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PubMed2001

Family lifestyle and parental body mass index as predictors of body mass index in Australian children: a longitudinal study.

OBJECTIVE: To investigate associations between body mass index (BMI) and family characteristics, including lifestyle, in parents and offspring from Australian families. DESIGN AND SUBJECTS: Longitudinal survey of 219 families of Australian children who had been surveyed 3-yearly between the ages of 9 and 18 y. MEASUREMENTS: Socio-economic status, weight and height, diet from 3 day records or food frequency questionnaires, alcohol consumption, smoking habits and physical fitness in offspring (bicycle ergometry in 18-y-olds). RESULTS: In 18-y-olds, in models examining offspring's lifestyle variables, BMI was predicted negatively by physical fitness (P=0.012), and positively by alcohol intake (P=0.046) in sons while, in daughters, only a negative association with physical fitness was significant. In models including parental characteristics, BMI in 18-y-old sons and daughters was significantly predicted by mothers' and fathers' BMI, independently of offsprings' alcohol intake, smoking, physical fitness and parents' education, and, in daughters, by fathers' alcohol intake. These models explained 48% of variance in daughters and 33% in sons. In both sons and daughters, BMI over the 9 y of the survey was consistently higher in offspring with overweight or obese fathers (P=0.033 for sons, P=0.024 for daughters) or mothers (P=0.031 for sons, P=0.037 for daughters). Physical fitness at the ages of 12, 15 and 18 y was negatively related to fathers' obesity in daughters and mothers' obesity in sons. Obesity in fathers was associated with a four-fold increase in risk of obesity at the age of 18 y in both sons and daughters with an independent eight-fold increase in risk for daughters if mothers were obese. Birthweight was unrelated to overweight or obesity in the 18-y-olds. Alcohol intake in sons related significantly to alcohol intake in either parent while, for daughters, there was a significant association only with fathers' alcohol consumption. In daughters, fat intake was positively associated with fat intake score in both fathers and mothers. CONCLUSION: Parental overweight or obesity may identify children at risk for a range of unhealthy behaviours. Promotion of a healthy lifestyle targeting overweight families, particularly in lower socio-economic groups, should be a priority.

Adolescent↗
PubMed2002

Familial resemblance of body mass index and familial risk of high and low body mass index. A study of young men in Sweden.

OBJECTIVE: Male familial correlations in body mass index (BMI) were studied using a large nationwide dataset of Swedish military conscripts examined at age 18-19 y. DESIGN: Record linkage was performed between Sweden's Military Service Conscription Register and the Multiple-Generation Register, enabling the identification of 92 869 families containing at least two brothers. Data on BMI at conscription was available for 196 743 sons and for 19 972 fathers. Pairs of relatives were used to estimate Pearson correlation coefficients for BMI, and to examine whether there are BMI intervals that show particularly strong familial resemblance. RESULTS: All biological family relations showed highly significant correlations for BMI: 0.28 (95% CI 0.27-0.29) for father-son pairs; 0.36 (0.35-0.37) for full-brothers, 0.21 (0.18-0.24) for maternal half-brothers, and 0.11 (0.08-0.14) for paternal half-brothers. Also, a significant correlation, of 0.06 (0.01-0.11), was found for non-biological quasi father-son relations. Full-brothers were more similar with respect to BMI at age 18 than father-son pairs, and maternal half-brothers were more similar than paternal half-brothers. The familial risk of having BMI values above or below various cut-offs was found to be equally strong for low BMI as for high BMI values. CONCLUSION: The almost twice as strong BMI correlation between maternal half-brothers as between paternal half-brothers illustrates the importance of factors of non-additive genetic origin, to the familial aggregation of BMI. The significant BMI association found between biologically unrelated individuals from the same family emphasizes that assortative mating (and regional clustering) should be taken into account when the heritability of BMI is estimated.

Adolescent↗
PubMed1998

Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves.

