Selection of the more adequate prediction index to estimate the frame size a group of institutionalized and free living elderly in Venezuela. (Preliminary study)

The objective of the study was to identify an easy to measure indicator of body frame size to allow refinement of anthropometric nutritional evaluation. Body dimensions and frame indices related to height, which might be potential frame size predictors in the elderly, were studied. In 307 subjects (163 women, 144 men) aged 60-99 years of whom 187 were institutionalized and 120 free-living outpatients, weight, height, mid-arm circumference; triceps, subscapular, midthigh and calf skinfolds; elbow, wrist, femur and biacromial widths, were measured. Body mass index, upper arm muscle area, upper arm fat area, fat percentage, sum of skinfolds and frame indices were calculated. Results were calculated in function of age, sex and life-style. Biacromial breadth, biacromial/height index, wrist breadth and wrist/height index gave variable correlations with indices of body mass and body fat. Femur breadth and femur/height index were significantly correlated with body fat indices. Elbow breadth, humerus/height index were not correlated to body fat indices, but were significantly correlated with weight, height and fat free mass. Elbow breadth and humerus/height index fulfilled most of the criteria of good predictors of body frame size in the group pf elderly studied.     

Blood pressure and obesity of children and adolescents association with body mass index and waist circumference

The objective of this work was to evaluate the association between the average levels of blood pressure of 706 children in Porto Alegre with their nutritional state--body mass index (BMI), body fat percentage, waist circumference--and with their social-economic state. A prevalence of 12.3% (n=87) of high blood pressure was found. According to the BMI, 11% of the sample was obese. 47.7% belonged to the social class with an income less than two monthly minimum salaries. All of the correlations of the SBP (systolic blood pressure) and DBP (diastolic blood pressure) with variables in the nutritional state showed to be significant (p < 0.001). What ended up having a stronger association was the BMI and waist circumference with SBP (R = 0.27). This study made it possible to notice that the anthropometric indicator that best is related to the existence of high BP is the BMI along with the waist circumference. This seems to be an easy method that is noninvasive and of low cost to detect the risk of high BP in children and adolescents.     

Fatness and fat distribution by social stratum in Venezuelan youths

Adiposity and distribution of body fat are important issues in the prediction of degenerative diseases. Measurements of weight, height, circumferences of thigh, waist and hip; triceps, biceps, subscapular and suprailiac skinfolds; body mass index (BMI), centripetal index (CI), waist/hip (WHR), waist/thigh (WTR) ratios and sigma skinfold thickness (sigma SK) were performed in 836 youths (373 males, 463 females) aged 11, 13 and 15 years. Analysis method included Student t test, ANOVA, Principal Component Analysis and simple linear regression model, with sigma skinfold thickness as independent variable. The sample was divided in two groups (A and B) according with Graffar-Méndez Castellano methodology. Sexual dimorphism in adiposity and differences in body fat distribution were found with a tendency towards peripherical distribution for girls and centripetal for boys. Group A (higher stratum) showed higher values of skinfolds in both trunk and extremities, and a more peripherical distribution than his peers from group B. First component from extremity/trunk and second component from upper/inferior trunk distribution explained 40.2% and 32.7% of the variability respectively. CI and WHR appear dependent from BMI, WHR showed independence from BMI, although significant differences was found by social stratum, reflecting differences in fat topography in boys and girls from group B. These results confirm more adiposity in group A and a tendency towards central distribution in group B. Studies of body fat distribution during these age should include waist/thigh ratio.     

Predictive accuracy of body mass index in estimating body fatness measured by bioelectrical impedance

