Accuracy of BMI and waist circumference cut-off points to predict obesity in older adults

Assessment of the performance of the body mass index in diagnosing obesity in community-dwelling older adults in Latin American and Caribbean countries

BACKGROUND

The body mass index (BMI) ≥30 kg/m2 is the universally accepted cut-off point for defining obesity; however, its accuracy in classifying obesity in older adults is poorly understood.

OBJECTIVES

To assess the performance of the BMI cut-off point ≥30 kg/m2 in classifying obesity in older adults, using the fat mass index (FMI) and fat mass percentage (FM%) as reference criteria; and to establish region- and sex-specific BMI-based cut-off points to classify obesity in older adults.

METHODS

The present study is a secondary analysis derived from a cross-sectional project that included a sample of 1463 older adults from ten Latin American and Caribbean countries. Volunteers underwent total body water measurements using the deuterium dilution technique to determine FMI and FM%. Accuracy of the BMI and derived cutoff points was assessed by the area under the receiver operating characteristic curve (AUC).

RESULTS

The BMI cut-off point ≥30 kg/m2 had low sensitivity for classifying obesity in these older adults compared to the FMI and FM%. The AUC values for the optimal BMI-derived cut-off points showed an acceptable-to-outstanding discriminatory capacity in diagnosing obesity defined by the FMI. There was also a better balance between sensitivity and specificity than with the values obtained by a BMI ≥30 kg/m2 in older subjects in both regions.

CONCLUSION

The BMI cut-off point ≥30 kg/m2 had poor sensitivity for accurately diagnosing obesity in older adults from two regions. The region- and sex-specific BMI-derived cut-off points for defining obesity using the FMI are more accurate in classifying obesity in older men and women subjects from both regions.

Association between Sarcopenia and Reduced Bone Mass: Is Osteosarcopenic Obesity a New Phenotype to Consider in Weight Management Settings?

Sarcopenic obesity (SO) is a frequent phenotype in people with obesity; however, it is unclear whether this links with an impaired bone status. In this study, we aimed to investigate the association between SO and low bone mass, and to assess the prevalence of a new entity that combines excessive fat deposition, reduced muscle mass and strength, and low bone mass defined as osteosarcopenic obesity (OSO). Body composition was completed by a DXA scan in 2604 participants with obesity that were categorized as with or without SO, and with low or normal bone mineral content (BMC). Participants with both SO and low BMC were defined as OSO. Among the entire sample, 901 (34.6%) participants met the criteria for SO. This group showed a reduced mean BMC (2.56 ± 0.46 vs. 2.85 ± 0.57, p < 0.01) and displayed a higher prevalence of individuals with low BMC with respect to those without SO (47.3% vs. 25.9%, p < 0.01). Logistic regression analysis showed that the presence of SO increases the odds of having low BMC by 92% [OR = 1.92; 95% CI: (1.60-2.31), p < 0.05] after adjusting for age, body weight, and body fat percentage. Finally, 426 (16.4%) out of the total sample were affected by OSO. Our findings revealed a strong association between SO and reduced bone mass in adults with obesity, and this introduces a new phenotype that combines body fat, muscle, and bone (i.e., OSO) and appears to affect 16% of this population.

Optimal Cut-Off Values for Body Mass Index and Fat Mass Index Based on Age in Physically Active Males Using Receiver Operating Characteristic Curve

This study aims to redefine obesity cut-off points for body mass index (BMI) and fat mass index (FMI) according to the different age groups of physically active males. Healthy physically active volunteers (N = 1442) aged 18-57 years (y), with a mean BMI = 22.7 ± 2.8 kg/m2, and mean FMI = 4.3 ± 1.7 kg/m2 were recruited from various fitness centers. BMI was calculated and individuals were categorized according to the Asia-Pacific BMI criterion of ≤22.9 kg/m2 and the previous WHO-guided BMI criterion of ≤24.9 kg/m2. FMI was also calculated for the study participants with a cut-off of 6.6 kg/m2. Redefining of BMI and FMI cut-off values was carried out based on different age groups categorized with a difference of 10 y and 5 y using the receiver operating characteristic (ROC) curve and Youden's index. For the entire study population, BMI redefined cut-off points for overweight and obesity were 23.7 kg/m2 and 24.5 kg/m2, respectively, while FMI redefined cut-off points for overweight and obesity were 4.6 kg/m2 and 5.7 kg/m2, respectively. With 10 y of age group difference, a constant BMI and FMI values were observed, while with 5 y of age group difference, a constant increase in the BMI cut-offs was observed as the age group increased, i.e., from 23.3 kg/m2 in 20-24 y to 26.6 kg/m2 in ≥45 y and a similar trend was seen in FMI cut-offs. To conclude, our study suggests that age-dependent BMI and FMI cut-off points may provide appropriate measurements for physically active males as the age group increases.

