scholarly journals Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa

2021 ◽  
Vol 12 ◽  
Author(s):  
Graham W. Redgrave ◽  
Colleen C. Schreyer ◽  
Janelle W. Coughlin ◽  
Laura K. Fischer ◽  
Allisyn Pletch ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Body Mass ◽  
Adult Women ◽  
Short Term ◽  
Illness Duration ◽  
Weight Restoration ◽  
The Impact

Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program. Participants included hospitalized adult women (N = 191) with AN or underweight other specified feeding and eating disorder (OSFED). Participants were characterized as short-term (ill <7 years; n = 74) or long-term ill (ill ≥ 7 years; n = 117). Compared with short-term ill, long-term ill patients were older, had lower lifetime body mass index (BMI), more prior admissions, and exhibited greater depression and neuroticism. Long-term vs. short-term ill patients gained weight at the same rate (~2 kg/wk) and were equally likely to be weight restored by discharge (>75% reached BMI ≥ 19 kg/m2 in both groups). At 6-month follow-up (n = 99), both groups had equivalent self-reported BMI, and depression, drive for thinness, body dissatisfaction, and bulimia scores. The only predictor of BMI ≥ 19 kg/m2 at follow-up was discharge BMI. The likelihood of a BMI ≥ 19 kg/m2 at follow-up was 5-fold higher for those with discharge BMI ≥ 19 kg/m2. Few studies of long-term ill inpatients with AN have examined the impact of full weight restoration on short-term outcomes. This study supports the therapeutically optimistic stance that, regardless of illness duration, hospitalized patients with AN benefit from gaining weight to a BMI ≥ 19 kg/m2.

Impact of body mass index on outcomes in European patients with atrial fibrillation: the ESC EHRA EORP Atrial Fibrillation General Long-Term registry (AFGen LT)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Boriani ◽  
M Proietti ◽  
C Laroche ◽  
L Fauchier ◽  
F Marin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Large Cohort ◽  
Funding Source ◽  
Increased Risk ◽  
Underweight Patients ◽  
The Impact

Abstract Introduction The impact of body mass index (BMI) on outcomes in patients with atrial fibrillation (AF) has been largely debated. Aims To describe the relationship between BMI categories and clinical outcomes in a large cohort of European AF patients. Methods We included all AF patients with available baseline BMI and creatinine clearance and 1-year follow-up data enrolled in the EORP-AF General Long-Term Registry. Outcomes considered were: i) a composite of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death; ii) CV death; iii) all-cause death. Results A total of 7,759 patients were included in this analysis. Of these, 55 (0.7%) were underweight, 2,074 (26.7%) were normal weight, 3,170 (40.9%) were overweight, 1,703 (21.9%) were obese and 757 (9.8%) were severe obese. Mean age was progressively lower across the categories (p<0.0001), with proportion of patients aged≥75 years also progressively lower (52.7% in underweight to 19.4% in severe obese patients; p<0.001). Both underweight (41.8%) and severe obese (25.0%) patients were more likely symptomatic (p<0.001). Mean CHA2DS2-VASc score was higher in underweight patients (p=0.0325). Use of any oral anticoagulant therapy was progressively higher across the BMI categories (p<0.001). At 1-year follow-up the rate of all outcomes considered were highest for underweight patients and lowest in severe obese [Figure 1]. On univariate Cox regression analysis, being underweight was consistently associated to a higher risk for all outcomes, while increasing of weight categories was associated with progressively lower risk for adverse outcomes. After full adjustment with clinical and pharmacological characteristics, no effect of higher BMI classes was found for any outcome, but an independent association with an increased risk of CV death and all-cause death was seen for underweight patients (Table 1). Conclusions In a large cohort of European AF patients a progressively lower rate of outcomes was found across increasing BMI classes. After full adjustments, no significant association was found between the higher BMI classes and outcomes. Underweight was associated with an increased risk for CV death and all-cause death. Figure 1. Outcomes at 1-year Follow-up Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Since the start of EORP programme, several companies have supported it with unrestricted grants

scholarly journals How Big Is Too Big?