The aim of this study was to determinate the performance of body mass index (BMI) for the diagnosis of obesity and as a predictor of body fatness in adult Chilean subjects. We conducted a study in 433 women (18-73 years old; BMI: 19.7 to 69.7 kg/m2) and 264 men (18-83 y.; BMI: 19.1 to 54.8 kg/m2). Bioelectrical resistance was measured by impedance method and fat mass percent (FM%) was calculated by fatness-specific equations developed by Segal et al. Obesity was defined as a BMI of at least 30 kg/m2. Increased fatness was defined by the FM% cut-off points of at least 25% for men and at least 30% for women. Sixty-four percent of women and 23.6% of men with BMI below 30 kg/m2 had FM% higher than 30% and 25%, respectively. A value of BMI of 26 kg/m2 in women and 30 kg/m2 in men had the best agreement to the cut-off points of fatness according to sensitivity vs. specificity analysis The following equations were developed to predict individual fatness: women FM% = 0.96 x BMI + 0.154 x age + 1.44 (r2 = 0.75; standard error 3.8%); men FM% = 0.99 x BMI + 0.141 x age - 9.914 (r2 = 0.66; standard error 4.4%). Differences between measured and predicted FM% presented a wide variation, with a range of +/- 2 sd of 7.5% in women and 8.8% in men. The commonly used value of BMI 330 kg/m2 as a cut-off point for obesity does not have adequate sensitivity and specificity for the screening of increased fatness subjects, specially in women. In this study BMI shows a low reliability as a predictor of individual body fatness, particularly in men and in subjects with a BMI below 30 kg/m2.     

Use of knee height to correct the body height of elderly Hispanics

Loss of stature in certain elderly subjects can be attributed to diseases such as osteoporosis, as well as to age and generational effects. In addition, many elders cannot stand straight for accurate measurement. For these cases, total height can be estimated with regression equations based on knee height. The aims of this study were, firstly, to evaluate the applicability of regression equations based on knee height for estimation of stature and, secondly, to document the differences between measured and estimated height in a group of elderly Hispanics with postural problems (n = 166) in comparison with a group of elderly Hispanic without postural problems (n = 270). Using both, estimated and measured height, we also calculated the body mass index (BMI) of both groups of elders. Statistical analyses were done with paired t-tests, within sex and study group. Within the group with postural problems, estimated height was higher than the measured height for both men (p < or = 0.001) and women (p < or = 0.001). There were no significant differences between measured and estimated height in the group without postural problems. Furthermore, in the group with postural problems, BMI values calculated with estimated height were lower than those estimated with the measured height, and these differences were also significant for both men (p < or = 0.001) and women (p < or = 0.001). With the aging of the Latin American population, there is a need for more nutrition and health research among elders. In order to do this we need to develop and use methods and criteria appropriate for each population.     

Prevalence and magnitude of body weight and image dissatisfaction among women in dietetics majors

Some authors have suggested that body weight dissatisfaction may be high in students majoring in dietetics. Therefore, this study was conducted to examine the extent of body weight and image dissatisfaction in a sample of women in dietetics major. Additionally, predictors of magnitude of body weight dissatisfaction were analyzed. Participants were 62 volunteers with normalweight whose mean age was 21.87 +/- 1.89 years old (non-random sample). The assessment instruments included anthropometric measurements, a somatomorphic matrix test and an eating disorders inventory (EDI-2). Data were analyzed using SPSS vs. 15.0. A larger proportion of students chose an ideal body weight lower than actual weight (67.7%) and body image with less body fat and more muscle mass than actual values (56.4%). The magnitude of body weight dissatisfaction was associated with muscle mass and body fat dissatisfaction, and with the subscale of EDI-2 "body dissatisfaction". So, from a public health standpoint, we consider important to continue working in this line of research with the aim of better understanding the extent of body weight dissatisfaction in women dietitians, and how this dissatisfaction could interfere with their professional practice.     

Optimal cut-off for obesity and markers of metabolic syndrome for Ethiopian adults

Background

Metabolic syndrome (MetS) is defined as the presence of central obesity plus any two of the following markers: high triglycerides (>?150 mg/dl), low high density lipoprotein (HDL) cholesterol <?40 mg/dl in men and?<?50 mg/dl in women, hypertension (blood pressure?>?130/85 mmHg or use of antihypertensive medication), high fasting blood glucose (>?100 mg/dl or use of treatment for diabetes mellitus). Since recently, metabolic syndrome and obesity have become emerging problems of both low and middle income countries, although they have been the leading cause of morbidity and mortality in high income countries for the past decades. It has been indicated that the international anthropometric cut-off for detecting obesity is not appropriate for Ethiopians. This study developed optimal cut off values for anthropometric indicators of obesity and markers of metabolic syndrome for Ethiopian adults to enhance preventive interventions.

