The Mini Nutritional Assessment-Short Form is more effective in predicting clinical outcomes among hospitalised patients with overweight than the Nutritional Risk Screening-2002.

Understanding of the association between nutritional risk and clinical outcomes in hospitalised patients with overweight is still at an early stage. Given the lack of specific tools for the patient with overweight, the objective of this study was to compare two of the main general screening instruments for assessing nutritional risk in predicting clinical outcomes in a population of hospitalised patients with overweight. A retrospective study was carried out in a medium-sized hospital in Brazil, with patients ≥20 years old admitted between July 2017 and December 2019. Patients who were overweight and had records of Nutritional Risk Screening-2002 (NRS-2002) and Mini-Nutritional Assessment-Short Form (MNA-SF) in their medical files were included in the study. Clinical outcomes data (longer length of stay, readmission during the study period and mortality before the end of study or during hospitalisation) were obtained. The Kappa coefficient assessed agreement between both tools, and their performance for predicting outcomes was analysed using characteristic receiver operating curves (ROC). Data were collected from 643 patients. The prevalence of nutritional risk was 17.7% and 36.1% according to the NRS-2002 and MNA-SF (k = 0.390; p < 0.001), respectively. According to both tools, all clinical outcomes were significantly more common among individuals at nutritional risk (p < 0.05). Only the MNA-SF showed a significant percentage of predictions for readmission (57.2%) and death during hospitalisation (65.7%). For mortality until the end of the study, the area under the ROC curve was similar for MNA-SF (60.5%) and NRS-2002 (60.7%; p = 0.057). The MNA-SF detected a greater proportion of nutritional risk among hospitalised patients with overweight and better predicted all clinical outcomes compared to the NRS-2002 and should be used to screen patients with overweight for nutritional risk.

Nutritional assessment of servicemen in relation to area of duty and feeding habits: a Pakistani prospective / Avaliação nutricional de militares em relação à área de dever e hábitos alimentares: uma perspectiva paquistanesa

The present study was carried out to determine incidence of overweight and obesity in Pakistani servicemen with reference to their area of duty, feeding habits and also to identify risk factors. Accordingly, 2,501 servicemen selected from all over Pakistan using multiple stage stratified sampling protocol. Nutrition assessment performed using body mass index (BMI), waist to hip ratio (WHR) and dietary assessment using food frequency questionnaire. Collected data was analyzed using the SPSS version 25. Regression was used to find risk factors of obesity and WHR. Results indicated that about 1/4th of servicemen were smokers. Approximately, 1/5th of them were overweight and about one quarter were eating fruits and vegetables for <3 days/ week and <4 days/week, respectively. Only 1/3rd of them were physically active for at least <40 minutes per day. Age and fruits intake were significantly predicting BMI with a direct relation and vegetable intake was negatively correlated to BMI of the servicemen. Age and rank were significant predictors of WHR while, physical activity was negatively correlated to WHR. It is concluded and suggested from our study that there is a need to modify eating patterns and habits as well as improving physical activity on daily basis for healthy and long life of the servicemen.

O presente estudo foi realizado para determinar a incidência de sobrepeso e obesidade em militares paquistaneses com referência à sua área de serviço, hábitos alimentares e também para identificar fatores de risco. Assim, 2.501 militares selecionados de todo o Paquistão usando protocolo de amostragem estratificada de múltiplos estágios. Avaliação nutricional realizada por meio do índice de massa corporal (IMC), relação cintura-quadril (RCQ) e avaliação alimentar por meio de questionário de frequência alimentar. Os dados coletados foram analisados por meio do SPSS versão 25. A regressão foi usada para encontrar fatores de risco para obesidade e RCQ. Os resultados indicaram que cerca de 1/4 dos militares eram fumantes. Aproximadamente, 1/5 deles estava com sobrepeso e cerca de um quarto comia frutas e vegetais por <3 dias / semana e <4 dias / semana, respectivamente. Apenas 1/3 deles era fisicamente ativo por pelo menos <40 minutos por dia. Idade e ingestão de frutas foram preditores significativos do IMC com uma relação direta e ingestão de vegetais foi negativamente correlacionada com o IMC dos militares. Idade e posição foram preditores significativos de RCQ, enquanto a atividade física foi negativamente correlacionada com RCQ. Conclui-se e sugere-se a partir de nosso estudo que há necessidade de modificar os padrões e hábitos alimentares, bem como melhorar a atividade física no dia a dia para uma vida longa e saudável dos militares.