Sex differences in the association between dynapenic abdominal obesity and onset of disability in activities of daily living among adults aged ≥50 years: A prospective analysis of the Irish Longitudinal Study on Ageing

BACKGROUND

Sex differences in the longitudinal relationship between dynapenic abdominal obesity, i.e., impairment in muscle strength and high waist circumference, and disability in activities of daily living have not been investigated to date. Therefore, we aimed to examine sex differences in the longitudinal association between dynapenic abdominal obesity at baseline and the onset of disability in activities of daily living during a four-year follow-up period among Irish adults aged ≥50 years.

METHODS

Data from Wave 1 (2009-2011) and Wave 3 (2014-2015) of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as waist circumference of >88 cm for women and >102 cm for men. Dynapenic abdominal obesity was defined as having both dynapenia and abdominal obesity. Disability was defined as having difficulty with at least one of six activities of daily living (dressing, walking, bathing, eating, getting in or out of bed, using the toilet). Multivariable logistic regression was conducted to assess associations.

RESULTS

Data on 4471 individuals aged ≥50 years and free of disability at baseline were analyzed [mean (SD) age 62.3 (8.6) years; 48.3 % males]. In the overall sample, compared to no dynapenia and no abdominal obesity, dynapenic abdominal obesity was associated with 2.15 (95%CI = 1.17-3.93) times higher odds for incident disability at 4-year follow-up. This association was significant among men (OR = 3.78; 95%CI = 1.70-8.38) but not among women (OR = 1.34; 95%CI = 0.60-2.98).

CONCLUSIONS

Interventions to prevent or address dynapenic abdominal obesity may aid in the prevention of disability, especially among men.

A New Approach Using BMI and FMI as Predictors of Cardio-Vascular Risk Factors among Mexican Young Adults

The study aimed to identify accurate cut-off points for waist circumference (WC), body fat percentage (BF%), body mass index (BMI), fat mass index (FMI), and fat-free mass index (FFMI), and to determine their effective accuracy to predict cardiovascular risk factors (CVRFs) among Mexican young adults. A cross-sectional study was conducted among 1730 Mexican young adults. Adiposity measures and CVRFs were assessed under fasting conditions. The optimal cut-off points were assessed using the receiver operating characteristic curve (ROC). Age-adjusted odds ratios (OR) were used to assess the associations between anthropometric measurements and CVRFs. The cut-off values found, in females and males, respectively, for high WC (≥72.3 and ≥84.9), high BF% (≥30 and ≥22.6), high BMI (≥23.7 and ≥24.4), high FMI (≥7.1 and ≥5.5), and low FFMI (≤16 and ≤18.9) differ from those set by current guidelines. High BMI in women, and high FMI in men, assessed by the 50th percentile, had the best discriminatory power in detecting CVRFs, especially high triglycerides (OR: 3.07, CI: 2.21-4.27 and OR: 3.05, CI: 2.28-4.08, respectively). Therefore, these results suggest that BMI and FMI measures should be used to improve the screening of CVRFs in Mexican young adults.

Waist-to-Height Ratio: A Sensitive Tool for Assessing the Need for Nutritional Risk Management in Elderly Populations from Brazil

INTRODUCTION

Nutritional status assessment commonly relies on body mass index (BMI), which overlooks lean mass and adipose tissue distribution. However, waist circumference (WC) and waist-to-height ratio (WHtR) provide additional insights into fat accumulation. By combining these indices, it may be possible to identify older adults needing weight management interventions.

OBJECTIVES

To assess the WC and WHtR as strategies for identifying individuals requiring weight management.

METHODS

A cross-sectional study was conducted with 509 elderly individuals in Northeast Brazil. Weight, height, hip circumference, and waist circumference were measured, and combined with indices such as BMI WC, WHR, and WHtR to identify those who require weight management. The DeLong test compared areas under the curves using receiver operating characteristic curves and statistical significance. Sensitivity, specificity, and positive and negative predictive values were calculated to verify usefulness for clinical application. A validation sample of 599 elderly individuals from the country's Southern region was used to confirm the results.