Methods

A total of 704 employees of Jimma University were randomly selected using their payroll as a sampling frame. Data on socio-demographic, anthropometry, clinical and blood samples were collected from February to April 2015. Receiver Operating Characteristic Curve analyses were used to determine optimal anthropometric cut-off values for obesity and markers of the metabolic syndrome. WHO indicators of obesity based on body fat percent (>?25% for males and?>?35% for females) were used as binary classifiers for developing anthropometric cut-offs. Optimal cut-off values were presented using sensitivity, specificity and area under the curve.

Results

The optimal cut-off for obesity using body mass index was 22.2 k/m² for males and 24.5 kg/m² for females. Similarly, the optimal waist circumference cut-off for obesity was 83.7 cm for males and 78.0 cm for females. The cut-off values for detecting obesity using waist to hip ratio and waist to height ratio were: WHR (0.88) and WHtR (0.49) for males, while they were 0.82 and 0.50 for females, respectively. Anthropometric cut-off values for markers of metabolic syndrome were lower compared to the international values. For females, the optimal BMI cut-offs for metabolic syndrome markers ranged from 24.8 kg/m² (triglycerides) to 26.8 kg/m² (fasting blood sugar). For WC the optimal cut-off ranged from of 82.1 cm (triglyceride) to 96.0 cm(HDL); while for WHtR the optimal values varied from 0.47(HDL) to 0.56(fasting blood sugar). Likewise, the optimal cut-offs of WHR for markers of metabolic syndrome ranged from 0.78(fasting blood sugar) to 0.89(HDL and blood pressure). For males, the optimal BMI cut-offs for metabolic syndrome markers ranged from 21.0 kg/m² (HDL) to 23.5 kg/m² (blood pressure). For WC, the optimal cut-off ranged from 85.3 cm (triglyceride) to 96.0 cm(fasting blood sugar); while for WHtR the optimal values varied from 0.47(BP, FBS and HDL) to 0.53(Triglyceride). Similarly, the optimal cut-offs of WHR form markers of metabolic syndrome ranged from 0.86(blood pressure) to 0.95(fasting blood sugar).

Conclusion

The optimal anthropometric cut-offs for obesity and markers of metabolic syndrome in Ethiopian adults are lower than the international values. The findings imply that the international cut-off for WC, WHtR, WHR and BMI underestimate obesity and metabolic syndrome markers among Ethiopian adults, which should be considered in developing intervention strategies. It is recommended to use the new cut-offs for public health interventions to curb the increasing magnitude of obesity and associated metabolic syndrome and diet related non-communicable diseases in Ethiopia.

     

Body Mass Index,percent body fat,and regional body fat distribution in relation to leptin concentrations in healthy,non-smoking postmenopausal women in a feeding study

Background  

The relationship between BMI and leptin has been studied extensively in the past, but previous reports in postmenopausal women have not been conducted under carefully controlled dietary conditions of weight maintenance using precise measures of body fat distribution. The aim of the present study was to examine the association between serum leptin concentration and adiposity as estimated by BMI and dual energy x-ray absorptiometry (DEXA) measures (percent body fat, central and peripheral fat, and lean mass) in postmenopausal women.     

Anemia in relation to body mass index and waist circumference among chinese women

Background

This study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified by body mass index (BMI) categories as underweight, normal weight, overweight and obese according to the Chinese standard. Central obesity was defined as a waist circumference?≥?80 cm. Anemia was defined as hemoglobin concentration?<?12 g/dl. Prevalence ratios (PRs) of the relationship between anemia and BMI or waist circumference were calculated using Poisson regression.

Findings

Overall, 31.1% of the Chinese women were anemic. The prevalence of overweight, obesity and central obesity was 34.2%, 5.8% and 36.2%, respectively. The obese group had the highest concentrations of hemoglobin compared with other BMI groups. After adjustment for confounders, overweight and obese women had a lower PR for anemia (PR: 0.72, 95% CI: 0.62-0.89; PR: 0.59, 95% CI: 0.43-0.79). Central obesity was inversely associated with anemia.

