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Anthropometric Measures of Adiposity as Predictors of Visceral and Subcutaneous Fat in Adolescence: The Saguenay Youth Study
S224
Abstracts / Can J Diabetes 37 (2013) S217eS289
510-OR Dysfunctional Sleep and Obesity: Unwitting Bed Partners KELLY OLSON, DAVID BAKER SleepImage, Broomfield, Colorado, United States of America It is understood and overwhelmingly accepted that obesity is a critical health care problem in our current day. According to Statistics Canada, approximately 52% of all Canadians over the age of 18 are overweight or obese. That’s a staggering statistic. Compounding the adverse health risks associated with excess body fat is the fact that obesity can increase the risk for dysfunctional sleep while dysfunctional sleep can contribute to obesity. It has been widely reported that lack of healthy sleep (also known as sleep debt) can disrupt metabolism and derail hormone function. These impairments can contribute to disruptions in glucose and insulin secretion and management, leading to increased appetite. Couple this with a sedentary lifestyle, often observed in those who do not get the proper amount of sleep and the result is a perfect recipe for weight gain and perpetuation of unhealthy sleep patterns and architecture. As clinicians, measuring a disease or monitoring symptoms associated with disease, is critical for promotion of positive therapeutic outcomes. There are scales to measure weight, pressure cuffs to measure cardiovascular health, and now there is an objective method to measure sleep quality, regardless of whether upper airway resistance (i.e. apnea) exists. Since it is accepted that correcting sleep issues in overweight and obese populations is a critical component in overall treatment, this lecture will focus on the interrelatedness of sleep and obesity, specifically how to use a simple, objective method to measure sleep quality as part of a patient’s therapeutic regimen. This technology, based on cardiopulmonary coupling, provides a physiological fingerprint that depicts sleep quality-specific to each patient. The ability to measure sleep quality in conjunction with weight management will equip the clinician with sharper, more focused tools for achieving therapeutic success. 511-OR Dilemmas & Controversies in the Management of Sleep Apnea in Gastric Bypass Patients STEPHEN GLAZER Humber River Regional Hospital, Toronto, Ontario, Canada The incidence of obstructive sleep apnea in patients undergoing gastric bypass surgery is extremely high. Failure to diagnose and treat obstructive sleep apnea has consequences that extend beyond gastric bypass surgery. The cardiac, respiratory, and metabolic conditions associated with obstructive sleep apnea can contribute to the morbidity associated with obesity. The optimal screening for the presence of sleep apnea is unclear. Several screening questionnaires are used in clinical practice. The optimal duration of treatment once diagnosed with OSA prior to gastric bypass surgery is undefined. Postoperatively, the CPAP requirements for gastric bypass surgery patient is changed as patient’s BMI decreases. Compliance with therapy is problematic. While there is a high probability for improvement or resolution of obstructive sleep apnea postoperatively with significant weight loss, OSA in some patients persists.
THURSDAY, MAY 2: CHILD & YOUTH I 512-OR Anthropometric Measures of Adiposity as Predictors of Visceral and Subcutaneous Fat in Adolescence: The Saguenay Youth Study KATIE GOODWIN, CATRIONA SYME, MICHAL ABRAHAMOWICZ, GABRIEL T. LEONARD, LOUIS RICHER, MICHEL PERRON, SUZANNE VEILLETTE, DANIEL GAUDET, TOMAS PAUS, ZDENKA PAUSOVA Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Objectives: Visceral fat (VF) is associated with higher cardiometabolic risk than fat elsewhere in the body in adults and
children. To measure VF directly is costly and not feasible in daily clinical settings. Here, we investigate how well routine clinical measures of adiposity, namely BMI and waist circumference (WC), predict VF in a large population-based sample of adolescents. As body-fat distribution differs between males and females, we performed these analyses separately in each sex. Methods: We studied 1,002 French-Canadian adolescents (482 males, 12 to 18-year old) as part of the Saguenay Youth Study. VF and subcutaneous fat (SF) were quantified by magnetic resonance imaging at the level of the umbilicus. Relationships between VF (or SF) and routine clinical measures of adiposity were tested with multivariate regression model, while adjusting for potentially confounding effects of age and height. Results: Males and females were of similar age (p¼0.18) and had similar BMI (p¼0.75), higher WC (p<0.0001), similar VF (p¼0.17) and lower SF (p<0.0001). In both sexes, VF (and SF) were highly correlated with BMI and WC, explaining 56-77% of each other’s variance. However, when VF was adjusted for SF, BMI and WC explained only 0% and 4% of variance in males, and 4% and 11% of variance in females, respectively. In contrast, when SF was adjusted for VF, BMI and WC explained 37% and 21% of variance in males, and 48% and 23% in females, respectively. Conclusions: In adolescent males and females, routine clinical measures of adiposity predict well subcutaneous but not visceral adiposity. Given the clinical importance of VF, development of new techniques to quantify VF that would be less costly and suitable for everyday clinical practice is warranted.
