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PubMed2005

Intentional weight loss, blood lipids and coronary morbidity and mortality.

PURPOSE OF REVIEW: Although weight reduction has been recommended to reduce cardiovascular risk, studies on the association between weight loss and coronary morbidity and mortality show conflicting results. This review summarizes findings from large studies examining this issue and accentuates the importance of carrying out additional well-designed research. RECENT FINDINGS: Many observational studies report that weight loss in older men and women is associated with increased cardiovascular morbidity and mortality. Recent studies suggest that this association may arise from the confounding effect of preexisting disease. Many studies do not report whether weight loss is intentional or unintentional. Unintentional weight loss may mask beneficial changes in cardiovascular risk due to intentional weight loss. In addition to issues related to the cause of weight loss, use of reported rather than measured weight may bias the results of large studies. However, one recent observational study with a methodology aimed at overcoming these limitations found that individuals who intentionally lost weight experienced a decreased coronary risk. SUMMARY: Weight reduction in overweight individuals is not universally associated with good health. This is true even if the weight loss results in normal body mass index. Reports of increased coronary risk associated with intentional weight loss may be explained by comorbidities that are also associated with weight loss. Individuals who are overweight and at high coronary risk may benefit from professionally supervised dieting and avoiding regain of lost weight. Clinical trials on cardiovascular outcomes in individuals who lose weight under supervised dieting are needed to assess this recommendation definitively.

Adult↗

PubMed1989

Relating growth rate to environmental factors--methodological problems in the study of growth-infection interaction.

The effect of infection on the growth of children under 2 was studied in a rural (Keneba, n = 176) and an urban (Bakau, n = 122) community in The Gambia, and in a Papua New Guinean village (PNG, n = 24). Weights taken every 4 to 6 weeks (n = 3929) were converted to weight velocities, and these were related to the intensity of infection (coded in ten categories) during each growth period using within-subject multiple regression analysis. Diarrhoea (in Keneba), lower respiratory tract illness (Bakau) and measles (PNG) all had highly significant effects on growth, reducing weight gain by between 17 and 69 g/day. Two statistical problems, i.e. the varying lengths of time between weight measurements, and the negative correlation between successive weight velocities, were discussed. However, redoing the analysis taking them into account made no practical difference to the conclusions.

Body Weight↗

PubMed2002

[Usefulness of selected ultrasonographic methods for evaluation of fetal weight in twins].

Evaluation of three mathematical methods, based on ultrasound examination, in order to estimate foetal weight in twins and compare them with actual birth weight. Retrospective analysis of ultrasonicly assessed 27 pairs of twin babies, who were born within 10 day of ultrasound examination and then outcome's comparison with newborn weight, measured just after the delivery. The ultrasonic measurements were performed to calculate estimated foetal weight using mathematical models of Shepard, McCallum and Hadlock. All outcomes were compared to birth weight. Statistical analysis, employed in our research, was percentage error according to formula: % = (EFW - BW) x 100/EFW (EFW - estimated foetal weight, BW - birth weight). The mean foetal weight calculated according to Shepard's method was 2605.9 g and 2651.6 g, relatively for the first (I) and second (II) twin baby. By using McCallum's method outcomes were as follows: (I) -2558.4 g (II) -2655.4 g and for Hadlock's method: (I) -2480.9 g and (II) -2540.3 g. Actual birth weight came to 2664.1 g for (I) and 2639.6 g for (II). Percentage error was found -2.23, using Shepard's method, -4.13, using McCallum's method and -7.38, using Hadlock's method, for the first twin-baby. Relatively, for the second twin-baby, values were found as follows: 0.45, 0.59, -3.91. Shepard's method is the most helpful in prediction of birth weight in twin pregnancy. Separate evaluation of each of twin babies can be more significant indicator in prognosis of appearance in intrauterine growth retardation (IUGR), comparatively to evaluation of weight's discordance between both twin-foetuses.

