Age and sex variation in measures of body composition among the elderly Bengalee Hindus of Calcutta, India

In the present cross-sectional study we examined 332 (171 men and 161 women) elderly (60 years and above) urban Bengalee Hindu resident in south Calcutta, India. Individuals were selected by random sampling procedure using local voter's registration list. Skin folds measures were used to compute body composition measures among them. There existed significant sex differences in various anthropometric body composition measures. Age had significant (p < 0.001) negative association with all anthropometric body composition measures namely percentage of body fat (PBF), fat mass (FM), arm muscle circumference (AMC), arm muscle area (AMA) and arm fat area (AFA) in both sexes. Fat free mass (FFM) in contrast had negative but not significant age impact. Regression analyses demonstrated that age had explained substantial amount of variance of PBF (men = 32%; women = 18.2%), FM (men = 18.2%; women = 12.8%), AMC (men = 23.4%; women = 19.2%), AMA (men = 22.2%; women = 10.2%) and AFA (men = 34%; women = 31%) in both sexes. Two-way ANOVA revealed age-sex interaction only had significant effect on FFM. The present investigation vindicated that there is a significant inverse age trends in anthropometric body composition measures among the Bengalee Hindus. Moreover, there existed sexual dimorphism in the effect of age on various anthropometric body composition measures.     

Food composition of the diet in relation to changes in waist circumference adjusted for body mass index

Background

Dietary factors such as low energy density and low glycemic index were associated with a lower gain in abdominal adiposity. A better understanding of which food groups/items contribute to these associations is necessary.

Objective

To ascertain the association of food groups/items consumption on prospective annual changes in “waist circumference for a given BMI” (WC_BMI), a proxy for abdominal adiposity.

Design

We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WC_BMI was defined as the residuals of waist circumference regressed on BMI, and annual change in WC_BMI (ΔWC_BMI, cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between food groups/items and ΔWC_BMI was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates.

Results

Higher fruit and dairy products consumption was associated with a lower gain in WC_BMI whereas the consumption of white bread, processed meat, margarine, and soft drinks was positively associated with ΔWC_BMI. When these six food groups/items were analyzed in combination using a summary score, those in the highest quartile of the score – indicating a more favourable dietary pattern –showed a ΔWC_BMI of −0.11 (95% CI −0.09 to −0.14) cm/y compared to those in the lowest quartile.

Conclusion

A dietary pattern high in fruit and dairy and low in white bread, processed meat, margarine, and soft drinks may help to prevent abdominal fat accumulation.     

Serum lipids, body mass index and waist circumference during pubertal development in Spanish adolescents: the AVENA Study.

AIM: To describe the effects of chronological age and biological age (pubertal development) on serum lipid and lipoprotein levels, body mass index (BMI) and waist circumference in Spanish adolescents. METHODS: A representative Spanish sample of 526 adolescents (254 males and 272 females), were studied. Total cholesterol (TC), high density lipoprotein cholesterol (HDLc), triglycerides, apolipoprotein A1 and B, and lipoprotein(a) were measured, and low density lipoprotein cholesterol (LDLc) was calculated. Additional measurements included BMI and waist circumference. Adolescents were classified according to chronological age, and pubertal development (also age of menarche in females). RESULTS: In males, serum TC levels were lower at late puberty in comparison with early puberty, and serum LDLc levels were lower at late puberty in comparison with mid and early puberty. Serum HDLc levels were lower at mid puberty in comparison with early and late puberty. Serum TC and LDLc levels were not different when analyzed according to chronological age. In females, HDLc levels were lower at late puberty in comparison with early and mid puberty, but no differences were found when HDLc and the other studied lipid and lipoprotein variables were analyzed according to chronological age, or age of menarche. All the observed differences persisted after adjusting for BMI and waist circumference. In female adolescents, both BMI and waist circumference were higher at late puberty in comparison with early and mid puberty, while in males, BMI and waist circumference were different when analyzed according to chronological age. CONCLUSION: The results suggest that the assessment of pubertal development may provide additional valuable information when interpreting lipid profile and body fat in adolescents.     

