Associations between area-level unemployment, body mass index, and risk factors for cardiovascular disease in an urban area

INTRODUCTION: Il existe peu d’évidences sur l’association entre le taux de chômage dans le milieu résidentiel (CR) et le risque de maladies cardiovasculaires parmi les résidents de milieux urbains. De plus, on ne sait pas si ce lien diffère entre les deux sexes. Cette thèse a pour objectif de déterminer la direction et la taille de l’association entre le CR et le risque de maladies cardiovasculaires, et d’examiner si cette association varie en fonction du sexe. MÉTHODES: Un sous-échantillon de 342 participants de l’Étude sur les habitudes de vie et la santé dans les quartiers montréalais a rapporté ses habitudes de vie et sa situation socio-économique. Des mesures biologiques et anthropométriques ont été recueillies par une infirmière. Le CR a été opérationnalisé en fonction d’une zone-tampon d’un rayon de 250 m centrée sur la résidence de chacun des participants à l’aide d’un Système d’Information Géographique (SIG). Des équations d’estimation généralisées ont été utilisées afin d’estimer l’association entre le CR et l’Indice de Masse Corporelle (IMC) et un score cumulatif de Risque Cardio-métabolique (RC) représentant la présence de valeurs élevées de cholestérol total, de triglycérides, de lipoprotéines de haute densité et d’hémoglobine glyquée. RÉSULTATS: Après ajustement pour l’âge, le sexe, le tabagisme, les comportements de santé et le statut socio-économique, le fait de vivre dans un endroit classé dans le 3e ou 4e quartile de CR était associé avec un IMC plus élevé (beta pour Q4 = 2.1 kg/m2, IC 95%: 1.02-3.20; beta pour Q3 = 1.5 kg/m2, IC 95%: 0.55-2.47) et un taux plus élevé de risque cardiovasculaires Risque Relatif [RR pour Q4 = 1.82 (IC 95 %: 1.35-2.44); RR pour Q3 = 1.66 (IC 95%: 1.33-2.06)] par rapport au 1er quartile. L'interaction entre le sexe et le CR révèle une différence absolue d’IMC de 1.99 kg/m2 (IC 95%: 0.00-4.01) et un risque supérieur (RR=1.39; IC 95%: 1.06-1.81) chez les femmes par rapport aux hommes. CONCLUSIONS: Le taux de chômage dans le milieux résidentiel est associé à un plus grand risque de maladies cardiovasculaires, mais cette association est plus prononcée chez les femmes.

Developmental trajectories of body mass index in early childhood : an 8-year longitudinal study

Trajectoires développementales de l’IMC durant l’enfance: Une étude longitudinale sur 8 ans. Introduction : L’obésité infantile, origine de nombreux problèmes de santé, représente un grand défi en santé publique. Récemment, l’importance d’étudier l’évolution du surpoids durant l’enfance ainsi que les facteurs de risques précoces pour l’obésité a été reconnue. Les trajectoires développementales d’indice de masse corporelle (IMC) chez les jeunes représentent une approche innovatrice qui nous permet de mieux comprendre cette problématique importante. Objectifs: 1) Identifier des trajectoires développementales distinctes de groupes d’enfants selon leur IMC durant l’enfance, et 2) Explorer les facteurs de risques précoces qui prédisent l’appartenance de l’enfant à la trajectoire d’IMC le plus élevé Hypothèses: 1) On s’attend à retrouver un groupe d’enfants qui suit une trajectoire d’IMC élevée durant l’enfance. 2) On s’attend à ce que certaines caractéristiques de la mère (ex : tabac pendant la grossesse et IMC élevé), soient associées à l’appartenance de l’enfant au groupe ayant la trajectoire «IMC élevé ». Méthodes: Estimation des trajectoires développementales d’IMC d’enfants, dans un échantillon populationnel (n=1957) au Québec (ELDEQ). Les IMC ont été calculés à partir de données fournies par les mères des enfants et recueillis chaque année sur une durée de 8 ans. Des données propres à l’enfant sa mère, ainsi que socioéconomiques, ont étés recueillies. Une régression logistique multinomiale a été utilisée pour distinguer les enfants avec un IMC élevé des autres enfants, selon les facteurs de risques précoces. Les programmes PROC TRAJ (extension de SAS), SPSS (version 16), et SAS (version 9.1.3) ont été utilisés pour ces analyses. Résultats: Trois trajectoires d’IMC ont étés identifiées : IMC « bas-stable » (54,5%), IMC « modéré » (41,0%) et IMC « élevé et en hausse » (4,5%). Le groupe « élevé et en hausse » incluait des enfants pour qui l’IMC à 8 ans dépassait la valeur limite pour l’obésité. Les analyses de régression logistique ont révélé que deux facteurs de risques maternels étaient significativement associés avec la trajectoire “en hausse” par rapport aux deux autres groupes : le tabac durant la grossesse et le surpoids maternel. Conclusions: Des risques d’obésité infantile peuvent êtres identifiés dès la grossesse. Des études d’intervention sont requises pour identifier la possibilité de réduire le risque d’obésité chez l’enfant en ciblant le tabac et le surpoids maternelle durant la grossesse. Mots clés: Indice de masse corporelle (IMC), obésité infantile, trajectoires développementales de groupe, facteurs de risque précoce, étude populationnelle, tabac pendant la grossesse, obésité maternelle.

