BMI values and other anthropometric and functional measurements as predictors of obesity in a selected group of adolescents

Evaluating the effects of dark chocolate formulated with micro-encapsulated fermented garlic extract on cardio-metabolic indices in hypertensive patients: A crossover, triple-blind placebo-controlled randomized clinical trial

This study aimed to investigate the health-related effects of microencapsulated fermented garlic extract (FGE) containing dark chocolate in hypertensive adults. For this purpose, 36 hypertensive adults (15 males vs. 21 females) were randomized to receive the FGE (5 g/day) dark chocolate containing 650 mg of FGE powder or the placebo. Intervention periods lasted for 6 weeks and were separated by a 3-week wash-out period. The response variables included blood pressure, anthropometric indices, lipid profile, and inflammatory and oxidative stress indices. Statistical analyses were performed using the Pkcross procedure, and Cohen's d was estimated for all response variables. There was no significant inter-period difference between the mean changes of body weight, waist circumference, and body mass index (BMI). Furthermore, no significant change was confirmed in participants' blood pressure, triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), serum homocysteine, high-sensitive c-reactive protein (hs-CRP), malondialdehyde (MDA), and total antioxidant capacity (TAC). It seems that the dose of FGE used in this study was not sufficient to cause any significant changes in the outcomes. Therefore, further studies with dose-response designs and longer durations are recommended.

Serum Interleukin 23 in Psoriatic Arthritis Patients: Relation to disease activity, physical function and health related quality of life

Objective To assess interleukin 23 (IL-23) levels in the sera of psoriatic arthritis (PsA) patients and to determine the relationship of IL-23 with different disease activity indices, physical function and quality of life (QoL).

Methods Fifty PsA patients and 46 matched healthy controls were included in this study. Data including a detailed history, a thorough clinical examination, skin severity based on the Psoriasis Area and Severity Index (PASI), the Disease Activity index for Psoriatic Arthritis (DAPSA) and the Composite Psoriatic Disease Activity Index (CPDAI) were obtained for all patients. Physical function was assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and health-related QoL was assessed using the Short Form Health Survey (SF-36), Psoriatic Arthritis Quality of Life (PsAQoL) and the Dermatology Life Quality Index (DLQI) were also assessed. Serum IL-23 levels were measured in the studied groups.

Results The study included 23(46%) females and 27 (54%) males with a mean age of 42.78±12.33 years. The mean serum IL-23 level was significantly higher in PsA patients (50.89±13.86 pg/ml) than in controls (43.88±6.34 pg/ml) (p=0.006). There were significant correlations between serum IL-23 levels and different grades of DAPSA activity (p=0.007) and PASI (p=0.015). No significant correlations could be detected between serum IL-23 levels and (HAQ-DI, DLQI, SF-36 or PsAQoL). CPDAI and DAPSA were significantly correlated with DLQI, SF-36 and PsAQoL.

Conclusion IL-23 is a useful biomarker for identifying joint activity or skin severity but not QoL or physical function.

Central obesity and hypertension among rural adults of Paschim Medinipur, West Bengal, India

Obesity is generally classified into generalized obesity (BMI ≥30 kg/m2) and abdominal or central obesity (WC ≥90 cm for men and WC ≥80 cm for women) based on World Health Organization recommendation for Asians. Hypertension is one of the most common obesity-related complications, and about 30% of hypertensive individuals can be classified as being obese. The present study aimed to investigate the effect of different age groups (years) on the anthropometric and derived variables. It determined the correlation between anthropometric and derived variables and also estimated the frequency of central obesity and hypertension. Finally, it investigated the relationship between central obesity and blood pressure among rural Bengalee adults of Dirghagram village of Ghatal Block, Paschim Medinipur, West Bengal, India. The present cross-sectional study was undertaken among 310 rural adults (154 males; 156 females) aged over 18 years. Our study was carried out during March, 2017. Height (cm), weight (kg), waist circumference (cm), hip circumference (cm) and blood pressure (systolic and diastolic) were measured using standard procedures. One way ANOVA analysis on most of the anthropometric and derived variables showed a statistically significant increase from younger to older age group in both sexes (p<0.001;p<0.01; p<0.05). In addition to that, more females had central obesity using waist circumference (55.8% vs. 19.5%), waist hip ratio (87.2% vs. 35.7%), waist height ratio (73.7% vs. 44.2%), and conicity index (87.2% vs. 57.8%) criteria, and hypertension (52.5% vs. 27.3%). The prevalence of central obesity was much higher in case of hypertensive individuals. Therefore, the present study showed a high prevalence of central obesity among the rural adults of Dirghagram village. Furthermore, central obesity contributed in increasing hypertension among the villagers.

Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus

Aims

No current clinical guidelines focus on weight management in youth with type 1 diabetes mellitus (T1DM). Our aim was to characterize the patient-perceived experience and barriers to weight management in youth with T1DM.

Methods

Participants were recruited from the University of North Carolina (n = 16, 56% female, 60% White, 50% insulin pump users, mean age 14.8 years, mean HbA1c 8.5% (69 mmol/mol)) and the University of Colorado (n = 18, 50% female, 80% white, 53% pump users, mean age 15.3 years, mean HbA1c 9.3% (78 mmol/mol)). Focus groups were stratified by sex and weight status (BMI cutoff = 25). Discussions were guided by a standardized set of questions, audio-taped, transcribed, and analyzed thematically using inductive qualitative methods.

Results

Youth with T1DM expressed four interrelated themes of antagonism between type 1 diabetes and weight management: dysregulated appetite, disruption of blood glucose levels associated with changing diet/exercise, hypoglycemia as a barrier to weight loss, and the overwhelming nature of dual management of weight and glycemic control, and two interrelated themes of synergism: improvement in shared, underlying heath behaviors and exercise as a tool for weight and glycemic control. Variation in emphasis of specific thematic elements was greatest across sex. Youth identified five major components of a weight management program for T1DM: intensified glucose management, healthy diet with known carbohydrate content, exercise, individualization and flexibility, and psychosocial and peer support.

Conclusions

There is critical need for personalized, T1DM-specific weight recommendations to overcome disease-specific barriers to weight management in the context of T1DM.

Identification of direct and indirect social network effects in the pathophysiology of insulin resistance in obese human subjects

OBJECTIVE

The aim of the present study was to examine to what extent different social network mechanisms are involved in the pathogenesis of obesity and insulin-resistance.

DESIGN

We used nonparametric and parametric regression models to analyse whether individual BMI and HOMA-IR are determined by social network characteristics.

SUBJECTS AND METHODS

A total of 677 probands (EGO) and 3033 social network partners (ALTER) were included in the study. Data gathered from the probands include anthropometric measures, HOMA-IR index, health attitudes, behavioural and socio-economic variables and social network data.

RESULTS

We found significant treatment effects for ALTERs frequent dieting (p<0.001) and ALTERs health oriented nutritional attitudes (p<0.001) on EGO's BMI, establishing a significant indirect network effect also on EGO's insulin resistance. Most importantly, we also found significant direct social network effects on EGO's insulin resistance, evidenced by an effect of ALTERs frequent dieting (p = 0.033) and ALTERs sport activities (p = 0.041) to decrease EGO's HOMA-IR index independently of EGO's BMI.

CONCLUSIONS

Social network phenomena appear not only to be relevant for the spread of obesity, but also for the spread of insulin resistance as the basis for type 2 diabetes. Attitudes and behaviour of peer groups influence EGO's health status not only via social mechanisms, but also via socio-biological mechanisms, i.e. higher brain areas might be influenced not only by biological signals from the own organism, but also by behaviour and knowledge from different human individuals. Our approach allows the identification of peer group influence controlling for potential homophily even when using cross-sectional observational data.