The relationship of age, body mass index and waist circumference with blood pressure in Bengalee Hindu male jute mill workers of Belur, West Bengal, India

A cross-sectional study of 150 adult Bengalee Hindu male jute mill workers of Belur, a suburb of Kolkata, West Bengal, India, was undertaken to study the relationship of age, body mass index (BMI) and waist circumference (WC) with systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure. The mean age and the BMI of the subjects were 40.7 years (S.D. = 15.2) and 23.2 kg/m2 (S.D. = 3.2), respectively. The mean SBP, DBP and MAP were 124.7 mmHg (S.D. = 7.8), 81.5 mmHg (S.D. = 5.7) and 95.9 mmHg (S.D. = 6.1), respectively. Age had similar significant (p < 0.001) correlations with BMI and WC. Age and WC were significantly correlated (p < 0.001) with all the three blood pressure variables. In general, the correlations of BMI with SBP (r = 0.24, p < 0.01), DBP (r = 0.15, n.s.) and MAP (r = 0.19, p < 0.05) were weaker. Age controlled multiple regression analyses demonstrated that BMI did not have a significant effect of any blood pressure variable. However, WC had a significant impact (p < 0.0001) on SBP (t = 7.068), DBP (t = 5.190) and MAP (t = 6.387), even after adjusting for the effect of age. Moreover, even after age adjustment, percent variations in SBP (20.7%), DBP (12.5%) and MAP (17.2%) explained by WC were high. This significant impact (p < 0.0001) of WC on SBP (t = 9.426), DBP (t = 8.349) and MAP (t = 9.642) remained even after controlling for the combined effects of age and BMI.     

Body mass index,waist circumference and employment: Evidence from older Irish adults

Data from the first wave of the Irish Longitudinal Study on Ageing are used to examine the relationship between fatness and obesity and employment status among older Irish adults. Employment status is regressed on one of the following measures of fatness: BMI and waist circumference entered linearly as continuous variables and obesity as a categorical variable defined using both BMI and waist circumference. Controls for demographic and socioeconomic characteristics, socioeconomic characteristics in childhood and physical, mental and behavioural health are also included. The regression results for women indicate that all measures of fatness are negatively associated with the probability of being employed and that the employment elasticity associated with waist circumference is larger than the elasticity associated with BMI. The results for men indicate that employment is not significantly associated with BMI and waist circumference when these are entered linearly in the regression, but it is significantly and negatively associated with obesity defined either using BMI or waist circumference as categorical variables. The results also indicate that the negative association between obesity and employment status is larger among women. For example, the probability of being employed for the obese category defined using BMI is around 8 percentage points lower for women and 5 percentage points lower for men.     

Diurnal salivary cortisol is associated with body mass index and waist circumference: The multiethnic study of atherosclerosis

Objective:

Neuroendocrine abnormalities, such as activation of the hypothalamic‐pituitary‐adrenal (HPA) axis, are associated with obesity; however, few large‐scale population‐based studies have examined HPA axis and markers of obesity. We examined the cross‐sectional association of the cortisol awakening response (CAR) and diurnal salivary cortisol curve with obesity.

Design and Methods:

The Multiethnic Study of Atherosclerosis Stress Study includes 1,002 White, Hispanic, and Black men and women (mean age 65 ± 9.8 years) who collected up to 18 salivary cortisol samples over 3 days. Cortisol profiles were modeled using regression spline models that incorporated random parameters for subject‐specific effects. Cortisol curve measures included awakening cortisol, CAR (awakening to 30‐min postawakening), early decline (30 min to 2‐h postawakening), late decline (2‐h postawakening to bedtime), and the corresponding areas under the curve (AUC). Body mass index (BMI) and waist circumference (WC) were used to estimate adiposity.

Results:

For the entire cohort, both BMI and WC were negatively correlated with awakening cortisol (P < 0.05), AUC during awakening rise, and early decline and positively correlated to the early decline slope (P < 0.05) after adjustments for age, race/ethnicity, gender, diabetes status, socioeconomic status, β‐blockers, steroids, hormone replacement therapy, and smoking status. No heterogeneities of effects were observed by gender, age, and race/ethnicity.

