Prior studies of immigrants to the United States show significant weight gain after 10 years of US residence. Pediatric refugees are a vulnerable population whose post-immigration weight trajectory has not been studied. We examined the longitudinal weight trajectory of 1067 pediatric refugees seen in a single university based refugee health program between the dates of September 3, 2012 and September 3, 2014 to determine how quickly significant weight gain occurs post-arrival. The most recent BMI was abstracted from the electronic health record and charts reviewed to obtain serial BMI measurements in 3 year increments after the date of US arrival. The mean arrival BMI percentile for all refugees was 47th percentile. This increased significantly to the 63rd percentile within 3 years of US arrival (p < 0.01). This rapid increase was largely attributable to African and South and Southeast Asian refugees. The overall prevalence of age and sex adjusted obesity rose from 7.4 % at arrival to 18.3 % within 9 years of US immigration exceeding the pediatric US national obesity prevalence of 16.9 %. Pediatric refugees are at increased risk of rapid weight gain after US immigration. Targeted interventions focused on prevention of weight gain in specific populations are warranted.

Class of 2010 Abstract / OBJECTIVES: To evaluate the product information and pivotal studies of injectable medications to determine if a specific size descriptor was included and if information was provided for dosing patients with extremes of body weight (body mass index < 18.5 or > 40 kg/m2). METHODS: This is a descriptive study of medications that received an approved new drug application (NDA) by the FDA between 1 January 2004 and 30 January 2009. Any information related to size descriptors, or dosing of patients with extremes of weight, was extracted and evaluated with a dosing usefulness score that ranged from a low of 0 to a high of 3. A score of 2 or greater was considered at least minimally adequate for dosing patients with extremes of weight. RESULTS: Of the 84 medications evaluated, some reference to weight descriptors was found for 23 (27%). None of the medications had information that generated a usefulness score of 2 or greater. CONCLUSIONS: The product information and pivotal studies involving newly approved medications is inadequate for dosing patients with extremes of weight and further research is needed. The FDA should mandate that product information contain the size descriptor and extremes of body weight relative to age and height that were used to develop dosing recommendations.

Guided by the expectancy value model of achievement choice, this study examined the relationships among expectancy value constructs (expectancy related beliefs and subjective task values), effort and intention for future participation in a culturally specific dance, soul line, among African American adult women in the church setting. Participants were 100 African American women who were members of the women’s ministries from four predominantly African American churches in the Dallas/Ft. Worth metropolitan area. Participants completed a 20-minute soul line session and responded to survey questions, validated in previous research, assessing their expectancy-related beliefs, subjective task values, effort, intention for future participation and physical activity. This was the first study to use the expectancy value model as a guide to determine motivations attached to physical activities among African American adult women. Usefulness, a component of subjective task values, emerged as a predictor of intention for future participation. Eighty-one percent of the women did not meet physical activity guidelines for aerobic activity. Of those inactive women 60% indicated an interest in doing soul line dancing often at their church after one short exposure to the activity as indicated by the strongest possible response to both intention questions. A slightly smaller percent of the active women provided with a strong positive response for future intention. These findings suggest that soul line dancing is a practical avenue to increase physical activity among African American women in the church. Future research should test this theoretical model on a wider variety of individuals who are sedentary to physically active, measure actual participation, and directly measure BMI and physical activity.