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Elizabeth D. Krebs ◽  
Jared P. Beller ◽  
J. Hunter Mehaffey ◽  
Nicholas R. Teman ◽  
Jamie L. W. Kennedy ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Organ Donation ◽  
Body Mass ◽  
Severe Obesity ◽  
Short Term ◽  
Transplant Outcomes ◽  
Severely Obese ◽  
The Impact ◽  
Over Time

Background: As the population becomes increasingly obese, so does the pool of potential organ donors. We sought to investigate the impact of donors with body mass index ≥40 (severe obesity) on heart transplant outcomes. Methods: Single-organ first-time adult heart transplants from 2003 to 2017 were evaluated from the United Network for Organ Sharing database and stratified by donor severe obesity status (body mass index ≥40). Demographics were compared, and univariate and risk-adjusted analyses evaluated the relationship between severe obesity and short-term outcomes and long-term mortality. Further analysis evaluated the prevalence of severe obesity within the pool of organ donation candidates. Results: A total of 26 532 transplants were evaluated, of which 939 (3.5%) had donors with body mass index ≥40, with prevalence increasing over time (2.2% in 2003, 5.3% in 2017). Severely obese donors more likely had diabetes mellitus (10.4% versus 3.1%, P <0.01) and hypertension (33.3% versus 14.8%, P <0.01), and 67.4% were size mismatched (donor weight >130% of recipient). Short-term outcomes were similar, including 1-year survival (10.6% versus 10.7%), with no significant difference in unadjusted and risk-adjusted long-term survival (log-rank P =0.67, hazard ratio, 0.928, P =0.30). Organ donation candidates also exhibited an increase in severe obesity over time, from 3.5% to 6.8%, with a lower proportion of hearts from severely obese donors being transplanted (19.5% versus 31.6%, P <0.01). Conclusions: Donor severe obesity was not associated with adverse post-transplant outcomes. Increased evaluation of hearts from obese donors, even those with body mass index ≥40, has the potential to expand the critically low donor pool.

scholarly journals Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

scholarly journals Paleolithic Diet—Effect on the Health Status and Performance of Athletes?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1019
Author(s):  
Barbara Frączek ◽  
Aleksandra Pięta ◽  
Adrian Burda ◽  
Paulina Mazur-Kurach ◽  
Florentyna Tyrała
Keyword(s):  
Blood Pressure ◽  
Body Mass ◽  
Positive Impact ◽  
Model Assessment ◽  
Paleolithic Diet ◽  
Short Term ◽  
Positive Effects ◽  
Short And Long Term ◽  
The Impact

The aim of this meta-analysis was to review the impact of a Paleolithic diet (PD) on selected health indicators (body composition, lipid profile, blood pressure, and carbohydrate metabolism) in the short and long term of nutrition intervention in healthy and unhealthy adults. A systematic review of randomized controlled trials of 21 full-text original human studies was conducted. Both the PD and a variety of healthy diets (control diets (CDs)) caused reduction in anthropometric parameters, both in the short and long term. For many indicators, such as weight (body mass (BM)), body mass index (BMI), and waist circumference (WC), impact was stronger and especially found in the short term. All diets caused a decrease in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), albeit the impact of PD was stronger. Among long-term studies, only PD cased a decline in TC and LDL-C. Impact on blood pressure was observed mainly in the short term. PD caused a decrease in fasting plasma (fP) glucose, fP insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) in the short run, contrary to CD. In the long term, only PD caused a decrease in fP glucose and fP insulin. Lower positive impact of PD on performance was observed in the group without exercise. Positive effects of the PD on health and the lack of experiments among professional athletes require longer-term interventions to determine the effect of the Paleo diet on athletic performance.

scholarly journals Correlation of Body Mass Index with Oncologic Outcomes in Colorectal Cancer Patients: A Large Population-Based Study

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3592
Author(s):  
Chong-Chi Chiu ◽  
Chung-Han Ho ◽  
Chao-Ming Hung ◽  
Chien-Ming Chao ◽  
Chih-Cheng Lai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Survival Rates ◽  
Normal Weight ◽  
P Value ◽  
Administrative Claims ◽  
The Impact

