P = 0.106), and body mass (P = 0.068). Our findings showed significant differences between pretest and posttest for aerobic capacity (P = 0.042) and body mass index (P = 0.037) in university soccer players. Conclusion: We conclude that there was a significant effect of the COVID-19 pandemic on the soccer player's aerobic capacity and body mass index. These findings may have implications, namely, as functional test's organization, administration, and outcomes while testing the players. Team coaches, trainers, and physiologists must consider the effects of lockdown on the players' performance while preparing players for competition. Further researchers should be established to modify other types of tests, conduct studies with a larger sample and population, and add other variables.

Surgical strategy regarding nerve identification and resection in relation to chronic postoperative pain remains controversial. A central question is whether nerves in the operation field, when identified, should be preserved or resected. In the present study, the hypotheses that the identification and consequent resection of nerves &#39;at risk&#39; have no influence on postoperative pain has been tested. A single-centre study was conducted in 525 patients undergoing Lichtenstein hernioplasty. One surgeon (364 operations, Group A) consequently resected nerves &#39;at risk&#39; for being injured and nine surgeons (161 operations, Group B) adhered to the general routine of nerve preservation. All cases were ambulatory surgery on anaesthetised patients and the groups were similar with regard to age, body mass index (BMI) and preoperative pain. Self-reported pain at 3 months was recorded on a 10-box visual analogue scale (VAS). The identification and resection of nerves were continuous...

Much remains to be clarified in the apparently protective effect of moderate alcohol use against coronary heart disease risk. Insulin levels are positively associated with coronary heart disease risk, so recent reports of decreased insulin sensitivity among nondrinkers and lower fasting insulin levels with increasing alcohol intake suggest the possibility that insulin may play a role. Between 1987 and 1991, the authors examined fasting insulin concentrations and the empiric fasting insulin resistance index in relation to reported alcohol intake (mean, 15.3 g/day; standard deviation, 19.6; range, 0-120.6) and potential confounders. The latter included age, obesity, fat distribution, smoking, energy, saturated fat intake, antihypertensive medication, and physical activity. Participants in this cross-sectional analysis were 938 nondiabetic men from the Boston, Massachusetts, area who were part of the Normative Aging Study. Unadjusted fasting insulin levels were significantly different (p = 0.008) between categories of alcohol intake, as were fasting insulin resistance index values (p = 0.01). After adjustment for potential confounders, analysis revealed that subjects consuming moderate amounts of alcohol had the lowest fasting insulin and fasting insulin resistance index values. Compared with values from moderate drinkers, fasting insulin resistance index values were higher in those subjects reporting no alcohol intake (p = 0.011), low intake (p = 0.004), and high intake (p = 0.04). A similar pattern was observed for fasting insulin values. Among this sample of nondiabetic men, moderate drinkers had the lowest levels of fasting insulin resistance index and fasting insulin, consistent with lower levels of insulin resistance and thus lower risk for cdronary heart disease. These findings suggest the possibility that the coronary heart disease-protective effects of moderate alcohol use are at least partially mediated by insulin. Am J Epidemiol 1997;145:909-16. alcohol drinking; coronary disease; insulin; risk factors Much remains to be clarified with regard to the protective effect of moderate habitual alcohol use against coronary heart disease risk (1). One plausible partial explanation (2) is that the lower coronary heart disease rates observed in subjects with low to moderate levels of alcohol intake are mediated by increased levels of high density lipoprotein cholesterol (3-5).

Based on community surveys of the elderly of their nutritional habits in big cities throughout Indonesia and in urban and rural areas, the following observations are reported: (i) the elderly tend to reduce their food intake by themselves, in calories, carbohydrate, fat, protein content (15−30% less); (ii) they even reduce their traditional fatty food by themselves in spite of their already low fat intake daily (30−40% less); (iii) they very seldom eat snacks between meals (6.7−25.5%) of the respondents only; (iv) they tend to eat (very seldom − never) new ‘trendy foods’ (78−95%) such as hamburger, pizza, fried chicken etc., which are available in big cities; (v) the elderly usually eat just enough before satiety (84.3%); (vi) the majority of the elderly usually eat rice or other local staple foods, with mostly vegetables every day (50−80%), especially the traditional témpé (soybean cake) and tahu (soybean curd) and green vegetables (80%); fruits are consumed less than vegetables (40%); (vii) milk consumption still needs to be improved; (viii) fish consumption, the best healthy animal protein source, still needs to be promoted to the whole country, especially to the elderly on Java island; and (ix) an urban−rural difference was noted, the urban elderly having a higher intake of calories, fat and protein. Gender differences were practically not observed, except the higher calorie intake in men. The following findings support the aforementioned observations. The elderly have a lower mean body mass index (BMI); only 15.9% are overweight and only 4.5% are obese, although it is admitted that there are many elderly people who are underweight and malnourished. They also have lower mean cholesterol, triglyceride and haemoglobin values, but a higher prevalence of glucose intolerance, hypertension, coronary heart disease etc. is reported in many studies. In conclusion, the elderly in general have good eating habits, and they adjust their food intake to the reduced daily physical activities they perform. However, the consumption of eggs and fish (as low-cost protein sources) needs to be improved. Hence overeating and obesity are not a problem for the Indonesian elderly people, although it is admitted that undernutrition will be a problem unless properly anticipated. They usually prefer to eat the already healthy traditional food, especially the still popular vegetable source of protein and anti-oxidants. They eat the traditional food, témpé and tahu, making them a stronghold against diet ‘westernization’, and they should be used as a good example for the younger generation. Reduced calorie intake among the elderly is also observed in Japan, but not yet in most European elderly populations.

