Combination of BMI and Waist Circumference for Identifying Cardiovascular Risk Factors in Whites

Objective: BMI (kilograms per meters squared) and waist circumference (WC) (measured in centimeters) are each associated with the risk of developing cardiovascular disease (CVD). Therefore, a combination of the two may be more effective in identifying subjects at risk than either alone. The present study sought to identify the combination of BMI and WC that has the strongest association with CVD risk factors in whites. Research Methods and Procedures: Subjects were 8712 white men and women from the Third National Health and Nutrition Examination Survey. The optimal combination of BMI and WC was developed using logistic regression models with BMI and WC as predictors and CVD risk factors as outcomes. The combined measure of BMI and WC using current cut‐off points was also examined. Sensitivity, specificity, and receiver operating characteristics curves were compared between the combined measures and BMI alone. Results: For white men, the optimal combination of BMI and WC for identifying CVD risk factors was 0.68 × BMI + 0.32 × WC. This combination generated a score that better estimated the odds of having CVD risk factors than either alone. For white women, WC alone largely determined the likelihood of having CVD risks. The combination of BMI and WC using current cut‐off points may provide an improved measure of CVD risk. Combined measures showed a higher sensitivity or a shorter distance in receiver operating characteristic curves in the identification of CVD risk factors. Discussion: Combined measures of BMI and WC may provide a higher overall test performance for CVD risk factors and may be useful in some ethnic groups as an improved means of screening subjects for further evaluation in the clinical setting.     

Decision‐Making Deficits and Overeating: A Risk Model for Obesity

Objective: To demonstrate that human overeating is not just a passive response to salient environmental triggers and powerful physiological drives; it is also about making choices. The ventromedial prefrontal cortex has been strongly implicated in the neural circuitry necessary for making advantageous decisions when various options for action are available. Decision‐making deficits have been found in patients with ventromedial prefrontal cortex lesions and in those with substance dependence—impairments that reflect an inability to advantageously assess future consequences. That is, they choose immediate rewards in the face of future long‐term negative consequences. Research Methods and Procedures: We extended this research to the study of overeating and overweight, testing a regression model that predicted that poor decision making (as assessed by a validated computerized gambling task) and a tendency to overeat under stress would correlate with higher BMI in a group of healthy adult women (N = 41) representing a broad range of body weights. Results: We found statistically significant main effects for both independent variables in the predicted direction (p < 0.05; R² = 0.35). Indeed, the decision‐making impairments across the 100 trials of the computer task were greater in those with high BMI than in previous studies with drug addicts. Discussion: Findings suggested that cortical and subcortical processes, which regulate one's ability to inhibit short‐term rewards when the long‐term consequences are deleterious, may also influence eating behaviors in a culture dominated by so many, and such varied, sources of palatable and calorically dense sources of energy.     

Trends in Childhood Obesity in Japan over the Last 25 Years from the National Nutrition Survey

Objective: To describe the 25‐year changes in BMI (measured in kilograms per meters squared) and the prevalence of obesity in Japanese children with special reference to urban‐rural differences. Research Methods and Procedures: We used the data sets from the cross‐sectional annual nationwide surveys (National Nutrition Survey, Japan) conducted from 1976 to 2000 and comprising 29, 052 boys and 27, 552 girls between 6 and 14 years of age. We carried out the trend analyses with the data on sex and age groups and on residential areas according to the size of the municipality (metropolitan areas, cities, and small towns). Results: The mean (age‐adjusted) BMI increased by +0.32 kg/m² per 10 years in boys and by +0.24 kg/m² per 10 years in girls, increases that were remarkable in small towns. The prevalence of obese boys and girls increased from 6.1% and 7.1%, respectively, in the time‐period 1976 to 1980, to 11.1% and 10.2% in 1996 to 2000. The increasing trend was most evident in 9‐ to 11‐year‐old children of both sexes living in small towns, whereas no changes were observed in girls in metropolitan areas. Discussion: Our data clearly show increasing trends in obesity prevalence in Japanese school children. Degrees of the increasing trends, however, differed across sex and age groups and residential areas, demonstrating a particular phenomenon that girls in metropolitan areas were unlikely to become obese. These epidemiological aspects indicate the priorities for intervention in population strategies to control obesity in children.     