Body fat assessment in youth with overweight or obesity by an automated bioelectrical impedance analysis device, in comparison with the dual-energy x-ray absorptiometry: a cross sectional study.

BACKGROUND: Bioelectrical impedance analysis (BIA) is a widely used method to assess total body fat (TBF) depots characterising obesity. Automated BIA devices provide an inexpensive and easy assessment of TBF, making them widely available to the general public and healthcare providers without specific qualification to assess body composition. The equations included in the automated BIA devices have been developed in very few specific populations, which means that they are not suitable to assess TBF for everyone and need to be validated before use in other populations. The aim of the present work is to evaluate the accuracy of the automated BIA device Tanita® BC-532 in youth of White European ethnicity, compared with the dual-energy x-ray absorptiometry (DEXA), gold standard measurement of TBF. METHODS: Total body fat percentage (TBF%) was measured with the BIA device Tanita® BC-532 and DEXA (Hologic® QDR4500W) in 197 youth of White European ethnicity (N = 104 girls), 7-17 years old, and visiting the Diabetes & Endocrinology Care Paediatrics Clinic, Centre Hospitalier de Luxembourg, for overweight or obesity management. RESULTS: TBF% evaluated with BIA was significantly correlated with TBF% measured with DEXA in both boys (r Pearson = 0.617) and girls (r Pearson = 0.648) (p <  10- 4). However, the residual mean between the assessment of TBF% by BIA and by DEXA [TBF BIA (%)-TBF DEXA (%)] is extremely high (mean ± standard deviation = 10.52% ± 5.22% in boys, respectively 9.96% ± 4.40% in girls). The maximal absolute residual value is also very high, about 24% in both genders. CONCLUSIONS: The automated BIA device Tanita® BC-532 appears to be not accurate to assess total body fat in youth with overweight or obesity. There is a need to calibrate the BIA device before its use in the populations where it was not previously validated.

Agreement in Infant Growth Indicators and Overweight/Obesity between Community and Clinical Care Settings.

BACKGROUND: Infants from low-income backgrounds receive nutrition care from both community and clinical care settings. However, mothers accessing these services have reported receiving conflicting messages related to infant growth between settings, although this has not been examined quantitatively. OBJECTIVE: Describe the agreement in infant growth assessments between community (Special Supplemental Nutrition Program for Women, Infants, and Children) and clinical (primary care providers) care settings. DESIGN: A cross-sectional, secondary data analysis of infant growth measures abstracted from electronic data management systems. PARTICIPANTS AND SETTING: Participants included a convenience sample of infants (N = 129) from northeastern Pennsylvania randomized to the WEE Baby Care study from July 2016 to May 2018. Infants had complete anthropometric data from both community and clinical settings at age 6.2 ± 0.4 months. Average time between assessments was 2.7 ± 1.9 weeks. MAIN OUTCOME MEASURES: Limits of agreement and bias in weight-for-age, length-for-age, weight-for-length, and body-mass-index-for-age z scores as well as cross-context equivalence in weight status between care settings. STATISTICAL ANALYSIS PERFORMED: Bland-Altman analyses were used to describe the limits of agreement and bias in z scores between care settings. Cross-context equivalence was examined by dichotomizing infants' growth indicators at the 85th and 95th percentile cut-points and cross-tabulating equivalent and discordant categorization between settings. RESULTS: Strongest agreement was observed for weight-for-age z scores (95% limits of agreement -0.41 to 0.54). However, the limits of agreement intervals for growth indicators that included length were wider, suggesting weaker agreement. There was a high level of inconsistency for classification of overweight/obesity using weight-for-length z scores, with 15.5% (85th percentile cut-point) and 11.6% (95th percentile cut-point) discordant categorization between settings, respectively. CONCLUSIONS: Infant growth indicators that factor in length could contribute to disagreement in the interpretation of infant growth between settings. Further investigation into the techniques, standards, and training protocols for obtaining infant growth measurements across care settings is required.