Patients with type 2 diabetes are commonly overweight, which can contribute to poor cardiovascular outcomes. ␤-blockers may promote weight gain, or hamper weight loss, and are a concern in high-risk patients. The current analysis of the Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial evaluates the effects of carvedilol and metoprolol tartrate on weight gain in patients with type 2 diabetes and hypertension. METHODS: This prespecified secondary analysis of the GEMINI study (nϭ1106) evaluated change in body weight after 5 months. RESULTS: Mean (ϮSE) baseline weights were 97.5 (Ϯ20.1) kg for carvedilol and 96.6 (Ϯ20.1) kg for metoprolol tartrate. Treatment difference (c vs m) in mean (ϮSE) weight change from baseline was Ϫ1.02 (Ϯ0.21) kg (95% confidence interval [CI], Ϫ1.43 to Ϫ0.60; P Ͻ.001). Patients taking metoprolol had a significant mean (ϮSE) weight gain of 1.19 (Ϯ0.16) kg (P Ͻ.001); patients taking carvedilol did not (0.17 [Ϯ0.19] kg; P ϭ.36). Metoprolol tartrate-treated patients with body mass index (BMI) Ͼ30 kg/m 2 had a statistically significant greater weight gain than comparable carvedilol-treated patients. Treatment differences (c vs m) in the obese (BMI Ͼ30 kg/m 2 ) and morbidly obese groups (BMI Ͼ40 kg/m 2 ) were Ϫ0.90 kg (95% CI, Ϫ1.5 to Ϫ0.3; P ϭ.002) and Ϫ1.84 kg (95% CI, Ϫ2.9 to Ϫ0.8; P ϭ.001), respectively. Pairwise correlation analyses revealed no significant associations between weight change and change in HbA 1c , HOMA-IR, or blood pressure. CONCLUSIONS: Metoprolol tartrate was associated with increased weight gain compared to carvedilol; weight gain was most pronounced in subjects with hypertension and diabetes who were not taking insulin therapy.

It has been hypothesized that the immune system plays a pathogenetic role in psychiatric disorders, in particular in major depression and schizophrenia. This hypothesis is supported by a number of reports on altered circulating levels and in vitro production of cytokines in these disorders. However, the respective evidence is not consistent. This may be in part due to an incomplete control for numerous confounding in¯uences in earlier studies. We investigated the plasma levels of cytokines and soluble cytokine receptors in psychiatric patients (N = 361) upon hospital admission and compared the results to those obtained in healthy controls (N = 64). By multiple regression analysis we found that circulating levels of interleukin-1 receptor antagonist (IL-1Ra), soluble IL-2 receptor (sIL-2R), tumor necrosis factor-a (TNF-a), soluble TNF receptors (sTNF-R p55, sTNF-R p75) and IL-6 were signi®cantly aected by age, the body mass index (BMI), gender, smoking habits, ongoing or recent infectious diseases, or prior medication. Cytokine or cytokine receptor levels were signi®cantly increased in patients treated with clozapine (sIL-2R, sTNF-R p75), lithium (TNF-a, sTNF-R p75, IL-6) or benzodiazepines (TNF-a, sTNF-R p75). Taking all these confounding factors into account, we found no evidence for disease-related alterations in the levels of IL-1Ra, sIL-2R, sTNF-R p75 and IL-6, whereas levels of TNF-a and sTNF-R p55 in major depression and sTNF-R p55 in schizophrenia were slightly decreased compared to healthy controls. We conclude that, if confounding factors are carefully taken into account, plasma levels of the above mentioned cytokines and cytokine receptors yield little, if any, evidence for immunopathology in schizophrenia or major depression. #

