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Objectives. This study aimed to investigate 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry, and assess the contribution of age, gender, body mass index (BMI) and physical activity (PA). Methods. The sample comprised 904 workers. Musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. χ2 tests assessed the association between musculoskeletal symptoms and age/gender/BMI/PA, and multivariate logistic regression models predicted the 12-month occurrence of symptoms in the five most prevalent regions. Results. The five most affected body regions were the lower back, shoulders, neck, knees and wrists/hands. Older workers presented more symptoms in all body regions, except dorsal; female gender was associated with neck symptoms (p = 0.001); overweight was associated with a higher prevalence of lower back (p = 0.01), knee (p = 0.017) and ankle/foot (p = 0.037) symptoms; and a moderate PA level was associated with thigh/hip symptoms (p = 0.006). Age was a significant predictor in all five most affected regions; gender was a significant predictor for shoulders, neck and wrists/hands; and BMI was a significant predictor for lower back symptoms. Conclusion. The 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry is higher in the lower back, shoulders, neck, knees and wrists/hands. [ABSTRACT FROM AUTHOR]

Aim: Low body mass index (BMI) and poor oral health are prevalent among older stroke patients and associated with adverse outcomes. However, their combined impact on functional recovery after stroke remains unclear. This study investigated the synergistic effects of low BMI and poor oral health on activities of daily living (ADL) independence, swallowing function, and cognitive status in post-stroke older patients., Methods: A retrospective cohort study was conducted on 708 hospitalized post-stroke patients aged ≥70 years. Low BMI was defined as <20 kg/m 2 , and poor oral health was assessed using the Revised Oral Assessment Guide (ROAG) with a score ≥13 indicating oral problems. The primary outcome was ADL independence (Functional Independence Measure-motor score >78) at discharge. Secondary outcomes included swallowing level (Food Intake Level Scale) and cognitive status (Functional Independence Measure-cognition score). Multiple regression analyses were performed to examine the associations of low BMI, poor oral health, and their combination with outcomes of interest., Results: The coexistence of low BMI and poor oral health was independently associated with lower odds of achieving ADL independence (odds ratio 0.130, 95% confidence interval [CI] 0.023-0.718), worse swallowing level (B = -0.878, 95% CI -1.280 to -0.476), and poorer cognitive status (B = -1.872, 95% CI -2.960 to -0.784) at discharge, after adjusting for confounders. The combined impact was stronger than either condition alone., Conclusions: The coexistence of low BMI and poor oral health exerts a synergistic negative impact on functional recovery in older stroke inpatients. Comprehensive interventions integrating nutritional support, oral management, and rehabilitation are crucial to optimizing outcomes in this vulnerable population. Geriatr Gerontol Int 2024; 24: 1045-1052., (© 2024 Japan Geriatrics Society.)

Objective: This study aimed to investigate the impact of the donor-recipient BMI ratio on the survival outcomes of heart transplant recipients., Methods: A retrospective analysis was conducted on 641 heart transplant patients who underwent surgery between September 2008 and June 2021. The BMI ratio (donor BMI divided by recipient BMI) was calculated for each patient. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed to evaluate survival rates and determine the hazard ratio (HR) for mortality., Results: Significant differences were found in donor age and donor-recipient height ratio between the BMI ratio groups. The BMI ratio ≥ 1 group had a higher mean donor age (37.27 ± 10.54 years) compared to the BMI ratio < 1 group (34.72 ± 11.82 years, p = 0.008), and a slightly higher mean donor-recipient height ratio (1.02 ± 0.06 vs. 1.00 ± 0.05, p = 0.002). The Kaplan-Meier survival analysis indicated that the survival rate in the BMI ratio ≥ 1 group was significantly lower than in the BMI ratio < 1 group. Cox multivariate analysis, adjusted for confounding factors, revealed a HR of 1.50 (95% CI: 1.08-2.09) for mortality in patients with a BMI ratio ≥ 1. No significant differences were observed in ICU stay, postoperative hospitalization days, or total mechanical ventilation time between the groups., Conclusion: A higher donor-recipient BMI ratio was associated with an increased risk of mortality in heart transplant recipients., (© 2024 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.)

Estimates of the impact of body mass index and obesity on health and labor market outcomes often use instrumental variables estimation (IV) to mitigate bias due to endogeneity. When these studies rely on survey data that include self- or proxy-reported height and weight, there is non-classical measurement error due to the tendency of individuals to under-report their own weight. Mean reverting errors in weight do not cause IV to be asymptotically biased per se, but may result in bias if instruments are correlated with additive error in weight. We demonstrate the conditions under which IV is biased when there is non-classical measurement error and derive bounds for this bias conditional on instrument strength and the severity of mean-reverting error. We show that improvements in instrument relevance alone cannot eliminate IV bias, but reducing the correlation between weight and reporting error mitigates the bias. A solution we consider is regression calibration (RC) of endogenous variables with external validation data. In simulations, we find IV estimation paired with RC can produce consistent estimates when correctly specified. Even when RC fails to match the covariance structure of reporting error, there is still a reduction in asymptotic bias., (© 2024 John Wiley & Sons Ltd.)