Exposure to food advertising on television: Associations with children's fast food and soft drink consumption and obesity

There is insufficient research on the direct effects of food advertising on children's diet and diet-related health, particularly in non-experimental settings. We employ a nationally-representative sample from the Early Childhood Longitudinal Survey–Kindergarten Cohort (ECLS-K) and the Nielsen Company data on spot television advertising of cereals, fast food restaurants and soft drinks to children across the top 55 designated-market areas to estimate the relation between exposure to food advertising on television and children's food consumption and body weight. Our results suggest that soft drink and fast food television advertising is associated with increased consumption of soft drinks and fast food among elementary school children (Grade 5). Exposure to 100 incremental TV ads for sugar-sweetened carbonated soft drinks during 2002–2004 was associated with a 9.4% rise in children's consumption of soft drinks in 2004. The same increase in exposure to fast food advertising was associated with a 1.1% rise in children's consumption of fast food. There was no detectable link between advertising exposure and average body weight, but fast food advertising was significantly associated with body mass index for overweight and obese children (≥85th BMI percentile), revealing detectable effects for a vulnerable group of children. Exposure to advertising for calorie-dense nutrient-poor foods may increase overall consumption of unhealthy food categories.     

Survival Expectations of the Obese: Is Excess Mortality Reflected in Perceptions?

Objective: This study compared self‐reported subjective life expectancy (i.e., probability of living to age 75) for normal‐weight, overweight, and obese weight groups to examine whether individuals are internalizing information about the health risks due to excessive weight. Research Methods and Procedures: Using data from the Health and Retirement Study, a total of 9035 individuals 51 to 61 years old were analyzed by BMI category. The primary outcome measure was individuals’ reports about their own expectations of survival to age 75. Absolute and relative risks of survival were compared with published estimates of survival to age 75. Results: Consistently, higher levels of BMI were associated with lower self‐estimated survival probabilities. Differences relative to normal weight ranged from 4.9% (p < 0.01) for male nonsmokers to 8.8% (p < 0.001) for female nonsmokers. However, these differences were substantially less than those obtained from published survival curve estimates, suggesting that obese individuals tended to underestimate mortality risks. Discussion: Individuals appeared to underestimate the mortality risks of excessive weight; thus, knowledge campaigns about the risks of obesity should remain a top priority.     

Association between obesity and prescribed medication use in England

We investigate the association between obesity and use of prescribed medications in England. Data were taken from fourteen rounds of the Health Survey for England (1999–2012), which has measures of current prescribed medication use based on therapeutic classifications in the British National Formulary, and nurse-measured height and weight. We find that obesity has a statistically significant and positive association with use of a range of medicines for managing diseases associated with obesity. The mean probability of using any type of medication is 0.40 in those of normal weight, 0.44 in the overweight, 0.52 in obesity class I and 0.60 in obesity class II/III. Significant positive associations were found between obesity and the use of medication for diseases of the cardiovascular system, gastrointestinal system, respiratory system, and central nervous system, as well as for infections, endocrine system disorders, gynaecological/urinary disorders and musculoskeletal and joint disorders. Use of anti-obesity medication is low, even among those with class II/III obesity.     

Phoenixin-14 stimulates differentiation of 3T3-L1 preadipocytes via cAMP/Epac-dependent mechanism