Body mass index as a standard of living measure: a different interpretation for the case of Colombia

We analyze the Body Mass Index (BMI) in a distinct way of its traditional use and it lets us use it as a proxy of standard of living for the case of Colombia. Our approach is focused on studying how far the people are from the normal range and not on the score of each one and this lets us to treat equally extreme cases as severe thinness and obesity. We use a probabilistic model (Ordered Probit) that evaluates the probability of being within the normal range or another level. We found that socioeconomic variables have a significant effect on the dependent variable and that there are no linear effects. Besides, people with difficulties for walking and adults have less probability of having a normal BMI.

Physical activity attenuates the body mass index-increasing influence of genetic variation in the FTO gene 1-3.

BACKGROUND: Intronic variation in the FTO (fat mass and obesity-associated) gene has been unequivocally associated with increased body mass index (BMI; in kg/m(2)) and the risk of obesity in populations of different ethnicity. OBJECTIVE: We examined whether this robust genetic predisposition to obesity can be attenuated by being more physically active. DESIGN: The FTO variant rs1121980 was genotyped in 20,374 participants (39-79 y of age) from the European Prospective Investigation into Cancer and Nutrition-Norfolk Study, an ethnically homogeneous population-based cohort. Physical activity (PA) was assessed with a validated self-reported questionnaire. The interaction between rs1121980 and PA on BMI and waist circumference (WC) was examined by including the interaction term in mixed-effect models. RESULTS: We confirmed that the risk (T) allele of rs1121980 was significantly associated with BMI (0.31-unit increase per allele; P < 0.001) and WC (0.77-cm increase per allele; P < 0.001). The PA level attenuated the effect of rs1121980 on BMI and WC; ie, whereas in active individuals the risk allele increased BMI by 0.25 per allele, the increase in BMI was significantly (P for interaction = 0.004) more pronounced (76%) in inactive individuals (0.44 per risk allele). We observed similar effects for WC (P for interaction = 0.02): the risk allele increased WC by 1.04 cm per allele in inactive individuals but by only 0.64 cm in active individuals. CONCLUSIONS: Our results showed that PA attenuates the effect of the FTO rs1121980 genotype on BMI and WC. This observation has important public health implications because we showed that a genetic susceptibility to obesity induced by FTO variation can be overcome, at least in part, by adopting a physically active lifestyle.

Six new loci associated with body mass index highlight a neuronal influence on body weight regulation

Common variants at only two loci, FTO and MC4R, have been reproducibly associated with body mass index (BMI) in humans. To identify additional loci, we conducted meta-analysis of 15 genome-wide association studies for BMI (n > 32,000) and followed up top signals in 14 additional cohorts (n > 59,000). We strongly confirm FTO and MC4R and identify six additional loci (P < 5 x 10(-8)): TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1 (where a 45-kb deletion polymorphism is a candidate causal variant). Several of the likely causal genes are highly expressed or known to act in the central nervous system (CNS), emphasizing, as in rare monogenic forms of obesity, the role of the CNS in predisposition to obesity.

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

Body mass index values for newborns according to gestational age

Objective: The combination of twho anthropometric parameters has been more appropriate to assess body composition and proportions in children, with special attention to the Body Mass Index (BMI), as it relates weight and length. However the BMI values for the neonatal period have not been determined yet. This study shows the BMI for newborns at different gestational ages represented in a normal smoothed percentile curve. Methods: Retrospective study including 2,406 appropriate for gestational age newborns following the Alexander et al curve (1996) from 29 to 42 weeks of gestational age. Weight and lenght were measured following standard procedures. For the construction aof a normal smoothed percentile curve, the 3(rd) 5(th), 10(th), 25(th), 5(th), 75(th), 90(th) and 95(th) percentiles were determined and a statistical procedure based on the mathematical model ""sinosuoidal fit"" was applied to establish a curve that estimates biological growth parameters. Results: The Body Mass Index values for gestational age in all percentiles shows a steady increase up to 38 weeks, levels off up to the 40(th) week, followed by a slight decrease to the 42(nd) week in both genders. Conclusion: The results show a direct correlation between gestational age and Body Mass Index for both genders in the nine percentiles, and can provide a useful reference to assess intra-uterine proportional growth.

