Patterns of body weight change affect weight loss during a multidisciplinary intervention in adolescents with obesity

AimThe current pediatric obesity health challenge necessitates a better understanding of the factors affecting weight loss success during interventions. The aim of this observational study was to test the impact of the rate of initial weight loss and body weight variability on weight loss during a 9-month residential, multidisciplinary weight loss program in adolescents with obesity.MethodsThis retrospective study considered a whole sample of 510 adolescents with obesity (12–16 years, 435 girls). Body weight assessment was performed before (T0) and each week during the 9 months of a multidisciplinary weight loss program. Initial weight change (week 4-W4) and overall weight change at week 12 (T1) and the end of the intervention (T2) were considered. Participants were divided into three groups (tertiles), based on their percentage of weight loss between T0 and W4; and weight variability was expressed by the root mean square error (RMSE) around each participant’s regression line at each considered period (W4, T1, T2).ResultsAdolescents with lower initial weight loss at W4 (tertile 3) displayed the lesser weight loss at T1 and T2 compared with adolescents in tertile 1 and 2. The RMSE was positively associated with the percentage of weight loss of the period considered, but when the analyses were adjusted for age and initial body weight, there was no more significant association.ConclusionsThe rate of weight loss during the first few weeks is crucial for weight loss success, and weight variability is positively associated with weight loss in adolescents with obesity. Overall, results show that initial body weight is a determinant characteristic to consider during a lifestyle intervention. Further studies are thus needed to better understand the relationship between body weight change patterns and weight loss during the dynamic state that is adolescence.     

体质指数与体重控制知信行的关系研究

目的：了解城市不同体质指数（BMI ）人群对控制体重的健康认识、主动意识及相关行为。方法采用随机整群抽样的方法调查杭州市2个区18～45岁的公务员、企业管理人员和事业单位人员共1175人,分析不同BMI值职业人群对体重控制的知识、态度和行为。结果杭州市城市职业人群超重率为21.70％,肥胖率为6.04％。体重过轻、正常、超重和肥胖等BMI 值人群自评超重肥胖对身体健康有影响知晓率分别为98.95％、98.81％、96.08％和95.77％,对心理健康有影响知晓率分别为90.53％、92.44％、83.92％和81.69％,对控制体重有信心分别占82.11％、79.18％、72.94％和50.70％,呈随体重增高而降低的趋势,差异均有统计学意义（P＜0.05）。不同BMI值人群在体重控制行为方面,差异无统计学意义（P＞0.05）。在累积体重控制行为方面差异无统计学意义（P＞0.05）。结论不同BMI值人群在超重肥胖对个人的健康影响、控制体重的主动意识方面有差异,在采取体重控制行为方面无差异。     

上海市青少年危险行为现状研究(六) --减肥行为与相关因素分析

目的 了解上海市青少年减肥行为的情况，分析不良减肥行为的相关因素。方法 2002年4-6月，抽取上海市19个区县27所初级中学、26所高级中学、13所完中和39所中等职业学校三层，进行问卷调查，共调查学生9308人，有效调查表为9246份(99．3％)。结果 认为自己体重偏重和太重的学生中只有31．4％是真正超重和肥胖的。有36．3％的人在调查前的1个月中曾经通过锻练的方式来城肥或防止增重。有11．0％的学生在调查前的1个月中曾经通过节食、减少热卡或脂肪的摄入来减肥或防止增重。在相同的调查时间内，有1．6％的学生曾经有过24h或更长时间不进食，1．8％的学生曾经在没有医生处方的情况下服用过减肥药，1．3％的学生曾经通过呕吐或腹泻来减肥或防止增重。逐步非条件logistic回归分析结果表明超重与肥胖、性别、就读学校类别(初中和中职校学生)、地区和消极情绪与不良减肥行为显著相关。结论 青少年中营养评价和控制体重的教育亟待加强，提倡开展个性化健康教育来预防和控制不良减肥行为。     

Longitudinal study of body composition changes associated with weight change and physical activity