Background: Metabolic and Bariatric surgery (MBS) leads to significant weight loss and improvements in obesity-related comorbidities. However, the impact of MBS on Apolipoprotein B100 (Apo-B100) regulation is unclear. Apo-B100 is essential for the assembly and secretion of serum lipoprotein particles. Elevated levels of these factors can accelerate the development of atherosclerotic plaques in blood vessels. This study aimed to evaluate changes in Apo-B100 levels following MBS., Methods: 121 participants from the Iranian National Obesity and Metabolic Surgery Database (INOSD) underwent Laparoscopic Sleeve Gastrectomy (LSG) (n = 43), One-Anastomosis Gastric Bypass (OAGB) (n = 70) or Roux-en-Y Gastric Bypass (RYGB) (n = 8). Serum Apo-B100, lipid profiles, liver enzymes, and fasting glucose were measured preoperatively and six months postoperatively., Results: Apo-B100 levels significantly decreased from 94.63 ± 14.35 mg/dL preoperatively to 62.97 ± 19.97 mg/dL after six months (p < 0.01), alongside reductions in total cholesterol, triglycerides, LDL, VLDL, AST, and ALT (p < 0.05). Greater Apo-B100 reductions occurred in non-diabetics versus people with diabetes (p = 0.012) and strongly correlated with baseline Apo-B100 (r = 0.455, p < 0.01) and LDL levels (r = 0.413, p < 0.01). However, surgery type did not impact Apo-B100 changes in multivariate analysis (p > 0.05)., Conclusion: Bariatric surgery leads to a significant reduction in Apo-B100 levels and improvements in lipid profiles and liver enzymes, indicating a positive impact on dyslipidemia and cardiovascular risk in individuals with high BMI., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: To study respiratory effects of exposure to soft paper dust exposure, a relationship that is rarely studied. Methods: Soft tissue paper mill workers at a Swedish paper mill were investigated using a questionnaire and lung function and atopy screening. Spirometry without bronchodilation was performed with a dry wedge spirometer, and forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were obtained and expressed as percent predicted. Exposure to soft paper dust was assessed from historical stationary and personal measurements of total dust, in addition to historical information about the work, department, and production. The impact of high exposure to soft paper dust (> 5 mg/m3) vs. lower exposure ≤ 5 mg/m3, as well as cumulative exposure, was analyzed using multiple linear regression models. Multivariate models were adjusted for smoking, atopy, gender, and body mass index. Results: One hundred ninety-eight current workers (124 male and 74 female) were included. There were significant associations between both cumulative exposure and years of high exposure to soft paper dust and impaired lung function. Each year of high exposure to soft paper dust was associated with a 0.87% decrease in FEV1 [95% confidence interval (CI) − 1.39 to − 0.35] and decreased FVC (− 0.54%, 95% CI − 1.00 to − 0.08) compared to the lower exposed workers. Conclusions: The present study shows that occupational exposure to soft paper dust (years exceeding 5 mg/m3 total dust) is associated with lung function impairment and increased prevalence of obstructive lung function impairment. [ABSTRACT FROM AUTHOR]

Background: Executive control and temperament have been associated with pediatric obesity. However, interactions between these constructs in relation to future weight outcomes have not been investigated., Objective: This longitudinal study examined early childhood executive control, early temperament (negative affectivity and surgency), and their interactions as predictors of adolescent BMI trajectories., Methods: At age 5.25, children (N = 229) completed executive control tasks, and parents completed the Child Behavior Questionnaire to assess temperament. BMI was calculated annually between ages 14-17., Results: Greater early negative affectivity predicted more positive BMI growth. Although early childhood executive control was not associated with BMI growth, greater negative affectivity predicted greater BMI escalation at average and below average executive control abilities., Conclusions: For children without robust executive control abilities early in development, negative affectivity may be a risk factor for accelerated adolescent BMI growth. Targeted assessment of early risk factors may be useful for childhood obesity prevention efforts., (© 2024 World Obesity Federation.)

Purpose of Review: This review explores characterizing candidates for obesity treatments including pharmacotherapy, endoscopic bariatric therapies, and metabolic bariatric surgery (MBS), focusing on established clinical parameters for diagnosing obesity beyond body mass index alone., Recent Findings: Existing literature primarily provides rates for fat mass percentage (i.e., a marker for adiposity quantity), waist circumference (i.e., a marker for adiposity distribution), and C-reactive protein levels (i.e., a marker for adiposity functionality) among obesity treatment candidates. Limited data on abnormal values and sex-based differentiation exist. The literature indicates high central-tendency measures for fat mass percentage and waist circumference, while C-reactive protein levels vary. Data on the Edmonton Obesity Staging System (i.e., a marker for adiposity-related disease severity) is predominantly available for MBS candidates. Future studies in obesity interventions should improve screening and diagnosis of obesity by incorporating sex-specific considerations and providing abnormal value rates for measurements to enhance understanding of patients' characteristics., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: Our study aims to provide an updated estimate of age- and sex-specific deaths and disability-adjusted life years (DALYs) associated with high body mass index (BMI) from 1990 to 2019 at the global, regional and national levels, and to forecast the global burden of disease attributed to high BMI from 2020 to 2035., Methods: We used the data for the number of deaths, DALYs, age-standardized rate (per 100 000 population), percentage change and population attributable fraction from the Global Burden of Disease Study 2019 (GBD 2019) to examine the disease burden attributable to high BMI. We further applied an autoregressive integrated moving average (ARIMA) model to predict the disease burden for the period 2020-2035., Results: From 1990 to 2019, the deaths and DALYs attributable to high BMI increased by 148% and 155.86% for men, and by 111.67% and 121.78% for women, respectively. In 2019, high BMI directly accounted for 8.52% [95% uncertainty intervals (UI) 0.05, 0.12] of all-cause deaths and 5.89% (95% UI 0.04, 0.08) of global DALYs. The highest death rates were observed in men aged 65-69 and women aged 75-79. The highest DALY rates were observed in the age group of 60-64 for both sexes. In 2019, the highest age-standardized deaths and DALY rates were observed in the Central Asia region [163.15 (95% UI 107.72, 223.58) per 100 000 people] and the Oceania region [4643.33 (95% UI 2835.66, 6902.6) per 100 000 people], respectively. Fiji [319.08 (95% UI 213.77, 444.96) per 100 000 people] and Kiribati [10 000.58 (95% UI 6266.55, 14159.2) per 100 000 people] had the highest age-standardized deaths and DALY rates, respectively. In 2019, the highest age-standardized rates of high BMI-related deaths and DALYs were observed in the middle-high socio-demographic index quintile and in the middle socio-demographic index quintile. The age-standardized deaths and DALY rates attributable to high BMI are projected to increase in both sexes from 2020 to 2035. The death rates are projected to rise from 62.79 to 64.31 per 100 000 people, while the DALY rates are projected to rise from 1946 to 2099.54 per 100 000 people., Conclusions: High BMIs significantly contribute to the global disease burden. The projected rise in deaths and DALY rates attributable to high BMI by 2035 highlights the critical need to address the impact of obesity on public health. Our study provides policymakers with up-to-date and comprehensive information., (© 2024 John Wiley & Sons Ltd.)