Receiver operating characteristic (ROC) curves were constructed to assess the value of body mass index (BMI) as a screening measure for total adiposity and to examine waist-to-hip ratio (WHR) and waist circumference as measures of central fat distribution. Body fat reference measurements were determined by dual-energy X-ray absorptiometry (DXA). The study population comprised 96 healthy white women aged 16-80 y. A positive reference test was defined as a result at or above the 75th percentile for our study population for all DXA measurements. Sensitivity and specificity were calculated at several percentile cutoffs for BMI, WHR, and waist girth. The areas under the ROC curves were calculated to compare the relative ability of each anthropometric technique to correctly classify subjects according to the reference measurement for that technique. BMI (our 75th percentile = 27.3) performed well as a screening measure of total adiposity, correctly identifying 83% of subjects with a high body fat mass while misclassifying only eight subjects [four false-negatives (subjects with high fat mass who were in the low BMI category) and four false-positives (subjects with a low fat mass who were in the high BMI category)]. The screening performance of WHR (our 75th percentile = 0.81) was lower, accurately categorizing 58% of subjects while misclassifying 28 subjects. By contrast, waist circumference (our 75th percentile = 86.9 cm) was significantly better than WHR at screening for regional fat distribution, accurately classifying 83% of subjects and misclassifying eight subjects (P < 0.05). We conclude that BMI and waist circumference provide simple yet sensitive methods for the estimation of total and central adiposity in groups of adult women.

Absorptiometry, Photon↗
PubMed1999

Validity of the body mass index as an indicator of the risk and presence of overweight in adolescents.

The validity of the body mass index (BMI) as an indicator of the risk of becoming overweight and of the presence of overweight was evaluated in 6 groups of adolescents comprising several ethnic groups (n = 1570, aged 9-19 y). With use of triceps skinfold thickness and estimated percentage body fat as the criteria for adiposity, BMI had high specificities (86.1-98.8% for risk of overweight and 96.3-100% for presence of overweight) and lower but variable sensitivities (4.3-75.0% for risk of overweight and 14.3-60% for presence of overweight). Thus, almost all adolescents who were not at risk for overweight or who were not overweight were classified correctly. In contrast, many adolescents who were at risk of overweight or who were overweight were not correctly identified as measured by BMI. Partial correlations, controlling for age, between BMI and the triceps skinfold thickness and estimated percentage body fat were generally moderate to moderately high, whereas BMI and triceps skinfold thickness appeared to be equally related to estimated total body fatness and percentage body fat in Mexican American and Austrian white males. BMI was better correlated with trunk skinfold thicknesses, but when relative subcutaneous fat distribu-tion was statistically controlled, the trunk-extremity contrast in the correlations was no longer apparent.

Journal Article↗
PubMed1999

Fatness and body mass index from birth to young adulthood in a rural Guatemalan population.

Body mass index (BMI; wt in kg/ht2 in m) has been proposed as a simple and valid measure for monitoring fatness. Using data from a 25-y longitudinal study of rural Guatemalans, we found that, as children, this population was stunted (mean height-for-age z = -2.6) and had low triceps skinfold thicknesses ( approximately 10% of reference medians), yet had mean BMIs above US reference medians. As young adults, mean BMIs were at the 50th and 20th percentiles for women and men, respectively. BMIs between ages 1 and 5 y were moderately correlated (r = 0.2-0.3) with those in young adulthood. BMI was correlated with subscapular (r = 0.5-0.8) and triceps (r = 0.2-0.7) skinfold thicknesses at all ages and with predicted percentage body fat in adolescence (r = 0.65) and adulthood (r = 0.8). Fatness was highly centralized, with ratios of subscapular to triceps skinfold thicknesses at the 50th-90th percentiles of reference medians at all ages. BMI was a poor indicator of central fat; the correlation between BMI and waist-to-hip ratio in 14-17-y-old males was -0.21). In stunted populations in developing countries, BMI alone should be interpreted with caution. In stunted children, BMIs may be high despite small extremity skinfold thicknesses; BMI alone may overestimate the prevalence of fatness in these children. In adults, measures in addition to BMI may be required to identify centralized adiposity in these populations.

Journal Article↗
PubMed1999

Tracking of body mass index in children in relation to overweight in adulthood.

Body mass index (BMI; in kg/m2) values at or above the 75th percentile are associated with increased morbidity and mortality in adulthood, and there are significant correlations between BMI values in childhood and in adulthood. The present study addresses the predictive value of childhood BMI for overweight at 35 +/- 5 y, defined as BMI >28 for men and BMI >26 for women. Analyses of data from 555 white children showed that overweight at age 35 y could be predicted from BMI at younger ages. The prediction is excellent at age 18 y, good at age 13 y, but only moderate at ages <13 y. For 18-y-olds with BMIs above the 60th percentile, the probability of overweight at age 35 y is 34% for men and 37% for women. A clinically applicable method is provided to assign an overweight child to a group with a known probability of high BMI values in adulthood.

Journal Article↗
PubMed2001

Family social class, maternal body mass index, childhood body mass index, and age at menarche as predictors of adult obesity.