Stress and Nutritional Status of Individuals in Uttarakhand, North-ern India: Differential Effect of Gender

BACKGROUND

Uttarakhand, Northern India is facing challenges in the issues concerning public health. Hence, researches identifying the stressors and nutri-tional factors influencing health are encouraged. This study attempts to assess the stress levels and nutritional status. Gender differences are also measured in the same.

METHODS

Stress and nutritional status related information was gathered (Nov, 2012-June, 2013) from 118 individuals residing in Uttarakhand state. Stress level was assessed using Personal Stress Score Inventory. Anthropo-metric details and dietary intake (3 day food recall method) were collected. Nutrient intake were calculated and compared with recommended dietary allowance (RDA) for Indi-ans. T-test and Chi-square (χ²) were performed to measure the gender difference in studied variables.

RESULTS

66.6% of females and 85.4% of males reported moderate stress (31-79). Males were seen to be more stressed then females, though no sig-nificant differ-ence was seen. A significant difference in BMI (Body mass Index) was seen be-tween males (24.1 kg/m(2)) and females (21.5 kg/m(2)). The study sample was found to be deficient in iron and zinc when compared with RDA. Females suf-fering from various level of stress had significantly lower levels of energy, pro-tein, zinc than males.

CONCLUSION

Majority of subjects were suffering from moderate level of stress. The anthropometric status of subjects was good, though females showed signifi-cantly lower intake of nutrients compared to men. Poor intake of iron and zinc points towards a possibility of hidden hunger. Hence, psy-chological and nutri-tional counseling may be required.

Epidemiology of whole body, peripheral, and central adiposity in adolescents from a Brazilian state capital

The aim of this study was to associate the epidemiology of whole body, peripheral, and central adiposity with sociodemographic characteristics, health-related behaviors, and biological maturation of adolescents from a Brazilian state capital. A cross-sectional school-based study was conducted in Florianopolis, Santa Catarina, Brazil with 818 adolescents aged 14 to 18 years, and 61.8% female. The peripheral adiposity was assessed by the triceps skinfold thickness and the central adiposity by the subscapular skinfold thickness, using cutoff greater than or equal to percentile 90 of the Centers for Disease Control and Prevention reference curve. Adolescents with high whole body adiposity were those showing skinfold thickness values above the reference percentile. Logistic regression analysis was applied using multivariable model. The prevalence of high whole body, peripheral, and central adiposity was 8.0%, 8.7%, and 10.3% for boys and 3.8%, 6.3%, and 11.1% for girls, respectively. Factors associated with this outcome in boys were overweight/obesity and low aerobic fitness (p < 0.05). Besides these factors, girls were also associated with excessive body fat, low paternal schooling, and puberty status (p < 0.05). Physical activity, sedentary behavior, and eating habits were not associated with this outcome. It was concluded that the main predictors of high body adiposity were overweight and low aerobic fitness in both sexes and low parental schooling and puberty status in females.

Correlation of Anthropometric Measures Among Obese and Severely Obese Adolescents and Young Adults

Anthropometric measures beyond the basic weight, height, and body mass index (BMI) calculation, such as skinfold thicknesses and arm circumference, are valuable assessments of adiposity in normal weight populations. However, they are difficult and time-consuming to obtain. This study investigates the correlations between anthropometric variables to determine the utility of obtaining measures beyond weight and height among obese and severely obese Hispanic adolescents. Data from anthropometric measurements of 58 obese and severely obese Hispanic females aged 14 to 24 years were analyzed. Weight, height, BMI, arm circumference, average deltoid skinfold thickness, and average triceps skinfold thickness measures were compared. Correlations were determined between obese (30 kg/m2 ≥ BMI < 40 kg/m2) and severely obese (40 kg/m2 ≥ BMI <52 kg/m2 ) subjects. There were significant differences between the obese and severely obese groups for weight, BMI, arm circumference, and triceps skinfold thickness. However, significant correlations between almost all anthropometric variables existed in the severely obese group versus only one correlation between 2 types of skinfold measurements in the obese group. These data indicate that obtaining anthropometric measures beyond weight and height, including skinfold thickness, reveal no additional, clinically useful information among severely obese (BMI ≥ 40 kg/m2) adolescent patients. These findings predict a valuable economy of time and effort obtaining anthropometrical data in future studies on the severely obese.

