Fatores associados à satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade / Factors associated with satisfaction and distortion of body image among children from 7 to 10 years of age

RESUMO O objetivo deste estudo é analisar a satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade e verificar quais fatores antropométricos e socioeconômicos estão associados a elas. Trata-se de um estudo transversal, realizado com 307 crianças de escolas públicas de Goiânia. A saúde da criança e os aspectos socioeconômicos da família foram avaliados por meio de um questionário semiestruturado; a imagem corporal foi avaliada por meio da Escala de Silhuetas Brasileiras Para Crianças; e também foram coletados dados antropométricos de peso, estatura, dobras cutâneas e circunferência da cintura. Observou-se homogeneidade do gênero neste estudo, predomínio de meninos (52%) eutróficos (73%). Apesar de se tratar de uma amostra com peso saudável, a insatisfação e a distorção da imagem corporal prevaleceram sobre a maior parte da amostra: a insatisfação esteve presente em 92% das crianças, prevalecendo o desejo por uma menor silhueta, enquanto a distorção esteve presente em 75% da amostra, com predomínio da subestimação da silhueta. No entanto, este estudo encontrou associação da insatisfação com a imagem corporal apenas com IMC (aferido, atual e desejado) e circunferência da cintura; e associação da distorção da imagem corporal apenas com os IMC (aferido e atual).

ABSTRACT The aim of this study is to analyze the satisfaction and distortion of body image in children from 7 to 10 years old and to verify which anthropometric and socioeconomic factors are associated with them. This is a cross-sectional study, carried out with 307 children from public schools in Goiânia. The child's health and the socioeconomic aspects of the family were assessed using a semi-structured questionnaire; body image was assessed using the Brazilian Silhouettes Scale for Children; and anthropometric data on weight, height, skinfolds and waist circumference were also collected. Gender homogeneity was observed in this study, with a predominance of eutrophic(73%) boys (52%). Despite being a sample with a healthy weight, dissatisfaction and distortion of body image prevailed over most of the sample: dissatisfaction was present in 92% of children, the desire for a smaller silhouette prevailing, while distortion was present in 75% of the sample, with a predominance of underestimation of the silhouette. However, this study found dissatisfaction association with body image only with BMI (measured, current and desired) and waist circumference; and association of the distortion of the body image only with the BMI (measured and current).

Performance of Two Novel Obesity Indicators for the Management of Metabolic Syndrome in Young Adults.

Background: Metabolic syndrome (MetS) is a pathophysiological change based on the abnormal metabolism of many substances. The study aims to investigate the performance of visceral adiposity index (VAI) and lipid accumulation product (LAP) of MetS in young adults. Methods: 448 young adults aged between 19 and 24 years old in Qinhuangdao had been included in this cross-sectional study. Receiver operating characteristic (ROC) curve analyses were used to assess the accuracy of these two obesity indicators for MetS. Results: The prevalence of MetS was 2.0%. In male subjects, LAP had the highest area under the ROC curve (AUC) value (AUC = 0.963), followed by VAI (AUC = 0.937). In female subjects, LAP also had the highest AUC value (AUC = 0.931), followed by VAI (AUC = 0.861). No significant difference was found between the two obesity indicators (P > 0.05). Conclusion: The two obesity indicators were valuable for the screening of MetS in young adults, and LAP was the simpler of the two.

Bioelectrical impedance analysis versus quantitative computer tomography and anthropometry for the assessment of body composition parameters in China.