Assessment of Age-Induced Changes in Body Fat Percentage and BMI Aided by Bayesian Modelling: A Cross-Sectional Cohort Study in Middle-Aged and Older Adults.

BACKGROUND: Loss of fat-free mass (FFM) and gain in body fat (BF) are the key disability risk factors, also instrumental in perpetuating already existing functional disorders. Obesity construed in terms of body mass index (BMI) values, in view of undesirable gain in BF, is a risk factor for cardio-metabolic disorders. Both detrimental processes clearly evidence a scope of involutionary changes characteristic of an aging population, also standing for one of its greatest burdens. PURPOSE: The present study aimed to assess the changes in body composition (BC), in conjunction with the relationship between BF% and BMI, for defining overweight and obesity status in middle-aged and older adults, against the select indicator variables under study. MATERIALS AND METHODS: The study involved 4799 individuals (33.7% men), PONS Project participants, aged 43-64 years. BF% was measured with the aid of bioelectrical impedance analysis (BIA) method. Age-induced changes in BC were determined against BF%, fat mass (FM), FFM, BMI, fat mass index (FMI), and fat-free mass index (FFMI). The relationship between BF% and BMI was established with the aid of Bayesian regression models, adjusted for gender and age. RESULTS: In both genders, BF% increased with age at a similar annual rate. The reduction of FFM was noted mainly in men, which in conjunction with BF% gain ensured BMI stability. The increase in BF% in women with stable FFM affected an increase in BMI. Regardless of the BMI threshold, the anticipated (predicted) BF% increased with age in both genders. CONCLUSION: Monitoring of BC is of particular importance in older adults, in view of appreciably better characteristics of both the short- and long-term health predictors, as well as overall potential for developing specifically targeted, effective health interventions.

Assessment of a proposed BMI formula in predicting body fat percentage among Filipino young adults.

Body mass index (BMI), while routinely used in evaluating adiposity, cannot distinguish between fat and lean mass, and thus can misclassify weight status particularly among athletic, physically active, and tall- and short-statured individuals, whose lean-to-fat ratios and body proportions vary considerably from average individuals. Believing that the traditional BMI formula divides weight by too much with short people and by too little with tall people, University of Oxford professor L. N. Trefethen proposed a modified formula in computing BMI. This study was conducted among a sample of Filipino young adults (n = 190) to assess the performance of the modified BMI formula against the traditional one in: (1) predicting body fat percentage (%BF) measured using bioelectric impedance analysis, and (2) diagnosing overweight/obesity. Using robust polynomial regression analysis (covariates: age, waist circumference, smoking history and alcohol intake), the BMI quadratic models had the highest adjusted R2 and the lowest AIC and BIC for both sexes compared to the linear models. The AuROCs of the traditional BMI were higher than those of the proposed BMI, albeit nonsignificant. In conclusion, both traditional and modified BMIs significantly predicted %BF, as well as adequately discriminated between %BF-defined normal and overweight-obese states using optimal BMI cutoff values.

Monitoring gestational weight gain and prepregnancy BMI using the 2009 IOM guidelines in the global population: a systematic review and meta-analysis.

