The relationship between psychosocial stress, age, BMI, CRP, lifestyle, and the metabolic syndrome in apparently healthy subjects

The aim of this cross-sectional study was to examine the factors which may be associated with the metabolic syndrome by exploring the relationship between psychosocial stress, age, body mass index (BMI), C-reactive protein (CRP), lifestyle factors, and the components of the metabolic syndrome, such as glycated hemoglobin (HbA1c), fasting blood sugar (FBS), body fat percentage, and triglyceride concentration, among apparently healthy subjects. Psychosocial stress was measured by the use of the inventory to measure psychosocial stress (IMPS). One thousand four hundred and ninety-nine people out of 1,941 public school workers admitted to a hospital for a medical check-up responded to the IMPS, yielding a response rate of 77.2%. A total of 1,201 workers excluding 298 who were taking medication for various diseases were analyzed with the use of hierarchical multiple regression models. It was found that IMPS-measured stress score, age, BMI, and smoking habit were associated with an increase in glycated hemoglobin among men, while alcohol consumption was associated with a decrease in glycated hemoglobin. Stress score, age, BMI, and alcohol consumption were found to be associated with an increase in FBS among men, while smoking and exercise habits were associated with a decrease in FBS. CRP was found to be associated with an increase in body fat percentage among men, though stress score was not associated with an increase in body fat percentage. Stress score, age, and BMI were associated with an increase in triglyceride concentration among women. The findings of the present study seem to be in line with the hypothesis that psychosocial stress plays an important role in developing the metabolic syndrome, which may be associated with inflammatory processes in the vascular wall, resulting in atherosclerosis and cardiovascular disease.     

Relationship between change in BMI with age and delayed menarche in female athletes

Body mass index (BMI) is widely used as an index of obesity in people from the school age children to adults. However, the relationship between the change in BMI with age and the coming of menarche has not been discussed as there are few reports on the changes in BMI with age. In this study, the change in BMI with age was examined by applying the wavelet interpolation method (WIM), and a critical period for body fat in terms of the coming of menarche was estimated from the growth velocity. We investigated delayed menarche according to the influence of stress in athletes by comparing delayed menarche between athletes and non-athletes in relation to the critical period. Data were obtained from 144 female athletes in their first year at university in the Tokai area, all of whom had competed in a national sports competition in high school (athlete group). Health examination records showing these subjects' heights and weights from the first grade of elementary school to the final year of high school (1984-1995) were collected and BMI was calculated for each grade. Ages at menarche were ascertained from questionnaires. A control group of 73 non-athletes was similarly examined. The age at maximum peak velocity (MPV) derived from the growth (aging) distance curve of BMI was determined in the control group to be 11.96+/-0.97 years old. This age at MPV of BMI was almost the same as the age at menarche (12.11+/-0.93 years old). Therefore, this age at MPV of BMI is estimated to be the critical period of body fat for the coming of menarche. The interval between the age at MPV of BMI and age at menarche was 0.74+/-1.30 years in the athlete group and 0.15+/-0.81 years in the control group, so there was a significant difference (P<0.01) between the two groups. It is suggested that the delayed menarche in athletes is influenced by the stress of regular sports training.     

Change with age in regression construction of fat percentage for BMI in school-age children

In this study, curvilinear regression was applied to the relationship between BMI and body fat percentage, and an analysis was done to see whether there are characteristic changes in that curvilinear regression from elementary to middle school. Then, by simultaneously investigating the changes with age in BMI and body fat percentage, the essential differences in BMI and body fat percentage were demonstrated. The subjects were 789 boys and girls (469 boys, 320 girls) aged 7.5 to 14.5 years from all parts of Japan who participated in regular sports activities. Body weight, total body water (TBW), soft lean mass (SLM), body fat percentage, and fat mass were measured with a body composition analyzer (Tanita BC-521 Inner Scan), using segmental bioelectrical impedance analysis & multi-frequency bioelectrical impedance analysis. Height was measured with a digital height measurer. Body mass index (BMI) was calculated as body weight (km) divided by the square of height (m). The results for the validity of regression polynomials of body fat percentage against BMI showed that, for both boys and girls, first-order polynomials were valid in all school years. With regard to changes with age in BMI and body fat percentage, the results showed a temporary drop at 9 years in the aging distance curve in boys, followed by an increasing trend. Peaks were seen in the velocity curve at 9.7 and 11.9 years, but the MPV was presumed to be at 11.9 years. Among girls, a decreasing trend was seen in the aging distance curve, which was opposite to the changes in the aging distance curve for body fat percentage.     