BACKGROUND: Obesity is an increasingly prevalent nutritional disorder throughout the world and is a risk factor for many chronic diseases. The prevalence of obesity increases with age. OBJECTIVE: The objective was to evaluate the associations between BMI at 31 y of age and family social class during early childhood, maternal body mass index (BMI) before pregnancy, BMI at birth and at 1 and 14 y of age, and age at menarche. DESIGN: This was a longitudinal study of the northern Finland birth cohort for 1966. Subjects were measured at birth and at 1, 14, and 31 y of age. The analysis was restricted to individuals for whom BMI data were available for all measurement points (n = 2876 males and 3404 females). RESULTS: The mean BMI at birth was highest in offspring from the highest social classes, but BMI was inversely related to social class at 1 y. BMI, the waist-to-hip ratio, and the proportion of obese subjects were inversely related to social class at 31 y. The heavier the mother, the heavier the offspring from birth to 31 y. The paired analyses between maternal BMI and daughter's BMI at 31 y showed no significant difference in BMI after adjustment for the age difference. BMI at 14 y was the most important predictor of BMI at 31 y. Early menarche in females was associated with a higher BMI at 14 and 31 y. CONCLUSIONS: Differences in BMI by social class are formed at least partly during early childhood. Low social class of the child's family, a high maternal BMI before pregnancy, a high BMI during adolescence, and early menarche are predictors of obesity in adulthood.

Adolescent↗
PubMed2006

Food glycemic index, as given in glycemic index tables, is a significant determinant of glycemic responses elicited by composite breakfast meals.

BACKGROUND: Recent studies have concluded that the carbohydrate content and glycemic index (GI) of individual foods do not predict the glycemic and insulinemic effects of mixed meals. We hypothesized that these conclusions may be unwarranted because of methodologic considerations. OBJECTIVE: The aim was to ascertain whether the GI and carbohydrate content of individual foods influence glucose and insulin responses elicited by realistic mixed meals in normal subjects. DESIGN: With the use of a crossover design, we determined the glucose and insulin responses of 6 test meals in 16 subjects in Sydney and the glucose responses of 8 test meals in 10 subjects in Toronto and then the results were pooled. The 14 different test meals varied in energy (220-450 kcal), protein (0-18 g), fat (0-18 g), and available carbohydrate (16-79 g) content and in GI (35-100; values were rounded). RESULTS: The glucose and insulin responses of the Sydney test meals varied over a 3-fold range (P < 0.001), and the glucose responses of the Toronto test meals varied over a 2.4-fold range (P < 0.001). The glucose responses were not related to the fat or protein content of the test meal. Carbohydrate content (P = 0.002) and GI (P = 0.022) alone were related to glucose responses; together they accounted for 88% of the variation in the glycemic response (P < 0.0001). The insulin response was significantly related to the glucose response (r = 0.94, P = 0.005). CONCLUSIONS: When properly applied in realistic settings, GI is a significant determinant of the glycemic effect of mixed meals in normal subjects. For mixed meals within the broad range of nutrient composition that we tested, carbohydrate content and GI together explained approximately 90% of the variation in the mean glycemic response, with protein and fat having negligible effects.

Adult↗
PubMed1998

Body mass index course in asymptomatic HIV-infected homosexual men and the predictive value of a decrease of body mass index for progression to AIDS.

Weight loss is a common characteristic of advanced stages of HIV infection. Weight changes during the asymptomatic stage of HIV infection have not been well documented and the possible predictive value of early weight loss for progression to AIDS is unknown. In 122 HIV seroconverters, the natural course of body mass index (BMI) following seroconversion was studied. No BMI decline was seen immediately following seroconversion. In the 56 AIDS cases, however, a steep BMI decline of 1.14 kg/m2 occurred 6 months before AIDS. This BMI decline was more pronounced in those with low CD4+ T cell counts (<100 x 10(6)/L) at the time of AIDS diagnosis (1.8 kg/m2). The relative hazard for progression to AIDS of a BMI decline of 1.14 kg/m2 per 6 months was 3.1, which remained similar after adjustment for CD4 count and p24 antigenemia. We conclude that the course of BMI in HIV-1 infection is biphasic: a relatively stable period is followed by a rapid decline in the 6 months preceding onset of AIDS. Furthermore, we found that this steep BMI decline was associated with faster progression to AIDS.

Adult↗
PubMed2000

The estimation of body mass index and physical attractiveness is dependent on the observer's own body mass index.