BACKGROUND: Previous studies have reported a high prevalence of excessive gestational weight gain (GWG) in women with prepregnancy BMI classified as overweight and obese. However, the joint evidence regarding GWG and prepregnancy BMI in the worldwide population has not been synthesized. Thus, this systematic review and meta-analysis aimed to estimate global and regional mean GWG and the prevalence of GWG above, within and below 2009 Institute of Medicine (IOM) guidelines. Second, we aimed to estimate global and regional prepregnancy BMI and the prevalence of BMI categories according to World Health Organization (WHO) classification. METHODS: We searched Medline, Embase, the Cochrane Library and Web of Science to identify observational studies until 9 May 2018. We included studies published from 2009 that used 2009 IOM guidelines, reporting data from women in general population with singleton pregnancies. The 2009 IOM categories for GWG and the WHO categories for prepregnancy BMI were used. DerSimonian and Laird random effects methods were used to estimate the pooled and their respective 95% confidence intervals (95% CIs) of the mean and by category rates of GWG and prepregnancy BMI, calculated by global and regions. RESULTS: Sixty-three published studies from 29 countries with a total sample size of 1,416,915 women were included. The global prevalence of GWG above and below the 2009 IOM guidelines, was 27.8% (95% CI; 26.5, 29.1) and 39.4% (95% CI; 37.1, 41.7), respectively. Furthermore, meta-regression analyses showed that the mean GWG and the prevalence of GWG above guidelines have increased. The global prevalence of overweight and obesity, was 23.0% (95% CI; 22.3, 23.7) and 16.3% (95% CI; 15.4, 17.4), respectively. The highest mean GWG and prepregnancy BMI were in North America and the lowest were in Asia. CONCLUSIONS: Considering the high prevalence of GWG above the 2009 IOM guidelines and women with overweight/obesity and their continuously increasing trend in most regions, clinicians should recommend lifestyle interventions to improve women's weight during reproductive age. Due to regional variability, these interventions should be adapted to each cultural context. TRIAL REGISTRATION: Prospectively registered with PROSPERO ( CRD42018093562 ).

Overweight and obesity among Vietnamese school-aged children: National prevalence estimates based on the World Health Organization and International Obesity Task Force definition.

BACKGROUND: Overweight and obesity is a severe global health issue in both developed and developing nations. This study aims to estimate the national prevalence of overweight and obesity among school-aged children in Vietnam. METHOD: We conducted a national cross-sectional study on 2788 children aged from 11-14 years old from September to November 2018. We applied the WHO 2007 and IOTF criteria to estimate the prevalence of overweight and obesity among participants. Poison regression analysis with cluster sampling adjustment was employed to assess associated factors with obesity and overweight. Metadata on sociodemographic characteristics, physical measurements, and lifestyle behaviors were also extracted to investigate these factors in association with overweight and obesity prevalence. RESULTS: The prevalences of overweight and obesity in Vietnamese children were 17.4% and 8.6%, respectively by WHO Z-score criteria, and 17.1% and 5.4%, according to the IOTF reference. Using WHO Z-score yielded a higher prevalence of obesity than the IOTF and CDC criteria of all ages and both sexes. The proportions of overweight and obesity were substantially higher among boys than girls across ages. Parental BMI was shown to be a significant factor associated with overweight/obesity status in both girls and boys. Only for boys, age (PR = 0.83, 95% CI 0.76-0.90) and belonging to ethnic minorities (PR = 0.43, 95% CI 0.24-0.76) were significant risk factors for overweight/obesity. CONCLUSION: Our findings indicate a high prevalence of childhood overweight and obesity in Vietnam, especially in boys.

Comprehensive assessment of coronary computed tomography angiography by using Leaman and Leiden score in overweight and obese patients.

Coronary computed tomography angiography (CCTA) is a non-invasive modality used to assess for coronary artery disease. The CT Leaman and Leiden scores utilize coronary plaque location, composition and severity of stenosis to risk stratify patients for cardiovascular events with remarkable precision. This study compares the CCTA Leaman and Leiden score between overweight and obese populations in addition to their associated baseline characteristics. All patients who underwent CCTA within the last 1 year from a single institution were included for initial analysis. Body mass index (BMI) was used to classify patients who were overweight (25.0 to < 30 kg/m2) or obese (≥ 30 kg/m2). Patients with a BMI of < 25 kg/m2 were excluded from further analysis. Patients were divided into overweight and obese groups. CT Leaman and Leiden scores, in addition to baseline characteristics were subsequently compared between the two groups. Overall, a strong correlation between CT Leaman and Leiden scores was found (R2 = 0.9831). Patients classified as obese have more coronary lesions 0.71 ± 0.12 vs 0.31 ± 0.50 in overweight patients (p = 0.02) and tended to have a higher positive CT Leiden (5.47 ± 4.10 vs 3.90 ± 1.36, p = 0.2) and Leaman (3.45 ± 2.58 vs 2.35 ± 0.90, p = 0.1). Furthermore, obese patients with a Leiden score > 5 had significantly higher scores compared to overweight patients (10.22 ± 2.54 vs 5.87 ± 0.64, p = 0.016). Obese patients had similar average CT Leaman and Leiden scores compared to overweight individuals but were more likely to have higher CT Leiden scores > 5 which may indicate a higher risk for adverse cardiovascular outcomes.