Objective: This review addresses the effect of overweight and obese weight status on pediatric health-related quality of life (HRQOL). Method: Web of Science, Medline, CINAHL, Cochrane Library, EMBASE, AMED and PubMed were searched for peer-reviewed studies in English reporting HRQOL and weight status in youth (o21 years), published before March 2008. Results: Twenty-eight articles were identified. Regression of HRQOL against body mass index (BMI) using pooled data from 13 studies utilizing the Pediatric Quality of Life Inventory identified an inverse relationship between BMI and pediatric HRQOL (r ¼ À0.7, P ¼ 0.008), with impairments in physical and social functioning consistently reported. HRQOL seemed to improve with weight loss, but randomized controlled trials were few and lacked long-term follow-up. Conclusions: Little is known about the factors associated with reduced HRQOL among overweight or obese youth, although gender, age and obesity-related co-morbidities may play a role. Few studies have examined the differences in HRQOL between community and treatment-seeking samples. Pooled regressions suggest pediatric self-reported HRQOL can be predicted from parent proxy reports, although parents of obese youths tend to perceive worse HRQOL than children do about themselves. Thus, future research should include both pediatric and parent proxy perspectives.

This study evaluates the impact of obesity on coronary endothelial function in patients with normal or mild coronary artery disease. BACKGROUND The American Heart Association (AHA) has recently classified obesity as a modifiable risk factor for coronary heart disease.

Objective: The objectives were (1) to examine whether 3 eating disorder subgroups, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) classification system, exhibit a specific profile in terms of early maladaptive schema (EMS) factors, and (2) to investigate the relationship between body mass index (BMI) and EMS factors in each of the individual eating disorder subgroups. Methods: The presence of EMS was measured by the Young Schema Questionnaire Long Form among patients affected by restrictive anorexia nervosa, binge/purging-type anorexia nervosa, and bulimia nervosa. Principal component factor analysis was used to investigate the factor structure of the EMS across eating disorder subgroups. General linear model analysis was applied to examine the differences of the subgroups in terms of their EMS factors. Differential association between BMI and schema factors was tested by analysis of covariance. Results: Four EMS factors were extracted, which accounted for approximately 72% of the variance. The 3 eating disorder subgroups differed in terms of their EMS factor profiles. The analysis of covariance resulted in a significant negative relationship between BMI and EMS factor 2 in the bulimia nervosa group ( P b .0099), indicating that higher severity on defectiveness, failure, dependence, enmeshments, subjugation, approval-seeking (EMS factor 2) was associated with lower values on BMI. Conclusion: The findings of this study indicate that EMSs based on Young's conceptualization of EMS, as measured by the Young Schema Questionnaire, differ significantly among eating disorder subgroups defined by the phenomenological approach used by the DSM-IV diagnoses. These results are consistent with the notion that dysfunctional cognitions may play an important role in the development and maintenance of the symptoms that underlie the DSM-IV classification of the eating disorder subtypes. D

Background This is the largest single-centre series of single-stage laparoscopic sleeve gastrectomy (LSG) reporting on perioperative outcomes, weight loss, comorbidity resolution including urological outcomes and results in the super obese. Review of prospectively collected data for patients who underwent LSG from March 2007-August 2009. Methods There were 253 patients with a mean age of 44 years (SD, 9) and a mean preoperative body mass index (BMI) of 50 kg/m 2 (SD, 7). There were 17 (7%) major complications and no deaths. The mean follow-up was 9 months. One hundred and seventy-one patients with a mean follow-up of 12 months had a mean postoperative weight loss of 41 kg (SD, 16) and mean excess BMI (meBMI) loss of 59% (SD, 22). Results One hundred fourteen patients were super obese (BMI, >50 kg/m 2 ). The mean weight loss was 45 kg (SD, 18), and the meBMI lost was 49% (SD, 21). Super-obese patients experienced more complications (p=0.02) and lost less eBMI (49% vs. 61%; p<0.01). Fifty-three patients (46%) remained morbidly obese (BMI, >40 kg/m 2 ) postoperatively. Hypertension and diabetes improved or resolved in 73 (79%) and 73 (90%) patients, respectively. Stress urinary incontinence was reported preoperatively in 60 (32%) females, and complete resolution or improvement was reported in 54 (90%) patients.