Anthropometric risk factors for elevated blood pressure in adolescents in Turkey aged 11-17

To investigate the relationship between anthropometric parameters and elevated blood pressure in adolescents, we measured blood pressure (BP), height, weight, triceps skinfold (TSF) thickness, waist circumference (WC), and mid-upper-arm circumference (MUAC) in 2,860 student volunteers aged 11-17 years in Kayseri, Turkey. Waist-to-height ratio (WHtR), waist-to-arm-span ratio (WASR), body mass index (BMI), arm-fat area (AFA), and fat percentage (FP) were also calculated. Participants were divided into two groups: hypertensive [systolic blood pressure (SBP) or diastolic blood pressure (DBP) ≥  95th percentiles, n = 246] and normotensives (SBP or DBP < 95th percentiles, n = 2614). Multiple logistic regression models were produced within these groups for the examined risk factors, and cutoff points were investigated for SBP or DBP ≥ 95th percentiles using receiver operating characteristics (ROC) analysis. BMI, WC, WHtR, WASR, MUAC, and BMI had statistically significant cutoffs among boys. Whereas BMI, WHtR, WASR, WC, MUAC, AFA, and TSF were statistically significant for girls younger than 15, only BMI and WC were statistically significant for participants older than 15. The independent risk factors for elevated BP were determined according to BMI and WC. Although several anthropometric measurements were significant in our participants, BMI and WC were significant among all participants irrespective of age and sex.

Antropometria como ferramenta de avaliação do estado nutricional coletivo de adolescentes

A antropometria tem sido apontada como o parâmetro mais indicado para avaliar o estado nutricional coletivo. A avaliação nutricional coletiva de adolescentes possui uma dinâmica muito peculiar por se tratar de um momento de intensas mudanças fisiológicas e psicossociais, diretamente associadas à dinâmica nutricional deste grupo. O acompanhamento dessa dinâmica e de suas variáveis intervenientes e interativas é, portanto, um tema de discussão extremamente relevante. Esta revisão tem por objetivo apresentar as aplicações de parâmetros antropométricos à avaliação do estado nutricional de adolescentes. Conclui-se que, enquanto não houver metodologia simples de avaliação da composição corporal, para estudos epidemológicos deve-se manter o uso do índice de massa corporal, associado ou não às variáveis de dobra cutânea e perímetros. Apesar das dificuldades e limitações, as evidências apontam para uma fundamental incorporação das informações sobre a maturação sexual à avaliação do estado nutricional coletivo de adolescentes. Além disso, as investigações devem atentar mais aos parâmetros de definição da população que estará sendo estudada, cuidando, para permitir a comparação entre os estudos.

Body mass index percentiles in adolescents of the city of São Paulo, Brazil, and their comparison with international parameters

OBJECTIVE: To describe the percentile distribution of body mass index (BMI) in school adolescents, by gender and age, comparing them with international parameters. SUBJECTS AND METHODS: The study included 8,020 adolescents aged 10-15 years from 43 schools in the city of São Paulo, southeastern Brazil. BMI values of the study sample were distributed in percentiles and compared to international parameters (CDC, Must and cols. and Cole and cols.). RESULTS: Both male and female adolescents aged 10 to 14 years showed BMI cut-offs over the international parameters, especially in the P50-P85 percentile range. At the age of 15, the observed values were very similar to reference data; however, BMI values in the 95th percentile were much higher than international parameters. CONCLUSIONS: The study results show how important it is to use adequate BMI values for Brazilian adolescents aged 10-15 since international parameters may not reflect the actual nutritional status of this group.