Hypertension and selected indicators of health assessment in a population of 19-year-old men subject to military qualifications.

Assessment the prevalence of hypertension and its relation to selected indicators of health status and performance, including classification of BMI, obesity classifications, and body structure in a large test group of 19-year-old men.The study was observational-retrospective, and included a group of 17,282 men, aged 19, from the Malopolska region. All subjects met the qualifications for compulsory military service in 2017. We analyzed selected data obtained from the records of the Ministry of National Defense-spiral-ZINT. Data collection and analysis were carried out from April 1, 2018 to August 31, 2018.Hypertension was found at 0.6%, weak body structure at 0.8% and obesityco-existing with cardiorespiratory insufficiency has been reported 2.6% of respondents and it was more frequent in the recruiters from HT II than I. The underweight concerned almost 7%, and the overweight and obesity of 1/4 of conscripts. The vast majority of people with hypertension were characterized by excessive body weight (74.8%), mainly overweight.Hypertension was seen in a negligible percentage of males studied and was significantly associated with an increase in BMI, particularly with regards to being overweight.

The use of Broca index to assess cut- off points for overweight in adults: A short review.

The Broca formula was developed in 1871 by Pierre Paul Broca (a French Army Doctor) to help establish ideal body weight or normal body weight. Initially, the Broca Index (BI) was used to work out the normal weight but was later expanded to ideal Body Weight. Ideal Body weight (kg) = [Height (cm)-100]. The common methods used to explore the levels of adiposity include body mass index (BMI), waist circumference, skinfolds, bioelectrical impedance analysis, dual energy x-ray absorptiometry (DEXA), computerized tomography (CT) and magnetic resonance imaging (MRI). Even though there have been several anthropometric measurements discoveries to assess obesity, BMI is still widely used in many clinic centers around the world. It remains simple and relatively inexpensive to measure and easily obtainable in non-laboratory settings. In this review, we will summarize the common methods used to measure body fat and their limitations. Second, we will show the correlation that may exist between Broca Index and BMI cutoffs. Last, we will underline some potential clinical usefulness that may present Broca index in assessing body fat.

STUDY OF AGREEMENT BETWEEN THE ROSSO-MARDONES AND ATALAH SCALES FOR NUTRITIONAL ASSESSMENT IN PREGNANCY. LA ERMITA CLINIC, CARTAGENA, 2017.

OBJECTIVE: To assess the degree of agreement between the model for maternal nutritional assessment proposed by Rosso-Mardones and the one proposed by Atalah. METHODS: Diagnostic agreement study. Pregnant women between the ages of 19 and 37 years with a gestational age of 10 or more weeks were incuded; patients with diabetes, thyroid disease, pregnancy-associated hypertension, twin pregnancy, severe fetal malformation, fetal death and hydrops fetalis were excluded. Non-probabilistic sampling. Sociodemographic, obstetrical and nutritional status variables were measured. RESULTS: Overall, 98 pregnant women were included. With the use of the Rosso-Mardones scale, 33% of the patients were classified as having a normal nutritional status, 22% as low weight, and 44% as overweight or obese. With the Atalah scale, 41% of the women were classified as having a normal nutritional status, 10% as low weight and 48% as overweight or obese. The weighted kappa value was 0.74 with a standard error of 0.04, a 95% CI of 0.66-0.82 and a p value < 0.05. CONCLUSIONS: There is substantial agreement between nutritional assessment scales used in pregnancy, namely the Rosso-Mardones nomogram and the Atalah scale. Further studies to assess the agreement of these scales in the pregnant population are required.