Female↗

PubMed1990

Long-term effects of a psychologically based group programme for women preoccupied with body weight and eating behaviour.

The effects of a 10 session group programme designed to discourage dieting behaviour and reduce preoccupation with body weight, food and eating were assessed in 87 women (mean age 40 years and mean body mass index 31.9) who attended three different agencies in Adelaide, South Australia. The subjects were selected on the basis of eating preoccupation and not body weight. Measurements of various psychological parameters and body weight were made at entry to the programme, at the completion of the programme and at 6 months, 1 year and 2 years after its completion. Eighty women completed the groups and data were obtained from 56 of them at 2 years. At the completion of the group programme and at 2 years there were significant improvements (P less than 0.01) in the psychological parameters self-esteem, depression, self-image, eating attitude, body image and assertion. At two years after the completion of the group, there was a significant (P less than 0.005) mean weight loss of 3.1 kg when compared to baseline. We conclude that this programme confers long-term beneficial effects on psychological function and body weight.

Adaptation, Psychological↗

PubMed1994

Reliability of measurements of static weight distribution of manual wheelchairs.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the reliability of measurements of weight distribution among the wheels of wheelchairs using a commercial balance testing system. Reliable data may be useful in the wheelchair evaluation and adjustment process. SUBJECTS: Three male full-time manual wheelchair users aged 30, 26, and 27 years with cervical spinal cord injuries 7.5, 6.5, and 10 years in duration participated. METHODS: Calibration weights, unoccupied wheelchairs, and occupied wheelchairs were repeatedly placed on the force transducers of the balance testing system to obtain measurements of weight distribution. RESULTS: The intraclass correlation coefficients of the measurements were .99 for calibration weights, .96 for unoccupied wheelchairs and .98 for wheelchairs occupied by the subjects. CONCLUSION AND DISCUSSION: The described use of this instrumentation appears to generate reliable measurements of static weight distribution. With further testing, this system may provide useful information related to manual wheelchair prescription and adjustment.

Adult↗

PubMed2006

Prevalence of overweight among elementary and middle school students in Mississippi compared with prevalence data from the Youth Risk Behavior Surveillance System.

INTRODUCTION: The purpose of the Child and Youth Prevalence of Overweight Survey was to estimate the prevalence of overweight and at risk for becoming overweight among children in Mississippi (grades 1-8) using height and weight measures instead of self-report and to compare the findings for grades 6 through 8 with data from the Youth Risk Behavior Surveillance System for middle school students (grades 6-8). METHODS: Students in randomly selected classes from 37 sampled elementary and middle schools throughout Mississippi participated in the study. School staff were trained to collect height and weight data using a standardized procedure. RESULTS: Overall, 24.0% of students in grades 1 through 8 were found to be overweight, and another 14.7% were at risk for becoming overweight. With the exception of sixth grade, there was a trend of increasing prevalence of overweight by grade (17.5% in grade 1 compared with 31.3% in grade 8). In the Child and Youth Prevalence of Overweight Survey, 25.2% of students in grades 6 through 8 were found to be overweight, compared with 18.5% in the Youth Risk Behavior Surveillance System. CONCLUSION: A high percentage of students in Mississippi are already overweight in first grade, and the prevalence tends to increase by grade. Data collected from middle school students through measured heights and weights in the Child and Youth Prevalence of Overweight Survey were higher than self-reported data from the Youth Risk Behavior Surveillance System. Our data suggest that self-reported data underestimate the prevalence of overweight among middle school students. Efforts to monitor students' body mass index and assess effectiveness of interventions should include all grades and use measured heights and weights rather than self-reports.

Child↗

PubMed2000

Profile of body composition of school children (6-18y) in Bahrain.

