Carbohydrate intake and body mass index in relation to the risk of glucose intolerance in an elderly population

The association between the intake of carbohydrates, body mass index (BMI), and the 4-y incidence of impaired glucose tolerance and diabetes mellitus (glucose intolerance) was investigated in elderly men and women aged 64-87 y. In 1971 the baseline population consisted of 175 normoglycemic subjects. During the follow-up period (1972-1975) an oral glucose-tolerance test (OGTT) was carried out annually. In univariate analyses, baseline BMI and the habitual intake of carbohydrates and pastries, as determined from a cross-check dietary history, were positively associated with the incidence of glucose intolerance. The habitual intake of legumes was inversely related to the incidence of glucose intolerance. These results could not be explained by potential confounding factors such as age, gender, alcohol use, energy intake, prescribed diet, medication use, and comorbidity. These results suggest that energy balance and the use of carbohydrate-rich foods are related to the development of glucose intolerance in an elderly population.     

Prepregnancy body mass index and gestational weight gain in relation to child body mass index among siblings

There is increasing evidence that in utero effects of excessive gestational weight gain may result in increased weight in children; however, studies have not controlled for shared genetic or environmental factors between mothers and children. Using 2,758 family groups from the Collaborative Perinatal Project, the authors examined the association of maternal prepregnancy body mass index (BMI) and gestational weight gain on child BMI at age 4 years using both conventional generalized estimating equations and fixed-effects models that account for shared familial factors. With generalized estimating equations, prepregnancy BMI and gestational weight gain had similar associations with the child BMI z score (β = 0.09 units, 95% confidence interval (CI): 0.08, 0.11; and β = 0.07 units, 95% CI: 0.04, 0.11, respectively. However, fixed effects resulted in null associations for both prepregnancy BMI (β = 0.03 units, 95% CI: -0.01, 0.07) and gestational weight gain (β = 0.03 units, 95% CI: -0.02, 0.08) with child BMI z score at age 4 years. The positive association between gestational weight gain and child BMI at age 4 years may be explained by shared family characteristics (e.g., genetic, behavioral, and environmental factors) rather than in utero programming. Future studies should continue to evaluate the relative roles of important familial and environmental factors that may influence BMI and obesity in children.     

Height and body mass index in relation to total mortality

BACKGROUND: The relation between body mass index (BMI) and mortality is not clear in the literature. An inverse relation between height and mortality has been suggested. We explore these relations in a very large cohort in Norway. METHODS: We studied two million men and women, age 20-74 years, who were measured during 1963-2000. These persons were followed for an average of 22.1 years. We used Cox proportional hazard models in the analyses. Also, the optimal BMI (the BMI at the time of measurement that was subsequently related to the lowest mortality) was estimated. RESULTS: Over the study period, 723,000 deaths were registered. The relative risk of death by BMI showed a J- or U-shaped curve, with the lowest rates of death at BMI between 22.5 and 25.0. In men, the optimal BMI increased from 21.6 when measured at age 20-29 to 24.0 when measured at age 70-74. In women, the optimal BMI was consistently higher, increasing from 22.2 to 25.7. Mortality decreased with increased height in men; in women, mortality decreased with height only up to heights of about 160-164 cm and then increased among the tallest women. CONCLUSIONS: The relation between BMI and mortality was J- or U-shaped, with the "optimal" BMI varying by age and sex. Height was inversely related to mortality in men and in women up to a height of 165 cm.     

The relation of body mass index to depressive symptoms

OBJECTIVE: Data from the 1995 Nova Scotia Health Survey were analyzed to determine the relation between body mass index (BMI) and the risk of depression as measured by the Center for Epidemiological Studies Depression Scale (CES-D). METHODS: Clinical measures for height and weight and CES-D scores were available for 2,482 subjects from an initial sample of 5,578 Nova Scotians stratified probabilistically to be representative of age, gender and area of residence. BMIs were categorized according to the international standards (BMI 18.5-24.9 acceptable weight; 25-29.9 overweight; > or = 30 obese). RESULTS: More men than women were classified as overweight (43.2% vs. 28.3%) but slightly more women than men were obese (25.6% vs. 23.4%). Based on the summary score of the CES-D, 14.2% were categorized as at risk for depression (> or = 16). Logistic regression indicated that lower education (p < 0.001) and income (p < 0.001), and BMI category (p < 0.05) were all significantly related to an increased risk of depression. The odds ratio for the association between obesity and depression, after controlling for education and income, was 1.41 [95% CI = 1.07-1.86]. DISCUSSION: More studies are needed to ascertain the mechanism by which obesity and depression could be related and the significance of this relation for the prevention and treatment of both obesity and depression. Given the effects of depression, we suggest that health professionals should assess their obese patients for risk of depression before embarking on a weight management protocol.     