Background: Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI., Methods: Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18-35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two-sample t-test, chi-squared and one-way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders., Results: The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m 2 . The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males., Conclusion: Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings., (© 2024 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Most patients undergoing the mitral transcatheter edge-to-edge repair (TEER) technique are elderly comorbid patients. Low body mass index (BMI) < 23 kg/m 2 has been identified in other elderly populations as a risk factor, but has not been studied sufficiently in mitral TEER., Aims: We aimed to study the impact of low BMI (23 kg/m2) on the outcome after mitral TEER., Methods: Patients undergoing first-time TEER for mitral regurgitation at a single tertiary center were included, with the exclusion of patients with preprocedural hemodynamic instability or missing BMI. The primary endpoint was all-cause mortality. Secondary endpoints were long-term major bleeding or admission with heart failure., Results: A total of 120 patients (mean age 76 ± 10 years, 76% men) were included in the study. Thirty-nine (31%) had low BMI. Patients with low BMI had a similar symptomatic benefit as patients with BMI ≥ 23 kg/m 2 at 1 year regarding decrease in diuretics dose and decrease in New York Heart Association (NYHA) class (p > 0.05). In a multivariable Cox regression analysis, BMI as a continuous variable (hazard ratio [HR]: 0.93 [95% confidence interval, CI: 0.87-0.99], p = 0.03) and low BMI (HR: 1.99 [95% CI: 1.12-3.52], p = 0.02) were associated with the primary outcome. Low BMI was not significantly associated with major bleeding (subdistribution hazard ratio [SHR]: 2.39 [95% CI: 0.96-5.97], p = 0.06) or admission with heart failure (SHR: 1.06 [95% CI: 0.61-1.88], p = 0.83) during follow-up with univariable competing risk regression analysis., Conclusion: Low BMI is a risk factor for mortality after mitral valve TEER, confirming the presence of an "obesity paradox" in this population and should receive attention in patient selection., (© 2024 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)

Objectives: To analyze the mode of school physical activity, the relationship with obesity, and participation willingness and behavior in the relationship between modes of school physical activity and BMI in students with overweight or obesity., Design: Cross-sectional study., Sample: Data from the 2014 Physical Fitness and Health Surveillance of Chinese School Students was used, wherein physical measurements and questionnaires of 3476 middle school students were collected., Measurements: Physical measurements and questionnaires were completed. Latent profile analysis and mediated effects analysis were conducted using Mplus 8.3 and IBM SPSS 26.0 for data description and statistical analysis., Result: After latent profile analysis divided into poor (9.35%), medium (65.16%), and good (25.49%) groups of school physical activity, among junior middle school students, medium (OR = 0.428, 95% CI = 0.259-0.707, p = .001) and good (OR = 0.448, 95% CI = 0.255-0.718, p = .002) groups were positive for controlling overweight. Among students with overweight or obesity, participation willingness mediated the relationship between the mode of school physical activity and BMI, with effect coefficients of -0.120 (95% CI = -0.264 to -0.016) and -0.240 (95% CI = -0.426 to -0.099)., Conclusions: School physical activity modes have a positive effect only on preventing and controlling overweight in junior middle school students. For middle school students with obesity, weight-specific measures should be considered for their prevention and control., (© 2024 Wiley Periodicals LLC.)