Conclusions:

Higher BMI and WC are associated with neuroendocrine dysregulation, which is present in a large population sample, and only partially explained by other covariates.     

BMI, waist circumference, and selected cardiovascular disease risk factors among preschool-age children

In adults, overweight is often associated with other cardiovascular disease (CVD) risk factors. We determined whether these associations were also present in young children. This study examined the relationships between elevated BMI (≥85th and ≥95th percentiles for age and sex) and the highest quintile of waist circumference (WC) with CVD risk factors, including fasting triglyceride (TGL), high- and low-density lipoprotein (HDL and LDL), total cholesterol (TC), non-HDL cholesterol, and C-reactive protein (CRP) in 3,644 3- to 6-year-old children included in the 1999-2008 National Health and Nutrition Examination Surveys (NHANES). Results showed that 20% (highest quintile) of the sample had a TC >170 mg/dl, LDL >109 mg/dl, TGL >103 mg/dl, non-HDL >128 mg/dl, CRP >0.13 mg/dl, WC >57.2 cm, and HDL <42 mg/dl. Increased BMI and WC were associated with increased CRP levels in non-Hispanic black boys and girls, Hispanic boys, and non-Hispanic white girls, whereas elevated TGL and non-HDL cholesterol and low HDL cholesterol were generally associated with elevated BMI and WC in Hispanic children. TC and LDL cholesterol were not significantly associated with elevated weight in 3- to 6-year-olds. BMI and WC were similar in predicting the same risk factors. In summary, this analysis shows that in preschool-age children, greater BMI and WC are associated with biomarkers that are related to CVD risk, but these associations vary by ethnicity. Child health providers should consider using both BMI and WC to identify young children who may be at risk for elevated CVD biomarkers.     

Waist circumference adjusted for body mass index and intra-abdominal fat mass

Background

The association between waist circumference (WC) and mortality is particularly strong and direct when adjusted for body mass index (BMI). One conceivable explanation for this association is that WC adjusted for BMI is a better predictor of the presumably most harmful intra-abdominal fat mass (IAFM) than WC alone. We studied the prediction of abdominal subcutaneous fat mass (ASFM) and IAFM by WC alone and by addition of BMI as an explanatory factor.

Methodology/Principal Findings

WC, BMI and magnetic resonance imaging data from 742 men and women who participated in clinical studies in Canada and Finland were pooled. Total adjusted squared multiple correlation coefficients (R²) of ASFM and IAFM were calculated from multiple linear regression models with WC and BMI as explanatory variables. Mean BMI and WC of the participants in the pooled sample were 30 kg/m² and 102 cm, respectively. WC explained 29% of the variance in ASFM and 51% of the variance in IAFM. Addition of BMI to WC added 28% to the variance explained in ASFM, but only 1% to the variance explained in IAFM. Results in subgroups stratified by study center, sex, age, obesity level and type 2 diabetes status were not systematically different.

Conclusion/Significance

The prediction of IAFM by WC is not improved by addition of BMI.     

Blood pressure and waist circumference: an empirical study of the effects of waist circumference on blood pressure among Bengalee male jute mill workers of Belur,West Bengal,India

An investigation of 150 adult Bengalee Hindu male jute mill workers in Belur, a suburb of Kolkata, West Bengal, India, was conducted to study the relationship between central obesity and blood pressure. In accordance with their waist circumference measurement, the subjects were divided into two categories: centrally non-obese (CNO) and centrally obese (CO). The participants were classified as the CO group if they had a WC of 80 cm or more. Results showed that none of the CNO subjects was mild hypertensive (SBP>/=140 mmHg and/or DBP>/=90 mmHg) while 85 of the CO subjects (82.5%) were mild hypertensives, the difference being statistically significant (chi-square=9.33; p<0.0025). Moreover, the data also revealed that the CO subjects had much (p<0.001) greater mean weight, body mass index (BMI), systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure than the CNO group members. The significant difference in blood pressure was found even after correcting the confounding effects of age and BMI variables. The results of this study showed that, the Bengalee male jute mill workers in the CO group had significantly higher blood pressure irrespective of age and overall adiposity (BMI). Therefore, the presence of central obesity is deemed a risk factor, for hypertension regardless of age and BMI. Thus, a WC cut-off point of 80 cm could be employed for health promotion among Bengalee men so as to prevent and manage hypertension effectively.     