OBJECTIVE: To study the body composition of Bahraini school children. DESIGN: Cross-sectional national school survey. SUBJECTS: School children aged 6-18y. The sample comprised 818 boys and 775 girls. MEASUREMENTS: Weight, height, arm circumference and skinfold thicknesses were measured. Sum of skinfold thickness, body mass index (BMI), mid arm circumference, percentage body fat, fat weight and lean body weight were then calculated to determine body composition. RESULTS: A significant difference in the sum of skinfold thickness was observed between boys and girls. The girls have almost 50% extra skinfold thickness than boys at all ages. Similar trends were found in BMI, except at ages 9 and 18y. The percentage of body fat was higher in girls than boys. The mean BMI for Bahraini girls aged 13y and above exceeds that of their American counterparts, indicating a trend towards fat accumulation in the Bahraini girls. CONCLUSION: The data obtained are useful for monitoring obesity in school children in Bahrain as well as being usable as reference data for similar countries in the region. The high proportion of body fat among Bahraini school children, especially girls, urges an intervention program to prevent and control obesity in this age group.

Adipose Tissue↗

PubMed2003

Incidence of lipoatrophy and lipohypertrophy in the women's interagency HIV study.

OBJECTIVE: To estimate the incidence of lipoatrophy and lipohypertrophy among HIV-infected and HIV-uninfected women from the Women's Interagency HIV Study. DESIGN: Eight hundred fifteen women with semiannual data on self-report of bidirectional change in body fat, anthropometric measurements, weight, and bioelectric impedance analysis were included in a 30-month incidence analysis. METHODS: Lipoatrophy and lipohypertrophy in both peripheral (arms, legs, and buttocks) and central (waist, chest, and upper back) sites were defined by self-report of either a decrease or an increase in a body fat region over the previous 6 months that was confirmed by a corresponding change in anthropometric measurement. RESULTS: Weight and total body fat increased in HIV-uninfected women but remained stable in HIV-infected women over 30 months. Among HIV-infected women, the incidence of peripheral (relative hazard, 2.1; 95% confidence interval [CI], 1.4-3.3) and central (relative hazard, 1.9; 95% CI, 1.2-2.8) lipoatrophy was about double that among HIV-uninfected women, after adjustment for age and race. The incidence of peripheral lipohypertrophy appeared lower among HIV-infected women than among HIV-uninfected women (relative hazard, 0.8; 95% CI, 0.6-1.1), while the incidence of central lipohypertrophy did not differ by HIV status. Of HIV-infected women with 2 of 4 lipodystrophy outcomes, most (81%) had combined peripheral and central lipoatrophy or combined peripheral and central lipohypertrophy. Only 14% of these women had both peripheral lipoatrophy and central lipohypertrophy. CONCLUSIONS: These prospective data suggest that lipoatrophy, affecting both peripheral and central sites, predominates in HIV-infected women. The simultaneous occurrence of peripheral lipoatrophy and central lipohypertrophy was uncommon.

Acquired Immunodeficiency Syndrome↗

PubMed1981

Clinical application of fetal weight determination by real-time ultrasound measurements.

The weights of 101 neonates delivered within 72 hours of real-time ultrasound examination were compared with the weight calculated from the ultrasonically measured biparietal diameter and abdominal circumference. A high degree of correlation (4 = .9624) was found between actual and calculated weights. This method of weight estimation has been clinically useful, especially in infants weighing less than 1500 g.

Abdomen↗

PubMed1979

Thrombus weight as a measure of hypercoagulability induced by drugs.

Thrombus weight was used as a measure of the thrombus enhancing effect of drugs in 135 rats. The weight of thrombus formed in one hour, on a 20 x 0.5 mm platinum wire, inserted in the vena cava was taken as a measure of thrombosis. The change in thrombus weight which followed the injection of ellagic acid to activate the coagulation system, adenosine diphosphate to activate the platelets, and epsilon-aminocaproic acid to inhibit the fibrinolytic system, was measured. Pilot studies showed that the drug doses used brought about the appropriate changes in the factors named. The mean thrombus weight in 45 control animals was 1.93 mg. Ellagic acid increased it about five-fold, and epsilon-aminocaproic acid almost two-fold, while adenosine diphosphate reduced it by almost a half. Concurrent controls were used in each case. Clotting tests (whole blood clotting time, kaolin-activated whole blood clotting time, thrombin time, and partial thromboplastin time), performed at the end of the hour, showed no significant correlation with thrombus weight.