Background: There are few prospective studies of factors that mediate the association between exposure to adverse childhood experiences (ACEs) and obesity in adolescence. Our aim was to address this limitation., Methods: We used prospective data from the Growing up in Ireland cohort study, with measurements at 9, 13, and 18 years old. The exposures were 14 adverse experiences before age 9. The main outcome was body mass index (BMI) at 18 years. Mediators were daily activity, diet quality, self-image and behavioural difficulties at 13 years., Results: Among the 4561 adolescents in the final cohort, 77.2% experienced any adversity, 50.5% were female and 26.7% were overweight/obese at 18 years. BMI Z was higher at ages 9 (0.54 vs 0.43, p < 0.05, 95% CI of difference: -0.22, -0.01) and 13 years (0.50 vs 0.35, p < 0.05, 95% CI of difference: -0.25, -0.06), in those exposed to an ACE, compared to those unexposed. Structural equation models revealed that behavioural difficulties (β = 0.01; 95% CI: 0.007-0.018, p < 0.001) and self-concept (β = 0.0027; 95% CI: 0.0004-0.0050, p = 0.026) indirectly mediate the association between exposure to ACEs and BMI at 18 years., Conclusions: The association between ACEs and BMI in adolescence is mediated by behavioural difficulties and self-concept., Impact: In a previous study, we found modest associations between exposure to a range of adverse childhood experiences and weight gain at 13 years of age. The strength of the association between adverse childhood experiences and weight gain was lower at 18 years of age compared to the association observed at 13 years and was no longer significant after controlling for confounding and including possible mediators. The association between adverse childhood experiences and BMI in adolescence is indirectly mediated by behavioural difficulties and self-concept., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Background: Protein leverage (PL) is the phenomenon of consuming food until absolute intake of protein approaches a 'target value', such that total energy intake (TEI) varies passively with the ratio of protein: non-protein energy (fat + carbohydrate) in the diet. The PL hypothesis (PLH) suggests that the dilution of protein in energy-dense foods, particularly those rich in carbohydrates and fats, combines with protein leverage to contribute to the global obesity epidemic. Evidence for PL has been reported in younger adults, children and adolescents. This study aimed to test for PL and the protein leverage hypothesis (PLH) in a cohort of older adults., Methods: We conducted a retrospective analysis of dietary intake in a cohort of 1699 community-dwelling older adults aged 67-84 years from the NuAge cohort. We computed TEI and the energy contribution (EC) from each macronutrient. The strength of leverage of macronutrients was assessed through power functions ( TEI = μ * EC L ). Body mass index (BMI) was calculated, and mixture models were fitted to predict TEI and BMI from macronutrients' ECs., Results: In this cohort of older adults, 53% of individuals had obesity and 1.5% had severe cases. The mean TEI was 7673 kJ and macronutrients' ECs were 50.4%, 33.2% and 16.4%, respectively for carbohydrates, fat, and protein. There was a strong negative association (L = -0.37; p < 0.001) between the protein EC and TEI. Each percent of energy intake from protein reduced TEI by 77 kJ on average, ceteris paribus. However, BMI was unassociated with TEI in this cohort., Conclusions: Findings indicate clear evidence for PL on TEI, but not on BMI, likely because of aging, body composition, sarcopenia, or protein wasting., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Body Mass Index (BMI) is a measurement of nutritional status, which is a vital pre-condition for good health. The prevalence of childhood malnutrition and the potential long-term health risks associated with obesity in Ethiopia have recently increased globally. The main objective of this study was to investigate the factors associated with the quantiles of under-five children's BMI in Ethiopia., Methods: Data on 5,323 children, aged between 0-59 months from March 21, 2019, to June 28, 2019, were obtained from the Ethiopian Mini Demographic Health Survey (EMDHS, 2019), based on the standards set by the World Health Organization. The study used a Bayesian quantile regression model to investigate the association of factors with the quantiles of under-five children's body mass index. Markov Chain Monte Carlo (MCMC) with Gibbs sampling was used to estimate the country-specific marginal posterior distribution estimates of model parameters, using the Brq R package., Results: Out of a total of 5323 children included in this study, 5.09% were underweight (less than 12.92 BMI), 10.05% were overweight (BMI: 17.06 - 18.27), and 5.02% were obese (greater than or equal to 18.27 BMI) children's. The result of the Bayesian quantile regression model, including marginal posterior credible intervals (CIs), showed that for the prediction of the 0.05 quantile of BMI, the current age of children [ β = -0.007, 95% CI :(-0.01, -0.004)], the region Afar [ β = - 0.32, 95% CI: (-0.57, -0.08)] and Somalia[ β = -0.72, 95% CI: (-0.96, -0.49)] were negatively associated with body mass index while maternal age [ β = 0.01, 95% CI: (0.005, 0.02)], mothers primary education [ β = 0.19, 95% CI: (0.08, 0.29)], secondary and above [ β = 0.44, 95% CI: (0.29, 0.58)], and family follows protestant [ β = 0.22, 95% CI: (0.07, 0.37)] were positively associated with body mass index. In the prediction of the 0.95 (or 0.85?) quantile of BMI, in the upper quantile, still breastfeeding [ β = -0.25, 95% CI: (-0.41, -0.10)], being female [ β = -0.13, 95% CI: (-0.23, -0.03)] were negatively related while wealth index [ β = 0.436, 95% CI: (0.25, 0.62)] was positively associated with under-five children's BMI., Conclusions: In conclusion, the research findings indicate that the percentage of lower and higher BMI for under-five children in Ethiopia is high. Factors such as the current age of children, sex of children, maternal age, religion of the family, region and wealth index were found to have a significant impact on the BMI of under-five children both at lower and upper quantile levels. Thus, these findings highlight the need for administrators and policymakers to devise and implement strategies aimed at enhancing the normal or healthy weight status among under-five children in Ethiopia., (© 2024. The Author(s).)

Background: Lipid metabolism affects type 2 immunity; however, the association between plasma lipids and eosinophilic inflammation in humans is uncertain. This study analysed the relationship between plasma lipids and peripheral eosinophils and whether patterns differ with different body mass indexes (BMI)., Methods: A cross-sectional survey including 62,441 healthy participants recruited from a regular health screening programme was conducted. Participants were divided into normal weight, overweight and obese subgroups according to BMI., Results: Multiple linear regression analysis revealed that elevated logarithmic-transformed eosinophil counts (log(EOS)) significantly correlated with high total cholesterol(TC), triglyceride(TG), low-density lipoprotein-cholesterol (LDL-C), and low high-density lipoprotein-cholesterol (HDL-C)levels in the overall population, as well as in men and women, while certain associations between peripheral blood eosinophil percentage and serum lipids varied by gender. These correlations existed across almost all BMI subgroups, and standardised β values decreased sequentially with increasing BMI. HDL-C had the most significant effect on eosinophils in obese women. Two-factor analysis of variance showed log(EOS) increased with higher BMI and hyperlipidemia whether in male or female and a synergistic effect exists of lipid levels (TG and LDL-C) and BMI in men., Conclusions: Blood eosinophil counts were correlated with blood lipid levels and modified by body mass index status. The effects of lipid levels and body mass index on blood eosinophil counts were synergistic. Therefore, lipid metabolism may be involved in systemic eosinophil inflammation., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objectives: Multiple regression approaches for estimating body mass by somatometry typically use stature and biiliocristal breadth. However, these measures were obtained largely from Europeans, Africans, and Indo-Mediterraneans, whereas mid-latitude Asians were not broadly reflected. Thus, new estimation formulas for circum-Pacific Asians were devised, and the accuracy was evaluated using raw individual data., Materials and Methods: Targeting Asians in the traditional society or before the 1960s and performing multiple regression analysis (MRA) with body weight as the objective variable, and stature, body breadth, and product of head length/breadth (HLBpr) as explanatory variables. The target population was divided into four climate groups, and the formulas were prepared for each sex or the combined-sexes., Results: The MRA by stature and body breadth indicated significant multiple correlation coefficients (R) in many formulas. R was higher in the combined-sexes. Among the four climate groups, the temperate group showed the highest R. In the East/Southeast Asians, R exceeded 0.8 in the MRA by stature and HLBpr. Substituting the raw data of 19th-century Japanese males, the temperate group formulas presented the least error, and the error in all the formulas using body breadth was <2 kg., Conclusions: As body mass index varies significantly depending on some climatic factors, estimation formulas mixed with various climate groups are not desirable because of the large errors. For the mid-latitude Asians, the temperate group formulas are expected to have a smaller error; however, in the group where the proportion of underweight individuals was originally high, any formula tends to be overestimated., (© 2020 Wiley Periodicals LLC.)

