A trajectory analysis of body mass index for Finnish children

The aim of this study is to investigate the early development of body mass index (BMI), a standard tool for assessing the body shape and average level of adiposity for children and adults. The main aim of the study is to identify the primary trajectories of BMI development and to investigate the changes of certain growth characteristics over time. Based on our longitudinal data of 4223 Finnish children, we took anthropometric measurements from birth up to 15 years of age for birth years 1974, 1981, 1991 and 1995, but only up to 11 years of age for the birth year 2001. As a statistical method, we utilized trajectory analysis with the methods of nonparametric regression. We identified four main trajectories of BMI growth. Two of these trajectories do not seem to follow the normal growth pattern. The highest growth track appears to yield to a track that may yield to overweight and the low birth BMI track shows that the girls’ track differs that of boys on the same track, and on the normal tracks. The so-called adiposity rebound time decreased over time and started earlier for those on the overweight track. According to our study, this kind of acceleration of growth might be more of a general phenomenon that also relates to the other phases of BMI development. The major change seems to occur especially for those children on high growth tracks.     

College Health Service and the Fast-Food Value System

Abstract

Objective: To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women. Methods: A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated from self-reported height and weight) among lesbian, bisexual and heterosexual college women. Results: Compared to heterosexuals female college students, lesbians and bisexual women were both significantly more likely to be overweight or obese. Lesbians were also less likely to be underweight compared to heterosexual college women. Conclusions: Self-identified lesbian and bisexual college women were more likely to be overweight or obese than their heterosexual counterparts. Health care professionals and educators should target these high-risk populations for obesity prevention programs. This study highlights the need for additional research examining the potential risk factors for overweight and obesity among young sexual minority women.     

Differences in Dietary Patterns Among College Students According to Body Mass Index

Objective and Participants: The authors surveyed 557 undergraduate students aged 18-56 years to assess weight status, health behaviors, and dietary variety. Methods: They used body mass index (BMI) to divide students into 4 weight categories: underweight (BMI < 19 kg/m²), healthy weight (19 kg/m² to 24.99 kg/m²), over-weight (25 kg/m² to 29.99 kg/m²), and obese (> 30 kg/m²). Results: Approximately 33% of respondents were overweight or obese, and 8% were underweight. Among the weight categories, the authors observed significant differences in diet (eg, cheese, pork, lamb, veal and game, fish, green leafy vegetables, other vegetables, and the cumulative total of all meats). Overall, 33% of the students consumed 1 fruit in 3 days. The authors found no differences among the weight categories related to eating fatty, sugary snacks. Conclusions: College administrators should create health promotion and skill-building programs to improve students' diet variety.     

Pregnancy care and birth outcomes for women with moderate to super-extreme obesity

PurposeTo describe the health service utilisation and birth outcomes of pregnant women with moderate to super-extreme obesity.BackgroundMaternal obesity is increasingly recognised as a key risk factor for adverse outcomes for both women and their babies. Little is known about the service utilisation and perinatal outcomes of women with obesity beyond a body mass index of 40.MethodWomen with a self-reported pre-pregnancy BMI of 40 or more, who had received care and birthed a baby at the study site between 1 January 2009 and 31 December 2010. Clinical audit was used to identify the health service utilisation and birth outcomes of these women.Results153 women had a BMI of 40 or more. Women saw 6 different health professionals during pregnancy (1–16). Most of their visits were with a medical practitioner, often with limited experience, and almost all women only saw a midwife once at their booking visit (n = 150, 98.0%). While the majority of women experienced a normal pregnancy, free from any complications, almost half the women in this study experienced a caesarean section (n = 74, 48.4%).ConclusionClinical audit has been useful in providing additional information which suggests current maternity care provision is not meeting the needs of this group of women. The model of antenatal care provision may be a mediating factor in the birth outcomes experienced by obese women. The development of effective, targeted antenatal care, designed to meet the needs of these women is recommended.     

Does Metabolic Syndrome Impair Sexual Functioning in Adults With Overweight and Obesity?

Objectives: Obesity is a growing public health concern worldwide, and results in increased risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, insulin resistance, dyslipidemia, hypertension, and reduced sex hormone production. Previous research suggests that obesity may contribute to sexual dysfunction. This review aims to determine the relationship between obesity and sexual dysfunction, and ascertain the associated cardiometabolic conditions that may contribute to impaired sexual functioning in individuals with obesity. Methods: Literature searches were conducted through PubMed and Embase from 1980 to 2016, to identify original research articles, reviews including systematic reviews and meta-analyses, using the search terms: obese, obesity, overweight, sexual function, sexual dysfunction, metabolic syndrome, CVD, T2D, hormones and weight loss. Results: This review found that individuals with obesity and cardiometabolic comorbidities were more likely to report the greatest degree or sexual dysfunction and/or reduction in sexual quality of life, compared to those without. Conclusions: Current evidence supports an association between sexual dysfunction and factors associated with obesity, such as reduced insulin sensitivity, dyslipidaemia, hypertension, and low oestrogen or testosterone. To establish efficacious treatments, research examining the impact of weight loss on the conditions associated with obesity, such as hypertension, reduced insulin sensitivity, dyslipidaemia, and low sex hormones and sexual functioning in individuals with overweight and obesity should be a priority.     

