Benchmarking the Discriminatory Performance of Body Mass Index and Body Fat for Obesity Detection in Patients Treated by Intragastric Balloon

Abstract Background Mechanisms underlying the associations of high levels of physical activity (PA) and adherence to the Mediterranean diet (MedDiet) with a better inflammatory profile remain unclear. Our objective was to assess the mediating role of changes in body mass index (BMI) and waist circumference (WC), as markers of body fat in the association of changes in PA and adherence to the MedDiet, with changes in the inflammatory profile. Method This study included 489 adults, aged 55–75 years, from the PREDIMED-Plus multicenter lifestyle intervention trial. An inflammatory score was calculated, based on 8 blood biomarkers: high-sensitivity C-reactive protein, interleukin 6, interleukin 8, interleukin 18, monocyte chemo-attractant protein-1, C-peptide, leptin, and regulated on activation, normal T-cell–expressed and secreted chemokine. Biomarkers, levels of PA, score of MedDiet adherence, BMI, and WC were measured at baseline and at 1-year follow-up. Linear regression models were fitted according to the Baron and Kenny framework for mediation analysis. Results Changes in BMI and WC mediated the association of both changes in PA and changes in the MedDiet adherence with the inflammatory score. Body mass index mediated 26% of the association of changes in total PA with the inflammatory profile, and 27% of the association of changes in the MedDiet, while WC mediated 13% and 12% of these associations, respectively. Conclusion In older adults at high cardiovascular risk, increasing PA levels and adherence to a MedDiet during 1 year were associated with a lower inflammatory score, which was partly mediated by a reduction in body fat. Clinical Trials Registration Number International Standard Randomized Controlled Trial Number: ISRCTN89898870; registration date July 24, 2014, retrospectively registered.

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Trends in obesity and adiposity measures by race or ethnicity among adults in the United States 2011-18: population based study

BMJ ◽

10.1136/bmj.n365 ◽

2021 ◽

pp. n365

Author(s):

Buyun Liu ◽

Yang Du ◽

Yuxiao Wu ◽

Linda G Snetselaar ◽

Robert B Wallace ◽

...

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

Ethnic Groups ◽

Body Mass ◽

Body Fat ◽

Lean Mass ◽

The United States ◽

Population Based ◽

Body Fat Percentage ◽

Fat Percentage

AbstractObjectiveTo examine the trends in obesity and adiposity measures, including body mass index, waist circumference, body fat percentage, and lean mass, by race or ethnicity among adults in the United States from 2011 to 2018.DesignPopulation based study.SettingNational Health and Nutrition Examination Survey (NHANES), 2011-18.ParticipantsA nationally representative sample of US adults aged 20 years or older.Main outcome measuresWeight, height, and waist circumference among adults aged 20 years or older were measured by trained technicians using standardized protocols. Obesity was defined as body mass index of 30 or higher for non-Asians and 27.5 or higher for Asians. Abdominal obesity was defined as a waist circumference of 102 cm or larger for men and 88 cm or larger for women. Body fat percentage and lean mass were measured among adults aged 20-59 years by using dual energy x ray absorptiometry.ResultsThis study included 21 399 adults from NHANES 2011-18. Body mass index was measured for 21 093 adults, waist circumference for 20 080 adults, and body fat percentage for 10 864 adults. For the overall population, age adjusted prevalence of general obesity increased from 35.4% (95% confidence interval 32.5% to 38.3%) in 2011-12 to 43.4% (39.8% to 47.0%) in 2017-18 (P for trend<0.001), and age adjusted prevalence of abdominal obesity increased from 54.5% (51.2% to 57.8%) in 2011-12 to 59.1% (55.6% to 62.7%) in 2017-18 (P for trend=0.02). Age adjusted mean body mass index increased from 28.7 (28.2 to 29.1) in 2011-12 to 29.8 (29.2 to 30.4) in 2017-18 (P for trend=0.001), and age adjusted mean waist circumference increased from 98.4 cm (97.4 to 99.5 cm) in 2011-12 to 100.5 cm (98.9 to 102.1 cm) in 2017-18 (P for trend=0.01). Significant increases were observed in body mass index and waist circumference among the Hispanic, non-Hispanic white, and non-Hispanic Asian groups (all P for trend<0.05), but not for the non-Hispanic black group. For body fat percentage, a significant increase was observed among non-Hispanic Asians (30.6%, 29.8% to 31.4% in 2011-12; 32.7%, 32.0% to 33.4% in 2017-18; P for trend=0.001), but not among other racial or ethnic groups. The age adjusted mean lean mass decreased in the non-Hispanic black group and increased in the non-Hispanic Asian group, but no statistically significant changes were found in other racial or ethnic groups.ConclusionsAmong US adults, an increasing trend was found in obesity and adiposity measures from 2011 to 2018, although disparities exist among racial or ethnic groups.

