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Nashandi HL, Monyeki MA, Reilly JJ. Validation of mid-arm circumference for surveillance of obesity in African adolescent girls and adult women. Br J Nutr 2023; 130:1437-1443. [PMID: 36890660 PMCID: PMC10511682 DOI: 10.1017/s0007114523000387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/18/2023] [Accepted: 02/01/2023] [Indexed: 03/10/2023]
Abstract
This study aimed to assess the validity of mid-arm circumference (MAC), also known as mid-upper arm circumference (MUAC), for classification of high body fatness in Namibian adolescent girls and women and to test whether classification accuracy of MUAC was higher than the traditional simple proxy for high fatness, the BMI. In 206 adolescent girls aged 13-19 years and 207 adult women aged 20-40 years, we defined obesity conventionally (BMI-for-age Z score ≥ 2·00, adolescents; adults BMI ≥ 30·0 kg/m2) and also defined obesity using published MAC cut-off values. 2H oxide dilution was used to measure total body water (TBW) to define high body fat percentage (≥ 30 % in the adolescents, ≥ 38 % in the adults), and we compared the ability of BMI and MAC to classify high body fatness correctly using sensitivity, specificity and predictive values. In the adolescents, obesity prevalence was 9·2 % (19/206) using BMI-for-age and 63·2 % (131/206) using TBW; sensitivity of BMI-for-age was 14·5 % (95 % CI 9·1, 22·0 %) but was improved significantly using MAC of 22·6 cm (sensitivity 96·9 %; 95 % CI 92·1 %, 99·3 %). In the adults, obesity prevalence was 30·4 % (63/207) using BMI and 57·0 % (118/207) using TBW, and sensitivity of BMI was 52·5 % (95 % CI 43·6, 62·2 %), but using a MAC of 30·6 cm sensitivity was 72·8 % (95 % CI 66·4, 82·6 %). Surveillance of obesity in African adolescent girls and adult women is likely to be improved substantially by use of MAC as an alternative to the BMI-for-age and BMI.
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Affiliation(s)
- Hilde L. Nashandi
- Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom2520, South Africa
- School of Nursing and Public Health, Faculty of Health Sciences and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Makama A. Monyeki
- Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom2520, South Africa
| | - John J. Reilly
- JJ Reilly, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
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Morikawa SY, Takeda Y, Fujihara K, Ikeda I, Kobayashi A, Hatta M, Mitsuma Y, Horikawa C, Ishiguro H, Yamada T, Ogawa Y, Sone H. Associations among metabolic health, weight status, and various physical fitness components in Japanese adolescents: a cross-sectional study (NICE EVIDENCE study- Agano 3). J Sports Sci 2023; 41:1279-1289. [PMID: 37881015 DOI: 10.1080/02640414.2023.2268358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/01/2023] [Indexed: 10/27/2023]
Abstract
Aim was to examine associations among metabolic health, weight status, and various physical fitness (PF) components in 1744 Japanese adolescents aged 13-14. Anthropometric measurements and PF tests (20 m shuttle run test [20mSRT], handgrip strength/body mass [HG], standing long jump [SLJ], and sit ups [SU]) were administered. The bottom sex-specific quintile of PF indicated "low fit". Participants were classified as non-overweight (non-OW) or overweight/obese (OW) according to the International Obesity Task Force. Clustered metabolic risk was defined as the sum of Z scores for mean arterial pressure, non-high-density lipoprotein cholesterol, and HbA1c, divided by three, and ≥ 1 SD. Combination of weight status and scores for HG or SU were additively associated with clustered metabolic risk. Compared with the non-OW-moderate-high fit group, the OW-low HG group was 3.05 (95%CI: 1.88-4.97) times more likely to have clustered metabolic risk although risk was not significantly elevated in the OW-moderate-high HG group (1.52 [95%CI: 0.88-2.62]). A similar association was observed between OW and low SU scores but not between OW and low 20mSRT or SLJ scores. Adolescents with OW and moderate-high HG or SU scores had a lower prevalence of an unfavourable metabolic state than those with OW and low HG or SU results.
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Affiliation(s)
- Sakiko Yoshizawa Morikawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
- Department of Food and Nutrition, Tokushima Bunri University Faculty of Human Life Science, Tokushima, Japan
| | - Yasunaga Takeda
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Izumi Ikeda
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Ayako Kobayashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
- Department of Nursing, Niigata College of Nursing, Joetsu, Japan
| | - Mariko Hatta
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yurie Mitsuma
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Chika Horikawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
- Department of Health and Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, Niigata, Japan
| | - Hajime Ishiguro
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Takaho Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yohei Ogawa
- Department of Pediatrics, Niigata University Faculty of Medicine, Niigata, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
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Sun X, Yan N, Peng W, Nguyen TT, Ma L, Wang Y. Association between body mass index and body fat measured by dual-energy X-ray absorptiometry (DXA) in China: a systematic review and meta-analysis. GLOBAL HEALTH JOURNAL 2023. [DOI: 10.1016/j.glohj.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Zhu Y, Wang Z, Maruyama H, Onoda K, Huang Q. Body Fat Percentage and Normal-Weight Obesity in the Chinese Population: Development of a Simple Evaluation Indicator Using Anthropometric Measurements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074238. [PMID: 35409919 PMCID: PMC8998592 DOI: 10.3390/ijerph19074238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 02/06/2023]
Abstract
Few studies explore the associations between body fat percentage (BFP) prediction and evaluation indicators for Chinese with normal-weight obesity. We aimed to explore convenient and cost-free BFP evaluation indicators to routinely monitor BFP status in Chinese patients with normal-weight obesity. Participants (N = 164) were divided into three groups according to body mass index (BMI) and BFP: normal-weight lean, normal-weight obese, and overweight and obese. Differences in body composition and circumference were compared to examine the relationship between BFP and circumference, determine a simple evaluation indicator reflecting BFP, and identify cutoff values for normal-weight obesity circumference. Significant differences in body composition and circumference were observed among the three groups. The correlation between thigh/height, hip/height, (hip + waist)/height, and BFP was stronger than that with BMI. The (hip + waist)/height ratio was the indicator most reflective of BFP (95% confidence interval: 3.004−9.018, p = 0.013), and a ratio above 1.115 (95% confidence interval: 0.936−0.992, p < 0.001) was predictive of normal-weight obesity. Furthermore, we suggest that the upper value for a normal BMI in Chinese individuals be lowered to 23.4 kg/m2 (95% confidence interval: 0.984−0.999, p < 0.001). The (hip + waist)/height ratio can be used with body mass index for a more accurate evaluations of BFP abnormalities and health risks.