BMI and Lifetime Changes in BMI and Cancer Mortality Risk

Body Mass Index (BMI) is known to be associated with cancer mortality, but little is known about the link between lifetime changes in BMI and cancer mortality in both males and females. We studied the association of BMI measurements (at baseline, highest and lowest BMI during the study-period) and lifetime changes in BMI (calculated over different time periods (i.e. short time period: annual change in BMI between successive surveys, long time period: annual change in BMI over the entire study period) with mortality from any cancer, and lung, colorectal, prostate and breast cancer in a large cohort study (n=8,645. Vlagtwedde-Vlaardingen, 1965-1990) with a follow-up on mortality status on December 31^st 2008. We used multivariate Cox regression models with adjustments for age, smoking, sex, and place of residence. Being overweight at baseline was associated with a higher risk of prostate cancer mortality (hazard ratio (HR) =2.22; 95% CI 1.19-4.17). Obesity at baseline was associated with a higher risk of any cancer mortality [all subjects (1.23 (1.01-1.50)), and females (1.40 (1.07-1.84))]. Chronically obese females (females who were obese during the entire study-period) had a higher risk of mortality from any cancer (2.16 (1.47-3.18), lung (3.22 (1.06-9.76)), colorectal (4.32 (1.53-12.20)), and breast cancer (2.52 (1.15-5.54)). We found no significant association between long-term annual change in BMI and cancer mortality risk. Both short-term annual increase and decrease in BMI were associated with a lower mortality risk from any cancer [all subjects: (0.67 (0.47-0.94)) and (0.73 (0.55-0.97)), respectively]. In conclusion, a higher BMI is associated with a higher cancer mortality risk. This study is the first to show that short-term annual changes in BMI were associated with lower mortality from any type of cancer.     

Regional, age and sexual differences of BMI of the Czech and Slovak adult populations at the end of the 20th century

Nowadays the Body Mass Index (BMI) is used everywhere as the coefficient of normal weight, overweight and obesity. In the years 1987-1988 an anthropometrical survey was carried out in the whole region of the former Czechoslovakia, which was done on 20,232 adult males and females, aged from 18 to more than 70 years. The research was made on the basis of three grade statistical choice and is representative for the entire territory of the Czech and Slovak Republics. Body height and body weight were determined according to Martin & Saller (1957; M 1, M 71). For the assessment of regional differences the whole set of data was divided into 12 separate groups in accordance to the administrative regions existing at that time. Each group was then analyzed considering eleven age classes.     

BMI及LDL-C水平与冠脉慢血流的相关性研究

目的:探讨低密度脂蛋白胆固醇及身高体重指数与冠状动脉慢血流现象(Coronary slow flow phenomenon,CSFP)的相关性。方法:在我院2013年上半年因不典型胸痛行冠脉造影术患者中,选取冠脉官腔无明显狭窄(40%)且至少一支冠脉根据校正的TIMI血流分级方法被评为慢血流的患者进入慢血流组(CSFP组)79例,选取同期无明显狭窄且血流速度正常的患者71例为对照组,对两组入院各项常规检查检验指标进行分析,筛选导致冠脉慢血流的危险因素。结果:在两组比较中,CSFP组的慢血流组吸烟率、身体质量指数(Body Mass Index,BMI)、甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、尿酸(Uric acid,UA)水平明显高于对照组;亚组分析中显示BMI、LDL-C水平随受累血管数量增多呈上升趋势,且具有统计学意义;经回归分析,显示BMI、LDL-C水平的升高对冠脉慢血流的发生有显著影响,且与冠脉血流速度(帧数)呈正相关。结论:BMI、LDL-C水平与冠脉慢血流的发病的密切相关。     

