The role of body height as a co-factor of excess weight in Switzerland

OBJECT: Excess weight (Body Mass Index [BMI] ≥25.0 kg/m2 ) is a major health issue worldwide, including in Switzerland. For high-income countries, little attention has been paid to body height in context of excess weight. The aim of this study is to assess the importance of body height as a co-factor for excess weight in multiple large nationwide data sets. DATA AND METHODS: In this comparative study, we included the largest nationwide and population-based studies in the fields of public health, nutrition and economics for Switzerland, as well as data of the medical examination during conscription for the Swiss Armed Forces, which contained information on BMI and, if possible, waist-to-height-ratio (WHtR) and waist-to-hip-ratio (WHR). RESULTS: The multinomial logistic regressions show that the probability of belonging to the excess weight category (BMI ≥25.0 kg/m2 ) decreased with increasing height in both sexes inall contemporary data sets. This negative association was shown to be constant, only among conscripts measured in the 1870s the association was positive, when increasing height was associated with a higher BMI. The negative association not only emerge in BMI, but also in WHtR and WHR. CONCLUSION: Our results emphasize the importance of body height as a co-factor of excess weight, suggesting a clear negative association between height and BMI, WHtR and WHR. Evidence indicates that both early-life environmental exposures and alleles associated with height may contribute to these associations. This knowledge could serve as further starting points for prevention programs in the field of public health

The role of body height as a co-factor of excess weight in Switzerland.

OBJECT Excess weight (Body Mass Index [BMI] ≥25.0 kg/m2 ) is a major health issue worldwide, including in Switzerland. For high-income countries, little attention has been paid to body height in context of excess weight. The aim of this study is to assess the importance of body height as a co-factor for excess weight in multiple large nationwide data sets. DATA AND METHODS In this comparative study, we included the largest nationwide and population-based studies in the fields of public health, nutrition and economics for Switzerland, as well as data of the medical examination during conscription for the Swiss Armed Forces, which contained information on BMI and, if possible, waist-to-height-ratio (WHtR) and waist-to-hip-ratio (WHR). RESULTS The multinomial logistic regressions show that the probability of belonging to the excess weight category (BMI ≥25.0 kg/m2 ) decreased with increasing height in both sexes inall contemporary data sets. This negative association was shown to be constant, only among conscripts measured in the 1870s the association was positive, when increasing height was associated with a higher BMI. The negative association not only emerge in BMI, but also in WHtR and WHR. CONCLUSION Our results emphasize the importance of body height as a co-factor of excess weight, suggesting a clear negative association between height and BMI, WHtR and WHR. Evidence indicates that both early-life environmental exposures and alleles associated with height may contribute to these associations. This knowledge could serve as further starting points for prevention programs in the field of public health

Body mass index in young men in Switzerland after the national shutdowns during the COVID-19 pandemic: Results from a cross-sectional monitoring study at the population level since 2010

Background: Owing to the COVID-19 pandemic, the Swiss goverment imposed a shutdown twice, which may have changed diet and physical activity. Regarding the question of weight change during the pandemic, little information based on measured weight data is available. We aimed to investigate whether the body mass indices (BMIs) of young Swiss men after the two shutdowns in spring and fall 2020 differed from those of young men examined before the shutdowns. Methods: We analysed young Swiss men's BMIs taken during mandatory recruitment for the Swiss Armed Forces at the cross-sectional (not individual longitudinal) monitoring level and across weeks of conscription between January 2010 and July 2021 (n = 373,016). These data allow for continuous health monitoring of young men at almost the population level (coverage, >90%). For statistical modelling, we used the generalised additive model (GAM) framework. Results: We showed that the BMIs of the conscripts examined in the 15 weeks after the two shutdowns in spring and autumn 2020 were not or only slightly different from their baseline values. Sensitivity analyses revealed that this conclusion also holds if the BMI distribution or prevalence of excess weight is assessed. The GAM further showed the significant effects of individual and area-based measures of socioeconomic position and age on BMI. Conclusion: Our results suggest that lifestyle changes during the pandemic in young men might have been too modest to be reflected in body weight. However, longitudinal data and/or data on women, children, or the elderly may lead to different conclusions. Keywords: BMI; GAM; Lockdown; Monitoring; Obesity; Swiss Conscription

Body mass index in young men in Switzerland after the national shutdowns during the COVID-19 pandemic: Results from a cross-sectional monitoring study at the population level since 2010.