Childhood nutrition and later fertility: pathways through education and pre-pregnant nutritional status

Better childhood nutrition is associated with earlier physical maturation during adolescence and increased schooling attainment. However, as earlier onset of puberty and increased schooling can have opposing effects on fertility, the net effect of improvements in childhood nutrition on a woman's fertility are uncertain. Using path analysis, we estimate the strength of the pathways between childhood growth and subsequent fertility outcomes in Guatemalan women studied prospectively since birth. Height for age z score at 24 months was positively related to body mass index (BMI kg/m2) and height (cm) in adolescence and to schooling attainment. BMI was negatively associated (-0.23 +/- 0.09 years per kg/m2; p < .05) and schooling was positively associated (0.38 +/- 0.06 years per grade; p < .001) with age at first birth. Total associations with the number of children born were positive from BMI (0.07 +/- 0.02 per kg/m2; p < .05) and negative from schooling (-0.18 +/- 0.02 per grade; p < .01). Height was not related to age at first birth or the number of children born. Taken together, childhood nutrition, as reflected by height at 2 years, was positively associated with delayed age at first birth and fewer children born. If schooling is available for girls, increased growth during childhood will most likely result in a net decrease infertility.

Associação entre o estado nutricional antropométrico e a situação sócio-econômica de adolescentes em Niterói, Rio de Janeiro, Brasil

Investigou-se a relação entre o estado nutricional e a situação sócio-econômica familiar de adolescentes moradores de Niterói, Rio de Janeiro, Brasil. Os dados de 523 adolescentes, pertencentes a uma amostra probabilística de 1.734 domicílios, foram coletados entre janeiro e dezembro de 2003 e representam os 71.922 jovens residentes em Niterói. As análises incluíram a estimação de intervalos de confiança de razões de prevalência e testes de distribuições proporcionais e de independência entre classes de estado nutricional e classes de renda familiar per capita e as faixas de número de moradores do domicílio. Foi encontrada uma associação positiva significativa entre baixo peso/magreza e o número de moradores do domicílio (sexo masculino: p < 0,05; sexo feminino: p < 0,001). O número de moradores do domicílio encontra-se diretamente associado ao baixo peso/magreza em adolescentes. Foi evidenciada uma tendência positiva de aumento na proporção de adolescentes com sobrepeso/obesidade segundo os quintos de renda familiar per capita.

Fatores associados a excesso de peso e concentração de gordura abdominal em adultos na cidade de Salvador, Bahia, Brasil

O objetivo foi identificar os fatores associados ao excesso de peso e concentração de gordura abdominal em adultos de ambos os sexos. Um estudo transversal envolvendo amostra representativa de 570 adultos de Salvador, Bahia, Brasil. A regressão de Poisson foi utilizada na análise, adotando-se o índice de massa corporal (IMC) e a circunferência da cintura como variáveis dependentes. Para as mulheres, a inadequação do IMC e da circunferência da cintura ocorreu com o aumento da idade e entre as que faziam dieta no momento do estudo, a história familiar de obesidade associou-se apenas com o IMC elevado. Para os homens, o IMC elevou-se na faixa etária de 30 a 39 e 50 a 59 anos. A circunferência da cintura elevou-se com a realização de três ou menos refeições-dia, com a hipertensão arterial, uso de bebida alcoólica e diminuiu entre mulatos e negros. Tanto IMC quanto circunferência da cintura elevaram-se com a historia familiar de infarto. Portanto são distintos os fatores que se associam ao excesso de peso e da gordura abdominal em homens e mulheres. Mas muitos deles podem ser modificados com a adoção do estilo de vida saudável.