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in upto 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 x 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for similar to 2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous systemin obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

Performance of body fat and body mass index cutoffs in elevated blood pressure screening among male children and adolescents

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Waist circumference, but not body mass index, is a predictor of ventricular remodeling after anterior myocardial infarction

Objective: The impact of obesity on ventricular remodeling after myocardial infarction (MI) is still poorly understood. Therefore, the aim of this study was to evaluate the role of waist circumference (WC) and body mass index as predictors of cardiac remodeling in patients after an anterior MI. Methods: Eighty-three consecutive patients with anterior MI were prospectively evaluated. Clinical characteristics and echocardiographic data were analyzed at admission and at a 6-mo follow-up. Ventricular remodeling was defined as a 10% increase in left ventricular end-systolic or end-diastolic diameter at the 6-mo follow-up. Results: In our study, 83 consecutive patients were evaluated (72% men). Ventricular remodeling was present in 31% of the patients (77% men). Patients with remodeling had higher creatine phosphokinase and creatine phosphokinase-MB peak values, a higher resting heart rate, a larger left atrial diameter, and a larger interventricular septum diastolic thickness. In addition, patients with remodeling had lower peak velocity of early ventricular filling deceleration time and ejection fraction. Patients with remodeling presented higher WC values (with remodeling, 99.2 ± 10.4 cm; without remodeling, 93.9 ± 10.8 cm, P = 0.04), but there were no differences in the body mass index values. In the logistic regression analysis, WC, adjusted by age, gender, ejection fraction, and creatine phosphokinase levels, was an independent predictor of left ventricular remodeling (odds ratio 1.067, 95% confidence interval 1.001-1.129, P = 0.02). Conclusion: Waist circumference, but not body mass index, is a predictor of ventricular remodeling after an anterior MI. Therefore, the WC of these patients should be measured in clinical practice. © 2013 Elsevier Inc.

Physical fitness in children with probable developmental coordination disorder and normal body mass index

Mudanças no índice de massa corporal (IMC), devido a diversos fatores, como o baixo nível de prática de atividade física, são frequentemente associadas ao baixo nível de aptidão física de crianças com provável transtorno do desenvolvimento da coordenação (pTDC). O presente estudo examinou se crianças com pTDC apresentariam desempenhos inferiores em termos de aptidão física quando comparado com seus pares de desenvolvimento típico (DT). Trinta e duas crianças com pTDC e IMC normal e 32 crianças com DT e IMC normal, pareadas por gênero, idade e IMC, realizaram os testes de sentar e alcançar, de salto horizontal, abdominal, puxada na barra 'modificado' e corrida de 9-min. Os resultados mostraram que crianças do grupo pTDC apresentaram menor força explosiva, resistência e força muscular e resistência cardiorrespiratória do que as crianças do grupo TD. Foi concluído que, mesmo com IMC esperado para a idade, crianças com pTDC têm baixo nível de aptidão física.

Body mass index, dental caries and sugar intake in 2-5 year-old preschoolers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Prevalence of obesity and relationship wit body mass index and symptoms of asthma in adolescents

To investigate the relationship between Body Mass Index (BMI) and asthma symptoms in adolescents between 13 and 14 years, to estimate the prevalence of obesity in this age group. This is a crosssectional study with a quantitative approach which was rated the Body Mass Index (BMI) and applied the Questionnaire International Study of asthma and Allergies in Childhood (ISAAC) phase III (asthma module) to determine the prevalence of asthma and related symptoms, as well as its severity in 85teenagers. According to the assessment of asthma in relation to BMI, it was found that there were significant findings, as well as in males and females. However, the association between BMI and asthma symptoms, there was a significant association to present as disturbed sleep and impaired speech. Conclusions: In this sample the prevalence of obesity was low, this fact may have contributed to the nonsignificant findings betweenasthma and BMI.

Reporting Results After Bariatric Surgery: Reproducibility of Predicted Body Mass Index

There is a controversy about the best way to report results after bariatric surgery. Several indices have been proposed over the years such as percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of excess body mass index loss (%EBMIL). More recently, it has been suggested to individualize the body mass index (BMI) goal to be achieved by the patients (predicted BMI-PBMI). The objective was to assess the reproducibility of this PBMI in our service. In this retrospective study, we assessed the %TWL, %EWL, %EBMIL (with expected BMI of 25 kg/m(2)), and %EBMIL (with PBMI) over 4 years of observation in two groups of patients: BMI < 50 kg/m(2) and BMI a parts per thousand yen50 kg/m(2). The medical records of 403 patients were studied. From 18 to 42 months after surgery, %TWL was higher in the superobese group, whereas %EWL was similar for the two groups. %EBMIL was higher in less obese patients up to 24 months and similar thereafter. In contrast, %EBMIL with PBMI was greater in the superobese group, although it never reached the 100% goal. We conclude that %EBMIL results according to PBMI were not reproducible in our institution. There is a need to elaborate a new easy-to-obtain and reproducible index.