BMI, body composition, and physical functioning in older adults

Objective: Recent studies have emphasized the importance of muscle and fat mass in relation to age‐related decline in physical function. Our objective was to determine whether BMI, as a surrogate measurement of fat mass, may be used as a measure of risk factor for physical functioning in older adults and whether body composition measurements confer any advantage over BMI. Research Methods and Procedures: Four thousand men and women ≥65 years of age living in the community, stratified by age and sex, underwent the following measurements: body composition by DXA; grip strength; and timed 6‐m walk. Subjects were grouped into five categories of BMI using Asian criteria for health‐related risks, and between‐group differences in physical performance measures and body composition were analyzed using analysis of covariance adjusting for age, physical activity level, and presence of chronic disease. Results: Subjects in the two obese categories had a significantly greater number of instrumental activities of daily living (IADL) impairments compared with the underweight and normal‐weight groups. Those with BMI ≥30 kg/m² had the worst walking performance, and the groups with BMI in the normal and overweight range had optimal performance. Fat mass, but not appendicular muscle mass, was associated with walking speed after adjusting for BMI. Discussion: Fat mass seems to be a more important factor than appendicular muscle mass in determining walking speed in community‐living older adults, even after adjusting for BMI.     

Genetic and environmental contributions to weight, height, and BMI from birth to 19 years of age: an international study of over 12,000 twin pairs

Objective

To examine the genetic and environmental influences on variances in weight, height, and BMI, from birth through 19 years of age, in boys and girls from three continents.

Design and Settings

Cross-sectional twin study. Data obtained from a total of 23 twin birth-cohorts from four countries: Canada, Sweden, Denmark, and Australia. Participants were Monozygotic (MZ) and dizygotic (DZ) (same- and opposite-sex) twin pairs with data available for both height and weight at a given age, from birth through 19 years of age. Approximately 24,036 children were included in the analyses.

Results

Heritability for body weight, height, and BMI was low at birth (between 6.4 and 8.7% for boys, and between 4.8 and 7.9% for girls) but increased over time, accounting for close to half or more of the variance in body weight and BMI after 5 months of age in both sexes. Common environmental influences on all body measures were high at birth (between 74.1–85.9% in all measures for boys, and between 74.2 and 87.3% in all measures for girls) and markedly reduced over time. For body height, the effect of the common environment remained significant for a longer period during early childhood (up through 12 years of age). Sex-limitation of genetic and shared environmental effects was observed.

Conclusion

Genetics appear to play an increasingly important role in explaining the variation in weight, height, and BMI from early childhood to late adolescence, particularly in boys. Common environmental factors exert their strongest and most independent influence specifically in pre-adolescent years and more significantly in girls. These findings emphasize the need to target family and social environmental interventions in early childhood years, especially for females. As gene-environment correlation and interaction is likely, it is also necessary to identify the genetic variants that may predispose individuals to obesity.     

Associations among education, cortisol rhythm, and BMI in blue-collar women

Objective: This study sought to test whether a biological measure of chronic stress, Δ cortisol, was related to BMI and whether the relationship between Δ cortisol and BMI varied according to education and positive affect. Research Methods and Procedures: One hundred fifty‐four women from a blue‐collar women's health project in 11 industrial sites in rural North Carolina provided saliva for cortisol assays for a substudy on “stress.” Δ Cortisol, the difference between awakening and midday cortisol measures representing diurnal decline, was calculated (lower values = greater stress). BMI was regressed on Δ cortisol, education, and positive affect. Analyses were controlled for age, race, and worksite. Standardized β‐coefficients were calculated. Results: For participants with complete data (n = 129), BMI was greater (β 95% confidence interval) for women with less than high school education (0.56; 0.18, 0.94) and those who completed high school (0.26; ?0.05, 0.57) relative to women with greater than a high school education (p = 0.009). Δ Cortisol was inversely related to BMI (?0.32; ?0.59, ?0.05; p = 0.022). Education positively modified the inverse relationship between Δ cortisol and BMI (p = 0.047). Positive affect was negatively associated with BMI (?0.44; ?0.82, ?0.06; p = 0.026) and positively modified the inverse association between Δ cortisol and BMI (0.33; ?0.03, 0.69; p = 0.074). Discussion: Education and Δ cortisol were inversely related to BMI, and the magnitude of the association between Δ cortisol and BMI was buffered by higher education. Positive affect was inversely related to BMI. Chronic stress is associated with higher BMI, with this relation attenuated by higher education and, possibly, a positive affect.     