Adenosine Diphosphate↗

PubMed1998

[Anthropometric skin-fold and impedance measurement assessment of the maternal nutritional status at the end of pregnancy. Comments deduced from a study of 54 cases].

BACKGROUND: It is generally accepted that an optimal maternal weight gain is indicative of a normal course of pregnancy. Nevertheless, evaluations of nutritional status should not be limited to the periodic body weight measurement alone, they should rather include the measurement of anthropoplicometric parameters more strictly associated with the variations of the different body components (fat mass, fat-free mass and body water). Therefore, it seems necessary to define standard parameters, such as to allow the attribution of a clinical value to the anthropometric variations that can be measured during pregnancy. In this study we preliminarily proposed to survey maternal nutritional status in a group of women examined in the second day after delivery. MATERIALS AND METHODS: Anthropoplicometric parameters and bioelectric impedance measurements were evaluated in order to study nutritional status of 54 puerperae within 48 hours after delivery. A linear regression analysis was carried out examining the relationship of anthropoplicometric measurements with gestational weight gain and post-partum impedance parameters. RESULTS AND CONCLUSIONS: The results of this study lead to believe that a correct examination of maternal nutritional status must necessarily include not only weight and body mass index, but also an accurate and periodic anthropoplicometric evaluation including limb circumferences and triceps plica.

Adult↗

PubMed1995

Deficiency of complement factor C5 reduces early mortality but does not prevent organ damage in an animal model of multiple organ dysfunction syndrome.

OBJECTIVE: To evaluate the role of complement factor C5 in a model of zymosan-induced multiple organ dysfunction syndrome. DESIGN: Experimental animal study. SETTING: Central animal laboratory of a university hospital. SUBJECTS: Twenty-five C5-deficient B2D10/Old and 25 C5-sufficient B2D10/New mice. INTERVENTIONS: On day 0, all mice received an intraperitoneal injection with zymosan suspended in paraffin in a dose of 1 mg/g body weight. MEASUREMENTS AND MAIN RESULTS: Between days 0 and 12, biological parameters (temperature, body weight, and clinical condition) were measured daily and mortality was monitored. Clinical condition was assessed as a symptom score by blindly grading the degree of lethargy, conjunctivitis, diarrhea, and ruffled fur of each mouse on a 2-point scale (maximum score of 4). On day 12, all surviving mice were killed and relative organ weights of lungs, liver, spleen, and kidneys were calculated. Relative organ weight was defined as (organ weight/body weight) x 100%. Zymosan administration induced a typical triphasic illness. Deterioration of the clinical condition, as indicated by the symptom score, and the decrease in temperature and body weight in the acute phase were all significantly less severe in C5-deficient mice (p < .005). In the late phase, no differences could be noticed in the courses of these biological parameters. Overall mortality was 2 (8%) of 25 in C5-deficient mice and 8 (32%) of 25 in C5-sufficient mice (p = .049), a difference that was mainly due to a difference in the acute phase. Organ damage, assessed as the relative organ weights, did not show any statistical differences for any organ between both strains. CONCLUSIONS: Complement factor C5 appears to play an important role in the acute hyperdynamic septic response in this model. However, deficiency of C5 could not prevent organ damage in the late multiple organ dysfunction syndrome phase. This finding suggests that other factors must be more important in the development of the inflammatory response leading to multiple organ dysfunction syndrome.

Aging↗

PubMed2003

Laparoscopic Roux-en-Y gastric bypass: preoperative determinants of prolonged operative times, conversion to open gastric bypasses, and postoperative complications.