subjects. The patients were divided into four groups: 18 with normoalbuminuria (urinary albumin excretion rate [AER] <30 mg/24 h, stage I), 10 with microalbuminuria (30 -< AER -< 300 mg/24 h, stage II), seven with overt proteinuria (AER > 300 mg/24 h, stage III), and 10 with uremia (serum creatinine levels >2.0 mg/dL, stage IV). There were no significant differences in age, body mass index (BMI), fasting plasma glucose, or hemoglobin Alc (HbAlc) among the four groups. No significant difference in M/I values was seen between stage I and stage II (6.30 -+ 0.73 and 5.95 4-0.85 mg/kg/(min per irU/mL) x 100, respectively). M/I values in the stage I and stage II groups were strongly correlated with BMI (r = -.790, P = .0001 and r = -.785, P = .007, respectively). M/I values in the stage III group (4.53 ---0.51) were lower than in the stage I group, although not significantly so. M/I values in the stage IV group (3.16 -+ 0.37) were significantly lower than in the stage I group (P = .025). In multiple regression analysis with a model in which age, sex, BMI, HbAlc, and creatinine clearance (Ccr) were included as independent variables, BMI and Ccr were demonstrated to be significant and independent contributors to insulin sensitivity indices as the dependent variable (l~ = -0.716 and ~ = 0.272, respectively, R 2 = .564, P < .0001). In conclusion, the present cross-sectional study demonstrated in non-obese NIDDM patients with nephropathy that microalbuminuria did not affect peripheral insulin resistance, but uremia did, as in nondiabetic patients, and that the peripheral insulin resistance was significantly contributed to by the degree of obesity and uremia.

The APOA2 gene has been associated with obesity and insulin resistance (IR) in animal and human studies with controversial results. We have reported an APOA2-saturated fat interaction determining body mass index (BMI) and obesity in American populations. This work aims to extend our findings to European and Asian populations. Cross-sectional study in 4602 subjects from two independent populations: a high-cardiovascular risk Mediterranean population (n = 907 men and women; aged 67 ± 6 years) and a multiethnic Asian population (n = 2506 Chinese, n = 605 Malays and n = 494 Asian Indians; aged 39 ± 12 years) participating in a Singapore National Health Survey. Anthropometric, clinical, biochemical, lifestyle and dietary variables were determined. Homeostasis model assessment of insulin resistance was used in Asians. We analyzed gene-diet interactions between the APOA2 -265T&gt;C polymorphism and saturated fat intake (&lt;or ≥ 22 g per day) on anthropometric measures and IR. Frequency of...

Serotonergic involvement has been implicated in preferential consumption of treat foods. We tested the effect of acute tryptophan depletion (ATD) on food consumption by overweight and lean adults with and without a history of recurrent major depressive disorder (MDD). ATD and taste-matched placebo challenges were administered double-blind in counter-balanced order. Participants were classified as lean (n = 36) or overweight (n=19) on the basis of body mass index (BMI). Total calorie, carbohydrate, protein, and sweet food consumption were assessed via a test meal 8-hours following ATD. Four food items of comparable palatability were offered as a part of the test: two sweet (one carbohydrate-rich, and one protein-rich) and two non-sweet (one carbohydrate-rich, and one proteinrich). As compared to the placebo challenge, ATD significantly increased sweet calorie intake among overweight participants and increased their propensity to consume sweet food first before any other type of food. Lean participants' sweet calorie intake and food preference were unaffected by ATD. Findings suggest serotonergic involvement in the sweet food consumption by overweight individuals.

Purpose To investigate the correlation between serum 25-hydroxyvitamin D (25-OH-VD) concentrations and metabolic parameters in obese and non-obese women with polycystic ovary syndrome (PCOS). Methods One hundred women with PCOS were divided into two groups, obese and non-obese, according to their body mass index (BMI). Waist-to-hip ratio (WHR), Ferriman-Gallwey score, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, triglycerides, calcium, 25-OH-VD, LH/FSH, total testosterone, and DHEAS were measured. Results The serum 25-OH-VD mean levels were 56.31% lower in the obese PCOS patients. There was an association of increased HOMA-IR, BMI, WHR, triglycerides, total testosterone, and DHEAS with decreased 25-OH-VD concentrations in the obese PCOS patients. Conclusion Low serum 25-OH-VD concentrations result from the presence of obesity and insulin resistance. However, the dependency between PCOS and hypovitaminosis D is questionable. Hypovitaminosis D should be kept in mind while managing obese women with PCOS.

Overweight is an endemic public health concern for children, adolescents, and adults. Reducing the prevalence of childhood overweight is a national health objective and nine million U.S. children, currently classified as overweight, require effective nutrition education and physical activity promotion services. The intent of this study was to evaluate the effectiveness of a family-based nutrition education and physical activity promotion program, Lifelong Eating and Activity Patterns (LEAP), as an effective approach for the prevention and treatment of child overweight. The study design was an eight-week intervention and participant files were analyzed retrospectively to ascertain information for the study variables. The main outcome measures were changes in body mass index (BMI), percent body fat, fitness level, and eating and activity behaviors for child and parent participants. Qualitative data gathered from an exit survey for both children and parents were used to assess perceive...