BMI, obesity, and sickness absence in the Whitehall II study

Objective: To study BMI and change in BMI from age 25 as predictors of sickness absence. Research Methods and Procedures: Data were collected from 2564 women and 5853 men, who were British civil servants (35 to 55 years) on entry to the Whitehall II study (Phase 1, 1985 to 1988). Employer's records provided annual medically certified (long, >7 days) and self‐certified (short, 1 to 7 days) spells of sickness absence. BMI at age 25 and Phase 1 were examined in relation to absences from Phase 1 to the end of 1998 (mean follow‐up, 7.0 years). Results: After adjustment for employment grade, health‐related behaviors, and health status, overweight (BMI = 25.0 to 29.9 kg/m²) and obesity (BMI > 30.0 kg/m²) at Phase 1 were significant predictors of short and long absences in both sexes; rate ratios (95% confidence intervals) ranged from 1.13 (1.05 to 1.21) to 1.51 (1.30 to 1.76) compared with a BMI of 21.0 to 22.9 kg/m². Additionally, a BMI of 23.0 to 24.9 kg/m² at Phase 1 predicted long absences in women, and underweight (BMI < 21.0 kg/m²) predicted short absences in men. Obesity at age 25 predicted long absences, and obesity at Phase 1 predicted short and long absences in both sexes. Chronic obesity was a particularly strong predictor of long absences in men, with a rate ratio of 2.61 (1.88 to 3.63). Discussion: Findings from this well‐characterized cohort suggest that the obesity epidemic in industrialized countries may result in significant increases in sickness absence. Further research is needed to determine the underlying mechanisms. Policy to reduce sickness absence needs to tackle the problem of excess weight in the working population.     

BMI, waist circumference, and incident urinary incontinence in older women

Overall body fat and central adiposity may reflect different mechanisms leading to urinary incontinence (UI). We examined the associations of BMI and waist circumference with incident UI, including the independent associations of BMI and waist circumference with UI type, among women aged 54-79 years in the Nurses' Health Study. Study participants reported their height in 1976 and their weight and waist circumference in 2000. From 2000 to 2002, we identified 6,790 women with incident UI at least monthly among 35,754 women reporting no UI in 2000. Type of incontinence was determined on questionnaires sent to cases with at least weekly incontinence. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. There were highly significant trends of increasing risk of UI with increasing BMI and waist circumference (P for trend <0.001 for both). Multivariable RRs of developing at least monthly UI were 1.66 (95% CI 1.45-1.91) comparing women with a BMI of > or =35 kg/m(2) to women with BMI 21-22.9 kg/m(2) and 1.72 (95% CI 1.53-1.95) comparing women in extreme quintiles of waist circumference. When BMI and waist circumference were included in models simultaneously, BMI was associated with urge and mixed UI (P for trend 0.003 and 0.03, respectively), but not stress UI (P for trend 0.77). Waist circumference was associated only with stress UI (P for trend <0.001). These results suggest that women who avoid high BMI and waist circumference may have a lower risk of UI development.     

Childcare, height and BMI among female Polish university students, 2005

The aim of this study is to consider whether socio-economic factors are related to the type of childcare and whether the type of childcare, in turn, affects adult stature and BMI. The sample includes 783 female students aged 20-24 (birth cohort of 1981-1985) from the south of Poland. Those whose parents have university education, live in a city and have no siblings attend day-care facilities more frequently than others of the same age, while those who grew up at home under their mothers' care, most frequently live in villages, come from large families and their parents have vocational education. Variables which are associated with being taller include material conditions and the type of childcare received. Women who had attended day-care centres are 2.4cm shorter than girls brought up at home by their mothers. Adult BMI values are influenced by educational level of the mother. The results suggest that mothers who work often do so at the cost of time devoted to the family which influences health and the rate of their children's development.     

