BMI in early adulthood is associated with severe COVID-19 later in life: A prospective cohort study of 1.5 million Swedish men

OBJECTIVE

Overweight and obesity have been identified as risk factors for severe COVID-19; however, prospective cohort studies investigating the association between overweight early in life and severity of COVID-19 are lacking.

METHODS

This study included 1,551,670 Swedish men, born between 1950 and 1987, with BMI registered at age 18 years. They were followed until January 9, 2021. COVID-19 cases and comorbidities were identified through the National Patient, Intensive Care, and Cause of Death registries. Outcomes included the following: 1) hospitalization; 2) intensive care unit admission; and 3) death.

RESULTS

The study found 4,315 cases (mean age = 56.4 years [SD 8.8]) of patients hospitalized because of COVID-19, of which 729 were admitted to an intensive care unit, and altogether there were 224 deaths. The risk for hospital admission increased with higher values of BMI at age 18 years, despite adjustment for comorbidities, from an odds ratio (OR) of 1.19 (95% CI: 1.08-1.31) at BMI = 22.5 to 25 to an OR of 1.68 (95% CI: 1.39-2.02) at BMI ≥ 30, compared with BMI = 18.5 to 20. ORs for intensive care unit admission were 1.44 (95% CI: 1.13-1.84) at BMI = 22.5 to 25 and 2.61 (95% CI: 1.73-3.93) at BMI ≥ 30.

CONCLUSIONS

Higher BMI in early adulthood was associated with severe COVID-19 many years later, with a risk increase starting already at BMI ≥ 22.5. This underlines the necessity of preventive actions against overweight in youth to offer protection against coming viral pandemics.

Validity and comparability of a wrist-worn accelerometer in children

BACKGROUND

Wrist-worn accelerometers may provide an alternative to hip-worn monitors for assessing physical activity as they are easier to wear and may thus facilitate long-term recordings. The current study aimed at a) assessing the validity of the Actiwatch (wrist-worn) for estimating energy expenditure, b) determining cut-off values for light, moderate, and vigorous activities, c) studying the comparability between the Actiwatch and the Actigraph (hip-worn), and d) assessing reliability.

METHODS

For validity, indirect calorimetry was used as criterion measure. ROC-analyses were applied to identify cut-off values. Comparability was tested by simultaneously wearing of the 2 accelerometers during free-living condition. Reliability was tested in a mechanical shaker.

RESULTS

All-over correlation between accelerometer output and energy expenditure were found to be 0.80 (P < .001).Based on ROC-analysis, cut-off values for 1.5, 3, and 6 METs were found to be 80, 262, and 406 counts per 15 s, respectively. Energy expenditure estimates differed between the Actiwatch and the Actigraph (P < .05). The intra- and interinstrument coefficient of variation of the Actiwatch ranged between 0.72% and 8.4%.

CONCLUSION

The wrist-worn Actiwatch appears to be valid and reliable for estimating energy expenditure and physical activity intensity in children aged 8 to 10 years.

Validity and Comparability of a Wrist-Worn Accelerometer in Children

BACKGROUND: Wrist-worn accelerometers may provide an alternative to hip-worn monitors for assessing physical activity as they are easier to wear and may thus facilitate long-term recordings. The present study aimed at a) assessing the validity of the Actiwatch (wrist-worn) for estimating energy expenditure b) determine cut-off values for light, moderate and vigorous activities, c) studying the comparability between the Actiwatch and the Actigraph (hip-worn) and d) assessing reliability. METHODS: For validity, indirect calorimetry was used as criterion measure. ROC-analyses were applied to identify cut-off values. Comparability was tested by simultaneously wearing of the two accelerometers during free-living condition. Reliability was tested in a mechanical shaker. RESULTS: All-over correlation between accelerometer output and energy expenditure were found to be 0.80 (P<0.001).Based on ROC-analysis, cut-off values for 1.5, 3 and 6 METs were found to be 80, 262 and 406 counts per 15 s, respectively. Energy expenditure estimates differed between the Actiwatch and the Actigraph (p<0.05). The intra- and inter-instrument coefficient of variation of the Actiwatch ranged between 0.72%, and 8.4%. CONCLUSION: The wrist-worn Actiwatch appears to be valid and reliable for estimating energy expenditure and physical activity intensity in children aged 8 to 10 years.