Background: Since inmates in Canada are excluded from household statistics, very little information is known about obesity prevalence or associated risks in this vulnerable population. This is a problem since obesity rates are high in Canada, and obesity is considered a public health crisis. Furthermore, the burden of obesity is disproportionately carried by low-income, vulnerable and marginalized populations (such as inmates). The goal of this study was to determine weight changes during incarceration in Canadian federal penitentiaries, and to determine which factors were influential at the socio-demographic, behavioral, institutional and policy level. Methods: This study was a retrospective cohort study that used a quantitative approach. The setting for this study was 12 correctional institutions in Ontario, New Brunswick and Nova Scotia (or the “Atlantic region”). Administrative data were collected from 1420 inmates, with 754 of these participants also participating in a face to face interview to gather additional data on self-reported behavioral determinants and measured anthropometric data. Eligibility criteria for inmates to participate were: a recorded admission weight in their medical chart, housed in their current institution for at least 6 months, not acutely or terminally ill (and requiring hospitalization), and not pregnant or in a wheelchair. Results: We found that almost three quarters of inmates (73%) gained weight during incarceration. Obesity rates increased by 71%, going from 26.6% to 45.4%. The observed weight gain was associated with the tobacco ban (macrosystem level), the use of commissary store (or “canteen”) (at the microsystem level), and many determinants at the individual level (physical activity, diet, smoking status). The observed weight gain was also significantly associated with age, ethnicity, length of incarceration, duration of total sentence and region. It was however not associated with the national menu, food service/feeding system, sleep, screen time, mental health status or psychotropic medication use. Some inmates who gained excessive weight also developed obesity related illnesses. Interpretation: The observed weight gain was deemed to be unhealthy, since obesity rates increased significantly (and the proportion of inmates with normal weight decreased). These findings have potential repercussions on inmate health, since the observed weight gain was associated with the development of obesity related illnesses. Lastly, many of the factors associated with the observed weight gain were modifiable, which means it is possible to intervene to manage weight gain during incarceration.

OBJECTIVE: To compare skeletal maturation of female and male subjects from historic samples to present day subjects by assessing Fishman’s Skeletal Maturity Index (SMI). Present day eating habits and lifestyle have been suggested as factors in accelerating pubertal maturation seen within the last century. Consequently, Body Mass Index (BMI) as well as BMI percentile were evaluated to determine whether it is associated with significant differences in skeletal maturation patterns. METHODS: This pilot study included hand-wrist films from 92 subjects from the Burlington and Forsyth longitudinal growth studies (1959-1970) and 146 patients currently enrolled in the Orthodontic department of the Boston University Henry M. Goldman School of Dental Medicine (BUGSDM). The age of the subjects ranged between 7 and 16 years. SMI stage was determined and BMI and BMI percentile were calculated for each subject. RESULTS: The mean chronologic ages of all the SMI stages were not different in males or females when comparing the historic sample to the present sample except for the mean ages at SMI stage 7 and 11 for females and SMI stage 5 for males. Females in the present sample reached SMI stages 7 and 11 significantly earlier: 11.6 versus 13.3 years for SMI 7 (p<0.001) and 15.6 vs. 16.0 for SMI 11 (p<0.05). Males in the present sample also reached SMI 5 significantly earlier: 12.5 vs 13.8 years (p<0.05). It was also seen that present day females at SMI stage 11 not only matured earlier, but also had significantly higher mean BMI and mean BMI percentile than the females at the same stage in the historic sample. This suggests that BMI may be associated with acceleration of maturation among females at SMI stage 11 (p<0.05). CONCLUSIONS: In both male and female subjects, there are differences between past and present populations at certain SMI stages. This evidence suggests that patterns of skeletal maturation may have changed and BMI may be associated with such changes. The differences in skeletal maturation between the two groups may also be a result of the different distribution of race in each group. In the current study, the historic sample consists of only Caucasian subjects whereas the present sample consists of subjects from many different backgrounds. As a result, effects of racial variations could have additionally played a role in the changes seen in skeletal maturation patterns. Increasing our sample size and controlling for race may help further elucidate these changes and determine if this transition towards earlier maturation is in fact due to increasing BMIs.

