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Midshaft is the most commonly used site for behavioral and robusticity inferences in cross-sectional studies of the femur. This work tries to revive an alternative location because the midshaft, as much as it is easy to locate, does not necessarily reflect the same adaptive remodeling in every individual. Femoral waist which is defined as the shaft’s mechanically weakest point is reintroduced as an alternative. The aim of this work is to describe waist’s general patterns of distribution along the shaft, to test which morphological characteristics influence its position, to compare its inferential potential with the midshaft, and to evaluate applicability of the concept under the mechanical predictions about stress and strain distribution along the femur. A total of 251 individuals representing four temporal samples spanning the Eneolithics to 19th century were analyzed using CT-derived cross-sectional properties. The results showed that the femoral waist tends to center around the midshaft but with a rather large amount of variation and that the samples do not seem to differ in this respect. General levels of mechanical loading and robusticity may influence its distribution as evidenced from the Early Middle Ages males who were the most robust group (in body size adjusted parameters) and had their waists positioned more proximally. Variables that influence waist’s location are primarily related to strain distribution but not its magnitude. Thus, neck-shaft angle, anteversion angle, femoral inclination, crural index, and femoral curvature proved to be significant predictors (their importance varies between sexes), while body size measures were insignificant. Behavioral and robusticity inferences made from the femoral waist and midshaft are rather incompatible. In closely related populations, results from the two locations would probably lead to different interpretations while in rather distant units (species or genera), this would not be as problematic. Whenever possible, true cross-sectional properties should be used to locate the femoral waist. External methods using subperiosteal contour are more acceptable than methods estimating cross-sectional properties only from external dimensions. Lastly, the femoral waist position can potentially be used for taxonomic purposes in earlier hominins as well as for the reconstruction of other femoral characteristics (e.g., femoral length). / acase@tulane.edu

Objective: Pedometer programs are effective in increasing physical activity in sedentary individuals, a population that is at an increased for developing metabolic syndrome and each of its individual components. The aim of this study was to observe the effects of incremental increases in pedometer assessed physical activity on MetS components in sedentary overweight women. Design: This study was a longitudinal, quasi-experimental design. Participants were recruited from a 12-week work-site pedometer program and grouped after the intervention based on their self-paced increases in pedometer assessed physical activity with (a) active participants that increased their daily activity by mean volume >3000 steps/day or (b) participants who remained sedentary. Subjects: A multi-ethnic heterogeneous sample of seventy-seven sedentary middle-aged women (BMI: 30.15 plus or minus 5.24 kg/m2, age: 46.00 plus or minus 9.93 years). Measurements: Self-reported physical activity, pedometer assessed physical activity (steps/day), body mass index, resting heart rate, waist circumference, blood pressure, triglycerides, HDL-C and fasting glucose at baseline and after the 12-week program. Results: The active group showed significant within-group improvements (P less than or equal to .01) in waist circumference and fasting glucose. Significant between group changes were observed in resting heart rate (P less than or equal to .01), weight (P less than or equal to .01), BMI (P less than or equal to .01), and systolic blood pressure (P less than or equal to .001); however, the changes observed in systolic blood pressure were not independent of weight loss. Conclusions: Our study showed that incremental increases in steps/day over 12 weeks is effective in inducing mild, but favorable changes in some MetS components. This data suggests that this approach to increasing step/day is a viable starting point for sedentary individuals that may find it difficult to initially accumulate 10,000 steps/day.

Current health recommendations encourage weight loss for overweight and obese individuals. However, the importance of weight to health is still unclear. The purpose of this study was to determine the impact of weight loss on overall health in a sample of adults who have completed a 10 or 12 week weight loss intervention. The study sample included males and females (n =99) between the ages of 27 -64 years that had a BMI of 29-45 kg/m². The study design is a secondary data analysis of data from two different behavioral weight loss interventions. Both interventions prescribed a reduced calorie diet, increased physical activity, and self-monitoring of diet and physical activity. Of the 99 participants, 28 lost greater than 5% of baseline body weight and saw the most significant changes in waist circumference (p<0.001), systolic blood pressure (p=0.004), diastolic blood pressure (p=0.002), and total cholesterol (p=0.001). This group experienced improvements in every lab value tested. More research with larger sample sizes and longer trial periods need to be done in order to strengthen the validity of the weight loss interventions.

Objectives: To determine whether for a given waist circumference (WC), a larger hip circumference (HC) was associated with a reduced risk of insulin resistance, type 2 diabetes (T2D), hypertension and cardiovascular disease (CVD) in HIV-infected patients. A second objective was to determine whether, for a given WC, the addition of HC improved upon estimates of abdominal adiposity, in particular visceral adipose tissue (VAT), compared to those obtained by WC alone. Methods: HIV-infected men (N=1481) and women (N=841) were recruited between 2005 and 2009. WC and HC were obtained using standard techniques and abdominal adiposity was measured using computed tomography. Results: After control for WC and covariates, HC was associated with a lower risk of HOMA-IR (p<0.05) and T2D [Men: OR=0.91 (95% CI: 0.86-0.96); Women: OR=0.91 (95% CI: 0.84-0.98)]. For a given WC, HC was also associated with a lower risk of hypertension (p<0.05) and CVD [OR=0.94 (95% CI: 0.88-0.99)] in men, but not women. Although HC was negatively associated with VAT in men and women after control for WC (p<0.05), the addition of HC did not substantially improve upon the prediction of VAT compared to WC alone. Conclusions: The identification of high-risk HIV-infected individuals by WC alone is substantially improved by the addition of HC. Estimates of VAT by WC are not substantially improved by the addition of HC and thus variation in visceral adiposity may not be the conduit by which HC identifies increased health risk. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2012-09-04 16:27:16.249