Glycemic index and glycemic load in relation to body mass index and waist to hip ratio

Purpose  

High-glycemic index (GI) diet has been associated with obesity, but epidemiological data are inconsistent. We therefore investigated the relation between GI and glycemic load (GL) with body mass index (BMI) and waist to hip ratio (WHR), as a measure of body fat distribution.     

Lipid, protein and carbohydrate intake in relation to body mass index

OBJECTIVE: To examine whether the same amount of energy intake has different consequences on body mass index (BMI), depending on the source of energy from specific macronutrients. DESIGN: Cross-sectional study, in the context of the European Prospective Investigation into Cancer and nutrition (EPIC). SETTING: Communities all over Greece. SUBJECTS: A total of 27 862 apparently healthy volunteers, men and women, ages 25-82 y. INTERVENTIONS: None. METHODS: Dietary information was collected through an interviewer-administered semi-quantitative food frequency questionnaire. In the context of a cross-sectional analysis, we calculated changes of BMI per increments of energy intake from protein, carbohydrates, saturated, polyunsaturated and monounsaturated lipids and ethanol, controlling for mutual confounding and other confounders, among all participants, and after exclusion of under-reporters and/or those on a diet. RESULTS: Protein intake was positively associated with BMI. The association was evident when nutrients were not mutually adjusted for and increased after mutual adjustment among nutrients (beta=0.80 kg/m(2) per 418.4 kJ or 100 kcal increment, 95% confidence interval 0.55-1.06 for men, and beta=1.59, 95% CI 1.30-1.88 for women), as well as after exclusion of under-reporters and/or those on a diet. The effects of other macronutrients were less substantial or consistent. CONCLUSIONS: There is evidence indicating that protein intake is conducive to obesity. Moreover, our data suggest that neither saturated or monounsaturated lipids nor carbohydrates are likely to play a major role in increasing BMI over and beyond that indicated by their energy content.     

Trimester-specific blood pressure levels in relation to maternal pre-pregnancy body mass index

We evaluated the influence of maternal pre-pregnancy body mass index (BMI), based on reported pre-pregnancy weight and height, on blood pressure (BP) levels during pregnancy by using information from a prospective cohort of 1733 women recruited before 20 weeks' gestation. Maternal antenatal BP values were abstracted from medical records, and we evaluated the mean BP differences according to BMI group in regression models, using generalised estimating equations to account for repeated BP records within each pregnancy. In each trimester, mean systolic BP (SBP) and diastolic BP (DBP) values were positively associated with maternal pre-gestational BMI. This association persisted after adjustment for maternal age, parity, smoking, education, marital status and physical activity. Overweight women (25-29 kg/m(2)) had first-, second- and third-trimester mean SBPs that were 8.1, 7.7 and 8.2 mmHg, respectively, higher than values observed in lean women (<20 kg/m(2)). Mean DBP values were 4.5, 5.4 and 5.6 mmHg higher for each successive trimester in overweight vs. lean women. Obese (>30 kg/m(2)) women consistently had the highest mean SBP and DBP values. Trimester-specific mean SBP values were 10.7-12.0 mmHg higher among obese women vs. lean women. Corresponding trimester-specific mean DBP values were 6.9-7.4 mmHg higher in obese vs. lean women. Similar patterns were observed when trimester-specific average mean arterial pressures were evaluated. Elevated pregnancy BPs associated with maternal pre-gestational BMI are consistent with a large body of literature that documents increased pre-eclampsia risk among overweight and obese women.     