Obesity, especially abdominal obesity, is correlated to increased risk of cardiovascular morbidity and mortality. It is urgent to search a simply method to predict visceral fat area (VFA). Herein, we evaluated the correlation of waist circumference (WC) measured by anthropometry and bioelectrical impedance analysis (BIA), and VFA estimated by BIA or measured by quantitative computed tomography (QCT) in China. The mean body mass index (BMI) was 25.09 ± 3.31 kg/m2 and the mean age was 49.16 ± 9.19 years in 2754 subjects. VFA-BIA were significantly smaller than VFA-QCT in both BMI and age subgroups between male and female (p < 0.001). High correlation was observed for WC between BIA and manually (r = 0.874 for all, r = 0.865 for male and r = 0.806 for female) and for VFA between BIA and QCT (r = 0.512 for all). The intraclass correlation coefficient (ICC) showed the perfect agreement between BIA and manually to measure WC (ICC = 0.832 for all, 0.845 for male and 0.697 for female) and implied a good reliability for VFA between BIA and QCT with women among subgroups (ICC = 0.623 for all, ICC = 0.634 for age < 50 years and ICC = 0.432 for BMI > 24 kg/m2), whereas the good reliability was lost in men (ICC = 0.174). The kappa analysis showed a moderate consistency for VFA measured by BIA and QCT (Kappa = 0.522 with age < 50 years, 0.565 with age ≥ 50 years in male; Kappa = 0.472 with age < 50 years, 0.486 with age ≥ 50 years in female). In addition, BIA to estimate VFA (r = 0.758 in male, r = 0.727 in female, P < 0.001) has a stronger correlation with VFA measured by QCT than BMI and WC according to gender categories. Furthermore, ROC analysis showed the cut-off point of VFA measured by BIA for predicting visceral obesity was: 101.90 cm2, 119.96 cm2 and 118.83 cm2 and the Youden's index was 0.577, 0.577 and 0.651, respectively and the Kappa value was 0.532, 0.536 and 0.611 in unadjusted model, model 1 and model 2. In conclusion, being non-invasive and free of radiation, BIA can be used as a safe and convenient tool to estimate VFA in female; especially for monitoring the VFA of the same person, the BIA has superiority to a certain extent. However, the consistency is not most ideal between BIA and QCT. When using BIA to assess whether a person is visceral obesity, we must take into consideration age, BMI and WC. Therefore, we established a regression formula to reflect VFA-QCT by VFA-BIA, age, BMI, and WC. In addition, a more accurate formula is needed to match the CT data in China.

Assessment of body composition in spinal cord injury: A scoping review.

The objective of this scoping review was to map the evidence on measurement properties of body composition tools to assess whole-body and regional fat and fat-free mass in adults with SCI, and to identify research gaps in order to set future research priorities. Electronic databases of PubMed, EMBASE and the Cochrane library were searched up to April 2020. Included studies employed assessments related to whole-body or regional fat and/or fat-free mass and provided data to quantify measurement properties that involved adults with SCI. All searches and data extractions were conducted by two independent reviewers. The scoping review was designed and conducted together with an expert panel (n = 8) that represented research, clinical, nutritional and lived SCI experience. The panel collaboratively determined the scope and design of the review and interpreted its findings. Additionally, the expert panel reached out to their professional networks to gain further stakeholder feedback via interactive practitioner surveys and workshops with people with SCI. The research gaps identified by the review, together with discussions among the expert panel including consideration of the survey and workshop feedback, informed the formulation of future research priorities. A total of 42 eligible articles were identified (1,011 males and 143 females). The only tool supported by studies showing both acceptable test-retest reliability and convergent validity was whole-body dual-energy x-ray absorptiometry (DXA). The survey/workshop participants considered the measurement burden of DXA acceptable as long as it was reliable, valid and would do no harm (e.g. radiation, skin damage). Practitioners considered cost and accessibility of DXA major barriers in applied settings. The survey/workshop participants expressed a preference towards simple tools if they could be confident in their reliability and validity. This review suggests that future research should prioritize reliability and validity studies on: (1) DXA as a surrogate 'gold standard' tool to assess whole-body composition, regional fat and fat-free mass; and (2) skinfold thickness and waist circumference as practical low-cost tools to assess regional fat mass in persons with SCI, and (3) females to explore potential sex differences of body composition assessment tools. Registration review protocol: CRD42018090187 (PROSPERO).

A comparison of obesity indices in relation to mortality in type 2 diabetes: the Fremantle Diabetes Study.

AIMS/HYPOTHESIS: This prospective association study aimed to compare the relationship between each of four obesity indices and mortality risk in people with type 2 diabetes. METHODS: The associations of BMI, waist circumference, WHR and A Body Shape Index (ABSI) with all-cause mortality were analysed in 1282 participants of the Fremantle Diabetes Study, followed for up to 20 years after baseline assessment. Models were adjusted for age and other confounders; assessments as continuous measures and by quintile were carried out for men and women separately. Sensitivity analyses were conducted to minimise reverse causality. RESULTS: When indices were assessed as continuous variables, there were significant bivariate associations with mortality for: ABSI, which was greater in both men and women who died (p < 0.001); WHR, which was greater in women only (p = 0.033); and BMI, which was lower in women only (p < 0.001). When assessed by quintile, there were significant bivariate associations with mortality for ABSI in men and women (p < 0.001) and BMI in women only (p = 0.002). In Cox models of time to death, adjusted for age, diabetes duration, ethnicity and smoking, ABSI quintiles showed a linear trend for both men (p = 0.003) and women (p = 0.035). Men in the fifth ABSI quintile had an increased mortality risk compared with those in the first quintile (HR [95% CI]: 1.74 [1.24, 2.44]) and women in the fifth ABSI quintile had an increased mortality risk that approached statistical significance (1.42 [0.97, 2.08], p = 0.08). Men in the fifth WHR quintile had an increased mortality risk (1.47 [1.05, 2.06]). There was no association between mortality and BMI or waist circumference in either sex. CONCLUSIONS/INTERPRETATION: ABSI was the obesity index most strongly associated with all-cause mortality in Australians with type 2 diabetes. There was no evidence for an obesity paradox with any of the assessed indices. ABSI may be a better index of central obesity than waist circumference, BMI or WHR when assessing mortality risk in type 2 diabetes.