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Affiliation(s)
- Yuetong Zhu
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi 324-8501, Japan;
| | - Zimin Wang
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8397, Japan
- Correspondence: ; Tel.: +81-070-3610-1857
| | - Hitoshi Maruyama
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan; (H.M.); (K.O.)
| | - Ko Onoda
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan; (H.M.); (K.O.)
| | - Qiuchen Huang
- Department of Physical Therapy, School of Rehabilitation Medicine, Capital Medical University, Beijing 100069, China;
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Liu N, Li H, Guo Z, Chen X, Cheng P, Wang B, Huang G, Shen M, Lin Q, Wu J. Prevalence and factors associated with overweight or obesity among 2- to 6-year-old children in Hunan, China: a cross-sectional study. Public Health Nutr 2022; 25:1-12. [PMID: 35034674 PMCID: PMC9991611 DOI: 10.1017/s136898002200012x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the prevalence of overweight or obesity (ow/ob) with WHO BMI cut-off points, International Obesity Task Force (IOTF) cut-off points and Chinese BMI criteria and examine its potential factors among preschool children in Hunan Province. DESIGN A cross-sectional survey including anthropometric measurements and questionnaires about children's information, caregivers' socio-demographic characteristics and maternal characteristics. χ2 tests and univariate and multivariate binary logistic regression were performed to evaluate the possible factors of ow/ob. SETTING Hunan, China, from September to October 2019. PARTICIPANTS In total, 7664 children 2 to 6 years of age. RESULTS According to Chinese BMI criteria, about 1 in 7-8 children aged 2-6 years had ow/ob in Hunan, China. The overall estimated prevalence of ow/ob among 2- to 6-year-old children was significantly higher when based on the Chinese BMI criteria compared with the WHO BMI cut-off points and IOTF cut-off points. According to Chinese BMI criteria, ow/ob was associated with residing in urban areas, older age, male sex, eating snacking food more frequently, macrosomia delivery, caesarean birth, heavier maternal prepregnancy weight and pre-delivery weight. CONCLUSION The prevalence of ow/ob in preschool children in Hunan Province remains high. More ow/ob children could be screened out according to Chinese BMI cut-offs compared with WHO and IOTF BMI criteria. In the future, targeted intervention studies with matched controls will be needed to assess the long-term effects of intervention measures to provide more information for childhood obesity prevention and treatment.
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Affiliation(s)
- Na Liu
- Department of Endocrinology, Xiang-Ya Hospital, Central South University, Hunan Province410008, People’s Republic of China
| | - Huixia Li
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, People’s Republic of China
| | - Zhanjun Guo
- Department of Endocrinology, Xiang-Ya Hospital, Central South University, Hunan Province410008, People’s Republic of China
| | - Xin Chen
- Department of Endocrinology, Xiang-Ya Hospital, Central South University, Hunan Province410008, People’s Republic of China
| | - Peng Cheng
- Department of Endocrinology, Xiang-Ya Hospital, Central South University, Hunan Province410008, People’s Republic of China
| | - Bian Wang
- Department of Endocrinology, Xiang-Ya Hospital, Central South University, Hunan Province410008, People’s Republic of China
| | - Guangwen Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, People’s Republic of China
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Qian Lin
- Xiangya School of Public Health, Central South University, Hunan Province, People’s Republic of China
| | - Jing Wu
- Department of Endocrinology, Xiang-Ya Hospital, Central South University, Hunan Province410008, People’s Republic of China
- Hunan Engineering Research Center for Obesity and its Metabolic Complications, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Hamad F, Mohammed SI, Mohamed AO, Elmustafa DOA. Patients’ characteristics, Cytochrome P4501A1 genetic polymorphisms and breast cancer risk in Sudanese women. SOUTH AFRICAN JOURNAL OF ONCOLOGY 2021. [DOI: 10.4102/sajo.v5i0.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Hypertension in Children with Obstructive Sleep Apnea Syndrome-Age, Weight Status, and Disease Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189602. [PMID: 34574528 PMCID: PMC8471072 DOI: 10.3390/ijerph18189602] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/03/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
Older age, obesity, and obstructive sleep apnea syndrome (OSAS) are known to increase the risk of hypertension in adults. However, data for children are scarce. This study aimed to investigate the relationships between hypertension, age, weight status, and disease severity in 396 children with OSAS. The prevalence rates of hypertension, obesity, and severe OSAS (apnea-hypopnea index ≥10) were 27.0%, 28.0%, and 42.9%, respectively. Weight z-score and apnea-hypopnea index were independently correlated with systolic blood pressure z-score, and minimal blood oxygen saturation (SpO2) was independently associated with diastolic blood pressure z-score. Overall, late childhood/adolescence (odds ratio (OR) = 1.72, 95% CI = 1.05–2.81), obesity (OR, 2.58, 95% CI = 1.58–4.22), and severe OSAS (OR = 2.38, 95% CI = 1.48–3.81) were independent predictors of pediatric hypertension. Furthermore, late childhood/adolescence (OR = 2.50, 95% CI = 1.10–5.71) and abnormal SpO2 (mean SpO2 < 95%; OR = 4.91, 95% CI = 1.81–13.27) independently predicted hypertension in obese children, and severe OSAS (OR = 2.28, 95% CI = 1.27–4.10) independently predicted hypertension in non-obese children. In conclusion, obesity, OSAS severity, and abnormal SpO2 are potentially modifiable targets to improve hypertension while treating children with OSAS.
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Shang J, Tan Z, Cheng Y, Tang Y, Guo B, Gong J, Ling X, Wang L, Xu H. A method for evaluation of patient-specific lean body mass from limited-coverage CT images and its application in PERCIST: comparison with predictive equation. EJNMMI Phys 2021; 8:12. [PMID: 33555478 PMCID: PMC7870732 DOI: 10.1186/s40658-021-00358-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 01/28/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Standardized uptake value (SUV) normalized by lean body mass ([LBM] SUL) is recommended as metric by PERCIST 1.0. The James predictive equation (PE) is a frequently used formula for LBM estimation, but may cause substantial error for an individual. The purpose of this study was to introduce a novel and reliable method for estimating LBM by limited-coverage (LC) CT images from PET/CT examinations and test its validity, then to analyse whether SUV normalised by LC-based LBM could change the PERCIST 1.0 response classifications, based on LBM estimated by the James PE. METHODS First, 199 patients who received whole-body PET/CT examinations were retrospectively retrieved. A patient-specific LBM equation was developed based on the relationship between LC fat volumes (FVLC) and whole-body fat mass (FMWB). This equation was cross-validated with an independent sample of 97 patients who also received whole-body PET/CT examinations. Its results were compared with the measurement of LBM from whole-body CT (reference standard) and the results of the James PE. Then, 241 patients with solid tumours who underwent PET/CT examinations before and after treatment were retrospectively retrieved. The treatment responses were evaluated according to the PE-based and LC-based PERCIST 1.0. Concordance between them was assessed using Cohen's κ coefficient and Wilcoxon's signed-ranks test. The impact of differing LBM algorithms on PERCIST 1.0 classification was evaluated. RESULTS The FVLC were significantly correlated with the FMWB (r=0.977). Furthermore, the results of LBM measurement evaluated with LC images were much closer to the reference standard than those obtained by the James PE. The PE-based and LC-based PERCIST 1.0 classifications were discordant in 27 patients (11.2%; κ = 0.823, P=0.837). These discordant patients' percentage changes of peak SUL (SULpeak) were all in the interval above or below 10% from the threshold (±30%), accounting for 43.5% (27/62) of total patients in this region. The degree of variability is related to changes in LBM before and after treatment. CONCLUSIONS LBM algorithm-dependent variability in PERCIST 1.0 classification is a notable issue. SUV normalised by LC-based LBM could change PERCIST 1.0 response classifications based on LBM estimated by the James PE, especially for patients with a percentage variation of SULpeak close to the threshold.