BACKGROUND Owing to the COVID-19 pandemic, the Swiss goverment imposed a shutdown twice, which may have changed diet and physical activity. Regarding the question of weight change during the pandemic, little information based on measured weight data is available. We aimed to investigate whether the body mass indices (BMIs) of young Swiss men after the two shutdowns in spring and fall 2020 differed from those of young men examined before the shutdowns. METHODS We analysed young Swiss men's BMIs taken during mandatory recruitment for the Swiss Armed Forces at the cross-sectional (not individual longitudinal) monitoring level and across weeks of conscription between January 2010 and July 2021 (n = 373,016). These data allow for continuous health monitoring of young men at almost the population level (coverage, >90%). For statistical modelling, we used the generalised additive model (GAM) framework. RESULTS We showed that the BMIs of the conscripts examined in the 15 weeks after the two shutdowns in spring and autumn 2020 were not or only slightly different from their baseline values. Sensitivity analyses revealed that this conclusion also holds if the BMI distribution or prevalence of excess weight is assessed. The GAM further showed the significant effects of individual and area-based measures of socioeconomic position and age on BMI. CONCLUSION Our results suggest that lifestyle changes during the pandemic in young men might have been too modest to be reflected in body weight. However, longitudinal data and/or data on women, children, or the elderly may lead to different conclusions

Persistence, prevalence, and polymorphism of sequelae after COVID-19 in unvaccinated, young adults of the Swiss Armed Forces: a longitudinal, cohort study (LoCoMo)

Background: Persistent COVID-19 sequelae could have global, public health ramifications. We therefore aimed to describe sequelae presenting more than 180 days after COVID-19-focussing on several organ systems, general health, and laboratory parameters-in non-hospitalised, unvaccinated, young adults. Methods: We did a longitudinal cohort study of all army bases in Switzerland. Eligible participants were personnel of the Swiss Armed Forces (SAF) who were aged 18-30 years with a positive or negative RT-PCR test for SARS-CoV-2 during their service between March 1, 2020, and Dec 31, 2020. Exclusion criteria were unwillingness to participate in testing. Females or men with a known reproductive anomaly were excluded from the optional component of male fertility testing. COVID-19 was defined as a positive diagnostic RT-PCR test result for SARS-CoV-2 with concurrent symptoms compatible with COVID-19. Participants were subdivided into four groups: control group (ie, serologically negative), asymptomatic infection group (ie, serologically positive but with no symptoms), non-recent COVID-19 group (>180 days since positive PCR test), and recent COVID-19 group (≤180 days since positive PCR test). Outcomes of interest were part of a comprehensive, intensive test battery that was administered during a single day. The test battery quantified the effect of SARS-CoV-2 infection on cardiovascular, pulmonary, neurological, renal, ophthalmological, male reproductive, psychological, general health, and laboratory parameters. This study was registered with ClinicalTrials.gov, number NCT04942249. Findings: Between May 20, 2021, and Nov 26, 2021, we enrolled 501 participants. 29 (6%) of 501 were female and 464 (93%) were male, and the median age was 21 years (IQR 21-23). Eight (2%) of 501 had incomplete data and were not included into the study groups. 177 participants had previous COVID-19 that was more than 180 days (mean 340 days) since diagnosis (ie, the non-recent COVID-19 group) compared with 251 serologically negative individuals (ie, the control group). We included 19 participants in the recent COVID-19 group and 46 in the asymptomatic infection group. We found a significant trend towards metabolic disorders in participants of the non-recent COVID-19 group compared with those in the control group: higher BMI (median 24·0 kg/m2 [IQR 22·0-25·8] vs 23·2 kg/m2 [27·1-25·0]; p=0·035), lower aerobic threshold (39% [36-43] vs 41% [37-46]; p=0·012), and higher blood cholesterol (4·2 μM [3·7-4·7] vs 3·9 μM [3·5-4·5]; p<0·0001) and LDL concentrations (2·4 μM [1·9-2·9] vs 2·2 μM [1·7-2·7]; p=0·001). The only significant psychosocial difference was found in the results of the Chalder Fatigue scale with the non-recent COVID-19 group reporting higher fatigue scores than the control group (median 12 points [IQR 11-15] vs 11 [9-14]; p=0·027). No significant differences in other psychosocial questionnaire scores, ophthalmological outcomes, and sperm quality or motility were reported between the control group and non-recent COVID-19 group. Interpretation: Young, previously healthy, individuals largely recover from SARS-CoV-2 infection. However, the constellation of higher BMI, dyslipidaemia, and lower physical endurance 180 days after COVID-19 is suggestive of a higher risk of developing metabolic disorders and possible cardiovascular complications. These findings will guide future investigations and follow-up management

Das Gewicht der Schweiz: Eine quantitative Synthesestudie zum Body Mass Index und Bauchumfang sowie den damit verbundenen Kofaktoren bei erwachsenen Männern und Frauen in der Schweiz