Role of pentraxin-3 in risk assessment of patients with metabolic syndrome.

BACKGROUND: Inflammation plays a major role in the development of metabolic syndrome (MetS) and its progression. Recent studies have shown that pentraxin-3 (PTX-3), osteoprogerin (OPG), and tumor necrosis factor-alpha (TNF-α) are key factors in MetS pathophysiology, but evidence for endorsing their clinical use is currently unclear and insufficient. AIM: The study aimed to evaluate the association between the inflammatory biomarkers' levels and the severity of MetS. METHODS: The study was observational, transversal, prospective, cohort, and analytical type. We enrolled 80 patients (M:F = 1, mean age = 55 ± 10.77 years) who met MetS criteria. The study protocol included: medical history, physical examination, 6-min walk test distance (6MWTD), biochemical tests, electrocardiogram, echocardiography, and carotid ultrasonography. We also performed plasmatic measurement of PTX-3, OPG, and TNF-α, in addition to standard biochemical tests. RESULTS: Subjects with severe MetS had higher values of body mass index (BMI) and waist circumference (p < 0.001, p = 0.001). PTX-3 levels were significantly higher in patients with severe MetS (p = 0.03) and the values were not influenced by age or gender. OPG positively correlated with BMI (r = 0.264, p = 0.018). 6MWTD was lower in patients with severe MetS (p = 0.005), whereas CCA-IMT was higher in this group of patients (p = 0.005). In addition, the receiver operating characteristic (ROC) curve analysis for PTX-3 identified a cut-off value of 10.7 ng/dl that differentiates between mild and severe MetS [AUC 0.656; sensitivity =47.1% (95% CI = 36.1%-62.3%); specificity = 78.9% (95% CI = 54.4%-93.9%)]. CONCLUSION: PTX-3 was correlated with the severity of MetS, with other inflammatory parameters and cardiovascular tests. CCA-IMT and 6MWTD are useful in differentiating between mild and severe MetS.

Association of breastfeeding, maternal anthropometry and body composition in women at 30 years of age.

This study aimed at assessing the association of breastfeeding with maternal body mass index (BMI), waist circumference, fat mass index, fat free mass index, android/gynoid fat ratio and bone mineral density. In 1982, the maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were daily visited and all live births were identified and examined. These subjects underwent follow-up for several times. At 30 years of age, the participants were interviewed and examined. Parous women provided information on parity and duration of breastfeeding. Multiple linear regression was used in the multivariate analysis, controlling for genomic ancestry, family income, schooling and smoking at 2004-2005. After controlling for confounding factors, breastfeeding was inversely associated with BMI and fat mass index, whereas breastfeeding per live birth was negatively associated with BMI, waist circumference and fat mass index. Women who had had a child in the last 5 years and had breastfed, showed lower BMI (ß = -2.12, 95%CI: -4.2; -0.1), waist circumference (ß = -4.46, 95%CI: -8.3; -0.6) and fat mass index (ß = -1.79, 95%CI: -3.3; -0.3), whereas no association was observed among those whose last childbirth was > 5 years, but the p-value for the tests of interaction were > 0.05. Our findings suggest that breastfeeding is associated with lower BMI and other adiposity measures, mostly in the first years after delivery. Besides that, it has no negative impact on bone mineral density.

The relationship between prevalence and severity of lower urinary tract symptoms (LUTS), and body mass index and mid-abdominal circumference in men in a resource-poor community in Southeast Nigeria: a cross-sectional survey.

BACKGROUND: There is paucity of information on the community-based prevalence and severity of lower urinary tract symptoms (LUTS) in men who are 40 years and older in the southeast region of Nigeria. This study seeks to determine the community-based prevalence of LUTS and the relationship between LUTS, and body mass index (BMI) and mid-abdominal circumference (MAC) in men. METHODS: An interviewer-administered, questionnaire-based survey. Three of nine settlement clusters were randomly selected while systematic random sampling of 1 in 3 eligible subjects was used to select participants. Analysis was done using SPSS® version 20. RESULTS: One thousand three hundred and nineteen duly completed questionnaires were analyzed. The respondents are within ages 40-92 years with mean age 54.2 ± 10.2 years, mean BMI 25.97 ± 4.18Kg/m2 and mean MAC 89.80 ± 12.43 cm. Overall prevalence of LUTS is 20.2%. Nocturia at a prevalence of 19.2% is the most prevalent lower urinary tract symptom and also the earliest to manifest. LUTS prevalence and severity increases with increasing age. About 9.6% report moderate LUTS while 2.3% report severe LUTS. Storage LUTS are reported more frequently than voiding LUTS. LUTS did not vary significantly with BMI, MAC or Wealth-Index. CONCLUSION: LUTS prevalence and severity vary with age, but not with BMI, MAC or Wealth-Index.