BMI and seatbelt use

Objective: Seatbelt use among obese persons may be reduced because seatbelts are uncomfortable. We investigated the association between obesity and seatbelt use with data from the 2002 Behavioral Risk Factor Surveillance System Survey. Research Methods and Procedures: Multivariable logistic regression was used to calculate odds ratios and 95% confidence intervals (CIs) for seatbelt use among overweight (BMI, 25.0 to 29.9), obese (BMI, 30.0 to 39.9), and extremely obese (BMI ≥ 40.0) persons, relative to a non‐overweight/non‐obese reference group (BMI ≤ 24.9), adjusted for age, race, gender, education, and state seatbelt law. Results: Adjusted odds ratios for seatbelt use were 0.89 (95% CI, 0.85 to 0.93) for overweight, 0.69 (0.66 to 0.73) for obese, and 0.45 (95% CI, 0.40 to 0.50) for extremely obese persons. Interaction effects were evident for all covariates, with stronger associations between increasing BMI and decreasing seatbelt use for women, increasing age, higher education, and residence in states with a secondary seatbelt law. There was a linear decrease in seatbelt use with increasing BMI for all subgroups except persons 18 to 24 years old. Discussion: Lack of seatbelt can be added to the list of risk factors associated with obesity. Effective preventive interventions are needed to promote seatbelt use among overweight and obese persons.     

Climate amenity and BMI

Objectives: Our goal was to examine the relationship between BMI and climate amenable for physical activity at the county level in the U.S. Research Methods and Procedures: Using Geographic Information Systems tools and 6‐year National Oceanic and Atmospheric Administration station hourly weather records, an index of amenable climate was derived for all U.S. counties. This index was linked to individual BMI in a multi‐level analysis that accounted for other individual characteristics from the 2002 survey of the Behavioral Risk Factor Surveillance System. Results: There was an inverse relationship between climate amenable to physical activity and BMI at the county level after controlling for individual risk factors, county road density, and median household income and unemployment rate. Residents in high climate‐amenity counties tended to have a lower BMI. Discussion: The contribution of less amenable climate to overweight and obesity in the U.S. is likely to be substantial because it cuts across wide geographic areas. Health promotion strategies that promote mixed land use or other urban design conducive to walking and other physical activities should consider broader environmental disamenities to mitigate their influence. Strategies for outdoor physical activity should also be tailored for people of different racial groups and educational backgrounds due to observed differences in their response to climate amenity.     

Factors associated with tracking of BMI: a meta-regression analysis on BMI tracking

Stable tracking of body composition is a prerequisite for the long-term effect of preventive measures against obesity and its harmful effects. As BMI tracking estimates reported by individual studies vary considerably, we performed a meta-regression analysis to provide a summary estimate and to assess determinants of BMI tracking. Using the Medline and EMBASE databases, a systematic review was conducted to identify publications reporting correlation coefficients as tracking estimates between BMI at baseline and follow-up measurements and the time interval between these measurements. Additional information recorded included age at baseline measurement, gender, and origin of the studied population. Based on the extracted data, a meta-regression analysis was performed using mixed effects models to account for multiple measurements of the same cohorts. Data on 55,072 individuals (797,094 person-years) extracted from 48 publications with follow-up times between 0.5 and 44 years entered the analysis. The overall estimates for the 1-year tracking correlation coefficient were strong (r = 0.78-0.86 depending on age at baseline measurement) and gradually decreasing over time (0.67-0.78 after 10 years, and 0.27-0.47 after 30 years). Study origin classified by continent was another significant predictor of BMI tracking whereas gender was not. In conclusion, this meta-regression analysis showed a high degree of BMI tracking across all age groups investigated and independent of BMI. Successful prevention in weight control is likely to have long term effects at any age, thereby being beneficial with respect to the associated risks of over- and underweight.