Übergewicht wird multifaktoriell verursacht und hat in der Schweiz seit den 1990er Jahren stark zugenommen. Eine breit abgestützte Untersuchung der involvierten Kofaktoren würde es ermöglichen, Risikofaktoren und damit auch Interventionsprogramme präziser als bisher zu definieren. Für die erwachsene Bevölkerung in der Schweiz wurden bisher die bestehenden gesamtschweizerischen bevölkerungsweiten Studien zu Übergewicht noch nie zusammengefasst in einer Synthesestudie ausgewertet. Wir haben alle uns bekannten gesamtschweizerischen und bevölkerungsbezogenen Studien aus den Bereichen Gesundheit, Ernährung und Wirtschaft zusammengetragen, die auch Informationen über den Body Mass Index (BMI) sowie wenn möglich auch zu Bauchumfang/Taillenumfang (Waist Circumference, WC) und Waist-to-Height-Ratio (WHtR) enthielten. Eingeschlossen wurden die Nationale Ernährungserhebung Schweiz (menuCH, 2014/2015), die Schweizerischen Gesundheitsbefragungen 2012 und 2017, das Swiss Household Panel 2013-2017, die Schweizer Erhebung über Einkommen & Lebensbedingungen (SILC, 2017), das Swiss Food Panel (2010 und 2017) sowie der Swiss Survey on Salt Intake (2010/2011). Wir haben die mehrheitlich repräsentativen Datensätze nicht gepoolt, sondern mittels mixed multinomial logistic Regressionsanalysen übergreifende Gesamteffekte geschätzt. Zusätzlich haben wir die anthropometrischen Monitoring-Daten der Stellungspflichtigen 2019 vergleichend hinzugezogen. Grundsätzlich sind von zehn erwachsenen Menschen in der Schweiz rund drei Personen (31.7 %) von Übergewicht und rund eine Person (11.2 %) von Adipositas betroffen. Die Analyse der acht bevölkerungsbasierten Studien zeigt, dass die Kofaktoren Geschlecht, Alter, Bildung, Körperhöhe, Sprachregion und körperliche Aktivität signifikant mit dem BMI zusammenhängen. Betrachtet man auch die Kofaktoren, welche nicht in allen Studien erhoben worden sind, dann finden sich weitere signifikante Assoziationen zu Stadt/Land, Nationalität, Fleischkonsum, Konsum von Süssgetränken, Einhalt der Empfehlungen zu körperlicher Aktivität, selbsteingeschätztem Gesundheitszustand und Schlafstörungen. Die Daten der Stellungspflichtigen für die Armee decken sich in der Aussagerichtung weitgehend mit diesem Bild: Der BMI der jungen Schweizer Männer 2019 ist assoziiert mit Alter, Körperhöhe, Sprachregionen, Stadt/Land, sozioökonomischem Berufsstatus, sozioökonomischem Nachbarschaftsindex, Blutdruck und Leistung im Sporttest. Die vergleichende Analyse zwischen BMI, WC und WHtR in den beiden populationsbasierten Studien menuCH und Swiss Salt Survey sowie bei den Stellungspflichtigen zeigt einerseits eine weitgehende Kongruenz zwischen den anthropometrischen Massen auf, anderseits aber auch den Mehrwert des WHtR, welcher den WC relativiert zur Körperhöhe und zu mehr akzentuierten Koeffizienten führt. Unsere Resultate zur Bedeutung der Körperhöhe als relevanter Kofaktor bestätigen, dass es sich beider Prävention von Übergewicht gleich mehrfach lohnt, bereits im Kindesalter anzusetzen: Einerseits wird dadurch ein günstiger kindlicher Gesundheitsstatus (Balance zwischen Ernährung, Bewegung und Gesundheit) gefördert, welcher sich auch auf das Wachstum auswirkt, andererseits werden damit früh gesundheitsrelevante Verhaltensmuster erlernt (Ernährung, Schlaf, Bewegung), was ebenfalls bis ins Erwachsenenleben nachwirkt. Dieser Ansatz ist ganz im Sinne des Life Course Approach to Health, wie er beispielweise auch in der NCD-Strategie des Bundesrates eingeflossen ist. Weiter haben sich in unseren Modellen die soziodemografischen Faktoren als besonders wichtig herausgestellt. Zukünftige Studien sollten Interaktionen zwischen soziodemografischen Faktoren, Lebensstilfaktoren und Gesundheitsfaktoren, welche für einzelne Datensätze gut dokumentiert sind, ebenfalls im Sinne einer Synthese über verschiedene Datensätze hinweg untersuchen. Unsere Ergebnisse schlagen vor, dabei ein besonderes Augenmerk auf Süssgetränke, Schlafstörungen und den selbsteingeschätzten Gesundheitszustand zu legen