Twin studies are useful designs for decomposing genetic and environmental influences on traits, with the basic goal being to map variations in phenotypic similarity onto variances in genetic similarity. In this review, we provide an overview of twin studies that have been used to decompose the genetic and environmental influences behind body composition, eating style, and their covariation. Although many published reports have established that genes contribute anywhere from 50-90% of the variance in body mass index (BMI, kg/m 2 ), fewer studies have used laboratory-based body composition measures. Moreover, comparable studies of human eating style are even more scarce.

The body mass index (BMI), defined as weight/height 2 , is often used to monitor childhood obesity. BMI values for 979 children (438 White, 283 Black, and 258 Hispanic) aged 3-18 years living in the Houston, Texas, metropolitan area from 1994 to 1998 were compared with percentage of fat (%Fat) measurements obtained by using dual-energy x-ray absorptiometry. The associations between %Fat and BMI were statistically significant (r 2 = 0.34-0.70, p < 0.0005) and were gender and ethnic dependent (p < 0.0005), indicating that BMI can provide a general description of the adiposity characteristics of a healthy pediatric population. However, BMI was a poor predictor for the individual child, with a standard error for %Fat of 4.7-7.3% of body weight. It is advantageous to identify accurately, as early as possible, those children who truly have excess adiposity, but this assessment should not be done at the risk of falsely mislabeling a significant number of healthy children as overweight or obese. Am J Epidemiol 1999;150:939-46. Abbreviations: BMI, body mass index; DXA, dual-energy x-ray absorptiometry; %Fat, percentage of fat; SEE, standard error of the estimate.

The Epworth Sleepiness Scale (ESS) is a selfadministered eight-item questionnaire that is widely used in English speaking countries for assessment of daytime sleepiness in adults. The aim of this study was to investigate the reliability and validity of the ESS in the Turkish language. The Turkish version of the ESS (ESStr) was applied to 194 healthy controls and 150 consecutive subjects attending the sleep centre with symptoms of sleepdisordered breathing. Test-retest reliability of the ESStr was tested in a separate group of 30 subjects. The ESStr scores of 60 subjects with mild to severe obstructive sleep apnoea (OSA) were compared with the ESStr scores of 60 healthy controls matched for age, gender, and body mass index (BMI). Concurrent validity with the Functional Outcomes of Sleep Questionnaire (FOSQtr) was also assessed in 12 subjects. The questionnaire had a high level of internal consistency as measured by Cronbach's alpha (≥0.86). The test-retest intraclass correlation coefficient was r =0.81 (95% confidence interval: 0.64-0.90) (p< 0.001) and Spearman's correlation coefficient was r=0.80 (p=0.01). The control group had lower ESStr scores than subjects with sleep-disordered breathing (3.6±3 vs 12.6±6, respectively; p<0.001). Subjects with mild sleep-disordered breathing also had lower scores of the ESStr than those with moderate and severe sleep-disordered breathing (10± 6.2 vs 14±5. and 10±6.2 vs 16±5.4, respectively; both p< 0.05), but there were no significant differences between moderate and severe subjects with sleep apnoea. There were significant correlations between the ESStr and total FOSQtr and its subscales (r =−0.22 to r=−0.92; all p = 0.05). Factor analysis of item scores showed that the ESStr had only one factor. The ESStr is a reliable and valid measure of daytime sleepiness. These features and the simplicity of the ESStr make it a valuable measure for clinical management and research.

The prevalence of hyperuricemia has rarely been investigated in developing countries. The purpose of the present study was to investigate the prevalence of hyperuricemia and the association between uric acid levels and the various cardiovascular risk factors in a developing country with high average blood pressures (the Seychelles, Indian Ocean, population mainly of African origin).

The TASER ® Conducted Electrical Weapon (CEW) is used by law enforcement agencies about 900 times per day worldwide and has been shown to reduce suspect and officer injuries by about 65%. However, since a CEW delivers rapid electrical pulses through injected probes, the risk of inducing ventricular fibrillation (VF) has been considered. Animal studies have shown that the tip of the probe must come within a few millimeters of the surface of the heart for the CEW to induce VF in a typical animal application. Early calculations of the CEW VF risk in humans used sophisticated 3-D chest models to determine the size of the probe landing areas that had cardiac tissue within a given distance of the inner surface of the ribs. This produced a distribution of area (cm 2 ) vs. mm of depth. Echocardiography was then used to determine the shortest distance from the skin surface to the cardiac surface. This produced a population distribution of skin-to-heart (STH) distances. These 2 distributions were then convolved to arrive at a probability of inducing VF for a typical human CEW application. With 900, 000 probe-mode field uses to date, epidemiological results have shown that these initial VF risk estimates were significant overestimates. We present model refinements that take into account the gender and body-massindex (BMI) of the target demographics and produce VF risk estimates concordant with the epidemiological results. The risk of VF is estimated at 0.4 per million uses with males. 978-1-4244-4122-8/11/$26.00 ©2011 IEEE 271 33rd Annual International Conference of the IEEE EMBS