Metabolic risk factors clustering among adolescents: a comparison between sex, age and socioeconomic status / Agregação de fatores de risco metabólico em adolescentes: uma comparação entre sexo, idade e nível socioeconômico

Abstract The aim was to compare the metabolic risk factors (MRF) between sex, age and socioeconomic status in a sample of adolescents from Curitiba, Brazil. A cross-sectional school-based study was conducted on 997 adolescents (429 boys) aged 12-17 years old from public schools. Total Cholesterol (TC), LDL-c, HDL-c, Triglycerides, Glycemia, Blood Pressure, waist circumference and body mass index were measured. Sex, age and socioeconomic status information was obtained using a questionnaire. Descriptive analyses, Fisher Exact and Chi-Square Tests were used to establish the sample's characteristics and the MRF comparison between variables. We found that 27.4% were classified as overweight/obese, almost half of them had TC and LDL-c classified as limitrophe/altered, with a difference between the sexes (p < 0.01), and that a higher percentage of altered values was seen among girls. The percentage of 3 and 4 or more MRF was 13.8% and 6.3%, respectively. In addition, 86.5% of the participants had at least one and 39.7% had at least two MRF. We conclude that there was a high percentage of overweight/obese, as well as a great number of subjects with altered TC and HDL-c. We also pointed out the large percentage of aggregated metabolic risk factors in both sexes. Strategies to reduce metabolic risk factors are required.

Resumo O objetivo do estudo foi comparar os fatores de risco metabólicos (FRM) entre sexo, idade e nível socioeconômico numa amostra de adolescentes de Curitiba, Brasil. O estudo transversal foi conduzido com 997 adolescentes da rede pública de ensino (429 meninos) com idade entre 12-17 anos. Coletaram-se dados de colesterol total (CT), LDL-c, HDL-c, triglicerídeos, glicemia, pressão arterial, circunferência de cintura e índice de massa corporal. Informações sobre sexo, idade e nível socioeconômico foram coletados por meio de um questionário. Foram utilizadas análises descritivas, teste exato de Fisher e Qui-quadrado. Observou-se que 27,4% foram classificados como sobrepeso/obeso, quase metade com CT e LDL-c limítrofes/alterados, com uma diferença entre os sexos (p < 0,01) e uma proporção maior entre as meninas. Verificou-se que as proporções de 3 e 4 ou mais FRM foram 13,8% e 6,3%, respectivamente. Adicionalmente, 86,5% e 39,7% dos adolescentes demonstraram ao menos um e dois FRM, respectivamente. Conclui-se que houve um elevado percentual de sobrepeso/obeso, assim como um grande número de sujeitos com CT e HDL-s alterados. Verificou-se um grande percentual de agregação de FRM em ambos os sexos. São necessárias estratégias para reduzir esses fatores de risco nessa fase da vida.

Assessment of cardiovascular disease risk factors in patients treated for schizophrenia. / Analiza czynników ryzyka sercowo-naczyniowego w populacji osób leczonych z powodu schizofrenii.

OBJECTIVES: The aim of the study was the analysis of the occurrence of cardiovascular risk factors (age, sex, smoking, level of cholesterol, systolic blood pressure, body mass index) among patients diagnosed with schizophrenia as well as searching for correlations between them and length of stay at long-term care facilities and clinical variables, such as severity of positive, negative and general symptoms of schizophrenia, illness duration, and type of pharmacotherapy (neuroleptic type and its dose). METHODS: Medical data were collected from 71 patients (30 women and 41 men) aged between 40 and 86 years who were treated in the residential care facility due to paranoid schizophrenia. Information concerning patient's clinical status was collected during periodic check-ups. Theexamination consisted of standard anamnesis regarding patient's general feeling, psychiatric assessment using the PANSS and identifying number of smoked cigarettes. Somatic assessment included: physical examination, measuring blood pressure, pulse, capillary blood glucose levels, height, weight, and BMI. RESULTS: Statistical analysis did not reveal significant differences in length of stay at long-term psychiatric care facility between patients with normal BMI vs. overweight and obese patients (p = 0.85). Study results indicate that prevalence of central obesity, hypertension, abnormal total - and LDL-cholesterol is higher in patients who stay at the long-term psychiatric care facility for a longer period of time. There is at least one cardiovascular risk factor in 74.6% of examined patients treated for schizophrenia. CONCLUSIONS: Imposing "healthy" lifestyle as part of clinical management in long-termcare setting in people treated with neuroleptics (atypical or typical) might reduce risk of body mass increase. Undertaking action towards reducing modifiable cardiovascular risk factors remains highly recommended in mental health care, particularly in long-term care.