OBJECTIVE: Weight changes result in fat-free mass (FFM) and body fat (BF) changes. This study determined FFM and BF changes after weight gain or loss and whether these changes differ by gender, physical activity, and age. METHODS: Healthy volunteers, recruited between 1991 and 2003, were followed for 1 y (n = 400) or 3 y (n = 305). Active subjects performed >3 h of physical activity of > or =4.0 metabolic equivalents/wk, sedentary subjects performed <3 h/wk. Body weight and body composition by bioelectrical impedance analysis were determined at year 0, 1, or 3. RESULTS: At years 1 and 3, FFM and BF decreased with weight loss and increased with weight gain. BF was more sensitive (P < 0.03) to weight change than FFM. Compared to weight-stable individuals at year 1, weight gains of 1.0-1.9, 2.0-2.9, and > or =3.0 kg changed FFM by -0.04 (P = 0.90), +0.48 (P = 0.15), and +1.39 kg and BF by +1.35, +1.87, and +3.09 kg, respectively (all P < 0.001). Comparable FFM and BF decreases were observed for weight losses (FFM -0.28 kg, P = 0.38; -0.75 kg, P = 0.04; -1.51 kg, P < 0.001; BF -1.01 kg, P < 0.01; -1.55 kg, P = 0.01; -3.13 kg, P < 0.001). These relations were similar across gender and age strata. At year 1, active individuals were less likely to gain BF with weight gain and more likely to lose BF with weight loss than were sedentary individuals, except for weight losses >3 kg. At year 3, the association between body weight and FFM and BF change was similar between active and sedentary individuals. CONCLUSION: Greater weight changes (>3 kg) are necessary for weight change to have a significant effect on FFM than to have an effect on BF.     

Weight cycling is associated with body weight excess and abdominal fat accumulation: A cross-sectional study

Background & aims

To investigate the association between history of multiple weight loss diets followed by weight regain, namely weight cycling (WCy), and both body weight excess and abdominal fat accumulation.

Methods

A one-day cross-sectional survey (“Obesity-Day”) including 914 participants (605F:309M). Anthropometric variables (body mass index [BMI], waist circumference [WC] and waist-to-height ratio [WtHR]), covariates and WCy (≥5 intentional weight loss episodes of ≥5 kg followed by rapid return to pre-diet or higher body weight) were assessed by a self-administered questionnaire, interview and physical examination.

Results

Data on central fat accumulation (by WC and WtHR) were available in a representative sub-group (n = 600). WCy was reported by 119 participants (13.0%) of total population and by 79 (13.2%) of those with available data on central fat accumulation. At multivariable linear regressions WCy was independently associated with higher BMI (P = .004), WC (P = .011) and WtHR (P = .008). Sensitivity analyses, performed after excluding those being on a diet at the time of assessment, confirmed these findings.

Conclusions

A history of WCy appears related to body weight excess and abdominal fat accumulation. These findings support the importance of designing adequate weight loss programs to achieve long-term weight maintenance and to prevent undesirable and unhealthy weight accumulation.     

Associations among body size dissatisfaction, perceived dietary control, and diet history in African American and European American women

European American (EA) women report greater body dissatisfaction and less dietary control than do African American (AA) women. This study investigated whether ethnic differences in dieting history contributed to differences in body dissatisfaction and dietary control, or to differential changes that may occur during weight loss and regain. Eighty-nine EA and AA women underwent dual-energy X-ray absorptiometry to measure body composition and completed questionnaires to assess body dissatisfaction and dietary control before, after, and one year following, a controlled weight-loss intervention. While EA women reported a more extensive dieting history than AA women, this difference did not contribute to ethnic differences in body dissatisfaction and perceived dietary control. During weight loss, body satisfaction improved more for AA women, and during weight regain, dietary self-efficacy worsened to a greater degree for EA women. Ethnic differences in dieting history did not contribute significantly to these differential changes. Although ethnic differences in body image and dietary control are evident prior to weight loss, and some change differentially by ethnic group during weight loss and regain, differences in dieting history do not contribute significantly to ethnic differences in body image and dietary control.     