RESULTS

Both WC and WHtR showed adequate diagnostic accuracy with no statistically significant difference in AUCs. WHtR ≥ 0.50 had 92% sensitivity in identifying men and women requiring nutritional management. WC presented lower sensitivity but 93% specificity, useful for excluding elderly individuals from the nutritional risk category. These results were consistent in the validation sample.

CONCLUSION

WHtR is a valuable index for screening nutritional risk management in the elderly population, applicable to men and women. Conversely, WC performs better in excluding individuals who do not need nutritional risk management.

Association between obesity and common mental disorders in women: a population-based study in Southern Brazil

PURPOSE

The study aimed to investigate the relationship between obesity and common mental disorders (CMD) among women.

METHODS

This is a cross-sectional population-based study with a representative sample of 981 adult women (20-60 years of age) living in the urban area of the municipality of São Leopoldo, RS, Brazil, in 2015. The presence of CMD was assessed using the Self-Reporting Questionnaire (SRQ-20 ≥ 8). Obesity was defined by body mass index (BMI ≥ 30.0 kg/m²). Prevalence ratios (PRs) for the association between obesity and CMD were measured by Poisson regression with robust variance, including their respective 95% confidence intervals (CIs).

RESULTS

The mean age of the sample was 40.3 years (standard deviation = 11.4 years). The prevalence of CMD was 33.7% (95% CI 30.8-36.7), while obesity was 31.2% (95% CI 28.3-34.1). The occurrence of CMD was higher in women with low levels of education and belonging to lower economic class, as well as smokers and those who were insufficiently active. Obesity was more prevalent in older women (50-60 years old) with less schooling, who did not consume alcohol, and those who were insufficiently active. After adjusting for potential confounding factors, women with obesity were 22% more likely to have CMD when compared to those without obesity (PR = 1.22; 95% CI 1.02-1.45; p = 0.030).

CONCLUSIONS

This study demonstrated a significant association between obesity and the presence of CMD among women. Additionally, the prevalence of obesity and CMD were high in this population group.

Is waist circumference associated with fear of falling in community-dwelling older adults? A cross-sectional study

INTRODUCTION

Fear of falling (FOF) is a prevalent condition among older adults and several variables have been pointed out as risk factors.

OBJECTIVES

To identify the cut-off point on waist circumference (WC), capable of discriminating between older adults with and without FOF, and to test the association between WC and FOF.

METHODS

A cross-sectional observational study was carried out with older adults of both sexes from Balneário Arroio do Silva, Brazil. We used Receiver Operating Characteristic (ROC) curves to determine the cut-off point on WC and logistic regression adjusted for potential confounding variables to test the association.

RESULTS

Older women with WC >93.5 cm [area under the curve: 0.61 (95%CI 0.53; 0.68)] had 3.30 (95%CI 1.53; 7.14) greater chances of having FOF compared with older women with WC ≤93.5 cm. WC was not able to discriminate FOF in older men.

CONCLUSION

WC values >93.5 cm are associated with higher chances of FOF in older women.

Optimal body composition indices cutoff values based on all-cause mortality in the elderly

The cutoffs of body composition indices are inconclusive in older populations. This study is designed toward determining the optimal cutoffs of the body composition indices based on the association with all-cause mortality. During 2009 and 2010, a cohort population of 1200 was enrolled in central western Taiwan. Of the 1200 subjects, 428 older subjects (mean age: 72.5 ± 5.4 yrs.; 47.7 % were women) were censored in this study. The waist circumference (WC) and body mass index (BMI) were measured using standard anthropometric methods. A multi-frequency bioelectrical impedance analysis device was utilized to estimate each participant's body composition indices, including percent body fat (PBF) and skeletal muscle mass index (SMMI). All claims records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. A receiver operating characteristic curve method and the highest Youden index were used to identify the optimal cutoffs. A Cox proportional hazards regression analysis was used to model associations between each of the recommended cutoff values with all-cause mortality. The all-cause mortality rate was 20.09 % after a follow-up period of 5.86 ± 2.39 person-years. The significant indices cutoff value was identified to be WC (86.7 cm) for older women and BMI (23.8 kg/m²) and as WC (77.6 cm), and SMMI (8.7 kg/m²) for older men. The recommended optimal cutoffs of the body composition indices were gender-specific and can be utilized to predict the risk of all-cause mortality.