Age and body mass index associations with body segment parameters

Body segment parameters (BSPs) such as segment mass, center of mass, and radius of gyration are required in many ergonomic tools and biomechanical models to estimate injury risk, and quantify muscle and joint contact forces. Currently, the full effects of age and obesity have not been taken into account when predicting BSPs. The goal of this study is to quantify the impact of body mass index (BMI) and age on BSPs, in order to provide more representative measures necessary for modeling inputs. A whole body dual energy X-ray absorptiometry (DXA) scan was collected for 280 working men and women with a wide range of BMI and aged 21 to 70 years. Established DXA processing methods were used to determine in-vivo estimates of the mass, center of mass, and radius of gyration for the upper arm, forearm, torso, thigh, and shank for males and females. Regression models were used to determine if age and BMI terms, as well as their interactions, were associated with these BSPs. The variability in BSPs explained by BMI alone ranged from 4 to 51%, and age explained an additional 3–19%. Thus, BMI and age are significant correlates of BSPs, and need to be taken into account when predicting certain BSPs in order to obtain accurate and representative results in biomechanical models.     

The relationship of waist circumference and BMI to visceral, subcutaneous, and total body fat: sex and race differences

The purpose of this study was to examine sex and race differences in the relationship between anthropometric measurements and adiposity in white and African-American (AA) adults. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured with computed tomography (CT). Fat mass (FM) was measured with dual-energy-X-ray absorptiometry (DXA). Correlation coefficients were used to assess the relationship of waist circumference (WC) and BMI to VAT, SAT, and FM within sex-by-race groups. General linear models were used to compare relationships between WC or BMI, and adiposity across sex and race, within age groups (18-39 and 40-64 years). The sample included 1,667 adults (men: 489 white; 120 AA; women: 666 white, 392 AA). WC and BMI correlations were highest for FM and SAT compared to VAT. Women had higher FM levels than men regardless of WC, but the sex difference in FM was attenuated in younger AA adults with a high BMI. For a given level of WC or BMI, women had higher levels of SAT than men; however, significant interactions indicated that the relationship was not consistent across all levels of BMI and WC. Sex and race differences in VAT varied significantly with WC and BMI. In general, white adults had higher levels of VAT than AA adults at higher levels of BMI and WC. Sex differences, and in some instances race differences, in the relationships between anthropometry and fat-specific depots demonstrate that these characteristics need to be considered when predicting adiposity from WC or BMI.     

Age at diagnosis, body mass index and physical morbidity in children and adults with the Prader-Willi syndrome

Age at diagnosis, Body Mass Index and physical morbidity in children and adults with the Prader-Willi syndrome: The medical findings of a population of 54 Prader-Willi patients with a molecular confirmed diagnosis are discussed. In the age group aged 18 or younger, a reasonably good control of weight as measured by Body Mass Index (BMI) is found. This is probably due to the fact that diagnosis was made at an early age and intensive diet management was started early. Despite their relatively low BMI, these children remain at high risk for developing scoliosis requiring active treatment (28% of the children). Adults (older than 18) diagnosed at the age of 10 or later have a high risk for developing obesity and obesity related health problems such as hypertension (38%), non-insulin dependant diabetes mellitus (11%) and cardio respiratory failure (16%).     