Approximately 32% of college-aged individuals are overweight or obese, yet few weight loss programs have effectively motivated this population to adopt a healthier lifestyle. A majority of this population frequently uses the social networking site Facebook. This study examined the impact of a Facebook social support group on weight loss efforts of college students. A total of 24 students were randomly assigned to either the intervention group, which consisted of a Facebook support group, or control group after attending a one-time weight loss class. Assessments were taken at baseline and four weeks. Of participants in this study, 83.3% were Facebook users. All but two participants were female with 47.8% identifying as black, non-Hispanic and 39.1% as white, non-Hispanic. Most participants were considered obese or overweight with 39-inch median waist circumference for women and 44-inch median waist circumference for men. The primary outcome was a mean weight loss of -3.55 ± 4.25 lbs. for those in the intervention group compared to -1.61 ± 3.24 lbs. for the control group after four weeks. Though results were not statistically significant, the intervention group lost more weight than the control group. Results indicate the potential for an innovative weight loss aid that utilizes an online site already integrated into the lifestyle of college students.

INTRODUCTION: Patients with systemic lupus erythematosus (SLE) are at increased risk of the metabolic syndrome (MetS) and its complications. In the absence of published studies from sub-Saharan Africa, we investigated the prevalence and associations of the MetS amongst recent-onset SLE patients. METHODS: A cross-sectional study of recent onset (<5 years disease duration) patients with SLE meeting the SLICC SLE classification criteria. The MetS was defined by Joint Interim Statement criteria. Clinical and demographic data and a Functional Assessment of Chronic Illness Therapy score and the 36-Item Short-Form Healthy Survey were completed. RESULTS: Of 75 patients, the mean age was 37.1 (11.7) years, disease duration was 30.8 (23.6) months, 65 (86.7%) were female, 68.0% were of mixed ethnic ancestry and 29.3% were Black Africans. The mean SLEDAI score was 0.9 (1.6). The prevalence of MetS was 40.0%, and age and body mass index were the only significant features associated with MetS (p = 0.003 and 0.001 respectively). Increased waist circumference (WC) was the most frequently observed feature, present in 92.9% of MetS patients. Patients with an elevated WC were 32.5 times more likely to have MetS. CONCLUSION: This study shows a high prevalence of MetS amongst South Africans with recently diagnosed SLE. This calls for aggressive strategies to reduce the prevalence of Mets and atherosclerotic cardiovascular disease. Waist circumference is a useful and costeffective screening tool to identify SLE patients at risk of MetS.

OBJECTIVE: This cross-sectional study investigated insulin resistance (IR) variation across physical activity (PA) levels in U.S. adults. METHODS: MET-minutes were utilized to quantify PA using 2 methods: 4 categories were based on relative MET-minutes, and 5 were based on U.S. PA guidelines. IR was indexed using the homeostatic model assessment (HOMA). Effect modification was tested by dividing waist circumferences into sex-specific quartiles, and then evaluating the relationship between PA and HOMA-IR within each quartile separately. RESULTS: Relative PA was associated with HOMA-IR after controlling for demographic and demographic and lifestyle covariates (F = 11.5, P < 0.0001 and F = 6.0, P = 0.0012, respectively). Adjusting for demographic and demographic and lifestyle covariates also revealed relationships between guideline-based PA and HOMA-IR (F = 8.0, P < 0.0001 and F = 4.9, P = 0.0017, respectively). Controlling for waist circumference with the other covariates nullified the relationship between PA and HOMA-IR. Effect modification testing showed that when the sample was delimited to adults with extra-large waists (Quartile 4), relative (F = 5.6, P = 0.0019), and guideline-based PA (F = 3.7, P = 0.0098) and HOMA-IR were related. PA and HOMA-IR were not related within the other quartiles. CONCLUSION: High levels of PA may play a meaningful role in glucose and insulin metabolism in those with abdominal obesity, but not in adults with smaller waists.

The primary objective of this study was to evaluate the relationship between milk-fat intake and obesity, particularly abdominal obesity, in 13,544 U.S. adults. A secondary objective was to determine the extent to which the association was influenced by multiple potential confounding variables. This cross-sectional study used data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Level of milk-fat content regularly consumed was the exposure variable. Body mass index (BMI) and sagittal abdominal diameter (SAD), a measure of abdominal obesity, were the outcome variables. SAD correlates strongly with visceral fat, when measured by computed tomography, and has been shown to predict cardiometabolic disorders better than BMI. After controlling for age, gender, race, physical activity, sedentary behavior, alcohol habits, and cigarette use, significantly lower BMIs were associated with regular nonfat and full-fat milk consumption (F = 4.1, P = 0.0063). A significantly lower SAD was associated only with regular consumption of nonfat milk (F = 5.0, P = 0.0019). No significant differences were found between the other milk-fat groups or milk abstainers. In this nationally representative sample, only 19.6% of adults regularly consumed low-fat milk. In conclusion, regular nonfat milk intake was associated with lower levels of abdominal adiposity compared to consumption of higher levels of milk-fat.

The objective of the study was to identify the relationship between percent body fat (%BF) and waist-to-hip ratio (WHR) in children ages 7 to 9 years. The sample (n=171) was divided into four groups. Bioelectrical impedance analysis was used to estimate %BF. Significant positive correlations were observed between WHR and %BF for black females (r = 0.48), white females (r = 0.66), black males (r = 0.34), and white males (r = 0.55). Although the correlations differed between groups, the amount of variation between the two variables was not significantly different between groups other than black females. Least squares means was used to estimate %BF using an average WHR (.85). Black females had higher %BF than other groups. Percent body fat cannot be fully explained by WHR (r2 = 0.32). Results show a relationship between %BF and WHR, yet predicting %BF from a given WHR may be difficult.