Sensitivity and Specificity of Anthropometric Indices in Identifying Obesity in Women over 40 Years of Age and Their Variability in Subsequent Decades of Life

Anthropometric measurements and indices are a simple and inexpensive method to assess normal physical development and quickly identify the risk of diseases. The aim of the study was to verify the sensitivity (Se) and specificity (Sp) of selected anthropometric indices in a group of women over 40 years. The study included 87 women (group I-40 to 49 years, group II-50 to 59 years, group III-60 to 69 years, and group IV-70 to 79 years). Anthropometric characteristics were measured: body mass (BM), body height (BH), waist circumference (WC), and hip circumference (HC). Body mass index (BMI), body adiposity index (BAI), waist-hip ratio (WHR), and waist-to-height ratio (WHTR) were calculated. The percentage of fat tissue (FT) and visceral fat volume (FV) were evaluated using DEXA. A decrease in mean BH with an increase in the mean WC, WHR, and WHTR in subsequent decades. There were strong statistically significant correlations between FT and most indicators (except for WHR). FV was correlated at a strong or moderate level with most parameters. In the group of women aged 40 to 80 years, the most favorable AUC was obtained for WC, followed by BMI. BAI can be recommended as a complementary indicator to BMI.

New BMI Cut-Off Points for Obesity in Middle-Aged and Older Adults in Clinical Nutrition Settings in Italy: A Cross-Sectional Study

Obesity is a major health problem defined as an excess accumulation of body fat (BF). The World Health Organization (WHO) usually relies on a body mass index (BMI) ≥ 30 kg/m2 as an indicator of obesity. Due to changes in body composition that occur across the lifespan, with an increase in BF and a decrease in lean mass, we aimed to test the validity of this BMI cut-off point for adiposity in middle-aged and older adults. This cross-sectional study, composed of 4800 adults of mixed gender aged between 40 and 80 years, included (according to the WHO BMI classification) 1087 normal-weight, 1826 overweight, and 1887 obese individuals who were referred to the Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy. The sample was then categorized by adiposity status based on the total BF% as measured by dual-energy X-ray absorptiometry (DXA), and the best sensitivity and specificity were attained for predicting obesity according to the receiver operating characteristic curve (ROC) analysis. In a real-world clinical setting, a new BMI cut-off point (BMI = 27.27 kg/m2) has been identified for predicting obesity in middle-aged and older adults. Obesity guidelines in Italy therefore need to be revised accordingly.

Use of Information and Communication Technologies among Adults in Weight Control: Systematic Review and Meta-Analysis

Information and communication technologies are part of our day-to-day life in the execution of all activities, including health care. However, it is not known how much the use of technologies can contribute to the adoption of healthy lifestyle habits. Thus, the objective of this study was to analyze whether the use of information and communication technologies contributes to weight control among adults when compared to the traditional approach method. The search was performed in November 2021 in eight electronic databases in addition to gray literature bases. The quality of the studies was assessed using the Cochrane risk of bias tool. The standardized mean difference was used for the meta-analytic measurement using the random effects model using the Dersimonian-Laid method in the Stata statistical package version 17. The body mass index of the intervention group decreased by an average of 0.56 (95% CI: -0.83; -0.30) when compared to the control group. When comparing the before and after groups, the intervention group also had a greater reduction in BMI (summarized mean: -0.83; 95% CI: -1.40; -0.26). Information and communication technologies contribute to the reduction of the body mass index in the adult population when compared to the traditional model of monitoring. Prospero registration: number 42020186340.

Sarcopenia and mortality risk in community-dwelling Brazilian older adults

We estimated the impact of sarcopenia parameters on mortality risk and assessed its prevalence and associated factors in the older adults according to the European Working Group on Sarcopenia in Older People's 2010 (EWGSOP1) and 2018 (EWGSOP2) criteria. This was a 10-year follow-up cohort study. Low muscle mass (MM) was defined as low skeletal muscle mass index (SMI) using dual-energy X-ray absorptiometry (DXA), and low calf circumference (CC). Cox regression and the Kaplan-Meier method were performed. The prevalence of sarcopenia and associated factors were influenced by the MM measurement method and diagnostic criteria used [6.8% (SMI and EWGSOP2), 12.8% (CC and EWGSOP2; and SMI and EWGSOP1) and 17.4% (CC and EWGSOP1)]. While a low BMI was associated with sarcopenia regardless of the sarcopenia definitions, diabetes, and high TGs were associated with sarcopenia only when using the EWGSOP1 criteria. Low SMI increased mortality risk (EWGSOP1: HR = 2.01, 95% CI 1.03-3.92; EWGSOP2: HR = 2.07, 95% CI 1.05-4.06). The prevalence of sarcopenia was higher according to EWGSOP1 than EWGSOP2. A low BMI, diabetes, and high TGs were associated with sarcopenia. A low SMI doubled the risk of mortality in community-dwelling older adults.