Objective: We designed this study to assess the validity and reliability of pictogram for estimating body mass index (BMI). Study Design and Setting: Participants of Golestan cohort study during 2000e2004 were recruited in this study. Demographic and anthropometric information (weight, height, and BMI) were collected on all participants. A set of drawings (pictogram) ranging from very lean to obese were used to assess the individual's perception of their body size. Sensitivity and specificity of each pictogram score were calculated and cutoff points were determined using sensitivity/specificity plots. We used receiver operating characteristic curves to assess the validity of pictogram scores.

We investigate the relationship between employability and obesity, particularly how obesity and overweight are associated with the percentage of working years spent unemployed and the ability to regain employment. Data for adults who responded to the 2003 Decennial Health Survey collected by the French National Institute of Statistics and Economic Studies revealed that the percentage of time spent unemployed during working years is significantly higher for each kg/m 2 deviation from the mean body mass index (BMI) attained at age 20 and that the probability of regaining employment after a period of unemployment is much lower. #

Background: The description of growth patterns of the different anthropometric measurements mainly used in epidemiological studies is useful to better understand the development of obesity in children and its consequences. Objective: Our aim was to establish growth curves of anthropometric indices in a general population of French children born during the 1980s and to compare them with the French reference curves based on children born in the 1950s. Design: As part of the Fleurbaix Laventie Ville Santé Studies I and II (FLVS), 441 girls and 467 boys were examined at least twice between 1993 and 2001. Height, weight and four skinfold thicknesses were measured. Body mass index (BMI), sum of peripheral and truncal skinfolds and truncal-to-peripheral ratio were calculated. Mean growth curves from ages 5 to 17 years were assessed for these indices, calculating means and 95% confidence interval per 1 year age group and by gender. Results: Trajectories with age differed importantly according to the index considered; BMI was the one with the smallest difference between genders and the most linear shape with age. From the age of 5 years and after, the FLVS children were on average taller and had a higher subcutaneous adiposity than children born 30 years earlier. Truncal-to-peripheral ratio was higher in our population; this difference became more marked with puberty in girls. Discussion: This study suggests the existence of a secular trend towards a precocious accelerated growth, and a more truncal adiposity distribution, especially in girls. It is a disquieting trend considering its expected consequences on adult health.

OBJECTIVE: To investigate the risks of height, weight and body fat distribution associated with colon cancer in subcategories of gender, age and site in the colon. Interaction with family history of colorectal cancer is also examined. DESIGN: Case-control study of diet, anthropometry and colon cancer risk. SUBJECTS: Nineteen hundred and eighty-three colon cancer cases (age 30±79 y) and 2400 age and gender matched population controls. MEASUREMENTS: Height, weight and waist and hip circumferences were obtained by trained interviewers. Body Mass Index (BMI) and Waist-Hip Ratio (WHR) were calculated. RESULTS: Of all anthropometric measurements examined, only BMI was consistently associated with an increased risk of colon cancer. The test for trend for BMI was signi®cant for men and women overall and for the majority of subgroups examined. In younger persons those with a family history of colorectal cancer had a greater risk of colon cancer associated with BMI (Men odds ratio (OR) 7.76, 95% con®dence interval (CI) 2.60, 23.1; Women OR 4.85, 95% CI 2.33, 10.12) comparing the third tertile to the ®rst, than those with no family history (Men OR 1.70 95% CI 1.25, 2.32; Women OR 1.53 95% CI 1.22, 1.92). WHR, after controlling for BMI was not associated with colon cancer in men, and was associated with a slight increase in women (primarily in those with distal tumors). CONCLUSION: This study contributes to mounting evidence that excess weight is associated with an increased risk of colon cancer.

The prevalence of hypertension, an important risk factor for cardiovascular disease (CVD), is increasing in the developing countries and this may be connected with the economic transition in those countries. Adult hypertension is thought to be related to childhood and adolescent increases in blood pressure, and hence the need to monitor patterns in early life. This study investigates the BP patterns, and their correlates, of adolescents from different geographic areas of residence in Nigeria.