O objetivo deste estudo foi avaliar a prevalência de cárie dentária e sua associação com índice de massa corpórea (IMC), bem como seus fatores de risco demográficos (sexo e idade), socioeconômicos, familiares (escolaridade dos pais, número de filhos) e comportamentais (dieta e práticas de higiene bucal) de crianças e adolescentes. Duzentos e trinta e sete crianças e adolescentes foram inseridos neste estudo. Após a autorização de participação, aplicou-se um questionário, realizou-se exame clínico intrabucal das crianças e a coleta dos dados antropométricos. Os parâmetros analisados neste estudo foram peso, altura, IMC-para-idade e número de dentes cariados, extraídos e obturados para posterior cálculo do ceo-d ou CPO-D para dentes decíduos e permanentes, respectivamente. Teste do Qui-quadrado e o teste T foram usados para analisar a associação entre as variáveis (idade, etnia, gênero, hábitos de higiene bucal e alimentar) e alterações do IMC. A média e desvio padrão do índice ceo-d nos grupos de baixo peso, peso normal, grupos de sobrepeso e obesidade, foram de 9.5 (± 0.70), 5.06 (± 4.54), 7.66 (± 4.41), e 6 (± 5.19), respectivamente (p>0,05). A porcentagem de indivíduos que estavam com a dentição hígida foi de 13,5%. Houve uma associação entre prevalência de cárie e etnia (p<0,05), indivíduos de cor branca e parda apresentaram maiores índices de cárie do que os indivíduos pretos. Características sociodemográficas como escolaridade materna e paterna não influenciaram na experiência de cárie das crianças e adolescentes (p>0,05). Em relação aos hábitos alimentares na primeira infância, o tempo de aleitamento materno não influenciou na experiência de cárie (p>0,05), por outro lado, o açúcar acrescido na mamadeira esteve associado à doença cáries (p<0,05). A escovação diária realizada somente pela criança, sem supervisão dos pais ou responsáveis, foi significativamente associada com a cárie. Não houve associação entre cárie dentária e IMC. / The aim of this study was to evaluate the prevalence of dental caries and its association with body mass index (BMI), as well as their demographic risk factors (gender and age), socioeconomic, family (parents\' education, number of children) and behavioral (diet and oral hygiene practices) of children and adolescents. Two hundred and thirty-seven children and adolescents 3-15 years treated were entered into this study at the Ribeirão Preto Dental School - USP. After the authorization of participation, we applied a questionnaire and an intraoral clinical examination of children was held and the collection of anthropometric data. The parameters analyzed in this study were weight, height, BMI-for-age and number of decayed teeth extracted and sealed for subsequent calculation of the dmft and DMFT for deciduous and permanent teeth, respectively. It was used the Chi-square test and T test to analyze the association between variables (age, ethnicity, gender, oral hygiene and dietary habits) and changes in BMI. The mean and standard deviation of the DMFT in groups of underweight, normal weight, overweight and obese groups were 9.5 (± 0.70), 5:06 (± 4:54), 7.66 (± 4:41), and six (± 5.19), respectively (p> 0.05). The percentage of subjects who were healthy female with the teeth was 13.5%. There was an association between caries prevalence and ethnicity (p <0.05), white and brown colored individuals had higher caries rates than black individuals. Sociodemographic characteristics such as maternal and paternal schooling did not influence the caries experience of children and adolescents (p> 0.05). With regard to eating habits in early childhood, the duration of breastfeeding did not affect the caries experience (p> 0.05), on the other hand, sugar plus the bottle was associated with caries disease (p <0.05). Daily brushing performed only by the child without supervision of parents or guardians, was significantly associated with caries. There was no association between dental caries and BMI.