Objectives: The aim of this study was to investigate how much variation in adult stature and body mass can be explained by growth disruption among soldiers who served in Napoleon's Grand Army during the Russian Campaign of 1812., Methods: Linear enamel hypoplasia (LEH) were recorded as representations of early life growth disruption, while the impact on future growth was assessed using maximum femur length (n = 73) as a proxy for stature and maximum femoral head diameter (n = 25) as a proxy for body mass. LEH frequency, severity, age at first formation, and age at last formation served as explanatory variables in a multiple regression analysis to test the effect of these variables on maximum femur length and maximum femoral head diameter., Results: The multiple regression model produced statistically significant results for maximum femur length (F-statistic = 3.05, df = 5 and 67, P = .02), with some variation in stature (adjusted r 2 = 0.13) attributable to variation in growth disruption. The multiple regression model for maximum femoral head diameter was not statistically significant (F-statistic = 1.87, df = 5 and 19, P = .15)., Conclusions: We hypothesized stress events during early life growth and development would have significant, negative, and cumulative effects on growth outcomes in adulthood. The results did not support our hypothesis. Instead, some variables and interactions had negative effects on stature, whereas others had positive effects. This is likely due to catch-up growth, the relationship between acute and chronic stress and growth, resilience, and plasticity in human growth over the life course., (© 2020 Wiley Periodicals LLC.)

Purpose: To examine the prospective associations between body mass index (BMI) and health-related quality of life (HRQoL)., Methods: Data were extracted from a longitudinal, nationally representative sample of 9916 men and women aged 18 years and over who were followed annually between 2006 and 2016 in the Household, Income and Labour Dynamics in Australia (HILDA) survey. HRQoL was assessed using the self-administered SF-36 questionnaire annually between 2006 (baseline) and 2016. BMI was calculated from self-reported height and weight and was classified into the following four categories of baseline BMI: underweight (< 18.5 kg/m 2 ), normal weight (18.5-24.9 kg/m 2 ), overweight (25-29.9 kg/m 2 ) and obese (≥ 30 kg/m 2 ). We used linear mixed-effects regression models to investigate the associations between change in BMI (kg/m 2 ) and concurrent changes in HRQoL scores over 11 years., Results: BMI gain was associated with deterioration of Physical Component Summary (PCS) (P < 0.001), but not with change in Mental component summary (MCS) over the 11-year period. BMI gain was inversely associated (P < 0.001) with five of the eight HRQoL domains (physical functioning, role physical, bodily pain, general health and vitality) with a significant graded association according to baseline BMI category. Over the 11-year study period, every unit increase in PCS was associated with a decrease of 0.02 (P < 0.001), 0.03 (P < 0.001) and 0.04 (P < 0.001) BMI units per year among participants who were normal, overweight and obese at baseline, respectively. Five of the eight domains of HRQoL (physical functioning, role physical, bodily pain, general health and vitality) were inversely associated with BMI (P < 0.001) with a significant graded association according to baseline BMI category., Conclusions: Weight gain was not only associated with deterioration of HRQoL, and vice versa. The bi-directional association was stronger for physical than mental domains of HRQoL.

Malnutrition can adversely influence women's overall health and development and that of their children. In the Yangon region of Myanmar, young women aged 15-19 years can be excessively thin, overweight, or anemic. A significant proportion of these young women working within the formal sector are employed in the garment industry. This study used a mixed-method approach to generate robust evidence on food security and nutrition in young female garment workers. The research revealed that women have poor quality of nutrition, restricted their food intake, and ate less preferred food. The risk factors for not meeting the minimum dietary diversity were related to migration patterns, employment, food security level, and living conditions. This study offers recommendations and identifies areas for interventions that are either wanted by consulted stakeholders and/or for which there is an evidence basis for their recommendation: (1) promote food- and nutrition-specific programming, (2) increase healthy food access, and (3) improve employment conditions. These future interventions should generate comprehensive research, data, and benefits to fill in the evidence gaps identified and provide guidance on how to promote nutrition in the workplace for this vulnerable group of workers., (© 2020 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, LLC on behalf of New York Academy of Sciences.)

People each around the world is getting increasingly concerned with their health and way of life in moment's ultramodern terrain of the moment. Still, simply avoiding junk food and exercising isn't enough, not sufficient; we need a well-balanced diet. We can live a healthy life with a balanced diet grounded on our height, weight, and age. Your diet can help you achieve and maintain a healthy weight, lower your chance of developing chronic conditions (including cancer and heart complaints), and ameliorate your general health when combined with physical exertion. For this, there is a need for a smart AI chatbot that can be a personal chatbot for suggesting diet and exercise and calculating BMI. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a major public health problem amongst elderly population in India. Anemia in old age further worsens the age-related decline in functional ability, mobility, fatigue, bone density, and skeletal muscle mass. There is lack of evidence on the prevalence and risk factors of anemia among elderly population. Hence, this study was undertaken. Methodology: A community-based cross-sectional study was conducted during the year 2015–2016 in District Nainital, Uttarakhand state, India. A total of 958 subjects were selected from 30 clusters (villages) identified using population proportional to size methodology. Information on sociodemographic profile, nutritional status, body mass index, and dietary intake was obtained. Blood sample was collected from each subject on the filter paper for estimation of hemoglobin (Hb) level using cyanmethemoglobin method. Results: We found that 92.1% of the elderly subjects were anemic. Moderate and severe anemia was found to be significantly higher among female subjects, unemployed, illiterates, subjects using smoke-producing fuel, subjects belonging to lower socioeconomic status, malnourished and underweight subjects, subjects with self-reported hyperacidity, and subjects who had not utilized health facility and had lower iron and vitamin C intake when compared with subjects with mild anemia and normal hemoglobin levels. Conclusion: High prevalence of anemia exists amongst elderly subjects living at high-altitude region of rural Uttarakhand State, India. There is a need to educate the elderly population about the importance of adequate intake of foods rich in iron and vitamin C to reduce the prevalence of anemia among them. [ABSTRACT FROM AUTHOR]

The article offers information on a study by Webb and colleagues evaluated the role of compression therapy in the prevention of cellulitis in chronic oedema of the leg.