TITULO: ESTUDIO DE CONCORDANCIA ENTRE LAS ESCALAS DE ROSSO-MARDONES Y ATALAH PARA LA EVALUACIÓN NUTRICIONAL EN EMBARAZADAS. CLÍNICA LA ERMITA DE CARTAGENA, 2017. OBJETIVO: evaluar el grado de concordancia entre el modelo de evaluación del estado nutricional materna propuesto por Rosso-Mardones con el propuesto por Atalah. METODOS: estudio de concordancia diagnóstica. Se incluyeron gestantes entre los 19 y 37 años, con una edad gestacional de 10 o más semanas; se excluyeron gestantes con: diabetes, enfermedad tiroidea, hipertensión asociada al embarazo, embarazos gemelares, malformaciones fetales graves, muerte fetal e hidrops fetalis. Muestreo no probabilístico. Se midieron las variables sociodemográficas, obstétricas y el estado nutricional. Se calculó el valor de kappa de concordancia entre las dos escalas de evaluación nutricional. RESULTADOS: se incluyeron 98 gestantes. La escala de Roso-Mardones clasificó al 33 % de las pacientes en estado nutricional normal, al 22 % con bajo peso y al 44 % con sobrepeso u obesidad. La escala de Atalah clasificó al 41 % de las gestantes en estado nutricional normal, al 10 % con bajo peso y al 48 % con sobrepeso u obesidad. El valor kappa ponderado obtenido fue 0,74 con un error estándar de 0,04 y un IC 95 %: 0,66-0,82 con valor p < 0,05. CONCLUSIONES: las escalas de evaluación nutricional en gestantes, nomograma de Rosso-Mardones y de Atalah, tienen un acuerdo considerable. Se requieren más estudios que evalúen la concordancia entre estas escalas en población gestante.

Inequalities in cardiovascular risks among Swedish adolescents (ABIS): a prospective cohort study.

OBJECTIVES: To investigate if socioeconomic status (SES) is predictive of cardiovascular risk factors among Swedish adolescents. Identify the most important SES variable for the development of each cardiovascular risk factor. Investigate at what age SES inequality in overweight and obesity occurs. DESIGN: Longitudinal follow-up of a prospective birth cohort. SETTING: All Babies in Southeast Sweden (ABIS) study includes data from children born between October 1997 and October 1999 in five counties of south east Sweden. PARTICIPANTS: A regional ABIS-study subsample from three major cities of the region n=298 adolescents aged 16-18 years, and prospective data from the whole ABIS cohort for overweight and obesity status at the ages 2, 5, 8 and 12 years (n=2998-7925). OUTCOME MEASURES: Blood pressure above the hypertension limit, overweight/obesity according to the International Obesity Task Force definition, low high-density lipoproteins (HDL) or borderline-high low-density lipoproteins according to National Cholesterol Education Program expert panel on cholesterol levels in children. RESULTS: For three out of four cardiovascular risk outcomes (elevated blood pressure, low HDL and overweight/obesity), there were increased risk in one or more of the low SES groups (p<0.05). The best predictor was parental occupational class (Swedish socioeconomic classification index) for elevated blood pressure (area under the receiver operating characteristic (ROC) curve 0.623), maternal educational level for overweight (area under the ROC curve 0.641) and blue-collar city of residence for low HDL (area under the ROC curve 0.641). SES-related differences in overweight/obesity were found at age 2, 5 and 12 and for obesity at age 2, 5, 8 and 12 years (all p<0.05). CONCLUSIONS: Even in a welfare state like Sweden, SES inequalities in cardiovascular risks are evident already in childhood and adolescence. Intervention programmes to reduce cardiovascular risk based on social inequality should start early in life.

Nutritional Status Assessment in Children and Adolescents with Various Levels of Physical Activity in Aspect of Obesity.

INTRODUCTION: A rational way of nourishment, combined with adequate physical activity, are the basic components of maintaining proper body condition. OBJECTIVE: The aim of the study was to evaluate nutritional status among children and adolescents with different levels of physical activity. METHODS: The study group consisted of 1,013 students of both genders aged between 7 and 18 years attending elementary and post-primary schools (general and sports profile) in Siemianowice Slaskie. RESULTS: The crude body mass index (BMI) values ranged from 12.78 to 35.3. Body mass within the limits of arbitrary standard referred to 70% of the examined group, overweight or obesity was found in over 25%. Percentage of body fat (FATP) values ranged from 5.7 to 45.2%. CONCLUSIONS: A significant number of children and adolescents were overweight or obese based on BMI categories and FATP values. Overweight and obesity were most common among younger children, particularly boys. Higher torso FATP levels were more common among sports-oriented class students. BMI is not a good tool for the determination of the nutritional status of children and adolescents, while the bioelectric impedance method enables one to conduct a precise analysis of adipose tissue content and location. Sports-oriented elementary school students from the study group were characterized by higher FATP values.