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Affiliation(s)
- Jingjie Shang
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Zhiqiang Tan
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Yong Cheng
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Yongjin Tang
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Bin Guo
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Jian Gong
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Xueying Ling
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Lu Wang
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China
| | - Hao Xu
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Road, Guangzhou, 510630, China.
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Development of population-specific prediction equations for bioelectrical impedance analyses in Vietnamese children. Br J Nutr 2020; 124:1345-1352. [PMID: 32616079 DOI: 10.1017/s000711452000241x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is a need for accurate, inexpensive and field-friendly methods to assess body composition in children. Bioelectrical impedance analysis (BIA) is a promising approach; however, there have been limited validation and use among young children in resource-poor settings. We aim to develop and validate population-specific prediction equations for estimating total fat mass (FM), fat free-mass (FFM) and percentage body fat (PBF) in Vietnamese children (4-7 years) using reactance and resistance from BIA, anthropometric variables and demographic information. We conducted a cross-sectional survey of 120 children. Body composition was measured using dual-energy X-ray absorptiometry (DXA), BIA and anthropometry. To develop prediction equations, we split all data into development (70 %) and validation datasets (30 %). The model performance was evaluated using predicted residual error sum of squares, root mean squared error (RMSE), mean absolute error (MAE) and R2. We identified a top performing model with the least number of parameters (age, sex, weight and resistance index or resistance and height), low RMSE (FM 0·70, FFM 0·74, PBF 3·10), low MAE (FM 0·55, FFM 0·62, PBF 2·49), high R2 (FM 0·95, FFM 0·92, PBF 0·82) and the least difference between predicted values and actual values from DXA (FM 0·03 kg or 0·01 sd, FFM 0·06 kg or 0·02 sd, PBF 0·27 % or 0·04 sd). In conclusion, we developed the first valid and highly predictive equations to estimate FM, FFM and PBF in Vietnamese children using BIA. These findings have important implications for future research on the double burden of disease and risks associated with overweight and obesity in young children.
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Measuring overweight and obesity in Chinese American children using US, international and ethnic-specific growth charts. Public Health Nutr 2020; 23:2663-2670. [PMID: 32611456 DOI: 10.1017/s1368980020000919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim is to determine the disparity between the overweight and obesity prevalence of Chinese American school-aged children and adolescents as measured by the Centers for Disease Control and Prevention (CDC) growth reference and the prevalence as measured by international and ethnic-specific-growth references. DESIGN This retrospective, cross-sectional study measured overweight and obesity prevalence among a paediatric population using the CDC, International Obesity Task Force (IOTF), World Health Organization (WHO) and an ethnic Chinese growth curve. SETTING A community health centre in New York City, USA. PARTICIPANTS Chinese American children aged 6-17 years in 2017 (N 9160). RESULTS The overweight prevalence was 24 % (CDC), 23 % (IOTF), 30 % (WHO) and 31 % (China). The obesity prevalence was 10 % (CDC), 5 % (IOTF), 10 % (WHO) and 10 % (China). When disaggregated by age and sex, the difference was the most prominent in girls; using the China reference compared with using the CDC reference almost doubles the overweight prevalence (school-aged: 31 v. 17 %, P < 0·001, adolescent: 27 v. 14 %, P < 0·001) and the obesity prevalence (school-aged: 11 v. 5 %, P < 0·001, adolescent: 7 v. 4 %, P < 0·001). CONCLUSIONS Use of the CDC reference compared with the Chinese ethnic-specific reference results in lower overweight and obesity prevalence in Chinese American girls. Almost half of the girls who were overweight and half of the girls who were obese were not identified using the CDC reference. Using ethnic-specific references or ethnic-specific cut-points may help improve overweight identification for Chinese American children.
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Comparison of different BMI cut-offs to screen for child and adolescent obesity in urban China. Public Health Nutr 2020; 23:2485-2493. [DOI: 10.1017/s1368980020000828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AbstractObjectives:To determine which set of BMI cut-offs is the most appropriate to define child and adolescent obesity in urban China.Design:A cross-sectional study was carried out between 1 November and 31 December in 2017.Setting:Community Healthcare Center in Minhang District, Shanghai, China.Participants:A total of 12 426 children and adolescents aged 7–17 years were selected by cluster random sampling. Bioelectrical impedance analysis was the gold standard to measure body composition.Results:Comparisons of three sets of BMI cut-offs by sensitivity and κ value revealed that the Working Group on Obesity in China (WGOC) (sensitivity 39·9–84·0 %; κ 0·51–0·79) and WHO (sensitivity 25·5–74·5 %; κ 0·35–0·78) cut-offs were not superior to the International Obesity Task Force (IOTF) (sensitivity 47·9–92·4 %; κ 0·58–0·85) cut-offs across all subgroups. The WGOC and WHO cut-offs yielded higher misclassification rates, in the worst case, categorising 11·2 % of girls with high adiposity as normal and 44·4 % of them as overweight, while the IOTF cut-offs categorised 2·3 % as normal and 30·7 % as overweight. Individuals who were classified by the IOTF cut-offs as overweight had the lowest ratios of high adiposity (4·2–41·6 %) than by the BMI cut-offs for each subgroup. Among pubertal girls, none of the BMI-based cut-offs indicated excellent agreement with body fat percentage, and κ value of the WHO cut-offs (0·35 (95 % CI 0·29, 0·41)) was lower than the other two sets of BMI cut-offs (all P < 0·001).Conclusions:The IOTF cut-offs for Asian should be recommended for child obesity screening in urban China. Pubertal individuals need a more accurate indicator of obesity screening.