Reported food choices in older women in relation to body mass index and depressive symptoms

This paper examines the relationships among reports of depressive symptoms, BMI and frequency of consumption of 30 foods in 4655 middle-aged women. Food was grouped into three categories: high-calorie sweet, high-calorie nonsweet, and low-calorie. Controlling for total energy intake, BMI and depressive symptoms were both inversely associated with a higher frequency of consumption of low-calorie foods. BMI was positively associated with consumption of high-calorie nonsweet foods and negatively related to consumption of high-calorie sweet foods. Depressive symptoms were positively associated with sweet foods consumption and negatively associated with nonsweet foods consumption. These findings suggest that the positive association between BMI and depression in women may be mediated by sweets consumption. This is consistent with the hypothesis that eating sweet foods reduces negative affect.     

海南省成年居民2型糖尿病与腰围、体质指数的相关性探讨

目的分析海南省居民2型糖尿病（简称糖尿病）与腰围、体质指数（BMI）相关联程度。方法采用多阶段分层整群抽样方法,于2007年和2010年对4320名18岁以上居民进行体格检查和生化检测,以空腹血糖≥7.0 mmol/L作为糖尿病诊断依据,使用率的χ2、单因素线性相关分析在腰围和BMI水平上糖尿病变化。结果超重率、肥胖率和中心性肥胖率的高峰值在45～54岁组,分别为23.03%、5.21%、29.51%,女性的中心性肥胖率高峰值推迟10岁。糖尿病患病率从35岁开始出现成倍数上升,平均每10岁糖尿病患病率上升1.78倍,55～64岁组男、女患病率趋于等同。女性超重率、肥胖率和中心性肥胖率分别为18.19%、4.51%、26.37%,比男性（14.34%、3.35%、18.35%）分别高出26.78%、23.88%、57.71%,男性糖尿病患病率为9.53%,比女性（7.08%）高出34.60%。空腹血糖与BMI、腰围呈正相关关系（rs=0.16,0.16,P〈0.01）,BMI≥24 kg/m2组或中心性肥胖者,平均每增长10岁患病率分别上升2.19倍和3.65倍,患病率是同一年龄组BMI〈24 kg/m2、非中心肥胖者的1.37～3.18倍,其中25～34岁组最高。结论糖尿病预防工作关口前移,应将体重、腰围和空腹血糖列为25岁以上居民的健康必检项目,尤其是男性。     

Genetic determinants of serum vitamin B12 and their relation to body mass index

Lower serum vitamin B12 levels have been related to adverse metabolic health profiles, including adiposity. We used a Mendelian randomization design to test whether this relation might be causal. We included two Danish population-based studies (n_total = 9311). Linear regression was used to test for associations between (1) serum vitamin B12 levels and body mass index (BMI), (2) genetic variants and serum vitamin B12 levels, and (3) genetic variants and BMI. The effect of a genetically determined decrease in serum vitamin B12 on BMI was estimated by instrumental variable regression. Decreased serum vitamin B12 associated with increased BMI (P < 1 × 10^?4). A genetic risk score based on eight vitamin B12 associated variants associated strongly with serum vitamin B12 (P < 2 × 10^?43), but not with BMI (P = 0.91). Instrumental variable regression showed that a 20% decrease in serum vitamin B12 was associated with a 0.09 kg/m² (95% CI 0.05; 0.13) increase in BMI (P = 3 × 10^?5), whereas a genetically induced 20% decrease in serum vitamin B12 had no effect on BMI [?0.03 (95% CI ?0.22; 0.16) kg/m²] (P = 0.74). Nevertheless, the strongest serum vitamin B12 variant, FUT2 rs602662, which was excluded from the B12 genetic risk score due to potential pleiotropic effects, showed a per allele effect of 0.15 kg/m² (95% CI 0.01; 0.32) on BMI (P = 0.03). This association was accentuated including two German cohorts (n_total = 5050), with a combined effect of 0.19 kg/m² (95% CI 0.08; 0.30) (P = 4 × 10^?4). We found no support for a causal role of decreased serum vitamin B12 levels in obesity. However, our study suggests that FUT2, through its regulation of the cross-talk between gut microbes and the human host, might explain a part of the observational association between serum vitamin B12 and BMI.     