It has been acknowledged that excess body weight increases the risk of colorectal cancer (CRC); however, there is little evidence on the impact of body mass index (BMI) on CRC patients’ long-term oncologic results in Asian populations. We studied the influence of BMI on overall survival (OS), disease-free survival (DFS), and CRC-specific survival rates in CRC patients from the administrative claims datasets of Taiwan using the Kaplan–Meier survival curves and the log-rank test to estimate the statistical differences among BMI groups. Underweight patients (<18.50 kg/m2) presented higher mortality (56.40%) and recurrence (5.34%) rates. Besides this, they had worse OS (aHR:1.61; 95% CI: 1.53–1.70; p-value: < 0.0001) and CRC-specific survival (aHR:1.52; 95% CI: 1.43–1.62; p-value: < 0.0001) rates compared with those of normal weight patients (18.50–24.99 kg/m2). On the contrary, CRC patients belonging to the overweight (25.00–29.99 kg/m2), class I obesity (30.00–34.99 kg/m2), and class II obesity (≥35.00 kg/m2) categories had better OS, DFS, and CRC-specific survival rates in the analysis than the patients in the normal weight category. Overweight patients consistently had the lowest mortality rate after a CRC diagnosis. The associations with being underweight may reflect a reverse causation. CRC patients should maintain a long-term healthy body weight.

Impact of body mass index on short-term and long-term survival in prevalent hemodialysis patients

2019 ◽  
Vol 23 (3) ◽  
pp. 375-383
Author(s):  
Muhittin Ertilav ◽  
W. Nathan Levin ◽  
Aygul Celtik ◽  
Fatih Kircelli ◽  
Stefano Stuard ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Hemodialysis Patients ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Long-Term Postoperative Total Knee Arthroplasty Flexion Scores in Relation to Body Mass Index

2020 ◽  
Author(s):  
Matthew A. Siegel ◽  
Michael J. Patetta ◽  
Angie M. Fuentes ◽  
Armaan S. Haleem ◽  
Craig W. Forsthoefel ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Statistical Significance ◽  
P Value ◽  
Preoperative Body Mass Index ◽  
Total Knee

AbstractKnee range of motion (ROM) is an important postoperative measure of total knee arthroplasty (TKA). There is conflicting literature whether patients who are obese have worse absolute ROM outcomes than patients who are not obese. This study analyzed whether preoperative body mass index (BMI) influences knee ROM after patients' primary TKA. A retrospective investigation was performed on patients, who underwent primary TKA at an academic institution, by one of three fellowship-trained adult reconstruction surgeons. Patients were stratified according to their preoperative BMI into nonobese (BMI < 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2) classifications. Passive ROM was assessed preoperatively as well as postoperatively at patients' most recent follow-up visit that was greater than 2 years. Mann–Whitney U tests were performed to determine statistical significance at p-value <0.05 for ROM outcomes. No statistically significant differences were observed when ROM in the nonobese group was compared with ROM in the obese group both preoperatively (105.73 ± 11.58 vs. 104.14 ± 13.58 degrees, p-value = 0.417) and postoperatively (105.83 ± 14.19 vs. 104.49 ± 13.52 degrees, p-value = 0.777). Mean follow-up time for all patients was 4.49 ± 1.92 years. In conclusion, long-term postoperative ROM outcomes were similar between patients who were nonobese and patients who were obese.

Does obesity affect the short-term outcomes after cardiothoracic surgery in adolescents with congenital heart disease?