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Mai TMT, Pham NO, Tran TMH, Baker P, Gallegos D, Do TND, van der Pols JC, Jordan SJ. The double burden of malnutrition in Vietnamese school-aged children and adolescents: a rapid shift over a decade in Ho Chi Minh City. Eur J Clin Nutr 2020; 74:1448-1456. [DOI: 10.1038/s41430-020-0587-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 11/09/2022]
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Body composition-derived BMI cut-offs for overweight and obesity in ethnic Indian and Creole urban children of Mauritius. Br J Nutr 2020; 124:481-492. [PMID: 31902380 PMCID: PMC7525118 DOI: 10.1017/s0007114519003404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
It is increasingly recognised that the use of BMI cut-off points for diagnosing obesity (OB) and proxy measures for body fatness in a given population needs to take into account the potential impact of ethnicity on the BMI–fat % relationship in order to avoid adiposity status misclassification. This relationship was studied here in 377 Mauritian schoolchildren (200 boys and 177 girls, aged 7–13 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent), with body composition assessed using an isotopic 2H dilution technique as reference. The results indicate that for the same BMI, Indians have more body fat (and less lean mass) than Creoles among both boys and girls: linear regression analysis revealed significantly higher body fat % by 4–5 units (P < 0·001) in Indians than in Creoles across a wide range of BMI (11·6–34·2 kg/m2) and body fat % (5–52 %). By applying Deurenberg’s Caucasian-based equation to predict body fat % from WHO-defined BMI thresholds for overweight (OW) and OB, and by recalculating the equivalent BMI values using a Mauritian-specific equation, it is shown that the WHO BMI cut-offs for OB and OW would need to be lowered by 4·6–5·9 units in Indian and 2·0–3·7 units in Creole children in the 7–13-year-old age group. These results have major implications for ethnic-based population research towards improving the early diagnosis of excess adiposity in this multi-ethnic population known to be at high risk for later development of type 2 diabetes and CVD.
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Adom T, Kengne AP, De Villiers A, Boatin R, Puoane T. Diagnostic Accuracy of Body Mass Index in Defining Childhood Obesity: Analysis of Cross-Sectional Data from Ghanaian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010036. [PMID: 31861542 PMCID: PMC6981394 DOI: 10.3390/ijerph17010036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/06/2019] [Accepted: 09/08/2019] [Indexed: 12/14/2022]
Abstract
Background: Screening methods for childhood obesity are based largely on the published body mass index (BMI) criteria. Nonetheless, their accuracy in African children is largely unknown. The diagnostic accuracies of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the International Obesity Taskforce (IOTF) BMI-based criteria in defining obesity using deuterium dilution as a criterion method in a sample of Ghanaian children are presented. Methods: Data on anthropometric indices and percent body fat were collected from 183 children aged 8–11 years. The sensitivity, specificity, and predictive values were calculated. The overall performance of the BMI criteria was evaluated using the receiver operating characteristics area under the curve (AUC). Results: Overall sensitivity of WHO, CDC, and IOTF were 59.4% (40.6–76.3), 53.1% (34.7–70.9), and 46.9% (29.1–65.3) respectively. The overall specificity was high, ranging from 98.7% by WHO to 100.0% by IOTF. The AUC were 0.936 (0.865–1.000), 0.924 (0.852–0.995), and 0.945 (0.879–1.000) by the WHO, CDC, and IOTF criteria respectively for the overall sample. Prevalence of obesity by the WHO, CDC, IOTF, and deuterium oxide-derived percent body fat were 11.5%, 10.4%, 8.2%, and 17.5% respectively, with significant positive correlations between the BMI z-scores and percent body fat. Conclusions: The BMI-based criteria were largely specific but with moderate sensitivity in detecting excess body fat in Ghanaian children. To improve diagnostic accuracy, direct measurement of body fat and other health risk factors should be considered in addition to BMI.
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Affiliation(s)
- Theodosia Adom
- School of Public Health, Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7535, South Africa;
- Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra LG80, Ghana;
- Correspondence:
| | - André Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa;
| | - Anniza De Villiers
- Division of Research Capacity Development, South African Medical Research Council, Cape Town 7505, South Africa;
| | - Rose Boatin
- Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra LG80, Ghana;
| | - Thandi Puoane
- School of Public Health, Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7535, South Africa;
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15
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Rathnayake N, Alwis G, Lenora J, Lekamwasam S. Development & cross-validation of anthropometric predictive models to estimate the appendicular skeletal muscle mass in middle-aged women in Sri Lanka. Indian J Med Res 2019; 150:297-305. [PMID: 31719301 PMCID: PMC6886138 DOI: 10.4103/ijmr.ijmr_1961_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & objectives: Attempts have been made to estimate appendicular skeletal muscle mass (ASMM) using anthropometric indices and most of these are country specific. This study was designed to develop and cross-validate simple predictive models to estimate the ASMM based on anthropometry in a group of healthy middle-aged women in Sri Lanka. Methods: The study was conducted on a randomly selected group of community-dwelling women aged 30-60 years. ASMM (kg) quantified with dual-energy X-ray absorptiometry (DXA) (ASMMDXA) was used as the reference standard. Anthropometric measurements such as body weight (kg), height (m), limb circumferences (cm) and skinfold thickness (mm) which showed significant correlations with ASMMDXA, were used to develop the models. The models were developed using a group of 165 women (aged 30-60 yr) and were cross-validated using a separate sample of women (n=167) (mean age: 48.9±8.56 yr), selected randomly. Results: Nine anthropometry-based models were developed using weight, height, skinfold thicknesses, circumferences, body mass index, menopausal status (MS) and age as independent variables. Four models which were based on height, weight, triceps skinfold thickness (TSFT), age and MS met all the validation criteria with high correlations (ranged 0.89-0.92) and high predictive values explaining high variance (80-84%) with low standard error of estimate (1.10-1.24 kg). Interpretation & conclusions: The four models (ASMM 1-ASMM 4) developed based on height, weight, TSFT, age and MS showed a high accuracy in estimating the ASMM in middle-aged women.
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Affiliation(s)
- Nirmala Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, Galle, Sri Lanka
| | - Gayani Alwis
- Department of Anatomy, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Janaka Lenora
- Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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16
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Hamiel U, Pinhas-Hamiel O, Vivante A, Bendor C, Bardugo A, Afek A, Beer Z, Derazne E, Tzur D, Behar D, Itzhak A, Skorecki K, Tirosh A, Grossman E, Twig G. Impact of Immigration on Body Mass Index and Blood Pressure Among Adolescent Males and Females: A Nationwide Study. Hypertension 2019; 74:1316-1323. [PMID: 31630574 DOI: 10.1161/hypertensionaha.119.13706] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Immigration from one cultural milieu to another has been associated with a greater risk for incident cardio-metabolic morbidity among adults. In this nationwide, population-based, cross-sectional study of data recorded from 1992 to 2016, we assessed the association between body mass index and blood pressure levels among adolescent immigrants, aged 16 to 19 years, of Ethiopian origin, and their secular trend of overweight and obesity. Adolescents of Ethiopian origin were classified as Israeli-born (n=16 153) or immigrants (N=23 487), with stratification by age at immigration. Adolescents whose fathers were at least 3 generations in Israel (n=277 789) served as a comparative group. Hypertensive-range blood pressure values adjusted for age, sex, and height served as outcome. Among adolescents of Ethiopian origin, overweight and obesity (body mass index ≥85th percentile), increased by 2.5 and 4-fold in males and females, respectively, during the study period, compared with a 1.5-fold increase among native Israeli-born males and females. The odds for hypertensive-range measurements increased with the length of residence in Israel: 7.3%, 10.6%, and 14.4% among males who immigrated at ages 12 to 19, 6 to 11.9, and 0 to 5.9 years, respectively; and 11.5%, 16.7%, and 19.3%, respectively, among females. Israeli-born Ethiopians had a significantly higher risk for hypertensive-range measurements at any body mass index level compared with native Israeli-born examinees, after adjusting for sociodemographic factors and health status. In conclusion, among Ethiopian Israeli adolescents, abnormal blood pressure correlates directly with the time-lapse since immigration. Immigrant populations require targeted surveillance and appropriate intervention.