皖南地区某高校新生身高体质量和肥胖状况调查

目的了解某高校新入学大学生身高、体质量、肥胖状况,为预防保健工作提供依据。方法对某大学2007—2009年新入学的7 895名本科大学生,进行医学体格检查。结果某大学2007—2009年男、女新生平均体质量分别为(61.26±9.51)kg、(51.69±6.26)kg,平均身高分别为(172.35±5.97)cm、(161.53±5.47)cm,平均人体质量指数(BMI)分别为(20.47±2.80)和(19.80±2.10)kg/m2,三项指标男生均高于女生。以国际推荐亚洲成人肥胖诊断标准,新生体质量超标检出率为6.9%,肥胖检出率为4.0%,合计10.9%,男女体质量超标率和肥胖率差异有统计学意义(P<0.01)。以国内肥胖组推荐标准,新生体质量超标检出率为5.6%,肥胖检出率为1.2%,合计为6.8%,其中男生为10.6%,女生为3.8%,男女体质量超标率和肥胖率差异有统计学意义(P<0.01)。结论肥胖已成为影响大学生身心全面发展的重要因素之一,应加强健康教育,促进体育锻炼,增强自我保健意识。     

Adolescent satisfaction with postpartum contraception and body weight concerns

Purpose: To explore factors that could be related to adolescents' satisfaction with postpartum contraceptives.

Methods: Three focus groups were conducted with a total of 22 adolescent mothers. The groups covered four content areas: feelings about birth control since becoming a mother, decision making about contraceptive use, factors that would influence contraceptive discontinuation, and the perceived side effects of the current contraceptive. Audiotapes from the groups were analyzed to identify major themes.

Results: Nineteen subjects received Depo-Provera when they were discharged after delivery and the majority reported that menstrual irregularities and weight gain were side effects. Two body weight-related themes were dominant: dissatisfaction with heavier than desired body weights and resignation about not returning to prepregnancy weights.

Conclusions: Depo-Provera may be an effective contraceptive for adolescent mothers who are generally at high risk for rapid repeat pregnancy. This qualitative study suggests that contraceptive continuation may be enhanced with specific counselling to manage body weight concerns.     

成人拳头体积与身高体重及体重指数关系研究

目的分析成人拳头体积与体重指数(BMI)的回归关系,并比较不同方程的回归系数。方法采用分层整群抽样法抽取舟山地区20~80岁健康成人并测量身高、体重和拳头体积,比较不同BMI成人的拳头体积大小。建立不同性别人群拳头体积与BMI的回归方程,进一步通过协方差分析交互作用比较回归直线线性趋势。结果 415名调查对象中,男性占41.93%,女性占58.07%;男性身高、体重、BMI及拳头体积均高于女性(P0.01)。成人拳头体积与BMI有关,男性为Y=167.603+9.445 X,女性为Y=111.183+7.779 X,总人群为Y=77.157+11.028 X(R2=0.324、0.322和0.271,P0.05),式中Y为拳头体积,X为BMI;不同体型人群中拳头体积与身高有关(R2=0.501、0.432、0.624和0.692,P0.05),且影响程度相同(P=0.07)。不同BMI人群的拳头体积不同(P0.01),超重体型(365.641±68.514)m L和肥胖体型(365.641±68.514)m L的拳头体积均大于偏瘦体型(261.081±59.478)m L和正常体型(314.261±59.590)m L,正常体型拳头体积大于偏瘦体型(P0.01)。结论成人拳头体积男性大于女性,拳头体积与BMI密切相关,不同体型人群中身高对拳头体积影响程度相同。     

烟台市0～7岁儿童身高、体重和体质指数的探讨

目的:建立烟台市0~7岁青少年儿童年龄别身高(HFA)、年龄别体重(WFA)及年龄别体质指数(BMl)百分位标准及体质指数。方法:采用分层整群随机抽样法,收集烟台市0~7岁11747例儿童(男6261例,女5486例)、出生年月及2003~2005年身高和体重测量资料。应用LMS方法建立烟台市0~7岁儿童HFA、WFA和BMI百分位曲线。结果:运用LMS软件,分别获得0~7岁男女WFA、HFA和BMI百分位曲线各9条,为P3、P5、P10、P25、P50、P75、P90、P95和P97。烟台市男、女儿童的身高、体重随年龄增长不断增加,男、女儿童各年龄段P50年龄别身高百分位值与WHOP50比较无显著性差异。男童0~5岁的体重略高于WHO标准,但差距不大,5岁以后明显高于WHO;女孩在0~5岁与WHO标准基本接近。结论:应用LMS软件,获得了烟台市0~7岁儿童身高、体重和BMI百分位参考值。     

