Automobile traffic around the home and attained body mass index: A longitudinal cohort study of children aged 10–18 years

ObjectivesThe objective of this study is to examine the relationship between measured traffic density near the homes of children and attained body mass index (BMI) over an eight-year follow up.MethodsChildren aged 9-10 years were enrolled across multiple communities in Southern California in 1993 and 1996 (n = 3318). Children were followed until age 18 or high school graduation to collect longitudinal information, including annual height and weight measurements. Multilevel growth curve models were used to assess the association between BMI levels at age 18 and traffic around the home.ResultsFor traffic within 150 m around the child's home, there were significant positive associations with attained BMI for both sexes at age 18. With the 300 m traffic buffer, associations for both male and female growth in BMI were positive, but significantly elevated only in females. These associations persisted even after controlling for numerous potential confounding variables.ConclusionsThis analysis yields the first evidence of significant effects from traffic density on BMI levels at age 18 in a large cohort of children. Traffic is a pervasive exposure in most cities, and our results identify traffic as a major risk factor for the development of obesity in children.     

Aminotransferase levels,body mass index,and the risk of diabetes: a prospective cohort study

Purpose

To investigate whether the relationship between body mass index (BMI) and incident diabetes is modified by different alanine or aspartate aminotransferases (ALT or AST) levels.

Does low body mass index matter? Relationship between body mass index and subjective well-being among long-lived women over 95 years of age

Objectives

To examine the relationship between body mass index (BMI) and subjective well-being (SWB) among long-lived women over 95 years of age and evaluate whether this relationship is mediated by functional ability.

Design

Retrospective cohort study.

Setting

Data from the Rugao longevity cohort, a population-based study in Rugao, China.

Participants

A sample of 342 long-lived women (mean age 97.4 ± 2.1, range 95–107) whose SWB and other covariates were available were included in this study.

Measurements

BMI was calculated as weight in kilograms divided by height in meters-squared (kg/m²). SWB was measured by life satisfaction (LS), positive affect (PA), negative affect (NA) and affect balance (AB). Functional ability was assessed by the Katz Index of Activities of Daily Living (ADL).

Results

According to BMI classification standards for China, the underweight group had lower levels of LS than the normal and overweight groups (28.62 vs. 30.51 and 31.57, respectively; p<.05). Correlation analysis showed that BMI was significantly related to LS (r = 0.166, p<.01). The strength of the BMI and LS association was diminished when ADL was included in the general linear regression models. Mediation analysis revealed that ADL mediated this relationship (effect size = 22.6%). We did not observe significant associations of BMI with other SWB components (PA, NA, and AB).

Conclusion

For long-lived women, low BMI, rather than elevated BMI, is an indicator of poor psychological well-being. The findings call for public health awareness about low body weight in long-lived women, especially in those with physical disabilities when focusing on quality of life.

     

Familial aggregation of body mass index and subcutaneous fat measures in the longitudinal Québec family study

Family resemblance for several measures of body fat and fat distribution was explored in the longitudinal Québec Family Study (QFS), including an overall measure of adiposity (body mass index, BMI), total subcutaneous fat (the sum of 6 skinfolds, SF6), and subcutaneous fat distribution (the trunk to extremity ratio, TER). Repeated measures were taken twice approximately 12 years apart. A longitudinal familial correlation model was used to assess familial resemblance at each of times 1, 2, and cross-time, and a univariate model was used for the change score. The change score was assumed to index the degree to which different familial factors impacted on the longitudinal resemblance, while the cross-time comparisons indexed similar familial factors across time. For BMI, the maximal heritability was 44 and 36% at times 1 and 2, respectively, 37% for the change score, and 33-43% for the cross-time comparison. While the etiology of the BMI familial effect at times 1, 2, and cross-time was assumed to be primarily polygenic, that for the change score was a function of cohort effects (environmental). For SF6, the maximal heritability (primarily genetic) was low at time 1 and for the change score (16%), but was nonsignificant at time 2 and cross-time. For TER, the maximal heritabilities were significant for each of times 1 (42%), 2 (40%), change score (59%), and cross-time comparisons (35-36%). In summary, simple univariate familial correlation analysis of the change scores and bivariate analysis of the longitudinal measures are useful in delineating the underlying factors leading to both change and stability across time.     