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Affiliation(s)
- Uri Hamiel
- From the Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel (U.H.).,Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.)
| | - Orit Pinhas-Hamiel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.).,Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital (O.P.-H.), Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Asaf Vivante
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.).,Department of Pediatrics B and Pediatric Nephrology Unit (A.V.), Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Cole Bendor
- Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel (C.B., A.B., Z.B., D.T., A.I., G.T.).,Department of Military Medicine, Hebrew University School of Medicine, Jerusalem, Israel (C.B., A.B., Z.B., G.T.)
| | - Aya Bardugo
- Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel (C.B., A.B., Z.B., D.T., A.I., G.T.).,Department of Military Medicine, Hebrew University School of Medicine, Jerusalem, Israel (C.B., A.B., Z.B., G.T.)
| | - Arnon Afek
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.).,Central Management (A.A., E.G.), Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Zivan Beer
- Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel (C.B., A.B., Z.B., D.T., A.I., G.T.).,Department of Military Medicine, Hebrew University School of Medicine, Jerusalem, Israel (C.B., A.B., Z.B., G.T.)
| | - Estela Derazne
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.)
| | - Dorit Tzur
- Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel (C.B., A.B., Z.B., D.T., A.I., G.T.)
| | | | - Avi Itzhak
- Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel (C.B., A.B., Z.B., D.T., A.I., G.T.)
| | - Karl Skorecki
- Azrieli Faculty of Medicine, Bar-Ilan University (K.S.)
| | - Amir Tirosh
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.).,Institute of Endocrinology (A.T.), Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ehud Grossman
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.).,Central Management (A.A., E.G.), Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel (U.H., O.P.-H., A.V., A.A., E.D., A.T., E.G., G.T.).,Department of Medicine and the Dr. Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel (C.B., A.B., Z.B., D.T., A.I., G.T.).,Department of Military Medicine, Hebrew University School of Medicine, Jerusalem, Israel (C.B., A.B., Z.B., G.T.)
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17
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Chung S. Body composition analysis and references in children: clinical usefulness and limitations. Eur J Clin Nutr 2018; 73:236-242. [PMID: 30258101 DOI: 10.1038/s41430-018-0322-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022]
Abstract
The prevalence of obesity is increasing over the world. Especially in Asians compared to Caucasians, there has been a significant increase in the population with major chronic diseases. This has developed over a shorter time period which is associated with socioeconomic changes in recent decades and a greater predisposition to cardiometabolic disorders. Many Asians could be classified has having normal weight but with obesity as evidenced by body composition (BC) and fat distribution. Overweight in Asian adults is classified as a BMI > 23 kg/m2 and obesity as a BMI > 25 kg/m2. An effective strategy to manage the obesity epidemic by focusing on childhood obesity is needed because of the huge impact that obesity exerts on population health. However, monitoring tools are limited to anthropometry such as BMI and BMI z-scores which define overweight and obese as a BMI exceeding the 85th and 95th percentiles, respectively, on reference growth charts. To overcome the limitations of BMI, reference values for BC components have been produced using various techniques. The use of BC charts for children in personalized therapeutic approach has increased, although there is a lack of a consensus on a single reference technique. Zones on BC charts and the personalized values of BC components could be practical, especially for the detection of metabolically unhealthy normal weight (MUN) children. BC charts should be included in the growth chart package and BC monitoring through the entire life course will help us understand the association between growth, aging, health and disease.
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Affiliation(s)
- Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
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18
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Nikolaidis PT, Kintziou E, Georgoudis G, Afonso J, Vancini RL, Knechtle B. The Effect of Body Mass Index on Acute Cardiometabolic Responses to Graded Exercise Testing in Children: A Narrative Review. Sports (Basel) 2018; 6:E103. [PMID: 30241337 PMCID: PMC6316372 DOI: 10.3390/sports6040103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/12/2018] [Accepted: 09/18/2018] [Indexed: 01/12/2023] Open
Abstract
Although the beneficial role of exercise for health is widely recognized, it is not clear to what extent the acute physiological responses (e.g., heart rate (HR) and oxygen uptake (VO₂)) to a graded exercise test are influenced by nutritional status (i.e., overweight vs. normal-weight). Therefore, the main objectives of the present narrative review were to examine the effect of nutritional status on acute HR, and VO₂ responses of children to exercise testing. For this purpose, we examined existing literature using PubMed, ISI, Scopus, and Google Scholar search engines. Compared with their normal-body mass index (BMI) peers, a trend of higher HRrest, higher HR during submaximal exercise testing, and lower HRmax was observed among overweight and obese children (according to BMI). Independent from exercise mode (walking, running, cycling, or stepping), exercise testing was metabolically more demanding (i.e., higher VO₂) for obese and overweight children than for their normal-weight peers. Considering these cardiometabolic differences according to BMI in children might help exercise specialists to evaluate the outcome of a graded exercise test (GXT) (e.g., VO2max, HRmax) and to prescribe optimal exercise intensity in the context of development of exercise programs for the management of body mass.
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Affiliation(s)
| | - Eleni Kintziou
- School of Health Sciences, University of West Attica, 12243 Egaleo, Greece.
| | | | - José Afonso
- Faculty of Sport, University of Porto, 4200-450 Porto, Portugal.
| | - Rodrigo L Vancini
- Center of Physical Education and Sport, Federal University of Espírito Santo, 29075-910 Vitória, Brazil.
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 9001 Zurich, Switzerland.
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19
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Diouf A, Adom T, Aouidet A, El Hamdouchi A, Joonas NI, Loechl CU, Leyna GH, Mbithe D, Moleah T, Monyeki A, Nashandi HL, Somda SM, Reilly JJ. Body mass index vs deuterium dilution method for establishing childhood obesity prevalence, Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania. Bull World Health Organ 2018; 96:772-781. [PMID: 30455532 PMCID: PMC6239005 DOI: 10.2471/blt.17.205948] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 07/25/2018] [Accepted: 08/10/2018] [Indexed: 11/27/2022] Open
Abstract
Objective To compare the World Health Organization (WHO) body mass index (BMI)-for-age definition of obesity against measured body fatness in African children. Methods In a prospective multicentre study over 2013 to 2017, we recruited 1516 participants aged 8 to 11 years old from urban areas of eight countries (Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania). We measured height and weight and calculated BMI-for-age using WHO standards. We measured body fatness using the deuterium dilution method and defined excessive body fat percentage as > 25% in boys and > 30% in girls. We calculated the sensitivity and specificity of BMI z-score > +2.00 standard deviations (SD) and used receiver operating characteristic analysis and the Youden index to determine the optimal BMI z-score cut-off for classifying excessive fatness. Findings The prevalence of excessive fatness was over three times higher than BMI-for-age-defined obesity: 29.1% (95% CI: 26.8 to 31.4; 441 children) versus 8.8% (95% CI: 7.5 to 10.4; 134 children). The sensitivity of BMI z-score > +2.00 SD was low (29.7%, 95% CI: 25.5 to 34.2) and specificity was high (99.7%, 95% CI: 99.2 to 99.9). The receiver operating characteristic analysis found that a BMI z-score +0.58 SD would optimize sensitivity, and at this cut-off the area under the curve was 0.86, sensitivity 71.9% (95% CI: 67.4 to 76.0) and specificity 91.1% (95% CI: 89.2 to 92.7). Conclusion While BMI remains a practical tool for obesity surveillance, it underestimates excessive fatness and this should be considered when planning future African responses to the childhood obesity pandemic.