Structured, aerobic exercise reduces fat mass and is partially compensated through energy intake but not energy expenditure in women.

BACKGROUND: Exercise-induced weight loss is often less than expected and highly variable in men and women. Behavioural compensation for the exercise-induced energy deficit could be through energy intake (EI), non-exercise physical activity (NEPA) or sedentary behaviour (SB). We investigated this issue in women. METHODS: Twenty-four overweight [body mass index (BMI) M = 27.9 kg/m2, SD = 2.7] women [age M = 33.1 years, SD = 11.7] completed 12-weeks of supervised exercise (5×500kcal per week) in a non-randomised, pre-post intervention study. Body mass (BM), waist circumference (WC), body composition, resting metabolic rate (RMR), total daily EI, individual meals, appetite sensations and appetite-related peptides were measured at baseline (week 0) and post-intervention (week 12). Free-living physical activity (PA) and SB were measured (SenseWear) at baseline, week 1 and 10 of the exercise intervention, and at post-intervention (week 13). RESULTS: Following the 12-week exercise intervention BM [p = .04], BMI [p = .035], WC [p < .001] and fat mass (FM) [p = .003] were significantly reduced, and fat-free mass (FFM) significantly increased [p = .003]. Total [p = .028], ad libitum [p = .03] and snack box EI [p = .048] were significantly increased and this was accompanied by an increase in hunger [p = .01] and a decrease in fullness [p = .03] before meals. The peptides did not explain changes in appetite [p > .05]. There was no compensatory reduction in NEPA [p > .05] and no increase in SB, rather there was a decrease in SB during the exercise intervention [p = .03]. CONCLUSIONS: Twelve-weeks of supervised aerobic exercise resulted in a significant reduction in FM and an increase in FFM. Exercise increased hunger and EI which only partially compensated for the increase in energy expenditure. There was no evidence for a compensatory reduction in NEPA or an increase in SB. Dietary intervention, as an adjunct to exercise, may offset the compensatory increase in EI and result in a greater reduction in BM. TRIAL REGISTRATION: Our trial was retrospectively registered on the International Standard Randomised Controlled Trials Registry (ISRCTN78021668, 27th September 2016) and can be found here: https://doi.org/10.1186/ISRCTN78021668.

Association of breastfeeding, maternal anthropometry and body composition in women at 30 years of age / Associação entre aleitamento materno, antropometria e composição corporal em mulheres de 30 anos de idade / Asociación entre lactancia materna, antropometría y composición corporal en mujeres con 30 años de edad

This study aimed at assessing the association of breastfeeding with maternal body mass index (BMI), waist circumference, fat mass index, fat free mass index, android/gynoid fat ratio and bone mineral density. In 1982, the maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were daily visited and all live births were identified and examined. These subjects underwent follow-up for several times. At 30 years of age, the participants were interviewed and examined. Parous women provided information on parity and duration of breastfeeding. Multiple linear regression was used in the multivariate analysis, controlling for genomic ancestry, family income, schooling and smoking at 2004-2005. After controlling for confounding factors, breastfeeding was inversely associated with BMI and fat mass index, whereas breastfeeding per live birth was negatively associated with BMI, waist circumference and fat mass index. Women who had had a child in the last 5 years and had breastfed, showed lower BMI (β = -2.12, 95%CI: -4.2; -0.1), waist circumference (β = -4.46, 95%CI: -8.3; -0.6) and fat mass index (β = -1.79, 95%CI: -3.3; -0.3), whereas no association was observed among those whose last childbirth was > 5 years, but the p-value for the tests of interaction were > 0.05. Our findings suggest that breastfeeding is associated with lower BMI and other adiposity measures, mostly in the first years after delivery. Besides that, it has no negative impact on bone mineral density.