"We analyze data on body mass index (BMI) in the third National Health and Nutrition Examination survey, predict finite population BMI stratified by different domains of race, sex and family income, and investigate what adjustment needed for nonresponse mechanism. We built two types of models to analyze the data. In the ignorable nonresponse models, each model is within the hierarchical Bayesian framework. For Model 1, BMI is only related to age. For Model 2, the linear regression is height on weight, and weight on age. The parameters, nonresponse and the nonsampled BMI values are generated from each model. We mainly use the composition method to obtain samples for Model 1, and Gibbs sampler to generate samples for Model 2. We also built two nonignorable nonresponse models corresponding to the ignorable nonresponse models. Our nonignorable nonresponse models have one important feature: the response indicators are not related to BMI and neither weight nor height, but we use the same parameters corresponding to the ignorable nonresponse models. We use sample important resampling (SIR) algorithm to generate parameters and nonresponse, nonsample values. Our results show that the ignorable nonresponse Model 2 (modeling height and weight) is more reliable than Model 1 (modeling BMI), since the predicted finite population mean BMI of Model 1 changes very little with age. The predicted finite population mean of BMI is affected by different domain of race, sex and family income. Our results also show that the nonignorable nonresponse models infer smaller standard deviation of regression coefficients and population BMI than in the ignorable nonresponse models. It is due to the fact that we are incorporating information from the response indicators, and there are no additional parameters. Therefore, the nonignorable nonresponse models allow wider inference."

While the role of obesity in health outcomes has been well described, the role of low body mass index (BMI), body weight relative to height, has largely been ignored. Those with low BMI are commonly excluded completely or combined with the normal BMI category in BMI studies. However, there have been some studies indicating poorer health outcomes among those with lower BMI, particularly that of increased risk of mortality. The purpose of this study is to explore the role of low BMI throughout the lifespan. Data from the Health and Retirement Study was used to evaluate 1) the association between childhood health and socioeconomic status (SES) exposures and low BMI in midlife adulthood, 2) the association between low BMI and health related outcomes in midlife adulthood (ages 50 to 65), and 3) the association between low BMI in midlife and health related outcomes, including mortality, over a longer follow-up (maximum of 20 years). To increase sample size, two low BMI definitions were used: the traditional Few significant results were found. Low BMI status was consistently associated with older age and female gender as well as current smoking status. Childhood exposure of respiratory disease and greater SES disadvantages was more common among those with low BMI in adulthood. In midlife adulthood, low BMI status was associated with increased difficulties with activities of daily living with either definition of low BMI. Increased risk of fracture was associated with a low BMI definition of <18.5. Increased risk of lung disease and decreased risk of high blood pressure was associated with a low BMI definition of ≤20. An analysis of those 30 years old or older found low BMI to be associated with increased risk of mortality and decreased risk of diabetes regardless of low BMI definition. When low BMI was defined as <18.5, those with low BMI were also more likely to experience difficulty with one or more activities of daily living. When low BMI was defined as ≤20, low BMI status was associated with greater risk of lung disease and decreased risk of high blood pressure. Further research is needed to fully characterize the role of low BMI on health outcomes as well as the role of SES on low BMI. Additionally, there is a need for greater understanding of the potential biological mechanisms of low BMI for health outcomes. Currently, there are few studies evaluating health outcomes and SES of low BMI. Limiting studies to the extreme upper end of the BMI spectrum limits the overall understanding of the role of BMI in health and may overlook unique characteristics and challenges those with low BMI may face.