Development of a Computational Model to Predict Excess Body Fat in Adolescents through Low Cost Variables.

BACKGROUND: Excess body fat has been growing alarmingly among adolescents, especially in low income and middle income countries where access to health services is scarce. Currently, the main method for assessing overweight in adolescents is the body mass index, but its use is criticized for its low sensitivity and high specificity, which may lead to a late diagnosis of comorbidities associated with excess body fat, such as cardiovascular diseases. Thus, the aim of this study was to develop a computational model using linear regression to predict obesity in adolescents and compare it with commonly used anthropometric methods. To improve the performance of our model, we estimated the percentage of fat and then classified the nutritional status of these adolescents. METHODS: The model was developed using easily measurable socio-demographic and clinical variables from a database of 772 adolescents of both genders, aged 10-19 years. The predictive performance was evaluated by the following metrics: accuracy, sensitivity, specificity, and area under ROC curve. The performance of the method was compared to the anthropometric parameters: body mass index and waist-to-height ratio. RESULTS: Our model showed a high correlation (R = 0.80) with the body fat percentage value obtained through bioimpedance. In addition, regarding discrimination, our model obtained better results compared to BMI and WHtR: AUROC = 0.80, 0.64, and 0.55, respectively. It also presented a high sensitivity of 92% and low false negative rate (6%), while BMI and WHtR showed low sensitivity (27% and 9.9%) and a high false negative rate (65% and 53%), respectively. CONCLUSIONS: The computational model of this study obtained a better performance in the evaluation of excess body fat in adolescents, compared to the usual anthropometric indicators presenting itself as a low cost alternative for screening obesity in adolescents living in Brazilian regions where financial resources are scarce.

Cutting through the fat: a retrospective analysis of clinical outcomes, cost, and quality of life with the addition of panniculectomy to ventral hernia repair in overweight patients.

BACKGROUND: Due to the increased prevalence of overweight patients with ventral hernia, abdominal wall reconstruction combining ventral hernia repair (VHR) with panniculectomy (VHR-PAN) in overweight patients is increasingly considered. We present a retrospective comparison between VHR-PAN and VHR alone in overweight patients by examining costs, clinical outcomes, and quality of life (QoL). METHODS: Patients with body mass index (BMI) > 25.0 kg/m2 underwent VHR-PAN or VHR alone between September 2015 and May 2017 with a single surgeon and were matched into cohorts by BMI and age (n = 24 in each cohort). QoL was assessed using the Hernia-related Quality of Life Survey (HerQLes). Cost was assessed using billing data. Statistical analyses were performed using Fisher's exact tests, Mann-Whitney U tests, and regression modeling. RESULTS: Hernia defect size (p = 0.127), operative time (p = 0.140), mesh placement (p = 0.357), and recurrence rates (p = 0.156) did not vary significantly between cohorts at average follow up of one year. 60% of patients completed QoL surveys, with 61% net improvement in VHR-PAN postoperatively (p = 0.042) vs 36% in VHR alone (p = 0.054). Mean total hospitalization costs were higher for VHR alone (p = 0.019). Regression modeling showed no significant independent contribution of procedure performed due to differences in cost, wound complications, or hernia recurrence. CONCLUSIONS: At mean follow up of 2 years, VHR-PAN patients reported a comparable increase in QoL to those who received VHR alone without significantly different cost and complication rates. Concurrent VHR-PAN may therefore be a safe approach for overweight patients presenting with hernia and excess abdominal skin.

Comparative study of mid-upper arm circumference, arm muscle area and arm fat area percentiles in Argentinean and US children aged 4-14 years.