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Effects of a novel mobile health intervention compared to a multi-component behaviour changing program on body mass index, physical capacities and stress parameters in adolescents with obesity: a randomized controlled trial

BMC Pediatrics ◽

10.1186/s12887-021-02781-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

A. Stasinaki ◽

D. Büchter ◽

C.-H. I. Shih ◽

K. Heldt ◽

S. Güsewell ◽

...

Keyword(s):

Health Care ◽

Body Mass Index ◽

Muscle Mass ◽

Body Mass ◽

Body Fat ◽

Mobile Health ◽

Health Intervention ◽

Randomized Controlled ◽

Physical Capacities ◽

Stress Parameters

Abstract Background Less than 2% of overweight children and adolescents in Switzerland can participate in multi-component behaviour changing interventions (BCI), due to costs and lack of time. Stress often hinders positive health outcomes in youth with obesity. Digital health interventions, with fewer on-site visits, promise health care access in remote regions; however, evidence for their effectiveness is scarce. Methods This randomized controlled not blinded trial (1:1) was conducted in a childhood obesity center in Switzerland. Forty-one youth aged 10–18 years with body mass index (BMI) > P.90 with risk factors or co-morbidities or BMI > P.97 were recruited. During 5.5 months, the PathMate2 group (PM) received daily conversational agent counselling via mobile app, combined with standardized counselling (4 on-site visits). Controls (CON) participated in a BCI (7 on-site visits). We compared the outcomes of both groups after 5.5 (T1) and 12 (T2) months. Primary outcome was reduction in BMI-SDS (BMI standard deviation score: BMI adjusted for age and sex). Secondary outcomes were changes in body fat and muscle mass (bioelectrical impedance analysis), waist-to-height ratio, physical capacities (modified Dordel-Koch-Test), blood pressure and pulse. Additionally, we hypothesized that less stressed children would lose more weight. Thus, children performed biofeedback relaxation exercises while stress parameters (plasma cortisol, stress questionnaires) were evaluated. Results At intervention start median BMI-SDS of all patients (18 PM, 13 CON) was 2.61 (obesity > + 2SD). BMI-SDS decreased significantly in CON at T1, but not at T2, and did not decrease in PM during the study. Muscle mass, strength and agility improved significantly in both groups at T2; only PM reduced significantly their body fat at T1 and T2. Average daily PM app usage rate was 71.5%. Cortisol serum levels decreased significantly after biofeedback but with no association between stress parameters and BMI-SDS. No side effects were observed. Conclusions Equally to BCI, PathMate2 intervention resulted in significant and lasting improvements of physical capacities and body composition, but not in sustained BMI-SDS decrease. This youth-appealing mobile health intervention provides an interesting approach for youth with obesity who have limited access to health care. Biofeedback reduces acute stress and could be an innovative adjunct to usual care.

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Pre-pregnancy body mass index is associated with offspring body composition in adulthood before adiposity-related disorders: a retrospective cohort

Public Health Nutrition ◽

10.1017/s1368980020005285 ◽

2020 ◽

pp. 1-17

Author(s):

Ilana Eshriqui ◽

Angélica Marques Martins Valente ◽

Luciana Dias Folchetti ◽

Bianca de Almeida-Pititto ◽

Sandra Roberta G. Ferreira

Keyword(s):