Women’s body mass index and oral administration of Misoprostol for induction of labor – A retrospective cohort study

Pregnant women who are obese are at greater risk of pregnancy complications, including preeclampsia, gestational diabetes, and macrosomia, leading to an increased likelihood of induced labor. Little is known about pregnant women with obesity and the dose of Misoprostol needed for induction of labor (IOL). To investigate whether the cumulative dose of Misoprostol needed for induction of labor (IOL) is associated with women’s body mass index (BMI), we conducted a retrospective study of the use of oral Misoprostol for IOL at the Department of Obstetrics and Gynecology, Aarhus University Hospital – a tertiary referral delivery unit with 4800 deliveries a year. Data on IOL among 1637 women with singleton pregnancies was collected in the period January 1st, 2014, to October 4th, 2017. Low-risk women were induced in an outpatient setting. Primary outcomes were Misoprostol dose, time between start of induction (first dose of Angusta®) and completed delivery, and mode of delivery. Secondary outcomes were neonatal data as Apgar score and pH of the umbilical artery. In this study, we found the total dose of Misoprostol needed for induction increased significantly with increasing BMI (p < 0.005). The time to delivery and the risk of Cesarean section increased with rising BMI class. However, 76% of inductions among the women with obesity ended in a vaginal delivery. For the neonatal outcomes, a total of 16 children had an Apgar score below 7 at five minutes and 14 had a pH less than 7.0; none of these results differed significantly between BMI classes. The perinatal and maternal mortality rate was 0%.     

Is body mass index a measure of adiposity in elderly women?

OBJECTIVE: To evaluate the accuracy of body mass index (BMI) as a predictor of body fat in elderly women. RESEARCH METHODS AND PROCEDURES: A total of 1423 women aged 67 +/- 5 (mean +/- SD, range: 60 to 88) years were consecutively enrolled into the study. Fat mass (FM) was measured using DXA. RESULTS: BMI explained 72.9% of FM variance (p < 0.0001), with a root mean square error of estimate (RMSE) of 3.5 kg. After standardization of RMSE on the dependent variable as RMSE%, the prediction error equaled 15%. BMI explained 54.8% of FM% variance (p < 0.0001), with an RMSE of 4.1%, corresponding to an RMSE% of 11%. DISCUSSION: The relatively high RMSE% of the FM and FM%-BMI associations caution against the use of BMI as an adiposity index in individual elderly women. However, an error corresponding to 11% of FM% may be accepted for population studies of body fat in elderly women.     

Association of self-perceived body image with body mass index and type 2 diabetes—The ADDITION-PRO study

ObjectiveWeight loss is important for prevention of type 2 diabetes and an accurate self-perceived body image can promote weight reduction. We evaluated the association of self-perceived body image with body mass index (BMI) and type 2 diabetes.MethodsData from the Danish ADDITION-PRO cohort study (2009–2011) were used. A total of 2082 men and women attended a health examination including assessment of BMI, waist circumference, the Stunkard scale of self-perceived obesity and an oral glucose tolerance test for assessment of diabetes risk.ResultsMean (SD) age was 66.2 (6.9) years and 24% were obese (BMI ≥ 30 kg/m²). However, only 7% of obese men and 11% of obese women perceived themselves as obese. Among obese women, for a given level of BMI and waist circumference, one unit higher self-perceived body image was associated with 52% (95% CI: 14–73) lower risk of having type 2 diabetes and 45% (95% CI: 12–65) lower risk of having pre-diabetes. Overweight, but not obese, men had a 35% (95% CI: 36–56) lower risk of type 2 diabetes per unit increase in body image.ConclusionsObese individuals seem to underestimate their body shape. However, having a realistic body image (higher self-perceived obesity) is independently associated with lower diabetes risk. Self-perceived body image might serve as a valuable tool for type 2 diabetes risk assessment.     

Association between dietary glycemic index, glycemic load, and body mass index in the Inter99 study: is underreporting a problem?