513-OR The Children’s Fitness Tax Credit (CFTC): Awareness and Use in the First Three Years (2007-2009) KOREN FISHER, BARBARA VON TIGERSTROM, TAMARA LARRE, AMIN MAWANI, CHRISTINE CAMERON, KAREN CHAD, BRUCE REEDER, MARK TREMBLAY College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada Introduced in 2007, the Children’s Fitness Tax Credit (CFTC) is a non-refundable tax credit available to parents of children under 17 years of age for eligible fees paid for enrolment in physical activity programs. Purpose: To assess the CFTC in the initial 3-year period following its implementation. Methods: Two population-based data sources were used: 1) federal tax data for the 2007-2009 tax years and 2) data related to public perceptions of the CFTC collected via a national physical activity survey. Three dependent variables (DVs) were examined: awareness and use of the CFTC and the amount claimed. Multivariable regression procedures were used to examine associations between the DVs and key demographic, family and geographic covariates. Results: In 2007, 31% of eligible families claimed the CFTC; in 2009, this increased to 36%. Adjusted analyses showed significant associations between the three DVs and all covariates. Women, parents with post-secondary education and incomes greater than $100,000 were most likely to be aware of the CFTC. Families with two parents, those with at least one boy and those living in urban areas were all more likely to claim the CFTC. The amount claimed was lower among younger parents, immigrants, lower income and rural families. Conclusion: The results of this analysis, which uses both federal tax data and survey-based behavioural data, provides important information regarding the demographic and social patterns of awareness and use of the CFTC that will be relevant to policy decisions.
Abstracts / Can J Diabetes 37 (2013) S217eS289
510-OR Dysfunctional Sleep and Obesity: Unwitting Bed Partners KELLY OLSON, DAVID BAKER SleepImage, Broomfield, Colorado, United States of America It is understood and overwhelmingly accepted that obesity is a critical health care problem in our current day. According to Statistics Canada, approximately 52% of all Canadians over the age of 18 are overweight or obese. That’s a staggering statistic. Compounding the adverse health risks associated with excess body fat is the fact that obesity can increase the risk for dysfunctional sleep while dysfunctional sleep can contribute to obesity. It has been widely reported that lack of healthy sleep (also known as sleep debt) can disrupt metabolism and derail hormone function. These impairments can contribute to disruptions in glucose and insulin secretion and management, leading to increased appetite. Couple this with a sedentary lifestyle, often observed in those who do not get the proper amount of sleep and the result is a perfect recipe for weight gain and perpetuation of unhealthy sleep patterns and architecture. As clinicians, measuring a disease or monitoring symptoms associated with disease, is critical for promotion of positive therapeutic outcomes. There are scales to measure weight, pressure cuffs to measure cardiovascular health, and now there is an objective method to measure sleep quality, regardless of whether upper airway resistance (i.e. apnea) exists. Since it is accepted that correcting sleep issues in overweight and obese populations is a critical component in overall treatment, this lecture will focus on the interrelatedness of sleep and obesity, specifically how to use a simple, objective method to measure sleep quality as part of a patient’s therapeutic regimen. This technology, based on cardiopulmonary coupling, provides a physiological fingerprint that depicts sleep quality-specific to each patient. The ability to measure sleep quality in conjunction with weight management will equip the clinician with sharper, more focused tools for achieving therapeutic success. 511-OR Dilemmas & Controversies in the Management of Sleep Apnea in Gastric Bypass Patients STEPHEN GLAZER Humber River Regional Hospital, Toronto, Ontario, Canada The incidence of obstructive sleep apnea in patients undergoing gastric bypass surgery is extremely high. Failure to diagnose and treat obstructive sleep apnea has consequences that extend beyond gastric bypass surgery. The cardiac, respiratory, and metabolic conditions associated with obstructive sleep apnea can contribute to the morbidity associated with obesity. The optimal screening for the presence of sleep apnea is unclear. Several screening questionnaires are used in clinical practice. The optimal duration of treatment once diagnosed with OSA prior to gastric bypass surgery is undefined. Postoperatively, the CPAP requirements for gastric bypass surgery patient is changed as patient’s BMI decreases. Compliance with therapy is problematic. While there is a high probability for improvement or resolution of obstructive sleep apnea postoperatively with significant weight loss, OSA in some patients persists.