Este estudo teve por objetivo avaliar a associação entre aleitamento materno e índice de massa corporal (IMC), circunferência da cintura, índice de massa gorda, índice de massa magra, razão de gordura andróide/ginóide e densidade mineral óssea maternos. Em 1982, as maternidades de Pelotas, Rio Grande do Sul, Brasil, foram visitadas diariamente e todos os nascidos vivos foram identificados e examinados. Essas pessoas foram seguidas em diversos momentos. Aos 30 anos de idade, as participantes foram entrevistadas e examinadas. As que haviam dado à luz forneceram informação sobre paridade e duração do aleitamento materno. Usamos regressão múltipla linear na análise multivariada, controlando por ancestralidade genômica, renda familiar, escolaridade e tabagismo em 2004-2005. Após controlar por fatores de confundimento, o aleitamento materno estava inversamente associado ao IMC e índice de massa gorda, enquanto o aleitamento materno por nascido vivo estava negativamente associado ao IMC, circunferência da cintura e índice de massa gorda. Mulheres que haviam dado à luz nos últimos 5 anos e que haviam amamentado apresentaram IMC (β = -2,12, IC95%: -4,2; -0,1), circunferência da cintura (β = -4,46, IC95%: -8,3; -0,6) e índice de massa gorda (β = -1,79, IC95%: -3,3; -0,3) mais baixos. Nenhuma associação foi observada entre aquelas cujo último parto havia sido > 5 anos, mas o valor de p dos testes de interação foi > 0,05. Nossos resultados sugerem que o aleitamento materno está associado a valores mais baixos de IMC e de outras medidas de adiposidade, especialmente nos primeiros anos após o parto. Adicionalmente, o aleitamento não tem impacto negativo sobre a densidade mineral óssea.

El objetivo de este estudio fue evaluar la asociación entre lactancia materna, índice de masa corporal (IMC), perímetro de cintura, índice de grasa corporal, índice de masa libre de grasa, proporción de grasa en hombres/mujeres y densidad mineral ósea. En 1982, se visitaron diariamente hospitales maternales en Pelotas, Rio Grande do Sul, Brasil, y se identificaron y examinaron todos los nacimientos vivos. A estos últimos se les realizó un seguimiento en varias ocasiones. Se entrevistó y examinó a madres con 30 años de edad. Las mujeres con hijos proporcionaron información en paridad y duración de la lactancia. Se usó una regresión múltiple lineal en el análisis multivariado, controlando la ascendencia genómica, los ingresos por hogar, la escolaridad y ser fumador en 2004-2005. Tras controlar los factores de confusión, la lactancia estuvo inversamente asociada con el IMC y el índice de grasa corporal, mientras que la lactancia en nacimientos vivos estuvo negativamente asociada con el IMC, el perímetro de cintura y el índice de masa corporal. Las mujeres que tuvieron un niño en los últimos 5 años, y habían amamantado alguna vez, tuvieron un menor IMC (β = -2,12, IC95%: -4,2; -0,1), perímetro de cintura (β = -4,46, IC95%: -8,3; -0,6) e índice de grasa corporal (β = -1,79, C95%: -3,3; -0,3), mientras que no se observó ninguna asociación entre quienes tuvieron el último parto en > 5 años, pero el valor de p para las pruebas de interacción fue > 0,05. Nuestros resultados plantean que la lactancia materna está asociada con el IMC y otras medidas de adiposidad, la mayor parte durante los primeros años tras el parto. Asimismo, no tuvo impacto negativo en la densidad mineral ósea.

Replacing Sedentary Time: Meta-analysis of Objective-Assessment Studies.

CONTEXT: The aim was to summarize estimates of the potential benefits for cardiometabolic risk markers and all-cause mortality of replacing time spent in sedentary behaviors with light-intensity physical activity or with moderate to vigorous physical activity, from studies using device-based measurement. EVIDENCE ACQUISITION: Four databases covering the period up to December 2016 were searched and analyzed (February 2017). Data were extracted by two independent reviewers. For the meta-analyses, the estimated regression coefficients (ß) and 95% CIs were analyzed for BMI, waist circumference, and high-density lipoprotein cholesterol. Pooled relative rate and 95% CIs were calculated for fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance values. Hazard ratios were extracted from studies of all-cause mortality risk. EVIDENCE SYNTHESIS: Ten studies (with 17,390 participants) met the inclusion criteria. Reallocation of 30 minutes of sedentary time to light-intensity physical activity was associated with reductions in waist circumference, fasting insulin, and all-cause mortality risk; and with an increase in high-density lipoprotein cholesterol. Reallocating 30 minutes of sedentary time to moderate to vigorous physical activity was associated with reductions in BMI, waist circumference, fasting glucose, fasting insulin, and all-cause mortality (not pooled) and with an increase in high-density lipoprotein cholesterol. CONCLUSIONS: Replacing sedentary time with either light-intensity physical activity or moderate to vigorous physical activity may be beneficial, but when sedentary time is replaced with moderate to vigorous physical activity, the predicted impacts are stronger and apparent for a broader range of risk markers. These findings point to potential benefits of replacing sedentary time with light-intensity physical activity, which may benefit those less able to tolerate or accommodate higher-intensity activities, including many older adults.