A disturbance in the evaluation of personal body mass and shape is a key feature of both anorexia and bulimia nervosa. However, it is uncertain whether overestimation is a causal factor in the development of these eating disorders or is merely a secondary effect of having a low body mass. Moreover, does this overestimation extend to the perception of other people's bodies? Since body mass is an important factor in the perception of physical attractiveness, we wanted to determine whether this putative overestimation of self body mass extended to include the perceived attractiveness of others. We asked 204 female observers (31 anorexic, 30 bulimic and 143 control) to estimate the body mass and rate the attractiveness of a set of 25 photographic images showing people of varying body mass index (BMI). BMI is a measure of weight scaled for height (kg m(- 2)). The observers also estimated their own BMI. Anorexic and bulimic observers systematically overestimated the body mass of both their own and other people's bodies, relative to controls, and they rated a significantly lower body mass to be optimally attractive. When the degree of overestimation is plotted against the BMI of the observer there is a strong correlation. Taken across all our observers, as the BMI of the observer declines, the overestimation of body mass increases. One possible explanation for this result is that the overestimation is a secondary effect caused by weight loss. Moreover, if the degree of body mass overestimation is taken into account, then there are no significant differences in the perceptions of attractiveness between anorexic and bulimic observers and control observers. Our results suggest a significant perceptual overestimation of BMI that is based on the observer's own BMI and not correlated with cognitive factors, and suggests that this overestimation in eating-disordered patients must be addressed directly in treatment regimes.

Anorexia Nervosa↗
PubMed2006

Development of the facial skin care index: a health-related outcomes index for skin cancer patients.

BACKGROUND: Existing health-related quality-of-life (HRQOL) tools do not appear to capture patients' specific skin cancer concerns. OBJECTIVE: To describe the conceptual foundation, item generation, reduction process, and reliability testing for the Facial Skin Cancer Index (FSCI), a HRQOL outcomes tool for skin cancer researchers and clinicians. METHODS: Participants in Phases I to III consisted of adult patients (N=134) diagnosed with biopsy-proven nonmelanoma cervicofacial skin cancer. Data were collected via self-report surveys and clinical records. RESULTS: Seventy-one distinct items were generated in Phase I and rated for their importance by an independent sample during Phase II; 36 items representing six theoretical HRQOL domains were retained. Test-retest I results indicated that four subscales showed adequate reliability coefficients (alpha=0.60 to 0.91). Twenty-six items remained for test-retest II. Results indicated excellent internal consistency for emotional, social, appearance, and modified financial/work subscales (range 0.79 to 0.95); test-retest correlation coefficients were consistent across time (range 0.81 to 0.97; lifestyle omitted). CONCLUSION: Pretesting afforded the opportunity to select items that optimally met our a priori conceptual and psychometric criteria for high data quality. Phase IV testing (validity and sensitivity before surgery and 4 months after Mohs micrographic surgery) for the 20-item FSCI is under way.

Adult↗
PubMed2004

Validity of the body mass index and fat mass index as an indicator of obesity in children aged 3-5 year.

The validity of the BMI and fat mass index (FMI) as indicators of obesity was evaluated in a group of 3-5 yr old (n=486) children. Bioelectrical impedance analysis (BIA) was measured (using 50 kHz and tetrapolar electrodes) in order to calculate percent fat mass (%FM) and FMI (fat mass/stature squared). For boys, obesity was defined as > or =20%FM. For girls, the cutoff for obesity was > or =25%FM. However, obesity was defined as a BMI at or above the 90th percentile of age- and sex-specific data in this study. The percentile cutoffs for FMI were the same as for BMI using the same sample. There were correlations between BMI or FMI and %FM, but there was no significant correlation between BMI or FMI and stature. Therefore, it appears that both the BMI and FMI in this study are far more useful indices with which to assess obesity, and are reasonable indicators of fatness. However, with the use of %FM by BIA as the criterion for obesity, BMI and FMI had high specificities (95.5-96.4% for BMI and 99.5-100% for FMI) and lower but variable sensitivities (30.4-37.5% for BMI and 42.9-68.8% for FMI). Thus, almost all children who were not obese were classified correctly. In contrast, many obese children were not correctly identified by BMI and FMI. Therefore, we conclude that BMI should be used with caution as an indicator of childhood obesity. The new recommendations based on the FMI approach for defining childhood obesity are associated with a level of sensitivity that is somewhat higher than that of the BMI approach. Caution should, however, be used in generalizing from the findings in this study, and a further investigation of the issue is required.

Adipose Tissue↗
PubMed2000

Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union.