Body Mass Index ◽

Body Composition ◽

Body Mass ◽

Body Fat ◽

Retrospective Cohort ◽

Statistical Significance ◽

Directed Acyclic Graphs ◽

Health Study ◽

Appendicular Skeletal Muscle ◽

Three Body

Abstract Objective: To investigate the association between maternal pre-pregnancy body mass index (BMI) and offspring body composition in adulthood. Design: Retrospective cohort. Undergraduates of nutrition or nutritionists were recruited at the baseline of the Nutritionists’ Health Study between 2014 and 2017. Maternal pre-pregnancy BMI and current life aspects were self-reported through online questionnaires. Three body compartments were DXA-determined. The following variables were obtained: body-fat (%), fat mass index (FMI) (kg/m2), android-to-gynoid fat ratio, visceral adipose tissue (VAT) (cm3), appendicular skeletal muscle mass index (ASMI) (kg/m2), total bone and femur mineral content (g) and density (g/cm2). Linear regression adjusted according to directed acyclic graphs recommendation was performed. Setting: São Paulo, Brazil. Participants: Healthy non-pregnant women (aged 20-45 years) (n=150). Results: Median age and BMI were 22 years (IQR=20; 29) and 22.3 kg/m2 (IQR=20.4; 25.3). Pre-pregnancy BMI≥25 kg/m2 was reported by 14.7% of mothers. In fully adjusted models, maternal pre-pregnancy BMI was associated with their daughters’ body-fat % (β=0.31; 95%CI=0.0004; 0.63), FMI (β=0.17; 95%CI=0.03; 0.30, android-to-gynoid ratio (β=0.01; 95%CI=0.004; 0.02) and VAT (β=0.09; 95%CI=0.02; 0.16), but not with total bone density (β=0.001; 95%CI=-0.003; 0.006) and content (β=7.13; 95%CI=-4.19; 18.46). Direct association with ASMI was also detected, but lost statistical significance when participants whose mothers were underweight were excluded. Conclusions: Maternal pre-pregnancy body mass index was directly associated with offspring general and visceral adiposity but seem not to be associated with bone mass. Results reinforce importance of avoiding excess of maternal adiposity, as an attempt to break the vicious cycle of obesity transmission.

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Limitations of body mass index for counseling individuals with unilateral lower extremity amputation

Prosthetics and Orthotics International ◽

10.1177/0309364616650079 ◽

2016 ◽

Vol 41 (2) ◽

pp. 186-193 ◽

Cited By ~ 3

Author(s):

Alexandra P Frost ◽

Tracy Norman Giest ◽

Allison A Ruta ◽

Teresa K Snow ◽

Mindy Millard-Stafford

Keyword(s):

Body Mass Index ◽

Lower Extremity ◽

Health Risk ◽

Body Mass ◽

Body Fat ◽

Lower Limb ◽

Dual Energy ◽

Limb Loss ◽

Percent Body Fat ◽

X Ray

Background: Body composition is important for health screening, but appropriate methods for unilateral lower extremity amputees have not been validated. Objectives: To compare body mass index adjusted using Amputee Coalition equations (body mass index–Amputee Coalition) to dual-energy X-ray absorptiometry in unilateral lower limb amputees. Study design: Cross-sectional, experimental. Methods: Thirty-eight men and women with lower limb amputations (transfemoral, transtibial, hip disarticulation, Symes) participated. Body mass index (mass/height2) was compared to body mass index corrected for limb loss (body mass index–Amputee Coalition). Accuracy of classification and extrapolation of percent body fat with body mass index was compared to dual-energy X-ray absorptiometry. Results: Body mass index–Amputee Coalition increased body mass index (by ~ 1.1 kg/m2) but underestimated and mis-classified 60% of obese and overestimated 100% of lean individuals according to dual-energy X-ray absorptiometry. Estimated mean percent body fat (95% confidence interval) from body mass index–Amputee Coalition (28.3% (24.9%, 31.7%)) was similar to dual-energy X-ray absorptiometry percent body fat (29.5% (25.2%, 33.7%)) but both were significantly higher ( p < 0.05) than percent body fat estimated from uncorrected body mass index (23.6% (20.4%, 26.8%)). However, total errors for body mass index and body mass index–Amputee Coalition converted to percent body fat were unacceptably large (standard error of the estimate = 6.8%, 6.2% body fat) and the discrepancy between both methods and dual-energy X-ray absorptiometry was inversely related ( r = −0.59 and r = −0.66, p < 0.05) to the individual’s level of body fatness. Conclusions: Body mass index (despite correction) underestimates health risk for obese patients and overestimates lean, muscular individuals with lower limb amputation. Clinical relevance Clinical recommendations for an ideal body mass based on body mass index–Amputee Coalition should not be relied upon in lower extremity amputees. This is of particular concern for obese lower extremity amputees whose health risk might be significantly underestimated based on body mass index despite a “correction” formula for limb loss.

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