BACKGROUND: We examined our database of 600 consecutive laparoscopic Roux-en-Y gastric bypasses (LRYGBP) to determine predictors of prolonged operations, conversion to open operations and postoperative complications. METHODS: All were primary bariatric operations. Body habitus, gender, and previous surgery were evaluated. RESULTS: Regression analysis showed the following parameters to correlate positively with increased operative time: 1) Waist, 2) BMI, 3) Weight, and 4) Waist/Hip ratio. Height and hip measurement did not correlate with operative time. No previous operations affected operative time. Conversion to open operation was necessary in 25/600 cases (4.2%). Conversion was necessary with larger waist measurement (P=0.00007) and increased waist/hip ratio (P=0.01) but not BMI. Conversion occurred more frequently in males (6/43, 14.0%) than females (19/557, 3.4%). This trend was statistically significant (P=0.006). An enlarged liver was responsible for 12/25 conversions. 6/12 patients with large livers had type II diabetes and 6/12 patients had biopsy-proven steatohepatitis. 2/12 had huge yellow-brown livers that were not biopsed. Liver function tests were normal in 8/8 patients preoperatively. Complications including leak (5), pulmonary embolus (2), hemorrhage (12), stenosis of the GI tract (24) and infection (7) occurred in 48/600 patients (8.0%). There were no deaths. Complications did not correlate with body habitus, gender, or previous surgery. CONCLUSION: Larger patients as measured by waist measurement, weight, and BMI but not previous surgery prolonged LRYGBP. Conversion to open surgery was more frequently necessary in patients with larger abdomens, central obesity, and type II diabetes. Complications did not correlate with any preoperative parameter measured.

Anastomosis, Roux-en-Y↗

PubMed1998

Differential relation of psychological functioning with the history and experience of weight cycling.

Two measures of weight cycling and indexes of psychological functioning were examined in a large sample of dieters. History of weight cycling was assessed to include number of dieting attempts, total lifetime weight lost and regained, and number of weight cycles over 20 lb (9.1 kg). Experience of weight cycling measured perception of being a yo-yo dieter and perceived success at maintaining past weight losses. Experience was more strongly related than history to all psychological measures. Further, when controlling for the effects of age, body mass index, and experience, the relation between history and the psychological variables was nonsignificant. This finding suggests that an individual's perception of being a weight cycler may be more related to psychological problems than the actual number of pounds lost and regained over time.

Body Image↗

PubMed1998

Sensitive measures of nutritional status in children in hospital and in the field.

Protein-energy malnutrition and obesity are the most common nutritional disorders that complicate the clinical course of children with neoplastic diseases. Sensitive measures of nutritional status should be used to detect these problems in children with cancer. Height and weight measurements are the mainstay of the nutritional assessment of the child. These measurements can be converted to growth velocities or to height-for-age and weight-for-height Z-scores or percent of expected values to provide a measure of the degree of under- or over-nutrition in the child. Skinfold thickness and circumference measurements of the arms, legs and/or trunk may be useful to characterize the changes in peripheral fat depots and muscle mass, respectively. However, the assessments of body composition using these measurements are subject to methodological error because selected skinfold sites are excluded. Whole-body potassium, measured by 40K counting, and total body water, measured by deuterium or 18O dilution, serve as "gold standards" to determine the lean body mass and body fat status of the child, but these techniques may not be practical in all settings. The assessment of the nutritional status of the child serves as a guide to early nutritional intervention. Indicators for early nutritional intervention include: (1) height-for-age and weight-for-height or -age Z-scores more than 2 SD below the mean for age, (2) height-for-age measurements less than 95% of expected, (3) weight-for-height measurements less than 90% or greater than 120% of expected and (4) height velocities less than 5 cm/year after 2 years of age. Early nutritional intervention is essential to restore normal body composition, reverse linear growth arrest, promote tolerance to chemotherapeutic and radiation regimens and improve the quality of life in children with cancer.

Body Composition↗

PubMed1991

Assessment of fetal well-being with magnetic resonance.