Does Abdominal Obesity Increase All-Cause, Cardiovascular Disease, and Cancer Mortality Risks in Older Adults? A 10-Year Follow-Up Analysis

There is insufficient evidence on the impact of abdominal obesity (AO) on mortality in older adults. Therefore, the objective to analyze the 10-year impact of AO, assessed using different diagnostic criteria, on all-cause, cardiovascular disease (CVD), and cancer mortality in older adults. In this prospective cohort study of older adults (≥60 years), sociodemographic, lifestyle, clinical history, laboratory test, and anthropometric data were analyzed. The considered were used for AO diagnostic: waist circumference (WC) of ≥88 cm for women and ≥102 cm for men; WC of ≥77.8 cm for women and ≥98.8 cm for men; and increased waist-to-hip ratio (WHR), being the highest tertile of distribution by sex. Multivariate Cox regression and Kaplan-Meier analyses were performed. A total of 418 individuals, with an average age of 70.69 ± 7.13 years, participated in the study. In the analysis adjusted for sex and age, WHR was associated with a high risk of all-cause mortality (p = 0.044). Both cutoff points used for the WC were associated with an increased CVD mortality risk. None of the AO parameters were associated with cancer mortality. An increased WHR was associated to a higher all-cause mortality risk factor, while an increased WC was a risk factor for a higher CVD mortality in older adults.

Differences in Classification Standards For the Prevalence of Overweight and Obesity in Children. A Systematic Review and Meta-Analysis

The prevalence of childhood obesity has increased dramatically all over the world in recent years. While obesity in adults can be easily measured using the BMI calculation, determining overweight and obesity in children is more controversial. The aim was to compare the three most used international classification systems (WHO 2007, CDC 2000 and Cole-IOTF) to determine overweight and obesity in infant and adolescent populations. We performed a systematic review in accordance with the PRISMA 2020 guidelines of articles comparing any of the three classification systems. The main findings were that the WHO 2007 criteria show the highest prevalence of overweight and obesity in the child and youth population. The prevalence of childhood overweight and obesity was determined to be higher in boys than in girls in most studies, when analysing the classifications of the WHO 2007, CDC 2000 and Cole-IOTF together. However, there was a higher prevalence of overweight and obesity in girls than in boys when only the CDC 2000 and Cole-IOTF criteria were considered. Both the results of the review and the great heterogeneity found in the meta-analysis show that it is necessary to unify the criteria for the classification of childhood overweight and obesity. International standards are insufficient for working with the current population. A working group should be created to address this issue and agree on the unification of a gold standard, taking into account the geographical region, the ethnic groups and the age groups of the child and youth population and above all, the secular growth.

Machine Learning Methods for Hypercholesterolemia Long-Term Risk Prediction

Cholesterol is a waxy substance found in blood lipids. Its role in the human body is helpful in the process of producing new cells as long as it is at a healthy level. When cholesterol exceeds the permissible limits, it works the opposite, causing serious heart health problems. When a person has high cholesterol (hypercholesterolemia), the blood vessels are blocked by fats, and thus, circulation through the arteries becomes difficult. The heart does not receive the oxygen it needs, and the risk of heart attack increases. Nowadays, machine learning (ML) has gained special interest from physicians, medical centers and healthcare providers due to its key capabilities in health-related issues, such as risk prediction, prognosis, treatment and management of various conditions. In this article, a supervised ML methodology is outlined whose main objective is to create risk prediction tools with high efficiency for hypercholesterolemia occurrence. Specifically, a data understanding analysis is conducted to explore the features association and importance to hypercholesterolemia. These factors are utilized to train and test several ML models to find the most efficient for our purpose. For the evaluation of the ML models, precision, recall, accuracy, F-measure, and AUC metrics have been taken into consideration. The derived results highlighted Soft Voting with Rotation and Random Forest trees as base models, which achieved better performance in comparison to the other models with an AUC of 94.5%, precision of 92%, recall of 91.8%, F-measure of 91.7% and an accuracy equal to 91.75%.