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Affiliation(s)
- Adama Diouf
- Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, BP 5005 Dakar Fann, Senegal
| | - Theodosia Adom
- Nutrition Research Centre, Ghana Atomic Energy Commission, Accra, Ghana
| | - Abdel Aouidet
- Association Tunisienne des Sciences de la Nutrition, Tunis, Tunisia
| | - Asmaa El Hamdouchi
- Unité Mixte de Recherche Nutrition et Alimentation CNESTEN-Université Ibn Tofail, Rabat, Morocco
| | - Noorjehan I Joonas
- Biochemistry Department; Victoria Hospital; Ministry of Health and Quality of Life, Quatre Bornes, Mauritius
| | - Cornelia U Loechl
- International Atomic Energy Agency, Vienna International Centre, Vienna, Austria
| | - Germana H Leyna
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Dar el Salaam, United Republic of Tanzania
| | - Dorcus Mbithe
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Thabisile Moleah
- International Atomic Energy Agency, Vienna International Centre, Vienna, Austria
| | - Andries Monyeki
- Physical Activity, Sport and Recreation, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | | | | | - John J Reilly
- School of Psychological Science and Health, University of Strathclyde, Glasgow, Scotland
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20
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Davidsson L, Al-Ghanim J, Al-Ati T, Al-Hamad N, Al-Mutairi A, Al-Olayan L, Preston T. Total Energy Expenditure in Obese Kuwaiti Primary School Children Assessed by the Doubly-Labeled Water Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101007. [PMID: 27754397 PMCID: PMC5086746 DOI: 10.3390/ijerph13101007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 11/30/2022]
Abstract
The aim of this pilot study was to assess body composition and total energy expenditure (TEE) in 35 obese 7–9 years old Kuwaiti children (18 girls and 17 boys). Total body water (TBW) and TEE were assessed by doubly-labeled water technique. TBW was derived from the intercept of the elimination rate of deuterium and TEE from the difference in elimination rates of 18O and deuterium. TBW was used to estimate fat-free mass (FFM), using hydration factors for different ages and gender. Fat mass (FM) was calculated as the difference between body weight and FFM. Body weight was not statistically different but TBW was significantly higher (p = 0.018) in boys (44.9% ± 3.3%) than girls (42.4% ± 3.0%), while girls had significantly higher estimated FM (45.2 ± 3.9 weight % versus 41.6% ± 4.3%; p = 0.014). TEE was significantly higher in boys (2395 ± 349 kcal/day) compared with girls (1978 ± 169 kcal/day); p = 0.001. Estimated physical activity level (PAL) was significantly higher in boys; 1.61 ± 0.167 versus 1.51 ± 0.870; p = 0.034. Our results provide the first dataset of TEE in 7–9 years old obese Kuwaiti children and highlight important gender differences to be considered during the development of school based interventions targeted to combat childhood obesity.
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Affiliation(s)
- Lena Davidsson
- Food and Nutrition Program, Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Jameela Al-Ghanim
- Food and Nutrition Program, Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Tareq Al-Ati
- Food and Nutrition Program, Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Nawal Al-Hamad
- The Public Authority for Food and Nutrition, Bayan 43600, Kuwait.
| | - Anwar Al-Mutairi
- Food and Nutrition Program, Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Lulwa Al-Olayan
- Food and Nutrition Program, Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Thomas Preston
- Stable Isotope Biochemistry Laboratory, Scottish Universities Environmental Research Centre, Rankine Avenue, Scottish Enterprise Technology Park, East Kilbride, Glasgow G75 0QF, UK.
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Titmuss AT, Srinivasan S. Metabolic syndrome in children and adolescents: Old concepts in a young population. J Paediatr Child Health 2016; 52:928-934. [PMID: 27301065 DOI: 10.1111/jpc.13190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 01/01/2023]
Abstract
Many years after first being described, there is still no clear consensus on diagnostic criteria for metabolic syndrome, particularly in children. However, identification of this cluster of cardiovascular risk factors especially in children with co-morbidities, is important in order to reduce their future risk of chronic disease and morbidity. Sustained multidisciplinary and family-based early intervention is required, aiming primarily at life-style change.
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Affiliation(s)
- Angela Therese Titmuss
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Shubha Srinivasan
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
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Falbe J, Cotterman C, Linchey J, Madsen KA. Ethnic Disparities in Trends in High BMI Among California Adolescents, 2003-2012. Am J Prev Med 2016; 51:e45-e55. [PMID: 27067033 PMCID: PMC4958536 DOI: 10.1016/j.amepre.2016.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Because California is home to one in eight U.S. children and accounts for the highest Medicaid and Children's Health Insurance Program spending, childhood obesity trends in California have important implications for the entire nation. California's racial/ethnic diversity and large school-based data set provide a unique opportunity to examine trends by race/ethnicity, including understudied Asian and American Indian youth, which has not been possible using national data sets. This study examined racial/ethnic disparities in prevalence of high BMI from 2003 to 2012. METHODS This observational study included 11,624,865 BMI records from repeated cross-sections of fifth-, seventh-, and ninth-graders who underwent California's school-based fitness testing. Analyses conducted in 2015 used logistic regression to identify trends in prevalence of high BMI (BMI ≥85th, 95th, and 97th percentiles) and differences in trends by race/ethnicity from 2003 to 2012. RESULTS African American and Hispanic girls and American Indian boys increased in prevalence of high BMI, whereas non-Hispanic white and Asian youth and Hispanic boys decreased in prevalence of high BMI (p-values<0.05) from 2003 to 2012. Over this period, African American, Hispanic, and American Indian youth had higher slopes for trends in high BMI than non-Hispanic white youth (p-values<0.05). CONCLUSIONS Based on California's statewide data, there is evidence that racial/ethnic disparities in prevalence of high BMI have widened over time. Minority youth have either decreased more slowly or increased in prevalence compared with non-Hispanic white youth. There continues to be an urgent need for policies and interventions that effectively reduce racial/ethnic obesity prevalence disparities.