The application of magnetic resonance techniques in the assessment of fetal growth, fetal growth patterns and fetal health was assessed. Eighty-four sets of fetal images were obtained using a fast-scan magnetic resonance imaging technique. Measurements were made of fetal subcutaneous fat thickness, uterine cavity length and width, fetal and uterine cross-sectional areas and fetal volume. Fetal area and fetal volume measurements were found to correlate well with birth weight. Measurement of subcutaneous fat thickness may prove to be a means of differentiating between those fetuses who are constitutionally as opposed to pathologically large or small. Thirteen women had additional spectroscopic studies carried out. Twelve of the women had normal pregnancies. One woman had a twin pregnancy in which one twin died. 31P phosphorus spectra were obtained from seven of the normal pregnancies. In the remainder, the depth of the abdominal wall prevented spectra being obtained from the placenta. Differences in phosphorus metabolites were obtained from the placenta of the dead twin compared to those from the healthy pregnancies.

Adipose Tissue↗

PubMed1998

Prevalence of overweight and thinness in high-school girls in Kerman, Iran.

OBJECTIVE: The prevalence of obesity and thinness is unknown among Iranian high-school age girls. We determined the prevalence of overweight and underweight among Iranian high-school girls from Kerman (south-east province of Iran). DESIGN: A cross-sectional study of indicative cluster sample. MEASUREMENTS: Weight, height, body mass index (BMI), chest, waist, abdomen, hip and thigh circumference of 1000 Iranian high-school girls aged 14-21 y (mean (standard deviation, s.d.) 16.2 (1.3)) were measured. The criteria for very underweight, underweight, desirable weight, grade 1, 2 and 3 overweight used in the present study were: BMI in kg/m2 < 15, 15-19.9, 20-24.9, 25-29.9, 30-39.9 and > or = 40, respectively. RESULTS: 4.6% (95% confidence interval (CI): 3.4%-6.1%) were grade 1 overweight (BMI = 25.0-29.9), 0.7% (95% CI: 0.3%-1.4%) were grade 2 overweight (BMI = 30-39.9), and none were grade 3 overweight (BMI > or = 40), while 54.6% (95% CI: 51.5%-57.7%) were underweight (BMI = 15-19.9) and 1.6% (95% CI: 0.9%-2.6%) were very underweight (BMI < 15). The mean (s.d.) BMI was 19.8 (2.9) (95% CI: 19.6-20.0). The mean (s.d.) waist-to-hip ratio (WHR), abdomen-to-hip ratio and chest-to-hip ratio values were 0.8 (0.06) (95% CI: 0.8-0.81), 0.8 (0.07) (95% CI: 0.8-0.81) and 0.9 (0.07) (95% CI: 0.9-0.91), respectively, in this sample. CONCLUSION: The results suggest a low prevalence of overweight among Iranian young women.

Adolescent↗

PubMed2004

[The fluid balance in the critically ill patient].

AIM: In the critically ill patient the hemodynamic management is essential. Usually the hemodynamic status is estimated by the measurement of the intravascular pressure or volume and by computing the fluid balance, while the change in body weight estimates the total body water. The fluid balance is computed by subtracting the fluid output to the input. Although the input (fluids, drugs, infusion.) are well known, the output are difficult to correctly compute, because they depend on several factors such as the body-room temperature, amount of humidity and may change with time. Aim of this study was to prospectively evaluate the accuracy of the fluid balance compared to the body weight measured by a dedicated mattress (Hill-Rom). METHODS: Fifteen critically ill patients were enrolled (mean age of 63.2+/-19.7 years, body mass index of 24.9+/-3.5 kg/m2) and the measurements were computed every 8 hours. The data were analyzed by the Bland-Altman test. RESULTS: Four-hundred and seventy-two measurements for a mean intensive care stay of 12.3.+/-7.3 days were computed. The Bland-Altamn showed a great inaccuracy, because the agreement (the difference between the 2 methods) was poor with a standard deviation of 1 840 L. CONCLUSION: Although the fluid balance was not accurate, the only body weight without any intravascular measurement is not helpful for a correct clinical hemodynamic management of the patient.

Adult↗