Obesity in Mediterranean region (1997-2007): a systematic review

The objective of this review is to determine the distribution of obesity by geographical location, income, age and sex in the Mediterranean region during the last decade. A meta-analysis was conducted for 102 articles cited during the period (1997-2007) in Medline database (for 17 Mediterranean countries) searched during the summer of 2007 using the word 'obesity' and its related keywords. The study showed that adults were more obese than children in all Mediterranean continents and in different levels of income. The prevalence of obesity among European children was higher than among Asians. Also, European adults were more obese than European children. The total female adults were found to be more obese (median: 25.3%) than male adults (median: 20.0%). The regression model analysis indicated that male adults were more likely to be obese in the Euro-Med region. Taking different factors into consideration, it was noticed that Mediterranean adults, especially those in the European region, are at higher risk of obesity. Awareness programmes addressing the importance of adopting healthy dietary habits combined with physical activity should target the whole community in general and adults in particular. The findings could guide health planners for better management of obesity.

Methods for the assessment of adolescent obesity in epidemiological studies

Az elhízás előfordulási gyakorisága nemcsak felnőtt-, de gyermekkorban is drámaian nő. Célkitűzés: Különböző antropometriai módszerek összehasonlítása. Módszerek: A vizsgálatban 654 fiú és 584 lány (életkor: 15–19 év) adatait értékelték. Az antropometriai adatok közül a testmagasságot és a derékkörfogatot mérték, a testtömeget és a testösszetételt InBody3.0 bioimpedancia-mérővel határozták meg. A testtömegindexet és a testzsír százalékos arányát a készülék számította ki. Eredmények: A testtömegindexre vonatkozó, nemre, korra specifikus diagnosztikus kritériumok szerint sovány a fiúk 6,7%-a, túlsúlyos 15,9%-a és elhízott 4,1%-a; a lányok 7,2%-a sovány; 7,9%-a túlsúlyos és 1,9%-a elhízott. Elhízott volt a testzsírszázalék alapján a fiúk 5,1%-a, a lányok 16,2%-a, míg a derékkörfogat alapján a fiúk 10,5%-a, a lányok 7,9%-a. Elhízott volt a túlsúlyosnak ítélt fiúk 10,5%-a és a lányok 77%-a a zsírszázalék szerint, míg 38%-a, illetve 55%-a a derékkörfogat alapján. Következtetés: Az epidemiológiai vizsgálatokban az elhízottak kiszűrésére, valamint a fogyókúrás dietoterápia nyomon követésére a testösszetétel meghatározásának kiemelt jelentősége van. Mindemellett az olcsó és könnyen kivitelezhető derékkörfogat mérését minden esetben el kell elvégezni.

Adolescent skinfold thickness is a better predictor of high body fatness in adults than is body mass index: the Amsterdam Growth and Health Longitudinal Study

BACKGROUND

Body mass index (BMI) during adolescence is predictive of BMI at adult age. However, BMI cannot distinguish between lean and fat body mass. Skinfold thickness may be a better predictor of body fatness.

OBJECTIVE

The objective of this study was to evaluate the relations between BMI and skinfold thickness during adolescence and body fatness during adulthood.

DESIGN

We included 168 men and 182 women from the Amsterdam Growth and Health Longitudinal Study, a prospective study that conducted 8 measurements of BMI and skinfold thickness between 1976 and 2000. BMI and skinfold thickness during adolescence were analyzed in relation to adult body fatness measured at a mean age of 37 y with dual-energy X-ray absorptiometry.

RESULTS

None of the boys and 1.7% of the girls were overweight at baseline, whereas the prevalence of high body fatness during adulthood was 29% in men and 32% in women. At the ages of 12-16 y, skinfold thickness was more strongly associated with adult body fatness than was BMI. Age-specific relative risks for a high level of adult body fatness varied between 2.3 and 4.0 in boys and between 2.1 and 4.3 in girls in the highest versus the lowest tertile of the sum of 4 skinfold thicknesses. For the highest tertile of BMI, the relative risk varied between 0.8 and 2.1 in boys and between 1.3 and 1.8 in girls.

CONCLUSION

Skinfold thickness during adolescence is a better predictor of high body fatness during adulthood than is BMI during adolescence.