中国成年人体重指数与生命质量的关系研究

目的 探讨中国成年人BMI与生命质量的关系。方法 纳入2010年中国慢性病及其危险因素监测的所有调查对象共83 347名。应用问卷收集调查对象的年龄、性别、相关疾病患病情况等信息。并使用WHO生存质量测定简表（QOL-BREF）测定其生命质量。测量体重和身高,计算BMI。采用秩和检验比较不同BMI分组的人群生命质量的差异;用多元logistic回归模型检验不同性别人群BMI与生命质量的关系。结果 83 347名调查对象中,与体重正常组相比,体重过轻、超重和肥胖组的生理维度得分均较低;超重组的心理和环境维度的得分高于其他3组;社会关系维度的得分以肥胖组最高,体重过轻组得分最低,差异均有统计学意义（P<0.000 1）。体重过轻男性的生理（OR＝1.38,95%CI：1.12～1.70）、心理（OR＝1.29,95%CI：1.08～1.54）、社会关系（OR＝1.26,95%CI：1.08～1.47）和环境（OR＝1.37,95%CI：1.12～1.67）4个维度的生命质量受损的危险度明显增加。超重和肥胖组男性的生理（OR＝0.88,95%CI：0.82～0.94;OR＝0.90,95%CI：0.82～0.98）、心理（OR＝0.88,95%CI：0.83～0.94;OR＝0.83,95%CI：0.77～0.90）、社会关系（OR＝0.89,95% CI：0.84～0.94;OR＝0.78,95% CI：0.71～0.85）和环境（OR＝0.85,95% CI：0.80～0.92;OR＝0.79,95%CI：0.73～0.86）维度的生命质量受损的危险度降低。超重组女性的社会关系（OR＝0.92,95%CI：0.85～0.98）和环境维度（OR＝0.91,95%CI：0.80～0.92）的生命质量受损的危险度显著降低。而肥胖女性社会关系维度的危险度也显著降低（OR＝0.86,95%CI：0.78～0.95）。结论 BMI分组不同的人群各个维度的生命质量不同,男性体重过轻组4个维度的生命质量均较差,男性超重和肥胖组各个维度生命质量均较好,女性超重组的社会关系和环境维度生命质量较好,女性肥胖组社会关系维度生命质量较好。     

Cross-sectional study on the relationship between body mass index and smoking, and longitudinal changes in body mass index in relation to change in smoking status: the Tromso Study

AIMS: To evaluate the effects of smoking and other lifestyle factors on body mass index (BMI), and changes in BMI in relation to changes in smoking status. METHODS: A cross-sectional study was performed on 10,920 males (3937 smokers) and 12,090 females (4343 smokers) who participated in the fourth Troms? Study (performed in 1994-95). A longitudinal study was performed on 2364 males (732 smokers in 1994-95) and 2738 females (942 smokers in 1994-95) who participated in both the fourth and the fifth Troms? studies (performed in 2001). RESULTS: In the cross-sectional study, current smokers of both genders had a lower BMI (25.0+/-3.4 vs. 25.5+/-3.2 kg/m(2) in males, and 23.9+/-3.9 vs. 25.3+/-4.6 kg/m( 2) in females, p<0.01), a lower degree of physical activity, and a higher consumption of coffee and alcohol than never-smokers. We found a U-shaped relationship between number of cigarettes smoked per day and BMI, with the lowest BMI in those smoking 6- 10 cigarettes per day. Heavy smokers and never-smokers had similar BMI. In the longitudinal study, continuing smokers had a smaller increase in BMI than those who gave up smoking. In those who gave up smoking, there was a significant, positive relationship between number of cigarettes smoked in 1994-95 and increase in BMI. CONCLUSIONS: There is a U-shaped relationship between number of cigarettes smoked per day and BMI. Smoking cessation is associated with an increase in weight as compared to those who continue smoking.     

