Performance of triponderal mass index, body mass index z scores, and body mass index performance in the diagnosis of obesity in children and adolescents

OBJECTIVES

Childhood obesity is a global health problem that affects millions of children and causes obesity-related adverse health outcomes in both childhood and adulthood. Although body mass index (BMI) z scores and percentiles are used in the diagnosis of obesity in children, it has been emphasized in recent years that the triponderal mass index (TMI) may be more accurate for this purpose. We aimed to compare TMI with BMI in the diagnosis of obesity in Turkish children and adolescents.

METHODS

The records of 3540 children who applied to Gülhane Training and Research Hospital were retrospectively scanned and the data of 1161 children were included in the study. The body fat percentage (BF%) was calculated by a formula, and children with body fat in the ≥95th percentile were classified as obese. Receiver study characteristics analysis was performed to compare the effectiveness of TMI and BMI in the diagnosis of obesity.

RESULTS

TMI correlated more with BF% (r = 0.863) than fat mass (r = 0.664); BMI correlated more with fat mass (r = 0.957) than BF% (r = 0.714) (P < 0.001). TMI had the highest area under the curve (AUC) in boys at diagnosis of obesity (6-11 y = 0.981; 12-15 y = 0.994). Girls ages 6 to 11 y had the same AUC for all 3 indexes (AUC = 0.977), whereas girls ages 12 to 15 y had the highest AUC for TMI (AUC = 0.967). However, the AUC values between all indices were very close.

CONCLUSIONS

TMI can be used to diagnose obesity in Turkish children and adolescents in both boys and girls similarly and with good performance. The correlation with BF% and stability of TMI makes this index more advantageous. However, it should be noted that the performance of each of the 3 indices is very close to that of the others, and adjustments should be made according to age and sex.

An alternative approach to obesity treatment: intermittent fasting

Overweight and obesity are an important public health problem that affects a significant part of the world population and increases the risk of many metabolic diseases. Weight loss is the primary goal in obesity treatment, and many different dietary interventions are tried for this purpose. Intermittent fasting is a diet that has become popular in recent years with the weight loss it provides and includes periods of fasting and feeding. In addition to providing weight loss, intermittent fasting also has positive effects on important risk factors such as glucoregulatory parameters, blood lipids, and oxidative stress. Intermittent fasting appears to be an effective and safe way to achieve weight loss in obesity. It could also have therapeutic effects on obesity-related diseases. The aim of this review was to bring together up-to-date information on the effects of intermittent fasting on obesity and various obesity-related diseases, mechanisms of action, possible benefits and harms, and potential uses.

Supplementation use and diet changes during COVID-19 pandemic according to anxiety level and Mediterranean diet adherence

Aim; This study was planned and conducted to examine the change in food consumption and nutritional supplement use during the COVID-19 pandemic according to individuals' status of anxiety and Mediterranean diet adherence. Methods; This prospective, cross-sectional research was completed online with the participation of 949 people (66.4% women). The Mediterranean Diet Adherence Screener Scale (MEDAS) and Coronavirus Anxiety Scale (CAS) were applied. After this section of the questionnaire was completed, the participants were tasked with answering questions regarding changes in food consumption and use of nutritional supplements during the pandemic. Results; While 50.8% of the participants had low adherence to the Mediterranean diet, 18.2% were considered to have a high adherence. It was observed that legume (p = 0.001), milk and dairy (p = 0.01), and fruit (p < 0.001) consumption of participants with high adherence to the Mediterranean diet increased during the pandemic, and packaged food (p < 0.001) consumption decreased. The increase in the consumption of fruit (p < 0.001) and vegetables (p = 0.018) were significantly higher in the group with anxiety. Age, sex, educational status, positive COVID-19 test, place of residence, CAS score and MEDAS score affect the use of dietary supplements according to binary logistic regression (R² = 0.106 p < 0.001). The three most commonly used supplements were identified as vitamins C, D and B₁₂. Conclusions: These results can shed light on how to prepare for possible future pandemics when it comes to dealing with anxiety through diet.

The factors associated with orthorexia nervosa in type 2 diabetes and their effect on diabetes self-management scores

PURPOSE

This study aimed to determine the factors affecting the ORTO-R scores in individuals with T2DM and to investigate their effect on diabetes self-management.

METHODS

The study included 373 individuals with type 2 diabetes between the ages of 18-65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January and May 2022. A questionnaire including sociodemographic data, information about diabetes, and nutritional habits, and the ORTO-R and Type 2 Diabetes Self-Management Scales were used to collect data. Linear regression analysis was performed to determine the factors affecting ORTO-R.

RESULTS

The linear regression analysis showed that age, gender, education level, and duration of diabetes affected ORTO-R scores in patients with type 2 diabetes. Body mass index, comorbidities (cardiovascular diseases, kidney diseases and hypertension), diabetes-related complications, diabetes treatment method and dieting had no significant contribution to the model (p > 0.05). We also found that education level, comorbidities, diabetes-related complications, diabetes treatment method, dieting, and BMI can affect diabetes self-management.

CONCLUSION

It should be kept in mind that type 2 diabetes are at risk of orthorexia nervosa (ON) in terms of various aspects such as age, gender, education level and duration of diabetes. Since the factors affecting the risk of ON and the factors affecting diabetes self-management are intertwined, orthorexic tendencies should be kept under control while trying to increase self-management in these patients. In this respect, developing individual recommendations according to the psychosocial characteristics of patients may be an effective approach.

LEVEL OF EVIDENCE

Level V, cross-sectional study.