Search

Purpose: Previous research highlights the adverse effects of visual impairment (VI) on academic achievement in children, yet its impact on cognitive performance among adolescents and young adults remains under‐studied. Therefore, this investigation aimed to analyse this association in a nationwide sample of Israeli adolescents. Methods: A retrospective population‐based cross‐sectional study was conducted among 1,410,616 Israeli‐born adolescents aged 16–19 years, who were assessed before mandatory military service between 1993 and 2017. The definition of VI was based on best‐corrected visual acuity (BCVA) measurements using a standard Snellen chart. Adolescents with BCVA worse than 6/9 in either or both eyes were classified as having unilateral or bilateral VI, respectively. Cognitive performance was measured using the General Intelligence Score (GIS), based on a validated four‐domain test. Relationships were analysed using regression models yielding adjusted odds ratios (ORs) for low (<−1 standard deviation [SD]) and high (≥1 SD) cognitive Z‐scores. Results: Of 1,410,616 adolescents (56.1% men), 13,773 (1.0%) had unilateral and 3980 (0.3%) had bilateral VI. Unilateral VI was associated with adjusted ORs for low and high cognitive Z‐scores of 1.24 (1.19–1.30) and 0.84 (0.80–0.89), respectively. ORs were accentuated for bilateral VI, reaching 1.62 (1.50–1.75) and 0.81 (0.74–0.90) for low and high cognitive Z‐scores, respectively. Cognitive performance subscores mirrored these results, with the visual–spatial functioning subtest demonstrating the greatest effect size. These associations persisted in sub‐analyses restricted to adolescents with amblyopia‐related VI, mild VI and unimpaired health status. Conclusions: Visual impairment, including mild and unilateral cases, is associated with reduced cognitive performance scores assessed in late adolescence. Further research is required to gain a comprehensive understanding of the dynamics underlying this relationship. [ABSTRACT FROM AUTHOR]

Summary: Background: Previous research on the association between body mass index (BMI) and visual impairment (VI) in youth has reported inconsistent findings. We aimed to investigate this association in a national cohort of Israeli adolescents. Methods: This retrospective, population‐based, cross‐sectional study included 1 697 060 adolescents (56.4% men; mean age 17 years) who underwent mandatory pre‐military service assessments from 1993 to 2017. BMI was classified based on the US age‐ and sex‐matched percentiles. Unilateral or bilateral VI was classified as best‐corrected visual acuity (BCVA) worse than 6/9 in either or both eyes, respectively. Sex‐stratified regression models adjusted for sociodemographic variables were used to analyse the BMI‐VI relationship. Results: Overall, 17 871 (1.05%) and 5148 (0.30%) adolescents had unilateral and bilateral VI, respectively. Compared with high‐normal BMI (50th to 85th percentile), adjusted odds ratios (ORs) for unilateral and bilateral VI gradually increased with higher BMI, reaching 1.33 (1.13–1.55) and 1.80 (1.37–2.35) in men with severe obesity, and 1.51 (1.24–1.84) and 1.52 (1.08–2.14) in women with severe obesity, respectively. Men with underweight also had increased ORs for unilateral and bilateral VI (1.23; 1.14–1.33 and 1.59; 1.37–1.84, respectively), a pattern not observed in women (0.96; 0.86–1.07 and 1.02; 0.83–1.25, respectively). Results were maintained when the outcome was restricted to mild VI, as well as in subgroups of adolescents with unimpaired health and those without moderate‐to‐severe myopia. Conclusions: Abnormal BMI, and particularly obesity, is associated with increased OR for VI in late adolescence. [ABSTRACT FROM AUTHOR]