Temporal relation between body mass index and renal function in individuals with hypertension and excess body weight

ObjectiveRecent evidence has suggested obesity as an independent risk factor for chronic kidney disease. However, the temporal relation between body mass index (BMI) and early renal dysfunction is unknown. This study aimed at evaluating whether longitudinal variations in BMI would reflect on changes in estimated glomerular filtration rate (GFR) in hypertensive individuals with excess body weight.MethodsThis was a cross-sectional, longitudinal study.ResultsOf the 218 participants who attended the first examination, 150 were available for paired final analyses. At the end of follow-up, GFR decreased by 1.024 mL/min for each 1-kg/m² increment in BMI (P < 0.03). When BMI was analyzed in quartiles, a positive graded relation with GFR changes was observed in quartiles 1 and 2 (individuals who maintained or lost weight), and a negative relation in quartiles 3 and 4 (individuals who gained weight, P = 0.05). A significant difference was observed between the smallest and highest BMI quartiles (P = 0.01). At the end of follow-up, the 76 participants (51%) who gained weight (+4.6 ± 0.4 kg) showed a reduction in GFR (?2.99 ± 1.99 mL/min) of borderline significance (P = 0.06) and a significant increase in fasting plasma glucose and triacylglycerol levels. Conversely, the 74 participants who maintained or lost weight showed no significant change in GFR and in fasting plasma glucose and triacylglycerol levels, although their blood pressure decreased significantly.ConclusionsOur study showed a significant temporal association between changes in BMI and GFR in overweight and obese hypertensive patients.     

Neighborhood socioeconomic status in relation to dietary intake and body mass index in female Japanese dietetic students

ObjectiveAn increasing number of studies conducted in Western countries have shown that living in a socioeconomically disadvantaged neighborhood is associated with unfavorable dietary intake patterns and an unfavorable health status. However, information on such neighborhood socioeconomic differences in diet and health among different cultural settings, including Japan, is absolutely lacking. This cross-sectional study examined the association of neighborhood socioeconomic status (SES) with dietary intake and body mass index (BMI) in a group of young Japanese women.MethodsSubjects were 3892 female Japanese dietetic students 18–20 y of age from 53 institutions, residing in 1033 municipalities in 47 prefectures in Japan. Neighborhood SES index was defined by seven municipal-level variables, namely unemployment, household overcrowding, poverty, education, income, home ownership, and vulnerable groups, with an increasing index signifying increasing neighborhood socioeconomic disadvantage. Dietary intake was estimated using a validated, comprehensive self-administered diet history questionnaire. BMI was computed from self-reported body weight and height.ResultsNeighborhood SES index was not materially associated with most of the dietary variables. However, neighborhood SES index was positively associated with BMI, with significance (P for trend = 0.020). This significant association remained after adjustment for potential confounding or mediating factors including household SES, dietary, other lifestyle, and geographic factors (P for trend = 0.037).ConclusionAlthough no material association was seen between neighborhood SES and dietary intake, increasing neighborhood socioeconomic disadvantage was independently associated with increasing BMI in a group of young Japanese women.     

Childhood body mass index and height in relation to site-specific risks of colorectal cancers in adult life

As colorectal cancers have a long latency period, their origins may lie early in life. Therefore childhood body mass index (BMI; kg/m²) and height may be associated with adult colorectal cancer. Using a cohort design, 257,623 children from The Copenhagen School Health Records Register born from 1930 to 1972 with measured heights and weights at ages 7 to 13 years were followed for adult colon and rectal adenocarcinomas by linkage to the Danish Cancer Registry. Hazard ratios (HRs) with 95% confidence intervals (CI) were estimated by Cox proportional hazard regressions. During follow-up, 2676 colon and 1681 rectal adenocarcinomas were diagnosed. No sex differences were observed in the associations between child BMI or height and adult colon or rectal cancers. Childhood BMI and height were positively associated with colon cancer; at age 13 years the HRs were 1.09 (95% CI 1.04–1.14) and 1.14 (95% CI 1.09–1.19) per z-score, respectively. Children who were persistently taller or heavier than average, had increased risk of colon cancer. Similarly, growing taller or gaining more weight than average was positively associated with colon cancer. No associations were observed between BMI or height and rectal cancer. Childhood BMI and height, along with above average change during childhood are significantly and positively associated with adult colon cancers, but not with rectal cancer, suggesting different etiologies.     

