Overweight and Human Immunodeficiency Virus (HIV) Progression in Women: Associations HIV Disease Progression and Changes in Body Mass Index in Women in the HIV Epidemiology Research Study Cohort
Clara Y. JonesJoseph W. HoganBradley S. SnyderRobert S. KleinAnne RompaloPaula SchumanCharles C. J. Carpenter
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Abstract:
An association of increased weight with a slower progression of human immunodeficiency virus (HIV) disease has been reported in studies that have not included large numbers of women. We evaluated the association of HIV disease progression with body mass index (BMI) in 871 women and present cross-sectional, survival, and longitudinal analyses. A higher baseline BMI was associated with a lower rate of occurrence of the first CD4 cell count <200 cells/mm3. In analyses that incorporated time-varying BMI, underweight and normal women had an increased risk of clinical acquired immune deficiency syndrome, and underweight women had increased risk of HIV-related death, compared with obese women. The association between change in BMI and CD4 cell count was estimated; increases in BMI were associated with slight increases in CD4 cell counts, even after controlling for prior values of CD4 cell count, viral load, and treatment. Higher BMI and increases in BMI are associated with a decreased risk of HIV progression.Keywords:
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India has one of the highest rates of underweight burden, with signs of rising obesity. Coexistence of underweight and overweight persons is symptomatic of the "double burden of malnutrition." The present study throws new light on the "double burden of malnutrition" among Indian women in the age group 22-49 years. The analysis is based on a nationally representative household survey, India Human Development Survey. Our results indicate the continuing pattern of socioeconomic segregation of underweight and overweight/obese women, with a large concentration of underweight women among the low socioeconomic group and of overweight/obese women among the high socioeconomic group. Further, relative food prices of food items like cereals and vegetables are significantly associated with the risk of being underweight and overweight/obese. Additionally, we find notable rural/urban differences. The relationship between socioeconomic factors and the probability of being underweight and overweight/obese is stronger in urban than in rural areas. Given that the health implications of being underweight and overweight/obese are equally grim, provision of healthy food items at affordable prices and implementation of programs for preventive and curative care of plausible illnesses related to underweight and overweight/obese are imperative.
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Background: Weight has long been known to be a determinant of health and disease. Both overweight and underweight are associated with health consequences. We report the results of a community survey of underweight, obesity and overweight in two suburban communities in northern Nigeria. Methods: We studied an adult population sample in suburban northern Nigeria. Obesity was defined as BMI >30KgM-2 while overweight was defined as BMI > 25.0 but <30.0; and underweight was defined as BMI <18.5 KgM-2. Results: 317 subjects participated in the study, 267 (84.23%) were males and 50 (15.77%) females. Forty-one (13.1%) of the subjects had obesity, overweight occurred in 58 (18.5%) while underweight occurred in 21(6.7%) subjects. Conclusion: Both over-nutrition and under-nutrition are common in these communities with the former being more prevalent. Concerted efforts should be made to appropriately control the prevalence of overweight and obesity. (Int J Diabetes Metab 15:68-69, 2007)
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To assess the association between weight perception and BMI among a large, diverse sample of adolescents. This study used both measured and self-reported height and weight to calculate BMI.A convenience sample of students (n = 2032) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, self-reported height and weight, and body weight perception. These students were then weighed and had their height measured using a standard protocol.Using BMI calculated from measured height and weight, 1.5% of students were classified as underweight or at risk for underweight, 51.2% of students were normal weight, and 47.4% were overweight or at risk for overweight. Among this same sample of students, however, 34.8% perceived themselves as underweight, 42.9% perceived themselves as about the right weight, and 22.3% perceived themselves as overweight. Even when using BMI calculated from self-reported height and weight, >20% of students who were overweight or at risk for overweight perceived themselves as underweight.Because perception of overweight is a key determinant of adolescent nutritional habits and weight management, many students who are overweight or at risk for overweight but who do not perceive themselves as such are unlikely to engage in weight control practices. Increasing awareness of medical definitions of overweight might improve accuracy of weight perceptions and lead to healthier eating and increased physical activity.
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Background: Previous published results showed a dual burden of underweight and overweight within households in Indonesia. Aim: This study documents the dual burden in stunted pre‐school children from Indonesia in 2000. Methods: Definitions for stunting, underweight, wasting and overweight/obesity are based on the WHO international growth standards. Maternal weight status is assessed based on BMI definitions for underweight, overweight, or normal weight. Results: Stunted children were predominantly normal weight (86.7%) whereas the prevalence of overweight (6.7%) and wasting (6.6%) were nearly equal. Furthermore, mothers of stunted children were also predominantly normal weight (69.1%) with only a slightly higher prevalence of overweight (17.2%) than underweight (13.7%). Comparing maternal under and overweight, stunted children two and under more frequently clustered together with underweight mothers. In contrast, the older children more frequently had overweight mothers. Conclusions: In 2000, stunted Indonesian children and their mothers were predominantly normal weight. Furthermore, by the age of 3, stunted children have more overweight than underweight mothers. More research is needed to understand the role of food quality and/or infectious disease to the dual burden of child under‐nutrition and overweight/obesity.