Bone marrow transplantation is frequently used as a consolidation therapy in patients with haematological malignancies to improve the outcome of these patients. Obese individuals have larger absolute lean body and fat masses than non-obese individuals of the same age, gender and height, which might lead to altered pharmacokinetics of chemotherapeutic agents. Data on the impact of body mass on transplant outcome is conflicting. This study included 331 patients (M, 230; F, 101) with 336 allogeneic transplant episodes from two large teaching hospitals in the West Midlands region in United Kingdom. A total of 105 patients had acute myeloid leukaemia, 83 had non-Hodgkin's lymphoma, three had myeloma, 21 had Hodgkin's lymphoma, 34 had acute lymphoblastic leukaemia, 19 had chronic myeloid leukaemia, 22 had chronic lymphocytic leukaemia, 24 had myelodysplasia, seven had T cell non-Hodgkin's lymphoma, six had aplastic leukaemia and seven had myelofibrosis. At transplantation, 40% (N=133) of the patients had normal and 60% (N=198) had high body mass index (BMI) with 14% of the patients being obese (BMI >30). After a median follow-up of 24 months (range, 2-79), the mean overall survival (OS) in patients undergoing allograft with normal BMI was 31 months as compared to 39 with high BMI (p:0.06). The mean progression free survival (PFS) in patients undergoing allograft with normal BMI was 33 months as compared to 38 with high BMI (p= 0.13). Of the patients in the high and obese BMI group, 16% developed acute GvHD with 8% grade III-IV and 28% in the normal BMI group with 14% grade III-IV acute GvHD (p= 0.11). Of the patients in the high BMI group, 17% developed chronic GvHD and 30% of the patients in the normal BMI group (p=0.09). However, higher infection rates and more days of inpatient stay in the first year post-transplant were observed in the high BMI and obese patients, but there was no difference in ITU admissions. This study shows that high BMI and obesity does not adversely impact on either OS or PFS in patients undergoing allogeneic transplantation for haematological malignancies, but it does have a significant impact on infection rates and hospitalisation of high BMI and obese patients. We recommend that patients with high BMI should not be excluded from allogeneic transplantation; however, good supportive care and careful patient selection on the basis of comorbidity index should be undertaken in order to avoid the risks from the increased rates of infection.

Few large-scale epidemiologic studies have quantified the possible link between obesity and chronic renal failure (CRF). This study analyzed anthropometric data from a nationwide, population-based, case-control study of incident, moderately severe CRF. Eligible as cases were all native Swedes who were aged 18 to 74 yr and had CRF and whose serum creatinine for the first time and permanently exceeded 3.4 mg/dl (men) or 2.8 mg/dl (women) during the study period. A total of 926 case patients and 998 control subjects, randomly drawn from the study base, were enrolled. Face-to-face interviews, supplemented with self-administered questionnaires, provided information about anthropometric measures and other lifestyle factors. Logistic regression models with adjustments for several co-factors estimated the relative risk for CRF in relation to body mass index (BMI). Overweight (BMI > 25 kg/m 2 ) at age 20 was associated with a significant three-fold excess risk for CRF, relative to BMI <25. Obesity (BMI >30) among men and morbid obesity (BMI > 35) among women anytime during lifetime was linked to three-to four-fold increases in risk. The strongest association was with diabetic nephropathy, but two-to three-fold risk elevations were observed for all major subtypes of CRF. Analyses that were confined to strata without hypertension or diabetes revealed a three-fold increased risk among patients who were overweight at age 20, whereas the two-fold observed risk elevation among those who had a highest lifetime BMI of >35 was statistically nonsignificant. Obesity seems to be an important-and potentially preventable-risk factor for CRF. Although hypertension and type 2 diabetes are important mediators, additional pathways also may exist.

Introduction: Two problems affecting school-aged children in the United States are inadequate sleep and an increased prevalence of obesity. The purpose of this study was to quantify media-related technology use and caffeine consumption in order to assess their potential effects on sleep duration and body mass index (BMI) in children.

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity remains relatively understudied. MI Values was developed to implement within an existing multidisciplinary treatment program for obese, ethnically diverse adolescents, the T.E.E.N.S. Program (Teaching, Encouragement, Exercise, Nutrition, Support). T.E.E.N.S. participants who consent to MI Values are randomized to either MI or an education control condition. At weeks 1 and 10 of T.E.E.N.S. participation, the subset of participants assigned to the MI condition engages in individual MI sessions and control participants view health education videos. All MI sessions are audiotaped and coded to monitor treatment fidelity, which has been satisfactory thus far. Participants complete comprehensive assessments at baseline, 3-and 6-month follow-ups. We hypothesize that MI participants will demonstrate greater reductions in Body Mass Index (BMI) percentile, improved diet and physical activity behaviors, better compliance with T.E.E.N.S., and lower attrition than participants in the control group. We present study design and methods for MI Values as well as data on feasibility of recruitment methods and treatment integrity. At study completion, findings will contribute to the emerging literature examining the efficacy of MI in the treatment of pediatric obesity.