2020 ◽  
Vol 30 (3) ◽  
pp. 372-376 ◽  
Author(s):  
Richard U. Garcia ◽  
Preetha L. Balakrishnan ◽  
Sanjeev Aggarwal
Keyword(s):  
Body Mass Index ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Body Mass ◽  
Congenital Heart ◽  
Adverse Outcome ◽  
Normal Weight ◽  
Adverse Outcomes ◽  
Short Term ◽  
The Impact

AbstractBackground:Obesity is a modifiable, independent risk factor for mortality and morbidity after cardiovascular surgery in adults. Our objective was to evaluate the impact of obesity on short-term outcomes in adolescents undergoing surgery for congenital heart disease (CHD).Methods:This retrospective chart review included patients 10–18 years of age who underwent CHD surgery. Our exclusion criteria were patients with a known genetic syndrome, heart transplantation, and patients with incomplete medical records. The clinical data collected included baseline demographics and multiple perioperative variables. Charting the body mass index in the Centers for Disease Control and Prevention growth curves, the entire cohort was divided into three categories: obese (>95th percentile), overweight (85th–95th percentile), and normal weight (<85th percentile). The composite outcome included survival, arrhythmias, surgical wound infection, acute neurologic injury, and acute kidney injury.Results:The study cohort (n = 149) had a mean standard deviation (SD), body mass index (BMI) of 22.6 ± 6.5 g/m2, and 65% were male. There were 27 obese (18.1%), 24 overweight (16.1%), and 98 normal weight (65.8%) patients. Twenty-seven (18%) patients had composite adverse outcomes. Overweight and obese patients had significantly higher adverse outcomes compared with normal weight patients (odds ratio (OR): 2.9; confidence interval (CI): 1–8.5, p = 0.04 and OR: 3; CI: 1–8.5, p = 0.03, respectively). In multivariate analysis, obesity was an independent predictor of adverse outcome in our cohort (p = 0.04).Conclusions:Obesity is associated with short-term adverse outcome and increased health resource utilisation in adolescents following surgery for CHD. Further studies should evaluate if intervention in the preoperative period can improve outcomes in this population.

scholarly journals Effects of Educational Counseling as Solitary Therapy for Chronic Primary Tinnitus and Related Problems

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yu-Qing Liu ◽  
Zhi-Ji Chen ◽  
Gang Li ◽  
Dan Lai ◽  
Peng Liu ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Problems ◽  
Controlled Trial ◽  
Dietary Advice ◽  
Short Term ◽  
Educational Counseling ◽  
Long Term Follow Up ◽  
The Impact

The aim of this study was to evaluate the early and sustained effects of tinnitus educational counseling on chronic primary tinnitus and related problems. A descriptive longitudinal cohort study was conducted with 159 adult patients suffering from chronic primary tinnitus and sleep problems. All patients received tinnitus educational counseling, sleep adjustment, and vegan dietary advice. At short-term assessment within 3 months and long-term follow-up at 6–26 months, perceived changes in tinnitus were assessed with the Tinnitus Handicap Inventory (THI) and the Tinnitus Evaluation Questionnaire (TEQ), respectively. In TEQ, the volume of subjective tinnitus was scored according to realistic environments in which tinnitus could be heard. Sleep quality was assessed with questionnaires developed in our laboratory. Most of the subjects showed significant early improvement in their THI scores (96/159, 60.38%; from 46.11 ± 22.74 to 31.94 ± 20.41,t= 11.16,p< 0.001, Cohen’sd= 0.66). Tinnitus volume (39/159, 24.53%, from 2,2 to 2,1,z= -3.56,p< 0.001) and sleep quality (68/159, 42.77%; from 7.13 ± 3.11 to 6.31 ± 2.75,t= 3.73,p< 0.001, Cohen’sd= 0.28) were also improved. Long-term follow-up TEQ results indicated that tinnitus loudness, the impact of tinnitus on sleep, concentration, and emotional state were all improved since the prior consultation (p= 0.001, 0.026, 0.012, and <0.001). Short-term improvement of tinnitus severity correlated directly with improvement of sleep quality (odds ratio (OR) = 0.30, 95% confidence interval (CI): 0.14–0.64,p= 0.002), initial THI score (OR = 1.02, 95% CI: 1.01 to 1.04,p= 0.006), compliance with sleep advice (OR = 2.27, 95% CI: 1.02–5.05,p= 0.044), and nervous disposition (OR = 2.80, 95% CI: 1.25–6.30,p= 0.013). A future randomized controlled trial would be carried out to examine the effect of sole tinnitus educational counseling.

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