The aim of this research was to determine ethnic and cultural influences on body composition, lifestyle, and aspects of body image (perception, acceptability, and satisfaction) of younger (age 18-40 years) Australian and Japanese males, the latter including groups living in Australia and Japan. The sample sizes of the three groups were 68 Japanese living in Australia, 84 Japanese living in Japan, and 72 Australian Caucasian males respectively. The methodology included body composition assessments (by anthropometry and DXA), lifestyle and body image questionnaires, and dietary records. The study found significant p<0.05) ethnic differences in the %BF at given BMI levels and for Japanese the BMI values of 23.6kg/m2 and 28.6kg/m2 were found to be equivalent to 25 and 30 for Caucasians when used to classify individuals as "overweight" and "obese". Equations in common use for the calculation of body composition in Japanese males were evaluated using modern methods of body composition assessment and found to need considerable modification. New regression equations that represent BMI-%BF relationships for Japanese and Australians were proposed: Japanese: Log %BF = -1.330 + 1.896(log BMI), (R2 = 0.547, SEE = 0.09); Australians: Log %BF = -1.522 + 2.001(log BMI), (R2 = 0.544, SEE = 0.10). Equations were also developed to predict %BF for Japanese and Australian males from body composition assessments using anthropometry and DXA: Japanese: %BF = 0.376 + 0.402(abdominal) + 0.772(medial calf) + 0.217(age), (R2 = 0.786, SEE = 2.69); Australians: %BF = 2.184 + 0.392(medial calf) + 0.678(supraspinale) + 0.467(triceps), (R2 = 0.864, SEE = 2.37). Lifestyle factors were found to influence perceptions of body image. / Australian males participate in physical activity more frequently than their Japanese counterparts (Australians = 98.6% involved in vigorous activity at least once per week, Japanese living in Japan = 85.7%, Japanese living in Australia = 72.1%). Significant differences p<0.05) in energy contribution patterns were found between the Japanese group (Protein: 14.4%, Carbohydrate: 50.4%, Fat: 28.1%) and Japanese living in Australia (JA: Protein: 16.3%, Carbohydrate: 47.3%, Fat: 32.3%) and the Australians (Protein: 17.1%, Carbohydrate: 47.9%, Fat: 30.6%). This shows that the Japanese living in Australia have adopted a more westemised diet than those living in Japan. Body Image assessments were done on all study groups using the Somatomorphic Matrix (SM) computer program and questionnaires, including the Ben-Tovim Walker Body Attitudes Questionnaires, (BAQ) the Attention to the Body Shape Scale (ABS), and the Eating Attitudes Test (EAT). Japanese males tended to overestimate their weight and amount of body fat, while Australian Caucasian males underestimated these parameters. The Japanese groups had higher scores on the selfdisparagement subscale and lower scores on the strengths and the attractiveness subscales of the BAQ questionnaire than Australian males. Australian males also had higher scores on the EAT total score and the dieting subscale of the EAT questionnaire than Japanese males. When all groups of subjects selected their perceived body image from the SM program menu, these results had no relationship with measured body composition values, suggesting that further development of this program is needed for use in these populations.

<p>Bakgrund: Olika metoder tillämpas för att mäta övervikt och fetma och är viktiga som primär åtgärd för sjuksköterskan.Varje patientmöte ska ses som en möjlighet att lyfta de hälsofrämjande aspekterna i sjuksköterskans arbete.</p><p>Syfte: Syftet med litteraturstudien var att jämföra olika mätmetoder för att undersöka vilken som är säkrast i upptäckten av överviktsrelaterad ohälsa i ett hälsofrämjande arbete. Mätmetoderna som jämfördes var BMI, midjemått och midjahöftkvot.</p><p>Metod: Litteraturstudie.</p><p>Resultat: Viktutvärderingens första steg är att mäta längd, vikt och midjemått. Sjuksköterskor är bäst lämpade att genomföra</p><p>mätningarna för att undvika felvärden eftersom patienter har benägenhet att över/underskatta sina mått. Midjemått är ensam bättre på att korrekt kategorisera individer med den verkliga mängden fett i midjeregionen. Mätmetoden är mindre</p><p>tidskrävande och ger färre felvärden. Normal kroppsvikt kan ge falsk trygghet för dem som är till synes smala men har en hög grad bukfetma. Antalet riskfaktorer ökar signifikant hos överviktiga med ett högt midjemått. Klara samband visas mellan</p><p>midjemått och kardiovaskulära sjukdomar.</p><p>Slutsats: Midjemåttet bör användas i en större omfattning eftersom måttet har ett starkt samband med bukfetma och ökad</p><p>risk för kardiovaskulära sjukdomar. Midjemätning är en av de säkraste metoderna och ses som en preventiv åtgärd som</p><p>skyddar mot framtida sjukdomar som är sammankopplade med övervikt och fetma.</p>