Adherence and accuracy of self-monitoring of dietary intake influences success in weight management interventions. Information technologies such as computers and smartphones have the potential to improve adherence and accuracy by reducing the burden associated with monitoring dietary intake using traditional paper-based food records. We evaluated the acceptability and accuracy of three different 7-day food record methods (online accessed via computer, online accessed via smartphone, and paper-based). Young women (N=18; aged 23.4±2.9 years; body mass index 24.0±2.2) completed the three 7-day food records in random order with 7-day washout periods between each method. Total energy expenditure (TEE) was derived from resting energy expenditure (REE) measured by indirect calorimetry and physical activity level (PAL) derived from accelerometers (TEE=REE×PAL). Accuracy of the three methods was assessed by calculating absolute (energy intake [EI]–TEE) and percentage difference (EI/TEE×100) between self-reported EI and TEE. Acceptability was assessed via questionnaire. Mean±standard deviation TEE was 2,185±302 kcal/day and EI was 1,729±249 kcal/day, 1,675±287kcal/day, and 1,682±352 kcal/day for computer, smartphone, and paper records, respectively. There were no significant differences between absolute and percentage differences between EI and TEE for the three methods: computer, –510±389 kcal/day (78%); smartphone, –456±372 kcal/day (80%); and paper, –503±513 kcal/day (79%). Half of participants (n=9) preferred computer recording, 44.4% preferred smartphone, and 5.6% preferred paper-based records. Most participants (89%) least preferred the paper-based record. Because online food records completed on either computer or smartphone were as accurate as paper-based records but more acceptable to young women, they should be considered when self-monitoring of intake is recommended to young women. [ABSTRACT FROM AUTHOR]

The article presents the discussion on judging to ‘be of a satisfactory degree of accuracy' while estimating body fat. Topics include proposing a series of initial body density equations solving for two components of body mass such as fat mass and fat-free mass (FFM); and curvilinear relationship between skinfold thickness and body density which being a proxy at the time for body fat content.

Objectives: Adiposity rebound (AR) refers to an increase in body mass index (BMI) after a nadir. Early AR, in which AR occurs earlier than five years old, is a risk factor for future obesity and metabolic syndrome, but has not been widely studied in very-low-birth-weight infants (VLBWIs)., Methods: The subjects were VLBWIs born in Dokkyo Medical University NICU from January 2008 to December 2010. Height and weight measured at birth and at intervals until seven years old were obtained from medical records. The lowest BMI after one year of age was used for the age of AR. The subjects were divided into those with early and normal AR (<5 and ≥5 years old). BMI percentile at age seven years was compared using the interquartile range (IQR). Changes in BMI were evaluated by repeated measures analysis of variance (ANOVA)., Results: There were 38 early AR cases and 62 normal AR cases, giving a prevalence of early AR similar to that in infants with normal birth weight. BMI percentile at age seven years was significantly higher in early AR cases than in normal AR cases (44.6 [IQR: 21.0-79.2] vs. 14.4 [IQR: 3.8-40.8] kg/m 2 ). Changes in BMI were also significantly higher in early AR cases (p=0.024 by ANOVA)., Conclusions: Early AR in VLBWIs is a predictor of future obesity., (© 2021 Koryo Nakayama et al., published by De Gruyter, Berlin/Boston.)

Aims and objectives. The aims of this study were to measure skin moisture and transepidermal water loss after application of uncoated paper and to compare skin moisture and transepidermal water loss after use of uncoated paper and disposable underpads. Study design. The study was a cross-over, prospective, open-labeled, randomized trial. Sample and setting. Bedridden patients aged ≥18 years at a medical center in Korea were included. Treatment order was randomly assigned using block randomization, with a block size of 4 and an assignment rate of one-by-one. Methods. Skin moisture was measured using a Corneometer 825 and transepidermal water loss was measured using a Tewameter 300. Results. Skin moisture after application of an uncoated paper was significantly lower than observed after application of a disposable underpad (mean 40·6 and SD 13·1 vs. mean 64·6 and SD 23·7, p < 0·001). Transepidermal water loss also showed greater health scores after using uncoated paper (mean 11·1 and SD 5·7 g/m2/hour) than after applying a disposable underpad (mean 23·2 and SD 11·1 g/m2/hour, p < 0·001). There were no statistical between-group differences in room temperature, relative humidity, and body temperature. Conclusion. We found that uncoated paper was helpful in avoiding excessive moisture without adverse effects. Relevance to clinical practice. As indicated by the results of this study, uncoated paper can be applied to bed-ridden patients who required incontinence care. Nurses may consider using uncoated paper as one of nursing methods in the routine care of bed-ridden patients for moisture control. [ABSTRACT FROM AUTHOR]

Electronic devices such as mobile phones are quickly becoming a popular way to gather participant reports of everyday thoughts, feelings, and behaviors, including food cravings and intake. Electronic devices offer a number of advantages over alternative methods such as paper-and-pencil (PNP) assessment including automated prompts, on-the-fly data transmission, and participant familiarity with and ownership of the devices. However, only a handful of studies have systematically compared compliance between electronic and PNP methods of ecological momentary assessment (EMA), and none have examined eating specifically. Existing comparisons generally find greater compliance for electronic devices than PNP, but there is variability in the results across studies that may be accounted for by differences across research domains. Here, we compared the two EMA methods in an unexamined domain - eating - in terms of response rate and response latency, and their sensitivity to individual difference variables such as body mass index (BMI). Forty-four participants were randomly assigned to report on their food craving, food intake, and hunger four times each day for 2 weeks using either a PNP diary (N = 19) or text messaging (TXT; N = 25). Response rates were higher for TXT than PNP (96% vs. 70%) and latencies were faster (29 min vs. 79 min), and response rate and latency were less influenced by BMI in the TXT condition than in the PNP condition. These results support the feasibility of using text messaging for EMA in the eating domain, and more broadly highlight the ways that research domain-specific considerations (e.g., the importance of response latency in measuring short-lived food craving) interact with assessment modality during EMA. [ABSTRACT FROM AUTHOR]

