Associations of body mass index and waist circumference with risk of Guillain-Barré syndrome in women and men: A prospective analysis of three cohort studies

BACKGROUND

The association of body mass index (BMI) and waist circumference (WC) with risk of Guillain-Barré syndrome (GBS) has been inconsistent in previous studies.

METHODS

We examined the associations of BMI and WC in relation to risk of GBS among 252,980 participants from the Nurses' Health Study (NHS), NHS-II, and the Health Professional Follow-up Study (HPFS). BMI and WC were assessed by self-reported questionnaire, and GBS cases were self-reported.

RESULTS

We documented 328 incident GBS cases during a total of 5,422,788 person years of follow-up. Compared to participants with BMI<25kg/m2, the multivariate pooled hazard ratio (HR) of GBS was 1.34 (95% CI: 1.04, 1.73) for overweight participants (25kg/m2≤BMI<30 kg/m2), and 1.68 (95% CI: 1.21, 2.35) for obese participants (BMI≥30 kg/m2) (P for trend = 0.001). Compared to participants with normal WC (<35 inches for women and <40 inches for men), the HR of GBS was 1.55 (95% CI: 1.10, 2.18) for participants with high WC (≥35 inches for women, and ≥40 inches for men). The positive associations of BMI and WC with risk of GBS were attenuated to null after mutually adjusting for BMI and WC. Joint analysis showed that the HR was 1.84 (95% CI: 1.27, 2.66) for participants with high WC and BMI≥25 kg/m2 in comparison to participants with normal WC and BMI<25kg/m2.

CONCLUSION

These data from large cohorts showed that higher BMI and WC jointly were associated with higher risk of GBS. Our study highlighted the importance of maintaining a normal body weight and waist circumference in prevention of GBS.

Demographic and Behavioral Correlates of Energy Drink Consumption

Objectives

This study assessed energy drink consumption and high-risk behaviors, including alcohol and drug use, cross-sectionally among participants in three cohort studies—the Nurses’ Health Study 3 (NHS 3), the Growing Up Today Study (GUTS) and GUTS2.

Methods

Questionnaires, including validated food-frequency questionnaires (FFQs), collected participant demographics, risky behavior, and energy drink consumption data. [The specific question used for energy drink intake read as follows: “Do you drink energy drinks, e.g., Red Bull, Rock Star, Monster (8 oz. can)?” for NHS3, 2010–2019; GUTS, 2011; and GUTS2, 2011.] Following descriptive analysis, multivariable-adjusted logistic regression estimated associations between energy drink consumption and odds of risky behaviors, including pooled odds-ratios (pORs) across all cohorts.

Results

Of the 46,390 participants this study assessed, ∼13% reported energy drink consumption at least monthly. Risky behaviors associated with energy drink consumption included smoking [pOR: 1.88 (95% CI 1.55–2.29)], having higher body mass index [pORs: 1.31 (95% CI 1.11–1.53) for overweight (25–30 kg/m2) and 1.67 (95% CI 1.34–2.08) for obesity (≥30 kg/m2) compared to &lt;25 kg/m2, respectively], insufficient sleep [pOR: 1.29 (95% CI 1.11–1.50) for &lt;7 hours compared to 7–9 hours], tanning bed use [pOR: 2.31 (95% CI 1.96–2.72)], binge drinking [pOR: 2.53 (95% CI 2.09–3.07)], marijuana use [pOR: 1.49 (95% CI 1.28–1.73)], and use of any illegal drugs (other than marijuana) [pOR: 1.45 (95% CI 1.16–1.81)]. Demographic factors associated with consumption of energy drinks included higher education, which was associated with lower odds of energy drink consumption [pORs: 0.71 (95% CI 0.56–0.91) for bachelor's degree and 0.55 (95% CI 0.40–0.74) for master's degree, compared to no bachelor's degree, respectively], and race/ethnicity [pOR: 4.43 (95% CI: 2.41–8.15) comparing African Americans to non-Hispanic white].

Conclusions

Both within and across the cohorts, risky behaviors were associated with higher odds of energy drink consumption.

Funding Sources

This study was funded via FDA contracts and NIH grants.