Differential relationship between waist circumference and mortality according to age, sex, and body mass index in Korean with age of 30-90 years; a nationwide health insurance database study.

BACKGROUND: A recent concept is that obesity, assessed by body mass index (BMI), is not always a sign of poor health. Thus, in order to use obesity metrics in clinical decision making, it is important to clarify the relationship between waist circumference (WC), a proxy for abdominal obesity, and mortality. METHODS: Data were used from 8,796,759 subjects aged between 30 and 90 years, who had participated in the Korea National Health Screening Examination between January 1, 2009 and December 31, 2009 and survived at least 1 year post screening. Data from a mean follow-up time of an additional 5.3 years (time at risk) were analyzed for the relationship between WC and mortality according to age, sex, and BMI category. RESULTS: An increased WC of more than 90 cm in men and 85 cm in women showed a definite negative influence on mortality. However, the detailed relationship between WC and mortality was J-shaped or U-shaped according to age, sex, and BMI category. In the normal BMI group, the optimal WC range with the lowest mortality was < 70 cm in men and 70-75 cm in women, whereas in obese individuals a WC between 80 and 90 cm in men and 75 and 85 cm in women showed the lowest mortality. The association between increased WC and higher mortality tended to be more obvious in normal-weight women than in normal-weight men or obese women. Furthermore, in normal-weight and obese women, the effect of increased WC on mortality was more critical for subjects aged < 60 years rather than those aged ≥ 60 years. CONCLUSIONS: Abdominal obesity, as measured by WC, showed a significant negative association on mortality, and its association with mortality was different according to age, sex, and BMI category. Therefore, WC should be considered in the assessment of obesity-related health risks, and individualized cut-off points for the definition of a healthy WC according to age, sex, and BMI category are necessary.

Should Waist Circumference Cutoffs in the Context of Cardiometabolic Risk Factor Assessment be Specific to Sex, Age, and BMI?

OBJECTIVE: A sex-specific standard waist circumference (WC) is widely used to determine cardiometabolic risk across ages even though aging impacts the link between fat distribution and cardiometabolic risk. The objective was to propose WC thresholds that better predict metabolic abnormalities according to sex, age, and body mass index (BMI) categories. METHODS: First, receiver operating characteristic analyses were performed to identify optimal age (20-49, 50-64, and 65-80 years) and BMI (normal weight, overweight, obese I, and obese II+) specific WC thresholds to correctly identify at-risk individuals, that is, presenting ≥2 cardiometabolic risk factors of metabolic syndrome (n = 23,482; NHANES 2007-2014). Second, cross-validation analyses (n = 18,686; NHANES 1999-2006) were used to validate these WC optimal thresholds. Univariate logistic regression models with WC as an independent predictor were performed to quantify odds of being at-risk for each age and BMI subgroups. RESULTS: When age and BMI categories were considered in the identification of optimal WC thresholds, sensitivity to correctly identify at-risk individuals significantly improved. CONCLUSIONS: Our results indicate that the use of WC thresholds that are specific to age and BMI subcategories significantly increases the capacity to accurately identify at-risk individuals. They would thus be highly appropriate for clinicians in the context of efficient cardiometabolic risk assessment and intervention recommendations.

Clusters of anthropometric indicators of body fat associated with maximum oxygen uptake in adolescents.

INTRODUCTION: The aim of this study was to evaluate different clusters of anthropometric indicators (body mass index | BMI |, waist circumference | WC |, waist-to-height ratio | WHtR |, triceps skinfold |TR SF|, subscapular skinfold |SE SF|, sum of the triceps and subscapular skinfolds | ΣTR + SE |, and sum of the triceps, subscapular and suprailiac folds | ΣTR + SE + SI|) associated with the VO2max levels in adolescents. METHODS: The study included 1,132 adolescents (aged 14-19 years) enrolled in public schools of São José, Santa Catarina, Brazil, in the 2014 academic year. The dependent variable was the cluster of anthropometric indicators (BMI, WC, WHtR, TR SF, SE SF, SI SF, ΣTR + SE and ΣTR + SE + SI) of excess body fat. The independent variable was maximum oxygen uptake (VO2max), estimated by the modified Canadian aerobic fitness test-mCAFT. Control variables were: age, skin color, economic level, maternal education, physical activity and sexual maturation. Multinomial logistic regression was used for associations between the dependent and independent variables. Binary logistic regression was performed to identify the association between adolescents with all anthropometric indicators in excess and independent variables. RESULTS: One in ten adolescents presented all anthropometric indicators of excess body fat. Multinomial regression showed that with each increase of one VO2max unit, the odds of adolescents having three, four, five or more anthropometric indicators of excess body fat decreased by 0.92, 0.85 and 0.73 times, respectively. In the binary regression, this fact was reconfirmed, demonstrating that with each increase of one VO2max unit, the odds of adolescents having simultaneously the eight anthropometric indicators of excess body fat decreased by 0.55. CONCLUSION: It was concluded that with each increase of one VO2max unit, adolescents decreased the odds of simultaneously presenting three or more anthropometric indicators of excess body fat, regardless of biological, economic and lifestyle factors. In addition, the present study identified that one in ten adolescents had all anthropometric indicators of excess body fat.