Background: The obesity epidemic may have substantial implications for the global workforce, including causal effects on employment, but clear evidence is lacking. Obesity may prevent people from being in paid work through poor health or through social discrimination. We studied genetic variants robustly associated with body mass index (BMI) to investigate its causal effects on employment., Dataset/methods: White UK ethnicity participants of working age (men 40-64 years, women 40-59 years), with suitable genetic data were selected in the UK Biobank study (N = 230,791). Employment status was categorised in two ways: first, contrasting being in paid employment with any other status; and second, contrasting being in paid employment with sickness/disability, unemployment, early retirement and caring for home/family. Socioeconomic indicators also investigated were hours worked, household income, educational attainment and Townsend deprivation index (TDI). We conducted observational and two-sample Mendelian randomisation (MR) analyses to investigate the effect of increased BMI on employment-related outcomes., Results: Regressions showed BMI associated with all the employment-related outcomes investigated. MR analyses provided evidence for higher BMI causing increased risk of sickness/disability (OR 1.08, 95% CI 1.04, 1.11, per 1 Kg/m 2 BMI increase) and decreased caring for home/family (OR 0.96, 95% CI 0.93, 0.99), higher TDI (Beta 0.038, 95% CI 0.018, 0.059), and lower household income (OR 0.98, 95% CI 0.96, 0.99). In contrast, MR provided evidence for no causal effect of BMI on unemployment, early retirement, non-employment, hours worked or educational attainment. There was little evidence for causal effects differing by sex or age. Robustness tests yielded consistent results., Discussion: BMI appears to exert a causal effect on employment status, largely by affecting an individual's health rather than through increased unemployment arising from social discrimination. The obesity epidemic may be contributing to increased worklessness and therefore could impose a substantial societal burden., (© 2021. The Author(s).)

Background and Objectives. The present study was conducted to evaluate the relationship between taste identification ability and body mass index (BMI) by studying the response to the administration of different taste stimuli to both sides of the tongue in three different groups of subjects. Subjects and Methods. Thirty healthy normal-weight volunteers, 19 healthy overweight subjects, and 22 obese subjects were enrolled. For each subject, the lateralization Oldfield score, body weight, height, and blood pressure were determined. The taste test is based on filter paper strips soaked with 4 taste stimuli presented at different concentrations to evoke 4 basic taste qualities (salty, sour, sweet, and bitter); pure rapeseed oil and water were also administered to evoke fat and neutral taste qualities. The stimuli were applied to each side of the protruded tongue. Subjects were asked to identify the taste from a list of eight descriptions according to a multiple choice paradigm. Results. The results showed a general lowering of taste sensitivity with the increase of BMI, except for the taste of fat with rapeseed oil as the stimulus. Other variables affecting taste sensitivity are age (negative association), gender (women generally show higher sensitivity), and taste stimuli concentration (positive association). Conclusions. Our findings could provide important insights into how new therapies could be designed for weight loss and long-term weight maintenance and how diets could be planned combining the correct caloric and nutritional supply with individual taste preferences. [ABSTRACT FROM AUTHOR]

Abstract: Self-monitoring of eating is associated with successful weight loss, but adherence is imperfect and deteriorates over time. Moreover, intentionally or not, many individuals have difficulty keeping faithful records. We used instrumented paper diaries (IPDs) to study self-monitoring in randomly chosen participants in the PREFER trial, a behavioral treatment for weight-loss study. The diaries they used to self-report eating were periodically replaced with IPDs at various times during an 18-month weight-loss program, consisting of three successive phases: intense treatment (n =35), less-intense treatment (n =13), and maintenance (n =16). We compared electronically documented self-monitoring data, showing when and how often IPDs were used, with self-reported data, then compared the electronically validated adherence and weight loss. Self-reported diary usage exceeded IPD-documented usage while the electronic data demonstrated a significant decline in self-monitoring over time. Diary recording often was not timely. Percentage weight lost correlated significantly with frequency of IPD use (p =.001) and the number of diary entries made within 15 min of opening the IPD (p =.002). This is the first study to document patterns of self-monitoring among participants in a weight-loss program, which demonstrated that individuals may falsify the times and frequency of self-monitoring. Furthermore, our results showed that adherence to self-monitoring and the timeliness of recording significantly correlate with improved weight loss. [Copyright &y& Elsevier]

The prevalence of obesity continues to rise worldwide, and anesthesiologists must be aware of current best practices in the perioperative management of the patient with obesity. Obesity alters anatomy and physiology, which complicates the evaluation and management of obese patients in the perioperative setting. Gastric point-of-care ultrasound (PoCUS) is a noninvasive tool that can be used to assess aspiration risk in the obese patient by evaluating the quantity and quality of gastric contents. An important perioperative goal is adequate end-organ perfusion. Standard noninvasive blood pressure (NIBP) is our best available routine surrogate measurement, but is vulnerable to greater inaccuracy in patients with obesity compared to the nonobese population. Current NIBP methodologies are discussed. Obese patients are at risk for wound and surgical site infections, but few studies conclusively guide the exact dosing of intraoperative prophylactic antibiotics for them. We review evidence for low-molecular-weight heparins and weight-based versus nonweight-based administration of vasoactive medications. Finally, intubation and extubation of the patient with obesity can be complicated, and evidence-based strategies are discussed to mitigate danger during intubation and extubation.