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Affiliation(s)
- Jennifer Falbe
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California.
| | - Carolyn Cotterman
- Interdepartmental Group in Biostatistics, University of California, Berkeley, California
| | - Jennifer Linchey
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California
| | - Kristine A Madsen
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California
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Physical Therapy as Treatment for Childhood Obesity in Primary Health Care: Clinical Recommendation From AXXON (Belgian Physical Therapy Association). Phys Ther 2016; 96:850-64. [PMID: 26637641 DOI: 10.2522/ptj.20150206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 11/05/2015] [Indexed: 02/07/2023]
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24
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Total body water measurement using the 2H dilution technique for the assessment of body composition of Kuwaiti children. Public Health Nutr 2016; 18:259-63. [PMID: 26263176 DOI: 10.1017/s1368980013003534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The 2H dilution technique is the reference method to estimate total body water for body composition assessment. The aims of the present study were to establish the total body water technique at the Kuwait Institute for Scientific Research and assess body composition of Kuwaiti children. DESIGN The isotope ratio mass spectrometer was calibrated with defined international reference water standards. A non-random sampling approach was used to recruit a convenience sample of Kuwaiti children. A dose of 2H2O, 1-3 g, was consumed after an overnight fast and 2H enrichment in baseline and post-dose urine samples was measured. Total body water was calculated and used to estimate fat-free mass. Fat mass was estimated as body weight minus fat-free mass. SETTING The total body water study was implemented in primary schools. SUBJECTS Seventy-five boys and eighty-three girls (7-9 years). RESULTS Measurements of the isotope ratio mass spectrometer were confirmed to be accurate and precise. Children were classified as normal weight, overweight or obese according to the WHO based on BMI-for-age Z-scores. Normal-weight and overweight girls had significantly higher percentage body fat (median (range): 32·4 % (24·7-39·3 %) and 38·3 % (29·3-44·2 %), respectively) compared with boys (median (range): 26·5 % (14·2-37·1 %) and 34·6 % (29·9-40·2 %), respectively). No gender difference was found in obese children (median 46·5 % v. 45·6 %). CONCLUSIONS The establishment of a state-of-the-art stable isotope laboratory for assessment of body composition provides an opportunity to explore a wide range of applications to better understand the relationship between body size, body composition and risk of developing non-communicable diseases in Kuwait.
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Waist-to-height ratio as a measure of abdominal obesity in southern Chinese and European children and adolescents. Int J Obes (Lond) 2016; 40:1109-18. [PMID: 26813958 DOI: 10.1038/ijo.2015.251] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/02/2015] [Accepted: 11/16/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Waist-to-height ratio (WHtR), with a 0.5 threshold (WHtR0.5), is regarded as a simple age- and gender-independent criterion of abdominal obesity (AO) and a better predictor than the 90th percentile of waist circumference (WCP90). OBJECTIVE An analysis of gender and ethnic differences of WHtR and other AO indices between children and adolescents from southern China (HK: Hong-Kong, China) and Europe (LD: Łódź, Poland). SUBJECTS Two large cross-sectional surveys of children and adolescents aged 7-19 years, one from LD (13 172) and one from HK (14 566). METHODS The percentile and standardized values of WHtR and other parameters (WC, body mass index (BMI)) were assessed using the LMS method. The WHtR values corresponding to WCP90 and to the BMI definition of global obesity (BMIP95) were evaluated with the polynomial regression model. The compliance of the AO prevalence data, obtained with two criteria (WCP90 vs WHtR0.5) was analyzed using Cohen's kappa index (κC). RESULTS The WHtR data of Polish subjects were generally higher than those of their HK peers, and the ethic differences increased with age. The WHtR values of HK boys showed a stronger relationship with BMI z-score. WHtR corresponding to WCP90 assumed values <0.5. An application of Cohen's kappa coefficient (κC) to Polish subjects showed either 'substantial' (κC>0.6) or 'almost perfect' (κC>0.8) agreement in the AO prevalence for both criteria (WCP90 and WHtR0.5). For these criteria, either 'fair' (κC <0.4) or 'moderate' (κC<0.6) AO consistency ratings were observed among HK girls. In HK boys, a significant difference in the prevalence of AO was observed, independent of the criterion used. CONCLUSIONS Our results provide further evidence of the need for developing ethnic-specific WC charts and for recommending that a WHtR cutoff of 0.5 may not be appropriate to predict cardiometabolic risk in children of different ethnic groups.
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Fanidi A, Ferrari P, Biessy C, Ortega C, Angeles-Llerenas A, Torres-Mejia G, Romieu I. Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and breast cancer risk in the Cancer de Màma (CAMA) study. Public Health Nutr 2015; 18:3337-48. [PMID: 25805146 PMCID: PMC10271688 DOI: 10.1017/s1368980015000634] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 10/08/2014] [Accepted: 01/23/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We investigated the association between adherence to the recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and breast cancer (BC) risk in the Cancer de Màma (CAMA) study in a Mexican population. DESIGN Population-based case-control study. SUBJECTS Incident BC cases (n 1000) and controls (n 1074) matched on age, region and health-care system were recruited. SETTING In-person interviews were conducted to assess BC risk factors and habitual diet was assessed with an FFQ. Conformity to the WCRF/AICR recommendations was evaluated through a score incorporating seven WCRF/AICR components (body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks and breast-feeding), with high scores indicating adherence to the WCRF/AICR recommendations. RESULTS No statistically significant associations between WCRF/AICR score and risk of BC were observed. After excluding BMI from the WCRF/AICR score, the top quartile was associated with a decreased BC risk overall, with ORQ4-Q1=0.68 (95% CI 0.49, 0.92, P trend=0.03), and among postmenopausal women, with ORQ4-Q1=0.60 (95% CI 0.39, 0.94, P trend=0.03). Inverse associations were observed between BMI and risk of BC overall and among premenopausal women, with OR=0.57 (95% CI 0.42, 0.76, P trend <0.01) and 0.48 (95% CI 0.31, 0.73, P trend<0.01), respectively. Physical activity level was inversely associated with BC risk. CONCLUSIONS The WCRF/AICR index was not related with BC risk in the CAMA study. A combination of six components excluding BMI showed strong protective associations, particularly in postmenopausal women. Further prospective studies are required to clarify the role of adherence to WCRF/AICR recommendations, particularly with respect to BMI, in the Mexican population.