Association of waist circumference with outcomes in an acute general surgical unit.

BACKGROUND: Obesity prevalence is increasing in Australia, particularly in non-metropolitan areas. The effect of obesity on acute surgical outcomes is not known. We aimed to record waist circumference (WC) (surrogate for obesity) amongst acute surgical unit (ASU) patients in a New South Wales regional hospital, and compare outcome measures (length of stay (LOS), unplanned return to theatre, readmission rates, intensive care unit (ICU) admission and mortality). METHODS: Retrospective cohort study of 4 months of consecutive ASU admissions, excluding age <16, pregnancy, out-of-area transfer and incomplete data. Patients were classified according to World Health Organization WC definitions as high-risk or non-high-risk (increased-risk and no-risk). RESULTS: Of 695 admissions, 512 met the inclusion criteria (47.1% female, average age 52.8 years (SD 22.3)), with 85.1% (P < 0.001) of females and 69.4% (P = 0.166) of males having an increased- or high-risk WC. This compares to rates amongst inner regional populations of 71.0% (female) and 66.4% (male). LOS was longer for high-risk patients (5.0 days versus 3.7 days, P = 0.002). However, the mean age of high-risk patients was greater (56.6 years versus 46.9 years, P = 0.001) and LOS was longer for those aged ≥60 (P < 0.001). After controlling for age, high-risk WC was not associated with any outcome measure, except amongst ICU admissions, where high-risk patients stayed longer (15.5 days versus 6.8 days, P < 0.001). CONCLUSION: Increased- and high-risk WC was overrepresented amongst female ASU patients. High-risk WC was associated with a significantly greater LOS in patients admitted to ICU. High-risk WC was not associated with other outcomes independent of age. WC is useful for quantifying obesity in the inpatient setting.

Preliminary assessment of neck circumference in benign prostatic hyperplasia in patients with metabolic syndrome

ABSTRACT Objectives To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. Materials and Methods Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alpha-blockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p<0.05 . Results In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p<0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1 st and 6 th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p<0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS. Conclusions MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS.

Preliminary assessment of Neck Circumference in Benign Prostatic Hyperplasia in Patients with Metabolic Syndrome.

OBJECTIVES: To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. MATERIALS AND METHODS: Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alphablockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p<0.05. RESULTS: In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p<0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1st and 6th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p<0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS. CONCLUSIONS: MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS.

The current prevalence and regional disparities in general and central obesity among children and adolescents in Shandong, China.

BACKGROUND: Childhood obesity has increased dramatically during the past decades, both in developing and developed countries. The present study examined the prevalence and regional disparities in general and central obesity among children and adolescents in Shandong, China. METHODS: A total of 30,459 students (15,249 boys and 15,210 girls) aged 7-18years participated in the study. Height, weight and waist circumference (WC) of all subjects were measured, body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. The BMI cutoff points recommended by the International Obesity Task Force (IOTF) were used to define general obesity. Central obesity was defined as WHtR≥0.5. Both BMI and WHtR were used to define three types of obesity as follows: general obesity only, central obesity only and combined obesity. RESULTS: The overall prevalences of general obesity only, central obesity only and combined obesity were 10.99, 8.47 and 8.70% for boys and 9.47, 5.12 and 3.19% for girls, respectively. The sum of the prevalence of the three types of obesity was 28.16% for boys and 17.78% for girls, boys had higher prevalence of obesity than girls (P<0.01). Substantial urban-rural and regional disparities exist in childhood obesity, children and adolescents from urban, coastal and high socioeconomic status (SES) districts showed a higher prevalence of obesity than their counterparts from rural, inland and low SES districts (P<0.01). CONCLUSION: The widespread prevalence of obesity in children and adolescents has become an important public health concern. Results from this study also suggested that the additional measurement of WC (WHtR) is better than BMI alone to identify obese individuals, distinguishing the types of obesity and examining the prevalence of various types of obesity is useful in practice.