Prevalence and diagnostic agreement of sarcopenic obesity with different definitions among Chinese community-dwelling older adults

OBJECTIVE

this retrospective study aims to compare the prevalence and diagnostic agreement of sarcopenic obesity (SO) using different obesity diagnostic methods among Chinese community-dwelling older adults.

METHODS

SO was diagnosed with sarcopenia and obesity diagnostic methods. Sarcopenia was defined using the Asian Working Group for Sarcopenia criteria 2019 (AWGS2019). Four widely used indicators were used to define obesity: body mass index (BMI), waist circumference (WC), percent of body fat (PBF) and visceral fat area (VFA). Cohen's kappa was used to analyse the diagnosis agreement of SO between different diagnostic methods.

RESULTS

a total of 1,050 participants were included, including 347 men (71.3 ± 7.4 years) and 703 women (69.9 ± 7.5 years). The prevalence of sarcopenia was 25% in total participants, there was no difference between men (24.2%) and women (25.5%), (P = 0.705). With different obesity diagnostic methods, the obesity prevalence ranged from 4.1 to 42.2%, the SO prevalence was 0.1-7.9%. The diagnosis agreement of SO was poor-to-moderate (κ ranged from -0.002 to 0.682). Among the four diagnostic methods, AWGS combined with BMI had the poorest agreement (κ = -0.002 with other methods), AWGS combined with VFA had the best agreement (κ = 0.641 and 0.682 with AWGS combined with PBF and with AWGS combined with WC, respectively).

CONCLUSION

the prevalence of SO vary considerably and the diagnostic agreement is poor-to-moderate with non-uniform diagnostic methods. BMI has the lowest sensitivity, whereas VFA has the highest sensitivity in diagnosis of SO, and VFA has a relatively good diagnostic agreement with other diagnostic methods.

Baixa reserva muscular em pessoas idosas e fatores associados

Resumo Objetivo Estimar a prevalência de baixa reserva muscular e identificar os fatores associados em pessoas idosas. Método Estudo transversal realizado com 784 idosos (60 anos ou mais) não institucionalizados, residentes em Viçosa, Minas Gerais no ano de 2009. As características de interesse foram sociodemográficas, hábitos de vida, condições de saúde e antropométricas. A baixa reserva muscular (BRM) foi definida como o perímetro da perna (PP) < 33 cm para mulheres e < 34 cm para homens. Realizou-se análise descritiva, análise bivariada e múltipla, por meio da regressão de Poisson com variância robusta, para identificar os fatores independentemente associados ao desfecho de interesse. Resultados Mais da metade da amostra era composta por mulheres (52,9%), maior frequência de idosos mais jovens (60 – 69 anos :49,5%), com no máximo quatro anos de estudo (79,9%). A prevalência de baixa reserva muscular foi de 21,7% (IC 95% 18,9%-24,7%) e os fatores independentemente associados foram a faixa etária de 70 a 79 anos (RP:1,31; IC95%: 0,96-1,795), 80 anos ou mais (RP:1,64; IC95%:1,12-2,70), histórico de internação hospitalar (RP: 1,46; IC95%: 1,02-2,09) e baixo peso (RP: 5,45; IC95%:3,77-7,88). Conclusões A prevalência da BRM na amostra é expressiva, se relaciona com a idade mais avançada, hospitalização e com o baixo peso. O monitoramento do PP mostra-se importante para o rastreamento de alterações relacionadas à baixa reserva muscular na pessoa idosa e os fatores associados devem ser considerados nas avaliações antropométricas destinadas a esta população.