Waist circumference and body mass index as predictors of health care costs

BACKGROUND: In the present study we analyze the relationship between body mass index (BMI) and waist circumference (WC) and future health care costs. On the basis of the relation between these anthropometric measures and mortality, we hypothesized that for all levels of BMI increased WC implies added future health care costs (Hypothesis 1) and for given levels of WC increased BMI entails reduced future health care costs (Hypothesis 2). We furthermore assessed whether a combination of the two measures predicts health care costs better than either individual measure. RESEARCH METHODOLOGY/PRINCIPAL FINDINGS: Data were obtained from the Danish prospective cohort study Diet, Cancer and Health. The population includes 15,334 men and 16,506 women 50 to 64 years old recruited in 1996 to 1997. The relationship between future health care costs and BMI and WC in combination was analyzed by use of categorized and continuous analyses. The analysis confirms Hypothesis 1, reflecting that an increased level of abdominal fat for a given BMI gives higher health care costs. Hypothesis 2, that BMI had a protective effect for a given WC, was only confirmed in the continuous analysis and for a subgroup of women (BMI<30 kg/m(2) and WC <88 cm). The relative magnitude of the estimates supports that the regressions including WC as an explanatory factor provide the best fit to the data. CONCLUSION: The study showed that WC for given levels of BMI predicts increased health costs, whereas BMI for given WC did not predict health costs except for a lower cost in non-obese women with normal WC. Combining WC and BMI does not give a better prediction of costs than WC alone.     

Trajectories of relative weight and waist circumference among children with and without developmental coordination disorder

Background

Children with developmental coordination disorder have been found to be less likely to participate in physical activities and therefore may be at increased risk of overweight and obesity. We examined the longitudinal course of relative weight and waist circumference among school-aged children with and without possible developmental coordination disorder.

Methods

We received permission from 75 (83%) of 92 schools in southwestern Ontario, Canada, to enrol children in the fourth grade (ages 9 and 10 at baseline). Informed consent from the parents of 2278 (95.8%) of 2378 children in these schools was obtained at baseline. The main outcome measures were body mass index (BMI) and waist circumference. Children were followed up over two years, from the spring of 2005 to the spring of 2007.

Results

Over the course of the study, we identified 111 children (46 boys and 65 girls) who had possible developmental coordination disorder. These children had a higher mean BMI and waist circumference at baseline than did those without the disorder; these differences persisted or increased slightly over time. Children with possible developmental coordination disorder were also at persistently greater risk of overweight (odds ratio [OR] 3.44, 95% confidence interval [CI] 2.34–5.07) and obesity (OR 4.00, 95% CI 2.57–6.21) over the course of the study.

Interpretation

Our findings showed that children with possible developmental coordination disorder were at greater risk of overweight and obesity than children without the disorder. This risk did not diminish over the study period.Developmental coordination disorder is a neuro-developmental condition that affects 5%–6% of school-aged children.¹ Children with the disorder present with a range of coordination difficulties, including fine and gross motor problems,² all of which interfere with normal daily activities, recreational activities and academic performance skills such as handwriting.³ Developmental coordination disorder is diagnosed when existing neurologic and physical problems are ruled out as the cause of motor coordination difficulties and intellectual development has been taken into consideration (Box 1).^1,4 The clinical implications of a diagnosis have been described previously.⁵

Box 1.?Diagnostic criteria for developmental coordination disorder

1. Performance in daily activities that require motor coordination is substantially below that expected given the person’s chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (e.g., walking, crawling, sitting), dropping things, “clumsiness,” poor performance in sports or poor handwriting.
2. The disturbance in criterion A significantly interferes with academic achievement or activities of daily living.
3. The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia or muscular dystrophy) and does not meet criteria for a pervasive developmental disorder.
4. If mental retardation is present, the motor difficulties are in excess of those usually associated with it.

Reproduced with permission from the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, Fourth Edition.⁴ Copyright © 2000 American Psychiatric Association.Because children with developmental coordination disorder have been found to be less likely to participate in physical activities,⁶ it has been hypothesized that this condition may be a risk factor for obesity.⁷ Only a few studies have examined the association between motor coordination problems and overweight or obesity in children.^7–10 Moreover, the literature in this area is limited in two key respects. First, previous research has relied almost exclusively on body mass index (BMI) as the outcome measure.^8–10 Although important, BMI is not the only indicator of relative weight and has been shown to be weakly correlated with fat mass in young children.^11,12 Waist circumference provides valid estimates of abdominal fat in pediatric populations¹³ and appears to be a stronger predictor of cardiovascular risk among children.^14,15 Second, previous research in this area has been limited to cross-sectional data, with two notable exceptions.^8,9 However, results from these two prospective studies were mixed: one study showed a significant effect of motor coordination on weight,⁸ the other did not.⁹Our objective was to document several measures of adiposity over time in children with and without developmental coordination disorder.