INTRODUCTION: Background: mid-upper arm circumference (MUAC), subcutaneous fat and muscle measurements are an alternative method to diagnose overweight and evaluate growth as well as protein and energy reserves. Aim: to compare MUAC, arm muscle area (AMA) and arm fat area (AFA) measurements of Argentinean boys and girls (Sa) with reference curves for US boys and girls (R). Subjects and methods: data from 22,736 school-children aged 4-14 years from six Argentinean provinces were collected. MUAC and triceps skinfold thickness were measured and the derived AMA and AFA measures were calculated. Analyses were performed with GAMLSS using the R software. Differences in mean values of Sa and R were compared in percentiles 3, 50 and 97. Results: mean values of MUAC and AMA in boys and girls were higher in R than in Sa at all ages; conversely, AFA values were lower. Conclusions: our results confirm differences in upper arm anthropometry of Argentinean school-children with respect to the US reference. The higher adipose tissue and lower skeletal muscle mass observed in Argentinean children could be partly associated with the different ethnic origin of both populations. However, differences should be interpreted in the context of an obesogenic environment, which has favored a calorie-protein imbalance.

INTRODUCCIÓN: Antecedentes: la medición de la circunferencia del brazo (MUAC), así como la estimación de la grasa subcutánea y muscular constituyen un método alternativo para diagnosticar el sobrepeso y evaluar el crecimiento y las reservas proteicas y energéticas. Objetivo: comparar las mediciones de MUAC, área muscular (AMA) y área grasa (AFA) del brazo de niños y niñas argentinos (Sa) con curvas de referencia para niños y niñas de Estados Unidos (R). Sujetos y métodos: se recopilaron datos de 22,736 escolares de 4 a 14 años de edad de seis provincias argentinas. Se obtuvieron medidas de MUAC y pliegue subcutáneo tricipital y se calcularon AMA y AFA. Los análisis se realizaron con GAMLSS utilizando el software R. Las diferencias en los valores medios de Sa y R se compararon para los percentiles 3, 50 y 97. Resultados: a todas las edades los valores medios de MUAC y AMA en niños y niñas fueron más altos en R que en Sa; por el contrario, los valores de AFA fueron más bajos. Conclusiones: nuestros resultados confirman la existencia de diferencias en la antropometría mesobraquial de los niños argentinos con respecto a los de la referencia. La mayor cantidad de tejido adiposo y menor de tejido muscular observada en los niños argentinos de ambos sexos puede ser parcialmente asociada con el diferente origen étnico de ambas poblaciones. Sin embargo, las diferencias podrían interpretarse en el contexto de un ambiente obesogénico, el cual habría favorecido el desbalance proteico-calórico.

Global patterns in excess body weight and the associated cancer burden.

The prevalence of excess body weight and the associated cancer burden have been rising over the past several decades globally. Between 1975 and 2016, the prevalence of excess body weight in adults-defined as a body mass index (BMI) ≥ 25 kg/m2 -increased from nearly 21% in men and 24% in women to approximately 40% in both sexes. Notably, the prevalence of obesity (BMI ≥ 30 kg/m2 ) quadrupled in men, from 3% to 12%, and more than doubled in women, from 7% to 16%. This change, combined with population growth, resulted in a more than 6-fold increase in the number of obese adults, from 100 to 671 million. The largest absolute increase in obesity occurred among men and boys in high-income Western countries and among women and girls in Central Asia, the Middle East, and North Africa. The simultaneous rise in excess body weight in almost all countries is thought to be driven largely by changes in the global food system, which promotes energy-dense, nutrient-poor foods, alongside reduced opportunities for physical activity. In 2012, excess body weight accounted for approximately 3.9% of all cancers (544,300 cases) with proportion varying from less than 1% in low-income countries to 7% or 8% in some high-income Western countries and in Middle Eastern and Northern African countries. The attributable burden by sex was higher for women (368,500 cases) than for men (175,800 cases). Given the pandemic proportion of excess body weight in high-income countries and the increasing prevalence in low- and middle-income countries, the global cancer burden attributable to this condition is likely to increase in the future. There is emerging consensus on opportunities for obesity control through the multisectoral coordinated implementation of core policy actions to promote an environment conducive to a healthy diet and active living. The rapid increase in both the prevalence of excess body weight and the associated cancer burden highlights the need for a rejuvenated focus on identifying, implementing, and evaluating interventions to prevent and control excess body weight.