An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women) to calculate the underestimation of body weight as assessed by body image among the overweight and obese population and identify the associated factors to this behavior. Participants were older than 15 years and they were living in the 15 European Union countries. Body mass index (BMI) was grouped into 4 categories using the cutpoints established by the WHO, while perceived body image (PBI) was assessed using a nine-silhouettes drawing. The degree of underestimation between PBI as compared to BMI was identified in overweight and obesity categories of BMI. A multivariable logistic regression model for each gender was used to adjust for potentially confounding variables. Men classified themselves worse than women, being more likely to underestimate their body weight (65.2% of men underestimated their weight vs 32.2% women), regardless of other socioeconomic and attitudinal variables. The greatest degree of underestimation was observed in Mediterranean individuals (68.7% of men and 37.9% of women underestimated their weight). The subjects in the 'maintenance' stage of physical activity tended more often to wrongly select their actual image (71.8% for men and 38.7% for women).

Adolescent↗
PubMed2002

Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults.

OBJECTIVE: To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. METHODS: The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. RESULTS: The data of 4 cohorts including 76,227 persons, with 745,346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8% increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15% for men, and 22% of both diseases for women. CONCLUSION: BMI < or = 18.5, 24-27.9 and > or = 28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.

Adult↗
PubMed1992

[Prognostic implications of the proliferation index (H3-TdR-labeling index) and ploidy in neuroectodermal tumors (astrocytomas and glioblastomas)].

Kinetic cellular methods were used in 53 cases of various sizes of astrocytomas and glioblastomas to obtain reliable prognostic information. Kinetic analysis revealed a wide variation of proliferative activity, with a gradual increase of the mean value from the most differentiated astrocytomas to glioblastomas. DNA content was significantly correlated with the degree of histological differentiation. Chromosomic patterns, which were detected in a few cases, were generally aspecific. The sole recurrent alteration in the karyotype was a small metacentric marker. The comparison of results obtained with the follow-up of patients showed that the labeling index offers a more accurate estimate of the proliferative potential of individual tumours, and thus of the probability of survival, than histological diagnosis and the evaluation of other biological parameters such as ploidy and karyotype.

Adolescent↗
PubMed2003

Development of an indexing search engine for the UMVF: proposal for an indexing method based on Dublin Core and XML.

The UMVF (French Virtual Medical University) has many heterogeneous resources hosted by the servers of university partners of the project. One of its objectives is to develop an efficient tool to perform a single search on these resources. We first defined a standardized and interoperable indexing method. For each document, an XML file containing information on the fifteen elements of Dublin Core was created. We checked its structure and content with a DTD. If the XML file was valid, its data were then integrated into a central database from which the engine carried out a search. We tested our tool successfully with the resources hosted by the Rennes Laboratory of Medical Informatics in cooperation with the Radiology Medical Campus [1]. Our method allows the standardization of the production of information by the various servers and it conforms to the constraints of the semantic Web owing to the technologies chosen.

Abstracting and Indexing↗
PubMed1994

[The carpus-metacarpus-index distance: a measurement for quantifying radiological lesions in rheumatoid polyarthritis. Comparison with Larsen's scores and Steinbrocker's index].

The carpus-to-digits distance measured on a posteroanterior roentgenogram of the hands and wrists takes into account 18 different joints. This study demonstrates that the carpus-to-digit distance is a simple, reproducible score which reliably reflects progression of roentgenological rheumatoid arthritis lesions and is correlated with Larsen's lesion score and with Steinbrocker's index, but not with Larsen's erosion score during the first two years after onset of the disease. Larsen's erosion score and similar parameters should be preferred for clinical studies of recent-onset rheumatoid arthritis. The carpus-to-digit distance, which requires neither a reference film not observer training, is appropriate for long-term clinical studies.

Arthritis, Rheumatoid↗
PubMed1997

[Biparametric analysis of the apoptotic index and the proliferation index (KI-67) in solid tumors].

INTRODUCTION: Cell kinetic data are important indicators of the aggressiveness of tumor and treatment response. In this study biparametric analysis of proliferation and apoptotic index was performed on paraffin-embedded tissue from certain neoplasia. MATERIAL AND METHODS: We studied 107 cases of neoplastic and non neoplastic lesions. For each case, on the same section, TUNEL reaction and immunohistochemical protein Ki67 expression analysis were performed. RESULTS: On 102 out of 107 cases (95.3%) we obtained valid results both about apoptotic and proliferative indices. CONCLUSIONS: This method could supply, at the same time, interesting information about the two possible different patterns of neoplastic growth: one related to an increase fraction of proliferating cells, the other to decrease in apoptotic cell death. Cell kinetic data may have interesting implications on therapeutic choice.

Antigens, Neoplasm↗