Importance: The increased incidence of adolescent obesity over recent decades may be associated with lower cognitive performance than the expected potential. Objective: We aimed to assess the association between adolescent body mass index (BMI) and cognitive function. Design: A nationwide, cross-sectional, population-based study. Setting: Pre-recruitment evaluation for military service during 1967-2018. Participants: All Israeli-born adolescents, 1 459 522 males and 1 027 953 females aged 16 to ≤20 years. Exposures: Weight and height were measured to calculate BMI. Main outcome: Cognitive performance was assessed by using a validated intelligence-quotient-equivalent test and was standardized to the year- and sex-Z-score. For 445 385 persons, parental cognitive scores could be identified. Multinomial logistic regression models were applied. Results: Among male adolescents with severe obesity, 29.4% achieved a cognitive score below the 25th percentile, compared with 17.7% among their normal-weight (50th-84th percentile) counterparts. A J-shaped relation was observed between BMI and the odds ratio (OR) for a low cognitive score among male adolescents: underweight, 1.45 (1.43-1.48); overweight, 1.13 (1.12-1.15); mild obesity, 1.36 (1.33-1.39); and severe obesity, 1.58 (1.52-1.64). Similar findings were observed in females. For both sexes, point estimates were overall consistent in models adjusted for sociodemographic confounders, coexisting morbidities, and parental cognitive scores. Examinees with abnormal BMI had higher ORs for a lower-than-expected cognitive score, based on their parents' data as adolescents, in a manner that depends on obesity severity. Conclusion and relevance: Abnormal BMI, and especially obesity, is associated with increased odds for a lower cognitive performance, and the inability to fully achieve cognitive potential, regardless of sociodemographic background. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a widespread medical complaint affecting many people worldwide and costing billions. Studies suggest a link between LBP and joint hypermobility. This study aimed to examine the association between symptomatic joint hypermobility (SJH), LBP, and gender. Methods: Data were obtained from a medical database containing 17-year-old candidates' records before recruitment into mandatory military service. According to the Regulations of Medical Fitness Determination, information on disability codes associated with LBP and SJH was retrieved. Results: According to this national survey, the prevalence of SJH is 0.11% (1355 cases out of 1,220,073 subjects). LBP was identified in 3.7% of the cohort (44,755 subjects). Subjects were further subdivided into LBP without objective findings (LBPWF) (3.5%) and LBP with objective findings (LBPOF) (0.2%). The association between SJH and LBP was examined: the Odds Ratio (OR) was 2.912 (p < 0.0001). The odds rations for LBPWF and LBPOF were further calculated to be 2.914 (p < 0.000) and 2.876 (p < 0.000), respectively. Subjects with SJH were almost three times more prone to LBPWF and LBPOF. Conclusion: SJH is strongly associated with LBP in young adults. Further pathophysiological research is needed. [ABSTRACT FROM AUTHOR]

Purpose: The incidences of obesity and attention-deficit/hyperactivity disorder (ADHD) have increased in parallel over recent decades. We assessed the association between obesity and ADHD in a national sample of adolescents. Method: In a nationwide population-based study of 1 118 315 adolescents (57% males; mean age 17 years), risks of obesity were compared between individuals with severe and mild ADHD and those without ADHD. Diagnoses of ADHD were confirmed by specialists in either neurology or psychiatry. Adolescents requiring regular and continuous treatment with stimulants with no improvement of symptoms under treatment were classified as having severe ADHD; data were available from 2004 to 2019. During 2015 to 2019, the diagnosis of ADHD was defined, and 65 118 (16.76%) of 388 543 adolescents with mild symptoms who required medications only for learning or who used stimulants irregularly were defined as having mild ADHD. Results: The prevalence of severe and mild ADHD was 0.3% and 20.1%, respectively. Obesity was more prevalent among adolescents with severe ADHD than among those without ADHD (13.5% vs 7.5%). In the mild ADHD group 12.6% of males and 8.4% of females were diagnosed with obesity compared to 9.7% and 6.4%, respectively, in the non-ADHD group. The adjusted odds of severe ADHD for males and females with obesity were 1.77 (1.56-2.02) and 2.09 (1.63-2.66) times the odds for males and females with low-normal body mass index, respectively, and 1.42 (1.37-1.48) and 1.42 (1.34-1.50) for males and females with mild ADHD, respectively. The elevated risk persisted in several sensitivity analyses. Conclusions: Both adolescents with severe and mild ADHD are at increased risk for obesity. [ABSTRACT FROM AUTHOR]

Context: Thyroid hormones play a key role in systemic metabolism, yet the relationship between thyroid dysfunction and risk for type 2 diabetes is unclear.Objective: To assess type 2 diabetes risk in adulthood among adolescents with thyroid disorders.Design and Setting: A nationwide, population-based study of Israeli adolescents who were examined before military recruitment during 1988 to 2007 and were followed until December 31, 2016.Participants: 1 382 560 adolescents (mean age 17.3 years).Interventions: The diagnosis of thyroid disorders was based on recent thyroid function tests. Data were linked to the Israeli National Diabetes Registry. Cox proportional hazard models were applied.Main Outcome Measures: Type 2 diabetes incidence.Results: During a mean follow-up of 18.5 years, 1.12% (69 of 6,152) of adolescents with thyroid disorders were diagnosed with type 2 diabetes vs 0.77% of adolescents without thyroid disorders. The hazard ratio (HR) for type 2 diabetes was 2.3 (95% CI, 1.8-2.9) among those with thyroid disorders, after adjustment for sex, birth-year, body mass index, and sociodemographic confounders. The increased diabetes risk was observed in both men and women, with the presence or absence of obesity, and in the absence of other health conditions and was associated with different types of thyroid disorders. It was also similar when the outcome was defined as type 2 diabetes diagnosed at or before the age of 30 years (HR 2.3, 95% CI, 1.5-3.5).Conclusions: Thyroid disorders diagnosed in adolescence are a risk factor for early-onset type 2 diabetes in both men and women. [ABSTRACT FROM AUTHOR]