Purpose: History of an anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong independent risk factors for knee osteoarthritis (KOA) onset. The combination of these risk factors may further negatively affect joint loading and KOA risk. We sought to determine the combined influence of BMI and ACLR on walking speed and gait biomechanics that are hypothesized to influence KOA onset., Methods: Walking speed and gait biomechanics (peak vertical ground reaction force [vGRF], peak vGRF instantaneous loading rate [vGRF-LR], peak knee flexion angle, knee flexion excursion [KFE], peak internal knee extension moment [KEM], and peak internal knee abduction moment [KAM]) were collected in 196 individuals with unilateral ACLR and 106 uninjured controls. KFE was measured throughout stance phase, whereas all other gait biomechanics were analyzed during the first 50% of stance phase. A 2 × 2 ANOVA was performed to evaluate the interaction between BMI and ACLR and main effects for both BMI and ACLR on walking speed and gait biomechanics between four cohorts (high BMI ACLR, normal BMI ACLR, high BMI controls, and normal BMI controls)., Results: History of an ACLR and high BMI influenced slower walking speed (F1,298 = 7.34, P = 0.007), and history of an ACLR and normal BMI influenced greater peak vGRF-LR (F1,298 = 6.56, P = 0.011). When evaluating main effects, individuals with an ACLR demonstrated lesser KFE (F1,298 = 7.85, P = 0.005) and lesser peak KEM (F1,298 = 6.31, P = 0.013), and individuals with high BMI demonstrated lesser peak KAM (F1,297 = 5.83, P = 0.016)., Conclusion: BMI and history of ACLR together influence walking speed and peak vGRF-LR. History of an ACLR influences KFE and peak KEM, whereas BMI influences peak KAM. BMI may need to be considered when designing interventions aimed at restoring gait biomechanics post-ACLR.

Objectives: The objective of the study was to determine whether exposure of pregnant women to stresses caused by World War II (WWII) negatively affected pregnancy and perinatal outcomes., Methods: Individual medical documents deposited in the Gynaecology and Obstetrics Clinic of Medical University, Poznań (1934-1943; N = 7058) were evaluated. These were divided into two birth cohorts: before WWII and during it. Frequency tables were constructed for the numbers of pregnancy outcomes: miscarriages, stillbirths, live births, and neonatal deaths, according to the period of birth and sex of a child. The numbers of recorded days were standardized and the numbers of cases per day were computed. Statistical differences in the averages (medians) between periods and years under study were tested. Birth weight, length, and body mass index (BMI) were compared according to the periods related to WWII., Results: Significant differences in proportions of males, females, and subjects with unknown sex were found between the periods: a higher proportion of males and different structure of/within negative outcomes were found during WWII. Children born during WWII were heavier and longer than those born before it., Conclusions: As an explanation, adverse conditions of WWII, related to the psychological stress and food shortages, could have influenced greater elimination of fetuses and neonates of male sex during pregnancy and shortly after delivery. Higher average body size in newborns recorded during WWI could be explained by a hidden process of increased early prenatal mortality of weaker individuals, differences in average gestation length between the periods, differences in parity, or some undocumented differences in social/ethnic composition of the sample., (© 2020 Wiley Periodicals, Inc.)

Background: The increased overweight and obesity prevalence has been a major concern worldwide. The present study aimed at investigating the effect of a mindfulness intervention on the attentional bias toward food in overweight individuals. Methods: The statistical population in this quasi-experimental study using a pretest-posttest design with the control group consisted of overweight individuals with a body mass index of higher than 25, referring to centers related to weight management in Mashhad. Using convenience sampling, 36 samples were selected based on inclusion-exclusion criteria and were placed in two experimental and control groups randomly. The repeated measures were undertaken by SPSS Software, v. 22 for attentional bias toward food. The test was done in three 7-week pre-intervention and post-intervention phases of mindfulness therapy and at follow-up for three months after the end of the intervention. Results: The results of the data analysis showed a significant difference between the two groups in terms of the reaction time of participants to the food emotional Stroop test. Conclusion: The results showed the significant effect of a mindfulness intervention on the attentional bias toward food in overweight individuals. [ABSTRACT FROM AUTHOR]

Background It remains unclear whether muscle strength, which reduces cardiovascular (CV) risk in adults, is associated with similar protection in Asian adolescents. This study investigated the association between handgrip strength and CV health in a large Korean sample of school-age adolescents. Methods We performed a cross-sectional analysis of adolescents aged 10-18 years (n=4,018) from the Korean National Health and Nutrition Survey between 2014 and 2017. Handgrip strength was measured using a dynamometer. CV risk factors include waist circumference, blood pressure, fasting glucose or hemoglobin A1c, and lipid levels. Logistic regression models were applied with adjustment for potential confounders. Results The mean age of participants was 14.0 years, and 53.6% were boys. Mean handgrip strength was 30.4 kg for boys and 22.0 kg for girls. Boys more frequently had high systolic blood pressure and impaired fasting glucose, whereas girls more frequently had low high-density lipoprotein cholesterol. Multivariate logistic regression analysis revealed that in boys only, handgrip strength was negatively associated with central obesity and hypertriglyceridemia and positively associated with higher systolic blood pressure. Conclusion Handgrip strength is independently associated with some CV risk factors only in boys.

Background: Previous studies have shown that occupants with obesity are at a greater risk of fatality and serious injury than other occupants in motor vehicle crashes., Objective: To provide a more complete description of the most frequent injuries and the most frequently injured body regions for occupants with obesity., Methods: Sampled cases (n = 13,470) representing ~4.7 million adult occupants involved in frontal crashes (between 2000 and 2015) were selected from the U.S. National Automotive Sampling System-Crashworthiness Data System database. A retrospective cohort study was performed to study the effect of BMI on the risk of injury to different body regions and to identify the most frequent injuries to occupants with different BMIs. Lastly, in-depth crash analysis cases from the U.S. Crash Injury Research and Engineering Network (CIREN) database were studied to elucidate the source of the most common injuries to occupants with obesity., Results: Occupants with obesity experienced a higher risk of upper extremity (4.79 vs 2.92%), lower extremity (8.37 vs 3.23%), and spine (1.53 vs 1.09%) injuries than other occupants. After adjusting for other variables, the risks of spinal, thoracic, and extremities injuries were found to be affected by the BMI class. Seven out of the ten most common injuries sustained by occupants with obesity were lower extremity injuries, and talus fractures were the most common overall. Direct loading through the plantar surface of the foot by the vehicle toe pan was found to be a likely cause of many of those injuries based on CIREN cases., Conclusions: The injuries of occupants with obesity are different than other occupants which can be attributed to their different interaction with the seat belt and vehicle interior. The findings of this study should be considered for designing restraint systems to protect occupants with obesity in car crashes.