BACKGROUND: The few studies examining the potential associations between glycemic index (GI), glycemic load (GL), and body mass index (BMI) have provided no clear pictures. Underreporting of energy intake may be one explanation for this. OBJECTIVE: We examined the associations between GI, GL, and BMI by focusing on the confounding factor of total energy intake and the effect of exclusion of low energy reporters (LERs). DESIGN: This was a cross-sectional study of 6334 subjects aged 30-60 y. Dietary intake was estimated from a food-frequency questionnaire. GI and GL were estimated by using white bread as the reference food. Underreporting of energy intake was assessed as reported energy intake divided by basal metabolic rate (EI/BMR); LERs were defined as those having an EI/BMR < 1.14. Univariate and multiple linear regression models were used to test for associations between GI, GL, and BMI. The confounders were sex, age, smoking, physical activity, alcohol intake, and energy intake. All analyses were conducted on 1) the entire population and 2) a subsample excluding LERs. RESULTS: In the univariate analyses of the entire population, GL was inversely associated with BMI. No association was observed for GI. After full adjustment (including energy intake), both GI and GL were positively associated with BMI. When LERs were excluded, GL was positively associated with BMI in all analyses, and GI was positively associated with BMI in the multiple analyses. CONCLUSIONS: We showed a positive association between GI, GL, and BMI. Energy adjustment and the exclusion of LERs significantly affected the results of the analysis; thus, we stress the importance of energy adjustment.     

Ten years of progress in the Hokkaido birth cohort study on environment and children’s health: cohort profile—updated 2013

The Hokkaido Study on Environment and Children’s Health is an ongoing cohort study that began in 2002. The study consists of two prospective birth cohorts, the Sapporo cohort (n = 514) and the Hokkaido large-scale cohort (n = 20,940). The primary goals of this study are to first examine the potential negative effects of perinatal environmental chemical exposures on birth outcomes, including congenital malformations and growth retardation; second, to evaluate the development of allergies, infectious diseases and neurodevelopmental disorders and perform longitudinal observations of the children’s physical development to clarify the causal relationship between these outcomes and environmental chemicals; third, to identify individuals genetically susceptible to environmental chemicals; finally, to identify the additive effects of various environmental factors in our daily life, such as secondhand smoke exposure or low folate intake during early pregnancy. In this paper, we introduce our recent progress in the Hokkaido study with a cohort profile updated in 2013. For the last ten years, we followed pregnant women and their offspring, measuring various environmental chemicals, i.e., PCB, OH-PCB and dioxins, PFCs (Perfluorinated Compounds), Organochlorine pesticides, Phthalates, bisphenol A and mercury. We discovered that the concentration of toxic equivalents (TEQ) of dioxin and other specific congeners of PCDF or PCDD have effects on birth weight, infants’ neurodevelopment and immune function. There were significant gender differences in these effects; our results suggest that male infants have more susceptibility to those chemical exposures than female infants. Interestingly, we found maternal genetic polymorphisms in AHR, CYP1A1 or GSTs that significantly modified the dioxin concentrations in maternal blood, suggesting different dioxin accumulations in the bodies of individuals with these genotypes, which would lead to different dioxin exposure levels. These genetic susceptibility factors influenced the body size of children born from mothers that either smoked or were passively exposed to tobacco smoke. Further studies investigating the correlation between epigenetics, the effects of intrauterine exposure to environmental chemicals and developmental factors related to health and disease are warranted.     

Is body mass index a risk factor for motor vehicle driver injury? A cohort study with prospective and retrospective outcomes

OBJECTIVE: To investigate the association between risk of motor vehicle driver injury and body mass index (BMI). METHODS: In a cohort study of 10 525 New Zealand men and women, BMI was assessed in 1992-1993 (baseline), and data on deaths and hospitalizations for motor vehicle driver injury were obtained by record linkage to national health databases for the period 1988-1998. Hazard ratios (HR) and CI were estimated by Cox regression. RESULTS: During a mean 10.3 years of follow-up, 139 fatal and non-fatal driver injury cases occurred (85 before baseline and 54 after). A U-shaped association was observed between driver injury risk and BMI, both crudely and after adjustment for covariates, which included age, sex, driving exposure, and alcohol intake (P-values for quadratic trend /=28.7 kg/m(2); HR = 2.00, 95% CI: 1.18-3.39) and lowest (<23.5 kg/m(2); HR = 2.17, 95% CI: 1.27-3.73) quartiles of BMI were twice as likely to have experienced a driver injury during the follow-up period as participants in the reference quartile (25.9-28.6 kg/m(2); HR = 1.00). CONCLUSION: Further research is needed to corroborate or refute the hypothesis that BMI is a risk factor for serious motor vehicle driver injury.     