Conclusion

In this Chinese population, women with overweight/obesity or central obesity were less likely to be anemic as compared to normal weight women. No measures are required currently to target anemia specifically for overweight and obese people in China.     

Validity of an equation based on anthropometry to estimate body fat in older adults

A prediction equation to estimate body fat mass from skinfold thickness for healthy elderly was developed using a four compartmental (4C) model as criterion method. This study included 202 subjects = 60 y old. The measurements of total body water, bone mineral content and body density were included in the 4C model equation. Total sample was randomly partitioned. Sub-sample one was used to design the equations, which were applied in sub-sample two. Its accuracy and precision was evaluated by lineal regression analysis and the bias by Bland and Altman analysis and simple lineal regression. The best model included body mass, sex and the calf and triceps skinfolds thicknesses, with an R2, standard error of the estimate and Cp of 0.85, 3.2 and 3.2, respectively. When the equation was applied in sub-sample two, it was accurate and precise, it showed no significant deviation from the line of identity (the intercept was no significantly different from zero, P>0.05), and slope was different from cero (or similar to 1) (P<0.05). Fat mass by the equation accounted for 86% of the variability of the mean fat mass estimated by the 4C model, having a low standard error of the estimate (3.2 kg) and low pure error (3.1 kg). The new equation was accurate and precise as well as free of significant bias in men and women together and for separately. This equation can be a good option to estimate fat mass in elderly men and women with similar physical characteristics to subjects of this study, and it can be used in clinical and epidemiological studies in this growing group.     

Medium- and Long-Chain Triacylglycerols Reduce Body Fat and Blood Triacylglycerols in Hypertriacylglycerolemic, Overweight but not Obese, Chinese Individuals

In contrast to the consumption of long-chain triacylglycerols (LCT), consumption of medium- and long-chain triacylglycerols (MLCT) reduces the body fat and blood triacylglycerols (TAG) level in hypertriacylglycerolemic Chinese individuals. These responses may be affected by BMI because of obesity-induced insulin resistance. We aimed to compare the effects of consuming MLCT or LCT on reducing body fat and blood TAG level in hypertriacylglycerolemic Chinese subjects with different ranges of BMI. Employing a double-blind, randomized and controlled protocol, 101 hypertriacylglycerolemic subjects (including 67 men and 34 women) were randomly allocated to ingest 25–30 g/day MLCT or LCT oil as the only cooking oil for 8 consecutive weeks. Anthropometric measurements of body weight, BMI, body fat, WC, HC, blood biochemical variables, and subcutaneous fat area and visceral fat area in the abdomen were measured at week 0 and 8. As compared to subjects with BMI 24–28 kg/m² in the LCT group, corresponding subjects in the MLCT group showed significantly greater decrease in body weight, BMI, body fat, WC, ratio of WC to HC, total fat area and subcutaneous fat area in the abdomen, as well as blood TAG and LDL-C levels at week 8. Based upon our results, consumption of MLCT oil may reduce body weight, body fat, and blood TAG and LDL-C levels in overweight hypertriacylglycerolemic Chinese subjects but may not induce these changes in normal or obese hypertriacylglycerolemic subjects.     

Lean adolescents with increased risk for metabolic syndrome

The aim of the present study was to determine in adolescents the relationship between insulin levels and body mass index (BMI), body fat distribution, diet, life style and lipid profile. We studied 167 adolescents (68 boys and 99 girls) whose ages ranged from 14 to 17 years. A detailed medical (including pubertal stage) and nutritional record was obtained from each subject. Biochemical measurements included fasting serum insulin, glucose, total cholesterol (TC), triglycerides (Tg), HDL-C, LDL-C and VLDL-C. HOMA insulin resistance (IR) and HOMA beta-cell function (beta-cell) were calculated. Insulin levels were over 84 pmol/L (cut off normal value in our lab) in 56% of the boys and 43% of the girls. Thirty-seven percent of lean adolescents whose BMI was 21.5 +/- 1.9 kg/m2 presented higher fasting insulin levels. HOMA IR, Tg, systolic (SBP) and diastolic blood pressure (DBP) values when compared to a lean normoinsulinemic group. Insulin levels were correlated (p < 0.01) with body mass index. Both boys and girls in the highest BMI quartile (BMI > 24 kg/m2) had significantly higher serum insulin, HOMA beta-cell, and Tg levels, and the lowest HDL-C levels. A high-energy intake rich in saturated fat and low physical activity were found in this lean but metabolically altered adolescents. We conclude that even with a BMI as low as 21 kg/m2 an inappropriate diet and low physical activity might be responsible for the high insulin levels and dislipidemias in adolescents.     