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Affiliation(s)
- Anouar Fanidi
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| | - Pietro Ferrari
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| | | | | | | | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
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Shinkai H, Iijima K, Koike T, Abe Y, Dairaku N, Inomata Y, Kayaba S, Ishiyama F, Oikawa T, Ohyauchi M, Ito H, Asonuma S, Hoshi T, Kato K, Ohara S, Shimosegawa T. Association between the body mass index and the risk of Barrett's esophagus in Japan. Digestion 2015; 90:1-9. [PMID: 25074386 DOI: 10.1159/000357776] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 12/06/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND We investigated the association between long-segment Barrett's esophagus and obesity in the Japanese population in a multicenter case-control trial. METHODS One hundred thirteen patients with endoscopically detected Barrett's esophagus with a length of more than 2 cm and the same number of sex- and age-matched controls were prospectively enrolled. Barrett's esophagus was diagnosed based on the Prague C and M criteria. The body mass index (BMI) of the subjects was categorized into the following groups: normal, BMI <22.9; overweight, BMI 23.0-24.9, and obese, BMI >25.0. To determine the association between BMI and the risk of Barrett's esophagus, multivariate logistic regression analyses were performed. RESULTS The basically adjusted regression model adjusted for smoking and alcohol consumption revealed that overweight and obesity were significantly associated with an elevated risk of Barrett's esophagus (OR 2.4, 95% CI 1.2-4.7, and OR 2.5, 95% CI 1.3-4.6, respectively). The intensity of the association was not attenuated even after adjustment for gastroesophageal reflux disease-related parameters. CONCLUSIONS An increased BMI was associated with an increased risk for Barrett's esophagus through a gastroesophageal reflux-independent mechanism in the Japanese population. Further, unlike in Caucasian populations, being even slightly overweight with a BMI of 23.0-24.9 was an independent risk factor in the Japanese population.
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Affiliation(s)
- Hirohiko Shinkai
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Kulkarni B, Kuper H, Taylor A, Wells JC, Radhakrishna KV, Kinra S, Ben-Shlomo Y, Smith GD, Ebrahim S, Byrne NM, Hills AP. Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women. J Appl Physiol (1985) 2013; 115:1156-62. [PMID: 23950165 PMCID: PMC3798815 DOI: 10.1152/japplphysiol.00777.2013] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Lean body mass (LBM) and muscle mass remain difficult to quantify in large epidemiological studies due to the unavailability of inexpensive methods. We therefore developed anthropometric prediction equations to estimate the LBM and appendicular lean soft tissue (ALST) using dual-energy X-ray absorptiometry (DXA) as a reference method. Healthy volunteers (n = 2,220; 36% women; age 18-79 yr), representing a wide range of body mass index (14–44 kg/m2), participated in this study. Their LBM, including ALST, was assessed by DXA along with anthropometric measurements. The sample was divided into prediction (60%) and validation (40%) sets. In the prediction set, a number of prediction models were constructed using DXA-measured LBM and ALST estimates as dependent variables and a combination of anthropometric indices as independent variables. These equations were cross-validated in the validation set. Simple equations using age, height, and weight explained >90% variation in the LBM and ALST in both men and women. Additional variables (hip and limb circumferences and sum of skinfold thicknesses) increased the explained variation by 5–8% in the fully adjusted models predicting LBM and ALST. More complex equations using all of the above anthropometric variables could predict the DXA-measured LBM and ALST accurately, as indicated by low standard error of the estimate (LBM: 1.47 kg and 1.63 kg for men and women, respectively), as well as good agreement by Bland-Altman analyses (Bland JM, Altman D.Lancet 1: 307–310, 1986). These equations could be a valuable tool in large epidemiological studies assessing these body compartments in Indians and other population groups with similar body composition.
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Affiliation(s)
- Bharati Kulkarni
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Genetic and Environmental Correlations Between Body Mass Index and Waist Circumference in China: The Qingdao Adolescent Twin Study. Behav Genet 2013; 43:340-7. [DOI: 10.1007/s10519-013-9597-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 05/22/2013] [Indexed: 01/06/2023]
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Role of obesity in the risk of breast cancer: lessons from anthropometry. JOURNAL OF ONCOLOGY 2013; 2013:906495. [PMID: 23431300 PMCID: PMC3575614 DOI: 10.1155/2013/906495] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 11/29/2012] [Indexed: 02/06/2023]
Abstract
An estimated 1.38 million new cases of breast cancer (BC) are diagnosed each year in women worldwide. Of these, the majority are categorized as invasive ductal cell carcinoma. Subgroups of BC are frequently distinguished into five "intrinsic" subtypes, namely, luminal A, luminal B, normal-like, HER2-positive, and basal-like subtypes. Epidemiological evidence has shown that anthropometric factors are implicated in BC development. Overall consistent positive associations have been observed between high body mass index (BMI) and waist-to-hip ratio (WHR) and the risk of BC among postmenopausal women, while conflicting results persist for premenopausal BC, both for BMI and for other anthropometric parameters as well as across ethnic groups. Furthermore, some evidence suggests that body size, body shape, and weight gain during childhood or adolescence may play a role in the risk of BC. In this paper, we describe the evidence linking anthropometric indices at different ages and BC risk, in order to improve our understanding of the role of body fat distribution in the risk of BC, investigate differences in these associations according to menopausal status and ethnic groups, and discuss the potential biological mechanisms linking body size and BC risk.
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Wulan SN, Westerterp KR, Plasqui G. Dietary and 24-h fat oxidation in Asians and whites who differ in body composition. Am J Clin Nutr 2012; 95:1335-41. [PMID: 22552026 DOI: 10.3945/ajcn.111.031369] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND With the same BMI, age, and sex, Asians were reported to have a higher body fat percentage than whites. OBJECTIVE This study aimed to determine the difference in body composition and its effect on dietary and 24-h fat oxidation between Asians and whites when they were fed a diet that contained 30% of energy as fat. DESIGN Seventeen Asians (8 men) were matched with 17 whites (8 men) for BMI, age, and sex. Physical activity was measured for 7 d with an accelerometer. During the last 3 d of the activity measurement, subjects were given a diet to maintain energy balances. Energy expenditure and substrate use were measured for 24 h in a respiration chamber. Dietary fat oxidation was determined from the percentage recovery of deuterium in the urine after a breakfast meal that contained deuterated palmitic acid. Body composition was calculated with a 3-compartment model from body mass, body volume (hydrodensitometry), and total body water (deuterium dilution). RESULTS Asians had 5% higher body fat than whites (28.1 ± 7.3% compared with 23.0 ± 6.9%, respectively; P = 0.03). The fat-free mass index tended to be lower in Asians than in whites (16.3 ± 1.6 compared with 17.0 ± 1.7 kg/m(2), respectively; P = 0.07). Dietary fat oxidation as a percentage of fat consumed was 11.7 ± 3.6% compared with 10.8 ± 4.5% (P = 0.50) for Asians and whites, respectively. In Asians and whites, the 24-h fat oxidation as a percentage of total energy expenditure was 17.7 ± 6.9% compared with 19.2 ± 5.1% (P = 0.63), respectively; carbohydrate oxidation was 68.0 ± 6.8% compared with 66.1 ± 5.1% (P = 0.51), respectively; and protein oxidation was 14.3 ± 2.2 compared with 14.7 ± 1.6% (P = 0.61), respectively. CONCLUSION Dietary and 24-h fat oxidation were not different between Asians and whites despite differences in body composition. This study was registered in the public trial registry at www.ccmo.nl as NL31217.068.10.
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Affiliation(s)
- Siti N Wulan
- Department of Human Biology, NUTRIM-School for Nutrition Toxicology and Metabolism, Maastricht University Medical Center, Universiteit Single 50, P.O. Box 616, 6200MD Maastricht,Netherlands.
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