Is consumption of breakfast associated with body mass index in US adults?

OBJECTIVE: To test the hypothesis that breakfast consumption is associated with weight status measured by body mass index in US adults. DESIGN: Analyses of data from the National Health and Nutrition Examination Survey, 1999-2000. PARTICIPANTS/SETTING: Men and women aged > or = 19 years (N=4,218), excluding pregnant and/or lactating women. STATISTICAL ANALYSES PERFORMED: SAS (release 8.1, 2000, SAS Institute Inc, Cary, NC) and SUDAAN (release 8.0.2, 2003, Research Triangle Institute, Research Triangle Park, NC) software were used to calculate sample-weighted means, standard errors, and population percentages of breakfast consumers. Multiple logistic and linear regression models, with controls for covariates, were used to determine the predictability of body mass index from breakfast consumption and from inclusion of ready-to-eat cereal (RTEC) in the breakfast meal. RESULTS: Breakfast consumers were more likely than breakfast nonconsumers to be older, female, white, nonsmokers, regular exercisers, and trying to control their weight. For women, daily energy intake was higher among breakfast consumers than among breakfast nonconsumers; for both men and women, energy intake from fat among RTEC breakfast consumers was significantly lower than among non-RTEC breakfast consumers, whereas energy from carbohydrate among RTEC breakfast consumers was significantly higher than among non-RTEC breakfast consumers. For women, the odds ratios for BMI > or = 25 were lower for breakfast consumers (odds ratio = 0.76) and RTEC breakfast consumers (odds ratio = 0.70) compared with breakfast nonconsumers and non-RTEC breakfast consumers, respectively, after adjusting the models for covariates. When RTEC consumption was added as a covariate, breakfast consumers no longer exhibited significantly lower odds ratios compared with breakfast nonconsumers. Furthermore, regression analyses supported an inverse association between RTEC breakfast consumption and body mass index in women (regression coefficient = -0.37, P<.01) after adjusting for covariates. CONCLUSIONS: When we document the association of breakfast consumption with lower prevalence of overweight and obesity, types of meal should be considered as an important determinant. RTEC breakfast consumption, associated with a desirable macronutrient profile for preventing obesity, predicted weight status in women, but not in men. In addition to sex difference in the association of breakfast consumption and RTEC breakfast consumption with lower prevalence of overweight, the effects of physiological variables and health-related behaviors on the relationship between total and RTEC intake at breakfast and weight status, remain to be established.     

Validity of self-reported weight and height and the body mass index within the "Pró-saúde" study

OBJECTIVE: Evaluate the validity of self-reported weight and height and the body mass index (BMI). METHODS: A study was made of 3,713 employees of a public university in Rio de Janeiro, in which they were participants in Phase 1 of a longitudinal study. Information was obtained through a self-administered questionnaire, and measurements were carried out after its application. Student's paired t-test, Bland & Altman's graphs and the intraclass correlation coefficient (ICC) were utilized to evaluate the differences between the measured and the reported parameters. The sensitivity and specificity of the various BMI categories were estimated. RESULTS: There was high agreement between the measured and reported weights (ICC=0.977) and heights (ICC=0.943). The BMI sensitivity, in its various categories, was around 80%, and the specificity was close to 92%. There was a slight and uniform tendency toward self-reported weight underestimation and self-reported height overestimation in both sexes. CONCLUSIONS: Self-reported and measured weight and height information had good agreement and validity. In similar populations, when few resources are available, it is possible to use self-reported data instead of actual measurements.     