OBJECTIVE: This study was undertaken to investigate the relationship between pregnancy outcome and prepregnancy overweight or obesity in women with a normal glucose tolerance test. STUDY DESIGN: A historical cohort study of 2459 pregnant women systematically examined for gestational diabetes was performed. Information of oral glucose tolerance test results and clinical outcome were collected from medical records. RESULTS: The risk of hypertensive complications, cesarean section, induction of labor and macrosomia was significantly increased in both overweight women (body mass index [BMI] 25.0-29.9 kg/m 2 ) and obese women (BMI ≥ 30.0 kg/m 2 ) compared with women who were of normal weight (BMI 18.5-24.9 kg/m 2 ). The frequencies of shoulder dystocia, preterm delivery, and infant morbidity other than macrosomia were not significantly associated with maternal BMI. CONCLUSION: Prepregnancy overweight and obesity is associated with adverse pregnancy outcome in glucose-tolerant women. (Am J Obstet Gynecol 2003;189:239-44.) Correction In the article by Hnat et al (Hnat MD, Sibai BM, Caritis S, Hauth J, Lindheimer MD, MacPherson C, et al. Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol 2002;186:422-6), an incorrect revision date was listed. The correct date is June 18, 2001.

Objective: The aim of this study was to determine whether memories of parental rules about food during childhood are linked to adult eating behaviors. Method: An adult community sample (N = 122) (56% female, 44% male) with a mean age of 44.6 years completed self-report measures of weight and dieting history, current eating patterns, and recollection of different types of rules about food from their parents. Three types of food rules were assessed: (a) rules which restrict intake of certain foods, (b) rules which encourage food intake, and (c) rules where food is used to reward or punish behavior. Results: Binge eating and dietary restraint in adulthood are significantly related to participants' recollection of their parents using food to control their behavior in childhood. These results held true regardless of body mass index (BMI), ethnicity, age, or childhood weight status. Discussion: This study suggests that some childhood food rules may have a long-lasting impact on eating behaviors. Further research on the impact of using food to reward and punish children's behavior is needed to inform recommendations to parents regarding the use of food for behavioral control. D

This paper uses French data on ideal body weight and food attitudes to analyse the role of social norms in the individual's weight control problem. A proxy measure of social norms is calculated by averaging individual perceptions of the ideal Body Mass Index (BMI) over all observations within a reference group. Testing for different definitions of the reference group, we find that individual representations of ideal body shape are differentiated mainly along gender and age lines. Social norms regarding body shape have a significant effect on perceptions of ideal BMI only for those women who want to lose weight, with an elasticity close to 0.5. For many women and for all men, ideal BMI is almost exclusively determined by habitual BMI. Last, ideal BMI predicts a number of attitudes towards food, while social norms do not. These results suggest that promoting medical norms regarding body shape should have little effect on individual food attitudes.

The gastrointestinal peptide hormone ghrelin promotes food intake and increases body weight and adiposity through activation of the growth hormone secretagogue receptor (GHSR1a). To promote its biological action ghrelin is acylated at its serine 3 residue by the recently discovered ghrelin O-acyltransferase (GOAT, a.k.a. membrane-bound O-acyltransferase 4, MBOAT4). Plasma levels of total and acylghrelin are negatively correlated with body-mass-index (BMI); as lower the BMI as higher plasma levels of total and acylated ghrelin and vice versa. Accordingly, plasma levels of total and acyl-ghrelin are elevated in patients with anorexia nervosa (AN) and decline upon weight regain. The importance of the endogenous Goat/ghrelin system in the neuroendocrine adaptation to fasting was recently highlighted by the observation that acyl-ghrelin mediated elevation of growth hormone (GH) release prevents starvation induced hypoglycemia in Goat À/À mice. The aim of this study was to test if genetic variation of GOAT is implicated in the etiology of AN. We therefore assessed association of 6 tagging single nucleotide polymorphisms (tagSNPs), which were predicted to cover 96% the common genetic variability of GOAT plus 50 kb of the 5 0 and 3 0 flanking region, in 543 German patients with AN and 612 German normal and underweight healthy controls. Based on a recessive mode of inheritance we observed some evidence for association of the G/G genotype at SNP rs10096097 with AN (nominal two-sided p ¼ 0.031). Based on our results we conclude that genetic variation in GOAT might be implicated in the etiology of AN.