徐州市0~7岁儿童身高、体重与体质指数研究

目的:对比世界通用的一些标准,建立徐州市0~7岁儿童年龄别身高(HFA)、年龄别体重(WFA)及年龄别体质指数(BM I)百分位标准及体质指数超重和肥胖界值点。方法:①采用分层整群随机抽样法,收集徐州市0~7岁儿童11 747例的性别、出生年月及2002~2004年身高和体重测量资料。②应用LMS方法建立徐州市0~7岁儿童HFA、WFA和BM I百分位曲线。结果:①运用LMS软件,分别获得0~7岁男女童HFA、WFA和BM I百分位曲线各9条,为P3、P5、P10、P25、P50、P75、P90、P95和P97。②徐州市男女童的身高随年龄不断增加,男童到6岁以后逐渐减缓,女童5岁后逐渐减缓。徐州市男女童的身高在7岁之前均大于WHO标准。③徐州市男女童的体重随年龄不断增加,到6岁以后均逐渐减缓。徐州市男女童体重7岁之前均高于WHO标准。④根据国际肥胖工作小组制定的7岁男女儿童肥胖和超重界值点,徐州市男女童7岁时通过该界值点的BM I百分位分别为:男童第72.6和第92.6,女童第82.1和第96.5。7岁男女童的超重流行率分别为27.4%和17.9%,肥胖流行率分别为7.4%和3.5%,在性别上存在差异。结论:应用LMS软件,获得了徐州市0~7岁儿童身高、体重和BM I百分位参考值。     

Postpartum weight retention in relation to gestational weight gain and pre-pregnancy body mass index: A prospective cohort study in Vietnam

BackgroundThe prevalence of maternal overweight and obesity is increasing in Asia. This study prospectively investigated the association between pre-pregnancy body mass index (BMI), gestational weight gain (GWG) and 12-month postpartum weight retention (PPWR) in a large cohort of Vietnamese mothers.MethodsOf the 2030 pregnant women recruited from three cities in Vietnam at 24–28 weeks of gestation, a total of 1666 mothers were followed up for 12 months after delivery and available for analysis. The outcome variable PPWR was determined by subtracting the pre-pregnancy weight from the 12-month postpartum measured weight, while GWG and pre-pregnancy BMI were classified according to the Institute of Medicine and WHO criteria for adults, respectively. Linear regression models were used to ascertain the association between pre-pregnancy BMI, GWG and PPWR accounting for the effects of plausible confounding factors.ResultsBoth pre-pregnancy BMI and GWG were significantly associated with PPWR (P < 0.001). The adjusted mean weight retention in underweight women before pregnancy (3.71 kg, 95% confidence interval (CI) 3.37–4.05) was significantly higher than that in those with normal pre-pregnancy weight (2.34 kg, 95% CI 2.13–2.54). Women with excessive GWG retained significantly more weight (5.07 kg, 95% CI 4.63–5.50) on average at 12 months, when compared to mothers with adequate GWG (2.92 kg, 95% CI 2.67–3.17).ConclusionsBeing underweight before pregnancy and excessive GWG contribute to greater weight retention twelve months after giving birth. Interventions to prevent postpartum maternal obesity should target at risk women at the first antenatal visit and control their weight gain during the course of pregnancy.     

不同体重指数孕期体重增长指导的重要性

目的:总结目前该院正常产前检查(产检)的不同体重指数孕妇妊娠期体重增长的情况,并对其妊娠结局进行分析,指出根据不同体重指数进行正确体重增长指导的重要性。方法:对2009年1月～2010年1月在该院检查及分娩的2 557例孕妇进行分析,按孕妇孕前体重指数(BMI)进行分组,计算出不同组别的孕期体重增长值,并与2009年Institute of Medicine(IOM)体重增长指南进行比较,得出超出指南建议体重的比率,并随访妊娠结局。结果:四组孕妇体重超出指南建议的比率分别为38.36%、40.77%、65.36%、63.64%。这些孕妇与正常孕妇相比,剖宫产率、妊娠期糖尿病(GDM)、妊娠期高血压疾病(HDCP)、产后出血的发生率均升高,差异存在统计学意义(P<0.05)。结论:妊娠期提供正确的体重增长指导有着重要的意义,可以减少不良的妊娠结局,并可以减少妇女及后代肥胖症的发生。     