Does physical activity modify the association between body mass index and colorectal adenomas?

Although both physical inactivity and obesity have been associated with an increased risk of colorectal adenomas, it is unclear whether physical activity modifies the relationship between obesity and colorectal adenomas or through what mechanism this might occur. The aim of this study is to evaluate whether physical activity modifies the relationship between body mass index (BMI) and colorectal adenomas and whether apoptosis is a plausible mechanism responsible for this effect modification. Study subjects were part of a large, cross-sectional study, the Diet and Health Study III. Consecutive patients underwent colonoscopy between August 1998 and March 2000. Apoptosis was measured by morphological evaluation of hematoxylin and eosin-stained sections obtained from rectal pinch biopsy samples. There were 226 patients with adenomas and 494 adenoma-free controls. When comparing overweight subjects with the referent group (high physical activity/normal BMI), the relative odds of having an adenoma decreased as physical activity increased: low (odds ratio, OR=1.6; 95% confidence interval, CI=0.7-3.4); moderate (OR=1.1; 95% CI=0.6-2.0); and high (OR=0.8; 95% CI=0.4-1.6). When comparing obese subjects with the referent group, relative odds of having an adenoma were increased regardless of physical activity level. Apoptosis was not associated with obesity or physical activity. Our results suggest that physical activity may modify the association between obesity and colorectal adenoma until a high level of obesity is achieved. Apoptosis does not appear to be associated with obesity or physical activity.     

Do cigarette taxes affect children's body mass index? The effect of household environment on health

Several recent studies demonstrate a positive effect of cigarette prices and taxes on obesity among adults, especially those who smoke. If higher cigarette costs affect smokers' weights by increasing calories consumed or increasing food expenditures, then cigarette taxes and prices may also affect obesity in children of smokers. This study examines the link between child body mass index (BMI) and obesity status and cigarette costs using data from the National Longitudinal Survey of Youth-79 (NLSY79). Controlling for various child, mother, and household characteristics as well as child-fixed effects, I find that cigarette taxes and prices increase BMI in the children of smoking mothers. Interestingly, and unlike previous research findings for adults, higher cigarette taxes do not increase the likelihood of obesity in children. These findings are consistent with a causal mechanism in which higher cigarette costs reduce smoking and increase food expenditures and consumption in the household.     

Absolute fat mass, percent body fat, and body-fat distribution: which is the real determinant of blood pressure and serum glucose?

Associations of body mass index (BMI), absolute fat mass, percent body fat, and regional fat distribution with concentrations of fasting blood glucose and blood pressure were examined cross-sectionally in 1551 men and women aged 15-79 y from two study centers. Measurements included height, weight, multiple skinfold thicknesses, body density by underwater weighing, and waist and hip girths. Three principal findings emerged: 1) Absolute overall body mass and fat mass were stronger predictors of blood pressure and blood glucose than were relative fat mass, after age, height, and current cigarette-smoking status were adjusted for; 2) when diastolic blood pressure and serum glucose were used as the external validity criteria, densitometry was not a "gold standard" for body composition associated with risk for increased blood pressure and serum glucose; and 3) BMI was as good a predictor of blood pressure and glucose as was any other measure of body fat in nearly all analyses.     

Psychosocial health and life-events – dynamical development in the short term. A follow-up study of children at four and six years of age

In this paper, (1) the psychosocial health in relation to (2) life-events was assessed among 156 children attending 20 schools by parents and teachers with the Child Behavior Checklist and the Caregiver-Teacher Report Form at the ages of four and six. Life-events were reported by parents. (1) According to the report, 93–96% children had no psychosocial problems. Parents and teachers report significant improvement of externalising (behavioural) problems and total problems in children with psychosocial problems at point of time 1. Teachers also report improvement of internalising (emotional) problems. Parents and teachers agree in 8–25% of the cases. (2) Of the children 46% experienced life events, no correlation was found with changes in psychosocial health. Findings may be explained by regular school attendance, resilience of the children and variability in the normative development. Remarkable dynamic is observed in change of psychosocial problems. Psychosocial development in early childhood is rather liable to change and life-events do not strongly influence psychosocial health.