Weight-for-Height, Body Fat, and Development in Children in the East Asia and Pacific Region

Importance: Weight-for-height z score (WHZ) is a standard indicator of children’s nutritional status even though it does not fully reflect body fat. Objective: To examine the combined association of WHZ and body fat with early development in the East Asia and Pacific region. Design, Setting, and Participants: Children from the East Asia–Pacific Early Child Development Scales validation study, with full data available regarding their nutritional status and outcomes, were included in this cross-sectional analysis. In brief, a multilevel stratified random sampling was used to select representative samples from each participating country in the study. WHZ and body fat were independently trichotomized using established references and were combined to form a 9-category exposure variable. Data collection was performed between 2012 and 2014, and the analyses were conducted in June 2021. Main Outcomes and Measures: The binary outcome variable of not being developmentally on track (hereafter referred to as poor development) was defined as a score less than the 25th percentile in the following domains: cognitive, language, socioemotional, motor development, and total development score. Poisson regression models were used to analyze the associations between the combined categories and poor development, adjusted for sociodemographic factors. Results: A total of 6815 children (mean [SD] age, 4.02 [0.8] years; 3434 girls [50.4%]) had full data available and were included in this study. Compared with children with normal weight and normal fat, those with wasting and low body fat had the highest likelihood of total poor development (prevalence ratio, 1.47; 95% CI, 1.28-1.70), followed by those with normal weight but low fat (prevalence ratio, 1.23; 95% CI, 1.11-1.36). Similar associations were found in language, cognitive, and socioemotional development, but not in motor development. Conclusions and Relevance: Poor development was more commonly found in children with low body fat independent of WHZ (wasted or normal weight). Early public health strategies may consider using a combination of WHZ and body fat as an indicator of poor development

Revisión sistemática de práctica de actividad física en estudiantes universitarios

La presente investigación tiene dos objetivos: (1) describir las investigaciones empíricas desarrolladas sobre la actividad física en estudiantes universitarios y (2) especificar limitaciones y orientaciones señaladas en los estudios sobre actividad física en estudiantes universitarios. El método desarrollado fue una Revisión Sistemática de las bases de datos Web of Science (WOS) y Scielo en el período de tiempo 2013 a 2018. Los resultados del primer objetivo son descripción de los estudios respecto del país, diseño, muestra, objetivos, e instrumentos de medida de las investigaciones. Respecto de los resultados del segundo objetivo, las dos principales limitaciones declaradas en los estudios son el uso de instrumentos de medida de tipo autorreporte y los diseños que son principalemente correlaciónales y escasos cuasiexperimento; las dos principales orientaciones son que las universidades fomenten la actividad física a través de programas de intervención y que sea integrada al currículum

The combination of physical activity and sedentary behaviors modifies the genetic predisposition to obesity

Objective: This study aimed to investigate whether the association between a validated genetic profile risk score for BMI (GPRS‐BMI) (based on 93 single‐nucleotide polymorphisms) and phenotypic obesity (BMI) was modified by the combined categories of physical activity (PA) and sedentary behaviors in a large population‐based study. Methods: This study included cross‐sectional baseline data from 338,216 white European adult men and women aged 37 to 73 years. Interaction effects of GPRS‐BMI with the combined categories of PA and sedentary behaviors on BMI were investigated. Results: There was a significant interaction between GPRS‐BMI and the combined categories of objectively measured PA and total sedentary behavior (P[interaction]  =  3.5 × 10−6); among physically inactive and highly sedentary individuals, BMI was higher by 0.60 kg/m2 per 1‐SD increase in GPRS‐obesity (P  =  8.9 × 10−50), whereas the relevant BMI difference was 38% lower among physically active individuals and those with low sedentary time (β: 0.37 kg/m2; P  =  2.3 × 10−51). A similar pattern was observed for the combined categories of objective PA and TV viewing (inactive/high TV viewing β: 0.60 vs. active/low TV viewing β: 0.40 kg/m2; P[interaction]  =  2.9 × 10−6). Conclusions: This study provides evidence that combined categories of PA and sedentary behaviors modify the extent to which genetic predisposition to obesity results in higher BMI

Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants

Introduction: Older people have been reported to be at higher risk of COVID-19 mortality. This study explored the factors mediating this association and whether older age was associated with increased mortality risk in the absence of other risk factors. Methods: In UK Biobank, a population cohort study, baseline data were linked to COVID-19 deaths. Poisson regression was used to study the association between current age and COVID-19 mortality. Results: Among eligible participants, 438 (0.09%) died of COVID-19. Current age was associated exponentially with COVID-19 mortality. Overall, participants aged ≥75 years were at 13-fold (95% CI 9.13–17.85) mortality risk compared with those <65 years. Low forced expiratory volume in 1 second, high systolic blood pressure, low handgrip strength, and multiple long-term conditions were significant mediators, and collectively explained 39.3% of their excess risk. The associations between these risk factors and COVID-19 mortality were stronger among older participants. Participants aged ≥75 without additional risk factors were at 4-fold risk (95% CI 1.57–9.96, P = 0.004) compared with all participants aged <65 years. Conclusions: Higher COVID-19 mortality among older adults was partially explained by other risk factors. ‘Healthy’ older adults were at much lower risk. Nonetheless, older age was an independent risk factor for COVID-19 mortality

Association between adiposity levels and cognitive impairment in the Chilean older adult population

Although both obesity and ageing are risk factors for cognitive impairment, there is no evidence in Chile on how obesity levels are associated with cognitive function. Therefore, the aim of the present study was to investigate the association between adiposity levels and cognitive impairment in older Chilean adults. This cross-sectional study includes 1384 participants, over 60 years of age, from the Chilean National Health Survey 2009–2010. Cognitive impairment was evaluated using the Mini-Mental State Examination. BMI and waist circumference (WC) were used as measures of adiposity. Compared with people with a normal BMI, the odds of cognitive impairment were higher in participants who were underweight (OR 4·44; 95 % CI 2·43, 6·45; P < 0·0001), overweight (OR 1·86; 95 % CI 1·06, 2·66; P = 0·031) and obese (OR 2·26; 95 % CI 1·31, 3·21; P = 0·003). The associations were robust after adjustment for confounding variables. Similar results were observed for WC. Low and high levels of adiposity are associated with an increased likelihood of cognitive impairment in older adults in Chile

Moderate-to-vigorous physical activity modifies the relationship between sedentary time and sarcopenia: the Tromsø Study 2015–2016

Background: Sarcopenia is an age-related muscle disease primarily characterized by reductions in muscle strength that increases the risk of falls, fractures, cognitive impairment, and mortality. Exercise is currently preferred in prevention and treatment, but it is unknown how different habitual physical activity and sedentary behaviour patterns associate with sarcopenia status. The purpose of the present study was to compare associations of these patterns with probable sarcopenia in older adults. Methods: In 3653 community-dwelling participants (51% women) aged 60–84 years from the seventh survey of the Tromsø Study, we assessed objective physical activity and sedentary behaviour collected over 8 days (ActiGraph wGT3X-BT Accelerometer), grip strength (Jamar+ Digital Dynamometer), five-repetition chair stands, and self-reported disease. We combined tertiles of sedentary (SED) time and moderate-to-vigorous physical activity (MVPA) to create nine different activity profiles (SEDHIGH, SEDMOD, and SEDLOW combined with MVPAHIGH, MVPAMOD, or MVPALOW). Multiple logistic regression models were used to examine how these profiles associated with probable sarcopenia, defined by low handgrip strength and/or slow chair stands time according to the revised European Working Group on Sarcopenia in Older People criteria. Results: Probable sarcopenia was present in 227 (6.2%) participants. Men with probable sarcopenia had on average 35.3 min more SED time and 20 min less MVPA compared with participants without sarcopenia (P HIGH–MVPALOW reference activity profile (714.2 min SED/day and 10.4 min MVPA/day), the SEDHIGH–MVPAMOD profile (697.1 min SED/day and 31.5 min MVPA/day) had significantly lower odds ratio (OR) for probable sarcopenia (OR 0.17, 95% confidence interval [CI] 0.08–0.35), while the SEDLOW–MVPALOW profile (482.9 min SED/day and 11.0 min MVPA/day) did not (OR 0.72, 95% CI 0.47–1.11). These findings were not influenced by age, sex, smoking, or self-reported diseases, and higher levels of MVPA did not further decrease ORs for probable sarcopenia. Conclusions: Older adults who achieve moderate amounts of MVPA have reduced odds for probable sarcopenia, even when they have high sedentary time. Those with low sedentary time did not have reduced odds for probable sarcopenia when they also had low amounts of MVPA. These findings need confirmation in longitudinal studies but suggest that interventions for preventing sarcopenia should prioritize increasing MVPA over reducing sedentary behaviour

Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank

Background: Frailty has been associated with worse prognosis following COVID-19 infection. While several studies have reported the association between frailty and COVID-19 mortality or length of hospital stay, there have been no community-based studies on the association between frailty and risk of severe infection. Considering that different definitions have been identified to assess frailty, this study aimed to compare the association between frailty and severe COVID-19 infection in UK Biobank using two frailty classifications: the frailty phenotype and the frailty index. Methods: A total of 383,845 UK Biobank participants recruited 2006–2010 in England (211,310 [55.1%] women, baseline age 37–73 years) were included. COVID-19 test data were provided by Public Health England (available up to 28 June 2020). An adapted version of the frailty phenotype derived by Fried et al. was used to define frailty phenotype (robust, pre-frail, or frail). A previously validated frailty index was derived from 49 self-reported questionnaire items related to health, disease and disability, and mental wellbeing (robust, mild frailty, and moderate/severe frailty). Both classifications were derived from baseline data (2006–2010). Poisson regression models with robust standard errors were used to analyse the associations between both frailty classifications and severe COVID-19 infection (resulting in hospital admission or death), adjusted for sociodemographic and lifestyle factors. Results: Of UK Biobank participants included, 802 were admitted to hospital with and/or died from COVID19 (323 deaths and 479 hospitalisations). After analyses were adjusted for sociodemographic and lifestyle factors, a higher risk of COVID-19 was observed for pre-frail (risk ratio (RR) 1.47 [95% CI 1.26; 1.71]) and frail (RR 2.66 [95% CI 2.04; 3.47]) individuals compared to those classified as robust using the frailty phenotype. Similar results were observed when the frailty index was used (RR mildly frail 1.46 [95% CI 1.26; 1.71] and RR moderate/severe frailty 2.43 [95% CI 1.91; 3.10]). Conclusions: Frailty was associated with a higher risk of severe COVID-19 infection resulting in hospital admission or death, irrespective of how it was measured and independent of sociodemographic and lifestyle factors. Public health strategies need to consider the additional risk that COVID-19 poses in individuals with frailty, including which additional preventive measures might be required

Search for anisotropic gravitational-wave backgrounds using data from Advanced LIGO and Advanced Virgo's first three observing runs

We report results from searches for anisotropic stochastic gravitational-wave backgrounds using data from the first three observing runs of the Advanced LIGO and Advanced Virgo detectors. For the first time, we include Virgo data in our analysis and run our search with a new efficient pipeline called {\tt PyStoch} on data folded over one sidereal day. We use gravitational-wave radiometry (broadband and narrow band) to produce sky maps of stochastic gravitational-wave backgrounds and to search for gravitational waves from point sources. A spherical harmonic decomposition method is employed to look for gravitational-wave emission from spatially-extended sources. Neither technique found evidence of gravitational-wave signals. Hence we derive 95\% confidence-level upper limit sky maps on the gravitational-wave energy flux from broadband point sources, ranging from $F_{\alpha, \Theta} < {\rm (0.013 - 7.6)} \times 10^{-8} {\rm erg \, cm^{-2} \, s^{-1} \, Hz^{-1}},$ and on the (normalized) gravitational-wave energy density spectrum from extended sources, ranging from $\Omega_{\alpha, \Theta} < {\rm (0.57 - 9.3)} \times 10^{-9} \, {\rm sr^{-1}}$, depending on direction ($\Theta$) and spectral index ($\alpha$). These limits improve upon previous limits by factors of $2.9 - 3.5$. We also set 95\% confidence level upper limits on the frequency-dependent strain amplitudes of quasimonochromatic gravitational waves coming from three interesting targets, Scorpius X-1, SN 1987A and the Galactic Center, with best upper limits range from $h_0 < {\rm (1.7-2.1)} \times 10^{-25},$ a factor of $\geq 2.0$ improvement compared to previous stochastic radiometer searches.Comment: 23 Pages, 9 Figure