Low muscle reserve in older adults and associated factors

Abstract Objective To estimate the prevalence of low muscle reserve and identify associated factors in older people. Method Cross-sectional study carried out with 784 non-institutionalized older people (60 years or older), living in Viçosa, Minas Gerais, in 2009. The characteristics of interest were sociodemographic, life habits, health and anthropometric conditions. Low muscle reserve (LMR) was defined as leg circumference (LC) < 33 cm for women and < 34 cm for men. Descriptive analysis, bivariate and multiple analysis were performed, using Poisson regression with robust variance, to identify the factors independently associated with the outcome of interest. Results More than half of the sample consisted of women (52.9%), more frequently younger seniors (60 – 69 years old :49.5%), with a maximum of four years of study (79.9%). The prevalence of low muscle reserve was 21.7% (95%CI 18.9%-24.7%) and the independently associated factors were the age group from 70 to 79 years (PR:1.31; 95%CI: 0.96-1.795), 80 years or older (PR:1.64; 95%CI:1.12-2.70), history of hospitalization (PR: 1.46; 95%CI: 1.02-2.09) and low weight (PR: 5.45; 95%CI: 3.77-7.88). Conclusions The prevalence of LMR in the sample is expressive, it is related to older age, hospitalization and low weight. LC monitoring is important for tracking changes related to low muscle reserve in older people and associated factors should be considered in anthropometric assessments for this population.

High blood pressure levels and cardiovascular risk among Munduruku indigenous people

Objective:

to identify the risk factors associated with prehypertension and arterial hypertension among Munduruku indigenous people in the Brazilian Amazon.

Method:

a cross-sectional study carried out with 459 Munduruku indigenous people selected by means of stratified random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glucose and lipid profiles were evaluated. An automatic device calibrated and validated to measure blood pressure was used. The analyses of the data collected were carried out in the R software, version 3.5.1. For continuous variables, the Kruskall-Wallis test was used; for the categorical ones, Fischer’s Exact. The significance level was set at 5% and p-value≤0.05.

Results:

the prevalence of altered blood pressure levels was 10.2% for values suggestive of hypertension and 4.1% for pre-hypertension. The risk of prehypertension among indigenous people was associated with being male (OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with substantially increased waist circumference (OR=5.46; 95% CI=1.78-16.75).

Conclusion:

among Munduruku indigenous people, men were more vulnerable to developing hypertension; age and increased waist circumference proved to be strong cardiovascular risk factors.

The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications

Obesity is globally a serious public health concern and is associated with a high risk of cardiovascular disease (CVD) and various types of cancers. It is important to evaluate various types of obesity, such as visceral and sarcopenic obesity. The evidence on the associated risk of CVD, cancer and sarcopenic obesity, including pathophysiological aspects, occurrence, clinical implications and survival, needs further investigation. Sarcopenic obesity is a relatively new term. It is a clinical condition that primarily affects older adults. There are several endocrine-hormonal, metabolic and lifestyle aspects involved in the occurrence of sarcopenic obesity that affect pathophysiological aspects that, in turn, contribute to CVD and neoplasms. However, there is no available evidence on the role of sarcopenic obesity in the occurrence of CVD and cancer and its pathophysiological interplay. Therefore, this review aims to describe the pathophysiological aspects and the clinical and epidemiological evidence on the role of sarcopenic obesity related to the occurrence and mortality risk of various types of cancer and cardiovascular disease. This literature review highlights the need for further research on sarcopenic obesity to demonstrate the interrelation of these various associations.

Body fat percentage assessment by skinfold equation, bioimpedance and densitometry in older adults

Background

Body fat estimation allows measuring changes over time attributed to interventions and treatments in different settings such as hospitals, clinical practice, nursing homes and research. However, only few studies have compared different body fat estimation methods in older adults with inconsistent results. We estimated body fat percentage (%BF) and the level of agreement among dual energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA) and Durnin & Womersley’s skinfold eq. (SF) in older Brazilian adults aged 60 years and older from the Elderly Project Goiânia, Brazil.

Methods

The analytical sample comprised of 132 participants who had DXA data. The level of agreement for the %BF estimated by BIA, SF and DXA i.e. reference method, was examined using Bland and Altman’s and Lin’s plot.

Results

Overall, women had higher body mass index and %BF values measured by all three methods used. BIA and SF equation showed strong concordance to estimate body fat percentage in all participants (CCC = 0.857 and 0.861, respectively) and among women (CCC = 0.788 and 0.726, respectively) when compared to DXA. However, both methods underestimated body fat percentage in women and men with high body fat percentage. A strong level of agreement was observed between DXA and the anthropometric equation developed by Durnin & Womersley in men (CCC = 0.846), while BIA had a moderate concordance (CCC = 0.505) in this group.

Conclusion

The examined methods indicated different body fat estimates. However, the best agreement was observed between DXA and the anthropometric SF equation for men. Future research in older adults should develop new SF equations considering different ethnic groups.