Health-related quality of life and body mass index among US adolescents

Purpose

To examine the magnitude of differences in health-related quality of life (HRQOL) by body mass index (BMI) in a population-based sample of United States adolescents overall and by sex, and to provide national prevalence estimates of reported HRQOL outcomes for not only obese and overweight but also underweight adolescents.

Methods

From the 2001 through 2010 cross-sectional National Health and Nutrition Examination Surveys, we estimated the percentages of four HRQOL outcomes—self-rated health, physically unhealthy days, mentally unhealthy days, and activity limitation days—in four BMI categories—obese, overweight, normal weight, and underweight—of approximately 6,000 US adolescents aged 12–17 years. We also estimated the percentages for boys and girls separately.

Results

Substantial gaps in self-rated health exist between normal-weight adolescents and those who are obese and overweight, but not underweight. Eighteen percent (95 % CI 15–22) of obese adolescents reported fair or poor health compared to only 5 % (95 % CI 4–7) of normal-weight adolescents. Thirty-seven percent (95 % CI 33–42) of obese adolescents reported excellent or very good health, compared to 65 % (94 % CI 63–67) of normal-weight adolescents. However, all BMI groups reported similar percentages of physically unhealthy days, mentally unhealthy days, and activity limitation days. The associations between HRQOL and BMI groups did not vary by sex. Boys generally reported significantly better self-rated health and mental health than girls. Specifically, obese boys reported better self-rated health, mental health, and fewer activity limitation days than obese girls.

Conclusions

Substantially, significant differences in some domains of HRQOL are found between above normal-weight and normal-weight US adolescents. This relationship between BMI and HRQOL is robust and observed among both boys and girls.     

Age-appropriate body mass index in children with achondroplasia: interpretation in relation to indexes of height

BACKGROUND: Achondroplasia is the most common short stature skeletal dysplasia, with an estimated worldwide prevalence of 250 000. Body mass index (BMI)-for-age references are required for weight management guidance for children with achondroplasia, whose body proportions are unlike those of the average stature population. OBJECTIVE: This study used weight and height data in a clinical setting to derive smoothed BMI-for-age percentile curves for children with achondroplasia and explored the relation of BMI with its components, weight and height. DESIGN: This was a longitudinal observational study of anthropometric measures of children with achondroplasia from birth through 16 y of age. RESULTS: The analysis included 1807 BMI data points from 280 children (155 boys, 125 girls) with achondroplasia. As compared with the BMI of peers of average stature, the BMI in children with achondroplasia is higher at birth, lacks a steep increase in infancy and a later nadir between 1 and 2 y of age, and remains substantially higher through 16 y of age in both sexes. Patterns of change in height and weight in children with achondroplasia are unique in that there is no overlap in the height distribution after 6 mo of age and no spike in height velocity during infancy or puberty-the 2 periods of greatest linear growth in individuals of average stature. CONCLUSIONS: Sex- and age-specific BMI curves are available for children with achondroplasia (birth to 16 y of age) for health surveillance and future research to determine associations with health outcomes (eg, cardiovascular disease, diabetes, and indication for and outcome of surgery).     

Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union

An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women) to calculate the underestimation of body weight as assessed by body image among the overweight and obese population and identify the associated factors to this behavior. Participants were older than 15 years and they were living in the 15 European Union countries. Body mass index (BMI) was grouped into 4 categories using the cutpoints established by the WHO, while perceived body image (PBI) was assessed using a nine-silhouettes drawing. The degree of underestimation between PBI as compared to BMI was identified in overweight and obesity categories of BMI. A multivariable logistic regression model for each gender was used to adjust for potentially confounding variables. Men classified themselves worse than women, being more likely to underestimate their body weight (65.2% of men underestimated their weight vs 32.2% women), regardless of other socioeconomic and attitudinal variables. The greatest degree of underestimation was observed in Mediterranean individuals (68.7% of men and 37.9% of women underestimated their weight). The subjects in the 'maintenance' stage of physical activity tended more often to wrongly select their actual image (71.8% for men and 38.7% for women).