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This study was carried out to compared the characteristics of the underweight university students with those of overweight university students. The survey was carried out by self-questionnaires with 97 underweight and 156 overweight university students. The results are summarized as follows. Breakfast was skipped in 37.1% of underweight and 46.2% of overweight students and it appeared overweight students eat faster than underweight students. The 16.5% of underweight and 75.0% of overweight students have correct perception about their body image. The percentage of weight control experience were 25.8 and 55.8 in the underweight and overweight students, respectively. Blood levels of lipid profiles(triglyceride, LDL cholesterol, and HDL cholesterol), hemoglobin, AST and ALT were anaylzed. Plasma levels of triglyceride, total cholesterol, LDL cholesterol, and HDL cholesterol of underweight students were 96.41, 143.75, 97.53 and 56.27 mg/dl, and those of overweight students were 107.99, 164.31, 100.08 and 53.64 mg/dl, respectively. Blood parameters were in normal range in both group. Plasma triglyceride, total cholesterol and LDL cholesterol levels of overweight students were higher than those of underweight students. On the other hand, plasma HDL cholesterol levels of overweight students were lower than those of underweight students. Plasma levels of AST and ALT were in normal range in both group. However, AST and ALT levels of overweight students were higher than that of underweight students. Therefore they should have a nutritional education program to improve their dietary and living habits for overweight students' health. And nutritional education program should be organized practically and systematically
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The aim of the study was to compare the prevalence of overweight, obesity, and underweight in children and adolescents from different provinces in Poland.Data from the recent, large, population-representative sample of school-aged children and adolescents (N=17573) OLAF study: "Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland" - PL0080 OLAF were used in the analysis. The survey was conducted in all provinces of Poland (N=16). Data were analyzed using SAS 9.2, EpiInfo 3.5.1 and LMSgrowth software packages. The frequency of overweight, obesity, and underweight were determined. For overweight and obesity (jointly) and underweight the odds ratio (OR) was calculated for gender and voivodship of residence. The body mass index (BMI) was standardized and expressed as a z-score. The statistical significance of differences between BMI z-scores depending on voivodship of residence was assessed by the t-test.Significant differences were found in the occurrence of overweight and obesity among the analysed regions, and voivodships with a lower (małopolskie, świętokrzyskie, lubelskie, and podkarpackie) and higher (mazowieckie) risk of overweight and obesity were identified. In case of underweight, łódzkie and podkarpackie (<0.040) provinces were higher risk areas, while mazowieckie (<0.001) had lower risk. The prevalence of overweight (including obesity) was higher compared to the prevalence of underweight in the majority of provinces (15 out of 16).Analysis of regional differences in the prevalence of obesity, overweight and underweight in children and adolescents may point to the direction in which nationwide and local efforts should be made to reduce the inequalities stemming from nutritional status.
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Evidences show that the burden of overweight and obesity is escalating in developing countries with predominant burden of underweight. The coexistence of underweight and overweight/obesity is known as double burden of malnutrition. Recent scanty studies confirmed that Bangladesh is currently experiencing augmented overweight and obesity as well as abating underweight. The present study aimed at assessing the changes of prevalence of overweight/obesity and underweight from 2004 to 2014 and investigated the socio-demographic correlates of being overweight/obese and underweight among ever-married women age 15-49 years.Data were collected from four consecutive Demographic and Health Surveys conducted in Bangladesh in 2004 (N = 11,173), 2007 (N = 10,993), 2011 (N = 17,749), 2014 (N = 17,690). Multinomial logistic regression model has been used to determine association between different socio-demographic predictors with overweight/obesity and underweight among ever-married women age 15-49 years considering normal weight as reference category.The prevalence of underweight decreased by 43.2% (from 32.2% in 2004 to 18.3% in 2014) and 130.5% increase in overweight and obesity (from 10.5% in 2004 to 24.2% in 2014) were found over the ten years period. Age, educational status, wealth index and year were positively associated with overweight and obesity and negatively associated with underweight. Also, 'not being married' status for rural women were positively associated with underweight and negatively associated with overweight and obesity. Rural women were less likely to be overweight and obese (OR = 0.7, 95% CI: 0.7-0.8) while more likely to be underweight (OR = 1.1, 95% CI: 1.1-1.2) relative to urban women respectively. The likelihood of being overweight and obese was 4.5 times (95% CI: 4.1-4.9) higher among women who were in richest quintile compared to poorest women. They were also less likely to be underweight (OR = 0.4, 95% CI: 0.3-0.4) relative to same reference category.The double burden of malnutrition is evidently prevailing in Bangladesh. Over the ten years period, overweight and obesity has been raised tremendously but underweight did not fall significantly. This study suggests that strategies for preventing both underweight and overweight/obesity simultaneously among reproductive women need to be implemented considering regional context and their socioeconomic status (SES).
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