Short stature and food habits as determining factors for the low productivity of sugarcane labourers in the State of Alagoas, north-eastern Brazil

Undernutrition, especially in the prenatal period and/or until 5 years of age, can cause stunting. Adults with short stature resultant from this process show a series of functional deficits, amongst which is a reduced capacity to do physical work. The aim of this investigation was to evaluate the dietary pattern, nutritional status and stature of sugarcane cutters, and to determine possible associations with worker productivity. Sixty-two male sugarcane cutters (18-50 y) were selected randomly from a population of 600 workers from a plantation in Alagoas (Brazil), and classified as underweight, normal weight or overweight according to BMI (BMI = 21.5, 21.5 to = 25 and >25 kg/m2, respectively). Body fat composition (%) was estimated by electrical bioimpedance and dietary intake by the direct weighing of food consumed. Whilst the average productivity was 8.13 ton/day, labourers with normal BMI values were more productive (9.12 ton/dia) and ingested significantly (p<0.05) greater amounts of energy (16506.4 kJ/dia) than their underweight (7.48 +/- 1.5; 12380.7 +/- 4184.1) or overweight (9.12 +/- 1.5; 16506.4 +/- 6360.0) counterparts, respectively. There were associations (p<0.05) between productivity, stature, energy intake and age. The tallest individuals (= 170 cm) had higher productivity and tended to have a higher energy intake, whilst those with the shortest stature (= 160 cm), had a significantly lower productivity, however ingested a similar quantity of energy, and tended to have a large accumulation of body fat. Multiple regression analysis identified stature as the parameter most associated with productivity, independent of age and body fat percentage. Productivity of the tallest individuals was 1.87 ton/day higher than that of the shortest individuals. The results emphasise the importance of good nutritional status throughout life for full development of working productivity.     

Multivariate study of the evolution of body dimensions in elderly Chilean women

Although in medical research the use of longitudinal data to analyze short time periods is frequently required, it does not permit the use of classic statistical methods for chronological series. The objective of this study is to present the possibility and plausibility of using the STATIS method (Structuration des Tableaux A Trois Indices de la Statistique), an explorative method for data analysis, in a study of the body composition of a sample of 57 women over 68 years of age in Santiago, Chile who were observed over a period of 30 months. The variables analyzed (measured every 6 months) were the following anthropometric measurements: weight, height, arm circumference, calf circumference, waist circumference, hip circumference and knee height. The results obtained suggested a regular chronological evolution during the first 24 months of observation with a change in structure after 30 months of the study, thereby classifying subjects according to body composition.     

Secular trends in growth in male adolescents: height and weight gains, nutritional state and relation with education

This work aimed at characterizing the modifications in adolescents nutritional status, growth evolution and education along time and the correlation with the height, weight and body mass index. Data came from 2616 male adolescents soldiers between 17 and 19 years old enlisted for Armed Services in the city of Vi?osa-Minas Gerais, Brazil, between 1995 and 2004. There was a positive secular trend for height and weight, with a 4cm and 3kg median increment, respectively, along time. There was a reduction from 28.0% to 11.6% on the prevalence of short stature in the period. It was estimated positive correlation (p < 0.05) between education and stature, weight and BMI. The prevalence of weight excess (risk of overweight and overweight) increased from 7.1% (1995) to 9.1% (2004). Although it was observed positive secular trend for stature and weight, it was not sufficient to reach the median of the National Center for Health Statistics/Center for Disease Control and Prevention. Weight excess and short stature prevalence must be monitored, being necessary the implementation of measures that focus to prevent these disturbance and aim at reaching or maintaining an adequate nutritional state for future generations.     