孕妇体重指数及其增长对妊娠结局影响的临床研究

目的:探讨孕期体重指数及其增长对妊娠结局的影响。方法:测量450例孕产妇的孕前体重、身高和孕期体重增加情况,计算体重指数(BM I),并随访妊娠结局。结果:超重组和肥胖组的妊娠高血压疾病、阴道助产、剖宫产、巨大儿以及高危新生儿率均明显高于消瘦组和正常组,但妊娠期糖尿病(GDM)+妊娠期糖耐量异常(G IGT)、产后出血和低体重儿较消瘦组和正常组略高,无统计学差异;C组的剖宫产率和巨大儿率明显高于A组和B组,而妊娠高血压疾病、GDM+G IGT、阴道助产、产后出血、低体重儿和高危新生儿率均略高于A组和B组,但无统计学差异。结论:孕期体重指数及其增长是影响妊娠结局的重要因素。     

Determinants of blood pressure in 7th grade Jerusalem school children

The determinants of blood pressure level were analyzed in a group of 1154 Jerusalem school children aged 12.After controlling for age, significant differences in blood pressure measurements were found between three groups: boys, pre-menarche girls and post-menarche girls. A comparison of the means of selected biological variables showed that girls who have reached menarche have levels of systolic blood pressure, weight, height and Quetelet's index higher than boys and pre-menarche girls. However, levels of triceps skinfold thickness and pulse rate were similar in the two groups of girls and higher than in boys. Using multiple regression analysis, we found that much of the variance (boys 29%, post-menarche girls 21% and pre-menarche girls 15%) of systolic blood pressure, could be explained by a combination of biological variables (Quetelet, pulse rte, triceps skinfold thickness and height) while these variables explained a much 'smaller proportion (boys 12%, postmenarche girls 17% and pre-menarch 9%) of diastolic blood pressure variance. The predictive power of systolic blood pressure by the measured biological variables was higher in boys than in girls, However, diastolic blood pressure was better predicted by the biological variables in the group of girls with menarche than in other groups.Elevated blood pressure was observed in 3.2% of the examined children. High values for Quetelet's index were observed in 6.4%. The prevalence of elevated measurements of blood pressure and Quetelet's index were significantly higher in girls with menarche. Among children aged 12, the association between socio-demographic characteristics and blood pressure level was weak, as measured in multiple regression analysis.     

Factors associated with body dissatisfaction in non-clinical adolescents at risk of eating disorders

Aim To examine factors (individual, familiar and socio-cultural) associated with body dissatisfaction (BD) by gender in non-clinical adolescents at risk of eating disorders (rED) and in a control group (CG). Subjects and methods A total of 2,967 adolescent students was screened using the Eating Attitudes Test-40 and the Youth’s Inventory-4. Of these, 217 students (161 girls and 56 boys) identified as being at rED were chosen for the study, and 208 students (168 girls and 40 boys) were chosen as the CG. The subjects were given the Body Areas Satisfaction Test, the Youth’s Inventory-4, a questionnaire to evaluate social influences on the “model of thinness” (SI-MT), the Family Environment Scale, and their body mass index (BMI) was determined. Results BD frequency in at-risk girls (44.6%) was significantly higher than in boys (27.3%). Girls at rED were most dissatisfied with their weight. BMIs were significantly higher and energy intake was significantly lower in dissatisfied girls than in satisfied girls at rED. In girls at rED, multiple linear regression analyses showed that SI-MT factors and dysthymia were associated with BD. In the CG, higher BMI were associated with BD. These relationships were not found in adolescent boys. Conclusion Within the at-risk group, adolescents with BD had higher BMIs, consumed fewer calories, were more influenced by socio-cultural factors and had more emotional issues than those who were satisfied. We suggest that although high BMIs are associated with BD, the interaction with other social and psychopathological characteristics increases the risk of the development of eating disorders.     

Tattooing and body piercing as lifestyle indicator of risk behaviors in Brazilian adolescents

Tattooing and body piercing may be visible markers to identify adolescents whose lifestyle may put them at a higher risk for morbidity and mortality. In 664 Brazilian adolescents we found 8.4% of body modifications. Further, sexual experience, illicit drug, alcohol consumption, and anti-HBc positivity were independently associated with them. These data suggest the potential risk of tattooing/body piercing in our youths.