Summary: Introduction: In a nationwide population of adolescents, we investigated the sex‐specific association of socioeconomic position (SEP) with severe obesity, and trends over time. Methods: The cohort comprises all Israeli adolescents (mean ± SD age 17.3 ± 0.5 years) who were medically examined, before mandatory military service during 2000 to 2015. Of 1 120 362 adolescents, 239 816 (21.4%) were classified with overweight or with obesity classes I to III using the International Obesity Task Force criteria. Data were compared between 2000 to 2009 and 2010 to 2015. Results: Considering more advantaged residential SEP as the reference group, the respective odds ratios (ORs ± 95%CI) of less advantaged SEP for obesity classes I to III in 2010 to 2015 were 1.48 (1.40‐1.56), 1.66 (1.51‐1.83), and 1.73 (1.45‐2.08) for males; and 1.72 (1.60‐1.84), 1.89 (1.66‐2.15), and 2.62 (2.04‐3.37) for females. All point estimates were higher than in the preceding decade. Considering female inductees from the more advantaged SEP as the reference group, ORs were higher for males in the more advantaged SEP group, for overweight, 1.31 (1.27‐1.36); class I obesity, 1.29 (1.20‐1.38); class II obesity, 1.34 (1.18‐1.53); and class III obesity, 1.60 (1.24‐2.07). Similarly, in the less and medium advantaged SEP groups, increased ORs for males compared with females were observed in all obesity groups. Results persisted using United States Centers for Disease Control and Prevention growth charts. Conclusions: Adolescents with less rather than more advantaged residential SEP are at greater risk of severe obesity. Adolescent males, of all residential SEP groups had higher odds than females for all classes of obesity. [ABSTRACT FROM AUTHOR]

Body mass index (BMI) (calculated as weight (kg)/height (m)2) and height are linked to the pathogenesis of low back pain, but evidence-based confirmation is lacking. We examined the prevalence of low back pain in adolescents and its association with BMI and height. Disability clauses (official military limitations related to a person's health status) indicating low back pain severity were divided according to symptoms of low back pain alone and symptoms of low back pain with objective corroborating findings. All 829,791 males and females undergoing mandatory premilitary recruitment examinations since 1998 were included. Logistic regression models assessed the relationships of BMI and height with low back pain. Prevalence of low back pain was 0.2% for both males and females with objective findings and 5.2% for males and 2.7% for females without objective findings. Higher BMI was significantly associated with low back pain in males (for overweight, odds ratio = 1.097, P < 0.001; for obese, odds ratio = 1.163, P < 0.001) and in females (for overweight, odds ratio = 1.174, P < 0.001; for obese, odds ratio = 1.211, P < 0.001). Height was associated with increased risk of low back pain in both genders. Odds ratios for low back pain in the tallest group compared with the shortest group were 1.438 (P < 0.001) for males and 1.224 (P < 0.001) for females. Low back pain with or without objective findings was associated with overweight and obesity as well as with height. [ABSTRACT FROM AUTHOR]

Background context The most common spinal deformities among adolescents are adolescent idiopathic scoliosis (AIS; 2%-3% prevalence) and Scheuermann kyphosis (SK; 1%-8% prevalence). Both are believed to have a genetic influence in their etiology. The association between body mass index (BMI) and body stature and their possible association to spinal deformities is uncertain. Study design A cross-sectional prevalence study. Purpose To examine the prevalence of all adolescent spinal deformities according to the extent of their severity as well as their possible association to BMI and body height. Outcome measures Subjects diagnosed as having spinal deformities were classified into one of three severity groups; "Mild," "Intermediate," or "Severe," according to their curve scoliosis or kyphosis measurement with a standing X-ray. Methods The data for this study were derived from a medical database containing records of 17-year-old male and female patients before their recruitment into mandatory military service. Information on the disability codes associated with spinal deformities according to the Regulations of Medical Fitness Determination was retrieved. Logistic regression models were used to assess the association between the BMI and body height to various degrees of spinal deformities by severity. Results The study cohort included 829,791 consecutive subjects, of whom 103,249 were diagnosed with spinal deformities (76% were mild in degree). The prevalence of spinal deformities was significantly greater among the underweight male and female patients (p<.001). Increased BMI had a protective effect for developing spinal deformities. The odds ratios for severe spinal deformities were greater compared with mild spinal deformities in the underweight groups. The risk for developing spinal deformities increased significantly with height for both genders (p<.001). Conclusions An association between height and the risk for spinal deformities by severity was found for all height groups. Below normal BMI is associated with severity of spinal deformities, whereas above-normal BMI apparently has a protective effect. Body height is also positively associated with the severity of spinal deformities. [ABSTRACT FROM AUTHOR]