Nutritional status and land tenure. A study in adults of the rural area of the northeastern Brazil

The present study was carried out in the rural areas of four municipalities in the North-East of Brazil as part of a broader survey which covered a sample of families living in the area. A subsample of adults (453 women and 126 men) was obtained from individuals who attended the survey's post for clinical and anthropometric evaluation. According to land tenure, they were stratified into four categories: those with-without land (W.L.); small land owner (S.O.); medium land owners (M.O.); and large land owners (L.O.). Means for anthropometric variables (height, weight, middle arm circumference and skinfold thickness) were calculated for each stratum. The differences between groups were statistically significant (p less than 0.05). Findings revealed that the larger the property, the greater the mean value for height; extreme values attained a difference of 7 and 6 cm in men and women, respectively. Mean weight increased as land ownership grew reaching a difference of 9 and 11 kg in men and women, respectively (p less than 0.01). Skinfold thickness and middle arm circumference showed significant differences between strata. To evaluate their present nutritional status, the adequacy of weight to height was obtained. In spite of the low proportion of individuals who exhibited less than 90%, adequate improvement was detected as land tenure increased. The study discusses the precariousness of criteria and patterns for the nutritional evaluation of adults, and suggests the existence of a relationship between nutritional status and land ownership.     

Serum insulin, leptin and growth hormone levels are associated with body mass index and obesity index in adolescents

Leptin, insulin and growth hormone levels seem to regulate body composition, fat distribution and fat mass. The purpose of this study was to determine the relationship among insulin, leptin and growth hormone levels in a group of adolescents. Ninety five adolescents (31 boys and 64 girls) between 13 and 18 y. of age were studied. A medical and nutritional history was made which included body mass index (BMI) and subcutaneous skinfolds measurements. Basal levels of glucose, triglycerides, total cholesterol, HDL-C, LDL-C, VLDL-C, leptin, insulin and growth hormone were determined. The leptin and insulin levels were positively associated with body mass index (BMI) and obesity index (OBI). Insulin, leptin and obesity markers were negatively associated with growth hormone level. Fifty two percent of the adolescents with BMI = 21.09 kg/m2 were considered metabolically obese because they had elevated levels of insulin (18.68 +/- 1.52 vs. 10.08 +/- 0.38 microU/ml), HOMA IR (3.34 +/- 0.24 vs. 1.76 +/- 0.07), leptin (16.30 +/- 1.24 vs. 8.11 +/- 1.32 ng./dl) and triglycerides (78.56 +/- 4.38 vs. 64.39 +/- 5.48 mg/dl) and lower levels of HDL-C (39.09 +/- 1.27 vs. 43.30 +/- 2.38 mg/dl), compared with normal group. The same alterations were observed in the obese group, in which significative decrease in growth hormone level was added. We conclude that hyperinsulinemia, hyperleptinemia and low growth hormone levels, may be established as risk factors related to obesity markers, lipid alterations and insulin resistance that can lead to an early development of Type II diabetes and cardiovascular disease.     

Relationship between calcium intake and body mass index in adolescents

Epidemiologic and experimental data support thee possibility that dietary calcium intake plays a role in human body weight regulation. The aim of the present study was to evaluate calcium intake and its relationship with body mass index (BMI) in adolescents. Weight, height, 3-day food record and a food frequency questionnaire were collected among all adolescents participants at the Outpatient Clinic for Adolescents at the Federal University of Sao Paulo between 2001 and 2003. The statistical analysis comprised Chi-square, Student's T-test, Pearson correlation and linear regression. One-hundred and twenty-one adolescents were studied (62.8% female), with a mean age of 14.9 +/- 2.2 years old. Mean energy and calcium intakes were 1729.9 +/- 557.8 kcal/day and 598.2 +/- 287.9 mg/day respectively, with no significant statistical differences between sex or age. Almost ninety-eight percent of adolescents presented a mean calcium intake lower than proposed values. Calcium intake adjusted for energy presented a significant negative correlation with body weight (r=-0.194, p=0.03) and BMI (r=-0.185, p=0.04). Furthermore, adolescents in the lowest quartile of calcium intake presented higher BMI (29.7 +/- 7.4 kg/m2) than adolescents in the highest calcium quartile. These results indicated a dietary calcium intake lower than recommendations for this life stage, and a contribution of this mineral in the body mass index.