THURSDAY, MAY 2: CHILD & YOUTH I 512-OR Anthropometric Measures of Adiposity as Predictors of Visceral and Subcutaneous Fat in Adolescence: The Saguenay Youth Study KATIE GOODWIN, CATRIONA SYME, MICHAL ABRAHAMOWICZ, GABRIEL T. LEONARD, LOUIS RICHER, MICHEL PERRON, SUZANNE VEILLETTE, DANIEL GAUDET, TOMAS PAUS, ZDENKA PAUSOVA Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Objectives: Visceral fat (VF) is associated with higher cardiometabolic risk than fat elsewhere in the body in adults and
children. To measure VF directly is costly and not feasible in daily clinical settings. Here, we investigate how well routine clinical measures of adiposity, namely BMI and waist circumference (WC), predict VF in a large population-based sample of adolescents. As body-fat distribution differs between males and females, we performed these analyses separately in each sex. Methods: We studied 1,002 French-Canadian adolescents (482 males, 12 to 18-year old) as part of the Saguenay Youth Study. VF and subcutaneous fat (SF) were quantified by magnetic resonance imaging at the level of the umbilicus. Relationships between VF (or SF) and routine clinical measures of adiposity were tested with multivariate regression model, while adjusting for potentially confounding effects of age and height. Results: Males and females were of similar age (p¼0.18) and had similar BMI (p¼0.75), higher WC (p<0.0001), similar VF (p¼0.17) and lower SF (p<0.0001). In both sexes, VF (and SF) were highly correlated with BMI and WC, explaining 56-77% of each other’s variance. However, when VF was adjusted for SF, BMI and WC explained only 0% and 4% of variance in males, and 4% and 11% of variance in females, respectively. In contrast, when SF was adjusted for VF, BMI and WC explained 37% and 21% of variance in males, and 48% and 23% in females, respectively. Conclusions: In adolescent males and females, routine clinical measures of adiposity predict well subcutaneous but not visceral adiposity. Given the clinical importance of VF, development of new techniques to quantify VF that would be less costly and suitable for everyday clinical practice is warranted.
513-OR The Children’s Fitness Tax Credit (CFTC): Awareness and Use in the First Three Years (2007-2009) KOREN FISHER, BARBARA VON TIGERSTROM, TAMARA LARRE, AMIN MAWANI, CHRISTINE CAMERON, KAREN CHAD, BRUCE REEDER, MARK TREMBLAY College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada Introduced in 2007, the Children’s Fitness Tax Credit (CFTC) is a non-refundable tax credit available to parents of children under 17 years of age for eligible fees paid for enrolment in physical activity programs. Purpose: To assess the CFTC in the initial 3-year period following its implementation. Methods: Two population-based data sources were used: 1) federal tax data for the 2007-2009 tax years and 2) data related to public perceptions of the CFTC collected via a national physical activity survey. Three dependent variables (DVs) were examined: awareness and use of the CFTC and the amount claimed. Multivariable regression procedures were used to examine associations between the DVs and key demographic, family and geographic covariates. Results: In 2007, 31% of eligible families claimed the CFTC; in 2009, this increased to 36%. Adjusted analyses showed significant associations between the three DVs and all covariates. Women, parents with post-secondary education and incomes greater than $100,000 were most likely to be aware of the CFTC. Families with two parents, those with at least one boy and those living in urban areas were all more likely to claim the CFTC. The amount claimed was lower among younger parents, immigrants, lower income and rural families. Conclusion: The results of this analysis, which uses both federal tax data and survey-based behavioural data, provides important information regarding the demographic and social patterns of awareness and use of the CFTC that will be relevant to policy decisions.