Phoenixin-14 (PNX) is a newly discovered peptide produced by proteolytic cleavage of the small integral membrane protein 20 (Smim20). Previous studies showed that PNX is involved in controlling reproduction, pain, anxiety and memory. Furthermore, in humans, PNX positively correlates with BMI suggesting a potential role of PNX in controlling fat accumulation in obesity. Since the influence of PNX on adipose tissue formation has not been so far demonstrated, we investigated the effects of PNX on proliferation and differentiation of preadipocytes using 3T3-L1 and rat primary preadipocytes. We detected Smim20 and Gpr173 mRNA in 3T3-L1 preadipocytes as well as in rat primary preadipocytes. Furthermore, we found that PNX peptide is produced and secreted from 3T3-L1 and rat primary adipocytes. PNX increased 3T3-L1 preadipocytes proliferation and viability. PNX stimulated the expression of adipogenic genes (Pparγ, C/ebpβ and Fabp4) in 3T3-L1 adipocytes. 3T3-L1 preadipocytes differentiated in the presence of PNX had increased lipid content. Stimulation of cell proliferation and differentiation by PNX was also confirmed in rat preadipocytes. PNX failed to induce AKT phosphorylation, however, PNX increased cAMP levels in 3T3-L1 cells. Suppression of Epac signalling attenuated PNX-induced Pparγ expression without affecting cell proliferation. Our data show that PNX stimulates differentiation of 3T3-L1 and rat primary preadipocytes into mature adipocytes via cAMP/Epac-dependent pathway. In conclusion our data shows that phoenixin promotes white adipogenesis, thereby may be involved in controlling body mass regulation.     

The effect of maternal obesity on self-esteem and body image

Abstract stress, dissatisfaction and the feeling of inadequacy experienced as a result of the change in appearance caused by weight gain affects self -esteem and body image of pregnant women negatively. The aim of this study was to determine the relationship between maternal obesity, self-esteem and body image. The study was performed through a questionnaire in a state hospital in Trabzon, Turkey with 300 unselected pregnant women who were recruited from the delivery unit. As data collection tools, Body Image Scale (BAS) and Coopersmith Self-Esteem Scale (GIS) were used between April and May 2016. According to BMI variables, 12.3%, 57.0% and 30.7% of the pregnant women were normal, overweight and obese respectively and gained an average of 12.11?±?3.03?kg during pregnancy. Accordingly, the majority of pregnant women who participated in this study were found to be overweight and obese. While the body image of pregnant women surveyed in this study was at a high level (158.84?±?21.34), their average self-esteem was found at a moderate level (64.01?±?15.88). Based on BMI, 56.8% of the women with normal weight perceived themselves as normal, 48.0% of overweight women perceived themselves as normal and 53.3% of obese women perceived themselves as overweight. There was a positive significant relationship between participants' body image and their BMI (r?=?0.119 p?<?0.05). The pregnant women with normal BMI were more likely to feel satisfied. While 56.8% of the pregnant women at normal weight based on BMI were found to feel satisfied and 43.3% of those overweight felt satisfied, 54.3% of obese ones did not feel satisfied. A weak positive significant correlation was found between body image and self-esteem (r?=?0.172; p?=?0.003?<?0.05). As the self-esteem increases, body image increases, too. It was found that the majority of pregnant women were overweight and obese according to BMI and their average body image and self-esteem were high and medium level respectively.     

Stunting at 2 Years in Relation to Body Composition at 9 Years in African Urban Children**

Objective: To determine whether African urban children who were stunted at 2 years of age demonstrated an altered body composition by the end of childhood, before entering puberty, at 9 years of age. Research Methods and Procedures: This was a mixed‐longitudinal study of 330 prepubertal African children (182 boys) from Soweto‐Johannesburg, South Africa. Anthropometric data at 2 years of age were compared with anthropometric, DXA‐determined body composition and fat patterning in late childhood (7 to 9 years). Results: Children who had been stunted at 2 years were significantly shorter and lighter than non‐stunted children at 7 to 9 years, but there were no differences in their BMI or centralization of body fat. Previously stunted status significantly predicted reduced weight and height at 7 to 9 years but did not predict BMI, body composition, or fat patterning after controlling for potential confounding factors. The odds ratio for stunting at 2 years as a predictor of overweight at 7 to 9 years was not significant at 1.09 (95% confidence limits: 0.30, 3.98). Discussion: Greater BMI in stunted infants does not demonstrate a tendency toward overweight or obesity but is a reflection of the greater reduction in height rather than weight in stunted children. Stunted children may be programmed to accumulate greater body fat at central sites during adolescence, but we have been unable to show that these changes are evident before the initiation of pubertal development.