Changes in Objective and Self-Reported Measures of Physical Capacity After an Intervention in Obese Older Women

The aim of this study was to determine if objective and self-reported measures of physical capacity are two equivalent methods to detect changes following an intervention in obese older women. 36 obese women aged between 55 and 75 years participated in a 3-month study with the aim of improving physical capacity by caloric restriction and/or resistance training. Physical capacity was measured objectively with 10 different tests and self-reported with the SF-36 physical functioning score (SF-36 PF score). Then the performance-to-objective tests were computed using quartiles to provide a baseline global physical capacity score. The mean percentage of change of the 10 tests as well as the SF-36 PF score were also calculated after the study. Body composition was measured by dual-energy X-ray (DXA) absorptiometry. The baseline global physical capacity score and the SF-36 PF score were significantly correlated at baseline (r = 0.43; P < 0.01). Eight out of the 10 objective tests of physical capacity improved after the intervention, while no improvement was observed for the SF-36 PF score. On average, percentage of change in physical capacity was 4.1 ± 5.9% for the SF-36 PF score and 11.1 ± 2.9% for the objective measures. However, no significant correlation was observed between percentage of changes between the two approaches after the intervention (r = 0.32; P = 0.07). Based on these results, the method used to quantify physical capacity after an intervention may have major implications on the outcomes. The methods used should be carefully analyzed in regard to the objective of the study.     

Exposing College Students to Exercise: The Training Interventions and Genetics of Exercise Response (TIGER) Study

Abstract

Objective: The Training Interventions and Genetics of Exercise Response (TIGER) study is an exercise program designed to introduce sedentary college students to regular physical activity and to identify genetic factors that influence response to exercise. Participants: A multiracial/ethnic cohort (N = 1,567; 39% male), age 18 to 35 years, participated in the study. Methods: Subjects underwent 30 weeks of exercise training, 3 days/week, for 40 minutes at 65% to 85% of age- and gender-predicted maximum heart rate reserve. Multiple measures of body size/composition, heart rate, and blood pressure were obtained. Results: A total of 1,567 participants, (39% male), age 18 to 35 years, participated in the TIGER study. The prevalence of overweight/obesity in participants was 48.0%/19.3% in non-Hispanic Whites, 55.3%/24.2% in Hispanic Whites, 54.9%/25.4% in African Americans, and 38.3%/11.3% in Asians. Average within-semester retention was 68%, but overall retention (30 weeks, 2 semesters) was 20%. Conclusions: The TIGER study represents an efficacious strategy for introducing college-aged individuals to regular aerobic exercise.     

A Longitudinal Examination of Family Processes,Demographic Variables,and Adolescent Weight

Nationally representative studies estimate that almost one in five adolescents in the United States is overweight. This is a major concern for individuals' physical and psychological health and the overall economy in terms of health care costs and loss of productivity. A 12- to 14-year-old subsample of 4,688 adolescents from the NLSY97 cohort was used to address the association between family processes, demographic variables, and adolescent body mass index (BMI) percentile over 4 years. The final model indicated that frequency of family meals, gender, race, control, and mothers' BMI were important predictors of adolescent BMI percentile over time. Mothers' BMI was the strongest predictor of adolescent BMI percentile. More frequent family meals led to decreases in BMI percentile over time, whereas males, African Americans, and Latinos had higher average BMI percentiles than other groups.     

Exploring the Climate for Overweight and Obese Students in a Student Health Setting

Attitudes and beliefs of health care providers, in conjunction with a nonthreatening physical environment, are important components in establishing a constructive and supportive climate for care of overweight and obese students. Objective: The authors explored providers' attitudes about obesity and assessed the physical environment in a student health clinic to identify areas that may be detrimental to the care of overweight and obese students. Participants: Eighteen direct care providers participated in the project. Methods: The authors conducted focus groups with direct care providers and assessed their experiences and perceived challenges in working with overweight and obese students. The authors also conducted a walk-through assessment of the physical environment. Results: Direct care providers expressed discomfort in deciding how and when to discuss weight with students. The authors found that elements of the physical environment could present barriers to care for overweight and obese students. Conclusions: The authors make recommendations for improving the health care climate for overweight and obese students.     

Pilot Study on Childhood Sexual Abuse,Diurnal Cortisol Secretion,and Weight Loss in Bariatric Surgery Patients

Childhood sexual abuse increases risk for adult obesity. A potential contributing factor is altered cortisol secretion. In this pilot study, relationships among childhood sexual abuse, diurnal salivary cortisol secretion, and weight loss were explored in 17 bariatric surgery patients. Measurement points were before surgery (baseline) and 3 and 6 months after surgery. Childhood sexual abuse was measured by the Childhood Trauma Questionnaire. The results showed moderate but nonsignificant positive correlations between the childhood sexual abuse subscale score and baseline morning cortisol, evening cortisol, and daily mean cortisol. An unexpected positive correlation was noted between the Childhood Trauma Questionnaire total score and weight loss at six months. Diurnal cortisol secretion did not change over time after surgery nor correlate significantly with weight loss at six months.